Health services -why Ugandans should sue their government for better services.

Posted on May 31, 2011


by Drew Ddembe on Monday, May 23, 2011 at 6:04pm

‎Emmy Oloya, I think you are looking at this from the wrong end.

You are actually using the NRM/Museveni argument the government has no blame. They essentially are transferring responsibility for providing health services to individual doctors!
It is not doctors responsibility to provide health care. It is the governments responsibility to do so. This includes providing facilities, medications, staff and adequate remuneration and motivation as well as monitoring and supervision.
In the case of the cases chosen above, if the complainants can provide proof that these women died as a result of a deficit or failure of the government to provide any of the above and also demonstrate that there is a systematic problem affecting the whole healthcare system, the government would be deemed as having failed in its duty of care. It would also be deemed to be liable for damages to the bereaved families. 
Options beyond that particular judgement can be extended to include any other families whose relatives that died as a result of negligence of the governments duty of care in a government facility.
The remedy would have to go beyond simple compensation. It would demand a formal inquiry into these deaths as well as the conditions that caused them. This would result into an overhaul.
In each individual case, the relevant medical worker maybe cited as a co defendant in the case of negligent or criminal death. However if the health worker can demonstrate that the death was primarily because their employer failed to provide adequate facilitation, their employer remains liable.
In Uganda, it is virtually impossible to prove negligent or criminal death against a health worker without some attendant liability to the employer because the whole health system is a shambles. There is always something not working due to the negligence of the government that can be used in defence as most of the time health workers are improvising! 
I will post some of my notes on this subject here.


My notes on Health in Uganda

My notes on Health in Uganda■ ■

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Bmk Gift Snr
Why is Government being taken to Constitutional Court? In Petition Number 16 of 2011, we are arguing that the non-provision of essential maternal health services by government violates the right to life and the right to health, as well as the rights of women, all of which are enshrined in Uganda’s Constitution. The lawyers are drawing from the examples of two women who died unnecessarily in childbirth in the Districts of Mityana and Arua. Petition Number 16 of 2011 argues that these women would be alive today if they had had access to emergency obstetric care from qualified health providers. 
What is the benefit of Petition Number 16 of 2011? A positive ruling by the Constitutional Court will help compel government to show leadership and shift its spending priorities, so that areas such as: Essential medicines and commodities for health facilities; Emergency obstetric care to respond to cases of hemorrhage, sepsis, and provide Caesarean deliveries in cases of emergency; Recruitment, training and remuneration of sufficient numbers of nurses, midwives and other health officers; HIV treatment for pregnant women to save their lives and prevent HIV transmission to newborns; and Malaria prevention and treatment for pregnant women and children; all receive the spending increases that are urgently needed—during Financial Year 2011. 
Unfortunately, these are areas of health sector spending that have been stagnant, while 16 pregnant women are dying unnecessarily every day. In fact, the draft Financial Year 2011 budget proposes no increases in health sector spending, while government has just procured fighter jets and other defence equipment for Shs 1.3 trillion—which is double the ordinary annual budget of the health sector. 
What is the current situation regarding maternal health and maternal mortality in Uganda? Uganda is facing a preventable crisis of maternal mortality—at least 16 women die in childbirth, or shortly after, every day. According to the government, the slight decrease in maternal mortality statistics reported in a recent national demographic health survey cannot be interpreted to be an actual decline—unfortunately, Uganda’s powerful economic growth has not benefitted women dying without access to essential maternal health care. 
Why are we demonstrating? May 27 is the first day in Constitutional Court for Petition Number 16 of 2011; we are holding peaceful processions in Kampala, Arua and Mityana on that date. This Petition provides a critical opportunity for advocacy for essential maternal health care services, including emergency obstetric care, HIV and malaria treatment, health workers who will attend births for free, and basic essential medicines and commodities such as gloves. Government has so far refused to scale up its investments significantly in these areas—and we are hopeful that, by being taken to Constitutional Court, it will be compelled to act. 
What are the main priorities in addressing maternal deaths? According to government, the main bottlenecks are: Emergency obstetric care, which addresses the major direct causes of maternal death. These are haemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructed labour. These major causes are responsible for about 80% of maternal deaths; 
• Skilled attendance at birth to help detect and manage complications, and to ensure appropriate referral for the further management of these complications;
• Family planning to prevent unintended pregnancies and enable women to have pregnancies neither too early, nor too late nor too frequently. Family planning can also promote Uganda’s economic growth by reducing the economic dependency ratio and increasing the per capita private consumption value; and 
• Effective antenatal care to prevent, detect, and treat problems such as malaria, anaemia, HIV and other infections, which frequently are indirect causes of maternal deaths. (Taken from: Millennium Development Goals Report for Uganda 2010: Special Theme Accelerating Progress towards Improving Maternal Health. Ministry of Finance, Planning and Economic Development, September 2010, p. 8.)
What are our key messages? 
1. We have a fundamental right to health as Ugandans, enshrined in our Constitution and in various regional and international Agreements that Uganda is party to. Government is defying that fundamental right to health, and as a result, pregnant women are dying unnecessarily. 
2. The catastrophe of 16 pregnant women dying every day in Uganda must stop—and it can stop. Through leadership, accountability, and increased budgetary allocation, other countries have progressed—Uganda can as well. According to government reports, overcoming the main bottlenecks preventing progress in saving the lives of pregnant women would cost an estimated $81 million over a four-year period.

Posted in: Health, Uganda