Lira – A joint monitoring exercise by civil society and local government authorities in sampled health centers in Lira district has exposed gaps in health service deliveries to the locals.
At least six facilities, three each in Erute North and South’s sub health districts respectively were on Tuesday and Wednesday tlast week visited by among others, Lira district vice chairperson, George Okello Ayo, the district Speaker, George Rashid Opio, Judith Ateng, the chairperson of the health and education committee.
Others were Edmond Aceka, the assistant district health officer and John Ocen, the programs manager of Global Forum for Development Uganda – GLOFORD, who in partnership with AMREF health Africa, and with support from the Foreign Affairs Ministry of Netherlands supported the district in the monitoring exercise.
Staff absenteeism a key challenge
This conmporary newspaper can attest to the fact that most of the health workers in Lira district are drawing salaries out of no work done.
This stems from the fact of all the facilities visited which includes, Aromo Health Center III, Agali Health center III, Ongica Health center III, Barapwo health center III, Abala health center III and Ogur health center III were non was found to be having all the staff on duty except Aromo which “fairly had a good number out of the 19 staff as per the ministry of health staffing norms.”
For instance, at Abala health center III, out of 17 staff only 10 were on duty at the time of the visit; in Agali health center III, only 5 out of the current 13 staff were present at the facility while at Barapwoo all the staff had abandoned the facility and back to the staff quarters as early as 3pm.
Santa Apio, an elderly woman who talked to TND News at Agali health center III said, “We always come early, but you rarely find anyone at the health facility. We feel ignored, government should do something.”
Time check is 3:30 pm on a Tuesday evening of 3rd September 2019 and the monitoring team arrives at Ogur health center IV, only to find some “skeleton staff” on the “ground” out of the required 42 and even the In charge of the facility was conspicuously missing from the facility.
This scenario has irked Lira district vice chairman, Mr Ayo who also doubles as the secretary for health and education. He has called for a tough stance on health workers who have become perennial absentees.
“It is a policy in this country that when a worker absconds duty for 15 days, he or she should not be paid. So Mr. DHO, please make sure we hold salaries of some of these errant health workers and also make sure we delete them from our pay roll.”
Meanwhile, James Omara Elem, a member of the district health and education committee has called on the office of the district health officer to ensure a report is produced on non compliant health officers so they can appear before the Rewards and Sanctions Committee of the district for disciplinary measures.
Staffs abandon quarters
Again during the monitoring visit, it was proven beyond reasonable doubt that Lira district has achieved in constructing enough accommodation facilities for health workers across health centers but the dilemma is that medics are not residing at the facilities.
At Ogur health center IV, which ideally monitors other health centers, the monitoring team was treated to a bizarre scene where only about five staff was found residing in the staff houses with the rest of the houses left to waste and bats has turned it to their residences.
The team counted about nine vacant rooms, with most of them turned in stores for soya beans while some are being used for rearing goats.
“This is disturbing that even the in charge is not residing here,” Dr Edmond Aceka, the assistant DHO remarked.
According to Aceka, the district would not waste time planning for more houses for health workers “because they are being misused.”
TND News has also realized that Lira district health centers have unique challenges that stand in the way of effective service delivery to the locals, ranging from water challenges. For instance, at Agali health center III seems to have iron filings and is not safe for drinking, according to experts in water and sanitation sector.
In Aromo, Jenifer Apio, a nursing officer tells TND News that they are currently faced with the challenge of “drug stock out including essential drugs for malaria.”
At the facility, according to Apio, health workers are sharing the toilet with the surrounding community and patients which inconveniences the health workers.
Nearly all the facilities are also advocating for fencing to avoid the community and animals from encroaching into the compounds.
Much as many grey areas and gaps were realized, there were a few areas that excited the monitoring team of the district.
In Aromo health center III which used to be synonymous with staff absenteeism and bickering, it was realized that most of the staff including the in charge are now residing within the facility.
And just like Aromo, all the facilities visited are up to about 98 percent staffing level and the uptake of sexual reproductive health services (family planning) has greatly increased.
Speaking TND News Frank Oyugi, George Rashid Opio, the district speaker Lira, said he was alarmed with the realities he saw on the ground such as staff absenteeism and the fact that medics have abandoned government structures erected for their accommodation.
“I am not happy with my councilors and some of the committees because the reports I have been receiving are sugar coated and completely different from the realities I have seen,” Opio added.
Morris Chris Ongom, the Chief Executive Officer of Global Forum for Development – GLOFORD Uganda, says “this is a true reflection of the challenges facing public health facilities in Lira district; I blame it on lack of leadership.”
“These are same gaps and problems we have always identified but where are the leaders to address these issues? How do you have a health center like Agali with all the midwives on maternity leave and there is no plan to replace the gaps created?” Ongom wondered, and challenged local governments to “move out of the conventional ways of management” but rather be “innovative, flexible and creative” if they are to deal with the challenges at hand.
He also appealed to the communities to embrace family planning services and argued at population growth rate of about 3.7 percent, adding: “Uganda could have an estimated population of 80 million people by 2037 yet land as a factor of production is not increasing.”