Uganda like any other developing country is facing challenges within its healthcare system that can be linked to the pedagogy of the oppressed through the following points
Health management information system: Critical think and make action
Health management information system is one of the building blocks for a health system that aims at strengthening healthcare system within public and private settings. Health management information system stands as a back up to the various activities within the health system through provision of adequate data and analysis. Uganda had progressively advanced from paper based work to computerized system however there are several challenges hindering the full implementation of the programmer. For instant lack of information technology materials such as computer , poor funding, lack of trained personnel and resistance to change specially the health record personnel that are comfortable to paper based. Much as these challenges are listed there is a lack of political motivation to accomplish a full functional system.(Umezuruike, 2017)
Treatment based on class (Injustices)
Paulo stated that persons who are deprived of their voices and cheated are the oppressed and they understand their situation better than anyone else as well as the struggle for freedom.
The Uganda Health Sector Strategic plan 2006-2010 clearly state its key action is to ensure universal access to health care for all its citizens where health care in the public health facilities will be free. Most people who access this services are the poor segment of the community who are unable to pay for private clinic, however this public facilities have poor quality of services coupling with lack of essential drugs hence the poor segments are left in dilemma of where to go, some of them ending up going to traditional doctors who are not recognized to seek treatment that they can afford. Women reported of poor treatment by health workers compared to the traditional birth attendant who take good care of them and their new born, The government also talked of free condom distribution but yet it’s not free you can’t walk in to any facility and your given condoms, the poor who are unable to buy condoms hence they received condoms indirectly through other programs such as immunization. (Bakeer et al.,2009)
Most of the health facilities are located in big towns compared to the villages that have few or none and it has greatly affected the population in seeking for health services where the majority cannot afford to travel to big towns. For instance the once who end up seeking treatment at the mobile clinic are faced with challenges of community health workers such as poor knowledge due to lack of proper training .(Musoke et al., 2014)
Poor Payment and treatment of Health works
Health workers are the backbone of the health system they work tirelessly for the achievement of a better health and through their hard labour the permanence of health is projected, however they are frustrated and unhappy with their job as a result of Poor management, corruption, poor treatment in terms of payments, benefit and working condition resulting to many of them wanting to quit their job and look for better opportunity abroad. Poor management and corruption were regarded as the underlining problem, where the difference in salaries has been noted. For the few who tries to do their best and remain devoted regardless of the above situation they are met with poor working conditions such as lack of equipment and supplies resulting to resulting to poor service delivery (Hagopian et al., 2009)
Community Participation and Ownership of Project:
Paulo talked about interactive education between teacher and students, this method of education create an environment where both teacher and student discover new concerns from different prospective.
Community participation is important in formulation of all health policies and priority setting this allows the community to take fully responsibility and ownership of projects, but this had not been the case in most of the district of Uganda .As much as decentralization is important in bringing change in health system of Uganda, public participation remains a big challenge and had been linked to the inheritance from the former centralized system where health was provided to the people without their full involvement. The achievement of decentralization system of health is influenced by the capacity of the community but at most time districts health official lack the knowledge to take full responsibility and run projects due to luck of empowerment and operationalizing of policies. Uganda health system need to adapt what Paulo said about education (Kapiriri,et al.,2003)
More dependency on donor for aiding health projects:
Freire talks of cultural invasion as one of the “anitidialogical action and he further said that invades penetrates cultural contexts of another group, they impose their own views of the world upon those they invade and inhibits the creativity of the invaded”, this is typically what is happening in Uganda heath system in relation to the donor funding and support verses ministry of health priorities,this is exactly what is happning in the healthcare of Uganda.
According to the Abuja Declaration on health in 2011, at list 15% of a country’s annual budget should be allocated for its health sector with support from other donar, however this is not the case in Uganda, where the spending per capital is lower than most Sub-Saharan Countries. For instance in 2009 the government annual budget for was at 8.22% and 9% in 2010/2011 respectively. This low allocation of budget to health is posing more challenge to the government in achieving equitable health for its citizens. (UHSA, 2011)
Uganda health Strategic and Investment plan indicated that about half of the country’s health finance is derived from household as out of pocket payment even more that the government and donor funding, these high expense of household on health is exposing them to suffering to a greater extend where by majority of them are from the poor and vulnerable.Uganda donor aid is received through bilateral or multilateral forms that support the government through different projects, however most of the founded projects are parallel to the government health priority hence resulting to duplication and more preferences to certain projects, donors take advantages of the poor leadership and system within the health system where they boycotting the government and channel the funds through National and international Organization and the government doesn’t have the capacity of monitoring this funds, reports indicated that some of these organization spend around 70% of the project funds for organizational and administrative cost . ( Nabyonga et al.,2009