SUSTAINABILITY, EQUITY AND EFFECTIVENESS IN PUBLIC FINANCING FOR HEALTH IN UGANDA: AN ASSESSMENT OF MATERNAL AND CHILD HEALTH SERVICES

Abstract

This assessment aimed to understand whether financing for maternal, child health and immunization services are sustainable, efficient, effective and equitable. Data sources included various national and international reports related to financing maternal and child health services. The results show that funding for maternal and child health (MCH) services are unsustainable over the long term because the main financing source is out-of-pocket (67% of the total for MCH). However, Uganda shows higher efficiency in delivery as it has the lowest average cost per delivery (USD 50) compared to USD 70 (Kenya) and USD 95 (Ghana). Overall, MCH interventions being financed show some levels of effectiveness; e.g. maternal mortality rates dropped from 420/100000 live births in 2010 to 343/100000 live births in 2016; under-5 mortality rates reduced from 151/1000 live births in 2000 to 64/1000 live births in 2016. There are, however, inequities by region, age, education status and wealth index; e.g. 37% in the poorest quintile have unmet family planning needs compared to only 23% in the wealthiest quintile. In conclusion, public financing for primary services such as MCH requires reforms to strengthen health sector performance. The reforms should address sustainable financing, efficiency, effectiveness, and equity in service delivery.