Friday 25 July 2014

WHO CARES ABOUT HIV PREVENTION IN OLDER PERSONS IN UGANDA?



By Baluku Matayo
 
John, 58 years walks into a drug shop and asks for a condom, to be specific, Rough Rider®. What would you think about him?

The Uganda National Policy for Older Persons defines an older person as one aged 60 years and above. Little is known about their Knowledge, attitudes and Practices towards HIV prevention, care and support. The recent Uganda AIDS indicator survey (2011) and others before it never included collecting data on this category of people. Even when it collected for those aged 50-59, the analysis and much of the reporting excluded them. POSSIBLE REASON: THEY’RE NOT A NATIONAL PRIORITY.

Worldwide, over 3.6 million people aged 50 years and above are living with HIV; 9% of whom live in Sub-Saharan Africa. In Uganda, some older persons are still sexually active. They are less likely to have comprehensive knowledge on HIV prevention; and less likely to have good access to HIV prevention services. They are more likely to be stigmatized. They care for 63% of the orphans and vulnerable children, some of whom are HIV infected. They are faced with many other problems such as poverty, ill health, food insecurity, mal nutrition, poor shelter, gender inequalities and abuse. The HIV and AIDS programs do not target them.  

What HIV prevention services and messages do you think would be appropriate for our senior citizens in Uganda?

Friday 11 July 2014

What if the figures presented to parliament about ‘state house salaries’ were true?



By Baluku Matayo


W
onders will never end. At least not in the Parliament of the Republic of Uganda—as far as Agnes Nantutu a reporter for National Television (NTV) is concerned.
The Drama
The way Honorable Cecilia Ogwal brought it up, you would see a woman with her facts. Especially knowing that she had just renewed her marriage vows that very week, only the kind of the popular Thomas would doubt her. Some of us then admired working in State House. Who wouldn’t like the 96 million shillings as salary leaving alone being in ‘near-constant touch’ with the biggest man of the land?    

While still in a bit of shock, my mind quickly rushed to 2014/15 Budget speech. Hon. Maria Kiwanuka, the Minister of Finance, Planning and Economic Development, in her ‘non-Ugandan English’ had declared:
“50. Madam Speaker …next financial year, total resource inflows are projected to amount to Shs 15,054 billion…”
“97. Madam Speaker, I have allocated Shs 1,197.8bn to enable implementation of the Government priority programmes in the health sector”.

If my mathematics hasn’t betrayed me—like it did in my Primary Leaving Examination (PLE), this is 7.95% of the total budget. This time I won’t write about the 15% Abuja Declaration, where the Government of Uganda, among others, committed that 15% of their budgets would be allocated to the health sector.


The context
T
hat budget speech will be the last one during implementation of the first phase of the National Development Plan 2010-15. It is also approaching the deadline of the Millennium Development Goals (MDGs), must I add that whose targets related to the health sector, Uganda is not near to achieving them? No I won’t. Let us first wait for what Honorable Sam Kahamba Kutesa, the President for the 69th session of the United Nations Assembly has to deliver on the post 2015 development agenda.

Needless to remember is the budget speech made in the year is closest to the general elections, that will determine who goes to the same state house that Hon. Cecilia Ogwal was trying to bring under the torch. Of course the “Kyankwazi Declaration’ is clear about who should be in state house by 2016.

In the beginning
T
here was a word. The word was with the health workers. The word was a complaint. This time not complaining of little pay, not the poor working environment, not the unavailability of basic equipment or medicines, or even running water to use in the labor room. By the way, these days some health worker slash the compound and mop the floor. Porter and cleaner is no longer a position in the staffing structure at some level. Ask the Nursing Officer in-charge of Mukabara Health Center III in Hoima district, or even the mid-wife at Acimi Health Center II in Oyam district, how many times they slashed the health center compounds and mopped the floor!  All that was not the complaint. But none payment of even the little salary. I am not going to talk about rights and privileges of employees. That was over 4 months back.

Before that
T
he government of Uganda is doing a lot to improve the health of her citizens so that they become very productive as an investment for growth and social economic transformation (See VISION 2040). Health Services are free in Uganda. That much I am sure. So is primary and secondary education. Unless you don’t support government programmes. Me I do. That is why I didn’t study at St. Lawrance Primary Schools neither do I know the exact location of International Hospital Kampala.

In absolute terms, yes Shs 1,197.8bn for the health sector for 2014/15 is quite a lot. I hope Hellen Kagina, the Uganda Revenue Authority Boss will be able to raise all the Shs 12,321 billion representing 81.8% of the total budget. If she doesn’t, the actual pie for the sector will be less. Last financial year she couldn’t collect up to Shs.475 billion of the projected income.

S
ome Ugandans and investors like dodging taxes. So far the private schools have petitioned the Madam Speaker of Parliament. Before that were the hotel owners. They don’t want to pay taxes in the name of Public Private Partnership (PPP). Guess who is next? Where on earth do you want government to get money to provide peace, social services, roads and railways if everyone doesn’t want to pay taxes? Don’t relate this to the anti-homosexuality law because what we are talking about here is health financing not politics.


The naked truth
T
hank God that what NTV thought was a big story were typo errors in the state house salary figures. The Opposition Chief Whip. Cecelia Ogwal might have to wait a little longer to crack the whip, assuming the inconsistences in the new payroll list is neglected. If it had been the truth, then most of us would have remembered that:

In a country where health services are free, households remain the major source of funds for their health constituting over 50% of the health expenditure. At least 9% of household income is spent on health. Sometimes it’s as high as 65%. You and I know how much we spent on health. I am not talking about you who present insurance cards instead of touching your pockets when it’s time to pay.

28% of Ugandans get poorer due to medical bills. The bills are much beyond what they can earn. They sell all they have to meet such bills. It’s called catastrophic expenditure on health. Some of the diseases to which the expenditure are made are preventable by simple and cheap interventions.

The government claim that even if Government expenditure on health reaches 15%, the resources will not be adequate to fully implement the Health Service Delivery is not necessarily true. If well used, it would make a great difference

Someone somewhere in the position of authority has failed to decide to make the National Health Insurance scheme move to the next level. Risk pooling is the only way the poor Ugandans can be protected from the everyday bills and improve universal coverage for health care

Tax holidays and waiving off some taxes is not the best thing in a situation where we would like to fund over 80% of our budget. Someone should join me so that we also take our petition to Mama Kadaga not to allow those ‘not-well-thought’ petitions.

The state can still protect us, the end user consumers, from the threats that we the local voters are the ones to feel pinch of the new tax proposals by Hon. Kiwanuka. Blindly speaking, the profits they get can enable them pay taxes, meet other operation costs and still get home with lots and lots of profit.

Surely how much do those schools spend on a nursery kid to justify school fess of over shs 800,000 per term and still claim they can’t pay tax? Let them pay tax and demand government to in return give them constant electricity, even if it’s Yaka; good roads and etc. I hope our accountant won’t read this. He may over-deduct my PAYE in the name of patriotism.

Lastly
All this would be remembered if the salaries at state house were true. But now that they weren’t, don’t mind me. If you do, then have your say.