For this study, UNHCO and HEPS, two organizations dedicated to health consumer rights, have joined in a coalition to assess the extent to which resources allocated to the health sector affect access to medicines in Uganda.

UNHCO

UNHCO’s mission is to ”advocate for health consumer rights and responsibilities”, a fundamental component of the broader quest for good governance, embracing accountability and the promotion of integrity and human rights in Uganda. Since its inception in 1999, UNHCO has been implementing programmes that advocate for a strong institutionalized platform that is able to articulate voices of consumers of health goods and services.  UNHCO’s activities focus on raising awareness among health service users, policy research and advocacy, creating alliances and synergies with CSOs, government, and media, and improving communications and relationships between health users and providers.

UNHCO has championed the Rights Based Approach (RBA) to healthcare delivery and spearheaded the development and adoption of the Patients’ Charter, whose objective is to provide a policy and legal framework for empowerment of health consumers enabling them to demand for high quality health care and promote accountability in the health sector. UNHCO is the secretariat and lead agency for Voices for Health Rights (VHR) which is a coalition of 14 Civil Society Organizations (CSO) working to promote the right to health.

HEPS

HEPS’ mission is to empower communities on their rights and responsibilites to health and advocates for health consumer rights with a special focus on access to essentail medicines. HEPS was established in the year 2000 as a coalition of health consumers, health advocates, health practitioners, CSOs and community-based organizations. HEPS has two core programs: Community Empowerment including Compliants, Compliments and Counselling and Health Policy Advocacy.

Since its inception, HEPS Uganda has written notable reports on medicines issues in Uganda, and through research, HEPS and partners in the Uganda Coalition on Access to Essential Medicines (UCAEM) have engaged in numerous campaigns for change in the health sector, including campaigns to increase access to ARVs, abolish a medicine tax, improve transparency in Global Fund processes, and stop stock outs. 

TAP PROJECT DESCRIPTION

Availability and access to medicines and health supplies is a key component of the health care system. There is a direct relationship between availability and access to medicines and attainment of the right to health which is embedded in the goals of both organizations; UNHCO’s being to contribute to the improvement of the quality of life of Ugandans through the rights Based Approach and HEPS’s goal of making health rights and responsibilities a reality. This research and advocacy project assesses the extent to which resources allocated to the health sector affect access to medicines in Uganda, focusing on the impact of Uganda’s new medicines supply system that mandates National Medical Stores as the sole public supply agent for medicines. It will also investigate infrastructural and human resource issues and other support services that facilitate effective delivery, availability and access of medicines to identify bottlenecks in the system and provide evidence for advocacy which will eventually increase efficiency and improve value for money in the delivery of medicines.

The project employees the Qualitative Service Delivery Survey (QSDS) tool with both qualitative quantitative methods. Qualitative approaches include in-depth interviews of the service providers, key informant interviews with officials from relevant institutions, district health offices, and chief administrative office, as well as exit interviews with patients. The methodology measures various dimensions of the quality of health service delivery including needs of the population vis-à-vis budget provided, infrastructural and human resources required to ensure access to medicines and the performance of National Medical Stores. The quantitative methods include a semi-structured questionnaire at health facility level, review of both published and unpublished documents, and analysis of budgets, allocations, and actual deliveries from records at different levels of health structure. The facility audit questionnaires collect information on availability and delivery of medicines at the units and support systems i.e. infrastructural and human resources that enable the effective delivery of medicines.

The overall population sample of the survey is drawn from both national level and district level. From the two districts selected (Bushenyi and Lira) a minimum of 30 public health facilities are randomly sampled from each.