By Dr. Ham Wasswa Matovu
Last week, a team of Ugandan medical experts from district hospitals arrived in Beijing China. Funded by the Chinese government, the team will spend three weeks in China at one of the country’s top Universities, Tsinghua University to attend a Seminar on Health Care and Public Health. This will boost their public health knowledge and health systems management so as to be able to make a tangible contribution when they return home.
Aware that China is one of few developing countries with a robust and well-functioning health system in the world, there is no doubt that the seminar will equip of medical team with the much-needed expertise and experience which will in turn help contribute in strengthening Uganda’s health sector. Through on his X account (formerly twitter,) Chinese Ambassador to Uganda His Excellency Zhang Lizhong explained that Uganda’s team in Beijing for the seminar under the arrangement of medical cooperation adding that; “delighted to see China-Uganda health communication & cooperation deepening through closer people-to-people exchanges.”
Studies indicate that despite some progress in addressing health sector challenges, African countries still face challenges among others limited training. A 2022 study published in the British Medical Journal Global Health which surveyed 47 African countries stressed the lack of refresher courses as a major challenge facing the health sector in the region. The study entitled “the health workforce status in the WHO African Region: findings of a cross-sectional study,” revealed that the region’s ratio of well-trained health workers is 1.55 per 1000 people which is below the World Health Organisation’s (WHO) recommended 4.45 health personnel per 10000 people.
The continent’s health sector challenges are a result of many factors among others inadequate or no training capacity, rapid population growth, weak governance of the health workforce, career changes and poor retention of health worker. In 2022, the WHO projected that the shortage of well-trained health personnel in Africa will grow to 6,100,000 by the year 2030 which is increment of about 45% if compared with figures of 2013 when the last projections were made.
The study; “the health workforce status in the WHO African Region: findings of a cross-sectional study,” recommended that to address these challenges, African countries must put up measures meant to boost training and recruitment of health workers, improve their deployment and retention and increase investments for building respective country’s health workforce to meet their current and future needs.
Reflecting on the above, one can only conclude that such trainings are needed our health sector to grow. China has a rich experience in this field. The country has had several reforms in their medical sector which has seen them become one of few countries with a robust functioning healthcare system and consequently significantly increased their life expectancy which is expected to even get better by the year 2035.
In 2007 for example, China embarked on planning another reform. In 2009, in consultation with the Central Committee of the Communist Party of China, on 6th April 2009, China’s State Council passed China’s Health Care Reform Plan promising to provide a universal primary health service to then country’s 1.3 billion people with the main being “everyone to enjoy basic health care services. Under this health care reform plan, it is the Government’s responsibility to build a safe, effective, convenient and inexpensive health care system covering both urban and rural residents.
Its major aim was universal health coverage by 2020 through strengthening health care delivery, health security and provision of essential medicines. This policy reform is a long-term endeavor but the returns are worth the investments. In 2022, China listed other key tasks for healthcare reforms major among them being the development of a multi-tiered insurance system.
In order to get the job done, the state council set up a state council health systems reform office where the activities of the reform would be coordinated. The following were the policy reforms.
Under social health security, the social health insurance package was extended, medical aid was extended to the eligible poor and those with catastrophic medical expenditure. The payment system was also reformed. Through this, 95% of the population has been covered by health insurance schemes by the end of 2017 and the so-called catastrophic health insurance introduced in all provinces.
Such a system in Uganda would reduce the burden of out of the pocket health expenditure and reduce suffering of many that find it hard to meet medical bills.
Today, China is implementing Healthy China 2030. The “Healthy China 2030” blueprint, was introduced by the Communist Party of China (CPC) Central Committee and the State Council, and it includes 29 chapters that cover key areas that focus on areas like public health services, environment management, the medical industry, and food and drug safety. The Primary goal of “healthy China 2030 is ‘all for Health” while its long-term goal is a universal health security system for China.
Important to note is that “Healthy China 2030” emphases disease prevention and encouraging people to adopt healthy lifestyles, improving the public health service system with aim of ensuring that ordinary residents will have their medical problems diagnosed earlier and so get timely treatment. Lastly, China wants to increase its citizens’ average life expectancy up from 76.34 recorded for 2015, to 77.3 by 2020 and 81 by 2035.
Aware that China is a developing country but has managed to achieve that much, even when it is quite challenging for the African setting, we ought to start on our own reforms. Like the Chinese say, a journey of 1000 miles starts with a single step. For Uganda, the journey should start with these training opportunities China is extending to Ugandan health workers through China-Uganda health communication & cooperation so that together, we continue efforts of building a community of shared for future for mankind in the new era of win-win cooperation.
Ham Wasswa Matovu is a medical doctor and research fellow at the Development Watch Centre.