Mulago Must be for free, Not for Profit

Uganda, Maternal health rights activists on Thursday confronted Uganda’s extremely poor record on delivering essential maternal health care services by filing an application in Uganda’s High Court (Civil Division).

The case, filed by the Center for Health, Human Rights and Development with the support of a national civil society coalition, challenges the deadly harm caused by Government’s decision to turn a hospital opened in 2018, the Mulago Specialized Women and Neonatal (Newborn) Hospital, into a private hospital charging exorbitant user fees pregnant women cannot afford

The application argues that the government is severely restricting access to essential services, and committing discrimination on the grounds of economic status that threatens the right to health, life, dignity, and equality that is guaranteed under the Constitution.

On 18th September 2018, Minister of Health Dr. Ruth Acheng announced a system of user fees for maternal health care services, replacing what had been free services provided within the old national referral center, Mulago Hospital. Dr. Acheng also announced a “waiver committee” that would determine eligibility to obtain free services from the new women’s hospital.

Human Rights Advocates argued that the governance of the waiver committee has been hidden from the public and that bureaucratic delays inherent to such a system would undermine access to life-saving services

Maternal health is a necessity, not a luxury. The act of restricting access to health services on grounds of economic status is a threat to the right to health. We can’t keep replacing public facilities with those that operate like private hospitals” – Ms. Noor Nakibuuka

Decades of evidence from Uganda and around the world show that health care systems base don user fees cause deadly harm to the poorest and most vulnerable, whether or not they include income-based exclusion criteria. More than one in four Ugandans live on less than UShs 7,000 ($1.90 per day) less than the cost of Mama Kits – Nakibuuka Noor Musisi, Programmes Director at Center for Health, Human Rights and Development said

More than 16 women die daily in Uganda from preventable causes including hemorrhage, sepsis, unsafe abortion, obstructed labour, and pre-eclampsia – Nakibuuka Noor added

Uganda has high rates of teenage pregnancy that also contributes to preventable maternal deaths, 25% of young women 15-19 in Uganda is pregnant or a mother, one of the highest rates in sub-Saharan Africa, a statistic that has remained unchanged since 2006 (source: Uganda Demographic Health Survey, 2016).

Although government a decade ago pledged to provide emergency maternal health care services at the local level by equipping Health Center IVs with the surgical theatres, health workers and commodities needed to save pregnant women’s lives, that promise has been broken, forcing pregnant women to rely on the national referral hospital

“This $25 million facility has been built with public funds to cater for the elite whilst ordinary women are dying around us, Most pregnant women cannot afford to buy a Maama’s kit, let alone pay these outrageous fees. Mulago must be for people, not for profit.” – Nakibuuka Noor Musisi, Programmes Director

The human rights advocates asked the Parliamentary Committee on Health to investigate the operations of the Waiver Committee and the implications of these operations on equity and human rights

`` There is nothing to smile about! I can not just sit in the comfort of my office when Uganda’s largest government hospital which is meant to be free for all women is dedicated to benefit a few rich Ugandans. Mulago Hospital should be free for all not for profit, (kirudu and Kawempe are in terrible conditions with nothing to consider as referral hospitals). The outrageous fees scare away the ordinary pregnant woman who can’t afford these fees to access services”. – Bwire Moses, Executive Director, Peer To Peer Uganda


Frank Byaruhanga is a human rights activist with years of experience in community dialogues, digital communication, advocacy and digital campaigns. He specializes in Media Relation Work, Management and Training with sufficient knowledge in Governance, Accountability, Sexual Reproductive Health and Rights, Youth-led research, Content developer, Creative Activism, Social Media Management and documentary photography.

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