Strategic Plan for Strengthening Medical Ethics, Bioethics and Health Law in the Independent (PFP) Private Health Subsector in Uganda

Strategic Plan for Strengthening Medical Ethics, Bioethics and Health Law in the Independent (PFP) Private Health Subsector in Uganda

INTRODUCTION

Uganda National Association of Private Hospitals (UNAPH) is an organization representing independent PFP Health Sector in Uganda.  To bring attention to medical ethics and to enhance the quality of health care in PFP Health Subsector, UNAPH has introduced a strategic plan for medical ethics, bioethics and health law at a national level. The increased recognition of ethical problems has contributed to the resurgence of ethics, bioethics and health laws in relation to health care and to the emergence of medical ethics as a new collaborative discipline through-out the world. The strategic plan will cover major areas of management, regulation, communication, research, education, training, and the public sensitization, monitoring and assessment of medical ethics, bioethics and health law activities in the PFP health subsector.

STRATEGIC PLANNING PROCESS

Given the multidisciplinary nature of medical ethics, bioethics and health law the establishment of a national program of medical ethics has been proposed to Uganda National association of Private Hospitals (UNAPH). After the initial discussion of this program, a final strategic plan for medical ethics activities will be produced as a necessary first point of action. In order to achieve this goal, interested authorities and stake-holders, such as, physicians, lawyers, medics, administrators, religious clergy, philosophers, and related organizations, such as, the law council, law society of Uganda, and Medical Councils, as well as other interested parties, will be invited to participate in consultation workshops that will be carried out.

Participants will discuss pertinent subjects relating to medical ethics, bioethics and health law. The main subjects to be discussed will be: the physician/patient relationship; ethics in research; medical ethics philosophy; private health consumer protection; information and education in the field of medical ethics; allocation of resources (human resources, financial credits, and equipment); ethics in education; reproductive health (abortion, AIDS, infertility, and family planning); organ transplantation; medical ethics related rules and regulations; the economy and medical ethics; brain death; genetics and biotechnology; euthanasia; supervision, assessment approaches and others.

The identification and definition of specific stakeholders will be carried out during the first work-shop. The vision, mission, and an analysis of strengths, weaknesses, opportunities and threats (SWOT) of medical ethics in Uganda will then be reviewed and discussed, followed by the definition of particular goals and activities.

VISION STATEMENT: The vision produced in the workshops will include setting and maintaining the ethical and professional standards in the PFP health care system by means of promotion of knowledge, attitude and the practice of health care professionals in the field of medical ethics, based on scientific and legal principles.

MISSION STATEMENT : The mission is currently defined as: the provision of comprehensive management (policy making, performance, monitoring  and evaluation) in medical ethics, bioethics and health law; the production of accurate and clear strategies; the coordination and the paving of the way for all private health sector players, universities and training centers with an interest in medical ethics; to provide appropriate and coordinated services for education and research, so that the advancement of knowledge, insight and the moral functions of health care providers could be attained.

STATEMENT OF VALUES:

The respect of human rights, patient safety and protection with due consideration to national and international regulations, will be accompanied by a special attention to available laws, ordinary customs and social morals. Furthermore, the national advancement of learning and empowerment of knowledge is an additional valuable principle.

SWOT ANALYSIS

Strengths: The main strengths are described as: the presence of desirable controlling regulations for health care’s social functions; the paying of special attention to medical ethics subjects by managers and health care professionals; an advancement of knowledge and sensitivity of the public to new medical ethics subjects and any increase in demand; the inexpensive nature of medical ethics supervision and research; the possibility of centralized medical ethics policy; the possibility of a defined structure for medical ethics.

Weaknesses: The weaknesses are defined as follows: the inadequacy of clarified studies about medical ethics, the insufficient integration and continuity of medical ethics research; the insufficient partnerships with, and contributions to and from, other research centers; the fragmented nature of private hospital sector regulation; the shortage of medical ethics professions; the lack of efficient international collaborative relations; the rapid changes in the level of medical ethics leadership; the insufficient support of medical ethics research projects; the inadequacy of the necessary initiatives for supporting medical ethics activities; the weak position of medical ethics education in the universities; the nonexistence of certified academic courses in the field of medical ethics.

Opportunities: The available opportunities are: the possible links with active medical ethics centers (national and international); the proper attention of health managers (in various levels of ministry of health and universities) in the support of medical ethics; the novelty of medical ethics for researchers; the presence of various appropriate backgrounds and internal and external support for medical ethics studies; the possibility of identifying, training, licensing and regulating illegal practitioners and drug vendors rather shutting them out; the demand for a quality of promotion for medical education and research; the appropriate support for medical ethics activities by the health sector strategic plan; the presence of researchers interested in medical ethics subjects.

Threats: The main threats consisted of: brain drain; a diminishing public confidence in medical society; diminishing assurance and motivation for attentive physicians; lack of communication with legal centers; an inadequate justification of stakeholders, and the diversity of insight and opinions among physicians, lawyers, clergymen and philosophers; management instability and fragmentation in the PFP health subsector and medical education; the presence of greed in some areas of medical society; the inappropriate situation of medical ethics in the organizational structure chart; the insufficient attention of high-ranking managers and neglect in resource allocation; the inadequacy of interest and attention towards medical ethics subjects within research centers and medical universities; people are continuously going to illegal practitioners and drug outlets for first-line treatments because they are cheaper and accessible; the excessive engagement of medical society in economic and executive matters; a disrespect towards ethical behavior by medical society; a lack of knowledge surrounding ethical concepts and philosophical approaches.

GOALS AND ACTIVITIES: In the continuing program, goals, objectives, activities and indices will be presented. We will review the goals and activities here:

•       Goal 1: Achievement of a uniform fundamental structure and official codes in medical ethics.

Activities:

a) Compilation of medical ethics codes on the basis of scientific and legal principles.

b)    Approval of necessary parts of a charter or compiled ethical codes by the authorities.

•       Goal 2: Development of medical ethics training in medical science education.

Activities:

a)     Designing the structure of medical ethics training workshops and developing a certification process in PFP health subsector and relevant universities.

b)    Provision of medical ethics training courses for medical professionals and students.

c)     Promotion of lecturers’ abilities in medical ethics content and training methods.

d)    Penetration of medical ethics education in the continual training of medical science graduates.

e)     Development of medical ethics in relevant fields within Uganda.

f)     Provision of an appropriate background for relevant research projects in universities and research centers within Uganda.

g)    Formation and development of relevant medical ethics task units within the sector.

h)    Support for the formation and expansion of task committees in other stakeholder organs.

•       Goal 3: Development of practical medical ethics in Uganda.

Activity:

a)     Support in making medical ethics practical in the health care system.

•       Goal 4: Expansion of internal and external medical ethics relations.

              Activities:

a)     Provision of a system for establishing collaborative communications between regulating authorities and private health sector associations that have a common interest in medical ethics.

b)    Establishment of a system for connecting with medical ethics policy makers.

c)     Provision of an appropriate system for connecting with the general population (and other stakeholders that have an interest in medical ethics).

d)    Establishment of scientific partnerships with international scientific research centers.

•       Goal 5: Establishment of a system for monitoring and evaluating the country’s medical ethics activities.

          Activity:

a)     Design and establishment of managerial and informational systems (MIS) that are to be updated each year.

THE SCOPE OF GOALS ATTAINMENT

Following the implementation of nationwide strategic planning in medical ethics, considerable plans and activities will be carried out by UNAPH and other partners. UNAPH will pave the way for the organization of regional committees in different districts and universities country-wide. These committees will undertake the supervision and observation of national and international laws relating to medical ethics, bioethics and health law in order to restore public trust in the health sector.

CONCLUSION

Due to the importance of medical ethics, bioethics and health law, a strategic plan has been set in place and we hope this planning will be implemented correctly, thereby making medical ethics, bioethics and health law practical in our society. This process will establish ethical standards in medicine in Uganda. Strong support for the implementation, regular monitoring and systematic assessment of the plan’s progress will certainly realize its vision, mission and goals in the near future. Furthermore, a periodic review of the strategic plan will be conducted, and it is envisaged that communication with regional and international organizations must be pursued and strengthened. Sensitization and Establishment of an integrated medical ethics networks, given the fundamental differences in professions and socio-cultural values is certainly required. However, it is noted that this program deserves to be implemented on a sector based level as a “One-size-fits-all” approach may work in the short run but it may not work in the long run because the chronic problems of some sectors may spillover to other subsectors, as blanket approaches are being proposed and planned to other health system strengthening initiatives.