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.
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