UNAPH Annual Report 2016/17
Uganda National
Association of Private Hospitals (UNAPH) is
membership organization representing independent private hospitals and private
health clinics in Uganda. Private hospitals and private health clinics are
regulated by Ministry of Health (MOH) through the respective medical
councils. UNAPH has developed quite a number
of policy guidelines and manuals though not respectively implemented with us.
As well, we have identified challenges and issues where a summary of the key findings
is here below highlighting some of the key issues observed during the year at
patient level and sector level.
Satisfaction
level of patients of Private Hospitals and Perceptions of Private Patients in
Kampala City
Characteristics
of the Patients
From the given information we can
easily determine the type of people who take health care from costly private
hospitals.
i.
Gender:
Majority
of the patients who have taken health care from private hospitals are women.
The number of male patients is relatively low. That is, about 60% patients are
female while another 40% are male. The reason behind the large number of female
patient is that most of the private hospitals are established based on female
disease.
ii.
Age:
The
age of the people who have taken health care from these hospitals are limited
to between 15 & 50 years. 12% patients are less than 20 years old; 28%
patients are less than 30 years old; 40% patients are less than 40 years old;
and other 20% patients are less than 50 years old. That is, among the patients
young adults are predominant.
iii.
Occupation of the family leader:
By
observing the patient or his family leader’s occupation, we found that, 65% are
businessmen, and other 35% are service holder. The families whose leaders are
Service holder have multiple sources of income out of their job. This is the
reason why service holders can afford the health service of expensive private
hospital. We observed that without having strong financial base people cannot
receive the services of private hospitals.
v.
Educational Qualification:
Those
people who receive the service of private hospitals mostly are literate. 55% of
them are graduates and the other 45% have an educational qualification of
either secondary or more. From this we can say that, there is a nexus between
education and health consciousness.
Experience and
Perception of Patients towards Private Hospitals and Private Clinics
Patients
have given the following data from their experience about private hospitals:
(a)
Reasons behind taking health care from Private Hospitals and clinics
1.
The
service quality of public hospital is most times poor.
2.
The
physical environment of public hospital is unattractive.
3.
The
doctors and nurses of public hospitals are not caring to patients.
4.
Proximity
5.
Easily
accessible and convenient dosages
Out
of these reasons, some other reasons are there behind taking health care from
private hospitals. These reasons are:
-
85%
patients get him/her admitted into a specific private hospital by following the
prescription of his/her doctor.
-
They
want to receive specialized health care.
-
Their
relatives, friends, colleagues have motivated them to get admitted in private
hospitals.
(b) Patient’s perception and
satisfaction toward Private Hospitals, What patients think of private
hospitals? The answer to this question lies in the following points:
1.
From
their response, it was found that, most of the patients think that getting
quality service from private hospitals is related with money.
2.
75%
think that they are getting quality service.
3.
40%
patients think that doctors do not hear their words carefully.
4.
But
about all the patients are satisfied of the service provided by the nurses.
5.
60%
patients give positive response about the foods provided by the hospital; other
40% think that it is not of good quality.
6.
About
85% patients said that there is no testing laboratory facility in most of the
hospital.
7.
More
than 85% of the patients are satisfied about the physical environment; other
15% are dissatisfied.
8.
50%
of the patients think that the service these hospitals and clinics are
providing and the amount they are charging not reasonable.
9.
More
than 60% of patients don’t have the capacity or knowledge to validate the
treatments and prescriptions of their doctors i.e whether it is influenced or
driven by the profit motive or not.
At
Sector Level and Institutional Level
Poor Communication by
Private Hospitals and Clinics
-
To patients on fees in general
-
Admitting patients
until exhaustion of medical insurance then pass to public institution
-
Poor
communication in handing over
patients from private institutions to public institutions ( after resources
have been exhausted)
-
Enhanced communication to patients during stabilization before
referral to public institutions
-
Enhanced communication
-
No feedback to referring clinicians / institutions
-
There are more caesarean sections in private hospitals
than in public hospitals
Duplication of Roles
-
Conflict of interest : Health Insurance Companies engaged in private
health service provision
-
Managed health care – setting targets for
health professionals – innovation
-
Guarantee letters by health insurance companies to patients for
admission in private hospitals which do not guarantee service provider payment
-
Orders given to practitioners and institutions
not to see patients with valid medical insurance
-
Directing patients to own Specialists by health insurance
companies restricting patient choice
-
Umbrella private organizations are engaged
in the roles of their sub-members associations
Private
Health Sector Governance
-
In
2011 Private Hospital Review report, UNAPH lobbied for the inclusion and
support of the independent private-for-profit health subsector in the
ministry’s health budget where it was successfully considered however, the
support was directed to certain office where it was not clear how it was
managed or appropriately planned and after some years the MOH ministry has
withdrawn this support which deserves to be reinstated and reviewed accordingly.
-
Most
private health sector funds are in the hands of private consultancy companies
and planning and direction of programs is dictated by consultants
-
Private
companies Limited by Shares posturing as representative organizations are
unknowingly running public programs of private associations posing a risk of
exploitation and duplication of programs.
-
Private
health sector has turned into a resource battleground and marketplace for
grants and contracts calling for need for guidelines and codes of conduct.
- There
is growing phenomena of consultancy companies taking the work and recycling
programs of private associations which weaken the health system strengthening
efforts.
Uganda National Association of Private Hospitals
P. O. Box 29324 Kampala, Uganda.
Email: unaph22@yahoo.com,
Website: www.unaph.org
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