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UNAPH Annual Report 2016/17



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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