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Citation Information

Type Thesis or Dissertation - Master Thesis
Title Health Sector Reforms (HSRS) in Uganda: A Viable Strategy to Effective Health Care Delivery?
Author(s)
Publication (Day/Month/Year) 2004
URL http://thesis.eur.nl/pub/8791/Bariyo2004HealthSectorReformsUganda.pdf
Abstract
At the time of independence, Uganda had of the best health care delivery systems in Africa. The country's economy was also one of the most vibrant in Africa. However, the decades of misrule by Idi Amin (1971-79) and Obote II (1980-85) led to a collapse of the country's health and economic structures. By 1986, when National Resistance Movement (NRM) captured power the whole economy was in ruins with high trade deficits, debts, high inflationary levels and poor health indicators. Owing to economic difficulties, coupled by the "mystical faith" in the "free-market" paradigm after the mid 1980s, concerns started to shift away from equity issues to efficiency and sustainability. Within the realm of health care, the neo-liberal paradigm led to adoption of the health sector reforms (HSRs) as a "panacea" of all health sectors' ills. The major HSRs adopted included cost-sharing, decentralization, civil service reforms, re-organization of Ministry of Health (MoH), Partnerships with non-state actors, Health Management Information Systems and privatization. The adoption of these policies had an "inspiration" from the neo-liberal thinking through IMF and World Bank, the New Public Management (NPM), the Alma Ata Declaration as well as the Bamako Initiative. Ever since their adoption, controversy has surrounded them. Many critics argue that HSRs have created more evils by worsening the health care delivery and utilization, thus being anti-people. At the same time, protagonists argue that HSRs have increased health care quality, delivery and utilization, thus being pro-people.

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