|hough the recent health reforms which include decentralisation of health services and creation of ‘minihospitals’ at every sub-county indicate that Government is committed to improving the state of health services in this country, not
much has been done to retain and motivate staff. For the past 30 years, health workers working in the Public Service have suffered from poor remuneration with subsequent massive brain drain to South Africa, U.S.A, Canada, U.K and
Saudi Arabia and various other places. The few who have chosen to stay, have either abandoned the Public Sector entirely, and have either joined U.N agencies, faith-based NGOs, or have opted for full time private practice. The majority of those who continue to work for Government are forced to supplement their meagre salaries through ‘moonlighting’(dual employment) in private clinics. The result has been a grossly understaffed health service with overworked and demoralised health workers, often showing negative attitudes to their patients and their work. Following the strikes of the 1990s, Government set up a Commission of Inquiry to look into the grievances of health workers. The Commission comprised of representatives of the Ministries of Health and Public Service, Uganda Medical Association and the Uganda Medical Workers Union. In addition to low salaries, health workers complained about gross delays in appointments, confirmations and promotions. Other concerns were related to lack of accommodation, transport and protective gear. Recommendations of the Commission included establishment of a constitutional body comprising of experienced health professionals whose main task would be address the delayed appointments, confirmations and promotions. The Health Service Commission has done a commendable job in this regard and in developing recruitment guidelines for the districts. Indeed, its continued existence as an autonomous body will be vital in ensuring a quality Health Service. Another recommendation of the Commission was to evaluate and appropriately grade jobs in the Health Service with the aim of improving the remuneration of health workers hence the Job Evaluation Exercise whose report was eventually completed and passed by Cabinet in 2000.