Uganda short of medical training schools

Agnes Kyotalengerire
Journalist @New Vision
Aug 29, 2022

Uganda has about 11 medical schools, 180 nursing midwifery and allied health training institutions.

The public medical schools include: Makerere University, Mbarara University of Science and Technology, Kabale University, Busitema University, Soroti University and Gulu University. Some of the private medical schools include:  Habib Medical School, IUIU and King Caesar.

These have continued to train and churn out skilled health workers every year.

Between 2014 and 2019, Uganda added more than 43,000 health workers in 128 districts, with support from Intra-Health International’s Strengthening Human Resources for Health (SHRH) in Uganda Activity.

Of those, only 4,000 are medical doctors. Every year, a total of 600 doctors complete internship. With an addition of nurses, pharmacists and dental surgeons at Bachelors level, the number goes to about 1,200.

Habib Medical School

Habib Medical School

 For diploma in nursing, clinical medicine and laboratory services, Uganda trains up to about 2,000 students and for certificates, a total of up to 4,000 are trained every year.

In 2015, Uganda was far below the World Health Organisation (WHO) standard of 2.3 doctors, nurses, and midwives per 1,000 people. And while new workers were graduating from health professional schools, they were not filling the major service gaps because staffing structures were not set up to meet the country’s increased demands and changing health needs, such as maternal health services.

Quality of education and training

The president of the Uganda Medical Association (UMA), Dr. Odong Oledo puts Uganda’s medical training standards at 70%.

Oledo notes that medical training is peculiar and it involves practical hands on instruction.

 Therefore, the need to have a fully-stocked anatomy laboratory with equipment is paramount. It also involves having enough bodies for practical anatomy sessions. They must be able to operate them, see and identify body parts through those associated with attachment to medical schools of post-affiliated hospitals.

In addition, there must be a fully-stocked physiological laboratory and the whole faculty with all the machines to carry out blood tests and machines for hormonal balances. There must be a micro-biology laboratory for sensitivity tests. A pharmacology laboratory, where students perform tests on rats and do their researches, is a must have.

Additionally, there must be the clinical part which requires a hospital. For example, if a medical school is in Soroti, there must be a hospital that that medical school is attached to for student’s practical hands-on clerkship, surgical and obstetric disciplines. This is possible for public universities like Makerere University, which is attached to Mulago Hospital, Mbarara University, which is attached to Mbarara Hospital, Kabale University-attached to Kabalae Hospital, Busitema University, which is attached to Mbale Hospital.

Is the training adequate?

Oledo says practical training is only possible for universities that are attached to hospitals. There are few medical schools with a demand of over 10,000 students completing A’level every year.

Out of about 5,000 who study sciences, about 3,000 qualify to study medicine. “Kampala International University (KIU) will take a maximum of 200 students, Makerere will take only 160, Mbarara absorbs about 120, Busitema takes 60, Soroto, 60 and Habib Medical School, IUIU will absorb about 80.

In total, medical schools are able to take only about 1,500 students every year. So, the question is, who will absorb the rest? As a result, those who had passion for medicine end up studying clinical medicine, Bachelors of Nursing and Pharmacy or diploma courses and yet they qualify to study medicine,” Oledo says. He adds that there is a need to encourage private institutions to take up the role of training medical students, because it is expensive.

Cost of training medical students.

Oledo estimates that it takes up to sh40m to train one doctor in a public medical school and up to sh85m in a private university, given that tuition per semester ranges from sh5m to 6m. He says this is why the loan scheme was introduced, to cater for students from vulnerable families.

 But, at the same time uptake is low because of the few medical training schools coming on board. According to the standards, every regional referral hospital is meant to have a medical school attached to it.

“With Kayunga and Entebbe Grade B being up graded, we are going to have 17 regional referral hospitals and five national referral hospitals, including Butabika,” Oledo says. He adds that the future in medical education and health training is seemingly bright because of the Government’s interest in training scientists.

“In the next 10 years, Uganda’s science discipline will be tending to modern medicine,” he notes. As medicine evolves, it calls for government to invest more resources in the revolutionary transformation in sciences and also engineering.

Professor Francis Omaswa, the director, Special Projects at African Centre for Global Health and Social Transformation (ACHEST) says there is a big shortage of health workers globally and in Uganda. “We do not have a definite link between training and absorption into the service.

So, training institutions do their thing, and then the people come out, the system is not prepared to absorb them, and you end up with a situation where you have qualified health workers, you have vacancies, but they are unemployed people,” Prof, Omaswa said.  He called for joint planning between the health sector by giving indications of the need for doctors in particular areas to sort it out. How many should enrol for training? How many should graduate?

Challenges

Oryem notes that courses such as anaesthesia are on high demand, yet the Government does not allow or grant health workers study leave to go and pursue the course. As such, the training targets (enrolment numbers) for that particular course are not met.

Also, there are limited tutors to support the training, forcing the sector to operate with a limited number of health workers. “Since the hospital is a teaching institute, we have decided to take in the numbers that they can manage although the facility could do much more,” Oryem noted.

 

  

   

   

      

  

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