Health System and EPI Program
Public health services in Uganda are delivered through a network of eleven regions in eighty health districts.
The Uganda National Expanded Programme on Immunization (UNEPI) is located in the Ministry of Health, Department of National Communicable Disease Control, within the Directorate of Clinical and Community Services. Immunization targets and budget projections are contained in the National Development Plan (2010/11 – 2014/15) and in a recently prepared comprehensive Multi‐Year Plan (cMYP) for 2010‐2014. Immunizations are delivered through a combination of facility based services, outreach services and child health days and campaigns. An Inter‐Agency Coordinating Committee, composed of government, external partner and civil society organization representatives, oversees UNEPI.
Over the period 2006-2011, Gross National Income (GNI) in Uganda increased from 340 US$ to 510 US$ per capita. According to the WHO/UNICEF-Joint Reporting Form Database, government expenditures reported for 2006, 2007 and 2009 range from 2-3 US$ per infant, an average of 3.3 million US$ for the three reporting years. There is an observable government expenditure decrease of 2.8 million from 2009 to 2011, resulting in a government investment of 0.52 US$ per infant. A similar decrease was observed in 2008, where expenditures dropped 2 million US$. Unfortunately data for 2010 is not available.
Uganda is a presidential republic, in which the President of Uganda is both head of state and head of government; there is a multi-party system. Executive power is exercised by the government. Legislative power is vested in both the government and the National Assembly. The President is elected by a popular vote to a five-year term. The cabinet is appointed by the president from among the elected legislators. The prime minister assists the president in the supervision of the cabinet.
The Cabinet of Uganda, according to the Constitution of Uganda, "shall consist of the President, the Vice President and such number of Ministers as may appear to the President to be reasonably necessary for the efficient running of the State."
The Ugandan Parliament comprises 215 Constituency Representatives, 79 District Woman Representatives, 10 Uganda People's Defence Forces Representatives, 5 Representatives of the Youth, 5 Representatives of Persons with Disabilities, 5 Representatives of Workers, and 13 Ex-officio Members. Immunization and immunization financing are overseen by Social Affairs and Budget, Finance and National Economy (shadow) Committees. Ugandan MPs have recently formed a Forum on Immunization that focuses their attention on the issues of vaccination and its sustainable financing.
The Constitution of Uganda lacks a substantive provision on the right to health generally but makes mention of the right under directive principles of government policy. Parliament has the mandate to make laws to operationalise that constitutional right.
The Public Health Act 1935 (Ch 281) identifies notifiable diseases, outlines the government’s epidemic control responsibilities, empowers the government to require certain vaccinations and identifies vaccination as a requirement for school entry.
The Local Government Act (Ch 243) gives powers to the local governments to carry out immunization and other public health functions and to pass laws, bylaws and local ordinances on immunization provided they are compatible with federal laws.
A draft immunization law has been elaborated by MPs and is under discussion by the stakeholders.
- January 2012: Senior Program Officer Diana Kizza Mugenzi and counterparts from the Ugandan Local Government Association organize a two-day briefing in Kampala for over 300 district-level delegates on immunization financing and performance.
- February 2012: McQuestion and Kizza attend a parliamentary briefing in Kampala. Ten MPs form an immunization core group.
- April 2012: Sabin, the Ugandan Local Government Association, USAID and the Ministry of Health sponsor a two-day seminar in Kampala on immunization financing.
- June 2012: Sabin sponsored Uganda Local Government Association (ULGA) meetings where the immunization coverage in Uganda was discussed and the need for the introduction of an immunization law was stressed.
- July 2012: Ugandan Parliament organized a two-day legislative briefing for all the members of parliament to discuss the legislative strategy of the country. It was decided that a draft immunization law will be elaborated.
- August 2012: Uganda’s MPs drafted an immunization law and it is under discussion by the stakeholders.
- November 2012: Uganda's Draft Immunization Bill was submitted to the Parliament as a Private Member's Bill.
- February 2013: Uganda's Parliament organized a meeting to get input for the Immunization Bill from the Ministry of Health officials.