More than sixteen Ugandan women die every day of complications related to pregnancy and childbirth – complications that almost never kill women in wealthy countries. Uganda’s national shortage of professional health workers is a cross-cutting health crisis, directly contributing to maternal mortality, lack of access to HIV treatment, and more.
Over the last two decades, while the country endured a catastrophic HIV epidemic, heartbreaking maternal mortality rates, and a range of other health crises, the Ugandan government did not prioritize health funding in spite of steady economic growth.
Since 2010, Health GAP and its partners in Uganda have made great strides to advance health justice. As a member of the Coalition to Stop Maternal Mortality in Uganda, Health GAP helped to support a historic lawsuit against the Ugandan government, ensuring the right of pregnant women to essential health services. The coalition, and the campaign to address the health worker crisis that this work on addressing maternal mortality inspired, has been helping to expand access to health care in Uganda ever since.
Uganda: Winning Human Resources for Health, a new case study released by the International Budget Partnership (IBP), follows the development and strategies of the Human Resources for Health (HRH) Campaign to address the government’s lack of attention to health. The case study examines the role of civil society organizations – highlighting Health GAP and our partners’ efforts – in winning increased public investment in health. It highlights the importance of strong and effective communication and coordination among civil society groups, government officials, and the media, in advancing major policy change. It also explores the need for mixing diplomacy and ‘polite politics’ with the power of grassroots mobilizations and protest.
The campaign has won approximately US$15 million in additional public funding for health justice in Uganda. These funds have allowed the government to recruit more than 7,000 new health workers, and succeeded in ensuring that government decision-makers were held accountable for meeting the needs of the citizens and communities they are supposed to serve. The case study has some valuable lessons for other civil society coalitions:
- There is power in collective voice: A coalition of persistent, audacious stakeholders including activists, citizens, government officials, and media with a common platform can be truly effective.
- Understanding the interests of policy-makers is critical: An important ingredient of the campaign’s success was the activists’ ability to successfully frame the campaign goals in ways that were attractive to key health and government officials.
- Protests and confrontations have their place: Direct action tactics, in addition to meetings and negotiations helped to increase the power of the campaign and coalition.
- Evidence is key: The coalition used budget analysis, facts, and statistics to illustrate its goals and the need for change.
- The work doesn’t end with one win: After the major victory of winning increased funding for health workers, the coalition works to ensure that this increase is sustained in the government’s budget each year, and to monitor implementation.
Fighting for health justice—whether access to HIV treatment on demand for all, or an end to preventable maternal mortality—is the heart of Health GAP’s work. The IBP case study shows the transformative power of strong, smart advocacy to ensure that no one dies for lack of essential care, simply because of where they live.