Getting an Education in Social Determinants of Health- Uganda National Symposium on Universal Health Coverage


 By Milly Nattimba



The National Symposium on Universal Health Coverage; arguably the first such national meeting to be convened in Uganda is underway. It is being convened by Makerere University School of Public Health under the Supporting Policy Engagement for Evidence-based Decisions (SPEED); an initiative that focuses on Universal Health Coverage. Attended by participants in the region on 150; these are coming from state and non-state sectors, academia, media and communications. It is an eclectic mix of professional backgrounds and sectors; making the discussions quite enlightening. It can get confusing and too much to take in at times though!

There are several sessions; plenary panels, parallel sessions and abstract presentations. This was a very interesting plenary panel; high-powered, highly experienced people, sharing their technical experiences and view-points. The topic of social determinants of health itself does always generate debate around responsibility. Who is really responsible for this and the other? Some want to claim sole responsibility, while others wish to run away from it; few will point out shared responsibility. In the case of Universal Health Coverage, responsibility has to be shared. There is no two ways around this one. Just consider these experiences we were served today.

One member of the panel was Engineer Dominic Kavutse from the Directorate of Water Development, Ministry of Water and Environment. His department has been working very hard to ensure that all Ugandans get access to clean safe water. Currently access stands at 65%, leaving 35% of the population with access but not safe access. This translates into 10 million Ugandans exposed to water-borne diseases due to consuming unsafe water. The Department has been able to invest the 2% of the national budget it receives from government to provide 800,000 new water points every year. However, the population added onto this resources every year is 1.2 million Ugandans born. The person working on controlling population growth needs to come on board this endeavor.


Mr. Livingstone Bagenda works with the Uganda Police Force Health Services. While we largely know the Police for ensuring law and order, he educated us on the fact that this is done to ensure that our health is preserved. He emphasized the aspect of community empowerment through community policing where members of a community are able to look out for the interests of each other, including health interests. This is the approach the Force plans to use to contribute to UHC. The question thrown at him was whether the people trained under this approach are not going to start asking for payment for doing ‘police’ work.

Dr. Grace Kabaniha, a Health Economist with WHO noted that while the concept of social determinants of health is key, it is right now quite scattered. She recommended a situation analysis on social determinants of health. “The extent to which each social determinant of health impinges on health, determines where more attention should be paid first”.

Dr. Patrick Kadama of ACHEST brought out a thorny matter; that the issue of health impact assessment in all economic interventions or projects has been completely ignored by governed. He summed up the situation as the existence of a huge governance deficit.

With so many issues being raised in 20 minutes; one can just imagine how much more can get unearthed in the five years SPEED will be supporting such engagements.



Dr. Jimmy Opigo is the District Health Officer of Nebbi. He also chairs the association of DHOs in Uganda. He raised three key questions; 1) is there awareness that we need to work together? 2) Are there institutional arrangements to facilitate this working together? 3) Who coordinates the process of working together?

Dr. Sarah Nahalamba of the National Planning Authority emphasized the need to nurture and produce human capital that is healthy and productive. She mentioned sectors like water, agriculture, environment, education among the very critical in ensuring this happens. Vision 2040 envisages transforming the Ugandan society to one of USD 9500 per capita.