In May 2009, the Medicus Mundi International Network launched the report “Contracting between faith-based and public health sector in Sub-Saharan Africa: An ongoing crisis?”. In a national workshop stakeholders from the public and private (faith-based) health sector discussed the report and, more generally, the challenges of integrating the private not for profit sector in the national health system of Uganda. The workshop concluded with the adoption of a “Kampala Declaration on the partnership between the Public and Private Not For Profit subsectors in the Ugandan Health System”.

The Workshop

The Kampala workshop of 9th and 10th December 2009 was organized by the Medicus Mundi International Network, the Makerere University – School of Public Health, and the Institute of Tropical Medicine Antwerp. Its purpose was to disseminate the results of an international study on contracting experiences between Private Not For Profit (PNFP) health institutions and public health authorities in Cameroon, Chad, Tanzania and Uganda.

Starting from the dissemination and discussion of the study results pertaining to the Uganda case study of contracting between the Presidential Emergency Plan For Aids Relief (PEPFAR) and PNFP hospitals, the workshop addressed the wider context of the public private not for profit partnership. The objective of the meeting was to discuss the study findings with all concerned stakeholders and to identify and plan the way forward.

The pluralistic composition of the meeting was exceptional. The following Ugandan stakeholders attended the meeting: representatives of the Ministry of Health (MoH), representatives of the Catholic, Protestant and Orthodox Medical Bureaux, representatives of the Ugandan academia, representatives of the development partners (donors) and Non-Governmental Organisations active in Uganda and representatives of the World Health Organisation Country Office.

The atmosphere of the meeting was frank and constructive. The participants appreciated the momentum created by this workshop. Cognizant of the existing collaboration, the workshop provided a window of opportunity to overcome existing constraints to achieve progress in the attainment of the common goal of universal coverage for all Ugandans, irrespective of their social, economic, religious, ethnic or political status.


Kampala Declaration on the partnership between the Public and Private Not For Profit subsectors in the Ugandan Health System

We, the participants of the Kampala Meeting reached a consensus and hereby declare as follows:

  1. Recognising that the Ugandan health system is pluralistic by nature, we hereby call upon all stakeholders to reaffirm their commitment to Universal Coverage of healthcare, which cannot be achieved without a genuine and lasting collaboration between all service providers.
  2. We urge that pragmatism and realism prevail over rigid ideological positions and that mutual trust be re-established. Future agreements between public and PNFP-subsectors should, of necessity, be based on mutual respect and recognition of the need for a genuine collaboration with the population’s benefit as the overriding consideration.
  3. We demand that the Public Private Partnership for Health (PPPH) policy be approved as soon as possible. Political commitment from both Ugandan authorities and development partners at all levels should be translated into action.
  4. We recommend that the MoH and development partners recognize the rising cost of service provision and provide a level of funding to the PNFP subsector that allows it to attain optimal levels of health care outputs.
  5. We exhort that all parties develop an organisational culture and appropriate institutional basis in the Ugandan health system that allows for continuous learning to strengthen the partnership in the context of overall national health system development.
  6. We urge that capacity be enhanced in the MoH and in the entire sector to adequately design, implement and evaluate partnership arrangements.

Kampala, December 10th 2009

Contracting: an ongoing crisis? The report

Contracting between faith-based and public health sector in Sub-Saharan Africa: An ongoing crisis? The case of Cameroon, Tanzania, Chad and Uganda. By Delphine Boulenger, Basile Keugoung & Bart Criel, Institute of Tropical Medicine, Antwerp. Study commissioned and published by the Medicus Mundi International Network (MMI), Basel, May 2009.

Download the full report: PDF
Download the Uganda case study: PDF
Other country reports: see MMI website