Our Side of the Story - VSO

Our Side of the Story: The lived experience and opinions of Ugandan health workersHealth and human rights training• Expand existing partnerships between training institutionsand health consumer advocacy organisations. Improvenursing course content to make sure that students takeon board the role of the nurse as a patient’s advocate.De-urbanise health worker training• Increase the number of training schools and residencyprogrammes in rural areas to produce staff already adaptedto rural environments and connected to the local community.• Improve the community service element in medical curriculaand increase the exposure of urban health students to ruralsettings with increased fieldwork.Nurses and Midwives Council registration interviews• The Nurses and Midwives Council should weigh up theadvantages of screening interviews held as a prerequisitefor registration post-qualification against detrimentaleffects on nurse morale.2. Raise the voices of health workersSharing of experience and common approaches• Encourage staff to meet with people from other healthcarefacilities to discuss solutions to common problems andcommunicate them to sub-district level managers. Thesemanagers could also be encouraged to instigate similar forums.Speaking through professional associations, unions andregulatory councils• Channel health worker concerns to the Ministry of Health,Government or Parliament through bodies that speak forthem, such as professional organisations and trade unions.• Professional associations and unions should do more to bringmembers together, for instance at local general meetings,and make greater efforts to visit facilities and talk with healthworkers so that the “right voices” can be taken to the top.They should compile strong collective arguments to improveconditions in the workplace, as well as addressing individualgrievances and traditional welfare issues.• The Health Workforce Advocacy Forum – Uganda (a coalitionof health professional associations, unions and health rightsorganisations) should expand its membership and continue itscampaign for a positive practice environment for health workers.3. Change public perceptions by influencing the media• Inform journalists about the obstacles to health workerrecruitment and discourage them from writing sensationalistor negative stories in the media. Put complaints on locallanguage radio call-in shows into a wider context. Encouragethe running of positive human interest features, such asprofiles of individual health workers and the work they do.Work with the Uganda Health Communication Alliance.• Improve the capacity of civil society and health workerorganisations to write press releases, hold press conferencesand build relationships with individual reporters and mediahouses, so the key campaign messages hit home.4. Build bridges between patient communities,healthcare facilities and staffTransparency on drug availability• Use well-managed public opening of medicine deliveries tohelp convince communities that medicines are not in stock,and to counter accusations of theft. Call on local notables,police or patients to witness the opening of boxes. Supportwith paperwork to show what has been ordered and delivered.• Ensure that local leaders are fully informed through regularmeetings about the demand for and supply of drugs and thatthey use this information responsibly.Connecting communities and facilities• Use opportunities to talk with people on their own groundand explain the problems health workers face, for instancethrough Village Health Teams, facility-based health workersproviding outreach immunisation services, and talks towomen awaiting prenatal checks.• Promote ‘community dialogue’ meetings bringing togetherservice users, local leaders and health unit managementteams. Increase funds to cover these activities.• Invite top local politicians to spend time in facilities alongsidestaff to see what the work is really like.• Civil society organisations should continue their work tocreate common cause between health workers and patients.11