2 Million Births, 28% Staffing: Uganda’s Health Crisis Deepens

Uganda’s health system is struggling to keep pace with a rapidly growing population, with officials warning that rising demand, chronic understaffing, and a shortage of specialists are compounding pressure on already congested public facilities.

Appearing before Parliament’s Public Accounts Committee (PAC) on Wednesday, April 9, the Permanent Secretary at the Ministry of Health, Diana Atwine, revealed that the country recorded two million births in 2025, an already staggering figure that could have reached three million if not for infant and maternal deaths.

“We have had an exponential population increase. Just last year alone, we delivered two million babies. So, if you count the ones that died, that means that the number could even have gone to three million,” Dr Atwine told legislators during scrutiny of the December 2025 Auditor General’s report.

She attributed the growing congestion in public health facilities to a mismatch between population growth and the expansion of health infrastructure. “The congestion is because the population over time has increased significantly; our facilities have not been expanded to match the number of people who are coming to these facilities,” she said.

Shift from Private to Public Care

Dr. Atwine also pointed to a notable shift in healthcare-seeking behavior, with more Ugandans turning to government facilities, further intensifying pressure on the system.

“I don’t really want to sound like I am blowing my trumpet, but what we are seeing now… some of their patients are leaving their facilities and they are coming to our facilities,” she said, referring to concerns raised by religious leaders who run private not-for-profit health centres. “We are seeing more and more patients now coming who used to be in the private sector.”

According to the Ministry, recent assessments show a significant increase in the number of patients accessing public healthcare, a trend officials partly attribute to improvements in government services.

Critical Staffing Gaps Persist

Despite the growing demand, staffing levels in public health facilities remain critically low. Dr Atwine disclosed that some regional referral hospitals are operating at staffing levels as low as 28%.

While the Ministry of Finance has allocated additional wage resources in the upcoming financial year, the increase is expected to raise staffing levels only modestly, to between 35 and 38%.

“We have articulated this so many times, but I am glad that this time… the Minister of Finance has given us some money, although not enough to hire up to at least 50%,” she said.

Members of Parliament expressed concern that the staffing gaps are directly contributing to congestion, particularly at higher-level facilities. Patrick Nsamba noted that many cases overwhelming regional referral hospitals could be managed at lower-level health centres if those facilities were adequately staffed.

Failure to Attract Specialists

Lawmakers also questioned the Ministry’s ability to attract and retain specialist doctors, even in relatively accessible areas.

Sarah Opendi cited Mubende Regional Referral Hospital, located roughly two hours from Kampala, as an example of the crisis.

“It is very appalling to see a regional hospital so close to Kampala… fail to attract consultants, senior consultants. Then it is really sad,” Opendi said, urging the Ministry to identify and address the underlying causes.

Training and Quality of Care at Risk

Dr Atwine warned that the shortage of specialists is not only affecting service delivery but also undermining the training of future health workers. Regional referral hospitals, which serve as internship centres, are expected to provide supervision by senior consultants, an expectation increasingly unmet.

“When you don’t have specialists, then it means that even the interns are not trained properly,” she said. “That has implications on the quality of service, because these are the people who are going out to treat patients.”

The Ministry is now calling for deliberate investment in specialist training, noting that some critical roles remain unfilled, not due to lack of funding alone, but because of a limited pool of trained professionals.

“We keep on advertising for intensivists… acute care nurses are not there, they are not trained,” Dr Atwine explained. “We depend on partners… they train a few, but those few are like a drop in an ocean.”

A System Under Pressure

The meeting laid bare a health system under mounting strain, where population growth, shifting patient preferences, and human resource gaps are converging to test the limits of public healthcare delivery.

As Parliament continues its scrutiny of government spending and service delivery, the Ministry of Health faces increasing pressure to translate incremental funding into tangible improvements in staffing, infrastructure, and training, before the widening gap between demand and capacity deepens further.