Uganda has 80 districts without a public hospital, leaving only 66 of the country’s 146 districts with government hospital facilities, according to a ministerial statement presented to Parliament by Health minister Chris Baryomunsi.
The statement on the status of health service delivery in Uganda, presented to the House under Rule 29 of Parliament’s Rules of Procedure, indicates that the country has 72 hospitals distributed across 66 districts, translating into district-level hospital coverage of about 45 percent.
The figures raise questions about access to hospital services, particularly for communities that may have to travel outside their districts to access higher-level medical care. The statement, which the Office of the Clerk to Parliament received on October 15, also reveals gaps in the distribution of lower-level public health facilities, although the government has registered progress in extending services to constituencies and sub-counties.
According to the report, coverage of constituencies with a functional Health Centre IV (HC IV) or community hospital stands at 63 percent, below the national target of 65 percent. The Ministry of Health, however, indicates that some Health Centre IIIs (HC IIIs) are being upgraded to HC IVs or community hospitals, a development expected to improve coverage. When constituencies with either HC IV or a hospital are considered, coverage rises to 78 percent, surpassing the 65 percent target.
The statement puts the number of constituencies at 353, of which 276 have a HC IV or a public hospital, while 77 lack either facility entirely. The figures suggest that although the government has exceeded its target for ensuring constituencies have access to a HC IV or a public hospital, a significant number remain without either facility.
Telling gaps
At the sub-county level, access to public health facilities offering services at HC III level and above also remains below the government’s target. Uganda has 2,191 sub-counties, divisions and town councils, according to the statement, a copy of which the Weekend Monitor has seen. Of these, 1,553 have a public health facility at HC III level or above, leaving 638 without one. This translates into coverage of approximately 71 percent.
The Ministry of Health says the commencement of the second phase of the Uganda Intergovernmental Fiscal Transfers Programme (UgIFT 2) is expected to support the construction of additional HC IIIs and improve access to services in underserved areas. However, the statement’s figures point to a gap between the availability of lower-level health facilities and access to hospitals at district level.
While HC IIIs and HC IVs provide essential services, hospitals offer higher levels of care and support the management of patients who require more specialised attention or referral services.
The extent to which the absence of public hospitals affects patients in the 80 districts, including the distances they travel and the costs they incur to obtain treatment, remains an important question for health service planning and resource allocation. The government’s challenge will be to ensure ongoing facility upgrades and planned construction translate into improved access to timely and appropriate healthcare, particularly in districts and sub-counties that remain underserved.
Interventions
In the statement, Dr Baryomunsi disclosed that specialised hospitals are five, national referral hospitals are five, regional referral hospitals are 16 out of the 19 required, general hospitals are 54 out of the 92 required, HC IVs are 240 out of the 460 required, HC IIIs are 1709 out of the 2189 required.
To address the above challenges and consolidate the gains realised, the minister offered that the Government of Uganda (GoU), through the Ministry of Health, will prioritise a range of interventions in FY2026/27. For one, it set out to progressively increase health sector staffing from the current 34 percent towards 55 percent by 2030. This, the minister added, will be done alongside continued investment in pre-service and in-service training.
The statement also lays out plans to ‘accelerate domestic resource mobilisation for health, including exploring dedicated health taxes and expanding social health insurance, to reduce reliance on volatile external financing’.
There are also plans to ‘fully implement the 10-year Health Supply Chain Roadmap to stabilise financing for essential medicines and strengthen last-mile distribution’.
Dr Baryomunsi said that the GoU will intensify malaria control under the Uganda Malaria Elimination Strategic Plan 2026-2030, focusing on high-burden regions.
Accordingly, there are plans to ‘expand infrastructure and capital investment at national and regional referral hospitals to ease bed-occupancy pressures, alongside continued strengthening of the primary healthcare referral pathway.’ The government also intends to ‘scale up the Community Health Extension Worker programme nationwide as a cost-effective platform for last-mile service delivery.’
The minister further revealed that the government will strengthen multi-sectoral action on the social determinants of health-including nutrition, sanitation, and adolescent sexual and reproductive health-to address stunting, wasting and teenage pregnancy.
Lastly, the government intends to ‘sustain investment in disease surveillance and emergency preparedness at points of entry and in border districts, building on lessons from the 2026 Ebola response.’
Hurdles
A senior doctor at Jinja Regional Referral Hospital, who requested anonymity, said there is a significant gap in healthcare delivery in the country, with limited health facilities forcing residents to travel long distances to access medical services. The doctor told Weekend Monitor that the government needs to construct more health facilities and upgrade existing ones to improve access to healthcare. The doctor further attributed some maternal deaths in the country to inadequate health facilities, saying limited access to essential medical services compromises the ability to provide timely care to expectant mothers.
Kakumiro is among the districts without a hospital. Dr Edward Sabiti, the Kakumiro District Health Officer, said: ‘By policy, a population of about 500,000 should be served by a referral hospital. A general hospital offers a broader range of services than a Health Centre IV. Without one, the district has to rely on neighbouring districts for referrals, which increases costs and delays access to specialised care.’
When this reporter recently visited Moruita Sub-county in Nakapiripirit District, Karamoja Sub-region, residents described enduring long and exhausting journeys of up to six hours to access basic healthcare services at Moruita Health Centre II (HC II), the only government health facility serving the vast area.
Located about 50kms from some of the farthest villages, the facility serves a wide catchment area whose residents lack access to a higher-level health facility such as a HC III. Consequently, many have no option but to walk long distances or rely on costly and unreliable transport to seek medical attention.
Ms Harriet Angolere, a resident of Kopedur Village, said residents leave home early in the morning and sometimes arrive at the health centre in the afternoon, exhausted from the journey. She said emergency cases often deteriorate before patients reach medical care, with the poor state of roads leading to Moruita HC II not helping matters.
Mr Patrick Longole, another resident, called for the facility to be upgraded to HC III status and for urgent improvements to the road network to ease access to essential health services. He said for families in Moruita, the journey to access healthcare is not merely a matter of distance but a daily struggle for survival.
‘Pregnant women often begin labour at home because they fear the long journey. Children with fever or malaria may arrive at the health facility after critical delays. In severe cases, some patients die before reaching care,’ Longole said.
A mixed bag
In his statement, Dr Baryomunsi told Parliament that output level results in the health sector are something of a mixed bag.
‘The health sector has continued to improve health services at community level with an improved coverage of community health workers; Parishes with at least 2 functional Community Health Extension Workers have increased to 41 percent against a target of 10 percent; villages with at least two VHTs [Village Health Teams] offering integrated community health service package stands at 52 percent against the annual target of 30 percent,’ he said.
‘Road traffic mortality rate per 100,000 population is still a big challenge at 35.4 against the 27.7 FY2025/26 target. These increasing deaths from road traffic injuries are largely driven by factors such as poor road infrastructure, weak enforcement of road safety policies, and unsafe road user behaviours. The coverage of ambulances by constituency still stands at 56.7 percent with only 200 out of the 353 constituencies equipped with an ambulance. The sub regions of north central Buganda, south central Buganda, Bunyoro, Bukedi, Bugisu and Ankole having the least coverage of constituencies with ambulances,’ he added.
Despite having 16 road ambulances, Ms Daisy Awilo Omech, the project monitoring and evaluation officer at ActionAid Uganda, said Karamoja residents, particularly in rural areas, face significant challenges accessing healthcare services.
She added that expectant mothers are among those who suffer most because of the difficulties in reaching health facilities. Despite these challenges, residents continue to walk for hours across dusty paths and rugged terrain in search of medical assistance.
What to do
Health experts warn that unless the government expands health infrastructure and constructs additional facilities, communities will continue to face delayed treatment and avoidable complications. Maternal and child health indicators in Karamoja remain among the poorest in Uganda, with delays in accessing care, shortages of health facilities and limited emergency transport systems contributing to the challenges.
Recently, Dr John Anguzu, the Nakapiripirit District Health Officer, said plans were underway to relocate Moruita HC II and upgrade it to HC III status to improve access to medicines and healthcare services. He said the sub-county was so vast that it functioned almost like a district, making service delivery more complex.
As short-term interventions, the district is implementing integrated health services and managing chronic cases separately. Dr Anguzu added that mobile outpatient departments (OPDs) were being conducted to extend services to remote communities.
Ms Shafiga Wanyenya, the Member of Parliament representing Bungokho North County in Mbale District, said the shortage of health facilities has significantly affected residents, particularly those living in hilly and mountainous areas such as the Elgon region.
She said there is a need for the government to establish more health facilities to improve access to healthcare for communities in hard-to-reach areas.