Mothers delivering at public health facilities across Kampala are being nursed in corridors and walkways, as health centers grapple with severe overcrowding, acute staff shortages, and unreliable water supplies.
The dire conditions came to light on Tuesday as the State House Health Monitoring Unit launched a six-week routine assessment of health service delivery across Kampala Capital City Authority (KCCA) facilities. The probe aims to evaluate resource allocation, track medicine supply chains, and address operational gaps affecting both patients and medical staff.
At Kawaala Health Centre IV, the space crisis has forced administrators to improvise to accommodate the high volume of patients. Dr. Olivia Kibuuka, a health official at the facility, disclosed that staff have been compelled to turn a walkway into a recovery ward for mothers after normal deliveries. Furthermore, two rooms previously used for post-normal delivery recovery have been converted into operating space for mothers undergoing Caesarean sections.
Dr. Kibuuka noted that the space constraints are compounded by a critical water shortage, which directly threatens hygiene and patient safety. National Water and Sewerage Corporation supplies the facility only once or twice a week, while the health center’s borehole fails to provide a steady backup when underground water levels drop.
“Given that this is a health facility, we are challenged with hygiene,” Dr. Kibuuka said, confirming that health workers have already reported cases of sepsis among patients.
A similar strain is unfolding at Kisugu Health Centre III, where staff are overwhelmed by patient numbers despite lacking essential infrastructure. Miriam Aliisa, the nurse in charge at Kisugu, explained that while the facility attends to between 160 and 180 mothers a month, it operates without an operating theatre. Emergency cases requiring specialized surgical intervention must be stabilized and referred to China-Uganda Friendship Hospital Naguru.
Aliisa highlighted that severe staffing shortages are also compromising antenatal care and health education. With up to 100 mothers arriving for antenatal services in a single day, the limited number of midwives cannot spend adequate time with each patient.
“As a result, not all mothers receive adequate health education, while those who do may struggle to retain all the information because of the large numbers and limited time available to health workers,” Aliisa said. She suggested that expanding community-based health education could help bridge the knowledge gap.
The Director of the State House Health Monitoring Unit, Dr. Warren Naamara, stated that the ongoing exercise is part of the unit’s routine mandate to act as the President’s independent eye on the health sector. The monitoring team will inspect eight KCCA facilities: Kisenyi HCIV, Kawaala HCIV, Komamboga HCIV, Kitebi HCIII, Kisugu HCIII, Kiswa HCII, Bukoto Clinic HCII, and City Hall Clinic.
Dr. Naamara emphasized that the six-week review will investigate financial utilization, staff absenteeism, and the drug supply chain from the National Medical Stores to the end user to curb medicine theft and diversion.
“This is routine and KCCA is not the first; we have monitored other districts and other hospitals. We continue to do this as a matter of routine,” Dr. Naamara said. “Are the drugs stolen, or are they given to the benefit of patients?”
Minister for Kampala Capital City and Metropolitan Affairs, Hajjat Minsa Kabanda, urged healthcare workers and local leaders to cooperate transparently with the investigators rather than viewing the probe as a witch-hunt.
“Monitoring is an important part of government business because it helps us establish what is happening on the ground and identify challenges and gaps that may not come to our attention when we are sitting in offices,” Minister Kabanda said. “We must be open and honest with them. Where there are challenges, let us bring them out. Where there are good practices, let them also be documented and shared.”
Echoing the Minister’s directive, KCCA Director of Public Health and Environment, Dr. Daniel Okello Akena, pledged full cooperation from city health officials, noting that the audit aligns with KCCA’s goal of improving service delivery standards.
“As Kampala Capital City Authority, a central government agency which runs the capital city on behalf of the central government, we are duty-bound to comply, cooperate and provide information to this particular exercise,” Mr. Akena said, adding that the assessment will help establish whether city health centers are meeting required national standards.