Current government allocations are not sufficiently meeting the country's health concerns as a whole and children's health needs in particular. National defense expenditures continue to receive far greater priority, primarily in response to the insurgency problems in the outlying districts of the country and to the ongoing instability in Uganda's neighboring countries. The health care delivery system in Uganda today remains inaccessible to many Ugandans, especially those residing in the rural areas. These mounting concerns are further exacerbated by the current decentralization of health services and by the implementation of cost sharing programs promoted by the World Bank. Health financing and delivery of services have devolved to district governments that are, in most cases, ill-prepared to assume these tasks.
Many local governments are still deficient in both financial resources and trained personnel.
The main aim of cost sharing is to improve quality of care and access to the poor by deriving more revenues from the non-poor. The cost sharing scheme in Uganda, far from achieving this aim, has resulted in a reduction in the use of preventative health care, a shift in utilization toward private and missionary health facilities, increased delays in seeking care, and increased resort to traditional practices. The plight of the health care system severely burdens the already precarious state of survival and health of Uganda's impoverished children. In summary, Uganda has suffered ruinous civil upheavals since the late 1960s. Although the current government has made impressive strides towards national recovery, major financial and human capacity constraints persist.