Access to Maternal Health Services in Rural areas of Uganda in the Decentralized Healthcare System in Conditions of increased Privatisation: A study Rukungiri District

This paper presents and understanding of issues related to access to maternal health services in rural areas under the decentralised health system and increased conditions of privatisation. Rukungiri district was chosen because of its representativeness both in rural populations and extensive decentralisation that has taken place. This study espoused the human rights approach in understanding accessibility and argues that women have specific health needs related to pregnancy that must be provided for in the public health care system. In Uganda, maternal health care has been made priority in public provisioning and policies have been enacted to improve maternal healthcare. This paper argues that though decentralisation has brought physical health infrastructure to closer proximity in rural areas, specific services for maternal healthcare are not necessarily provided at these health centres. Also in this paper it is argued that privatisation has increased not only due to market forces but also due to failure in public sector to provide services pledged by government in its minimum healthcare package. This paper argues that this privatisation has led to proliferation of health service providers, but these have remained largely in urban areas and charge prohibitive costs and thus remain inaccessible to may poor women in rural areas. For this reason many poor women continue using services of TBAs who are untrained and pose increased dangers to the mothers they help deliver. This is a violation of the rights of women to access proper health and unless improvements are made in this area, Uganda will not register much progress towards the highly acclaimed MDG goal on maternal mortality.