Bunyoro loses health partners over lack of substantive District Health Officers
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Leaders in the Bunyoro sub-region are urging the government to lower the qualification requirements for District Health Officers (DHOs), citing the loss of health partners due to the lack of substantive officers.
They argue that the current demand for a master's degree in public health or a related field, along with eight years of experience, paired with inadequate remuneration, is driving qualified candidates to NGOs or other sectors.
The Bunyoro sub-region consists of nine local government administrative units, but only Kibaale and Kakumiro have substantive DHOs.
Kikuube District has been without a substantive DHO since the passing of Dr. Nelson Neyise early this year, while the DHO for Kagadi District retired three years ago, and the position remains unfilled.
According to government structure, a DHO is required to hold a bachelor's degree in medicine, a master's in public health or a related field, and have eight years of experience at a U1 salary scale.
However, local leaders believe these qualifications are too stringent.
Yosiya Ndibwami, Chairman of Kagadi District, highlighted the recruitment challenges.
"We have advertised three times since our substantive DHO retired three years ago, but we have failed to attract a suitably qualified candidate," he stated.
Dr. Alex Feti, the acting DHO for Buliisa District, noted that many qualified candidates avoid the DHO role due to the pressure and political interference, while receiving a salary nearly equivalent to that of a clinical doctor.
"Many prefer to remain as doctors rather than assume these responsibilities, where they are held accountable for things beyond their control. The salary difference is minimal," Dr. Feti explained.
Amlan Tumusiime, Resident District Commissioner for Kikuube, added that individuals in acting roles face limitations in decision-making and are often undermined by other medical staff.
"Acting officers sometimes supervise colleagues with higher seniority and qualifications, leading to a lack of authority. When a substantive officer is appointed, they can make decisive actions," Tumusiime said.
Badru Mugabi, Resident City Commissioner for Hoima, echoed the call for revising the qualifications.
"The current qualifications are too high — eight years of experience, a master's degree, and more. By the time someone meets these criteria, they are highly sought after by international organizations. We need to review these standards," Mugabi suggested.
The absence of substantive DHOs is also causing Bunyoro districts to lose potential health partners. Yosiya Ndibwami lamented, "Many health partners refuse to work with us because we lack a substantive DHO who can make key decisions, so they move to other districts. Our district is not fine, but we have struggled to fill this position. This time, we are considering headhunting."
Dr. Cosmas Byaruhanga, Chairman of Masindi District, appealed to the Ministry of Health to intervene by posting qualified doctors from regional hospitals to the districts lacking substantive DHOs.
"The Ministry can identify doctors from other regional referral hospitals and assign them to districts like Masindi, which has been without a substantive DHO for eight years," Byaruhanga proposed.
Florence Natumanya, Woman Member of Parliament for Kikuube, urged the Ministry of Health to provide guidance on the issue.
"We ask the ministry to consider measures such as offering further studies for these doctors, free accommodation, and allowances as motivation. It does not always have to be about salary increments. Let the government study why these professionals prefer NGOs and find lasting solutions," Natumanya emphasized.
The district leaders hope that by revising the qualification requirements and providing additional incentives, they can attract qualified candidates and retain critical health partners in the region.
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