Background: The government of Uganda faces a multitude of challenges in the health care
system from ensuring provision of drugs, to physical infrastructure, human resource and
delivery of service in the most fair and equitable manner. This study examined equity of
access and utilization of health care services in Uganda with a view to selected factors that
influence access and utilization. This research is based on data from various waves of Uganda
National Housing Surveys (2005/06 and 2009/10) and other sectoral surveys such as the
Annual Health Sector Performance, Panel surveys and Integrated Household Survey (2004/05
and 2010/11). It is driven by objectives that seek to describe and discuss current health care
issues in Uganda by highlighting existing policies meant to drive equitable access to and
utilization of health care services (in relation to key killer diseases such as malaria, TB and
HIV/AIDS); analyses their extent of implementation in the context for which they were put in
place. Thirdly, this study analyses a number of factors (both supply and demand) that affect
access to and utilization of health care services in Uganda such as education, age, household
expenditure, outpatient department utilization, hospital and bed capacity, deliveries in health
facilities and distance from health facilities.
Results: This study established a number of actions that have been undertaken in policy
implementation especially in main key policy areas like malaria, TB and HIV/AIDS. The
analysis shows however that despite efforts to improve the wellbeing through improvement of
health outcomes for the people, there still remains mountain high challenges. For instance,
living close to essential health services, though it works as an incentive to use care, does not
necessarily ensure that health services will actually be used. Secondly, the removal of user
fees in all government health facilities, rates of use of modern health care facilities especially
government providers remains constant and at a cost with increased catastrophic expenditures.
Conclusion: There have been changes in policy to align them with the needs of the people
and improve their health outcomes. Despite increased investment in health infrastructure,
there seems to be an increasing gap in access and use of these facilities. Low use of
government facilities spells more challenges and questions about the quality of facilities and
care received by both urban and rural poor. There have been studies that have confirmed how
quality of care significantly affects people’s use of health care.