Located in East Africa, Uganda is landlocked between South Sudan, the Democratic Republic of the Congo, Kenya, Tanzania and Rwanda. Since the late ’80s, when the current government came into power, Uganda has been aiming to improve its health care system through changes in financing, centralization and engagement with the private sector. Health reforms in Uganda are implemented to address infrastructure, human resources and access to health care.

Ministry of Health Strategic Plan

Uganda’s Ministry of Health Strategic Plan (2020/21–2024/25) guides the country’s health sector priorities in alignment with the National Development Plan III and Vision 2040. It focuses on improving access to quality health care, enhancing health system efficiency and promoting disease prevention.

The plan emphasizes universal health coverage, infrastructure development, human resources and digital health integration. It also outlines strategies for strengthening governance, financing and community health systems to achieve better health outcomes and resilience.

Sector-Wide Approach

In the early 2000s, Uganda’s Ministry of Health implemented a Sector-Wide Approach (SWAp) as part of its broader health reform strategy. This model aimed to align all stakeholders, the government, donors and implementers, under a unified national health plan. While decentralization of the health sector had already begun in the ’90s, SWAp helped reinforce the process by channeling resources and decision-making to local governments.

A key advantage of SWAp was its role in reducing aid fragmentation. By encouraging pooled funding and sector-wide planning, the approach helped prioritize high-impact investments in alignment with national goals. Though some major global health donors operated outside the SWAp framework, the model enhanced coordination and accountability for many key health programs.

SWAp also strengthened district-level governance. It provided Uganda’s districts with planning, monitoring and performance review tools, while increasing attention to health information systems and evidence-based management. Though the SWAp was initially successful, its impact has declined due to capacity constraints and a weakening Ministry of Health.

The National Health Insurance Scheme

Uganda is currently seeking to establish a National Health Insurance Scheme (NHIS) to improve financial risk protection through pooled contributions, where wealthier individuals subsidize others. Although Parliament passed the NHIS Bill in March 2021, the President has not yet signed it into law. Furthermore, the revised version is pending Cabinet approval.

Currently, health insurance coverage in Uganda remains extremely low. Only around 1% of the population is insured, leaving the vast majority exposed to high out-of-pocket health costs. Many households are pushed into poverty due to medical expenses, particularly in rural areas where access to care is limited.

The proposed NHIS, if enacted, would pool contributions from citizens, allowing those with greater financial means to help offset health care costs for lower-income Ugandans.

Moving Forward

Through its strategic health plan, Uganda has formulated a solid plan for moving forward. The future of the health care sector in Uganda is bright, especially with reforms like NHIS, which could be a sustainable way to establish high-quality, accessible health care.

– Ariana Wang

Ariana is based in Dallas, TX, USA and focuses on Global Health for The Borgen Project.

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