Health facilities under the Uganda Protestant Medical Bureau (UPMB) are warning they could slip into financial distress following a sharp decline in donor support and uncertainty over sustained government funding.
The Uganda Protestant Medical Bureau is the coordinating agency for all Protestant-founded health facilities in Uganda. These facilities form one of the country’s largest Private Not-for-Profit (PNFP) health networks and are founded by and affiliated with Protestant denominations like Church of Uganda, Adventist Church, Pentecostal churches, Baptist Mission and other Protestant missionary groups.
UPMB facilities mostly provide affordable care in rural and underserved communities, offer maternal and child health services, support HIV, TB, and malaria programmes, operate ambulances and community outreach and often serve as the main health provider in remote districts.
Dr. Charlotte Aguti Ongom, Executive Director of Bwindi Community Hospital, told officials from the Ministry of Health and UPMB that more than 45% of the hospital’s operations depend on donor contributions. Although facilities receive Primary Health Care (PHC) grants from the government, she said many hospitals in her region have already experienced funding cuts, forcing them to explore options such as adjusting service charges.
Even so, the exact annual amount government allocates to Private Not-for-Profit (PNFP) hospitals remains unclear. Over the years, some members of the public have questioned why facilities receiving government support still charge fees comparable to — and sometimes higher than — private hospitals.
Dr. Ongom said dwindling funds have forced several hospitals to slightly increase fees to remain functional, a decision that has triggered backlash from communities who believe such facilities should be more affordable. She noted that the widening funding gaps have disrupted critical services, including maternal health, HIV care, and laboratory operations, even as running costs continue to rise.
She warned that keeping prices too low while support shrinks risks turning PNFP facilities into what she called “private-for-loss hospitals.”
Dr. Bildard Baguma, Executive Director of Joint Medical Stores, advised facilities to strengthen financial discipline and adopt innovative strategies for generating income, stressing that government grants are not guaranteed. He revealed that the PHC conditional grant was nearly scrapped two years ago and survived only after prolonged negotiations.
As a long-term measure, Dr. Charles Olaro, Director General of Health Services, urged PNFP hospitals to adopt the government’s integrated service model. He said heavy donor involvement has historically led to duplication of services—an issue that can be avoided through coordinated planning and investment. Olaro added that the Ministry is developing a framework to help health providers streamline fragmented funding into a unified national health outcome.
Dr. Baguma disclosed that UPMB facilities recorded a business volume of 9 billion shillings at Joint Medical Stores during the current financial year. However, more than 3.9 billion shillings remain unpaid, underscoring what he called the urgent need for facilities to cost their services accurately while pursuing integrated care.
He said the current funding landscape is a wake-up call for PNFP health facilities to adopt sustainable financial models before donor dependency pushes them into deeper strain.
