Uganda is the largest refugee-hosting country in Africa and the fifth largest in the world. Over the decades, Uganda has hosted refugees from countries including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of 31st August 2024, there were 1,7400 000 refugees in Uganda primarily situated within refugee settlements in northern and southwestern Uganda and Kampala City.

Kampala, Geneva, Brazzaville – A new report on “Refugee and Migrant Health System Review: Challenges and Opportunities for Long-term Health System Strengthening in Uganda” calls for a holistic approach to fortifying Uganda’s health system. The report underscores the importance of enhancing health worker capacities, improving access to essential medical resources, and fostering stronger stakeholders’ coordination. Together, these efforts aim to create a more resilient and inclusive health system that serves refugees, migrants, and host communities, while laying the foundation for long-term sustainability.

The report is a result of collaborative efforts between Uganda’s Ministry of Health (MoH) and World Health Organization (WHO), in partnership with the United Nations High Commissioner for Refugees (UNHCR), and the International Organization for Migration (IOM).

The report launch was officiated by the Ugandan Minister of Health, Dr Jane Ruth Aceng together with the WHO Director of Health and Migration, Dr. Santino Severoni, the IOM Chief of Mission, Mr. Sanusi Tejan Savage, and the UNHCR Assistant Representative in Uganda, Mr Benson Ochiel Ngiela.

The hybrid event which took place in Kampala and online brought together key players from the Ugandan government, United Nations Agencies, donors, and other partners to discuss the report's findings. The event also highlighted the collaborative efforts of UN agencies to improve the delivery of health services for refugees, migrants, and host communities in Uganda, to catalyze further action and resource mobilization.

While hosting the launch event, Dr. Jane Ruth Aceng explained that “to ensure that Uganda has a strong health system able to meet the needs of its entire population, it is crucial to further improve existing policies and strategies that grant migrants equitable access to health services”.

In March 2024, WHO, together with MoH, and UNHCR conducted a joint review mission to provide a comprehensive overview of the health system's response to refugees. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening its health system capacity and ensuring continued access to health services for refugees, migrants, and host communities.

Key findings from the report indicate that Uganda’s government supports refugees through policies promoting freedom of movement, integration, and access to social services, employment, and land. Refugees and asylum seekers also receive a comprehensive health package including emergency care, psychological first aid and continuous access to primary health care services once settled.

Although the report commended the integration of people forced to flee into national services, key challenges identified include recurrent stock out of essential medicines and supplies, cultural and language barriers among refugees and the healthcare team, and limited resources to recruit and manage the needed health workforce in health facilities.

The report highlights key steps to improve Uganda's healthcare system by integrating refugees and addressing the specific needs of both migrants and host communities. WHO's Director of Health and Migration, Dr. Santino Severoni, stated, “Uganda's leadership in integrating refugees and migrants into the health system is a model of solidarity in action, ensuring access to essential health services for all.”

For the WHO Regional Director for Africa, Dr Moeti Matshidiso, “Countries should use the potential of migrants and refugees to contribute to the task force of service delivery, using their competencies and experience.”
Further considerations from the report include Identifying and implementing new funding strategies and creating a comprehensive health insurance system; Incorporating traditional healers into health systems and strengthening intersectoral collaboration with other ministries to address broader health determinants, among others.

Efforts to strengthen the health system and act on the mapped action items are already underway. In March 2024, UNHCR and WHO signed a Letter of Understanding to enhance their collaboration in supporting Uganda’s government to improve health services to migrants, refugees, and host communities in the country.

“This partnership aims to reinforce the rights and health of people forced to flee while supporting Uganda's efforts to achieve the 2030 Sustainable Development Goals,” explained Mr Benson Ochiel Ngiela, the UNHCR Assistant Representative in Uganda.

Uganda’s dedication to hosting millions fleeing conflict and hardship, and its efforts in integrating and protecting refugees and migrants are remarkable. Uganda’s open-door policy and Comprehensive Refugee Response Framework are exemplary models for providing safety, dignity, and hope.