Neoliberal Pathologies and African Development: The Case of the Ugandan Healthcare Sector

Abstract

Uganda's healthcare system has undergone significant transformations influenced by neoliberal policies over the past few decades. How has Uganda's historical embrace of neoliberalism influenced the structure of its modern healthcare system, and what are the resultant effects on the quality and accessibility of healthcare services? This paper examines the impact of neoliberalism on Uganda's healthcare system, focusing on disparities in access, high out-of-pocket payments (OOPs), and the role of public-private partnerships (PPPs). Despite policy transitions and objectives, neoliberalism has perpetuated poverty and uneven development, leading to regional and socioeconomic disparities. The implementation of policies such as the Poverty Eradication Action Plan (PEAP) and National Health Policy I (NHP I) failed to address rural/urban healthcare gaps, entrenching neoliberal paradigms further. Subsequent policies under UgandaVision 2040 and NHP II continued to prioritize PPPs but failed to resolve deeper socioeconomic issues. High OOPs remain a barrier to equitable healthcare, despite the abolition of user fees in 2001. The reliance on private healthcare and informal charges exacerbates financial burdens on households, leading to impossible choices compromising living standards. This thesis argues that the neoliberal approach to healthcare in Uganda prioritizes market efficiency over equity, commodifying healthcare and neglecting social welfare. Overall, it highlights the need for a shift away from neoliberal ideologies towards a healthcare system that prioritizes collective well-being and government intervention.