Business & Management
Cancer Patients Spend an Average of Shs 300,000 on a Single Visit at UCI
To access treatment and care services at the Uganda Cancer Institute (UCI), patients spend on average 300,000 Uganda shillings on a single visit although some spend to as high as 800,000 (Figure 1). This was revealed by a study done by Makerere University in collaboration with the Strengthening Institutional Capacity for Research Administration (SICRA) and Uganda Cancer Institute (UCI) with funding from the Government of the Republic of Uganda through Makerere University Research and Innovation fund (Mak-RiF).
Conducted in 2021 during the Covid-19 pandemic lockdown, this study titled “Impoverishing and Catastrophic Health Expenditure on Cancer Care among Persons affected by Cancer in Uganda” is among the first few in the country to estimate the catastrophic health expenditure among cancer patients receiving care in Uganda.
The study revealed that patients suffering from Prostate and Colorectal Cancers were the most affected, with their out-of-pocket expenditure greater than 600,000 per visit. Out of pocket expenditure refers to all direct payments for healthcare or services from household income or savings that patients incur at the point they receive health services.
The study also highlighted that a considerable proportion of cancer patients experience catastrophic health expenditure. “Overall, at least half of all cancer patients experienced catastrophic health expenditure on Cancer Care and treatment. 5 out of 10 patients spent at least 40% of their household income on Cancer health care,” the study findings reveal in part. Further, “Cancer patients or households with patients are unable to solely meet costs associated with cancer care. Often they depend on family, relatives, and friends’ support. However, the continuity of support coming through is not guaranteed throughout the patient’s time of sickness.” Speaking during the Dissemination and Stakeholders Engagement at UCI, Dr. Allen Kabagenyi, the Principal Investigator, noted that unemployed patients, who constituted 86% in the study, were among those who spend at least 300,000 Uganda shillings whenever they visit UCI. “This money is spent on buying missing drugs, imaging services, and tests among others,” she added.
Besides digging deep into their pockets to meet the cancer treatment costs, the findings reveal that families often sell their household property like land, animals, homes among others, in order to raise money for treatment and any related care. “The Shs300,000 is for only one visit but remember a cancer patient who is on stage one and two has to visit regularly, translating to almost Shs. 3.6 million in a year,” Dr. Francis Kiweewa, the Director Strengthening Institutional Capacity for Research Administration (SICRA) said.
The Assistant Commissioner – Non communicable diseases (NCDs) prevention and control Department at Ministry of Health, Uganda, Dr. Gerald Mutungi said; “At the ministry, we have adopted the approach of evidence-based policy decision making. Therefore, the policy recommendations of this study are well received.” He further said that as the Ministry waits for the passing and implementation of the National Health Insurance Scheme, researchers need to investigate and come up with measures aimed at cancer prevention and control.”
Dr. Jackson Orem, the Executive Director of Uganda Cancer Institute, while responding to the study findings admitted to the growing cancer burden, which he said could only be managed through establishing regional Cancer management centers. He said “currently when you look at the statistics of the number of cancer patients we receive at UCI, 15% are from central region while 85% come from up country. What I can say is that we need to decentralize our services so that these people are able to access them with ease in their respective areas.”
Dr. Nixon Niyonzima, the Head of Research at UCI, said government should have focused interventions of increasing household income so that the patients are able meet the cancer care and treatment related expenses.
Speaking to journalists, Prof. Bruno Yawe, the Ag. Principal College of Business and Management Sciences (CoBAMS) noted that the study speaks to the objectives of Makerere University’s strategic planning framework for the 2020–2030 period, which seeks to enhance a research-led university. He commended the multidisciplinary study team led by Dr. Allen Kabagenyi, saying that the findings were timely especially when Uganda is registering rising cancer related morbidity and mortality. He thanked the Mak-RIF Grants Management Committee representative Dr. Mercy Amiyo, for insights and continued support to researchers at Makerere University.
In Uganda, over 56,238 are living with cancer and more than 21,000 deaths were registered in 2020, according to the Globocan Cancer Statistics report. Further the report shows the top seven cancers in Uganda including; cervical cancer, Kaposis Sarcoma, breast, prostate, Non-Hodgikin Lymphoma, cancer of the liver and esophageal – account for 70% of new cancer cases. Knowing the catastrophic health expenditure on cancer care is crucially important to design strategies of providing financial protection against the rising medical expenditure by households with cancer patients.
Meet the study team
Acknowledgements
This study was funded by the Government of the Republic of Uganda through Makerere University Research and Innovation Fund (MAK-RiF). Special thanks to all the patients, Care Givers and Key informants who participated in this study. Graduate Assistants Mr. Ronald Wasswa and Mr. Kayemba, Makerere University.
The Public Investment Management (PIM) Centre of Excellence has commenced a three-day refresher training for members of the Development Committee (DC) of the Ministry of Finance, Planning and Economic Development. The training, which began today in Jinja, aims to enhance the analytical and technical skills of committee members who are tasked with reviewing government projects submitted by various Ministries, Departments, and Agencies (MDAs).
The training was today February 19, 2025, officially opened by Dr. Hennery Ssebukeera, who represented the Director of the Budget Directorate. In his opening remarks, Dr. Ssebukeera emphasized the importance of the refresher course in enabling the Development Committee to effectively conduct quality reviews and fulfill its mandate as a key gatekeeper of the Public Investment Plan. He noted that the training would improve the participants’ ability to appraise and implement public investments in line with the Public Investment Management System (PIMS) framework.
Speaking at the same event, Prof. Ibrahim Mike Okumu, representing the Centre Director, Prof. Edward Bbaale, expressed the Centre’s gratitude for the opportunity to contribute to Uganda’s PIM cycle. He highlighted the importance of the training in harmonizing the relationship between the MDAs that draft project proposals and the analysts who review them. Prof. Okumu reiterated the Centre’s commitment to building the capacity of government officials in Public Investment Management, thereby supporting the country’s development aspirations.
The need for this training was identified during the Development Committee retreat held in 2024, which revealed limited capacity among DC members in project appraisal, specifically in reviewing prefeasibility and feasibility reports, Dr Ssebukeera noted. In response, the Ministry of Finance, Planning and Economic Development, in collaboration with the PIM Centre of Excellence, organized this refresher course to strengthen the participants’ technical and analytical skills.
DC is a statutory committee of government that evaluates the viability of public investment projects. Its statutory composition includes: Office of the President, Office of the Prime Minister, Ministry of Finance, Planning and Economic Development, National Planning Authority, Public Procurement and Disposal of Public Assets Authority (PPDA), Office of the Solicitor General, Ministry of Gender Labour and Social Development, National Environment Management Authority, Equal Opportunities Commission, Ministry or Work and Transport, Ministry of Water and Environment, Public Private Partnership Unit. The PIM Center of Excellence was recently admitted to the Development Committee as a non-voting member.
The training will cover a wide range of topics, including the role of PIMS in the country’s development goals, the logical flow of project profiles, costing, and the interpretation of interconnections between prefeasibility/feasibility reports and financial models. Additionally, participants will explore the role of public-private partnerships in national development.
Dr. Ssebukeera encouraged participants to actively engage in discussions, share their expertise, and apply the knowledge gained from the training. He noted that this engagement would empower the Development Committee to effectively perform its role in reviewing and approving public investment projects, ensuring they align with national priorities and deliver value for money.
The Public Investment Management Centre of Excellence, established by the Ministry of Finance, Planning and Economic Development in partnership with Makerere University School of Economics, continues to play a pivotal role in building the capacity of MDAs in managing public investments. To date, the Centre has trained over 300 officers and produced several research papers, reflecting its commitment to enhancing public investment management in Uganda.
The training in Jinja is expected to enhance the participants’ capacity to effectively review government projects, thus supporting the effective implementation of Uganda’s Public Investment Plan.
Business & Management
Somali Officials Complete Executive Training in Infrastructure Asset Management at CoBAMS
Six Somali government officials have successfully completed a three-day Executive Training in Infrastructure Asset Management, held at Makerere University’s Public Investment Management Centre of Excellence (PIM CoE). The training, funded by the United Nations Capital Development Fund (UNCDF), took place from January 27 to 29, 2025, and aimed to enhance regional capacity in infrastructure planning and management.
The training brought together senior civil servants and policymakers from Somalia, equipping them with practical knowledge and strategies for sustainable infrastructure asset management. It also fostered valuable cross-border collaboration, facilitated by UNCDF Uganda, which played a crucial role in connecting Makerere University with the Government of Somalia.
The program was delivered by experienced faculty from Makerere University’s College of Business and Management Sciences (CoBAMS), alongside experts from the Ministry of Finance, Planning and Economic Development (MoFPED) and the Uganda National Roads Authority (UNRA). A special session was also led by the Makerere University Bursar, offering practical insights into financial management in infrastructure projects.
Speaking at the opening of the training, Mr. Ncube Mkhululi, the Regional Technical Advisor for UNCDF emphasized the importance of infrastructure asset management in driving sustainable economic growth. He highlighted UNCDF’s commitment to supporting capacity-building initiatives in developing economies, noting that effective infrastructure planning and management are critical to national development. He also expressed confidence in Makerere University’s expertise in delivering high-impact executive training programs for government officials.
During the closing ceremony, Prof. Bbaale Edward, the Principal of the College of Business and Management Sciences expressed gratitude to all partners, including UNCDF, Makerere University management, and the PIM CoE faculty, for their commitment to making the training a success. He emphasized Makerere University’s ongoing efforts to internationalize its research-led agenda, positioning itself as a hub for regional knowledge exchange.
UNCDF Program Manager, Mr. Joel Mundua, the commended the participants for their dedication and encouraged them to share the acquired knowledge with fellow officials in Somalia. This was reaffirmed by one of the participants, who pledged to apply and disseminate the learnings within their respective departments.
Mr. Sunday Denis Aliti, the Program Officer at UNCDF highlighted the importance of ensuring that infrastructure asset management strategies are practical, adaptable, and aligned with national development goals. He commended Makerere University for its leadership in knowledge transfer and regional training and encouraged continued collaboration between universities, governments, and international development partners to strengthen institutional capacity.
Dr. John Sseruyange, Manager of the PIM CoE, applauded both the participants and the expert trainers who contributed to the program. He reiterated the Centre’s commitment to advancing infrastructure asset management through continued training and collaboration with regional stakeholders.
As the training concluded, participants departed with valuable insights and practical tools to improve infrastructure management in Somalia and beyond. The success of this initiative highlights Makerere University’s role as a leading institution in public investment management, fostering capacity-building efforts that drive sustainable development across Africa.
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