Low bed occupancy rates in Uganda's peripheral health units: is it a policy problem?

A survey of 71 government and non-governmental health units ranging from hospitals to dispensaries was made to determine the utilisation of available beds in these units. In addition, an assessment of consumer practices on the use of beds was made using qualitative methods. The major finding of the study was the very low bed occupancy rates at the primary health care (PHC) level, ranging from 0.2-42%; compared to very high bed occupancy rates at the hospitals, ranging from 54-153%. Most patients referred themselves directly to the hospitals, travelling very long distances of up to 80 km. The reason for low bed occupancy rates at the primary health care level are multifactorial, including lack of medically trained personnel at this level, sporadic supply of drugs and other medical supplies and a complete breakdown in the transfer and referral system. In order to implement the policy of PHC which government has adopted, there is need to redirect resources to the PHC level and revive the referral system.