Faces Behind the Numbers: How Health Service Delivery Impacts Real People in Gulu

Healthcare is a fundamental human right, and access to adequate healthcare services is critical for every community’s well-being and development.

Access to healthcare has long been a problem in Gulu, a bustling city in Northern Uganda. Despite efforts by the government and other organizations to enhance healthcare services in the area, many individuals continue to struggle to obtain adequate care.

When the Africa Freedom of Information Centre team visited Gulu in 2021, it chose several contracts for health care delivery to monitor in the district and city.

Lapeta Health Centre, located in Pakwelo Parish, Unyama Sub-County, a few kilometers from Gulu City, was among the many selected health clinics.

Lapeta Health Centre 11, Gulu district.

AFIC is a Pan-African membership organization and resource center that promotes African individuals’ access to knowledge. Among AFIC’s mandates is the promotion of transparency and accountability in service delivery.

Against this backdrop, AFIC followed up on the construction of an outpatient department at Lapeto Health Centre 111 and discovered that, while the contract had been issued, most of the terms of the contract, including the timetable for delivery, had been broken.

AFIC team with the nursing officer and chairman health management committee at Lapeta Health Centre 11 on 25th, April, 2023.


The contract provided for completion of the project in July 2021. Yet, when we came over in October 2021, three months after, the OPD was still not operational.” Monitoring and Evaluation officer at AFIC.

Among other provisions in the contract, was a pit latrine, an insulator which had not been constructed.

AFIC also found out that whereas the contract did not provide for a patient waiting area, it was necessary. There was a lot of water going to waste as there was a lack of gutters and water tanks.

AFIC wrote a letter to the district authorities and brought these issues to their attention, and also made some recommendations.

In our letter, we requested the district authorities that the OPD be completed soon to enable usage by patients. We also recommended that the insulator and Pit latrine be constructed as  per the contract.” Charity Komujjurizi, the Monitoring and Evaluation officer at AFIC says.

Besides this, AFIC recommended that though the contract does not provide for a waiting area for patients, gutters and water tanks, these could be completed for better services. 

And for the sake of pregnant mothers who might need operation services, AFIC recommended that power be put in place to help in such instances because the health center had no power at all.” Komujjurizi adds.

The monitoring and Evaluation Cordinator at AFIC, Charity Kumujjurizi, the communications and advocacy officer, Gaaba Lakel Maria and AFIC community monitor in Gulu, Otto Richard, made a follow up visit in Gulu on 25th, April, 2023.

It was established that the OPD was completed and opened for use by the end of 2022 in November, though it had not been  officially launched. Though electricity had not been put in place, there was provision for solar.

Operational Out-Patient Department at Lapeta Health Centre 11.

The number of patients has since increased tremendously according to the nursing officer at Lapeta Health Centre.

Adoch Florence, nursing officer at Lapeta Health Centre.

“In March 2022, we received 101 patients, after the opening of the OPD, we received 741 patients in November of the same year.” Adoch Florence, nursing officer at Lapeta Health Centre.

She said these numbers have not fallen and at the time of our visit, the number was at 285 patients for April, which Miss Adoh said is likely to increase by the end of the week.

The waiting area had been put in place and patients had a resting area as they waited for their turn to be worked on.

Patient waiting area.

However, despite these achievements, we  discovered that despite our recommendation for the insulator and the pit latrine and their provision in the contract, these had not been constructed. More so, the health center workers had no idea why this was so.

There were still challenges in drug availability and supply from the National medical store.

Otim Keneth Kennyeta, chairperson, health management committee at Lapeta health center.


“This health center had last received drugs in December 2022 till February when we also received only two tins of Panadol and Conterm which are always available. We have since February operated with no drugs.” Otim Keneth Kennyeta, chairperson, health management committee at Lapeta health center.

Odong Patrick Ongee, staff at the Lapeta health centre revealed that they lacked HIV testing kits though youths were willing to do voluntary testing.

Odong Patrick Ongee, staff at the Lapeta health centre.

“Recently a number of youths in this area came and requested to be tested voluntarily. Unfortunately we didn’t have HIV testing kits. In fact, up to now we don’t have them.”

Ongee requested that the government through the ministry of health look into this situation and provide the testing kits.

Lapeto is not the only health centre that AFIC has followed up.

Aywee health centre is yet another facility in northern Uganda, Gulu district, that has been impacted by AFIC’s monitoring work.

When AFIC visited the facility, there were issues with drug outages, no emergency transportation, and no electricity. Recommendations were given to district officials. Following a follow up visit, AFIC discovered that the health center now has electricity and a solar backup system.

AFIC team at Aywee health centre.

They received a medicine supply in February and are currently waiting for  more. Emergency transportation and adequate equipment had also been addressed.

While there are many areas for improvement, it is vital to acknowledge government efforts in public service delivery and emphasize the need of community empowerment.

Service delivery can be improved by emphasizing transparency and accountability, access to information, and citizen participation in addition to government operations.

Read our report on the analysis of procurement in Africa