Biomedical Models of Healthcare has let Uganda down

 Health,

The subject of maternal mortality and rising fistula cases in Uganda truly underpins the failures of biomedical healthcare model. Although there is an elaborate healthcare structure in Uganda, most of the priorities of government when it comes to funding and policy enforcement are not focused on ensuring a robust healthcare system. In this article, I will argue that Uganda needs to adopt a paradigmatic shift in its practices from biomedical model of healthcare delivery to a psychosocial model that caters to people’s real lived health experiences.

The overarching assumptions here are that a healthy population is a formidable engine to a robust economic growth and that underneath the pervasive failures of Uganda’s healthcare system resides a deliberate effort that ignores the centrality of social determinants of health. The key objective of this discourse therefore is to explicate the myth embedded prevailing biomedical model as overly authoritative, rigid, assumptuous, inefficient, expensive and wasteful of taxpayer’s money.

There is a contradiction between modern healthcare delivery systems and the old approaches in delivering healthcare. Truly, our contemporary society has become more diverse, sophisticated and complex. These attributes reflect that our needs for a healthy society have also become diverse, sophisticated and complex.

To contain these emerging needs, the healthcare system must respond congruently. The Ugandan system has clearly not been able to expand in that direction to accommodate the new realities of our health needs. The healthcare system is entrenched in its biomedical model where health and illnesses are defined by signs and symptoms of diseases or absence thereof.

The problem with biomedical model is that it is so linear and rigid. It does not strive to address underlying causes of ill-health in order to eliminate them. Healthcare professionals will prescribe and dispense anti-malarial drugs without providing a hint as to the means of preventing malaria; orthopedics will cater to broken bones without tackling causes of trauma and assault. This paradigm of care is clearly outdated, costly, ineffective and frustrating to modern society.

In contrast, a more robust and contemporary healthcare system is the psychosocial model, which views individuals as composites of their bigger communities. This model locates the individual within a holistic environmental and recognizes a multiplicity of environmental factors as being primal in determining the health of that individual or the community.

The psychosocial model pursues upstream thinking that permits healthcare providers to work collaboratively with other stakeholders in the community to identify environmental factors that potentiates health including community capacity to maintain their own health.

Road safety, architecture and legislation are some of the areas that the inputs of healthcare professionals become very crucial. Many people have lost lives and limbs in road accidents; many buildings lack safety measures and access to persons with physical challenges and; some legislations are insensitive to social determinants of health. Inter-sectoral collaboration therefore would enable the enactment of healthy public policies effective enough to minimize or eliminate some of these negative impacts on community’s health.

Psychosocial model of care support communities to stay on their feet - it wouldn’t wait until someone is immobilized with symptoms of disease.

One of the failures of our healthcare system is in procurement of tones of drugs and yet most of that money could be diverted to funding community outreach through inter-sectoral collaboration to address causes of ill-health from the onset. This approach would provide evidence based health information to the locals; provide the rural folks with life-skills to avoid illness so they can remain healthy, strong and productive.

In establishing a causal triumph of primary healthcare and community based healthcare, I recommend that Uganda’s education system must embrace a paradigmatic change through curricular overhaul to enhance healthcare professionals’ transition from the overly rigid biomedical model to psychosocial practices of healthcare. Unless we get our priorities and realities harmonized, we shall continue to provide health services that are mutually exclusive and diabolically opposed to the health needs of our society.

The site of dilapidating healthcare facilities; rotten mattresses, congested wards, dehumanized patients and demoralized healthcare workers in the hospitals epitomizes biomedical practices.

END.