Selective Salary Reward for Health Workers: Realistic or a Distortion?

Abstract

Uganda’s civil service is perhaps one of those with some of the lowest salaries in the world. This has remained the case in spite of improvements in the pay package over the last decade. Staff working in the delivery of health services (here referred to as Medical Workers) are not spared. In fact, because of their peculiar working conditions, the Medical Workers have been among the most discontented civil servants since Uganda entered the era of misrule and mismanagement of the early 1970s. In 1995, the Uganda Medical Workers’ Union (UMWU) called for and eventually instituted a sit-down, non-violent strike as a method of pressing for better working conditions. The initial reaction from the administration of the Ministry of Health was hostile. There was a blanket condemnation of the strikers who were singled out as individual “antipeople, unethical hooligans”. The executive members of UMWU were picked and locked up, and had to report to the police station every week and later monthly for over a period of year. However, after the dissolution of this strike, Government decided to award an extra pay increase to Medical Workers alone. Since this was in the middle of a budget year, which had seen salary increase in the whole service, it was decided that Medical workers alone receive a monthly lunch allowance. This had an effect of giving them a differential pay rise without having to appear so open and this incited workers in other sectors of the service. Initially, lunch allowances of Ug. Shs. 66,000 for all established Medical Workers and Ug. Shs. 44,000 for support staff were introduced with effect from 1st July 1996. The administrative staff and other common cadres in the health sector did complain and eventually the lunch allowance was extended to them as well. This seemed to quench the fire and although the Medical Workers continued to press for increase in salary, there was no real crisis until 7th July 2003 when the Circular Standing Instruction No.2 of 2003 (CSI. 2) was issued.