Festus Kuushomwa - Public Health Insights

07/07/2026

Shortage of Medications at Public Health Facilities: The Driving Force

Analytical Perspective By: Festus Kuushomwa

Despite substantial investment in expanding health infrastructure through the construction of additional health facilities and the establishment of outreach points, overcrowding remains a persistent challenge in many health systems. This apparent paradox reflects a broader imbalance in health system priorities rather than simply a shortage of physical infrastructure. Increasing the number of facilities without addressing the underlying drivers of disease is unlikely to reduce demand for healthcare services sustainably.

A major contributing factor is the continued dominance of a curative, treatment-oriented model of care. Health systems often allocate a disproportionate share of resources to diagnosing and treating illness after it has occurred, while comparatively fewer resources are invested in disease prevention, health promotion, and addressing the social determinants of health. This approach results in an ever-growing number of patients requiring clinical management, particularly for preventable communicable diseases and the rapidly increasing burden of non-communicable diseases. Consequently, health facilities experience high patient volumes, prolonged waiting times, increased workloads for healthcare workers, and pressure on limited financial and material resources.

From a public health perspective, prevention is both more effective and more cost-efficient than treatment. Evidence consistently demonstrates that investments in immunisation, health education, sanitation, nutrition, early disease detection, vector control, to***co control, physical activity promotion, and community-based preventive interventions substantially reduce disease incidence and healthcare utilisation. Strong primary healthcare systems that prioritise prevention reduce avoidable hospital admissions and improve population health outcomes while enhancing health system resilience.

The recurrent shortages of medicines observed in many health systems are also closely linked to the predominance of curative care. As increasing numbers of patients require long-term treatment for conditions that could have been prevented or detected earlier, demand for pharmaceuticals rises substantially. This places considerable strain on procurement systems, supply chains, and health budgets. Medicine stock-outs therefore reflect not only supply chain inefficiencies but also the cumulative consequences of a disease burden that exceeds the capacity of the health system to respond sustainably.

A prevention-oriented health system would fundamentally alter this trajectory. By reducing the incidence of preventable diseases, fewer individuals would require expensive clinical interventions, thereby decreasing demand for medicines, diagnostic services, and hospital admissions. Resources currently consumed by treatment could be redirected towards strengthening community health programmes, preventive services, health promotion initiatives, and broader investments in primary healthcare. Such a reorientation aligns with the principles of sustainable health systems, universal health coverage, and the preventive vision articulated in the World Health Organisation framework on primary healthcare.

However, prevention should not be viewed as an alternative to curative services but rather as the foundation upon which effective health systems are built. High-performing health systems maintain an appropriate balance between health promotion, disease prevention, early diagnosis, treatment, rehabilitation, and palliative care. Countries that achieve better health outcomes typically invest heavily in community-based prevention while ensuring equitable access to quality clinical services when needed.

Therefore, the persistent overcrowding of health facilities is less a consequence of insufficient infrastructure than of an imbalance in health system investment. Expanding facilities without simultaneously strengthening prevention and health promotion merely increases the system's capacity to treat disease rather than reducing the occurrence of disease itself. A strategic shift towards preventive and promotive healthcare would lower disease incidence, reduce medicine consumption, improve health system efficiency, decrease healthcare expenditure, and ultimately contribute to more equitable and sustainable population health outcomes.

06/06/2026

Prevention is better than cure # Festus Kuushomwa - Public Health Insights @

06/06/2026

Global Nutrition Strategies and the Role of Nurses in Addressing Micronutrient Deficiencies: Evaluating Food Fortification, Nutrition Education, and Dietary Guidelines in Reducing the Burden of Nutrition-Related Diseases

by Festus Kuushomwa - Friday, 24 April 2024

One of the most important health risks linked to food and nutrition globally is micronutrient deficiency often called “hidden hunger.” This includes deficiencies in iron, iodine, vitamin A, and folate, which contribute to anaemia, impaired child development, weakened immunity, and increased maternal and neonatal mortality. Global responses led by organisations such as the World Health Organization and the Food and Agriculture Organization have focused on three main strategies: food fortification, nutrition education, and dietary guidelines. While these approaches are widely used, their effectiveness depends on how well they are implemented in real-world settings.

Food fortification has been one of the most successful strategies in reducing micronutrient deficiencies at population level. For example, iodised salt has significantly reduced iodine deficiency disorders, while iron and folic acid fortification of staple foods has helped lower rates of anaemia and birth defects. The strength of fortification is that it does not require individuals to change their behaviour it works through commonly consumed foods. However, its impact is not equal everywhere. In many low-resource or rural settings, people rely on locally produced foods that are not fortified. In addition, weak regulation and poor monitoring can result in inconsistent quality. This means that while fortification reduces risk, it does not fully eliminate the problem, especially among the most vulnerable groups.

Nutrition education is meant to complement these structural interventions by helping people make healthier food choices. Health campaigns often promote balanced diets, breastfeeding, and reduced intake of salt, sugar, and unhealthy fats. These efforts can improve awareness and influence behaviour, particularly when delivered through schools and health services. However, education alone is often not enough. Many people already understand what healthy eating looks like but cannot afford it or do not have access to diverse foods. In such cases, the problem is not knowledge but poverty and food availability. This limits the overall impact of education programmes unless they are combined with broader social and economic support.

Dietary guidelines provide a framework for healthy eating at national level, translating scientific evidence into practical advice. They are important for guiding policy decisions, school feeding programmes, and public awareness campaigns. However, their effectiveness depends on how well they are adapted to local contexts. In some countries, guidelines may not reflect cultural food practices or economic realities, making them difficult to follow. In addition, without strong policies such as food regulation, taxation of unhealthy products, or food labelling their influence on actual behaviour can be limited.

Nurses play a central role in making these strategies work in practice. As frontline health workers, they are often the main point of contact between the health system and the community. Nurses provide nutrition education during routine services such as antenatal care, child health visits, and chronic disease management. They help translate general dietary advice into practical guidance that fits the patient’s situation, which improves understanding and adherence.

Nurses also contribute to evaluating the effectiveness of these interventions. Through activities such as growth monitoring, anaemia screening, and data reporting, they generate information that helps track progress and identify gaps. This is particularly important in surveillance systems, where early signs of malnutrition or nutrition-related diseases need to be detected and addressed.

At the same time, nurses observe the everyday challenges that communities face, including poverty, food insecurity, and limited access to services. This places them in a strong position to advocate for better policies and more inclusive programmes. However, their ability to do this is often limited by heavy workloads, resource constraints, and limited involvement in decision-making processes.

In conclusion, global strategies such as food fortification, nutrition education, and dietary guidelines play an important role in addressing micronutrient deficiencies and improving population health. However, their success depends on strong systems, effective implementation, and addressing underlying social and economic conditions. Nurses are essential in bridging policy and practice, but they require adequate support to fully contribute to reducing the burden of nutrition-related diseases worldwide.@

06/06/2026

05/06/2026

MPox prevention measures