Forced Migration in the OIC Member Countries:
Policy Framework Adopted by Host Countries
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facilities and doctors per person can be significantly below the national average.100 In 2010,
Uganda’s health worker to population ratio was three times higher than the World Health
Organization guidelines.101
Local healthcare systems can be placed under considerable pressure during a surge in refugee
arrivals, particularly when these flows contain a significant share of refugees with complex
health needs. Following the arrival of thousands of South Sudanese refugees in Adjumani
district in December 2013, a rapid needs assessment reported outbreaks of diarrhea, malaria,
and measles among refugee children; a lack of psychosocial support to help traumatized
refugees; and shortages of drugs, and supplies for newborns.102
Refugees can encounter barriers when trying to access government health facilities. For
example, government health facilities do not usually have interpreters, which can prevent
refugees who do not speak English or Luganda from accessing their services. In addition,
refugees in urban areas may not be able to access or afford transportation to government-
operated health centers or hospitals.103
Host communities can also access healthcare services in refugee settlements, and a 2014
review estimated they constituted a third of consultations, on average. 104 This additional
demand has led to shortages of medicine and other supplies. And while these health services
are provided in emergency settings, there is a risk that these services will be discontinued
once the emergency is perceived to have passed and funding dries up. The goal is to eventually
mainstream refugee health services: this can require significant investment in host
communities, for example constructing or upgrading health centers, but can improve coverage
and quality of services for refugees and host communities alike.
3.4.4. Conclusions and Assessment of Impacts of Forced Migration
Uganda has received international acclaim for its liberal refugee policies that enable refugees
to work and access education and health services across Uganda, which allocate land in rural
settlements to refugees for purposes of shelter and cultivation. The 2006 Refugee Act replaced
the much-criticized Control of Alien Refugees Act of 1960 (CARA), which focused on
controlling refugee populations and contravened aspects of international refugee law, and
instead closely follows international refugee and human rights legislation, setting out the
rights and freedoms refugees and asylum seekers can expect in Uganda. However, aspects of
the 2006 Act have proved quite challenging to implement, owing to factors like a lack of
resources, government officials and employers being unfamiliar with the provisions of this
Act, and ambiguity in the law itself (e.g. nominal restrictions on freedom of movement).
100 Yuko Amizaki, Terry Hu, Shirley Li, and Jeongyeon Shim, “Country briefing: Uganda – health,” September 1, 2010,
and IRIN News, “Patients go private as state sector crumbles,” September 18,
2012
101 In 2010, Uganda’s health worker-population ratio was 1:1,298, compared with the WHO guidelines of 1:439; the doctor-
patient ratio was 1:24,725 and the nurse-patient ratio was 1:11,000. Ministry of Finance, Planning, and Economic
Development, “Health workers’ shortage in Uganda: Where should the government focus its efforts?” BMAU Briefing Paper
[6/13], May 2013, 1,
103 Bureau of Population, Refugees, and Migration, “Report of a Joint UNHCR-PRM Mission to Review Urban Refugee Issues
in Uganda and Ethiopia,” August 28, 2012
104 UNHCR, OPM, and WFP, Uganda Joint Assessment Mission 2014, 16.