At least 27 private health facilities that were recommended for closure by the Ministry of Health and health regulatory councils are still operating illegally, with no evidence of reassessment or formal approval to reopen, the Auditor General has revealed.
The findings are contained in the December 2025 Auditor General’s report to Parliament, in which Edward Akol raises serious concerns over weak regulation of private healthcare practice in Uganda, gaps he warns are enabling unqualified practitioners, rising medical negligence, and persistent malpractice.
According to the report, inspections carried out on 189 private health facilities found widespread non-compliance. Forty-nine facilities took no action at all on inspection recommendations, while regulatory councils failed to maintain a follow-up system to track compliance.
“Audit noted that all selected 27 facilities recommended for closure were still operating, with no evidence of reassessment or formal approval to reopen,” Akol said, adding that the violations that prompted closure recommendations were still present.
Further scrutiny showed that none of the 39 sampled facilities issued with corrective actions fully complied. About 36.7 percent implemented none of the recommendations, while 63.3 percent only partially complied, undermining efforts to enforce minimum health standards.
The Auditor General also exposed major data gaps in the regulation of private healthcare. Uganda lacks a comprehensive database of private health practitioners and facilities, as records only capture those that voluntarily seek registration, limiting planning, inspections, and enforcement.
Akol noted stark inconsistencies between records held by the Ministry of Health and regulatory councils, revealing that 10,458 registered private health facilities appearing in council databases were missing from the National Health Facility Registry.
“These data gaps limit the Ministry’s capacity to plan, coordinate, monitor, and enforce compliance with minimum standards, and to take timely corrective action against non-compliant facilities,” he said.
The report also faulted key regulatory bodies, the Uganda Medical and Dental Practitioners Council, Uganda Nurses and Midwives Council, and the Allied Health Professionals Council, for failing to gazette licensed facilities and professionals as required by law.
Over a three-year period, the councils failed to gazette an annual average of 1,804, 406, and 295 licensed private facilities respectively, limiting public awareness of qualified healthcare providers.
The Auditor General further cited weak inspection planning and budgeting, arguing that inadequate inspections and supervision pose serious risks to patient safety. Inspection reports reviewed also lacked documentation on whether previously identified violations had been resolved.
“Follow-up on prior findings is largely verbal, with no provision for documenting these actions in inspection reports,” Akol observed.
Regulatory councils were also criticised for slow complaint handling and weak public sensitisation. A total of 204 disciplinary cases were pending, with average resolution times stretching to 12 months at AHPC, 24 months at UMDPC, and 37 months at UNMC.
Although councils conduct sensitisation activities, Akol noted that these efforts are not specifically aimed at empowering the public to report complaints.
In response, the Auditor General recommended that the Ministry of Health and regulatory councils develop a comprehensive national database covering both registered and unregistered practitioners and facilities, regularly update the National Health Facility Registry, and prioritise funding for inspections and gazetting.
He also urged joint inspections among regulatory bodies to reduce duplication and costs, amendments to existing laws to strengthen enforcement powers, and expanded public awareness campaigns supported by multi-channel complaint reporting systems.
While acknowledging ongoing regulatory efforts, Akol concluded that current measures remain inadequate.
“Addressing the identified weaknesses requires stronger collaboration and coordination among all health sector stakeholders to ensure compliance with standards and protect the public from malpractice,” he said.
The Office of the Auditor General defended its scrutiny, noting that an estimated 54 percent of Ugandans seek healthcare from private facilities, making effective regulation critical to public safety.
