NRM Manifesto Review: Health Sector Key Achievements Revealed

Securing Uganda’s future through efficient health service delivery; President Museveni launched Marine Ambulances in 2022 as a means to improve access to health services.

The National Resistance Movement (NRM) has recorded key achievements under the health sector in as far as implementing the 2021-2026 Manifesto commitments is concerned.

Below are the Key Achievements of the NRM Manifesto Implementation under the Health Sector:

Infrastructure development

• Completion of the National Medical Stores (NMS) warehouse at Kajjansi, in Wakiso district. A State-of-the-art 30,000 pallet, the best in Sub Saharan Africa was commissioned in November 2022. This has increased the pallet space available from 8,000 at Entebbe warehouse.
• Construction of Regional Cancer Centre in Gulu is complete and was commissioned in December 2022.
• Construction of Lubowa International Specialised Hospital; work is ongoing at about 33%; completion date is 30th Dec. 2024.
• 14 Regional Referral Hospitals have been equipped with CT scans. They include: Arua, Entebbe, Fort Portal, Gulu, Hoima, Jinja, Kabale, Lira, Mbale, Mbarara, Moroto, Mubende, Mbarara and Soroti. Installation of the CT Scans is ongoing and will be commissioned this FY.

Oxygen Supply

• All Regional Referral Hospitals (RRHs) are equipped with 15cc per hour plants and currently operational.
• Government procured an additional sixteen 100cc per hour plants and four 50cc / hour plants and installation is ongoing in all RRHs.
• NMS has procured and installed a 60,000 litre Cryogenic oxygen storage tank to improve supply of oxygen in the country.

Renovation and equipping of General Hospitals

• Renovation of Gombe GH has been completed. 
• Renovation and expansion of Busolwe hospital in Butaleja District commenced in October 2022 and is at about 15% completion.
• Renovation of Kambuga hospital in Kanungu District has commenced.

 Upgrading of Health Centre IVs (HCIVs) to General Hospitals

• Kotido HC IV was upgraded to a general hospital in FY 2021/22.
• Kyegegwa HC IV infrastructure was upgraded with support from the DRDP project and upgraded to a general hospital in FY 2021/22.
• Ministry of Health has also approved the upgrading of Kisenyi HC IV to a general hospital to cater for the population needs.

Upgrading of HC IIIs to HC IVs

• 10 HC IIIs have been upgraded to HC IVs in various parts of the Country. These include: Kawuanzeki HCIII and Bondo HC III in Arua; Bugaya HC III in Buyende; Palabek-kal in Lamwo; Mayuge HC IV; Rwebisengo HC IV in Bundibugyo; Panyandoli HC IV in Kiryandongo; Rugyeyo in Kanungu; Ruteete in Kabarole and Ongica HCIII in Lira is ongoing.
• In Kampala Metropolitan Area, upgrade of Kiira HC III to IV is ongoing with funding from the UgIFT Program Development Grant; construction of a 60-bed maternity ward is ongoing at Kiswa HC III for upgrading to a HC IV on completion; construction of a theatre is ongoing at Goma HC III in Mukono Municipality.

Upgrading of Health Centre IIs to IIIs

• 381 (100%) target HC IIs (340 UgIFT and 41 URMCHIP) were funded for upgrade.

Under the UgIFT Program;

• 220 out of 340 (65%) upgrades are complete.
• 64 have been fully equipped and the rest to be fully equipped by end of this FY.

Under URMCHIP;

• 35 out of 41 upgrades have been completed.
• Over 45 facilities have minor works ongoing and are expected to be completed by June 2023.

 Construction of HC IIIs in subcounties without any health facility

• Construction of 31 out of the 134 planned new HC IIIs is ongoing with funding under the UgIFT program.

 Key outcomes of upgrades

• Increased number of public HC IIIs from 1,165 in 2018/19 to 1,536 in 2022/23.
• Mothers accessing quality antenatal care and delivery services.
• Vaccination services now more accessible.
• More comprehensive OPD services including laboratory.
• Enhanced In-patient services.
• Improved quality of healthcare services.
• Reduced walking distances; 77% of the population is within 3km distance of any health facility (NSDS Report 2021).
• Over 20,000 deliveries have been conducted in the completed facilities.

 Establishment of 3 additional Blood Banks

• Soroti Regional Blood Bank is under construction with funding from the COVID-19 Fund and is at 80% completion.
• Construction of Arua and Hoima Regional Blood Banks is ongoing with funding from the UgIFT Program to be completed and equipped in FY 2023/24.

Prevention and control of Non-Communicable Diseases

• Scaling up services for screening of cancer of the cervix.
• Human Papilloma Virus (HPV) testing sites increased from 16 to 62 in FY 2021/22. This helps in identifying and treating those affected to reduce the risk of developing cervical cancer. 25% of women aged 30 to 49 years were screened for cervical cancer.
• Immunization of young girls against cancer of the cervix achieved 105% first dose vaccination coverage for Human Papilloma Virus for the10-year-old girls and 56% for 2nd dose (fully immunised) in FY 2021/22.

 Prevention and control of Communicable Diseases

HIV/AIDS

• HIV prevalence has reduced from 6% in 2016 to 5.5% in 2020.
• The Country is on track towards achieving UNAIDS targets for HIV cascade. (95% HIV positive Know Status: 95% On Treatment: 95% on treatment with Viral Suppression).
• ART coverage is 95%, ART viral load suppression 96% and ART retention 83%. Low retention is mainly due to non-adherence by adolescents and hard to reach areas.
• HIV positive pregnant women initiated on ARVs at 98%.
• Proportion of HIV exposed infants with first DNA PCR test within 2 months, at 81%.

 Tuberculosis

• TB prevalence reduced from 234 per 100,000 population in 2019/20 FY to 192 per 100,000 in 2021/22.
• The achievements under the TB program are largely due to;
• Increased awareness through the Community Awareness, Screening, Testing and Treatment Campaigns held every 6 months and a total of 14,500 TB cases identified.
• Increased access to diagnostic services like the 320 Gene Xpert machines which have been placed in all National and Regional Referral Hospitals, 79 General hospitals, 123 HC IVs and 55 high-volume HC IIIs.
• Community Engagements with cultural leaders.
• Three Mobile TB Clinics with digital x-rays procured to increase community access.

 Malaria

• Epidemic response interventions for the high burden districts included distribution of mosquito nets, Indoor Residual Spraying, RDTs and antimalarials.
• Seasonal Malaria Chemoprophylaxis (SMC) is conducted in Karamoja every six months.
• Indoor residual spraying was conducted in West Nile region.
• Larviciding was conducted in Kabale, Kisoro, Rubanda and Lira.
• A total of 28million Long Lasting Insecticide Treated Nets are to be distributed this year 2023.

 Management of emerging diseases and outbreaks

• The Government has been able to swiftly detect and respond to all emerging diseases and outbreaks.

COVID-19 response

• Uganda reported her first case of COVID-19 in March 2020.
• Despite challenges, Uganda has been applauded as the best in responding to COVID-19 on the African continent registering fewer cases.
• By April 2023, 82% of the population above 18 years had received at least one dose and 53% were fully vaccinated.
• This achievement is attributed to; early detection of cases using good laboratories set by the Government; availability of vaccines; increased efforts by the MoH to reach the target groups through three Accelerated Mass Vaccination Campaigns; reduced risk perception currently limiting uptake of vaccination.
• A COVID-19 stabilization and transition Plan was developed to guide integration of COVID-19 care and management into routine care.

Ebola Virus Disease outbreak

• Uganda reported Ebola Virus Disease Outbreak in Mubende on 20 September 2022.
• Over 9 districts including Mubende, Kassanda, Kyegegwa, Kagadi, Bunyangabu, Wakiso, Jinja, Masaka and Kampala were affected.
• The Ministry of Health and partners working with the District Task Forces mounted a swift and well-planned response to the Ebola outbreak.
• Government was able to contain the outbreak in a record 69 days.

 Port Health Services

• Following the COVID-19 pandemic, over 53 port health infrastructure have been set up at most of the points of entry. These help screen all incoming travellers against common diseases including COVID-19.
• Malaba Border Post laboratory and staff houses were completed.
• This will strengthen disease surveillance at the border points of entry.

 Ambulance dispatch system

• 120 equipped ambulances were acquired through procurements by Government of Uganda, Development Partners and donations.
• These have been deployed according to the Government policy of regional ambulance systems to ease coordination, maintenance, control, and accessibility.
• 2 regional hubs established at Naguru National referral hospital and Masaka regional referral hospital.

 Water ambulance system

• Procured and distributed 14 Boat Ambulances for the Local Governments with islands.
• These were launched by H.E President Yoweri Museveni.

  

 Training of Emergency Medical Services (EMS) teams

• 860 lay first responders trained in Kampala and Masaka to respond to emergencies.
• 460 professional health workers have been trained in Basic Emergency Care.
• To strengthen the EMS system, MoH provided scholarships for training of Emergency Physicians and Emergency Medical technicians.

Human Resource Welfare

Enhancing health workers’ salaries and other benefits

• Health workers salaries were enhanced beginning July 2022.
• 99 Masters and Fellowship scholarships and 41 Bachelor of Anaesthesia scholarships have been awarded to increase the number of specialists and critical cadre.

 Plan for the Future

• Mobilize and sensitize the community for primary prevention of diseases to improve overall health of the population before any signs of morbidity.
• Investment in prevention and control of the high burden of communicable diseases especially malaria, HIV/AIDS and TB.
• To address high levels of out-of-pocket expenditure in order to protect households from catastrophic spending by broadening pre-payment mechanisms such as National Health Insurance Scheme as well as mobilizing the population to join other Social Protection Schemes.