Uganda has shown effectiveness in disease prevention and health care

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Over the last four years Uganda has registered tremendous achievement in disease prevention, compared to other countries across the region and world.

Back in 2020 when Covid-19 was declared a pandemic, there were fears and concern that so many lives would be lost especially in Africa including Uganda.

“But from surveillance, case management, to disease prevention Uganda excelled. Uganda is ranked the best in Africa for managing Covid-19 very well,” says Dr. Diana Atwine, the Permanent Secretary in the Ministry of Health. She was Speaking to the New Vision about the performance of the Health Sector in the recent years.

According to the experts, Uganda demonstrated preparedness in responding to the COVID-19 pandemic even before the country recorded its first case by restricting travel to and from high-risk countries.

Uganda also disbanded gatherings of people in crowded points such as schools, places of worship, stopped social and political gatherings and enforced mandatory institutional quarantine of all incoming travelers.

Uganda had an effective national response strategy including risk communication, robust testing, contact tracing at district and community levels, implemented physical and social distancing measures, hand hygiene, use of personal protective equipment, and had gradual easing of restrictions.

The available statistics as of today show there were 172,149 coronavirus cases in Uganda, 3,632 deaths and 100,431 recoveries.

According to researchers Uganda handled COVID-19 admirably. “That is because we have built over time the capacity to respond to pandemics,” says Atwine.

“But most important this time was that COVID-19 helped us further strengthen our laboratory capacity that we were even confident to establish a mobile laboratory in the epicenter. That gave us a short turnaround time during the tests.

“Even with anticipation that many people were going to get sick no one was infected from our mobile lab which was very important.”

Atwine says this was the first of kind mobile laboratory to be deployed in such an epidemic. “That tells the capacity and skill Uganda has in dealing with dangerous pathogen’s or organisms that causes disease.”

Ebola success

Also when Ebola hit Uganda in September 2022, although it was detected late we were still able to control the disease despite movement of people from the affected districts to those not affected, says Atwine.

“We were able to control and prevent the Ebola spreading and therefore we did not lose as many people as it was anticipated.”

In response to 2022 Ebola outbreak, Uganda took immediate measures at both national and sub-national levels to strengthen all pillars of the response in the nine affected districts, including Mubende, where the first case was confirmed, Kassanda, Kyegegwa, Kagadi, Wakiso, Kampala, Masaka, Jinja and Bunyangabu.

On January 11, 2023, not more than four months after the oubreak, Uganda was declared Ebola free, marking an end to Uganda’s first encounter with the not so common Sudan Ebola virus strain, which is one of six species of the Ebola virus against which no therapeutics and vaccines have been approved yet.

Uganda put a swift end to the Ebola outbreak by ramping up key control measures such as surveillance, contact tracing and infection, prevention and control.

“While we expanded our efforts to put a strong response in place across the nine affected districts, the magic bullet has been our communities who understood the importance of doing what was needed to end the outbreak, and took action,” said Dr Jane Ruth Aceng Ocero, Uganda’s Minister of Health, while announcing the end of Ebola at the time.

Reduced maternal and infant mortality

From the findings in the Uganda Demographic and Health Survey (UDHS) 2022, we have reduced maternal mortality to almost half, and reduced infant mortality in children under five years, says Atwine.

“We are seeing more people gaining confidence to come to our health institutions to deliver (give birth) and to get health services.

 “About 91% of our mothers are now delivering in our facilities from around 60%,” she says.

The maternal mortality ratio for the seven-year period before the 2022 survey was 189 deaths per 100,000 live births

After the 2022 survey Infant mortality rate is at 36 deaths per 1,000 live births and under-5 mortality rate is 52 deaths per 1,000 live births.

Also 91% of births were delivered in a health facility and 54% of children received all basic vaccinations, according to the 2022 UDHS.

Family Planning

Although there is still an unmet gap for family planning, Atwine says more people are now using family planning.

We are seeing a good percentage of the population in Uganda more family planning.

According to the 2022 UDHS, the percentage of currently married women age 15-49 who were using any method of family planning was at 37% from 14% in 2000 to 2001, and the percentage is likely to have increased as of now. While the unmet family planning need was at 22%, but that percentage may have declined further as more people get to use family planning.

Improved Infrastructure

In the last three years we have upgraded 342 Health Centre IIIs and we have functionalized about 25 Health Centre IVs that were not functional, reveals Atwine.

“It has improved access to healthcare,” says Atwine of the Upgrades done to hundreds of Health Centre IIIs and some Health Centre IVs.

A successful Kidney transplant

In December last year, Uganda successfully conducted kidney transplant. The historic first ever kidney transplant was Kiyemba Mark Maurice of Munyonyo, Kampala, who received the kidney donated by his brother Steven Mpagi.

“We had our organ transplant and that patient is doing very well. We are just limited by resources because we must functionalise the f Human Organ Transplant Council.

Section 13 of the Uganda Human Organ Donation and Transplant Act, 2023, states that the functions of the Council  include regulating, organising, and supervising the national organ, tissue, and cell donation and transplant; regulating designated transplant centres and approved banks; enforcing standards; regulating the allocation of organs; and overseeing the national waiting list.

The Minister of Health, Dr Aceng, said to functionalise the council requires sh5bn. The Ministry intends to spend sh3.6bn on training and benchmarking from other nations, whereas sh1.4bn is for the Council’s operations.

Plans to deliver even better healthcare

What we are trying to do now are the reforms to bring efficiency and effective service delivery in our operations, says Atwine.

“For instance, what is happening now in emergency response is that we have deployed ambulances, we have trained our personnel, and the response time to any emergency is much better.”

Now we are embarking on efficient service delivery in the country, and we are coming up with methods of instill efficiency.

This month Atwine suspended stopped the holding of workshops for Ministry of health workers in hotels to minimise costs

In our reforms, we told our staff we don’t have enough resources yet we have so much to do.

“No more hotel workshops have saved lots of money.  In just one event held away from the hotel, I have saved over $3m

“We need to continue preaching the message so that people know that we have a duty to serve, whatever little resources we have,

“The population does not know about not having money we must deliver; we must find innovative ways of utilizing resources effectively.

Atwine also says they are now looking at integration of services. When we are going to do an activity everyone is involved. That way we use the little resources together and do more,” she says of delivering effective health care to Ugandans.