essential package of health services country snapshot: uganda

ESSENTIAL PACKAGE OF HEALTH SERVICES COUNTRY SNAPSHOT: UGANDA

July 2015 This publication was produced for review by the United States Agency for International Development (USAID). It was prepared by Jenna Wright for the Health Finance and Governance Project. The author’s views expressed in this publication do not necessarily reflect the views of USAID or the United States Government.

The Health Finance and Governance Project USAID’s Health Finance and Governance (HFG) project helps to improve health in developing countries by expanding people’s access to health care. Led by Abt Associates, the project team works with partner countries to increase their domestic resources for health, manage those precious resources more effectively, and make wise purchasing decisions. As a result, this five-year, $209 million global project increases the use of both primary and priority health services, including HIV/AIDS, tuberculosis, malaria, and reproductive health services. Designed to fundamentally strengthen health systems, HFG supports countries as they navigate the economic transitions needed to achieve universal health care. July 2015 Cooperative Agreement No: AID-OAA-A-12-00080 Submitted to: Scott Stewart, AOR

Jodi Charles, Senior Health Systems Advisor Office of Health Systems Bureau for Global Health Recommended Citation: Wright, J., Health Finance & Governance Project. July 2015. Essential Package of Health Services Country Snapshot: Uganda. Bethesda, MD: Health Finance & Governance Project, Abt Associates Inc. Photo: Smiling children in Mpoma, Uganda. Credit: © 2014 Alexaya Learner/ GlobeMed at UCLA, Courtesy of Photoshare

Abt Associates Inc. | 4550 Montgomery Avenue, Suite 800 North | Bethesda, Maryland 20814 T: 301.347.5000 | F: 301.652.3916 | www.abtassociates.com Avenir Health | Broad Branch Associates | Development Alternatives Inc. (DAI) | Johns Hopkins Bloomberg School of Public Health (JHSPH) | Results for Development Institute (R4D) | RTI International | Training Resources Group, Inc. (TRG)

CONTENTS

Acronyms................................................................................................................... i About the Essential Package of Health Services Country Snapshot Series ... 1 The Essential Package of Health Services (EPHS) in Uganda .......................... 2

Priority Reproductive, Maternal, Newborn and Child Health Interventions .............. 3 Use of Selected Priority Services .............................................................................................. 3 How the Health System Delivers the EPHS .......................................................................... 4 Delivering the EPHS to Different Population Groups ........................................................ 4 Providing Financial Protection for the EPHS ......................................................................... 5

Sources ...................................................................................................................... 7 Annex A. Uganda's EPHS ....................................................................................... 9 Annex B. Comparison between the EPHS and the Priority RMNCH Services ................................................................................................... 61 Annex C: Uganda Health Equity Profile ............................................................. 65

ACRONYMS

EPHS Essential Package of Health Services

HC Health center

RMNCH Reproductive, maternal, newborn and child health

UNMHCP Uganda National Minimum Health Care Package

ABOUT THE ESSENTIAL PACKAGE OF HEALTH SERVICES COUNTRY SNAPSHOT SERIES

An Essential Package of Health Services (EPHS) can be defined as the package of services that the government is providing or is aspiring to provide to its citizens in an equitable manner. Essential packages are often expected to achieve multiple goals: improved efficiency, equity, political empowerment, accountability, and altogether more effective care. There is no universal essential package of health services that applies to every country in the world, nor is it expected that all health expenditures in any given country be directed toward provision of that package. Countries vary with respect to disease burden, level of poverty and inequality, moral code, social preferences, operational challenges, financial challenges, and more, and a country’s EPHS should reflect those factors.

This country snapshot is one in a series of 24 snapshots produced by the Health Finance & Governance Project as part of an activity looking at the Governance Dimensions of Essential Package of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. The information presented in this country snapshot feeds into a larger cross-country comparative analysis undertaken by the Health Finance & Governance Project to identify broader themes related to how countries use an EPHS and related policies and programs to improve health service delivery and health outcomes.

Each country snapshot includes annexes that contain further information about the EPHS. When available, this includes the country’s most recently published package; a comparison of the country’s package to the list of priority reproductive, maternal, newborn and child health interventions developed by the Partnership for Maternal, Newborn and Child Health in 2011 (PMNCH 2011), and a profile of health equity in the country.

1

THE ESSENTIAL PACKAGE OF HEALTH SERVICES (EPHS) IN UGANDA

Uganda’s EPHS is referred to as the Uganda National Minimum Health Care Package (UNMHCP). The UNMHCP was first established in the 1999/2000 National Health Policy, accompanied by the country’s first Health Sector Strategic Plan. Health sector policy documents have continued to center around the concept of the UNMHCP. The most recent revision of the UNMHCP is included at a high level in the Second National Health Policy. The high-level package is restated in the country’s Health Sector Strategic and Investment Plan 2010/11– 2014/15. Annex A is a selection from this policy document. The selection contains the high-level UNMHCP, which states four main categories of health services, and the specific priority interventions under each category. The four main categories of the UNMHCP are:

A. Health promotion, environmental health, disease prevention, and community health initiatives, including epidemic and disaster preparedness and response

B. Maternal and Child Health

C. Prevention, management, and control of communicable diseases

D. Prevention, management, and control of noncommunicable diseases

Additionally, the selection from the Health Sector Strategic and Investment Plan 2010/11– 2014/15 in Annex A includes a slightly different list of priority categories for financial investment by the government and donors, which some may interpret as a separate version of the country’s EPHS:

Sexual and reproductive health: in recognition of the slow progress being made toward attaining good health outcomes relating to this area of services

Child health: in recognition of the need to accelerate implementation of cost-effective interventions to improve child health

Health education: in recognition of the critical role that addressing health factors plays in attaining the overall health goals

Control and prevention of communicable diseases (HIV, AIDS, malaria, and tuberculosis): in recognition of their major contribution to the overall disease burden

According to the Health Sector Strategic and Investment Plan 2010/11–2014/15, the above categories should have first priority above other investments by both government and donors.

2

Priority Reproductive, Maternal, Newborn and Child Health Interventions To see a comparison of Uganda’s EPHS and the priority reproductive, maternal, newborn and child health (RMNCH) interventions (PMNCH 2011), refer to Annex B.

Status of Service in EPHS Status Definition # of Services

Included

The literature on the essential package specifically mentioned that this service was included. 37

Explicitly Excluded

The literature on the essential package specifically mentioned that this service was not included. 1

Implicitly Excluded This service was not specifically mentioned, and is not clinically relevant to one of the high-level groups of services included in the essential package. 0

Unspecified The literature on the essential package did not specifically mention this service, but this service is clinically relevant to one of the high-level groups of services included in the essential package.

22

The following priority RMNCH intervention is explicitly excluded from Uganda's EPHS:

Safe abortion

Use of Selected Priority Services The table below presents the country’s data on common indicators.

Indicator Year Value Urban Value Rural Value

Pregnant women sleeping under insecticide-treated nets (%) 2011 55.5 45.7

Births attended by skilled health personnel (in the five years preceding the survey) (%)

2011 89.1 52.8

BCG immunization coverage among one-year-olds (%) 2013 93

Diphtheria tetanus toxoid and pertussis (DTP3) immunization coverage among one-year-olds (%)

2013 78

Median availability of selected generic medicines (%)– private 2004 80

Median availability of selected generic medicines (%)– public 2004 20 Source: Global Health Observatory, World Health Organization.

3

How the Health System Delivers the EPHS RMNCH services from the EPHS are delivered through:

government-sponsored community health workers

public sector primary care facilities

public sector referral facilities

Health sector management rests mainly with local governments at the district level. The local government plans, budgets, and implements health policies; manages and supervises the public sector health facilities; and regulates private sector health facilities in the district. The UNMHCP was developed for all levels of the health system and for both the public and private sector. According to the Health Sector Strategic and Investment Plan 2010/11-2014/15, private sector health facilities account for about 50 percent of health sector outputs in Uganda. Private not-for-profit health facilities are more structured, and are prominently present in rural areas; and the (less-structured) private for-profit sector is growing rapidly in urban centers. The government has subsidized some private sector facilities.

The public sector health care delivery system includes hospitals, health centers, and village health teams. Village health teams facilitate health promotion, service delivery, and community participation and empowerment in access to and use of health services. Health centers (HCs) are classified as HC II-IV. HC IIs provide the first level of interaction between the community and the health system, and provide only outpatient services, outreach, and linkages with village health teams.

As of 2010, the country had two public sector national referral hospitals, which operated semi-autonomously; 11 public sector regional referral hospitals; and 52 public sector general hospitals. There were also 56 private not-for-profit hospitals and nine private for-profit hospitals. The government owns about half of the health care facilities in Uganda, and has been trying to scale up the infrastructure in recent years.

Delivering the EPHS to Different Population Groups The government's strategy for implementing the EPHS includes specific activities to improve equity of access for specific populations; these include:

women, and

rural populations

See Annex C for the World Health Organization's full health equity profile of Uganda based on data from a 2011 Demographic and Health Survey.

Key findings from the health equity profile include:

Antenatal care coverage is similar across wealth quintiles, education levels, and places of residence (urban versus rural).

Percentage of births attended by skilled health personnel is positively associated with wealth, higher education, and urban place of residence. Only 55 percent of rural births are attended by skilled health personnel compared to 90 percent of urban births.

Immunization coverage is also similar between wealth quintiles, education levels, and place of residence.

4

The Second National Health Policy specifies the following populations to be targeted for improving their access to the UNMHCP: mothers, children, and vulnerable populations.

Additionally, the government has been working to establish village health teams in all districts across the country to better serve hard-to-reach populations. In 2010, coverage of village health teams was still low nationally (Health Sector Strategic and Investment Plan 2010/11-2014/15).

Recently, the Ugandan and international community have expressed concerns related to marginalization of certain vulnerable groups and equitable access to health services (http://www.hrw.org/node/129329).

Providing Financial Protection for the EPHS Community-based insurance is available in parts or all of the country.

All services included in the EPHS are legally exempt from user fees on a national scale.

The government formally abolished user fees in public sector facilities in 2001, but the government is aware that unofficial fees demanded by public sector health workers are still a financial barrier to accessing health services for much of the population (Health Sector Strategic and Investment Plan 2010/11-2014/15).

Social health insurance for formal or informal sector workers is not currently available in Uganda. The National Health Insurance Bill 2007 would require civil servants and formally employed Ugandans to make mandatory contributions to the National Social Health Scheme. However, this bill has not become law at this time. Dr. Asuman Lukwago, the Permanent Secretary in the Ministry of Health, stated that the scheme will start operating this year since they are in the final stages of drafting the law (The Independent 2015). While tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection, and limited cross-subsidy. A few community-based insurance initiatives cover about 2 percent of the catchment population, but most of them face severe sustainability problems (Zikusooka et al. 2009).

5

SOURCES

Ministry of Health, Republic of Uganda. Health Sector Strategic Plan 2000/01–2004/05. Kampala.

Ministry of Health, Republic of Uganda. Health Sector Strategic Plan II 2005/06–2009/10. Kampala.

Ministry of Health, Republic of Uganda. Health Sector Strategic & Investment Plan: Promoting People’s Health to Enhance Socio-economic Development 2010/11–2014/15. Kampala.

Ministry of Health, Republic of Uganda. Manual of the National Tuberculosis and Leprosy Programme, second edition. 2010. Kampala.

Ministry of Health, Republic of Uganda. National Adolescent Health Policy for Uganda. 2004. Kampala.

Ministry of Health, Republic of Uganda. National Antiretroviral Treatment and Care Guidelines for Adults, Adolescents and Children. January 2008. Kampala.

Ministry of Health, Republic of Uganda. National Policy Guidelines and Service Standards for Reproductive Health Services. May 2001. Kampala.

Ministry of Health, Republic of Uganda. The Integrated National Guidelines on Antiretroviral Therapy, Prevention of Mother to Child Transmission of HIV and Infant & Young Child Feeding (1st edition). June 2011. Kampala.

Ministry of Health, Republic of Uganda. The Second National Health Policy: Promoting People’s Health to Enhance Socio-economic Development. July 2010. Kampala.

Ministry of Health, Republic of Uganda. Uganda Clinical Guidelines 2012 Revision: National Guidelines for Management of Common Conditions. Kampala.

Ministry of Health, Republic of Uganda. Uganda National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights: Addendum to Section 3.8: Family Planning Service Standards.

Partnership for Maternal, Newborn & Child Health. 2011. A Global Review of the Key Interventions Related to Reproductive, Maternal, Newborn and Child Health (RMNCH). Geneva, Switzerland: PMNCH.

The Independent. “Social health insurance faces tough hurdle in Parliament.” By Nassaka F. Published January 11, 2015. Accessed at http://www.independent.co.ug/features/features/9631-social-health-insurance-faces-tough-hurdle-in-parliament

Uganda: EquityProfile - Reproductive, Maternal, Newborn and Child Health Services. World Health Organization. Accessed February 2015 at http://www.who.int/gho/health_equity/countries/en/

Zikusooka, C.M., R. Kyomuhang, J.N. Orem, and M. Tumwine. Is Health Care Financing in Uganda Equitable? African Health Sciences 2009 9(S2):S52-S58.

7

http://www.independent.co.ug/features/features/9631-social-health-insurance-faces-tough-hurdle-in-parliament

http://www.independent.co.ug/features/features/9631-social-health-insurance-faces-tough-hurdle-in-parliament

http://www.who.int/gho/health_equity/countries/en/

ANNEX A. UGANDA'S EPHS

9

Ministry of Health

HEALTH SECTOR STRATEGIC& INVESTMENT PLAN

Promoting People’s Health to Enhance Socio-economic Development

2010/11 – 2014/15

July 2010

Health Sector Strategic & Investment Plan

HSSIP 2010/11 – 2014/15 53

4: Improve !"#$%!&$'(and budget effectiveness

REC 3: Better understanding of investments needed to achieve the health outputs being sought.REC 7: A comprehensive Health Financing Strategy

NHP 7: Increasing motivation, productivity, performance, integrity and ethical behaviour of HR)*+(,-(.&/01%&2(3453(!//!&3%567(!"#$5$%80/7(/5"!7(9056%3'(5&:(affordable medicines are available, and used rationally)*+(;-(+18<%:%&27(5&:(=5%&35%&%&2("0&$3%8&567(!"#$%!&3(/5"!7(environmentally friendly and sustainable health infrastructure)*+(>?-(@8A%6%B%&2(/0"#$%!&3(#&5&$%56(1!/801$!/(38("0&:(34!(health sector programmes

5: Deepen health stewardship

REC 5: Comprehensive knowledge management approach is needed in the sectorREC 8: Scale up sector coordination and partnership.

NHP 1: Strengthening the organization and management of the national health systemsNHP 3: Building a harmonized and coordinated national health information systemNHP 4: Creating a culture in which health research plays a /%2&%#$5&3(186!(%&(20%:%&2(C86%$'NHP 5: Reviewing and developing relevant acts and regulations governing health)*+(>?-(@8A%6%B%&2(/0"#$%!&3(#&5&$%56(1!/801$!/(38("0&:(34!(health sector programmesNHP 11: Effectively building and utilising the full potential of the public and private partnershipsNHP 12: Strengthening collaboration between the Health Sector, and other Government Ministries and departmentsNHP 13: Implementing the National Health Policy and HSSP’s within the Sector Wide Approach and IHP+ framework,

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HSSIP 2010/11 – 2014/1554

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Service cluster Intervention areas

Cluster 1: Health Promotion, Environmental Health, Disease Prevention and Community Health Initiatives, including epidemic and disaster preparedness and response

Promote individual and community responsibility for better healthD8&31%A03!(38(34!(5335%&=!&3(8"(5(/%2&%#$5&3(1!:0$3%8&(8"(=81A%:%3'(5&:(=81356%3'(:0!(38(!&<%18&=!&356(health and unhygienic practices and other environmental health related conditions.Reducte morbidity and mortality due to diarrhoeal diseasesImproveme the health status of the school children, their families and teachers and to inculcate appropriate health seeking behaviour among this population..&/01!(!90%35A6!(5$$!//(A'(C!8C6!(%&(+EF+(:%/31%$3/(G%&($8&H%$3(5&:(C8/3I$8&H%$3(/%3053%8&/J(38(*!5634(ServicesPrevent, detect, and promtly respond to health emergencies and other diseases of public health importance.Scale up delivery of nutrition services

Cluster 2: Prevention, Management and Control of Communicable Diseases

Prevent STI/HIV/TB transmission and mitigation of the medical and personal effects of the epidemic.Reduce the morbidity, mortality and transmission of tuberculosis.Sustain the elimination of leprosy in all the districts.Reduce the morbidity and mortality rate due to malaria in all age groups.@5%&35%&(34!(K0%&!5(L81=("1!!(/3530/(8"(34!($80&31'(3418024(=5%&3!&5&$!(8"(4%24(9056%3'(C8/3I$!13%#$53%8&(surveillance.Eradicate onchocerciasis and its vector in all endemic districts in UgandaAchieve the global target for the elimination of trachoma.Reduce, and ultimately interrupt transmission of the disease in all endemic communities through the use of chemotherapy with Ivermectin and albendazole.Eliminate sleeping sickness as a public health problem in Uganda.

Reduce morbidity caused by the worms by decreasing the worm burden among communitiesReduce morbidity and mortality due to Leishmaniasis among the endemic communitiesReduce morbidity and mortality due to endemic , emerging and re-emerging zoonotic diseases

Cluster 3: Prevention, Management and Control of Non-Communicable Diseases

Prevent Type 1 and Type 2 diabetes and reduce morbidity and mortality attributable to diabetes and its complications.Prevent cardiovascular and related diseases and reduce morbidity and mortality attributable to CVDsEstablish a national framework for cancer control with emphasis on cancer preventionPrevent chronic respiratory diseases and reduce morbidity and mortality attributable to COPD and asthmaReduce the morbidity and mortality associated with sick cell disease.Decrease the morbidity and mortality due to injuries, common emergencies and disabilities from visual, hearing and age-related impairments.Ensure increased access to primary and referral services for mental health, prevention and management of substance abuse problems, psychosocial disorders and common neurological disorders such as epilepsy.Improve the oral health of the people of Uganda by promoting oral health and preventing, appropriately treating, monitoring and evaluating oral diseases.Improve the quality of life of terminally ill patients and their families especially the home carers

Cluster 4: Maternal and Child Health

Reduce mortality and morbidity relating to sexual and reproductive health & rightsImprove newborn health and survival by increasing coverage of high impact evidence based interventions, in order to accelerate the attainment of MDG 4.Scale up and sustain high, effective coverage of a priority package of cost-effective child survival %&3!1<!&3%8&/(%&(81:!1(38(1!:0$!(0&:!1(#<!(=81356%3'MPrevent morbidity and mortality due to gender based violence.


HSSIP 2010/11 – 2014/15 55

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5.2.1.1 Promote individual and community responsibility for better healthC+'1("6"%,&)>6#>+(6&.'6"'@72&(S#>5'7&(%5&3+()0)'7&)-%70#>#'&7-8'&-@&#$'&8(/-+&5'#'+8"%(%#7&-@&$'(6#$&7''="%,&.'$(1"->+&"%&8-7#&U@+")(%&)->%#+"'7:&E,(%5(&"7&%-&'V)'30-%&<"#$&WXY&-@&#$'&3'-36'&7''="%,&)(+'&@+-8&;JLC7&.'@-+'&+'7-+0%,&#-&8-5'+%&$'(6#$&@()"6"0'7:&C'-36'&8",$#&.'&",%-+(%#&(.->#&#$'&('0-,4&-@&5"7'(7'&(%5&$-<&#-&3+'1'%#&"66&$'(6#$:&BCQ&$'637&#-&(55+'77&#$'7'&"77>'7&(%5&7$->65&#$'+'@-+'&.'&(&)-83-%'%#&-@&(66&$'(6#$&3+-,+(88'7&(7&"#&3+-8-#'7&.'$(1"->+(6&)$(%,':&

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


HSSIP 2010/11 – 2014/1556

5'8(%5:&J>++'%#64&$(6@&-@&#$'&5"7#+")#7&$(1'&$'(6#$&'5>)(#-+7&<$"6'&8-7#&-@&#$'&%'<&-%'7&-%64&$(1'&-%'&-+&%-%':&;$'&L-B&<"66&(67-&+'1"#(6"7'&#$'&$'(6#$&'5>)(0-%&3+"%0%,&>%"#&(%5&@>%57&8-."6"7'5&@-+&5"77'8"%(0-%&-@&8'77(,'7&-%&#$'&`L&+(5"-&7#(0-%7:

Strategies and interventions!" !"#$%&"'$%( )*+( ,%,-.-/$0( "1( 2#,%&( .213"( 4'.%&$0( ,%( '$.5"'( .%6( #$5."$6( 2$'./,13#0( .71%&( 8$185$( ,%(

Uganda.

o C+-1"5'&6'(5'+7$"3&"%&7'S%,&7#(%5(+57&(%5&,>"5'6"%'7&@-+&#$'&3+-5>)0-%&(%5&5'6"1'+4&-@&DQJ&8'77(,'7&(8-%,&"%70#>0-%7&#$(#&(+'&+'73-%7".6'&@-+&7>)$&()01"0'7:

o I'1'6-3&(%5&5"77'8"%(#'&DQJ&8'77(,'7&-%&$'(6#$&"77>'7&#$+->,$&ZB;72&3+"%#&(%5&'6')#+-%")&8'5"(:

o a"("7'&<"#$&I'3(+#8'%#&-@&B>8(%&b'7->+)'&I'1'6-38'%#&(%5&D%70#>0-%7&-@&B",$'+&a'(+%"%,&#-&.>"65&)(3()"#4&@-+&$'(6#$&'5>)(0-%&(%5&3+-8-0-%&(%5&3+-1"5'&"%)'%01'7&@-+&BbB&#-&#(='&>3&#$'&#+("%"%,:&

!" Roll out the VHT strategy in all districts in Uganda.

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o C+-1"5'&(5'O>(#'&#--67&c':,:&+',"7#'+72&DQJ&8(#'+"(67d&#-&8(='&#$'&ZB;7&-3'+(0-%(6:

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!" )%,-."$( .%6( ,785$7$%"( .6/14.49( 8#1&#.77$0( "1( ,%:3$%4$( 8#1/,0,1%( 1;( $<$4-/$( 8#$/$%-/$( '$.5"'(services.

o C+-8-#'&#$'&5'1'6-38'%#&(%5&'%@-+)'8'%#&-@&.4'6(<7&.4&5"7#+")#&6-)(6&,-1'+%8'%#7&"%&)-%/>%)0-%&<"#$&-#$'+&6"%'&8"%"7#+"'7::

!" !"#$%&"'$%(,%"$#0$4"1#.5(5,%=.&$0(;1#('$.5"'(8#171-1%>

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Indicators with targets!" *#(%5(+57&(%5&,>"5'6"%'7&c"%)6>5"%,&)+"#'+"(&@-+&,'%5'+&7'%7"01"#4d&@-+&#$'&3+-5>)0-%&(%5&5'6"1'+4&-@&DQJ&

8'77(,'7&5'1'6-3'5&(%5&5"77'8"%(#'5&(8-%,&"%70#>0-%7&.4&[X^^e[X^[:

!" ;$'&3+-3-+0-%&-@&5"7#+")#7&<"#$&#+("%'5&ZB;7&"%)+'(7'5&@+-8&]^Y#-&^XXY&.4&[X^Te[X^f:

!" ;$'&3+-3-+0-%&-@&$'(6#$&@()"6"0'7&<"#$&DQJ&8(#'+"(67&8("%#("%'5&(#&^XXY:

Implementation arrangementsU#&#$'&%(0-%(6&6'1'62&#$'&I"1"7"-%&-@&B'(6#$&C+-8-0-%&(%5&Q5>)(0-%&(#&#$'&L-B&$'(5O>(+#'+7&<"66&#(='&#$'&6'(5&(%5&7#'<(+57$"3&+-6'&"%&"836'8'%0%,&BCQ&3+-,+(88'7:&;$'&I"1"7"-%&<"66H

!" D%&)-%/>%)0-%&<"#$&#$'&3+"1(#'&7')#-+2&J*g7&(%5&-#$'+&+'6'1(%#&M-1'+%8'%#&(,'%)"'7&5'1'6-3&(%5&+'1"'<&(&7#+(#',")&36(%&@-+&BCQ&(%5&+'6(#'5&()01"0'7:

!" J-66(.-+(#'&<"#$&73')"9)&#')$%")(6&3+-,+(88'7&"%&#$'&+'1"'<e5'1'6-38'%#&-@&3-6")42&-1'+(66&)--+5"%(0-%&(%5&,>"5(%)'&-%&BCQ&()01"0'7&)->%#+4<"5'&(%5&"#&<"66&(67-&3+-1"5'&#')$%")(6&7>33-+#&(%5&7>3'+1"7"-%&#-&IB*&"%)6>5"%,&#$'&J*g7&(%5&#$'&3+"1(#'&7')#-+:&

!" a"("7'&<"#$& -#$'+&M-1'+%8'%#& (,'%)"'7& (%5&AMg7& #-& '7#(.6"7$& (%5& +'1"'<& 7#(%5(+57& (%5& +',>6(0-%7&3'+#("%"%,&#-&BCQ&(%5&8-%"#-+&(%5&7>3'+1"7'&()01"0'7:

U#& 5"7#+")#& 6'1'6& #$'& I"7#+")#& B'(6#$& gP)'& 7$(66& .'& +'73-%7".6'& @-+& 36(%%"%,2& 8(%(,'8'%#2& 8-%"#-+"%,&


HSSIP 2010/11 – 2014/15 57

(%5& )--+5"%(0%,& DQJ& ()01"0'7& (%5& <"66& <-+=& <"#$& (66& (,'%)"'7& "%)6>5"%,& #$'& I"7#+")#& D%@-+8(0-%& gP)'2&)-88>%"#4& 5'1'6-38'%#& -P)'+72& 3+"1(#'& $'(6#$& "%70#>0-%72& +'6","->7& (%5& )>6#>+(6& "%70#>0-%7& (%5& )"1"6&7-)"'#4&-+,(%"7(0-%7:&g3'+(0-%(6&36(%7&<"66&(67-&.'&5'1'6-3'5&@-+&BCQ&<"#$&#$'&6'(5'+7$"3&-@&#$'&IBg:&U#&$'(6#$&)'%#+'&6'1'6&BCQ&()01"0'7&<"66&.'&)(++"'5&->#&.4&(1("6(.6'&$'(6#$&3+-@'77"-%(67&(%5&ZB;7&(%5&#$"7&<"66&.'&.(7'5&-%&%''5&(%5&$'(6#$&3+-.6'87&8-7#&3+'1(6'%#&(#&$->7'$-65&(%5&)-88>%"#4& 6'1'6:& ;$'&'G')01'&"836'8'%#(0-%&-@&#$"7&)-83-%'%#&-@&#$'&$'(6#$&3+-8-0-%&(%5&5"7'(7'&3+'1'%0-%&)6>7#'+&<"66&5'3'%5&-%&'G')01'&)--+5"%(0-%&(%5&(&8>607')#-+(6&(33+-()$&#-&3+-,+(88"%,&-@&BCQ&()01"0'7:&

!"#"$"#% &'()*+,-).%)'%)/.%0))0+(1.()%'2%0%3+4(+560()%*.7-6)+'(%'2%1'*,+7+)8%0(7%1'*)09+)8%7-.%)'%environmental health and unhygienic practices and other environmental health related conditions.

Q%1"+-%8'%#(6&@()#-+7&7>)$&(7&(1("6(."6"#4&-@&7(@'&<(#'+2&3"#&6(#+"%'7&(%5&7(@'&5"73-7(6&-@&<(7#'&&@()"6"0'7&(+'&8(/-+& 5'#'+8"%(%#7& -@& $'(6#$& ->#)-8'7:& ;$'& B'(6#$& C+-8-0-%2& Q%1"+-%8'%#(6& B'(6#$& (%5& J-88>%"#4&D%"0(01'7&J6>7#'+&#$'+'@-+'&@-)>7'7&-%&"83+-1"%,&#$'&(.-1'&'%1"+-%8'%#(6&$'(6#$&@()#-+7:&C--+&$4,"'%'&(%5&-#$'+&'%1"+-%8'%#(6&$'(6#$&@()#-+7&<$")$&(+'&-h'%&6"%='5&#-&5"7'(7'&(%5&3-1'+#4&(+'&#$'&8(/-+&)(>7'7&-@&"66&$'(6#$&"%&E,(%5(:&;$'&[XXW&EIB*&7$-<7&#$(#&f\Y&-@&#$'&$->7'$-657&$(1'&3"#&6(#+"%'7K&iiY&$(1'&())'77&#-&7(@'&<(#'+&7->+)'7K&ifY& 6"1'& "%&$->7'7&8(5'&-@& #'83-+(+4&8(#'+"(67K&(%5&^TY&-@&3'+7-%7&<(7$&$(%57&<"#$& 7-(3:&g%64&[fY&-@& #$'&5"7#+")#7& (+'& "836'8'%0%,&<(#'+&O>(6"#4& 7>+1'"66(%)':& ;$'+'&(+'&(&%>8.'+&-@&@()#-+7&#$(#&(+'&+'73-%7".6'&@-+&#$"7&7"#>(0-%H&"%(5'O>(#'&(66-)(0-%&-@&+'7->+)'7&@-+&'%1"+-%8'%#(6&$'(6#$&()01"0'7K&"%(5'O>(#'&$>8(%&+'7->+)'K&$",$&6'1'67&-@&3-1'+#4K&(%5&"%(5'O>(#'&@()"6"#(0-%&'73')"(664&#+(%73-+#:&J6"8(#'&)$(%,'&<$")$&"7&+'6(#'5&#-&,6-.(6&<(+8"%,&$(7&7",%"9)(%#&"83()#&-%&$>8(%&$'(6#$2&'%1"+-%8'%#&(%5&$'(6#$&7'+1")'&5'6"1'+4:&;$'&"%)+'(7'&"%&#'83'+(#>+'7&$(7&(%&"%j>'%)'&-%&#$'&,'-,+(3$")(6&+(%,'&-@&5"7'(7'7&':,&8(6(+"(& (%5& 5"(++$-'(6& +'6(#'5& "66%'77'7:& J6"8(#'& 3(N'+%7& 7>)$& (7& Q6& A"%-& +'7>6#& "%#-& j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

Strategies and key interventions!" ?6/14."$( .%6( 8#171"$( ,78#1/$6( 0.%,".-1%( .%6( '9&,$%$( .0( 6$".,5$6( ,%( "'$( @.78.5.( A$45.#.-1%( 1%(

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o *'%7"0k'& 3-6"0)(62& +'6","->7& (%5& )>6#>+(6& 6'(5'+7& -%& #$'& "83-+#(%)'& -@& 7(%"#(0-%& (%5& $4,"'%'&3+-8-0-%:

o D836'8'%#&C(+0)"3(#-+4&B4,"'%'&(%5&*(%"#(0-%&;+(%7@-+8(0-%7&cCBU*;d&(%5&J-88>%"#4&a'5&;-#(6&*(%"#(0-%&cJa;*d:

o E35(#'& 7="667& -@& 7#(G& "%& #$'& Q%1"+-%8'%#(6& B'(6#$& I"1"7"-%& (%5& #$'& 3+"1(#'& 7')#-+& -%& '8'+,"%,&#')$%-6-,"'7&5'(6"%,&<"#$&#$'&3+-8-0-%&-@&7(%"#(0-%&(%5&$4,"'%':

!" Support and encourage Local Governments to formulate ordinances and bye-laws on environmental health and ensure that they are enforced.

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o g+"'%#&6-)(6&,-1'+%8'%#7&"%&#$'&5'1'6-38'%#&(%5&"836'8'%#(0-%&-@&'%1"+-%8'%#(6&$'(6#$&.4'&6(<7&(%5&-+5"%(%)'7:


HSSIP 2010/11 – 2014/1558

o *'%7"07'&6(<&'%@-+)'+7&-%&%'<&.4'&6(<7&(%5&-+5"%(%)'7:

!" Strengthen the capacity of public and private health care providers in health care waste and industrial waste management.

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o *'%7"07'&"%5>7#+"(6&8(%(,'+7&-%&7(@'&"%5>7#+"(6&<(7#'&8(%(,'8'%#:

o Q%@-+)'&#$'&3+-1"7"-%&-@&"%5>7#+"(6&<(7#'&8(%(,'8'%#&7'+1")'7:

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!" Support and advocate for food hygiene and safety, safe water chain and hand washing with soap and mass hand washing campaigns.

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o J--+5"%(#'&)6"8(#'&)$(%,'&+'73-%7'&"%#'+1'%0-%7&"%&#$'&$'(6#$&7')#-+&(%5&)-66(.-+(#'&<"#$&+'6'1(%#&6"%'&8"%"7#+"'7&(%5&(,'%)"'7:

!" !"#$%&"'$%C(03881#"(.%6(,78#1/$(*%/,#1%7$%".5(D$.5"'(B.%.&$7$%"()%;1#7.-1%(!90"$7(,%(21"'(E325,4(and Private sector service delivery.

o ?>"65&)(3()"#4&@-+&(66&#$'&Q%1"+-%8'%#(6&B'(6#$&7#(G&(#&(66&6'1'67&-@&,-1'+%8'%#&(%5&J*g7:

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o *>33-+#&Q%1"+-%8'%#(6&B'(6#$&+'7'(+)$&(%5&5-)>8'%#(0-%:

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!" ?'&+'73-%7".6'&@-+&)--+5"%(0%,&'%1"+-%8'%#(6&$'(6#$&3+-,+(88'7:


HSSIP 2010/11 – 2014/15 59

!" ?'&+'73-%7".6'&@-+&3-6")42&,>"5'6"%'7&(%5&7#(%5(+57&5'1'6-38'%#&(%5&3'+"-5")(6&+'1"'<7&-%&(66&'%1"+-%8'%#(6&$'(6#$&(73')#7:&;$"7&<"66&.'&)(++"'5&->#&"%&6"("7-%&<"#$&='4&7#(='$-65'+7:

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!" *$(66&)(++4&->#&-3'+(0-%(6&+'7'(+)$2&5(#(&)-66')0-%2&>06"7(0-%&(%5&5-)>8'%#(0-%&-@&.'7#&3+()0)'7:

U#&5"7#+")#& 6'1'62& #$'&IBg&<"66&.'&+'73-%7".6'& @-+&)--+5"%(0%,&#$'7'&()01"0'7&<"#$& #')$%")(6& 7>33-+#& @+-8&#$'&L-B&$'(5O>(+#'+7:&U#&B*I&6'1'62&#$'&"%F)$(+,'&<"#$&7>33-+#&@+-8&#$'&B'(6#$&D%73')#-+7&<"66&)--+5"%(#'&()01"0'7:&;$'&B'(6#$&U77"7#(%#&7$(66&)--+5"%(#'&#$'&'%1"+-%8'%#(6&$'(6#$&()01"0'7&(#&7>.F)->%#4&6'1'6&<$"6'&(#&)-88>%"#4&6'1'6&ZB;7&7$(66&.'&+'73-%7".6'&@-+&)+'(0%,&(<(+'%'77&(.->#&#$'7'&"%#'+1'%0-%7:&L-%"#-+"%,&(#&)-88>%"#4&6'1'6&7$(66&.'&#$'&+'73-%7"."6"#4&-@&(&#')$%")(6&7#(G&@+-8&#$'&7>.F)->%#4:

5.2.1.3 Reduce morbidity and mortality due to diarrhoeal diseases I"(++$-'(6&5"7'(7'7&"%)6>5"%,&()>#'&<(#'+4&5"(++$-'(&#$(#&"7&%-#&)$-6'+(2&)$-6'+(2&547'%#'+4&(%5&3'+7"7#'%#&5"(++$-'(&(+'&#$'&#$"+5&6'(5"%,&)(>7'7&-@&(N'%5(%)'7&(#&$'(6#$&@()"6"0'72&(h'+&8(6(+"(&(%5&()>#'&+'73"+(#-+4&"%@')0-%:&I"(++$-'(6&5"7'(7'7&(+'&#$'&7')-%5&6'(5"%,&)(>7'&-@&)$"65$--5&5'(#$&(h'+&8(6(+"(:&I>+"%,&B**C&DD&'3"5'8")&5"(++$-'(6&5"7'(7'7&c)$-6'+(&(%5&547'%#'+4d&->#.+'(=7&<'+'&)-%#+-66'5&"%&(66&3(+#7&-@&#$'&)->%#+4:&;$'&->#.+'(=7&<'+'&5>'&8("%64& #-&3--+&7(%"#(0-%2& 6-<&7(@'&<(#'+&)-1'+(,'2&3--+&5-8'70)&(%5&3'+7-%(6&$4,"'%'&3+()0)'7&(%5&8(77&8-1'8'%#&-@&3-3>6(0-%7&F&+'@>,''7&(%5&"%#'+%(664&5"736()'5&3'+7-%7&-<"%,&#-&5"7(7#'+7&7>)$&(7&6(%576"5'72&j--572&(%5&3-7#F'6')0-%&1"-6'%)':&

U7&$(7&.''%&8'%0-%'5&"%&J$(3#'+&]&-1'+(66&#$'+'&<(7&(&5')+'(7'&"%&#$'&"%)"5'%)'&-@&5"(++$-'(6&5"7'(7'7&(%5&#$'&J`b&@-+&5"(++$-'(&(%5&)$-6'+(&5>+"%,&#$'&3'+"-5&-@&#$'&B**C&DD:&;$'+'&"7&)-%0%>"%,&%''5&@-+&7#+'%,#$'%"%,&%(0-%(6& )(3()"#4& (#& (66& 6'1'67& #-& 3+'1'%#& (%5& 'G')01'64& )-%#+-6& '3"5'8")7& -@& 5"(++$-'(:& I>+"%,& B**DC2&'83$(7"7&7$(66&.'&36()'5&-%&"%#',+(0-%&-@&"%#'+1'%0-%7&@-+&DLJD2&'%1"+-%8'%#(6&$'(6#$2&$'(6#$&3+-8-0-%&(%5&'5>)(0-%2&)(3()"#4&.>"65"%,&-@&7'+1")'&3+-1"5'+7&'73')"(664&<"#$&+',(+5&#-&#$'&%'<&5"(++$-'(&8(%(,'8'%#&3-6")"'7&c':,:&>7'&-@&k"%)d&(%5&)-88>%"#4&.(7'5&$'(6#$&()01"0'7:

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HSSIP 2010/11 – 2014/1560

Implementation arrangements;$'&)-%#+-6&-@&5"(++$-'(6&5"7'(7'7&"7&8>607')#-+(6:&D#&"7&.(7'5&-%&#$'&"%1-61'8'%#&-@&1(+"->7&7')#-+7&"%)6>5"%,&B'(6#$2& !(#'+2& Q5>)(0-%2& a-)(6& M-1'+%8'%#2& D%@-+8(0-%& (%5& gP)'& -@& #$'& C+"8'& L"%"7#'+& c5"7(7#'+&3+'3(+'5%'77&(%5&+'73-%7'd:&;$'&L-B&$'(5O>(+#'+7&<"66&5'1'6-3&-+&+'1"'<&+'6'1(%#&3-6")"'7&(%5&,>"5'6"%'7K&8-."6"7'&+'7->+)'7K&5-&%(0-%(6&6'1'6&36(%%"%,K&(%5&)(++4&->#&#')$%")(6&7>33-+#&7>3'+1"7"-%2&8-%"#-+"%,&(%5&'1(6>(0-%&-@&JII&"%#'+1'%0-%7:&B-<'1'+2&#$'&()#>(6&"836'8'%#(0-%&-@&JII&"%#'+1'%0-%7&"7&#$'&+'73-%7"."6"#4&-@&I"7#+")#& a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

5.2.1.4 Improve the health status of the school children, their families and teachers and to inculcate appropriate health seeking behaviour among this population.

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HSSIP 2010/11 – 2014/15 61

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5.2.1.5 Prevent, detect early and promptly respond to health emergencies and other diseases of public health importance.

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42


HSSIP 2010/11 – 2014/15 63

%'",$.->+"%,&5"7#+")#7d&"%&#$'&3(7#&4'(+7&+'7>6#'5&"%&8(77"1'&5"736()'8'%#&-@&#$'&3-3>6(0-%&"%#-&D%#'+%(664&I"736()'5&C'-36'7&)(837:&;$'&#(.6'&.'6-<&7$-<7&#$'&(G')#'5&5"7#+")#&(7&-@&[XXi&

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Location Northwest (West Nile) North Central North East

N'C!(8"(D8&H%$3( Armed Rebellion Armed Rebellion Deterioration of Law and Order

Districts Moyo, Adjumani, Gulu, Kitgum, Pader, Lira, Kotido, Moroto, Nakapiripirit, Soroti, Nebbi, Arua, Apac, Amuru, Dokolo, Kumi, Pallisa, Kapchorwa, Mbale,

Yumbe, Koboko, Maracha Amolatar, Oyam, Masindi and Buliisa

Sironko, Kaberamaido, Katakwi, Abim, Kaabong, Bukwo, Bukedea, Budaka,

*-8'&-@&#$'&DIC&)(837&<'+'&)-%,'7#'5&<"#$&"%(5'O>(#'&7-)"(6&"%@+(7#+>)#>+':&U))'77&#-&<(#'+&(%5&'5>)(0-%&<(7&(67-&"%(5'O>(#':&L-7#&-@&#$'&#+("%'5&$'(6#$&<-+='+7&<'+'&"%&>+.(%&(+'(7&6'(1"%,&-3'+(0-%&-@&7'+1")'7&"%&+>+(6&(+'(7&#-&>%O>(6"9'5&3'+7-%%'6:&D%&(55"0-%2&#$'&"%7')>+"#4&5"7+>3#'5&#$'&3+-1"7"-%&-@&$'(6#$&7'+1")'7&6'(5"%,&#-&)6-7>+'&-@&7-8'&$'(6#$&@()"6"0'7&(%5&7#(,%(0-%&7-8'&7'+1")'7:

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Indicator National average

Rural areas average

North Region

West Nile Region

IDPs Karamoja

Infant mortality rate, per 1,000 births 76 88 106 98 123 105Under 5 mortality rate, per 1,000 births 137 153 177 185 200 174Total fertility rate 6.7 7.1 7.5 7.2 8.6 7.2

Women using modern contraceptive methods (%)

18 15 8 11 18 0

TT2 coverage in pregnancy (%) 51 50 55 51 63 53Births with skilled birth attendant (%) 42 37 31 35 34 18DPT3 coverage in children 12-23 months (%)

64 64 67 61 84 66

Under 5 stunted children (%) 38 40 40 38 37 54Under 5 wasted children (%) 6 6 7 8 6 11

.713*)-%OEG=.PEQ&.%#HH!PRS

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Cluster 2: Control of Communicable DiseasesJ-88>%")(.6'&5"7'(7'7&())->%#&@-+&(.->#&fTY&-@&#$'&#-#(6&.>+5'%&-@&5"7'(7'&"%&E,(%5(:&L(6(+"(2&BDZeUDI*&(%5&;?&(+'&6'(5"%,&)(>7'7&-@&"66&$'(6#$&(%5&8-+#(6"#4:&B**C&DD&3+"-+"0k'5&#$'&3+'1'%0-%&(%5&)-%#+-6&-@&)-88>%")(.6'&5"7'(7'7&"%&-+5'+&#-&+'5>)'&#$'&$",$&%(0-%(6&5"7'(7'&.>+5'%:&;$'&3+"-+"#4&$'(6#$&)(+'&"%#'+1'%0-%7&"%&#$'&J6>7#'+&-@&C+'1'%0-%&(%5&J-%#+-6&-@&J-88>%")(.6'&I"7'(7'7& "%)6>5'H&C+'1'%0-%&(%5&J-%#+-6&-@& *;DeBDZeUDI*2& C+'1'%0-%& (%5& J-%#+-6& -@&L(6(+"(2& C+'1'%0-%& (%5& J-%#+-6& -@& ;>.'+)>6-7"7& (%5& '6"8"%(0-%& (%5e-+&'+(5")(0-%&-@&7-8'&3(+0)>6(+&5"7'(7'7&7>)$&(7&a'3+-742&M>"%'(&!-+82&g%)$-)'+)"(7"72&;+()$-8(2&a483$(0)&`"6(+"(7"72&(%5&;+43(%-7-8"(7"7&7-"6&#+(%78"N'5&$'68"%#$7&(%5&*)$"7#-7-8"(7"7:&;$'&-1'+(66&-./')01'&@-+&#$'&)-88>%")(.6'&5"7'(7'7&)6>7#'+&"7&#-&+'5>)'&#$'&3+'1(6'%)'&(%5&"%)"5'%)'&-@&)-88>%")(.6'&5"7'(7'7&.4&(#&6'(7#&fXY&(%5&#$>7&)-%#+".>#'&#-<(+57&()$"'1"%,&#$'&$'(6#$&+'6(#'5&LIM7&(%5&#$'&-1'+(66&,-(6&-@&#$'&AIC:&;$"7&7')0-%&3+-1"5'7&5'#("67&@-+&'()$&5"7'(7'&"%&#$"7&)6>7#'+&"%)6>5"%,&#$'&-./')01'72&7#+(#',"'7&(%5&#(+,'#7:&

5.2.1.8 Prevent STI/HIV/TB transmission and mitigate the medical and personal effects of the epidemic. D%7"5'&(&O>(+#'+&-@&(&5')(5'2&BDZeUDI*&+'8("%7&(&8(/-+&$'(6#$&)-%)'+%:&E,(%5(&$(7&8(5'&,+'(#&3+-,+'77&"%&BDZeUDI*&7'+1")'&5'6"1'+4&(%5&3+'1'%0-%&7"%)'&#$'&(51'%#&-@&#$'&'3"5'8")&"%&^\m[:&&?4&*'3#'8.'+&[XX\2&BDZ&

44 Ministry of Health. (2009). Policy guidelines on infant and young child feeding. Kampala: Ministry of Health.MoH.


HSSIP 2010/11 – 2014/1568

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45 CRANE Study 2009


HSSIP 2010/11 – 2014/15 69

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Strategies and interventions !" Expand and consolidate high-quality DOTS services in all districts by 2015.

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HSSIP 2010/11 – 2014/15 71

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HSSIP 2010/11 – 2014/1572

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5.2.1.10 Sustain the elimination of leprosy in all the districts. I>+"%,&B**C&DD2&#$'&'6"8"%(0-%&7#(#>7&-@&3+'1(6'%)'&-@&6'77&#$(%&^&6'3+-74&3(0'%#7&3'+&^X2XXX&3-3>6(0-%7&<$")$&<(7&()$"'1'5&"%&^\\T&%(0-%(664&(%5&(&747#'8&-@&8-%"#-+"%,&6'3+-74&'6"8"%(0-%&(#&%(0-%(6&(%5&5"7#+")#&6'1'67&$(1'&.''%&8("%#("%'5:&b'$(."6"#(01'&7'+1")'7&6"='&@--#&<'(+2&3+-7#$'7"7&(%5&7-)"-F')-%-8")&()01"0'7&@-+&3'+7-%7&(G')#'5&.4& 6'3+-74&$(7&.''%&8("%#("%'5& "%&(66& #$'&7"V&%(0-%(6&)'%#+'7:&;$"7& 7>))'77&)->65&.'&$(83'+'5& .4& '6"8"%(0-%& -@& #$'& 3-7"0-%& -@& I"7#+")#& ;?& (%5& a'3+-74& *>3'+1"7-+7& cI;a*d& 5>+"%,& #$'& a-)(6&M-1'+%8'%#&+'7#+>)#>+"%,&'V'+)"7'&<"#$&#$'&3-#'%0(6& #-& 6-<'+&#$'&O>(6"#4&-@&7>33-+#&7>3'+1"7"-%&#-&>%"#7&(%5&7>7#("%"%,&=%-<6'5,'&(%5&7="667&@-+&a'3+-74&(8-%,7#&#$'&,'%'+(6&$'(6#$&<-+='+7&<"#$&+'5>)'5&3+'1(6'%)'&+'8("%7&(&)$(66'%,':&

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Strategies and key interventions!" Strengthen the capacity of health workers to diagnose and treat leprosy cases.

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5.2.1.11 Reduce the morbidity and mortality rate due to malaria in all age groups. L(6(+"(& +'8("%7& -%'&-@& #$'&8(/-+& )(>7'7& -@&8-+."5"#4& (%5&8-+#(6"#4& "%&E,(%5(:&I>+"%,&B**C& DD& 3+-,+'77&<(7&8(5'&"%&#'+87&-@&7''="%,&#+'(#8'%#&<"#$"%&[T&$->+7&(h'+&#$'&-%7'#&-@&@'1'+&(7&<'66&(7&)-1'+(,'&-@&Db*2&D;A7&(%5&(1("6(."6"#4&-@&(%08(6(+"(67&"%&$'(6#$&@()"6"0'7&(#&(66&6'1'67:&;$'7'&8-5'7#&,("%7&<'+'&>%5'+3"%%'5&


HSSIP 2010/11 – 2014/15 73

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Strategies and interventions!" Strengthen measures to control malaria transmission.

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HSSIP 2010/11 – 2014/1574

!" ;$'&3+-3-+0-%&-@&3+',%(%#&<-8'%&<$-&$(1'&)-836'#'5& DC;[&>3#(='& "%)+'(7'5& @+-8&T[Y&#-&mXY&.4&[X^f:

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HSSIP 2010/11 – 2014/15 75

5.2.1.12 Maintain the Guinea Worm free status of the country through maintenance of high % % <-09+)8%='3)C6.*)+560)+'(%3-*E.+990(6."%

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HSSIP 2010/11 – 2014/1576

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cJLI7d:&U7& (& +'7>6#2& #$'&JLI*& @("6& #-&5-&(5'O>(#'&)-88>%"#4&8-."6"k(0-%:&;$'+'&"7&#$'+'@-+'&(&%''5&@-+&7>7#("%'5&(51-)()4&@-+&JI;D&"836'8'%#(0-%&(#&(66&6'1'67&(%5&#-&"%#',+(#'&"836'8'%#(0-%&(%5&7>3'+1"7"-%&-@&(66&)-88>%"#4&"%#'+1'%0-%7:&

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5.2.1.14 Achieve the global target for the elimination of trachoma. E,(%5(&"7&(&7",%(#-+4&#-&#$'&!Bg&(66"(%)'&@-+&#$'&M6-.(6&Q6"8"%(0-%&-@&;+()$-8(&cMQ;d&.4&[X[X:&;+()$-8(&"7&=%-<%&#-&.'&'%5'8")&"%&[T&5"7#+")#7&<$'+'&(.->#&iXX2XXX&)$"65+'%&.'6-<&#$'&(,'&-@&^X&4'(+7&$(1'&()01'&5"7'(7'&(%5&(.->#&i&8"66"-%&3'-36'&(+'&(#&+"7=&-@&.'"%,&"%@')#'5:&C+'5-8"%(%#64&#+()$-8(&(G')#7&3'-36'&<"#$&3--+&())'77&#-&<(#'+2&7(%"#(0-%&(%5&$'(6#$&7'+1")'7:&D#&"7&(67-&'708(#'5&#$(#&-1'+(662&Ti2XXX&3'-36'&"%&E,(%5(&(+'&.6"%5&@+-8&1(+"->7&@-+87&-@&#+()$-8(:&

I>+"%,&B**C&DD&(&7>+1'4&<(7&5-%'&#-&O>(%0@4&#$'&.>+5'%&-@&#+()$-8(&"%&^\&5"7#+")#7:&;$'&3+'1(6'%)'&-@&()01'&(%5&%-%F()01'&;+()$-8(&"%&(66&#$'&7>+1'4'5&5"7#+")#7&<(7&8-+'&#$(%&[XY&(%5&8-+'&#$(%&TY2&+'73')01'642&<$")$&(+'&(.-1'&#$'&#$+'7$-65&7'#&.4&!Bg&@-+&8(77"1'&(%0."-0)&5"7#+".>0-%2&<"#$&#$+''&.'"%,&$43'+'%5'8")&c;`vWfYdTW:&;$'&)-%#+-6&-@&#+()$-8(&"7&$"%5'+'5&.4&7$-+#(,'&-@&BbB2&6-<&@>%5"%,&6'1'67&(%5&6-<&3+"-+"0'7&())-+5'5&#-&#$'&5"7(."6"#4&7')#-+&"%&,'%'+(6&(#&(66&6'1'67:&U7&(&7",%(#-+4&#-&MQ;&E,(%5(&"7&)-88"N'5&#-&'6"8"%(#'&#+()$-8(&#$+->,$&#$'&*U`Q&7#+(#',4Ti&(7&5'1'6-3'5&(%5&+')-88'%5'5&.4&!Bg:

46 Ministry of Health. (2007). Trachoma Control Strategic Plan 2007-2010. Kampala: Ministry of Health47SAFE is an acronym for a comprehensive strategy which combines treatment with public health education and environmental health


HSSIP 2010/11 – 2014/15 77

Strategies and interventions!" Build the capacity of health workers to provide services to patients suffering from trachoma.

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!" ;$'&3+-1"7"-%&-@&7>+,")(6&7'+1")'7&#-&3(0'%#7&<"#$&#+")$"(7"7&"%)+'(7'5&@+-8&^XY&#-&]XY&.4&[X^f:

!" A>8.'+&-@&6"5&+-#(0-%&7>+,'-%7&#+("%'5:

5.2.1.15 Reduce and ultimately interrupt transmission of the disease in all endemic communities through the use of chemotherapy with Ivermectin and albendazole.

I>+"%,&B**C&DD&8(77&8'5")"%'&(58"%"7#+(0-%&<(7&7)(6'5&>3&@+-8&[&3"6-#&5"7#+")#7&#-&[T&5"7#+")#7&<"#$&(&3-3>6(0-%&-@&i:[&8"66"-%&3'-36'&.'"%,&+'()$'5:&I"7(."6"#4&8(%(,'8'%#&"%"0(#'52&"%&#$'&@-+8&-@&hydrocelectomies and lymphoedema managem'%#2&<(7&>%5'+#(='%&"%&#<-&5"7#+")#7:&U&#+("%"%,&-@&#+("%'+7R&8(%>(62&9'65&,>"5'&@-+&J-88>%"#4&L'5")"%'&I"7#+".>#-+72&b',"7#'+7&(%5&DQJ&8(#'+"(67&<'+'&5'1'6-3'52&3+"%#'5&(%5&5"7#+".>#'5:&;$'&8(/-+&)$(66'%,'7&"%)6>5'5&6()=&-@&@>%57&@-+&8(77&8'5")"%'&5"7#+".>0-%&cLLId&(#&5"7#+")#&6'1'6&(%5&"%7')>+"#4&"%&7-8'&5"7#+")#7:&;$'+'&"7&7066&%''5&-@&8(33"%,&@-+&6483$(0)&96(+"(7"7&"%&#$-7'&5"7#+")#7&<$'+'&"#&$(7&%-#&4'#&.''%&5-%'K&*)(6"%,F&>3&-@&LLI&#-&)-1'+&(66&#$'&'6",".6'&5"7#+")#7&(%5&#-&5'1'6-3&(&)-83+'$'%7"1'&5"7(."6"#4&8(%(,'8'%#&3+-,+(88'&#-&.'&"836'8'%#'5&(6-%,7"5'&LLI:

Strategies and key interventions !" Improve access to chemotherapy, disability management programmes and control measures in all

endemic districts.

o C+-)>+'&(%5&5"7#+".>#'&"1'+8')0%&(%5&(6.'%5(k-6'&"%&(66&'%5'8")&5"7#+")#7&#$+->,$&"%#',+(#'5&A;I&)-%#+-6:

o J-%5>)#&8(33"%,&-@&(+'(7&@-+&6483$(0)&96(+"(7"7&"%&5"7#+")#7&<$'+'&"#&$(7&%-#&.''%&5-%':

o I'1'6-3&(%5&"836'8'%#&(&)-83+'$'%7"1'&5"7(."6"#4&8(%(,'8'%#&3+-,+(88':

o D%#',+(#'& )-%#+-6& ()01"0'7& @-+& 6483$(0)& 96(+"(7"7& "%#-& 5"7#+")#& <-+=36(%7& (%5& <"#$& -#$'+& )-%#+-6&7#+(#',"'7&7>)$&(7&aaDA7.

improvements: S: Surgery; A: Antibiotics; F: Face washing; and E: Environmental change.


HSSIP 2010/11 – 2014/1578

!" !"#$%&"'$%()*+(.4-/,-$0(;1#("'$(41%"#15(.%6(8#$/$%-1%(1;(5978'.-4(I5.#,.0,0>

o I'1'6-32&3+"%#&(%5&5"77'8"%(#'&'%5'+&7'%7"01'&DQJ&8(#'+"(67&-%&3+'1'%0-%&(%5&)-%#+-6&-@&6483$(0)&96(+"(7"7:

o Q%,(,'&ZB;7&(%5&-#$'+& )-88>%"#4&8'8.'+7& "%& )+'(0%,&(<(+'%'77&(.->#& 64383$(0)&96(+"(7"7& (#&)-88>%"#4&6'1'6:

Indicators with targets!" ;$'+(3'>0)& )-1'+(,'& @-+& #$'&(G')#'5&3'-36'&<"#$& 7"%,6'& (%%>(6& 5-7'&-@& D1'+8')0%&(%5&U6.'%5(k-6'&

"%)+'(7'5&@+-8&\]Y&#-&^XXY&.4&[X^f:

!" L(33"%,&-@&(+'(7&<"#$&6483$(0)&96(+"(7"7&)-836'#'5&"%&(66&'%5'8")&5"7#+")#7&)-%5>)#'5&.4&[X^^e^[:

!" L-+."5"#4&(%5&5"7(."6"#4&(77-)"(#'5&<"#$&6483$(0)&96(+"(7"7&+'5>)'5&.4&[fY&.4&[X^f:

5.2.1.16 Eliminate sleeping sickness as a public health problem in Uganda. I>+"%,& B**C& DD2& #$'&L-B& "%& )-%7>6#(0-%&<"#$&L"%"7#+"'7& -@& U,+")>6#>+'& 5'1'6-3'5& (& 5+(h& %(0-%(6& 3-6")4&(%5&36(%&-@&()0-%&-%&)-%#+-6&-@&#7'#7'&s&#+43(%-7-8"(7"7:&&*'1'%&cid&%'<&76''3"%,&7")=%'77&5"(,%-70)&(%5&#+'(#8'%#&)'%#+'7&<'+'&'7#(.6"7$'5&(%5&-3'+(0-%(6"7'5:&g1'+&^XX2XXX&3'-36'&<'+'&7)+''%'5&@-+&76''3"%,&7")=%'77&"%&#$'&%'<64&(G')#'5&5"7#+")#7&c*-+-02&n>8"&(%5&n(.'+(8("5-d&(%5&5+>,7&@-+&76''3"%,&7")=%'77&<'+'&(1("6'5&^XXY&-@&#$'&08':&B-<'1'+2&#$'+'&"7&6()=&-@&#+(%73-+#&@-+&#$'&7>+1'"66(%)'&7#(G&"%&#$'&9'65K&"%(5'O>(#'&*-)"(6&8-."6"k(0-%K&,+(5>(66&#$+'(#'%"%,&-@&,'-,+(3$")(6&-1'+6(3&-@&#$'&)$+-%")&5"7'(7'&<"#$&#$'&()>#'&5"7'(7'&(%5&+'7"7#(%)'&#-&L'6(+7-3+-6&cL'6:?d&"7&'7)(6(0%,&4'(+&.4&4'(+:&

;$'+'&"7&#$'+'@-+'&%''5&#-&7#+'%,#$'%&5"7'(7'&7>+1'"66(%)'&(%5&)-88>%"#4&3(+0)"3(0-%&(%5&8-."6"k'&9%(%)"(6&+'7->+)'7&@-+&3+-,+(88'&"836'8'%#(0-%:&I>+"%,&B**C&DD2&#$'&@-)>7&<(7&-%&7)(6"%,&>3&'G-+#7&#-&"%#'++>3#&#+(%78"77"-%7&#$+->,$&"%#',+(#'5&1')#-+&8(%(,'8'%#&(%5&()01'&)(7'&5'#')0-%&(%5&8(%(,'8'%#:

Strategies and key interventions!" !"#$%&"'$%("'$(4.8.4,"9(1;('$.5"'(,%0-"3-1%0("1(41%"#15(.%6(8#$/$%"(05$$8,%&(0,4=%$00>

o ;+("%&$'(6#$&<-+='+7&"%&)-%#+-6&(%5&3+'1'%0-%&-@&76''3"%,&7")=%'77:

o *'#&>3&7>+1'"66(%)'&747#'87&@-+&76''3"%,&7")=%'77:

!" Improve access to drugs for the control and treatment of sleeping sickness.

o J-%5>)#&8(77&)$'8-3+-3$46(V"7&-@&$>8(%&3-3>6(0-%7:

o J-%5>)#&()01'&7)+''%"%,&-@&)-88>%"0'7&(#&+"7=&#-&"5'%0@4&3(0'%#7&(#&(%&'(+64&7#(,':

o C+-)>+'&(5'O>(#'&O>(%00'7&-@&AQJ;&@-+&'G')01'&8(%(,'8'%#&-@&76''3"%,&7")=%'77:

!" !"#$%&"'$%(.6/14.49(.%6(014,.5(712,5,0.-1%(."(.55(5$/$50>

o I'1'6-3&(%5&5"77'8"%(#'&DQJ&8(#'+"(67&>7"%,&5"G'+'%#&8'5"(&)$(%%'67:

o U51-)(#'&@-+&(%&"%)+'(7'&"%&+'7->+)'7&(66-)(#'5&@-+&#$'&)-%#+-6&(%5&3+'1'%0-%&-@&76''3"%,&7")=%'77:

o *#+'%,#$'%&76''3"%,&7")=%'77&)-%#+-6&(%5&8(%(,'8'%#&(#&)-88>%"#4&6'1'6&>7"%,&ZB;7:

Indicators with targets!" U))'77&#-&5"(,%-70)&3+-)'5>+'7&(%5&#+'(#8'%#&-@&76''3"%,&7")=%'77&@-+&)-88>%"0'7&#-&"%)+'(7'&@+-8&

TXY&#-&mXY&.4&[X^f:


HSSIP 2010/11 – 2014/15 79

5.2.1..17 Reduce morbidity caused by the worms by decreasing the worm burden among communities;$'&"836'8'%#(0-%&-@&B**C&DD&@-)>7'5&-%&7)(6"%,&>3&)-+'&"%#'+1'%0-%7&#-&+'()$&#$'&%'<&3-3>6(0-%&(#&+"7=&"%&(55"0-%&#-&+'F#+'(#8'%#&-@&3+'1"->764&#+'(#'5&3-3>6(0-%7&"%&.-#$&#$'&)-88>%"0'7&(%5&7)$--67:&I>+"%,&B**C&DD&)-%#+-6&<(7&7)(6'5&>3&@+-8&[X&5"7#+")#7&#-&)-1'+&T[&5"7#+")#7&(%5&"#&<(7&"%#',+(#'5&<"#$&J$"65&I(47&36>7&cJICd:&J(3()"#4&.>"65"%,&@-+&7)$--6&#'()$'+7&(%5&)-88>%"#4&8'5")"%'&5"7#+".>#-+7&cJLI7d&@-+&8(77&)$'8-#$'+(34&$(7&)-%0%>'5:&U&%>8.'+&-@&$'(6#$&>%"#7&"%&,'-,+(3$")(6&(+'(7&<$")$&5-%R#&O>(6"@4&@-+&8(77&)$'8-#$'+(342&<'+'&7#-)='5&<"#$&3+(k"O>(%#'6&(%5&(6.'%5(k-6'&@-+&7'6')01'&)$'8-#$'+(34:&DQJ&8(#'+"(67&<'+'&5'7",%'52&3+-5>)'5&(%5&5"7#+".>#'5&#-&7)$--67&(%5&)-88>%"0'7&"%&(G')#'5&5"7#+")#7&@-+&7-)"(6&8-."6"k(0-%:&

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

Strategies and interventions !" !"#$%&"'$%(.6/14.49(.%6(014,.5(712,5,0.-1%(."(.55(5$/$50(;1#("'$(41%"#15(.%6(8#$/$%-1%(1;(04',0"17,.0,0>

o I'1'6-3&(%5&5"77'8"%(#'&DQJ&8(#'+"(67&-%&7)$"7#-7-8"(7"7:

o D%#',+(#'&7)$"7#-7-8"(7"7&)-%#+-6&<"#$&)$"65&36>7&5(47:

!" Improve access to treatment and control of schistosomiasis.

o D836'8'%#&3'+"-5")&8(77&)$'8-#$'+(34&(#&)-88>%"#4&6'1'6:

o J-%5>)0%,&747#'8(0)&+',>6(+&#+'(#8'%#&"%&7)$--6F(,'&)$"65+'%&(#&+"7=&-@&8-+."5"#4:

o J-%5>)#&7'6')01'&1')#-+&c7%("6d&)-%#+-6:

!" +.8.4,"9(23,56,%&(,%(41773%,-$0(.%6(04'1150("1(.66#$00("'$(8#$/$%-1%(.%6(41%"#15(1;(!4',0"1017,.0,0>

o g+"'%#&ZB;7&(%5&#'()$'+7&"%&#$'&3+'1'%0-%&(%5&)-%#+-6&-@&7)$"7#-7-8"(7"7:

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Indicators with targets!" J-1'+(,'&<"#$&8(77&)$'8-#$'+(34&"%&(66&#$'&'%5'8")&5"7#+")#7&"%)+'(7'5&@+-8&iTY&#-&^XXY&.4&[X^fTm:

!" U66&'%5'8")&5"7#+")#7&"%#',+(#'&3+'1'%0-%&(%5&)-%#+-6&8'(7>+'7&<"#$"%&#$'&5"7#+")#&<-+=&36(%7&5>+"%,&(66&#$'&4'(+7&-@&#$'&7#+(#',")&36(%:

5.2.1.18 Reduce morbidity and mortality due to Leishmaniasis among the endemic communities ;$'&)-%#+-6&-@&#$"7&5"7'(7'&"%&#$'&(+'(&<$'+'&"#&"7&'%5'8")&"%&#$'&)->%#+4&<(7&>%5'+#(='%&.4&L'5")"%7&*(%7&`+-%0'+7&cL*`d&-@&*<"#k'+6(%5&.'#<''%&[XXX&(%5&[XXW&<$'%&#$'4&cL*`e*<"#k'+6(%5d&+'6-)(#'5&#-&n()$'6".(2&n'%4(2&6'(1"%,&(&1()>>8&>%06&U>,>7#&[XXi&<$'%&#$'&I+>,7&@-+&A',6')#'5&I"7'(7'7&D%"0(01'&cIAI"d&#--=&-1'+&#$'&3+-,+(88'&(#&#$'&+'O>'7#&-@&#$'&L-B:&IAI"&"7&)>++'%#64&7>33-+0%,&)-%#+-6&()01"0'7&"%&-+5'+&#-&(N+()#&3(0'%#7&@-+&(&5+>,&)-8."%(0-%&7#>54&(#&U8>5(#&B-73"#(6:&a'"7$8(%"(7"7&"7&#$'&)-66')01'&%(8'&@-+&(&%>8.'+&-@&5"7'(7'7&<$")$&$(1'&5"1'+7'&)6"%")(6&8(%"@'7#(0-%7:&;$'&@-+8&#$(#&"7&8-7#&5'(5642&1"7)'+(6&6'"7$8(%"(7"7&cZad&"7&#$'&-%'&#$(#&"7&'%5'8")&"%&E,(%5(:&;$"7&5"7'(7'&cZad&"@&6'h&>%#+'(#'52&"%1(+"(.64&6'(57&#-&5'(#$2&#$>7&8(="%,&'(+64&5"(,%-7"7&(%5& #+'(#8'%#&(&8(N'+&-@&3(+(8->%#& "83-+#(%)':&;$'&)"+)>87#(%)'7&-@& #$'& #+(%78"77"-%&-@&#$"7&5"7'(7'&(+'&)-%0%>(664&)$(%,"%,&"%&+'6(0-%&#-&'%1"+-%8'%#(62&5'8-,+(3$")&(%5&$>8(%&.'$(1"->+(6&@()#-+7:&J$(%,'7&"%&#$'&$(."#(#&-@&#$'&%(#>+(6&$-7#&(%5&1')#-+2&BDZ&D%@')0-%2&(%5&#$'&J-%7'O>'%)'7&-@&)-%j")#2&48This is based on 9 districts in 2008/09.


HSSIP 2010/11 – 2014/1580

(66&)-%#+".>#'&#-&#$'&)$(%,"%,&6'"7$8(%"(7"7&6(%57)(3':&;--67&(1("6(.6'&@-+&#$'&)-%#+-6&-@&#$'&5"7'(7'&(+'&%-#&3+-3'+64&1(6"5(#'5:&;$'&7')#-+&<"66&<-+=&#-<(+57&+'5>)"%,&8-+."5"#4&(%5&8-+#(6"#4&5>'&#-&a'"7$8(%"(7"7&(8-%,&#$'&'%5'8")&)-88>%"0'72&#$+->,$&'83-<'+"%,&#$'&'%5'8")&)-88>%"0'7&#-&3(+0)"3(#'&"%&#$'&3+'1'%0-%&(%5&)-%#+-6&-@&#$'&5"7'(7':

Strategies and interventions!" .63)5A6<)5%6<)%*756370%/5C%23),)5+75%863/6)A4)8%;73%0)48<L/54/848

o I'36-4&D%#'+,+(#'5&1'#-+&L(%(,'8'%#&cDZLd2&>7"%,2&':,:&D;A7:

o J-%5>)#&8(33"%,&@-+&#$'&5"7'(7'&#-&'7#(.6"7$&"#7&8(,%"#>5'&(%5&'V#'%#&"%&#$'&)->%#+4:

o J-%5>)#&7-)"(6&8-."6"k(0-%&(%5&(51-)()4&)(83(",%7:

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Targets!" ;$'&8(,%"#>5'&(%5&@>66&'V#'%#&-@&#$'&5"7'(7'&"%&#$'&)->%#+4&"7&'7#(.6"7$'5&.4&[X^Xe[X^^

!" D%)+'(7'&'(+64&)(7'&5'#')0-%&#-&WXY&.4&[X^f:

Implementation arrangements for diseases targeted for elimination ;$'&I'3(+#8'%#& -@& J-88>%"#4& B'(6#$& "%& #$'&L-B& 7$(66& )--+5"%(#'& #$"7& 3+'1'%0-%& (%5& '6"8"%(0-%& (%5&7$(66&<-+=&<"#$&-#$'+&5'3(+#8'%#7&<"#$"%& #$'&L-B&(%5& #$'&'%0+'&$'(6#$& 7')#-+& #-&5'1'6-3&3-6")"'7& (%5&,>"5'6"%'7&@-+&#$'&5"7'(7'7&#(+,'N'5&@-+&'6"8"%(0-%&-+&'+(5")(0-%:&J*g7&(%5&-#$'+&,-1'+%8'%#&7')#-+7&7$(66&.'&"%1-61'5:&D#&<"66&$(1'&+'73-%7"."6"#4&(7&<'66&#-&3+-1"5'&#')$%")(6&7>33-+#&(%5&7>3'+1"7'&#$'&IBg7&<$")$&<"66&"%&#>+%&7>3'+1"7'&(%5&7>33-+#&6-<'+&6'1'6&'G-+#7:&;$'&ZB;7&(#&)-88>%"#4&6'1'6&<"66&.'&)(3()"#(#'5&#-&'5>)(#'&8'8.'+7&-@&#$'&)-88>%"#4&(.->#&#$'&)-%#+-6&(%5&3+'1'%0-%&-@&5"7'(7'7&#(+,'#'5&@-+&'6"8"%(0-%:&

Q%5'8")2&'8'+,"%,&(%5&+'F'8'+,"%,&w--%-0)&I"7'(7'7&

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HSSIP 2010/11 – 2014/15 81

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HSSIP 2010/11 – 2014/1582

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HSSIP 2010/11 – 2014/1584

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HSSIP 2010/11 – 2014/15 85

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HSSIP 2010/11 – 2014/1586

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!" D%)+'(7'5&O>(6"#4&-3'+(0-%(6&+'7'(+)$&#(+,'#'5&#-&"83+-1'&#$'&3+'1'%0-%&(%5&8(%(,'8'%#&-@&JgCI&and asthma


HSSIP 2010/11 – 2014/15 87

5.2.1.24 Reduce the morbidity and mortality associated with sick cell disease. D%&!'7#&U@+")(%&)->%#+"'7&7>)$&(7&M$(%(&(%5&A",'+"(2&#$'&@+'O>'%)4&-@&#$'&7")=6'&)'66&#+("#&"7&̂ fY&#-&]XY&<$'+'(7&"%&E,(%5(&"#&7$-<7&8(+='5&#+".(6&1(+"(0-%72&+'()$"%,&TfY&(8-%,&#$'&?((8.(&#+".'&"%&#$'&<'7#&-@&#$'&)->%#+4:&U#&#$'&L>6(,-&B-73"#(6&*")=6'&J'66&J6"%")&TWX&%'<&)(7'7&-@&7")=6'&)'66&<'+'&5"(,%-7'5&"%&[XXf2&ffW&3(0'%#7&"%&[XXW2&Tf\&3(0'%#7&"%&[XXi&(%5&Tf\&3(0'%#7&"%&[XXm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b',"-%(6&@()"6"0'7&(+'&4'#&#-&.'&'7#(.6"7$'5&<"#$"%&#$'&)->%#+4:&;+("%"%,&-@&(33+-3+"(#'&8(%3-<'+&(%5&3+-)>+"%,& #$'& +'O>"+'5&'O>"38'%#& "7& 7066& (&.",&)$(66'%,':&E%5'+&#$'&*")=6'&)'66& D%"0(01'2&3(0'%#7& 2&3(+'%#7&(%5&<'66&<"7$'+7&$(1'&@-+8'5&#$'&*")=6'&)'66&U77-)"(0-%&<$")$&5'6"1'+7&)-88>%"#4&$'(6#$&'5>)(0-%&(%5&)->%7'6"%,&#-&3'+7-%7&6"1"%,&@(+&@+-8&&#$'&%(0-%(6&#'()$"%,&$-73"#(6:&g1'+& #$'&%'V#&f&4'(+7&3+"-+"#4&<"66& .'&,"1'%& #-& +("7"%,&(<(+'%'77&(.->#& #$'&5"7'(7'2& @-+8>6(0%,&3-6")"'7&-%&8(%(,'8'%#&-@&7")=6'&)'662&)(3()"#4&.>"65"%,&(%5&'V3(%5"%,&())'77&#-&7'+1")'7:

Strategies and interventions!" !"#$%&"'$%(8325,4(.G.#$%$00(8#1&#.77$0(;1#( "'$(41%"#15C(8#$/$%-1%(.%6(7.%.&$7$%"(1;(6,.2$"$0( ,%(

Uganda.

o C+-8-#'& )-88>%"#4& '5>)(0-%2& "%)6>5"%,& $'(6#$& )->%7'6"%,2& (%5& (77-)"(#'5& '#$")(6& (%5& 7-)"(6&"77>'7:

o U51-)(#'&@-+&@-+8>6(0-%&-@&3-6")"'7&(%5&,>"5'6"%'7&@-+&7")=6'&)'66&3+'1'%0-%&(%5&8(%(,'8'%#::

o D%)+'(7'&())'77&#-&7")=6'&)'66&7)+''%"%,&(%5&5"(,%-70)&7'+1")'7o Q7#(.6"7$&*")=6'&)'66&)6"%")7&(#&'1'+4&b',"-%(6&b'@'++(6&B-73"#(6:o QO>"3&*")=6'&)'66&)6"%")7&<"#$&.(7")&@()"6"0'7&(%5&'O>"38'%#&#-&)-%5>)#&7)+''%"%,&(%5&5"(,%-70)&#'7#7&

cJ?J&#'7#72&E+"%(647"7&(%5&B?&'6')#+-3$-+'7"7d:

!" Improve the policy environment for management of sickle cell disease

o `-+8>6(#'&3-6")"'7&(%5&,>"5'6"%'7&-%&7")=6'&)'66&5"7'(7':&

!" Build capacity to improve quality of sickle cell care

o ;+("%&$'(6#$&<-+='+7&-%&7")=6'&)'66&"77>'7&(%5&8(%(,'8'%#&-@&7")=6'&)'66&5"7'(7':&

o *#+'%,#$'%&"%F7'+1")'&#+("%"%,&-%&7")=6'&)'66&5"7'(7':!"Create and sustain partnerships for the control and management of sickle cell

o Q%)->+(,'&#$'&@-+8(0-%&-@&*")=6'&)'66&(77-)"(0-%7&"%&1'+4&b',"-%(6&b'@'++(6&B-73"#(6:

o Q7#(.6"7$& 3(+#%'+7$"37& (%5& 7#+'%,#$'%& )-66(.-+(0-%& <"#$& ='4& 7#(='$-65'+7& ':,:& 8"%"7#+"'72& $'(6#$&5'1'6-38'%#& 3(+#%'+72& J*g72& AMg72& #$'& 3+"1(#'& 7')#-+2& 3+-@'77"-%(6& -+,(%"k(0-%7& #-& )+'(#'& (%&'%(.6"%,&'%1"+-%8'%#&@-+&7")=6'&)'66&3+'1'%0-%&(%5&)-%#+-6&()01"0'7:&

Indicators with targetso C-6")4&(%5&,>"5'6"%'7&-%&*")=6'&)'66&5"7'(7'&5'1'6-3'5&.4&[X^Te^f:o *")=6'&)'66&)6"%")7&'7#(.6"7$'5&"%&]XY&-@&b',"-%(6&b'@'++(6&B-73"#(67&.4&[X^f:


HSSIP 2010/11 – 2014/1588

5.2.1.25 Decrease the morbidity and mortality due to injuries, common emergencies and disabilities 2*'1%E+3-09G%/.0*+(4%0(7%04.C*.90).7%+1=0+*1.()3"%

D%/>+"'72&5"7(."6"0'7&(%5&+'$(."6"#(01'&$'(6#$&'%)-83(77&)-%5"0-%7&#$(#&+'7>6#&"%&(%&"%5"1"5>(6R7&5'3+"1(0-%&-+&6-77&-@&#$'&%''5'5&)-83'#'%)4:&;$"7&)(%&.'&5>'&#-&5(8(,'&-+&$(+8&5-%'&#-&-+&7>G'+'5&.4&(&3'+7-%&.'@-+'&-+&(h'+&."+#$:&*>)$&5'3+"1(0-%&-+&6-77&-@&)-83'#'%)4&"%)6>5'7&)-%5"0-%7&6"='H&5'(@%'772&.6"%5%'772&3$47")(6&5"7(."6"#4& (%5& 6'(+%"%,&5"7(."6"#4:& *-8'&)$(66'%,'7&'V"7#& #$(#&5'#'+& #$'&'G')01'&3+'1'%0-%&(%5&)-%#+-6&-@&"%/>+"'72&5"7(."6"0'7&(%5&+'$(."6"#(01'&$'(6#$H&>%5'+7#(P%,2&"%(5'O>(#'&7>33-+#&#-&-+#$-3('5")&<-+=7$-372&6-<&3+"-+"#4&())-+5'5&#-&5"7(."6"#4&(#&(66&6'1'67&(%5&)$(66'%,'7&-@&)--+5"%(0-%&-@&8(%4&5"G'+'%#&7#(='$-65'+7&<"#$&1(+4"%,&"%#'+'7#7:&;$'+'&"7&%''5&#-&(55+'77&#$'7'&"77>'7:&&

Strategies and key interventions!" E3"(,%(85.4$(8#$/$%-/$C(8#171-/$(.%6(#$'.2,5,".-/$(,%"$#/$%-1%0("1(#$634$(71#".5,"9(.%6(71#2,6,"9(1#(

6,0.2,5,"9(4.30$6(29(,%T3#,$0>

o J+'(#'&(<(+'%'77&(#&%(0-%(62&5"7#+")#&(%5&)-88>%"#4&6'1'67&(.->#&#$'&3+'1'%0-%&(%5&8(%(,'8'%#&-@&"%/>+"'7&(%5&5"7(."6"0'7&#$+->,$&>7'&-@&8'5"(&(%5&ZB;7:

o C+-8-#'&#$'&+'$(."6"#(0-%&(%5&)-%7#+>)0-%&-@&3>.6")&(%5&3+"1(#'&@()"6"0'7&#-&8(='&#$'8&())'77".6'&#-&3'-36'&<"#$&5"7(."6"0'7:

o U51-)(#'&@-+&'%@-+)'8'%#&-@&3+-#')01'& 6',"76(0-%&':,:&>7'&-@&7'(#&.'6#72&3-6")"%,&5+>%='%&5+"1"%,2&+'7#+")#'5&78-="%,&(8-%,&-#$'+7:

o *)(6'&>3&#$'&3+-5>)0-%&-@&1(+"->7&#43'7&-@&(77"701'&5'1")'7&@-+&3'-36'&<"#$&5"7(."6"0'7:o I'1'6-3&(%5&5"77'8"%(#'&,>"5'6"%'7&-%&$(%56"%,&-@&#+(>8(2&5"7(."6"0'7&(%5&+'$(."6"#(0-%:

o *#+'%,#$'%& "%#'+7')#-+(6& )-66(.-+(0-%& "%& #$'& 3+'1'%0-%& (%5& 8(%(,'8'%#& -@& "%/>+"'7& (%5&5"7(."6"0'7:&

o J-%5>)#& 3'+"-5")& 7#>5"'7& #-& 5'#'+8"%'& #$'& .>+5'%& -@& 5"7(."6"#4& "%& E,(%5(&<$")$& <"66& "%@-+8& #$'&5'1'6-38'%#&-@&3-6")"'7&(%5&"%#'+1'%0-%7:

!" )78#1/$(.44$00("1('$.5"'(0$#/,4$0(29(8$185$(G,"'(6,0.2,5,-$0>

o I'1'6-3&(%5&5"77'8"%(#'&(&3+-#-)-6&@-+&3+-1"7"-%&-@&7'+1")'7&"%)6>5"%,&+'3+-5>)01'&$'(6#$&7'+1")'7&#-&3'-36'&<"#$&5"7(."6"0'7:

o b'$(."6"#(#'&$'(6#$&@()"6"0'7&#-&8(='&#$'8&())'77".6'&#-&3'-36'&<"#$&1(+"->7&@-+87&-@&5"7(."6"0'7:

o g+"'%#&$'(6#$&<-+='+7&-%&)-%#+-62&3+'1'%0-%&(%5&#+'(#8'%#&-@&"%/>+"'7&(%5&5"7(."6"0'7:

Indicators with targets!" B'(+"%,&"83("+8'%#&+'5>)'5&@+-8&mY&#-&WY&.4&[X^Te[X^f:

!" Z"7>(6&"83("+8'%#&+'5>)'5&@+-8&(%&'708(#'5&X:mY&#-&X:iY&.4&[X^Te[X^f:

!" U77"701'&5'1")'7&3+-1"5'5&#-&mXY&-@&C!I7&<$-&%''5&#$'8&.4&[X^f:

!" ;$'& 3+-3-+0-%& -@& #$'& 3-3>6(0-%& +'()$'5&<"#$&8'77(,'7& -%& 5"7(."6"#4& 3+'1'%0-%& (%5& +'$(."6"#(0-%&"%)+'(7'5&#-&mXY&.4&[X^f:&

5.2.1.26 Ensure increased access to primary and referral services for mental health, prevention and management of substance abuse problems, psychosocial disorders and common neurological disorders such as epilepsy.

L'%#(6&$'(6#$&3+-.6'87&(%5&7>.7#(%)'&(.>7'&5"7-+5'+7&)-%#+".>#'&̂ [:fY&-@&#$'&,6-.(6&.>+5'%&-@&5"7'(7':&;$'&


HSSIP 2010/11 – 2014/15 89

.>+5'%&"7&6"='64&#-&.'&$",$'+&"%&E,(%5(&5>'&#-&'G')#7&-@&)"1"6&7#+"@'2&#$'&)-%7'O>'%)'7&-@&BDZeUDI*&(%5&"%)+'(7'&"%&(6)-$-6&(%5&5+>,&(.>7'&5>'&#-&(%&"%'P)"'%#&(%5&3--+64&'%@-+)'5&7>.7#(%)'&>7'&)-%#+-6&6(<:&I>+"%,&B**C&DD2&#$'+'&<(7&(%&"%)+'(7'&-@&8'%#(6&$'(6#$&7'+1")'7&(#&bbB7&@+-8&fXY&#-&^XXY&>%5'+&*B*CC&DDK&)-88>%"#4&())'77&#-&8'%#(6&$'(6#$&7'+1")'7&"%)+'(7'5&@+-8&[XY&#-&8-+'&#$(%&fXY&(%5&#$'&3+-3-+0-%&-@&BJ&DZ7&<"#$&(#&6'(7#&-%'&(%0374)$-0)2&-%'&(%05'3+'77(%#&(%5&-%'&(%0&'3"6'30)&8'5")"%'&"%)+'(7'5&@+-8&^XY&#-&]XY:&&;$'+'&"7&(&%''5&#-&=''3&#$"7&8-8'%#>8&#$+->,$&"%)+'(7"%,&374)$"(#+")&7#(G&%>8.'+7&(%5&.4&(66-)(0%,&8-+'&+'7->+)'7&@-+&3>+)$(7'&-@&'77'%0(6&8'%#(6&$'(6#$&8'5")"%'7:8'5")"%'7:&;$'&8'%#(6&$'(6#$&3+-,+(8&(67-&)--+5"%(#'7&8(%(,'8'%#&-@&%'>+-6-,")(6&5"7-+5'+7&7>)$&(7&'3"6'374&<$")$&(G')#7&(.->#&]Y&-@&#$'&,'%'+(6&3-3>6(0-%&(%5&)-%#+".>#'7&iXY&-@&(N'%5(%)'7&(#&L'%#(6&B'(6#$&E%"#7:&;$'&"836'8'%#(0-%&-@&8'%#(6&$'(6#$&3+-,+(88'7&"7&"83'5'5&.4&>%5'+@>%5"%,2&7#-)=->#7&-@&8'%#(6&$'(6#$&(%5&'3"6'374&8'5")"%'72&5'6(4'5&+'3'(6&-@&8'%#(6&$'(6#$&6(<&(%5&%',(01'&(S#>5'7&-@&7-8'&8(%(,'+7&<$")$&$"%5'+7&"%#',+(0-%&-@&8'%#(6&$'(6#$&"%#-&,'%'+(6&7'+1")'7:

Strategies and interventions!" Strengthen the legal and policy environment for provision of mental health services in Uganda.

o b'3'(6&#$'&L'%#(6&;+'(#8'%#&U)#&<$")$&"7&->#5(#'5:

o I'1'6-3&8'%#(6&$'(6#$&3-6")4&(%5&7#+(#',")&36(%:

o C+-8-#'&#$'&+",$#7&-@&#$'&8'%#(6&"66:

o I'1'6-3&(&)-88>%"#4&7#+(#',4&@-+&)-%#+-6&(%5&3+'1'%0-%&-@&8'%#(6&$'(6#$&3+-.6'87:

o I'1'6-3&(%5&"836'8'%#&(%&(66)-$-6&)-%#+-6&3-6")4&(%5&5+>,&)-%#+-6&8(7#'+&36(%:

!" Improve access to mental health services.

o I'1'6-3&(%5&5"77'8"%(#'&7#(%5(+57&(%5&,>"5'6"%'7&@-+&#$'&"%#',+(0-%&-@&8'%#(6&$'(6#$&"%#-&3+"8(+4&$'(6#$&)(+':

o D%#',+(#'&8'%#(6&$'(6#$&7'+1")'7&"%#-&3+"8(+4&$'(6#$&)(+':

o C+-1"5'&)(+'&@-+&%'>+-6-,")(6&5"7-+5'+7&(#&3+"8(+4&)(+'&6'1'6:

o C+-1"5'&@--5&@-+&(66&>%())-83(%"'5&8'%#(6&$'(6#$&3(0'%#7:

o C+-1"5'&'77'%0(6&8'%#(6&$'(6#$&(%5&(%0F'3"6'374&5+>,7:

o Q%7>+'&#$'&(1("6(."6"#4&-@&@>%)0-%(6&8'%#(6&$'(6#$&>%"#7&"%&(66&bbB7:

o C+-1"5'&(&374)$"(#+"7#&(%5&-#$'+&73')"(6"7#&8'%#(6&$'(6#$&3+-@'77"-%(67&@-+&'()$&bbB:

o C+-1"5'&(6)-$-6&(%5&5+>,&(.>7'&#+'(#8'%#&(%5&+'$(."6"#(0-%&7'+1")'7&(#&(66&6'1'67&-@&)(+':

!" Build the capacity of health workers in provision of health services to the mentally ill.

o g+"'%#& $'(6#$& <-+='+7& "%& 8'%#(6& $'(6#$& "%& -+5'+& #-& (55+'77& #$'& %',(01'& (S#>5'7& -@& 7-8'&8(%(,'+7:

o D%)+'(7'& #$'& %>8.'+& -@& C74)$"(#+")& A>+7'7& (%5& C74)$"(#+"7#7& .'"%,& #+("%'5& "%& $'(6#$& #+("%"%,&"%70#>0-%7:&

o C+-1"5'&.(7")&#+("%"%,&"%&8'%#(6&$'(6#$&#-&,'%'+(6&3+()00-%'+7&(%5&$'(6#$&-P)'+7:

o C+-1"5'&+'@+'7$'+&#+("%"%,&@-+&8'%#(6&$'(6#$&(%5&,'%'+(6&$'(6#$&<-+='+7

!" !"#$%&"'$%( )*+( 7$00.&$0( 4#$."$( .G.#$%$00( .213"( 7$%".5( '$.5"'( ,%4536,%&( 6$N0-&7.-0.-1%( 1;( "'$(mentally ill.

o I'1'6-3&(%5&5"77'8"%(#'&(33+-3+"(#'&8'77(,'7&@-+&"83+-1"%,&)-88>%"#4&8'%#(6&$'(6#$:&

o C+-1"5'&3>.6")&'5>)(0-%&@-+&5'8(%5&+'5>)0-%&@-+&(6)-$-6&(%5&5+>,&(.>7':


HSSIP 2010/11 – 2014/1590

Indicators with targets!" L'%#(6&B'(6#$&a(<&'%()#'5&.4&[X^^e^[:

!" L'%#(6&B'(6#$&C-6")4&9%(6"7'5&(%5&-3'+(0-%(6"7'5&.4&[X^Xe^^:

!" g3'+(0-%(6"7'&L'%#(6&B'(6#$&E%"#7&"%&(66&bbB7&.4&[X^Xe^^:

!" J-88>%"#4&())'77&#-&8'%#(6&$'(6#$&7'+1")'7&"%)+'(7'5&@+-8&WXY&#-&mXY:

!" U&)-88>%"#4&7#+(#',4&@-+&3+'1'%0-%&-@&8'%#(6&$'(6#$&3+-.6'87&5'1'6-3'5&.4&[X^Xe^^:

!" *'+1")'7&@-+&(6)-$-6&(%5&5+>,&(.>7'&8(%(,'8'%#&(+'&(1("6(.6'&(#&BJ&DZ&.4&[X^]e^T:

5.2.1.26 Improve the oral health of the people of Uganda by promoting oral health and preventing, appropriately treating, monitoring and evaluating oral diseases.

g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k(0-%&-@&8(%4&-@&#$'&-+(6&$'(6#$&)(+'&<-+='+7&"%&#$'&5"7#+")#&CBJ&()01"0'7&(%5&6()=&-@&73')"(6"7#7&"%&#$'&5'%#(6&9'65&(%5&6()=&-@&#+(%73-+#&@-+&7>33-+#&7>3'+1"7"-%:&;$>7&#$'+'&"7&%''5&#-&&.>5,'#&@-+&3$(7'5&+'$(."6"#(0-%&(%5&)-%7#+>)0-%&-@&%'<&"%@+(7#+>)#>+'&@-+&-+(6&$'(6#$2&'73')"(664&"%&#$'&%'<64&)+'(#'5&5"7#+")#7K&'O>"3&#$'&,-1'+%8'%#&$'(6#$&>%"#7&<"#$&5'%#(6&'O>"38'%#&7$->65&.'&5-%'&"%&3$(7'72&':,:&f&$'(6#$&>%"#7&3'+&(%%>8:&&

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o J-%5>)#& "%F7'+1")'& #+("%"%,& @-+& 5'%07#7& (%5& -#$'+& #')$%")"(%72& -+(6& (%5& %-%F-+(6& $'(6#$&3+-@'77"-%(67:

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HSSIP 2010/11 – 2014/15 91

!"#$%&$'()*+#(,!" g+(6&$'(6#$&3-6")4&"836'8'%#(0-%&,>"5'6"%'7&5'1'6-3'5&(%5&5"77'8"%(#'5&.4&[X^Xe[X^[:

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5.2.1.27 Improve the quality of life of terminally ill patients and their families especially the home carers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h'%&>%7>33-+#'5&(%5&#$(#&$(7&.''%&5-)>8'%#'5&#-&6'(5&"%&7-8'&)"+)>87#(%)'7&#-&#$'&5'#'+"-+(0-%&-@&#$'&$'(6#$&-@&#$'&)(+'+2&(%5&"%&-#$'+&)"+)>87#(%)'7&"%&7-8'&,"+67&$(1"%,&#-&5+-3&->#&-@&7)$--6&#-&36(4&#$"7&+-6':

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Implementation strategyD%&[XXW&#$'&L-B&)+'(#'5&#$'&C+-,+(88'&@-+&A-%FJ-88>%")(.6'&I"7'(7'7&<$")$&$(7&#$'&+'73-%7"."6"#4&#-&)--+5"%(#'&#$'&)-%#+-6&(%5&3+'1'%0-%&-@&'3"5'8")7:&;$'&A(0-%(6&A-%FJ-88>%")(.6'&I"7'(7'7&C+-,+(88'&<"66&<-+=&<"#$&-#$'+&I'3(+#8'%#7&<"#$"%&#$'&L-B2&#$'&3+"1(#'&7')#-+&(%5&J*g7&#-&5'1'6-3&3-6")"'72&7#+(#',"'7&(%5&,>"5'6"%'7&@-+&#$'&)-%#+-6&(%5&3+'1'%0-%&-@&AJI7:&;$'&+'73-%7"."6"#4&#-&)--+5"%(#'&#$"7&3+-,+(88'&(#&5"7#+")#&6'1'6&7$(66&6"'&<"#$&#$'&IBg:&

Cluster 4: Sexual, Reproductive Health and Rights and Child Survival

5.2.1.28 Reduce mortality and morbidity relating to sexual and reproductive health, and rightsL(#'+%(6&(%5&)$"65&8-+#(6"#4&+(#'7&"%&E,(%5(&(+'&O>"#'&$",$H&LLb&7#(%57&(#&T]fe^XX2XXX&(%5&DLb&(#&iWe^2XXX:&;$'&3+-3-+0-%&-@&5'6"1'+"'7&.4&7="66'5&3'+7-%%'6&"7&7066&6-<&(#&]TY&(%5&#$'&3+-1"7"-%&-@&Q8'+,'%)4&(%5&?(7")&g.7#'#+")&(%5&A'<.-+%&J(+'&cQ8gAJd&"7&6"8"#'5:&;$'&JCb&"7&6-<&(#&[TY&(%5&#$'&>%8'#&%''5&-@&`C&"7&T^Y:&


HSSIP 2010/11 – 2014/1592

;-#(6&@'+06"#4&+(#'&$(7&+'8("%'5&$",$&(#&W:f:&!$"6'&(&7",%"9)(%#&3+-3-+0-%&-@&E,(%5(R7&3-3>6(0-%&)-%7"7#7&-@&(5-6'7)'%#72&(5-6'7)'%#&7'V>(6&(%5&+'3+-5>)01'&$'(6#$&7'+1")'7&(+'&6"8"#'5&(%5&#$'4&5-&%-#&(55+'77&#$'&%''57&-@&(5-6'7)'%#7:&U5-6'7)'%#&3+',%(%)4&7#(%57&(#&[]Y&cEIB*&[XXWd:&L(#'+%(6&8(6%>#+"0-%2&5>'&#-&.-#$&8()+-&(%5&8")+-&5'9)"'%)"'72&7066&)-%#+".>#'&3+-8"%'%#64&#-&7066&."+#$72&8(#'+%(6&(%5&)$"65&8-+."5"#4&(%5&8-+#(6"#4:& *'V>(6&(%5&M'%5'+F?(7'5&Z"-6'%)'& "7&(&8(/-+&)-%)'+%& #$(#& "83()#7&-%&8(#'+%(6&8-+."5"#4&(%5&8-+#(6"#4:&;$'&+",$#&#-&*'V>(6&(%5&b'3+-5>)01'&B'(6#$&(%5&b",$#7&"7&"83-+#(%#&(7&"#&("87&(#&+'5>)"%,&#$'&LLb2&EfLb&(%5&;`b2&(66&='4&'6'8'%#7&-@&#$'&$'(6#$&LIM7:&&;$'+'&"7&"%#'+%(0-%(6&)-%7'%7>7&-%&#$'&"%#'+1'%0-%7&#-&.+"%,&#$'7'&7#(070)7&5-<%:&;$'&)$(66'%,'&+'8("%7&<"#$&#$'&"836'8'%#(0-%&-@&#$'7'&"%#'+1'%0-%7&"%&(&)--+5"%(#'5&(%5&7>7#("%'5&@(7$"-%:&U7&$(7&.''%&$",$6",$#'5&"%&J$(3#'+&]&"836'8'%#(0-%&-@&"%#'+1'%0-%7&#-&(55+'77&8(#'+%(6&$'(6#$&3+-.6'87&"%&E,(%5(&"7&$(83'+'5&.4&"%(5'O>(#'&@>%5"%,&-@&#$'&"%#'+1'%0-%72&6()=&-@&Bb2&8'5")"%'7&(%5&7>336"'7&(%5&(33+-3+"(#'&.>"65"%,7&(%5&'O>"38'%#&"%)6>5"%,&#+(%73-+#&(%5&)-88>%")(0-%&'O>"38'%#&@-+&+'@'++(6:&;$'&6()=&-@&5')"7"-%&8(="%,&(#&$->7'$-65&6'1'6&.4&<-8'%&(G')#7&#$'"+&$'(6#$&7''="%,&.'$(1"->+&"%)6>5"%,&5>+"%,&3+',%(%)4:

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HSSIP 2010/11 – 2014/15 93

o C+'1'%#&(%5&)-%#+-6&g.7#'#+")(6&`"7#>6(':

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5.2.1.29 Improve newborn health and survival by increasing coverage of high impact evidence based interventions, in order to accelerate the attainment of MDG 4.

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HSSIP 2010/11 – 2014/1594

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decisions and respond appropriately to illness.

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HSSIP 2010/11 – 2014/15 95

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o )78#1/$( 8.$6,."#,4(D)JK?)A0( 8#$/$%-1%( 4.#$& #$+->,$& 3+'1'%0-%& -@&8-#$'+& #-& )$"65& #+(%78"77"-%&cCL;J;d&"%)6>5"%,&#'70%,&(%5&)->%7'66"%,&-%&"%@(%#&@''5"%,&-30-%72&'(+64&"%@(%#&5"(,%-7"7&>7"%,&CJb&5>+"%,&->#+'()$'7&(%5&6"%="%,&#'7#'5&.(."'7&#-&)(+'K&"%)'%01'7&@-+&)(+',"1'+&>7'&-@&#'70%,&7'+1")'7&(%5& +'F(N'%5(%)'& @-+& @-66-<&>3K& CJC& C+-3$46(V"7& @-+& )$"65+'%&-@&BDZy&8-#$'+7& (%5& #+'(#8'%#& -@&-33-+#>%"7#7&"%@')0-%7K&(%5&"%#',+(0-%&-@&3+-8-0-%&-@&@(8"64&36(%%"%,&)->%7'66"%,:

o *F8.%6( .%6( ,%"$&#."$( #13-%$( '$.5"'( ;.4,5,"9( 13"#$.4'$0( 0$#/,4$0& #-& )-1'+& (66& "%#'+1'%0-%7&c"88>%"7(0-%2&Z"#(8"%&U&7>336'8'%#(0-%2&5'<-+8"%,2&8(6%>#+"0-%&7)+''%"%,2&̀ (8"64&36(%%"%,2&BDZ&#'70%,2&#+'(#8'%#&-@&)-88-%&)$"65$--5&"66%'772&"%@-+8(0-%&(%5&'5>)(0-%&-@&8-#$'+7&(%5&@(8"6"'7dK&)-%5>)#& /-"%#e"%#',+(#'5&8")+-& 36(%%"%,& @-+& ->#+'()$& 7'+1")'7&<"#$& "%1-61'8'%#& -@& )-88>%"0'7K&7#+'%,#$'%"%,&"%@-+8(0-%&)-66')0-%2&+'3-+0%,&(%5&@''5.()=K&5"7#+")#7&(%5&7>.&5"7#+")#7&)(3()"#4&#-&8(%(,'&s7#+'%,#$'%&)-88-5"#4&7>3364&)$("%:

!"-4>'1/)$>')/).0/)$+.=(.&$?$,;+57$,(')$&;'18*;$+448.+2(01."

o Ensure vaccine supply and quality;&#$+->,$&'V3(%7"-%&-@&)-65&7#-+(,'&73()'&(#&#$'&%(0-%(62&+',"-%(62&5"7#+")#&(%5&$'(6#$&7>.&5"7#+")#&6'1'67K&+'1"'<&(%5&7#+'%,#$'%&)-65&)$("%&747#'8&(#&(66&6'1'67K&7#+'%,#$'%&(%5&8("%#("%&#$'&,(7&(%5&1())"%'&7>3364&)$("%&(%5&.>"65&5"7#+")#&(%5&7>.&5"7#+")#&)(3()"#4&@-+&)-65&)$("%&8(%(,'8'%#:

o Improve .44$00("1(,773%,O.-1%(0$#/,4$0R(#$+->,$&+("7"%,&(<(+'%'77&(%5&5'8(%5&@-+&"88>%"k(0-%&(8-%,&)-88>%"#4&8'8.'+7&(%5&@(8"6"'7K&"88>%"k(0-%&#$+->,$&7#(0)&(%5&->#+'()$&7'+1")'7&>7"%,&"%%-1(0-%7&#$(#&<"66&'%7>+'&#$(#&t8"77'5F->#7u&(%5&t5+-3F->#7u&@+-8&+->0%'&7'+1")'7&(+'&"5'%09'52&3(+0)>6(+64&"%&>+.(%2&+'8-#'&(%5&>%5'+7'+1")'5&(+'(7K&(51-)(#'&@-+&(%5&7)(6'F>3&-@&BCZ&1())"%(0-%&(%5&"%#+-5>)0-%&-@&3%'>8-)-))(6&&(%5&+-#(1"+>7&1())"%'7&"%#-&#$'&+->0%'&"88>%"k(0-%&3+-,+(88'K&7#+'%,#$'%&8-%"#-+"%,&(%5&'1(6>(0-%&-@&#$'&"88>%"7(0-%&7'+1")'7&"%)6>5"%,&)-1'+(,':&

o !"#$%&"'$%(7$.05$0(41%"#15C(7."$#%.5(.%6(%$1%.".5("$".%30(.%6(815,1($#.6,4.-1%(7$.03#$0("'#13&'R )-%5>)0%,&3+-1'%&"%#'+1'%0-%7&#-&()$"'1'&,6-.(6&#(+,'#7&-@&3-6"-&'+(5")(0-%2&&'6"8"%(0-%&-@&8(#'+%(6&(%5& %'-%(#(6& #'#(%>72& (%5& ())'6'+(#'5& 8'(76'7& )-%#+-6& 7>)$& (7& 8(77& "88>%"k(0-%& )(83(",%7K&7>33-+#&5"7'(7'F73')"9)&7>+1'"66(%)'&'G-+#7&(%5&+'7'(+)$&#-&"%@-+8&@>#>+'&3-6")4&"%&#$'7'&(+'(7:&

!"<'1/+2+1.$1=$+.7+/+78(556$1'+).&)7$,5+.+,(5$2)'/+,)2$=1'$.):91'.$?$,;+57$;)(5&;$9(2+2"

o Improve neonatal care at primary health facility level& #$+->,$& "%)+'(7'& )(3()"#4& -@& @()"6"#4& .(7'5&<-+='+7&#-&8(%(,'&%'<.-+%&)-%5"0-%7&c."+#$&(73$4V"(2&1'+4&6-<&."+#$&<'",$#2&7'37"72&/(>%5")'&(%5&BDZd&"%)6>5"%,&+'1"7"-%&-@&)>++")>6(&#-&"%)6>5'&%'<.-+%&$'(6#$&)(+'K&"%&(%5&3+'F7'+1")'&#+("%"%,K&"83+-1'&


HSSIP 2010/11 – 2014/15 97

O>(6"#4&-@&)(+'&#$+->,$&5'1'6-38'%#2&+',>6(+&'V#'+%(6&(%5&"%#'+%(6&(77'778'%#7e(>5"#7K&)'+09)(0-%&-@&@()"6"0'7&(7&%'<.-+%&@+"'%564K&(%5&.>"65&)(3()"#4&@-+&3'+"F%(#(6&5'(#$&(>5"#&(%5&+'1"'<7:

o Improve the management of common childhood illness at the primary level through improving health @()"6"#4&7>33-+#7& @-+& DLJDK& "83+-1'&(%5&'V3(%5&$'(6#$&<-+='+&)(3()"#4&#-&8(%(,'&)-88-%& "66%'77&"%)6>5"%,& %>+7"%,& (77"7#(%#7K& '7#(.6"7$& O>(6"#4& "83+-1'8'%#& (33+-()$'7& (%5& 7#+'%,#$'%& +'@'++(6&)-836"(%)'&#-&$",$'+&6'1'6:&

o !"#$%&"'$%( 45,%,4.5( #$;$##.5( 5$/$5( 0$41%6.#9( .%6( "$#-.#9( 4.#$& #$+->,$& 5'9%"%,& )$"65& (%5& %'<.-+%&8"%"8>8& 7#(%5(+572& "83+-1'5& "%@+(7#+>)#>+'& (%5& 'O>"38'%#2& 5+>,& (1("6(."6"#4& -@& $-73"#(67& @-+&73')"(6"7#& )(+'K& "%#+-5>)0-%& (%5& .>"65& )(3()"#4& @-+& '8'+,'%)4& #+"(,'& (%5& #+'(#8'%#& cQ;U;d& (%5&$'63"%,&.(."'7&.+'(#$'&cB??dK&"%%-1(01'&<(47&3+-1"7"-%&-@&-V4,'%2&8'5")(0-%&)-6->+&)-5"%,2&7'37"7&3+'1'%0-%&(%5&)-%#+-6K&7#+'%,#$'%&)(3()"#4&@-+&73')"(6"7#&->#+'()$&7'+1")'7K&(%5&)-%0%>->7&O>(6"#4&"83+-1'8'%#&"%)6>5"%,&$'(6#$&"%@-+8(0-%&8(%(,'8'%#&747#'87:&

!" @')(01.$1=$(.$).(95+.*$)./+'1.4).&$(&$.(01.(5$5)/)5$

o Regular review of policy and regulatory frameworks&@-+&)$"65&$'(6#$&"%)6>5"%,&#(7=&7$"h"%,2&+',>6(0-%&@-+&)-5'&@-+&8(+='0%,&.+'(7#&8"6=&7>.70#>#'72&'%@-+)'8'%#&,>"5'6"%'7&@-+&$4,"'%'&(%5&7(%"#(0-%2&(51-)()4&(%5&7'%7"07(0-%&-@&@--5&"%5>7#+"'7&#-&@-+0@4&@--52&3-6"0)(6&(%5&5')"7"-%&8(='+7&-%&%'<&)$"65$--5&1())"%'7&(%5&5'1'6-38'%#7&"%&)$"65&$'(6#$:

o Expand district and %.-1%.5 programme management&)(3()"#4&#$+->,$&+')+>"#8'%#&-@&7#(G2&73')"(6"7#&':,:&%>#+"0-%"7#2&-+"'%#&8(%(,'+7&-%&8(%(,'8'%#&-@&)$"65&$'(6#$&3+-,+(87K&3(+#%'+7$"37&<"#$&3+"1(#'&7')#-+7&(%5&-#$'+&7')#-+7&':,:&(,+")>6#>+'&(%5&'5>)(0-%&#-&'%7>+'&(33+-3+"(#'&3+'F7'+1")'&#+("%"%,&(%5&6-%,&5"7#(%)'&#+("%"%,&@-+&+'6'1(%#&)$"65&$'(6#$&7="667K&

o +11#6,%.-1% of ,%"$#/$%-1%0e"'$7.-4 policy across child health concerned department through (51-)(0%,& #-& @>664& 8("%7#+'(8& )$"65& $'(6#$& "%#-& CLAJB& 3+"%)"36'72& $(+8-%"k(0-%& -@& CL;J;2&BDZ2& 8(6(+"(& 3-6")"'7& "%& )$"65& $'(6#$2& 5'1'6-3& "%#',+(#'5& )-88>%")(0-%& (%5& (51-)()4& 7#+(#',"'7&'%)-83(77"%,&)$"652&%'<.-+%&(%5&8(#'+%(6&$'(6#$2&%>#+"0-%2&CL;J;2&BDZ&(%5&$4,"'%'K&7#+'%,#$'%&@>%)0-%(6"#4&(%5&+'1"'<&#'+87&-@&+'@'+'%)'7&@-+&)$"65&$'(6#$&'V3'+#&)-88"N''7:

o Build knowledge base on 4#,-4.5 areas of child survival&#$+->,$&-3'+(0-%(6&+'7'(+)$&-%&)$"65&7>+1"1(6&5'6"1'+4&)$(%%'67&c@(8"642&3-3>6(0-%&(%5&"%5"1"5>(6&7'+1")'7d2&3-7#&%(#(6&)-88>%"#4&%'<.-+%&)(+'2&3'+@-+8(%)'&.(7'5&9%(%)"%,2&3+"1(#'&7')#-+&'%,(,'8'%#2& DLJD2&QDI2&CL;J;2&(%5&A?BK&7#+'%,#$'%&5-)>8'%#(0-%& -@& 3-6"-& @+''& 7#(#>7& (%5& 7>+1'"66(%)'& 'G-+#7& cB".2& 3%'>8-)-))>72& 4'66-<& @'1'+2&b-#(1"+>7dK&)$"65&%'<.-+%&1'+.(6&(>#-374&(77'778'%#7K&3+-,+(8&'1(6>(0-%7&#-&"%@-+8&@>#>+'&3-6")4:&

Indicators with targets!" C+-.(.6'&(%5&)-%9+8'5&8(6(+"(&"%3(0'%#&>%5'+&91'&5'(#$7&+'5>)'5&@+-8&X:W&#-&X:]Y

!" *#>%0%,&+(#'7&(8-%,&)$"65+'%&>%5'+F91'7&+'5>)'5&@+-8&]mY&#-&[mY&

!" A'-%(#(6&7'30)('8"(&+(#'7&"%&$'(6#$&@()"6"0'7&+'5>)'5&.4&]XY

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!" E%5'+F91'7&<$-&76'3#&>%5'+&(%&D;A&#$'&3+'1"->7&%",$#&"%)+'(7'5&@+-8&^X&#-&WXY&

!" IC;F]eC'%#(1(6'%#&)-1'+(,'&@-+&>%5'+&^R7&"%)+'(7'5&@+-8&iTYFmfY

!" L'(76'7&1())"%(0-%&)-1'+(,'&.4&^[&8-%#$7&"%)+'(7'5&@+-8&ifY&#-&\fY&

!" Ef7&<"#$&8(6(+"(&#+'(#'5&)-++')#64&<"#$"%&[T&$+7&"%)+'(7'5&@+-8&[WY&#-&WXY

!" Ef&3%'>8-%"(&8(%(,'5&<"#$&)-++')#&(%0."-0)&"%)+'(7'5&@+-8&^iY&#-&fXY

!" J$"65+'%&WFf\&8-%#$7&+')'"1"%,&5-7'7&-@&Z"#(8"%&U&"%)+'(7'5&@+-8&]WYFmXY


HSSIP 2010/11 – 2014/1598

!" BDZF'V3-7'5&"%@(%#7&7#(+#'5&-%&)-#+"8-V(k-6'&3+-3$46(V"7&<"#$"%&[&8-%#$7&-@&."+#$&"%)+'(7'5&#-&mXY

!" L-#$'+e%'<.-+%&3("+&)$')='5&#<")'&"%&^st&<''=&-@&6"@'&c^7#&1"7"#&<"#$"%&[T&$+7d&"%)+'(7'5&#-&fXY

!" QV)6>7"1'&.+'(7#F@''5"%,&+(#'&.4&#$'&(,'&-@&W&8-%#$7&"%)+'(7'5&#-&WXY

!" I"(++$-'(&)(7'7&+')'"1"%,&gb;&5>+"%,&"66%'77&"%)+'(7'5&@+-8&]iY&#-&WXY&&

!" D%5'V&-@&Ef7&8(%(,'5&"%&(%&"%#',+(#'5&8(%%'+&(#&#$'&@()"6"#4&>7"%,&DLAJD&"%)+'(7'5&@+-8&]XYFWXY

!" D%5'V&-@&@()"6"#4&(1("6(."6"#4&-@&#+()'+&5+>,7&(%5&1())"%'7&c(%0F8(6(+"(62&)-#+"8-V(6'2&8'(76'7&1())"%'2&7>63$(5-V"%'e34+(8'#$(8"%'2&5'3-3+-1'+(&(%5&gb*2d&"%)+'(7'5&@+-8&[]Y&#-&fXY&

!" A>8.'+&-@&@()"6"0'7&(77'77'5&(%5&())+'5"#'5&(7&.(.4&@+"'%564&c?`BDd&"%)+'(7'5&@+-8&^f&#-&iX

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HSSIP 2010/11 – 2014/15 99

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HSSIP 2010/11 – 2014/15 131

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ANNEX B. COMPARISON BETWEEN THE EPHS AND THE PRIORITY RMNCH SERVICES

RMNCH Essential Interventions Service

Included in EPHS

Source and Additional Notes

Adolescence and pre-pregnancy

Level: Community Primary Referral

Family planning (advice, hormonal and barrier methods) Yes Source: National Adolescent Health Policy for

Uganda

Prevent and manage sexually transmitted infections, HIV Yes Source: National Adolescent Health Policy for

Uganda

Folic acid fortification/supplementation to prevent neural tube defects

Unspecified

Source: Health Sector Strategic and Investment Plan; only lists folic acid fortification under maternal health services, unclear whether folic acid is targeted towards adolescents.

Level: Primary and Referral

Family planning (hormonal, barrier and selected surgical methods) Yes Source: National Policy Guidelines and Service

Standards for Reproductive Health Services

Level: Referral

Family planning (surgical methods) Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Pregnancy (antenatal)


Iron and folic acid supplementation Yes Source: Health Sector Strategic and Investment Plan

Tetanus vaccination Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Prevention and management of malaria with insecticide treated nets and antimalarial medicines

Yes Source: Health Sector Strategic and Investment Plan

Prevention and management of sexually transmitted infections and HIV, including with antiretroviral medicines

Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Calcium supplementation to prevent hypertension (high blood pressure) Unspecified This service was not specified in reviewed

documents

Interventions for cessation of smoking Unspecified This service was not specified in reviewed documents


Screening for and treatment of syphilis Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

61


Included in EPHS


Low-dose aspirin to prevent pre-eclampsia Unspecified This service was not specified in reviewed documents

Anti-hypertensive drugs (to treat high blood pressure) Unspecified This service was not specified in reviewed

documents

Magnesium sulphate for eclampsia Unspecified

Source: National Policy Guidelines and Service Standards for Reproductive Health Services; magnesium sulfate not specified

Antibiotics for preterm prelabour rupture of membranes Yes Source: National Policy Guidelines and Service


Corticosteroids to prevent respiratory distress syndrome in preterm babies Unspecified This service was not specified in reviewed

documents

Safe abortion

No

Source: National Policy Guidelines and Service Standards for Reproductive Health Services excluded safe abortion in the updated list of priority RH services

Post abortion care Yes Source: National Adolescent Health Policy for Uganda

Level: Referral

Reduce malpresentation at term with External Cephalic Version Unspecified This service was not specified in reviewed

documents

Induction of labour to manage prelabour rupture of membranes at term (initiate labour) Unspecified This service was not specified in reviewed

documents

Childbirth Level: Community Primary Referral

Prophylactic uterotonics to prevent postpartum haemorrhage (excessive bleeding after birth)

Unspecified This service was not specified in reviewed documents

Manage postpartum haemorrhage using uterine massage and uterotonics Unspecified This service was not specified in reviewed

documents

Social support during childbirth Unspecified This service was not specified in reviewed documents


Active management of third stage of labour (to deliver the placenta) to prevent postpartum haemorrhage (as above plus controlled cord traction)

Yes

Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Management of postpartum haemorrhage (as above plus manual removal of placenta) Unspecified This service was not specified in reviewed

documents

Screen and manage HIV (if not already tested) Yes Source: Health Sector Strategic and Investment Plan

Level: Referral

Caesarean section for maternal/foetal indication (to save the life of the mother/baby) Yes Source: National Policy Guidelines and Service


62


Included in EPHS


Prophylactic antibiotic for caesarean section Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Induction of labour for prolonged pregnancy (initiate labour) Unspecified This service was not specified in reviewed

documents

Management of postpartum haemorrhage (as above plus surgical procedures) Yes Source: National Policy Guidelines and Service


Postnatal (Mother)


Family planning advice and contraceptives Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services

Nutrition counselling Yes Source: Health Sector Strategic and Investment Plan


Screen for and initiate or continue antiretroviral therapy for HIV Yes Source: Health Sector Strategic and

Investment Plan

Treat maternal anaemia Yes Source: Health Sector Strategic and Investment Plan

Level: Referral

Detect and manage postpartum sepsis (serious infections after birth) Yes Source: National Policy Guidelines and Service


Postnatal (Newborn)


Immediate thermal care (to keep the baby warm) Yes Source: Health Sector Strategic and

Investment Plan

Initiation of early breastfeeding (within the first hour) Yes Source: Policy Guidelines on Infant and Young

Child Feeding

Hygienic cord and skin care Yes Source: National Policy Guidelines and Service Standards for Reproductive Health Services


Neonatal resuscitation with bag and mask (by professional health workers for babies who do not breathe at birth)


Kangaroo mother care for preterm (premature) and for less than 2000g babies Unspecified This service was not specified in reviewed

documents

Extra support for feeding small and preterm babies Yes Source: Policy Guidelines on Infant and Young

Child Feeding

Management of newborns with jaundice (“yellow” newborns) Yes Source: Health Sector Strategic and

Investment Plan

Initiate prophylactic antiretroviral therapy for babies exposed to HIV Yes Source: National Policy Guidelines and Service


Level: Referral

Presumptive antibiotic therapy for newborns at risk of bacterial infection Unspecified This service was not specified in reviewed

documents

63


Included in EPHS


Use of surfactant (respiratory medication) to prevent respiratory distress syndrome in preterm babies


Continuous positive airway pressure (CPAP) to manage babies with respiratory distress syndrome


Case management of neonatal sepsis, meningitis and pneumonia Yes Source: Health Sector Strategic and

Investment Plan

Infancy and Childhood


Exclusive breastfeeding for 6 months Yes Source: Policy Guidelines on Infant and Young Child Feeding

Continued breastfeeding and complementary feeding from 6 months Yes Source: Health Sector Strategic and

Investment Plan

Prevention and case management of childhood malaria Yes Source: Health Sector Strategic and

Investment Plan

Vitamin A supplementation from 6 months of age Yes Source: Health Sector Strategic and

Investment Plan

Routine immunization plus H. influenzae, meningococcal, pneumococcal and rotavirus vaccines

Yes Source: Health Sector Strategic and Investment Plan

Management of severe acute malnutrition Yes Source: Health Sector Strategic and Investment Plan

Case management of childhood pneumonia Yes Source: Health Sector Strategic and Investment Plan

Case management of diarrhoea Yes Source: Health Sector Strategic and Investment Plan


Comprehensive care of children infected with, or exposed to, HIV Yes Source: Health Sector Strategic and

Investment Plan

Level: Referral

Case management of meningitis Unspecified This service was not specified in reviewed documents

Across the continuum of care

Level: Community Strategies

Home visits for women and children across the continuum of care Unspecified This service was not specified in reviewed

documents

Women’s groups Unspecified This service was not specified in reviewed documents

64

ANNEX C: UGANDA HEALTH EQUITY PROFILE

65

essential package of health services country snapshot: uganda

Healthcare