Improving Immunization Services in Bugambe and

Buseruka sub counties in Hoima district.

Dr Ruyonga Joseph

District Health Officer-Hoima

Academic Mentor Institutional Mentor

DR Kabagambe Geofrey-OHCEA Mr Luke. L L Lokuda -CAO Hoima

Final Dissemination workshop

Golf Course Hotel – Kampala

July 14th 2016

Background/Introduction

Map of Hoima District

Located MW Uganda

Projected pop 593,900

54 health facilities

Children <1 yr 29,695

DRC

Introduction

Immunization is one of the proven health intervention in

reducing under-five morbidity and mortality rates.

Poor immunization coverage has led to outbreaks of

immunisable diseases like measles in some districts.

Hoima district had measles outbreak from 18th January

to 24th February 2014, 55 cases reported with 2 deaths

Problem identification and prioritization

8 members of DHT through brain storming

identified areas which were performing poorly .

Areas identified where subjected to multi-voting

7/8 members voted immunization as priority that

needed improvement and did not need a lot of

resources and was achievable in a shorter period

Baseline coverage's (%age) at end of February

2016

Sub county Target pop DPT1 DPT3 Measles DPT1-DPT3

DOR

Cat

Bugambe 151 63.0 48.0 87.0 15 4

Buseruka 148 87.0 58.0 82.0 29.0 4

District 2,143 107 92.0 84.0.0 15.0 2

Root cause analysis (using Fishbone method )

Low involvement of the private sector

Lack of regular technical supervision

Low community involvement

Irregular outreaches

Inadequate data use

Problem statement and justification

There was low immunization coverage in Bugambe and

Buseruka sub counties.

This is attributed to lack of regular technical Support

supervision, lack of private sector engagement and low

involvement of the community.

If the root causes are not addressed would lead to

outbreaks of childhood immunizable diseases in Hoima

district.

General objective

To increase immunization coverage in Bugambe

and Buseruka sub counties in Hoima district by

end of June 2016.

Specific objectives

1: To increase immunization coverage of DPT1,

DPT3, Measles to 90.0% by June 2016.

2: To reduce DPT1-DPT3 drop out rate to less than

10.0% by June 2016

Support supervision

Focused on data analysis

and utilization and

guided in planning, target

setting and estimating

vaccine requirements

Training in data analysis at Bugambe Tea HC III HC III

Dialogue meetings with the communities

Identified mobilisers

and outreach sites

Identified key persons

to monitor outreach

functionality with a

technical staff. Dialogue meeting with community members at Kabaale HC III

Private sector engagement

Had dialogue meeting with Bugambe Tea

Estate management and provided.

Transport for outreaches

Facilitation for staff going for outreaches

Mobilization allowances to the VHT/mobilisers

RESULTS

DPT1 Coverage for Bugambe and Buseruka

sub counties 2016

63.0

94.0

87.0

108.0

0.0

20.0

40.0

60.0

80.0

100.0

120.0

February June

Pe

rce

nta

ge

co

ve

rag

e

Month of the year

Bugambe

Buseruka

Target

DPT3 Coverage and Bugambe sub

counties

48.0

91.0

58.0

119.0

0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

February June

Perc

en

tage c

ove

rage

Month

Bugambe

Buseruka

Target

Measles coverage for Bugambe and

Buseruka sub counties 2016.

53.0

88.0

82.0

94.0

0.010.020.030.040.050.060.070.080.090.0

100.0

February June

Pe

rce

nta

ge

co

ve

rag

e

Month

Bugambe

Buseruka

Target

DPT1-DPT3 Drop out rates for Bugambe and

Buseruka sub counties.

11

1

29

3

10 10

0

5

10

15

20

25

30

35

February June

Ra

te (

Pe

rce

nta

ge

)

Month

Bugambe

Buseruka

Target

Lessons Learnt

Community involvement improves uptake of

immunization services.

Involvement of the private sector to mobilize

resources improves service delivery

Appreciation of health workers motivates and leads

to more commitment

Challenges/Solutions

Challenge

Too much rain

Mass population

movements

In migration from DRC

Solution

Rescheduling of

outreaches

Regular updates of

registers

Need segregation

Conclusion

This intervention had made Bugambe and

Buseruka sub counties improve immunization

coverage for DPT1, DPT3 and measles.

Way forward/Next steps

Continue with community engagement to improve

service delivery

There is need for multi-sectoral approach to

improve service delivery

There is need to register all children in Bugambe

tea plantation during recruitment exercise.

There is need for cross border collaboration

Acknowledgement

MakSPH, CDC and Ministry of Health

Academic Mentor, Dr Kabagambe G

Institutional Mentor, Mr Luke L L Lokuda

Hoima District Local Government staff

Health Unit staff in the project area

District Health Team

World Vision/Uganda Cares

Management of Bugambe Tea Factory

Communities of Bugambe and Buseruka sub counties

All Medium Term Fellows

THANK YOU