Uganda: Improving Health and Strengthening Systems

June 12, 2018

Abt Global is working in many ways to improve the health and well-being of Ugandans. Beginning in 2009, Abt-led projects have delivered health services in more than 85 percent of the country. Our work in Uganda will continue through at least 2021.

“Since Abt began malaria prevention work in Uganda in 2009, our efforts have expanded to 100 of the nation’s 111 districts. We have provided a wide variety of services, including HIV and AIDS treatment, maternal, newborn, and child health, and family planning,” said Diana R. Silimperi, M.D., division vice president for International Health. “We aim to be a strong implementer for improved health systems, responding to challenges in communities throughout the majority of the country.”

Protecting Millions from the Threat of Malaria

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Malaria remains a high threat to Ugandans. Ministry of Health statistics from 2016 indicate that Uganda has the highest malaria incidence rate in the world: 478 cases per 1,000 people each year.

Uganda Indoor Residual Spraying (IRS) Phase II is a USAID-funded project that is reducing the threat of malaria in households by spraying insecticide on the walls, ceilings, and other indoor resting places of mosquitos that transmit malaria. We have carried out both strategic spray and sustainability strategies across a total of 24 districts beginning in 2009.

Our quality IRS activities have been highly effective in reducing malaria incidence in Ugandans.
We have empowered local stakeholders to take over IRS activity planning, spray operations, and entomological monitoring, and established robust monitoring and evaluation procedures.

Uganda IRS Phase II has, since 2009, protected approximately 6,812,000 million people from malaria including 1,556,000 million children and 745,000 pregnant women.

Read more about Uganda IRS

Responding to Acute Childhood Diarrhea Threats

The USAID-funded Strengthening Health Outcomes through the Private Sector (SHOPS) Zinc/ORS project worked to increase awareness and proper facilitation of childhood diarrhea in Uganda from 2013-2015.

The project worked with the National Drug Authority and the Pharmaceutical Society of Uganda to train private health providers to increase the provision of oral rehydration salts and zinc through the private sector. Abt led the training about the new protocols for childhood diarrhea treatment to increase knowledge and improve the quality of services.

Between 2013 and 2015, SHOPS Zinc/ORS:

Made more than 10,000 contacts with drug shops, selling more than 288,000 zinc treatments and 393,000 sachets of ORS;
Trained nearly 12,000 drug shop vendors in 100 of Uganda’s 112 districts;
Reached 365 pharmacists, 67 pharmacy interns, and 285 pharmacy technicians through medical education events and targeted training sessions; and
Worked with local zinc manufacturers and importers to support marketing and promotion of the new protocol, aiming to increase sales volume and reach of their product distribution.

Examining the Continuum of Care for ART Care in Uganda

Accessing and adhering to antiretroviral therapy (ART) treatment is a long-term journey involving multiple interactions with the health system. Understanding patient health-seeking behavior, pathways to HIV care, and movement through the health system in Uganda is important in ensuring ART regimens are managed to full effect for patients.

The global SHOPS project interviewed more than 1,400 people living with HIV receiving ART in local commercial, public, and nonprofit facilities across four provinces: Gulu, Jinja, Kampala, and Mbarara. One key question we asked patients was, “Where did they receive care at distinct times on the HIV cascade of care, and did they move between the public, private, and traditional health sectors for different health needs or at different times?”

We asked respondents about the timing and location of services, their overall levels of satisfaction, and reasons for choosing different types of health facilities. The study found:

Recently diagnosed patients commonly switched between public, commercial, and NGO providers as they sought a stable long-term source of ART;
Treatment pathways usually stabilized after ART began regardless of the choice of sector; and
Patients chose their facilities based on location and expected quality of service.

Uganda Indoor Residual Spraying (IRS) Phase II, funded by USAID and led by Abt Global, is reducing the threat of malaria in households by spraying insecticide on the walls, ceilings, and other indoor resting places of mosquitos that transmit malaria. The project has carried out both strategic spray and sustainability strategies across a total of 24 districts beginning in 2009.

Safer Pregnancies and Births to End Preventable Deaths

The USAID-funded Uganda Voucher Plus Activity works to expand the use of high quality reproductive, maternal, and neonatal health services through the private sector in the northern and eastern regions of Uganda. Abt and its partners are working to end preventable child and maternal deaths, in part by increasing safe pregnancies and deliveries.

The five-year project runs from 2016 through 2021, covering 30 districts, and is expected to provide approximately 250,000 safe, facility-based deliveries.