HEALTH SECTOR PRIORITIES FOR FY 2010/11 TO 2015/16 PRESENTED AT THE LAUNCH OF UGANDA UK HEALTH ALLIANCE LONDON, UK. TUESDAY 12 TH FEBRUARY 2013 DR. ASUMAN LUKWAGO PERMANT SECRETARY MINISTRY OF HEALTH

Climax of Good standard of Health in Uganda

The National Referral Hospital

PRIORITY AREAS FOR THE NATIONAL HEALTH POLICY More than 75% of the overall burden of disease is preventable (NHP 1999). A. The focus for the NHP II is on 1. Health promotion, disease prevention and early diagnosis and treatment with emphasis on vulnerable populations. 2. Cost-effective and affordable primary, secondary and tertiary preventive services.

PRIORITY AREAS FOR THE NATIONAL HEALTH POLICY Contd. 3. Health systems strengthening, specifically: In line with decentralisation - through training, mentoring, technical assistance and financial support. Re-conceptualising and organising supervision and monitoring at all levels in both public and private health sectors Improving the collection and utilisation of data for evidence- based decision making at all levels. Establishing a functional integration within the public and between the public and private sectors in healthcare delivery, training and research. Addressing the human resource crisis and re-defining the institutional framework for training health workers. Leadership and coordination mechanisms, with the aim of improving the quantity and quality of health workers production.

CLUSTER APPROACH

1. Health Promotion & Education Aims at increasing health awareness and promoting community participation in health care delivery and utilisation of health services 1. Promotion of Good sanitation practices 2. Prompt detection of outbreaks and emergencies

Health Promotion & Education Contd. Individual and community responsibility for better health Ill-health due to environmental health and unhygienic practices and other environmental health related conditions. Diarrhoeal diseases School children, their families and teachers - appropriate health seeking behaviour Equitable access by people in conflict and post-conflict situations to Health Services Health emergencies and other diseases of public health importance. Nutrition services

2. Maternal and Child Health Highest total burden of disease However the Road Map to accelerate Reduction of Maternal and Child morbidity and mortality has been formulated. The effective implementation of these strategies is what is needed to move towards achievement of MDGs 4 and 5 by 2015.

Maternal and Child Health sexual and reproductive health & rights newborn health and survival by increasing coverage of high impact evidence based Attainment of MDG 4. Scale up and sustain high, effective coverage of a priority package of cost-effective child survival interventions. Reduce morbidity and mortality due to gender based violence.

3. Communicable Diseases Forms 54% of the total burden of disease; HIV/AIDS, tuberculosis (TB) and malaria, being the leading causes of ill health. Malaria remains most important disease in terms of morbidity, mortality and economic losses. The HSSP II - availability of ACTs consistently, RDTs for diagnostics and treatment, pre-referral treatment for severe malaria at community level, use of IRS, IPT, LLINs and early detection and treatment of malaria policy in place although not fully implemented. Uganda is on course for diseases that have been targeted for elimination namely guinea worm, trachoma, onchocerciasis, schistomiasis, lymphatic filariasis and measles. Address NTDs by chemotherapy, MDA insecticide sprays

4. Non Communicable Diseases (NCD) An emerging problem in Uganda. Includes Diabetes, CVS complications, Chronic respiratory dses, Cancer, sickle cell disease, road traffic injuries, mental health, substance abuse and medical pediatric and obstetric emergencies and deaths NCDs are mostly preventable through a broad range of simple, cost-effective public health interventions. The treatment of NCDs and their complications is costly. The Ministry of Health has undertaken to strengthen the planning, coordination and implementation of interventions such as provision of pre- hospital ambulance services and enactment of a NCD control strategic plan.

Emerging Issues and Recommendations 1. Overall health of Ugandas population remains poor with a low level of life expectancy and high level of mortality 2. Although there has been an improvement in overall health this remains slow suggesting that some interventions are having a positive impact. 3. There remains significant disparities in the distribution of health services with some regions of country having poorer services compared to others.

14 Progress of Key Health sector performance indicators IndicatorPerformance 2006Performance 2011 Infant Mortality rate76/1,000 Live Births54/1,000 Live Births Under five mortality rate137/1,000 Live births90/1,000 Live Births Full Immunization Coverage46%52% Deliveries by skilled health workers 38%59% Maternal Mortality ratio435/100,000 Live births438/100,000 Live births * Insecticide Treated Bednet ownership 16%60% Children receiving treatment within 24hours of onset of malaria 1%43% Approved posts filled by qualified health workers 56%58% 14

Way forward Designed different strategies, tailored to address the challenges to health in different parts of the country Proposed a comprehensive approach to addressing health services Worked out a better understanding of the investments needed to achieve the health outputs being sought Pursue Scale up of health services. Undertaken a comprehensive knowledge management approach in the sector Achieving equity in health Prepare a comprehensive Health Financing Strategy Agree to scale up sector coordination and partnership

Thank you indeed!! For GOD and my Country