Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
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New Vision (Kampala) - November 1, 2006
For 20 years the Ministry of Health has been moving towards fulfilling the mission of the health sector; "the attainment of a good standard of health by all the people in Uganda, in order to promote a healthy and productive life."
Paul Kagwa, the Assistant Commissioner of Health Education and Promotion, says when the Movement government took over power 20 years ago, there was a total breakdown of health services.
Subsequently, the government set up the Health Review Commission, headed by Prof. Raphael Owor, to give direction to the health sector.
This resulted into the development of three-year, five-year and 10-year plans as well as the Health Sector Strategic Plan (HSSP) I and II. The first plan (HSSP I) was implemented in the 2000/01-2004/5 period.
Upon its completion, the ministry embarked on the second plan (HSSP II), which is an improvement and a consolidation of the achievements of HSSP I. Blow are the achievements of the first plan.
Health infrastructure
This includes buildings, medical and hospital equipment, communication facilities, ambulance services and other transport facilities. Kagwa says patients used to walk over 10km to access health care but the distance has been reduced to less than 5km.
Following the transformation of Mbarara University Teaching Hospital into a national referral hospital, there are three national referral hospitals and 10 regional referral hospitals. Hospitals and health centres have been constructed in Kamuli and Kisoro districts.
For mental health, Butabika Hospital has undergone major rehabilitation. In addition six mental health units have been constructed at selected regional referral hospitals.
Other developments include the procurement and distribution of multipurpose vehicles and the supply and installation of imaging equipment to two regional referral and general hospitals.
Drug stock
The problem of drug shortage has been minimised with the introduction of credit lines. This is a system where districts order for drugs directly from the National Medical stores (NMS).
In addition, clinical guidelines have been provided and distributed for use by health workers at all levels, and 101 Medicines and Therapeutic Committees (MTC) have been established in the country.
Manpower Development
Health Sub-districts have been set up with full-time doctors and other health workers. During HSSP I, about 2,900 health workers were recruited.
The ministry has continued to support postgraduate training at various higher institutions of learning. However, the responsibility of pre-service training of health workers lies with the Ministry of Education and Sports.
The Ministry of Health retains the role of defining the standards and to guide the Ministry of Education on the number of people to be trained for a particular position.
Malaria control
Since 2000, major progress has been made in implementing national malaria prevention and control programmes.
The Home-Based Management of Fever (HBMF) strategy has been designed and implemented in 54 out of 56 districts. It involves the training of distributors and thereafter availing them with antimalarial drugs.
There has also been increased treatment of children within 24 hours, the use of bed nets in rural areas and a reduction in death of malaria patients.
Immunisation
The Uganda National Expanded Programme on Immunisation (UNEPI) is a countrywide programme whose target population comprises infants and women of childbearing age. It targets eight diseases.
Consequently, no case of wild polio virus has been identified since 1997; reported measles cases have reduced by 85 percent and during 2004 no indigenous cases of guinea worm were reported.
HIV/AIDS
Focus in the fight against HIV/AIDS and other sexually transmitted diseases was placed on Behavioural Change Communication, Voluntary Counselling and Testing (VCT), Prevention of Mother-to-Child Transmission (PMTCT), care and support including Anti-Retroviral Therapy (ART) and a National HIV/AIDS Sero-Behavioural survey which indicated a decline in the HIV prevalence from a peak of 18 percent in 1992 to seven percent in 2005.
Health research institutions
The major health research institutions in this period include the Uganda National Health Research Organisation (UNHRO), Uganda Virus Research Institute (UVRI) and the Uganda National Chemotherapeutics Research Laboratory (UNCRL).
Significant steps have been taken in the production of health research priorities, continued research in the area of AIDS and drafting guidelines for registration of herbal medicines.
Internally displaced Persons (IDPs) The main obstacle to the provision of healthcare and social services in Gulu, Kitgum, Pader, Lira and Apac was the insurgency.
This obstacle spread to Katakwi, Soroti and Kaberamaido in 2003. Irrespective of the odds, provision of drugs in these areas has been going on.
Care for AIDS patients was done through education, provision of anti-retroviral drugs, condoms and voluntary Counselling and testing (VCT). Pregnant women received clean delivery kits.
This was coupled with the provision of emergency sanitation in the camps, control of disease outbreaks, Immunisation and training of health workers and Community Own Resource Persons (CORPs) in the management of common disease conditions.
As the ministry embarks on the second Health Sector Strategic Plan (HSSP II) for the 2005/6û2009/10 period, it should be commended for the gains made so far and be assisted in achieving its goal.
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