in district border crossing temperture screened at Cover Photo:

Aboy being TABLE OF CONTENTS OF TABLE 44 28 18 08 04 MAJOR ACHIEVEMENTS...... Introduction...... HEALTH SYSTEMS (HSS)CLUSTER FOREWORD Challenges ofMobileMoneyChallenges payment Method...... Advantages ofMobile Money...... Complimentary payment by method UseofMobile Money...... EFFICIENT PROGRAMME IMPLEMENTATION...... LONG TERMAGREEMENTS (LTAS) ENABLETIMELY, i) INNOVATIONS andEFFICIENCIES...... WHO PRESENCEINUGANDA WAY FORWARD...... CHALLENGES...... vi) v) iv) iii) ii) i) MAJOR ACHIEVEMENTS...... Introduction...... DISEASE PREVENTIONANDCONTROL (DPC)CLUSTER WAY FORWARD...... CHALLENGES...... iv) iii) ii) i) MAJOR ACHIEVEMENTS...... Introduction...... HEALTH SECURITYANDEMERGENCYCLUSTER WAY FORWARD...... CHALLENGES...... xiii) xii) xi) x) ix) viii) vii) vi) v) iv) iii) ii) i)

Nutrition...... Adolescent Heal Child Health...... HumanRights...... And Gender Family Planning...... Reproductive an Laboratory...... HumanResour and Library Data, Information K and Public Health Infor Health Pr Heal and Medicines Leader Information &Tec Health En and DiseasesNon-communicable (NCDs)...... Tuberculosis...... HIV AIDS...... and Malaria...... Refugee emergen Ebola Virus Disease (EV Emergenc Immunization Vaccin Hepatitis...... ship and Governance...... ship and omotion and Communication...... and omotion y preparedness response...... and vironment...... th...... d Maternal Health...... hnology Management...... hnology cy...... matics...... th Technologies...... e Development...... D) Preparedness...... D) nowledge Management...... ces for Health......

50 50 49 48 47 47 43 42 41 40 39 38 35 31 31 29 27 26 26 23 22 20 20 19 17 17 17 16 16 16 15 14 13 13 12 11 10 10 10 10 9

Annual Report 2018 Annual Report 2018 4 FOREWORD “ T remains principle. ourguiding WHOespoused inthe Constitution in publichealth thatmission inUganda, Therefore, contributions inallthe made or socialcondition”. gender, religion, political belief, economic inpursuitUganda ofthe of health without distinction ofrace, distinction without of health possiblelevel highest peoples ofthe attainment enjoyment and by all Government Republic of ofThe ofthe (WHO) remains partner the Worldhe Health Organization

partners. partners. ofHealth ourleading and Ministry the developed inclose consultation with Cooperation Strategy (CCS) that was articulated guidedby inand Country the technicalThe work we did in2018 was which are also how the office is organised. way forward ineach four ofthe chapters to seeinfuture are these and presented as provide aglimpseofwhatwe would like are these and presented aswell. We also there were challenges way the along health to Ofcourse, allpeopleinUganda. government’s to efforts deliver good our majorcontributions to the we highlight In this2018 AnnualReport, 5

Annual Report 2018 Annual Report 2018 6 infectious diseases associated with fever re-emergingand fatal zoonotic spotlight of as emerginga the hotspot recentIn the hasbeen in past, diseases.these reducing morbidity due mortality and treatmentand interventions thus were reached with prevention, control HIV/AIDS which under many people by achievements the onmalaria and realistic possibility. We are encouraged diseaseselimination of some is now a Neglected Tropical Diseases for instance, heartening to area thatinthe report of in chapter three Itis ofthisreport. prevention control and aspresented achievements attained disease inthe We are to glad tremendous the report Regional Director for Africa. Agenda championed by ourWHO driving force Transformation the behind General. Attainment ofUHCisalsothe Triplethe BillionsvisionofourDirector (UHC) which isalsoWHO’s goal under towards Universal Health Coverage able to government support make steps development inUganda. contribution to health systems We take pride in our particular Development Plan2015/16-2019/20. 2019/20 eventually and to National the Healththe Sector Strategy – 2015/16 Framework for 2016 Uganda, –2020, Nations Development Assistance CCSThe isinturn to aligned United the We have been epicenter outbreak. ofthe readiness given proximity the ofthe 2018 tested Uganda’s preparedness and Democratic RepublicofCongo inAugust the in outbreak EVD of confirmation The International Health Regulations (2005). excellent compliance withthe process inthe and of time demonstrating outbreaks inconsiderably periods short hasbeenabletocountry stop allthese Rift Valley(H1N1) and Fever. Luckily, the Haemorrhagic Fever, Pandemic Influenza Fever, Yellow Fever, Crimean Congo Disease (EVD), Marburg Haemorrhagic has experienced outbreaks ofEbolaVirus tendencies. bleeding and country The by government counterparts also accountability excellent and diplomacy Transparency,duplication ofefforts. minimal with efficient easier, activities of coordinationand implementation made effectiveIn 2018, government leadership public health development country. inthe to partners other us and contribute to clear and government leadership firm thathasguided the mention must We community level. the its operationalization right from rigorous training, setting standards and to build this system through preparation, associated governments’ withthe effort Wereport. are happy to beclosely responseand ashighlighted inthis backbone ofsuccess inpreparedness surveillance system hasbeenthe Uganda’s vibrant responsive and disease In alldisease outbreak situation, in Uganda. challengesthese deliver and better health as wemore support strive to overcome Weattainment ofUHC. lookforward to but surely ismoving close country the to contributionsthe we which made slowly we wouldn’tthis support, have made invariousactivities areas ofwork. Without thatenabledus to report the implement of which ishighlighted inchapter four of fromfinancial support our partners some we acknowledge tremendous the interventions. reached withourcommunity-based which are individuals and households such Village asthe Health Teams through communitynurturing health structures also becommended for setting upand Yetreport. ofHealth must Ministry the reasonthe we achievements report isthis contribution to work the we didin2018 is health challenges we deal with.Their all work experience who and public the communitiesUgandan for we whom We forget cannot to recognize the positive results period. inthisreporting towards support increased financial and technical to significantly contributed health inUganda. for planning discussions and better public thatitformsand basis the for feedback, We you hope willenjoy reading ourreport be implemented in2019 onwards. review the will Recommendations from align them to and specific nationalhealth priorities. office the of needs resource was intended to determine human the ofRD’sis part Transformation agenda period.this reporting review, The which during office our of reviewundertook and functional a supported who Office Regional the colleagues and (RD) from to WHO the RegionalDirector for Africa butbyLast means no least, we are grateful WHO Representative Dr Yonas TegegnWoldemariam

7

Annual Report 2018 Annual Report 2018 8 (HSS) CLUSTER HEALTH SYSTEMS to organization’s the 13 approach. WHOgovernment supports to achieve thisgoal which isaligned of delivering Universal Health Coverage (UHC)through amulti-sectoral continuesUganda to build sustainable resilientand health system capable INTRODUCTION Country Office (WCO), the Health Systems Cluster contributed to UHC contributed Cluster Systems through achievements the highlighted inthischapter. Health the (WCO), Office Country A scientistcarryingouttestsattheUgandaCancerInstitute

th General Programme of Work (GPW). WHO Inthe 9

Annual Report 2018 Annual Report 2018 10 • • • • • MAJOR ACHIEVEMENTS Working Groups. Technical ofthe management and procurement MoHmedicines the providing technical leadership to pharmaceuticalof the sector by coordination oversight and role WHOIn addition, strengthened the Sector Strategic Plan2016-20. review NationalPharmaceutical ofthe technical for mid-term the support Pharmaceutical Sector by providing leadership governance and ofthe WHO strengthened MoH the ii) for 13 the organisationalThe strategic planning SDG3. UHC and commitment tocountry’s achieving Coverage the (UHC),thusenhancing map for achieving Universal Health developmentthe nationalroad ofthe WHO provided technical to support governance health ofthe sector. strengthened MoHleadership and 2016-20 was completed resulting in Sector Development Plan(HSDP) mid-termThe review Health ofthe i) accountability for results. to priorities country as well as strengthened WCO’s responsiveness of Work was completed which

Leadership andGovernance Technologies Medicines andHealth th WHO Global Programme • • • iii) Institutional Development Plan. monitoring ofthe implementation the in pharmacovigilance as well as in build capacity ofhealth workers developmentthe oftools usedto qualityand assurance through to strengthen regulation medicines WHO worked MoH withthe further

CNN and WHO/HQ.CNN and (London), News Chinese Agency, Relief web, Guardian News Paper international including media AFP, generated widely and used by the out ofwhich afeature story was exercise was aresounding success communities The inHoimadistrict. Settlement in and refugee-hosting carried outinKyangwali Refugee Vaccine campaign thatwas component Oral ofthe Cholera RiskCommunicationof the implementation and in planning WHO Supported participated and investment cost. would compared behigher to the community health returns the and is value for money for investing in casedemonstratedThe thatthere Community Health inUganda. Investmentof the Case for participated preparation inthe supported and partners other delivery WHOmodel, services and bestcommunitythe health As MoHcontinues the to explore Communication Health Promotion and • • • and DATAand collection for 7 the GlobalThe Youth Tobacco Survey partners. other MoHsupportedthe by WHO and advocacy public educationby and This was aresult ofrelentless areas isnow punishable by law. smoking orsmoking inrestricted Public declared citythe smoke free. Capital City Authority period, reporting same In the five high-risk districts. Daily EVD situation updates were also districts. high-risk five community inthe engagement opinionleadersand to implement Village Health Teams members training and messages, over 10,000 activationdesign and ofradio (IEC) materials messages, and Education Communication and preparation of Information, encompassing activities in these WCO supported participated and including risk communication. The ofpriorityimplementation activities necessitated and planning neighbouring DRC cases from ofEVD Possible importation global study. inthis selected to represent Africa two ofthe one Uganda, countries Tobaccothe Compliance Study in successfully to done implement exercises. Arrangements were also been produced two outofthe Preliminary have reports dataand participation. and support implemented with WCO active wereReport successfully Edition Global ofthe Tobacco th

• • iv) • by uptake scaling utilizationof and potentialthe ofdigitaltechnology developed. atharnessing It aimed includes Uganda’s priorities was REACH initiative) Strategic Plan which Community Health initiative (Digital DigitalRegionalEastThe African technology MoHand the partners. by digitalhealth implementers from ofdigitalhealthimpact investments strengthensand value the and Atlas (DHA)thatallows coordination information through DigitalHealth MoHtothe improve for demand WHO technical enabled support

humanitarian work inUganda. attainment to SGDsand ofthe contributionthe ofWHO to the to UNagencies other highlight collaborationalso sustained with were undertaken. There was Day AIDSday and others, among Day, World NoTobacco Day, UN World Health Day, World Malaria commemorative days such as website. eightWHO Allthe WCO ofthe management and regular and engagement update platforms,social media media of of bulletins,management achieved through production Enhanced WHO visibility was prepared. which a national version was stakeholders including MoHfrom produced sharedand with many Public HealthInformatics 11

Annual Report 2018 Annual Report 2018 12 • • • v) Interoperability frame work. Interoperability frame Enterpriseof the Architecture and It willbefollowed by implementation harmonized sustainablemanner. and useinamore their eHISs and identified of ownership instituting to step first a as ecosystem health Systems usedinUganda’s being of existing Health Information Criteria tool to establishknowledge System Assessment Validation interim electronic Health Information WHO Supported MoHto develop an sector. across health ofthe alldimensions communication technologies (ICT) linking information and East Africa initiativeThe will beimplemented in for improved health delivery. service digital technologies solutions and

and Readinessand Assessment (SARA) WHO the using Availability Service and in districts WHO supported a baseline survey over time. of health system strengthening provide key information onprogress nationalhealththe strategy and tohelping monitor evaluate and national of healththe system, ofmonitoringpart evaluation and Assessment (SARA2017/18 as FY) Availability Readiness and of Health to undertake Service WCO supported Ministry the Knowledge Management Data, Information and • • • standards, training ofteachers recommended WHO quality in accordanceservices withthe to them equipping and deliver capacitythe ofhealth workers of projectthe such as building addressed during duration the achieved. Itfocused onareas project to progress document conducted at completion of the surveyAn end-line was also communities.and readinessand health inthe facilities hindrances to availability service critical identified monitoring, for baseline values the established communityand assessments health health The services. facility regarding maternal child and practicesand ofcommunities knowledge, attitudes, perceptions awareness,that assessedthe survey household sectional It was complemented by across during life the project. ofthe subsequent monitoring ofprogress at inception facilitated and values for project the indicators surveyThe baseline established population. health deaths and the amongst atreducingaimed preventable ill newborn child and health services integrated reproductive, maternal, districts Iganga that providedand capacity project building inKamuli Agency (KOICA) implemented a Korea International Cooperation the WHOand from with funding protocol. ofHealth Ministry The vi) • • •

next UNDAF. years formulation the and of the next inthe activities remaining two inform ofpending implementation Framework (UNDAF) thatwill Nations Development Assistance Evaluation (MTE)ofUnited WCO supported The support. wereactivities ofthis alsopart of preparedness response and visualization based and planning to guidecoordinated evidence- Regular information products screeningand atpointsofentry. trends oftraveler movements including contribution significant response ofthe aspects was a Provision ofinformation ondifferent Open DataKit Excel. (ODK)and covered included VHF application, of EVD Areas inNeighboring DRC. outbreaks, following outbreak and for Viral Hemorrhagic Fever (VHF) managers ondatamanagement contact tracers district and data WHO supported training of child health services. districts to improve maternal and leadershipthe at all levels ofthe reproductive health sensitizing and students and in sexual and Hospitals which also serveas Lira and RegionalReferral through provision ofbooks to health literature inhealth facilities WHO Contributed to availability of for Health Library andHumanResources Mid-Term • • vii) • •

to hours respectively. 72.5 estimated 72to 25.6 hours96 and an bacterialand etiologiesfrom average turnaround for time viral major outbreaks hasreduced the especially investigations during toSupport laboratory work management. referral, bio-risk and transportation which hasimproved sample Transportationand Network National Sample the Referralusing packaging transportation and on quality samplecollection, Hoimaregionsand were trained 135 , health workers from development. continuingand professional Medical Education (CME) at strengthening Continuing Development Institute aimed Human Resources for Health undertake of the assessment A consultant was to engaged activities. planned inthe and Uganda Plan for UN-Wellness the in developmentin the ofastrategic bystaff inUganda participating psychological wellbeing ofUN WHO contributed to physical and MoH. training the institutions under Laboratory 13

Annual Report 2018 Annual Report 2018 14 The ProjectDirector MCH Program Mr KimSang Chul at theSouth Korean Embassy handing over Health • • capacity use ofthe onthe building resist. Thiswas aresult ofnational antibioticsthey the pathogens and Surveillance System thatmonitors Global Antimicrobial Resistance shared resistance datainthe successfully Uganda In 2018, antimicrobials. optimal and use of quality organisms ensure and availability to control spread the ofresistant launch. overallThe objective planis ofthe and approval official for WHO was over handed to MoH National Academy ofSciences and Foundation,Fleming Uganda developed from withsupport Plan(AMR-NAP)National Action AntimicrobialThe Resistance equipments to the Permanent Secretary Ministry of Health Diana Dr Atwine (second right) • viii) •

Guidelines 2016Guidelines Situation the and WHOThe Antenatal Care (ANC) this system. laboratories been registeredhad in seventy of2018, end (79) nine laboratories.of poliointhe By is intended to ensure containment promotes biosafety practices. This Materials (PIMs) stores inthe and presence ofPotential Infectious assesses laboratories for the Inventory (NLI)system that establish aNationalLaboratory initiatedUganda processthe to data sharing. WHO Netsoftware coordinated and Health Reproductive andMaternal • • • Grant. TeenageGrant. pregnancies and KOICA the under post-abortion and Manual Vacuum Aspiration (MVA) districts were trained use on of the Kamuli and Iganga workers from hundred forty-four and (244) health period, reporting In the two communities.in their of maternal health delivery services to contribute to improvement the postnatal care. They are expected Newbornand Care (EMONC)and Antenatal, Emergency Obstetric districtsIganga were trained on Kamulihealth and workers from (358) eight fifty and hundredThree country.the RMNCAH skills ofhealth workers in care initiative thatseeks to improve ChildHealthand (MNCH)quality of component inMaternal, Newborn finalized guideisa The with WHO support. was (RMNCAH) Health Newborn, Adolescent Childand workers onReproductive, Maternal, guidance onmentoring health aguidethatprovidesIn 2018, baby. and mother pregnancy outcomes for both which contribute should to better based onevidence guidelines and provide quality Antenatal care health by health enabling workers to improvement the ofmaternal new willcontribute guidelines These 2018 withWHO support. were adapted completed and in Maternal the and Health Passport Analysis including ANCcard the • ix) • •

Family (PAFP) Planning protocols (PPFP)Planning Post and Abortion updated Postpartum Family the from the benefited further services family time, same the planning baseline surveyof the tools. At onuse and the guidelines the stakeholders were oriented on was adopted (30) Thirty in2018. human rights standards checklist information based on services and qualityThe ofcare incontraceptive services. services. provisionsupport of quality MCH Kamuli and in Iganga districts to distributed to different the facilities worth USD892,798 thatwere Maternal ChildHealth equipment procurement of28different types of KOICAThe Grant facilitated information for students. Reproductiveand Health (SRH) into increased access to Sexual term long inthe should translate improvement inknowledge which training the showed marked from health workers. Preliminary results districts to compliment work the of Reproductive Health in same the ten (210)teachers onSexual and trainingthe oftwo hundred and KOICAThe Grant alsoenabled health workers. necessitated capacity of building too highinthissub-region which wereunsafe abortions reportedly Family Planning 15

Annual Report 2018 Annual Report 2018 16 • x) • •

services onsexualservices violence. quality improvement deliveryof be used to monitor support and tool.supervision toolThe will Gender-Based Violence support version final the adaptedof the WHO/JHPIEGO on agree and WHO supported MoHto review Uganda. familyfor in planning postpartum to reduce need highunmet the a family inorder method planning are counselled provided and with children for immunization.They first their year of pueperium bringwho their in mother to services family immunization and planning are now ableto offer integrated Kamuliand Iganga districts. They in immunizationservices and on integration offamily planning 368 Health workers were trained injectables. information onprogestogen-only guidance isintended to provide for acquiring HIV infection. This in women with veryhighrisk Acetate (DMPA) contraceptives of DepotMedroxyprogesterone recommendationsand use onthe updated WHO onthe guidance Country stakeholders were integrate. districtat nationaland levels was users the in which feedback from Gender AndHumanRights

• • • xi) • xii)

resource mobilization. willbeusedforand advocacy and 2019 in finalized be will It Uganda. BasedViolenceon Gender for developedsupport aDraft Strategy MoHwithWHOThe technical (IMNCI) review. Newborn Illnesses Childhood and Global Integrated of Management WHO/UNICEF the as well asfrom Children Adolescent and Health Global Strategy for Women, the the key recommendation from updated withinformation and Strategy was revised and ChildSurvival Uganda The tool. born quality ofcare assessment adolescents into existing the new- standards for children young and components of qualitythe of care of Care Standards incorporated key Paediatric the Quality adapted from inhealthservices facilities. tool The both Paediatric new-born and comprehensive tool usedto assess WHO supported MoHto develop a standards will be finalized and finalized approved in2019. be will standards health The inUganda. services atimprovingaimed adolescent of Care Standards for Adolescents MoHadaptedThe WHO the Quality Child Health Adolescent Health

• CHALLENGES Strategic plan. Pharmaceutical the in reflected not by onpharmaceuticals partners are implementedA numberofactivities • • • xiii) profile model for the country. the for model profile to inform developmentthe nutrition of the be used will test field the information collected from thresholds draft inthe The model. nutrient contents withnutrient in Kampala comparing and their foodsadvertised insupermarkets examining samplesofcommonly in the country.’’ The field testProfile involved Model for the Africa Region Draft ‘‘ the of testing field WHOStill in2018, supported the updated version. Malnutrition were retained in the of Severe Management the Acute WHOthe 2013 on guidelines from 2018 by MoH.Key recommendations Malnutrition were also updated in ofSevereManagement Acute onthe NationalGuidelines The on nutrition inemergencies. captures agreed global focus areas in humanitarian settings and guidance onnutrition response nutrition programming. Itprovides recent WHOup-to-date most guidance on the using finalized Emergency Response Planwas in Nutrition five-year the 2018, In

Nutrition Nutrient • • • • WAY FORWARD • • • • UHC agenda. UHC agenda. to extentthe possible to advance the MoHtoSupport ensure inclusiveness pharmacovigilance. including limited butnot to capacity for regulation medicines Continue to strengthen institutional implementation. their pharmaceutical sector monitoring and in harmonization ofactivities Work to with partners strengthen coordinationand health ofthe sector. strengthen overall MoHleadership to coordinate to and partners Continue to provide leadership between partners and Ministry the beenjointlyagreedthat had to majoractivities implement resultedengagements indelays Competing schedules and implementation. which may affect ownership and roadmapof the for achieving UHC, represented development inthe keySome stakeholders are not Development plan. National DrugAuthority Institutional progress ofthe on implementation There islow staffmotivation to report by patients. products useofmedical resulting from health care workers of adverse events There is continued low by reporting 17

Annual Report 2018 Annual Report 2018 18 EMERGENCY CLUSTER HEALTH SECURITYAND the humanlife-course.the ofanintegratedpart people-centred platform ofdisease prevention thatspans this cluster government the supports deliver quality as immunizationservices assess respondand detect, report, to public health emergencies. In addition, core emphasis onbuilding emergencies withparticular capacities to prevent, toUganda buildaresilient health system capable ofresponding to health HealthThe Security Emergency and cluster Government the supports of INTRODUCTION A WHO Risk Communication officer educating school children about the EbolaDisease Virus 19

Annual Report 2018 Annual Report 2018 20 • MAJOR ACHIEVEMENTS cholera infection Euvichol using Plus district were protected against refugee populations in fivehot spots of and host the targetthe of367,898 from persons 1year aged above and against one hundred seventyand six (357,176) seven, fifty and hundred Three i) that 91.4% (89.9 – 93.0) coverage of the vaccine. coverage The survey showed persons received second the doseofthe coverage of 97% while 301,065 (81%) vaccine animmunization giving

Figure 1:DPT3Coverage 2018In Uganda Immunization Vaccine Development TM

for vaccinated being not was absence reason main The significant. not was 60 were 36% lesslikely to bevaccinated which above Persons significant. be vaccinated, which was statistically 20 –49 years were 33% lesslikely to (59.4 were 62.2% – 64.9) achieved. Persons aged of coverage confirmed 78.3% (75.9 –80.6), avaccine and card- round. Overall, atwo dosecoverage of round 80.5%and (78.2 – 82.6) in secondthe first the in population target • • • to national levelthe to enable multi- grassrootsthe level information from to collate, analyze transmit and two districts ( Luwero) and SystemsManagement (VAEIMS) in Vaccine Adverse Events Information WHO supported MoH to pilot the Uganda. vaccine studyinthree sites sentinel in effectiveness and impact ofrotavirus MOH to launch anevaluation ofthe vaccine,of the WCO supported the infection. Following introduction the protected severe against rotavirus Rotarix vaccine respectively hence and of dose second and first the received (110%) 416,297and (59%) children had of December atotal 2018, of777,878 immunization programme. Byend at 10weeks during ofage routine secondwith the doseadministered targets allchildren 6weeks aged ofage launched Rotarix the vaccine that DrRuhakanaof Uganda Rugunda Right HonorableThe Prime Minister immunization. routine Response(IDSR)and and Integrated Disease Surveillance in technical supervision support quality,time effective focused and of ODKtool. tool The and monitors real- regional district level national, were trained use onthe at officers One hundred and fifty(150) surveillance visitsbythe vaccination the team. respondentof the during of time the • • is leftout. issues of MOV to ensure that childno the atmitigating planaimed an action used be develop will to findings These for immunization is still inadequate. capacitythe ofquality health workers care givers health and workers; and immunization knowledge gapamong access dueto distances; long there is health facilities are stillhard to chain systems lack and gas;many breakdownthere ofcold isfrequent System (HMIS)tool management; Health Information Management that there ispoorvaccine supplyand regions. indicated assessment The each demographic ofthe health from (MOV) in19districts withrepresentation ofVaccinationMissed Opportunities (CHAI) to conduct an on assessment Clintonthe Health Access Initiative WHO worked withMoH,UNICEF and private inthe services sector. that willstrengthen immunization lead to development the ofastrategy privatethe sector. Thisinformation will of needs and opportunities services, strengthsthe weakness and ofthe extent, their immunization services, generated information on statethe of privatedelivery inthe sector that analysis ofimmunizationservices MOHsupportedand alandscape WHO inclose collaboration withCDC responding to immunizationerrors. in real and including time identifying level vaccine safety decisionmaking 21

Annual Report 2018 Annual Report 2018 22 • • • Health to review multi-hazard the WHO of supported Ministry the preparedness. and financing; and policy legislation, national include: Points ofEntry; External Evaluation areas (JEE).The Joint the in identified were that areas which capacity aimsatbuilding in WHO RESOLVE and from support PlanforAction Health Security with MoHworkedThe National onthe ii) in 50health facilities. system conducted in10districts and on administrative DHIS2 data and following a system wide assessment year DataImprovement plan(MYDIP) ofHealth toMinistry develop aMulti- UNICEF, AFENET(CDC)supported WHO incollaboration withJSI,CHAI,

response Emergency preparednessand Figure 2:Proprotion of vaccinated peoplefollowed upby scheduled visit anddistrict • • • produced ofHealth. by Ministry the strengthened is regularly and weeklyThe Epi Bulletin was country. Surveillance Responseinthe and thirdthe editionofIntegrated Disease MoH districtsand were trained onrollout of the from officers (51) one Fifty to disease outbreaks inalldistricts. investigationssupport response and RRT The members partners. MoH and comprising ofAgriculture, Ministry expandedthe multi-sectoral team operations) they and now constitute emergency response (concepts and Response Team were trained on Forty (40) membersRapid ofthe finalised in 2019. will be and developed was draft final recommendationsthe The JEE. ofthe Response Planincompliance with to upgrade itinto Emergency the preparedness response and planand iii) Figure 3:WeeklyIDSR reportingRates

Travellers from the Democratic Republic of Congo disinfecting their feet before crossing to the Uganda Ebola VirusDisease (EVD) Preparedness side at Mpondwe border crossing. 23

Annual Report 2018 Annual Report 2018 24 • district of Hoima and and .district and ofHoimaand region refugee the and hosting risk districtsRwenzori inthe sub- urgent interventions 5high inthe quick operationalizationsupport of WHO deployed term short staffto NTFareof the and allfunctional (NTF). seven The sub-committees through National Task the Force coordination preparedness ofthe government withoversight and SystemManagement (IMS) to assist WHO alsoactivated Incident the USD 12.6 million for activities. (EVD) preparedness which raised Contingency first Plan for Ebola Virus Disease the develop WHO supported MoHtothe A Health Worker vaccinating one of the eligible people against Ebola Virus in Disease • • tracing, WHO supported MoH the surveillanceUnder contact and readiness country. inthe very useful feedback onlevelthe EVD Monitoring Missionswhich provided CommitteeAdvisory Joint and Oversight Independent missions of the were captured. WHO coordinated contributions variouson the activities a dashboard through which partner with introduction 4W ofthe Matrix and was partners strengthened further Daily information sharing with ofHealth partners. and Ministry the outputs delivered from withfunding for jointinformation sharing onthe to organize accountability the Forum WHO ofHealth supported Ministry the A WHO staff organising refugeesfrom DRC for screeningEVD and subsequent entry in Uganda. samples. All samples were negative testing and transportation of340 enabled detection, samplecollection, of December activities these 2018, Villageand Health Teams (VHTs). As workers care atprimary facilities weretransport provided to healththe and forms investigation definitions, telephone case guidelines, hotline, Ntorokoand districts. A24/7 ,Portal, Bunyangabu risk communication in Kasese, Fort Disease Surveillance (CBDS)and to conduct Community-Based 6,417 VHTs were trained in 26 districts and officers surveillance 1,600 investigations.suspect For instance district level for promptand alert to buildcapacity atnationaland • infe bra, 1 on psychosocial 110 burial, dignified 170case management, onsafe and health workers were trained inEVD Entebbeand isolation centers. 526 , Kyangwali, Olio, Lacor, Naguru suppliedto equipment and , Bundibugyo and districts centres were constructed inKasese, cases inmany districts. Isolation ininvestigationinstrumental ofalert in 7regional which hospitals were preposition VHF one 500ModuleKit ofHealthsupported to Ministry the For WHO casemanagement, Valley Fever (RVF). (CCHF) eight(8)positive and for Rift Congo Crimean Hemorrhagic Fever for EVD, (9) nine were positive for 25

Annual Report 2018 Annual Report 2018 26 • • • into country. the WHO mobilized and Congo (DRC)were regularly crossing areas Democratic ofthe Republicof EVD some affected refugees from oftravellersthousands including WHO. Thiswas after realization that initiated by MoHsupported the by EVDPoints ofEntry screening was South Western Uganda. best at 91% in healthmost facilities in availability hygiene ofhand the being improved for indicators most with Consequently, IPCpractices have facilities targeted inthe districts. were revitalized inmany health high-risk districts. IPCcommittees workers in562health facilities in11 tomanaged reach upto 9,806 health facility level. IPC mentors trainersand mentorshipand ofhealth staffat districts through on jobinstruction was enhanced EVD inthe high-risk Infection Prevention Control and (IPC) identified districts. successfully carried vaccination inthe teams were formed, trained they and WHO. national vaccination Thirteen (13) developed by from MoHwithsupport ZEBOV vaccine following a protocol arrangement rVSV- the using EVDagainst compassionate the under 14 high-risk districts were vaccinated health workers from 4,420 frontline supported by WHO. psychosocial trainers all established a and national teamsupport of 15 • • activities. activities. Over were 100 alerts detected in these screened atvarious ground crossings. International over and Airport 7,073104 been screenedhad at travelers atotal2018, of 264,820 Since Augustsupported supervision. thermometers, thermo scanners and trained screeners, provided infrared iv)

operationalize CBDSstrategy inthe There were continued to efforts outbreak.the contributed to containment the of source hygiene and situationwhich communities improve water their refugeeswith the host and community activities engagement control There guidelines. was also National Cholera prevention and training materials to revised the choleradistricts, aligning and cholera kits refuges inthe hosting five of preposition management, of health workers incholera training transportation, and investigations, sample collection included active surveillance and districts.support The refugeesamong inHoima,and respond to cholera the outbreak WHO supported MoHtothe WHO Central Fund for Emergencies, the CERFand With from funding Refugee emergency • • • • Health workers have alsobeen healthsupplies inthe facilities. preparedness is availability of IPC mainchallengeThe inEVD task. a daunting controlmade ofzoonotic diseases animalsector inthe services has Privatization ofpublic health activities. planned to delayed of implementation delayed release leads offunding Secondly, limited resources and were recorded in54Districts. instance, measles in2018, outbreaks providers. service and services For ofconsumers engagement and of result ofsuboptimalinvolvement of unvaccinated children. Thisisas outbreaks dueto highnumbers are stillpreventable diseases Despite achievements, the there CHALLENGES Strategy finalized. thatisbeing a NationalRefugeeResponse to developmenta and report of status was conducted leading onrefugeeassessment health A three level WHO/MoH CBDS. requiredwith the tools for been trained equipped and Arua Yumbeand districts have Kyegegwa, , Masaka, Team members inAdjumani, Villagea total Health of2,822 refugee settlements. To date • • health importance. to tackle zoonotic diseases ofpublic takes charge ofanimalvaccination animal sector sothatgovernment Health Approach - a policy shift in the There to isneed strengthen One the recommended by GVAP. the areservices as agenda high on the leadership to ensure that immunization required political highest atthe Continuous advocacy isurgently WAY FORWARD health facilities. of water are also a challenge in many Waste availability and management consolidate EVD readiness activities. view enormous ofthe requirement to isyet challengesupervision another in after touching patients. District IPC practices hygiene especiallyhand slow atembracing comprehensive 27

Annual Report 2018 Annual Report 2018 28 CLUSTER AND CONTROL (DPC) DISEASE PREVENTION (NTDs) and environmental(NTDs) and management. HIV/AIDs, Hepatitis, Tuberculosis (TB), Cancers, Neglected Tropical Disease of communicable Non-Communicable and Diseases (NCDs)including Malaria, ofHealth DPCclusterThe prevention inthe Ministry the supports control and INTRODUCTION Member of Uganda’s Security forces demostrationg their support for malaria action

29

Annual Report 2018 Annual Report 2018 30 is0.5%. Uganda childrenamong 5–14years aged in indicated prevalence thatthe ofHIV respectively.men UPHIA the Inaddition, 7.5% in2016 inwomen and 4.3% and 6.1% and in2011 to 8.3% declined from compared to 7.3% in2011. HIV prevalence showed HIV nationalprevalence at6% HIV Assessment (UPHIA) Impact that indicated 2016 inthe Population Uganda progress nationalHIV inthe response as significant make to continues Uganda implementation. focused ontopartners ensure their were articulated which WHO and UMRSP 2017, strategic recommendations During mid-term the review ofthe StrategicReduction Plan(UMRSP). 2020the targets Malaria Uganda ofthe atachieving allaimed implementation district-focusedpartnership, and funding There isincreased politicalsupport, A Health worker testing for malaria parasites which one is of the ways of fighting malaria in the country 4.4% East 3.8%inWest and inNorth Nile. regionNorthern with4.6% inmidNorth, that Hepatitis Bprevalence in ishighest women).among survey The indicates (5.6% at4.3% stands 3.1% and men among of Hepatitis adults Binfection among Assessment (UPHIA) Survey, prevalence Population-basedUganda HIV Impact know status.According their to 2016 the out ofevery donot 10peopleinUganda exposuretime population,while9 ofthe countries for life- Hepatitis with52% B, highlyendemic ofthe isone Uganda is expected continue in subsequentyears. and significantly reducing number of people missing with TB is peoplewithTBdisease. missing the The finding in progress register to continues Despite burden,the country the burden TB/HIV countries world. inthe remainsUganda 30-high the among this chapter. DPCcluster the under are highlighted in 2016-2020. 2018The WCO achievements Health the and Sector Development Plan National Development Plan 2016-2020 health priorities highlighted inthe country.the NCDsare national among also shows trends escalating ofNCDsin routine The in Uganda. surveillance data accounted for 33% (297,000) ofdeaths According to WHO NCDs of2018, report Figure 4:Incidence of MalariainUganda2018. MAJOR ACHIEVEMENTS • i)

incidence between 2017 2018. and was a30%reduction inmalaria incidence mortality. and There in reducing malaria both the progress some made country The trends Malaria Morbidity Mortality and Malaria

31

Annual Report 2018 Annual Report 2018 32 • • Figure 5:AnnualreportedMalariaCases anddeaths 2015-2018 Strategy for Malaria Reduction Integrated Vector Management completed printed and included policy guidelines and documents from WHO.financial support Other was updated withtechnical and with avisionfor malaria elimination NationalMalariaThe Control Policy Strategies Guidelines and Policy Standards, Documents, There was areduction of54% in western southwestern and areas. reductions ascompared to central, Karamoja regions showing minimal Westmid northern, the Nileand with reduction homogeneous isnot However,population in2018. this in 2017 to 191 casesper1000 272 cases per 1000 population incidenceThe rate reduced from

• • Repurposing ofLLINs forGuidelines Use,Repair and WHO include: from with support developed documents Other . Guidelines Nets DistributionInsecticidal and for Malaria Vectors inUganda Resistance Plan Management for Guidelines Insecticide Uganda, ImplementationManagement Integratedin Uganda, Vector 60 %) inthisperiod average of49% to 39%(range: 30to an period.same TPR reduced from regions except in Karamoja in the Test Positivity Rate (TPR) across all There was a25% reduction inmalaria deaths per100,000 population. deaths per 100,000 population to 9 19.3 2017 2018; and areduction from malaria ratethe mortality between School-Based Long-lasting

; Routine Routine

• the trainingthe to 23districts reaching theyand consequently cascaded staffwere(NMCD) trained asTOTs 26 NationalMalaria Control Division making. thisarrangement, Under of entomological data for decision trained surveillance, monitoring on and use were on entomologicalconducting Officers Control subnationalVectorNational and LLIN Distribution Guidelines Capacity Building were alsoproduced. parasite-based inUganda diagnosis Malaria and Implementation Malaria training, diagnostics, on . Guidelines Mapping and Framework AgainstAction Malaria (MAAM) A Health worker in Northern Uganda spraying ahut to control Malaria Partner Inventory Partner ; and ; Mass

• • 35 Vector Control Officers. eventually brought control. under Nwoyaand districts which were to two malaria upsurges inKisoro respond and confirm investigate, WHO supported NMCDto the During period, reporting the Preparedness Response and Evaluation Epidemic and Surveillance, Monitoring, visualization and GIS. GIS. visualization and evaluation indataanalysis, surveillance, monitoring and for NMCD staff responsible for WHO alsoconducted training

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Annual Report 2018 Annual Report 2018 34 • eastern districts ofUganda. and (SURMA) project in25northern Uganda’s ResponseinMalaria grant The fund. willstrengthen period. same inthe Malaria Report submitdataforand was alsoableto compile, analyses year NMCD The with WHO support. 2017/18 were produced during the for Financial the YearReport Bulletin Executive Brief, Quarterly The Weekly SituationUpdate, The Key information products i.e.: The The NMCDAnnual The and HE President Yoweri Kaguta Museveni signing aCommitment plaque in The WorldThe support of the mass action against malaria Resource Mobilization

• • worth $60MthatDFIDagreed to Health to draft agrant proposal WHO worked of Ministry withthe played a central role. In addition, a grant proposal inwhich WHO of negotiation submission and malaria following successful writing, Fund Grant of$185m to combat was country The awarded aGlobal (MAAM) where(MAAM) launched at the AgainstAction Malaria initiative Forum onMalaria Mass the and Parliamentary Uganda The AgainstAction Malaria Initiative Advocacy, Mass Dialogueand

HE President Yoweri Kaguta Museveni signing aCommitment plaque in support of the mass action against malaria

• • • every two persons inahousehold. all people-aratio of1LLIN for Coverage Campaign targeting inaUniversal country the (LLINs) were distributed throughout Insecticide-treatedLasting Nets atotalIn 2018, millionLong of26.5 Groups RBMpartnership. the and supported Technical the Working WHO together withpartners jointly plan reviewand progress. Forum were successfully to held Roll Back Malaria (RBM) Partnership regular quarterly ofthe meetings Despite coordination challenges, collaboration Multisectoral and Partnerships commemoration 13 ofthe members national ofparliament, such as breakfast with meetings A numberofadvocacy engagements initiatives.important launchinitiation and two ofthese WHO was inplanning, instrumental country. inthe elimination efforts towards malaria prevention and commitment and financial support Museveni pledgedpolitical who Excellency President Yoweri Kaguta groundsparliamentary by His with insecticides werewith insecticides raised. ResidueSprayinguse ofIndoor especially onLLINutilizationand malaria community and awareness Increased resource domestic for organized commemorated. and conference were successfully scientific and Day Malaria World

th

• ii) •

mortality by 50%, by year by the mortality 50%, 2023. HIVthe incidence HIVand related goal whose istodocument reduce development ofthisstrategic WHO supported partners and health inthe activities sector. ofHIV/AIDSimplementation to 2022/2023 to guide the HIV/ AIDS strategic plan 2018/2019 a costed NationalHealth sector ofHealth developed Ministry The project. project. tools checklists and this under (iCCM)Management supervision integrated Community Case artesunate the updating and useofqualityand assured rectal advocated for registration the severe malaria. WHO successfully 5 children presenting to VHTs with a pre-referral treatment to under administering rectal artesunate as at increasing child survival by Kole Apac districts and aimed rolled outin Kwania, Oyam, (CARAMAL) project was effectively Artesunate for severe malaria CommunityThe Access to Rectal workingand subcommittees. guidance incoordination meetings by providing technical and support WHO participated efforts inthese coverage ofover 98% was attained. An operational/administrative Guidelines Policies, Strategies and AIDS HIV and 35

Annual Report 2018 Annual Report 2018 36 • • Figure 6:Total PLHIVvs those onART 2010 -2018inUganda. districts. Furthermore, 428 ofthe wereand completed ofall in32% trainings begunin118districts (92%) ofallARTfor 72% facilities. Facility have beencompleted accounting to Dolutegravir based regimen oldART regimens patients from training sessionsfor transitioning March 2019, 1440health facility facilityand level asof5th and have beenrolled outatdistrict Consequently, guidelines the support monitoring psychosocial and advanced HIV disease, viral load of management management, preventive therapy, IYF, TB/HIV PrEP,HTS, EMTCT, cotrimoxazole include; Dolutegravir (DTG) use, updates thatwere incorporated tools based onWHO guidance. The related and Guidelines training HIV Prevention Treatment and revisedpartners consolidated the Program (MoH/ACP), WHO and ofHealth AIDSControl Ministry The • • 527 priority TLDSites (81%), have guidelines and aroadmap and guidelines to guide prevention, treatment care and revisedin the 2018 consolidated updatesThe were incorporated adaptation. discussionsand country adolescentand programming for updates area inthe ofpaediatric were to held share new WHO Similarly, consultations in-country 2017). to 60%inyear 2017 (MoH&ICAP, in year 42% 2016 (UAC, 2016) from increase inviral suppression rates Viral Load suppressed (with an people initiated onART have their progress towards ensuring that Theremen. hasbeentremendous with disparities children among and a coverage of above 90% on ART, care, 1.16million were onART giving knew HIVtheir status wereand in People withHIV Living (PLHIV) of Uganda’s estimated million 1.38 By December atotal 2018, of81.9% been trained.

• • • was launched under inUganda to childhood end AIDSinAfrica campaign which isaglobal drive FreeThe to nationalEMTCT Shine EMTCT Free to Campaign Shine levels. Localat nationaland Government withovermade 5,000 leaders both engagements and country in the now beenrolled outinalldistricts Kampala regions. initiative The has Central, Central 1,Central 2and Midwest, Southwest, East- East, North-East, Nile, Mid-Northern, accountabilityand fora inWest regional stakeholder engagement working groups thatorganized committee technical the and was provided through steering the out to more Technical men. support adolescentsamong reaching and at reducing new HIV infections Fast- Track Initiative that aims point program Presidentialof the five the of operationalization the WHO continued to advocate for coordination Advocacy, and partnerships drug resistance. inprogrammingcountry for HIV Research Institute to guidethe WHO Virus Uganda the and from developed withtechnical support Resistance Strategic Planwas NationalHIV the In addition, Drug actions. country the

• • AIDS response sub atnationaland evaluation system for HIV the and monitoring country The and Strategic information mile EliminationPlan2019. to develop eMTCT Uganda the last used be will findings The approval. Global Validation Committee for secretariat subsequentlyto and the to RegionalValidation the submitted be and 2019 in finalized A draft validation will report be collaboration withJointUNteam. WHOthe tools was completed in collection analysis and based on process. process The ofdata role validation onthe advisory requirements their thusenhancing validationon the process its and together withACP program staff Committee (NVC) thatwas trained 42-member National Validation with WHO constituted a from support MoH/ACP the certification, In pursuit ofglobal WHO eMTCT delivery Service realized. heightened to ensure thatthisis Transmission of HIV are efforts and toelimination ofMother Child countriesof the on track towards transmission of HIV. is Uganda one toof eliminationMother child aspires to achieve global targets WHO. from thiscampaign, country Under the support with office auspicesthe of Firstthe Lady’s 37

Annual Report 2018 Annual Report 2018 38 • The Minister of state for Primary HealthCare HonSarah Opendi Administering TB drugs to a patient. estimates was enhanced through to generate HIV projections and HIV estimates. capacity In-country generation ofregional districtand developed for subsequent demographic projections disseminated,and sub- and projections were produced 2018The HIV estimates and 2017/2018the JointAnnualAIDS GlobalThe HIV/AIDS and report prioritization of interventions. to inform and implementation for data generation use and leading to improved capacity national levels was strengthened • iii)

(CSOs). selected CivilSociety Organization Commission, MOH,PEPFAR and Bureau AIDS ofStatistics,Uganda training Uganda ofstaffthe mémoire. period are articulated aide- inthe recommendations for next the Multisectoral HIV response and highlight progress inthe made Review were supported these and costs (expenditure thatismore TB caseexperienced catastrophic that 53% with a households ofthe was conducted it revealedand TBCatastrophicThe Costs Survey Tuberculosis they seekTBcare also and services to track patient expenditures as of Monitoring Evaluation and Plan survey results willinform development the The protection. financial in treatment adherence in and costs contributes to improvement demonstrate thatreduction ofTB END TBtargets. Italsosoughtto progressthe to made achieve a baseline whichagainst to measure Public Health atestablishing aimed Makererethe University School of MoH incollaboration withWHO and elderly.the survey The by done young lessthan15 years among and extremesat the i.e. ofage inthe income). situationwas The worse than 20% annualhousehold ofthe HE President Yoweri Kaguta Museveni leading awalk during commemoration day the of of Physical Activites, in 2018. • • to deliver enablethem quality VHTsand members was done CB Dotstraining for Health workers refugee settlements. Additionally, Kiryadongo, Nakivule Arua and wasTB assessment conducted in ofMDRTB management and This will promote diagnosis timely Parliamentwith the of Uganda. procured by WHO inpartnership prisonthe health was services ofMDRTBmanagement within A GeneXpert machine for catastrophicwith the expenses. were found to affected bemost sinceTB services patients these inform future programing for MDR 39

Annual Report 2018 Annual Report 2018 40 • iv)

establishment ofasurveillanceestablishment mission alsorecommended the Hepatitis strategic plan.This development National ofthe key recommendations for the offices) Country on Hepatitis thatprovided and Regional scoping mission (Headquarters, WHO supported athree level community levels. at both facilityTB services and Hepatitis Figure 7:Cases of Prostate Cancer per10,000population • v)

System. is captured Global inthe Reporting which willensure progress country system for Hepatitis the program communicable Diseases 2013-2020 Prevention Control and ofNon- Globalon the Planfor Action Diseases Multi-sectoral Planbased A costed Non-communicable Policies, Strategies and Guidelines (NCDs) DiseasesNon-communicable • • manufactured tobacco products increment for imported locally and Development onprogressive tax ofFinanceMinistry Economic and the WHO trained taxexpertsfrom tobacco use reduction strategy, In promotion taxation ofthe of Convention for Tobacco Control. goals WHOthe ofthe Framework will contribute to realization the of regulation ofthe Implementation Tobaccothe Control (2015). Act to of implementation support tobaccothe control regulations WHO developed partners and MoH The in collaboration with cancer.elimination ofcervical towards efforts national scale-up evidence generated willinform regionalat select referral sites. The Global Fund started HPV screening the from MoH withseedfunding guidance global and trends, the nextthe few years. BasedonWHO screening to HPV screening over aVIA-based on transitioning from Cancer Strategic Planthatfocuses developed partners and aCervical Similarly, ofHealth Ministry the byone-third 2030. SDGtarget the planand action of by 25% by 2025 NCDglobal inthe reduction ofpremature mortality towards achievement oftargets on will contribute to advancement ofthisplan Implementation was developed withWHO support. • • patientand monitoring system. for nationaltraining the curriculum of NCDswere adopted by MoH the package for prevention control and revised the and HEARTS technical low resource settings (WHO-PEN) of Essential NCDinterventions for are based WHO onthe Package was developed. tools The developed patient monitoring based on trialthe toolsand for both clinical care and trainingA participatory curriculum greater Masaka region. register longitudinal in the for the datawas their and incorporated patients were enrolled inNCDcare Masaka region. More than2000 diabetes risk other and factors in ofhypertension,management cardiovascular risk-based especially withregards to management and NCD diagnosis IMCI, initiated aproject to improve by WHO Walimu, IMAI- the and ofHealth supported Ministry The Capacity Building by year the 2020. decrease intobacco consumption significant a projects use tobacco in WHOUganda. estimates on 41

Annual Report 2018 Annual Report 2018 42 • • Health and Environment and Health financing situation. financing the of WASHunderstanding the to facilitate data Trackfin be used to collect analyzeand This teamor sub-national. will the (WASH) sector national atthe to financing water, sanitation hygieneand track and toidentify able be to (Trackfin) Financing to WASH Methodology were trained Tracking onthe of Water Environment and Twenty (20) Ministry staffofthe Quality. forGuidelines Drinking-water which isconsistent withWHO acceptability of drinking water of ensuring safety the and effective most the means water. Water safety plansare safehad households drinking safe water only29%ofthe and only 41% ofwater sources had thatindicatedassessment that following awater quality developing water safety plans worked on a road map for Health supported by WHO of with Ministry partnership ofWater Ministry The in Capacity building Guidelines Policies, Strategies and CHALLENGES • • vi)

Cluster are in inadequacies Disease Prevention Control and main challengesThe the under reports. of nationaldatainto global NTD includingreporting contribution accountability for resources and program reviews, and mobilization through assessments, impact supported included evidence generation areas Other field. the as officers MoH well in assupportivesupervision by events and inWHOparticipation meetings for NTDsthrough trainings, WHO supported capacity building partnership. Inaddition, country programs atstrengthening aimed platformsother and of NTD the WHO served on several TWGs to various the NTDprogrammes. providedand technical guidance involved instrategic operations NTDsbyof most 2020. WHO was set targets including elimination national program objectives and areof NTDs.These based onthe prevention, control treatment and to key other interventions for the affected communities inaddition continued to be implemented in the Mass drug administration multisectoral collaboration, (NTDs) Neglected Tropical Diseases • • • leading to highNCDmortality. presentation with complications populationleadingthe to late riskabout NCDand factors by compounded by Lack ofawareness inevitable mortality. situationis The care the escalating and from continues to exclude poor the funding partner with dwindling of NCDs by government the prevention management and Inadequate investment in Coverage. attainment ofUniversal Health remain majorobstacles to the generation useofhealth and data basic and technologies,medicines health, irregular access to essential inhumanresourcesshortages for Health systems challenges such as setdates.the prevention controland targets by ability country’s on the to achieve incidence of NCDs pose queries infectious diseases aswell asraising morbidity dueto mortality and challenges. increasing The significant also are funding donor finance to response coupled withreducing resources Domestic involvement health and promotion. involvement, community of commodities, private sector procurement management and WAY FORWARD • • Physical Activity willreduce promoting Healthy Dietsand Development Programme for Regulatory Fiscal and Capacity Tobaccothe Control 2015 Act and NCD targets. of Implementation achievement ofglobal national and plan willbolster progress towards NCDmulti-sectoral the implement investment partner and to For NCDs,increasing government challenges. quality willaddress ofthe some technologies improved and data budget for commodities, supplies, periodically systematically and (Government) resources to diseases. Increasing National or even elimination of these critical to prevention, the control to communicable diseases are acoordinatedand response multisectoral involvementsupport, Political legislative commitment, exposure to NCDrisk factors.

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Annual Report 2018 Annual Report 2018 44 IN UGANDA WHO PRESENCE contributions (AS). (VC); 21%isAssessed Contributions (AC) 4% and isAdministrative support received Outof61%funds 61% (18,531,206). 75% isVoluntary Contributions approvedThe at isfunded biennialworkplanand isUSD31,246,856 2018/19 PROGRAMME MANAGEMENTANDSUPPORT The WHORepresentativeDrYonasTegegnWoldemariamchairingastaffmeeting 45

Annual Report 2018 Annual Report 2018 46 tolocally amounting USD6,817,942 resources financial mobilized office During year the country the 2018, Figure 9:Locally mobilizedfundsby donor Figure 8:Total fundsavailable by fundtype mobilised fund by fund mobilised donor. Figure 8below presents locally the since country August inthe efforts 2018. EbolaVirussupport Disease Preparedness greatlycontributed financial resources to USAID. Irish The UKAid Aidand have Cooperation Agency (KOICA); GAVI and Fund (CERF); Korea International (UKaid); Central Emergency Response Ireland (Irish British Aid);The Government Government The namely: (6) partners of all Voluntary Contributions bymade six (excluding PSC).Thisconstitutes 49% of i) INNOVATIONS andEFFICIENCIES

• • Management members. submitted by various team used for consolidating information be thatwouldtime otherwise which document same saved collaboration onworking onthe was enjoyed was simultaneous the sharedof the drive staff thatthe various advantage Another reports. etc); Administration templates and Strategy, General Program ofWork, (e.g. Country The Corporation to relevant strategic documents shared drive facilitated easy access acrossand clusters. During the 2018, information sharing withinteams shared drive drive one and that facilitates office country of use the Increased saving time through work. tools new and applicationsintheir productivity by using more efficient 2019. Thisinitiative increased staff staff withnew tools by of end the foris ongoing 95% coverage of new computers process the and More than 80% of staff received to continue work mobile. when Applications thatenablestaff with newer ITEquipment & environment by staff equipping Enhanced working enabling Information &Technology

• • of financial documents (i.e. materials for workshops. documents accountability and documents) financial of printingin-house especially various workshops thatdemanded due to Ebolapreparedness and attributed to increased activities 50,000 papers Thiswas permonth. targetedwithin the maximum of This increasing trend was, however, reversed sharply inquarter 1(2019). to quartertrend the 4and was quarter 2 trend of printing from During there 2018, was arising office.country greening ongoing ofthe effort thereforeand contributing to the that documents are in process significantly reduces intermediate printing of documents-flow operating central printing as online tracker save willfurther cost the of It isforeseen document thatthe papers, of power, toners, maintenance. and use the in efficiency in existing central printing resulted towards agreen environment. The complements WCO’s the efforts 2019 was innovation another that tracking applicationin January Introduction ofdocument 47

Annual Report 2018 Annual Report 2018 48 been a24% decrease in printing ofitsoperation. within1.5months Ever since introductionthe trackerof document the in Mid-February there 2018, has LONG TERMAGREEMENTS (LTAS) ENABLETIMELY, EFFICIENTPROGRAMME Figure 10:Quarterlyprinting trendin2018and2019 Motorcycles for Ebola response provided by WHO with support for Irish Aid. IMPLEMENTATION

U The use of the LTA useofthe The hasdrastically simplification ofprocurement. ensures quality, standardization and reduce turnaround and time, toservices enhance cost effectiveness, Agreements for different categories of embarked Long on establishing Term Version 1.0, in2016 WCO the Uganda As perWHO Procurement Strategy reducing mobility mortality. and human resources plays akey role in deployment and supplies, services of procurement provision and of essential Consequently,activities. aresponsive preparedness, responsetimely and to Logisticsand system which enables requires asolidOperations Support A resilient, appropriate response population. onthe mortality high inflict burden ofpreventable morbidity and to continue events These with many events recorded each year. a forhotspot public health emergencies Over years, the isproving Uganda to be CCSUganda 2016/2020). death and causes ofillness (WHO preventable diseases are leading the diarrheal, epidemic-prone vaccine- and Malaria, HIV/AIDS, respiratory, and TB, for over 50%ofmorbidity mortality. and communicable diseases, which account of disease which is dominated by experiencesganda highburden vehicle hire stationery. and services development ledthe Uganda ofLTAs for toner developed. cartridges and WHO supply, vehicle maintenance, courier fuel services, system, monitoring field conferences, clearing forwarding, and LTAs these under include hotel and on LTAs Services ofUN other agencies. categories by way ofpiggybacking use the of LTAs to services other To WCO thiseffect, hasexpanded Uganda 2018) Workflow, Procurement Uganda (WCO suppliestoand respond to emergencies. ensuring rapid deployments ofteams anaverage 14days tofrom 1day, thus reduced procurement the line time 49

Annual Report 2018 Annual Report 2018 50 Table 1:List of LTAs andusageby WHO 14 13 12 11 10 9 8 7 6 5 4 3 2 1 S/N money asapayment method. decision to increase useofmobile the wasa there of 2019, quarter first the In on asmallscale. wasmethod already inplace however money useofmobile The asapayment Use of MobileMoney Complimentary payment method by useofLTAs. the adopts and asmoreservices appreciates agencies fast procurement ofcritical goodsand anticipates even more responsive and comingIn the years, WCO Uganda Office rental/real estate Internet services Toner/Cartridges Cleaning services Central printing Vehicle maintenance Fuel supply Fleet monitoring systems Clearing forwarding and Tyres Stationery Vehicle hire services advertising Media and Hotel conference and services Service Category 01 04 02 01 02 04 03 03 02 03 03 02 03 07 LTAs Number of available 4. 3. 2. 1. Advantages of MobileMoney

facilitates reconciliation the Receipt ofcashisinstantand for correction oferrors inadvance. allowsdetails and errors payment inparticipants’ effecting payment, thisminimizes details iscarried outprior t verificationThe of participant to bank accounts (Table 10 below) transactions compared to EFT the reduced numberofreversed the moneyUse ofmobile payment process. 01 03 01 01 01 01 01 01 01 02 03 02 01 06 WHO No of LTAs used by o

Figure 2. 1. Challenges of MobileMoney payment Method

of another person’sof another numberdetailsissought. mobile number, payment isdela have doesnot Once aparticipant avalid registered telephone 10 above; Use ofMobileMoney increased bank the charges asshown intable 1: Comparison of numberof Reversals vs numberof Transactions perquarter yed asvalidation confirmation and use onthe

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Annual Report 2018 Annual Report 2018 52 oT eT rS Su Sa Fr Th We Tu Mo Date: /