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Annual Health Sector Performance Report THE REPUBLIC OF UGANDA Annual Health Sector Performance Report Financial Year 2009/2010 ii Annual Health Sector Performance Report Foreword The Annual Health Sector Performance Report for 2009-10 provides a review of sector performance in the 2009-10 financial year, and an overall assessment of sector performance against the targets set in the second Health Sector Strategic Plan (HSSP II). It also reports on implementation progress against the sector priorities set at the 7th National Health Assembly and the 15th Joint Review Mission with stakeholders. The Government of Uganda recognizes the contribution of Health Development Partners, Civil Society, the Private Sector and all Ugandans in the achievement of the progress reported in the sector performance. The sector also appreciates the constructive criticism, useful guidance and inputs that the said stakeholders put in correcting inadequacies in the health sector. The sector cannot afford to continue with the usual way of doing things in the face of unacceptable failure to improve indicators in maternal and child health. This report coincides with the launching of the new National Health Policy II (NHP II) and the Health Sector Strategic and Investment Plan (HSSIP). These have been aligned to the National Development Plan to enable holistic implementation of the Development agenda of Government. The sector will continue to prioritize interventions defined in the Uganda National Minimum Health Care Package under a Sector-Wide Approach arrangement, so as to maximize gains from invested resources. This will further be supported by the International Health Partnerships Plus framework. However, this will require concerted efforts by all stakeholders in health systems strengthening, including, crucially, the leadership and management capacity development in the sector. It is only by strengthening the health system that we can deliver on strategies in the HSSIP and NDP. Dr. Stephen O. Mallinga, MP MINISTER OF HEALTH Annual Health Sector Performance Report iii Dr. Stephen Mallinga, MP Minister of Health Hon James Kakooza MP Dr. Richard Nduhuura MP Minister of State for Health, Minister of State for Health (Primary Health Care) ( General Duties) iv Annual Health Sector Performance Report Dr. Asuman Lukwago Ag. Permanent Secretary / Deputy PS Dr. Nathan Kenya-Mugisha Dr. Isaac Ezati Ag. Director General Director Health Services of Health Services Planning and Development Annual Health Sector Performance Report v Table of Contents List of Tables ........................................................................................................................................ vii List of Figures and boxes ......................................................................................................................ix Annexes ................................................................................................................................................xi Acronyms ............................................................................................................................................. xii Execuve Summary ............................................................................................................................ xvii Chapter One: Introducon ...................................................................................................... 1 1.1 Background ..................................................................................................................................... 1 1.2 The framework for achieving sector goals & objecves .................................................................1 1.3 The Annual Health Sector Performance Report FY 2009/10 .......................................................... 1 1.4 The draing process ....................................................................................................................... 2 1.5 Sources of Informaon ................................................................................................................... 2 1.6 Outline of the Report ..................................................................................................................... 3 Chapter Two: Overview of Health Sector Performance (Summave Evaluaon of HSSP II) ......5 2.1 Performance against HSSP II Indicators .......................................................................................... 5 2.2 Performance for the HSSP II indicators .......................................................................................... 12 2.3 Summary Financial Report for the HSSP II ..................................................................................... 14 2.4 Comparing Local Government Performance ................................................................................. 16 2.5 Hospitals performance assessment ............................................................................................... 18 2.6 Conclusion ..................................................................................................................................... 20 Chapter Three: Delivery of the Uganda Naonal Minimum Health Care Package ................... 21 3.1 Health promoon, disease prevenon and community health iniaves ....................................21 3.2 Maternal and child health ............................................................................................................. 50 3.3 Prevenon and control of communicable diseases .......................................................................69 3.4 Non-communicable diseases/condions cluster ..........................................................................104 Chapter Four: Integrated Health Sector Support Systems ......................................................133 4.1 Health Financing ........................................................................................................................... 133 4.2 Human Resources for Health ........................................................................................................ 147 4.3 Health Infrastructure Development and Management ................................................................168 4.4 Management of Essenal Medicines and Supplies ...................................................................... 172 4.5 Diagnosc and Blood transfusion services ................................................................................... 187 4.6 Informaon for decision making .................................................................................................. 193 4.7 Health policy, research and development .................................................................................... 198 4.8 Legal and Regulatory Framework ................................................................................................. 207 4.9 Public Private Partnership in Health ............................................................................................. 235 Chapter 5: Implementaon Monitoring of the HSSP II........................................................... 237 5.2 Monitoring of the HSSP II Indicators ............................................................................................ 240 5.3 Quality of Care .............................................................................................................................. 245 5.4 Health Services and health status in recovery areas .................................................................... 248 5.5 Funconality of Health Centre IVs ................................................................................................ 251 vi Annual Health Sector Performance Report List of Tables TABLE 1: PERFORMANCE AGAINST THE 8 PEAP INDICATORS FOR THE HSSP II PERIOD ..................... xvii TABLE 2.1: PERFORMANCE AGAINST THE 8 PEAP INDICATORS FOR THE HSSP II PERIOD .................... 5 TABLE 2.2: PERFORMANCE OF THE HSSP II INDICATORS ..................................................................... 12 TABLE 2.3: HSSP II INDICATORS WITH NO INFORMATION ................................................................... 14 TABLE 2.4: MTEF ALLOCATION TO THE HEALTH SECTOR DURING THE HSSP II PERIOD .......................14 TABLE 2.5: DISTRICT RANKING AND LEAGUE TABLE ............................................................................ 17 TABLE 2.6: DISTRICT RANKING FOR NEW DISTRICTS ........................................................................... 18 TABLE 2.7: DISTRICT RANKING FOR HARD TO REACH DISTRICTS .........................................................18 TABLE 3.1: HEALTH PROMOTION AND EDUCATION ACHIEVEMENTS OVER THE HSSP II PERIOD ........22 TABLE 3.2: ACHIEVEMENTS OF THE ENVIRONMENTAL HEALTH PROGRAMME DURING THE HSSP II PERID . 25 TABLE 3.3 ACHIEVEMENTS OF THE CDD PROGRAMME .......................................................................35 TABLE 3.4: ACHIEVEMENTS OF THE SCHOOL HEALTH PROGRAMME ..................................................36 TABLE 3.5: INTEGRATED DISEASE SURVEILLANCE AND RESPONSE INDICATORS ..................................39 TABLE 3.6: MAJOR OUTBREAKS INVESTIGATED IN UGANDA FROM JULY 2009 TO JUNE 2010 ............40 TABLE 3.7: ACHIEVEMENTS OF THE OCCUPATIONAL HEALTH AND SAFETY PROGRAMME .................45 TABLE 3.8: SEXUAL REPRODUCTIVE HEALTH AND RIGHTS KEY OUTPUTS ........................................... 51 TABLE 3.9 BI-ANNUAL CHILD DAYS PERFORMANCE ...........................................................................
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