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Monthly Programme Update

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EMERGENCY AND HUMANITARIAN ACTION, UGANDA APRIL 200 9 Monthly Programme Update Highlights ♦ Under surge capacity organised by IST/AFRO, supported cholera control in Zimbabwe and VHF training in Zambia. ♦ Continued supporting the second round of Polio supplemental immunization activities continued in northern Uganda, Karamoja and Kamapla with an achievement of over 100 % coverage ♦ Continued supporting Hepatitis E epidemic in Kitgum district ♦ Support to Dokolo district in sleeping sickness control 1. General Situation: Political, Social and Security ♦ Security situation in northern Ugandan districts continued being stable ♦ In Karamoja the security situation remained stable on the roads although raids and other criminal activities continue to be reported in many places of the region. ♦ Disarmament initiated by the government in Karamoja is ongoing 2. Programme Implementation a. Activities Emergency Health, Nutrition and HIV/AIDS Response Project (Sida) In Kitgum District the programme; ♦ Continued to provide technical support towards Hepatitis E interventions to support/ guide sub- county activities including supervision A who staff assists health workers arrange vaccines used for the 2nd round of mass Polio campaigns. of VHTs to enhance community mobilization and public health education. ♦ Finicailly supported VHTs and CBDs with incentives to enable them perform health education/promotion and inspection, establishing completed latrines and tracing for Hepatitis E patients. ♦ Techinically and logistically supported the Polio supplemental immunization. In Gulu and Amuru ♦ Technically and logistically supported Gulu and Amuru districts with the 2nd round of mass Polio campaigns In Pader District, WHO/HAC ♦ Continued to technically support the district health team to coordinate, supervise and monitor Hepatitis E epidemic control interventions by organizing weekly coordination meetings. ♦ Financially and technically supported the District Surveillance Focal Person (DSFP) and the District Laboratory focal person to investigate a suspected case of measles by transporting blood samples to Uganda Virus Reaserch Institute (UVRI) in Entebbe for lab investigation awaiting results. ♦ Technically supported the DSFP WHO staff together with the District Surveillance Focal Person Pader district conducte support to collect stool specimen for supervision on the Integrated Disease Surveillance Reporting at Puranga HC III. Standing are transportation to the staffs of the Health facility URVI Entebbe and investigate a suspected AFP case ♦ Technically and logistically supported Pader district health team during the second round of mass polio campaign plus the Child Health Day plus through provision of a vehicle, monitoring and supervision. In Lango sub region the programme; ♦ Technically and logistically supported Child Health Days and 2nd Round mass polio campaign ♦ Technically and finacially supported Dokolo district in sleeping sickness control – plan for mass screening drawn up for two sub-counties. This awaits for funding ♦ Under surge capacity organised by IST/AFRO, Lango sub-region professional staff supported the cholera control in Zimbabwe and VHF training in Zambia. The programme continued to provide technical, financial and logistical support to Health Management Information System and Integrated Disease surveillance and Response (HMIS/IDSR) in all the districts in northern Uganda and Karamoja. Support is being provided to facilitate communication between health facilities and the district health teams, and transportation for support supervision and collection of data. In addition all District Surveillance Focal Points are being technically supported to analyze and disseminate the information on completeness and timeliness of reporting and diseases trends for each health facility. 3 Emergency Health and Nutrition Response in Karamoja (CERF) With support from CERF, the programme; ♦ Financially supported 100 VHTs in 2 sub counties of Kotido and 85 VHTs in Moroto municipality to improve mobilization of urban communities for health and hygiene activities ♦ Financially supported the VHT supervision and monthly meetings across all the districts of Karamoja The staff monitors one of the Polio SNID posts during campaign in Amolatar district region conducted by health units ♦ Financially and logistically supported Bokora Health Sub District to conduct an outreach at Apetolim resettlement site. A total of 467 patients received treamtment ♦ Finacially and logistically supported an outreach to Okududu resettlement camp in Nakapiripirit through provision of drugs and incentives to the health workers. Okududu camp has one of the worst sanitary conditions in the region. ♦ Financially and technically supported the region with the development and designing of IEC materials for Epidemic Preparedness and Response. The final process of IEC pre test was completed and mass production should be done soon. ♦ Techincally and financially supported districts in the region to consolidate nutrition surveillance activities through support supervision, incentives for the VHTs & basic electronic reporting tools b) Surveillance Data Analysis and Emergency Preparedness and Response In Karamoja sub region; ♦ All the health facilities in the region are currently functional with IDSR reporting completeness at 95% ♦ The incidence of malaria and dysentery slightly decreased last month as compared to 2008. In Kitgum district, ♦ Completeness reporting remained at 97%. The sustainability of reporting continues to be a big challenge as fluctuation is experienced due to the erratic presence of staff at their stations. However timeliness of reporting decreased from 67% to 60%. Mainly caused due to lack of staff commitment and absenteeism from their work. ♦ Hepatitis E outbreak trend during the month of April was stagnant at an average of over 40 cases per week, the cumulative number of cases and deaths is 9953 and 160 respectively with a CFR OF 1.6% see fig below. 4 In Lango sub region; ♦ Completeness and timeliness of weekly reporting have been sustained to a high level of 99% and above ♦ There continues to be significant differences in the number of reported clinical malaria cases in districts where IRS was conducted with DDT (i.e. Apac and Oyam) compared to those where IRS was not done. The standardized trends of wkly cases of malairia in Apac and Oyam have consistently remained lower than those of Lira, Amolatar and Dokol In Gulu and Amuru; ♦ The timeliness of reporting remains high at 100% for Amuru and above 90% for Gulu. In Pader district, ♦ completeness of reporting has been maintained at 80% ♦ Technical support was given to the District Health Team (DHT) to develop a Cholera contingency plan. c) Constraints Across all the regions; ♦ Limited funding to facilitate activities at the districts ♦ Gaps in staff accommodation remain a big challenge. This encourages absenteeism especially for staff communting from distant places ♦ Despite continued reports of weekly animal bites, Lango sub region lacks antirabies vaccine Dokolo 5 and Amolatar have no vehicle for support supervision - UNICEF is yet to provide one vehicle to each district / no records store yet. ♦ lack of office space and stores for drug storage in Amolatar and Dokolo; ♦ Lack of transportation for surveillance activities in Apac and Amolatar - vehicles in Apac are in poor state of repair; and ♦ Difficulties in attracting and retaining doctors mostly in HC IVs which have remained with unfilled posts. some form of incentives required as many health facilities across all the regions remain with low staffing levels. ♦ Funding to CAP remain low especially for the health, nutrion and HIV/AIDS section. 3. Partnership, Collaboration with other sectors, Coordination and Resource Mobilization (MOH, UN & NGOs) ♦ Discussion wioth DFID on the possible support to PRDP, preparation of a draft proposal jointly with UNICEF and UNFPA. ♦ Participated in Epidemic Preparedness meeting and briefed partners on gaps that need to be filled especially to the Hepatitis E affected communities. ♦ Participated in a regional nutrition meeting organised by UNICEF for Karamoja region. ♦ Participated in the monthly humanitarian coordination meetings at OCHA and provided updates on HEV, Polio campaigns and other health conditions. A who staff joins other partners in the 2nd round of mass Polio campaigns ♦ In Pader district participated in a meeting with the UN Resident/Humanitarian Coordinator for Uganda during which members were briefed on the plans for adjusting the health cluster interventions and coordination with in the District to meet the current humanitarian/recovery needs of the population ♦ Participated in the District Health Team meeting organized by MoH to find ways of imporving HIV/AIDS services in the district health facilities. ♦ Together with other partners, participated in the second round of mass polio campaign & child health days plus activities ♦ Particpated in a meeting oragnised by the UNICEF representative to brief leaders of Lango sub region of their exit strategy ♦ Participated in a visit to Alenga HC III together with Apac district engineer to harmonize the Bill of 6 Quantity for the renovation of the maternity unit. ♦ Participated in donor meeting where the crioitcal gap on funding CAP was discussed. ♦ Continue the support to MOH and UBOS in finalizing the tool for mini DHS in Acholi and Karamoja region. The tool has been finalized the householde listed and the data collectors are being trained. ♦ Submited proposal
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