THE REPUBLIC OF UGANDA MINISTRY OF HEALTH ANNUAL HEALTH SECTOR PERFORMANCE REPORT Financial Year 2014/2015 THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Annual Health Sector Performance Report Financial Year 2014/2015 yY Annual Health Sector Performance Report for Financial Year 2014/15 AHSPR 2014/15 Hon. Dr. Elioda Tumwesige Honourable Minister of Health Hon. Sarah Opendi Hon. Dr. Chris Baryomunsi Minister of State for Health/ Minister of State for Health/ Primary Health Care General Duties i yY yY AHSPR 2014/15 AnnualAnnual HealthHealth SeSectorctor PPerformanceerformance ReportReport forfor FinancialFinancial YYearear 2014/152014/15 AHSPR 2014/15 Dr. Asuman Lukwago Permanent Secretary Hon. Dr. Elioda Tumwesige Honourable Minister of Health Dr. Jane Ruth Aceng Director General Health Services Hon. Sarah Opendi Hon. Dr. Chris Baryomunsi Minister of State for Health/ Minister of State for Health/ Primary Health Care General Duties Dr. Henry Mwebesa Prof. Anthony Mbonye Ag. Director of Health Services / Director Health Services/ Community and Clinical Planning and Development Services iii yY Annual Health Sector Performance Report for Financial Year 2014/15 AHSPR 2014/15 iii yY Annual Health Sector Performance Report for Financial Year 2014/15 AHSPR 2014/15 FOREWORD The Annual Health Sector Performance Report for 2014/15 Financial Year provides analysis of health sector performance against set targets, goals and objectives for the Financial Year 2014/15 with a comparative analysis of the previous trends towards achieving the HSSIP 2010/11 – 2014/15 targets. The report is premised on an analysis of commitments in the National Development Plan, Ministerial Policy Statement, Budget Framework Paper, the HSSIP, the 20th JRM Aide Memoire and the annual sector workplans at various levels. The report is discussed at the Annual Health Sector Joint Review Mission, and is based on the assessment of what has been achieved and what has not, and reasons why, to guide future programming. The sector is committed to refocusing priorities to interventions aimed at making positive progress towards implementing the strategies of the National Health Policy II, and achieving the National Development Plan targets and Millennium Development Goals. The sector continues to prioritize interventions defined in the Uganda National Minimum Health Care Package under a Sector-Wide Approach arrangement, with emphasis on recommendations of the HSSIP 2010/11 -2014/15 Mid-Term review. This is further supported by the resolutions of the World Health Assembly, the International Health Partnerships, the Paris Declaration on Harmonization and Alignment and the Accra Agenda for Action and related initiatives. The Government of Uganda recognizes the contribution of Health Development Partners, Civil Society, the Private Sector and the community in the reported sector performance. Sector performance cannot be improved and sustained without the dedicated efforts of all categories of health workers, working under sometimes challenging conditions, especially in the rural and hard-to-reach parts of the Country. I commend the dedicated and productive health workers, and I implore those health workers whose work ethic, behaviour and conduct hold back sector progress, to improve. I wish to thank the Health Policy Advisory Committee members for always giving policy guidance to the sector and for their contribution in the preparation of the Joint Review Mission. Special gratitude goes to the JRM Secretariat, Task Force and Subcommittees that ensured that this annual report was compiled. For God and My Country Hon. Dr. Elioda Tumwesigye, MP MINISTER OF HEALH iv yY Annual Health Sector Performance Report for Financial Year 2014/15 AHSPR 2014/15 TABLE OF CONTENTS FOREWORD............................................................................................................................................................... iv LIST OF FIGURES ................................................................................................................................................... vi TABLES ...................................................................................................................................................................... vii ACRONYMS ............................................................................................................................................................... ix Executive Summary ................................................................................................................................................. xvi CHAPTER ONE .......................................................................................................................................................... 1 1 Introduction ........................................................................................................................................................ 1 1.1 Background .................................................................................................................................................................................... 1 1.2 The process of compiling the report .................................................................................................................................... 1 1.3 Outline of the report .................................................................................................................................................................. 1 CHAPTER TWO ........................................................................................................................................................ 3 2 Overall sector performance and progress ..................................................................................................... 3 2.1 Overall sector performance and progress .......................................................................................................................... 3 2.1.1 Health Impact Indicators........................................................................................................................... 3 2.2 Health Output Indicators ......................................................................................................................................................... 8 2.3 Other health determinants and risk factors and behaviour ...................................................................................... 10 2.4 Service access, readiness, quality and safety................................................................................................................... 11 2.4.1 Health Investments and Governance .................................................................................................... 13 2.5 Local Government Performance .......................................................................................................................................... 30 2.5.1 District League Table (DLT) ................................................................................................................. 30 2.5.2 Regional Performance Level Performance ......................................................................................... 35 2.6 Hospital Performance .............................................................................................................................................................. 37 2.6.2 National referral hospitals ...................................................................................................................... 39 2.6.3 General Hospital Performance ............................................................................................................... 47 2.6.4 Functionality of HC IVs ........................................................................................................................... 51 3 Achievements against Planned Outputs in the MPS 2014/15 .............................................................. 54 3.1.1 Finance and Administration .................................................................................................................... 54 3.1.2 Planning ...................................................................................................................................................... 55 3.1.3 Quality Assurance ..................................................................................................................................... 57 3.1.4 Clinical and Community .......................................................................................................................... 58 3.1.5 Communicable Disease Prevention and Control ................................................................................ 66 3.1.6 Semi-Autonomous Institutions .............................................................................................................. 75 3.1.7 Regulatory Bodies ..................................................................................................................................... 79 3.1.8 PNFP Sub-Sector ...................................................................................................................................... 84 4 Annex .................................................................................................................................................................. 93 v yY Annual Health Sector Performance Report for Financial Year 2014/15 AHSPR 2014/15 LIST OF FIGURES Figure 1: institutional maternal