THE REPUBLICTHE REPUBLIC OFOF UGANDA UGANDA MINISTRY OF HEALTH ANNUAL HEALTH SECTOR PERFORMANCE REPORT FINANCIAL YEAR 2019/20 THE REPUBLIC OF UGANDA MINISTRY OF HEALTH ANNUAL HEALTH SECTOR PERFORMANCE REPORT FINANCIAL YEAR 2019/20 Published by: Ministry of Health P.O. Box 7272 Kampala, Uganda Email: [email protected] Website: www.health.go.ug ii MINISTRY OF HEALTH Hon. Dr. Aceng Jane Ruth Ocero Minister of Health Hon. Dr. Joyce Moriku Hon. Robinah Nabbanja Minister of State for Health / Minister of State for Health / Primary Health Care General Duties Dr. Diana Atwine Kanzira Permanent Secretary ANNUAL HEALTH SECTOR PERFORMANCE REPORT - FY 2019/20 iii Dr. Henry G. Mwebesa Director General Health Services Dr. Charles Olaro Dr. Joseph Okware Director Health Services Director Health Services Clinical Services Governance & Regulation iv MINISTRY OF HEALTH TABLE OF CONTENTS ACRONYMS .................................................................................................................................................................... xi FOREWORD ..................................................................................................................................................................xiv EXECUTIVE SUMMARY ..................................................................................................................................................xv 1 INTRODUCTION ...............................................................................................................1 1.1 Background ...................................................................................................................................................... 1 1.2 Vision, Mission, Goal and Strategic Objectives of the HSDP 2015/16 – 2019/20 ........................................... 1 1.2.1 Vision .................................................................................................................................................... 1 1.2.2 Mission .................................................................................................................................................. 1 1.2.3 Goal ....................................................................................................................................................... 1 1.2.4 Strategic Objectives ............................................................................................................................. 1 1.3 The Projected Demographics for FY 2019/20 ................................................................................................. 1 1.4 The process of compiling the report ............................................................................................................... 2 Overall Sector Performance and Progress ..................................................................................................... 3 1.5 Disease Burden ............................................................................................................................................... 3 1.5.1 Common Conditions in OPD Attendance ............................................................................................ 3 1.5.2 Injuries ................................................................................................................................................. 3 1.5.3 Conditions Leading to Admissions ...................................................................................................... 4 1.5.4 Causes of Mortality .............................................................................................................................. 6 1.6 Performance against the key Health and Related Services Outcome Targets .............................................. 7 1.7 Performance against the key Health Investment and Quality Output Targets ........................................... 29 1.7.1.1 EMHS Credit Line at NMS .................................................................................................................. 34 1.7.1.2 EMHS Credit Line for PNFP’s at Joint Medical Stores (JMS) ............................................................. 35 1.7.2 Improving Quality of Care ................................................................................................................. 36 1.7.3 Health Financing ................................................................................................................................ 51 1.7.4 Budget Allocations ............................................................................................................................. 51 1.7.5 Budget Performance .......................................................................................................................... 53 1.7.5.1 Overall Sector Performance ............................................................................................................... 53 1.7.5.2 MoH Headquarters Performance ..................................................................................................... 55 1.8 Summary of performance against the Key HSDP Indicators ....................................................................... 57 1.9 Health Partnerships ....................................................................................................................................... 59 1.9.1 Progress in implementation of the HSDP Compact ......................................................................... 59 1.9.1.1 Performance of HPAC ......................................................................................................................... 59 1.9.1.2 Performance of MoH Senior Management Committee .................................................................... 62 1.9.1.3 Performance of the MoH Technical Working Groups (TWGs): .......................................................... 62 1.10 Local Government Performance ................................................................................................................... 63 1.10.1 District League Table Performance .................................................................................................. 63 1.10.1.1 Most Improved Districts ................................................................................................................. 66 2 HOSPITAL AND HC IV PERFORMANCE ...............................................................................68 2.1 Performance of National, Regional Referral and Large PNFP Hospitals ..................................................... 68 2.1.1 Quality Parameters at the NRHs, RRHs and Large PNFP Hospitals ................................................. 68 2.1.2 General Hospital Performance .......................................................................................................... 75 2.1.2.1 Quality Parameters at the General Hospitals .................................................................................... 77 2.1.3 Health Centre IV Performance ........................................................................................................... 78 ANNUAL HEALTH SECTOR PERFORMANCE REPORT - FY 2019/20 v 3 ANNEXES ......................................................................................................................81 3.1 Annex 1: Delivery of the Uganda National Minimum Health Care Package (UNMHCP). ............................ 81 3.1.1 Health Promotion and Education ..................................................................................................... 81 3.1.2 Environmental Health and Sanitation .............................................................................................. 82 3.1.3 Vector Borne and Neglected Tropical Diseases Control .................................................................. 84 3.1.3.1 Community Health ............................................................................................................................ 85 3.1.4 Uganda National Expanded Program on Immunization (UNEPI) .................................................... 86 Impact of Lock Down due to Covid-19 pandemic ............................................................................. 88 3.1.5 Reproductive, Maternal, Child and Adolescent Health .................................................................... 89 3.1.6 Tuberculosis and Leprosy Control ..................................................................................................... 91 Treatment outcomes among MDR-TB patients ................................................................................. 95 TB surveillance among health workers ............................................................................................. 95 3.1.7 HIV/AIDS Prevention, Care and Treatment ........................................................................................ 99 3.1.8 Non-Communicable Diseases (NCD) ............................................................................................... 103 3.1.9 Integrated Curative Services ............................................................................................................ 104 3.1.10 National Malaria Control Program ................................................................................................. 105 3.1.11 Pharmacy and Natural Medicine ..................................................................................................... 107 3.1.12 Integrated Epidemiology Surveillance and Public Health