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UNICEF Innovations critical to avert Typhoid outbreak in Uganda

By Catherine N. Makumbi

UNICEF-supported innovations are proving critical to efforts to avert a typhoid outbreak in Uganda, even as Government and its partners establish emergency safe water points in the capital, Kampala.

mTrac and U-report have been utilized to assist in the response, monitoring and alerting of typhoid cases since the outbreak in March, which started in Kampala and has since spread to  surrounding districts affecting over 2, 688 people. As of 10th March, 271 new suspected cases were reported.

“From U-report, we sent an initial message on 4th March to 40, 000 U-reporters in Kampala, Mpigi, Wakiso and Mukono districts to tell them that there is an outbreak and ask if they wanted to receive a series of informational messages,” explains Ms. Aida Girma, UNICEF Representative in Uganda.  Out of the 40, 000, about 3, 000 requested for additional information.

Key messages developed by Ministry of Health with support from UNICEF Uganda’s Communication for Development teams have been disseminated through U report, mTrac, traditional and social media, faith-based organizations and community leaders. 8 Face Book posts on Typhoid have been posted reaching 203, 439 people with 200 comments and 249 shares. Through 15 tweets on Twitter, 15, 800 impressions were realised with 80 retweets.
“The Ministry (Health) is focusing on sensitizing the public to improve sanitation and hygiene through washing hands and drinking only boiled water,” Dr. Anthony Mbonye, Director for Health Services Ministry of Health told journalists.

UNICEF is running a multimedia campaign airing 372 radio spots on 15 radio stations and 40 TV commercials on 4 TV stations in the Central region of Uganda. This is supplemented by 67,870 posters, 110,500 leaflets, and 162,300 fliers in English and local languages.  House to House sensitisation in Kampala is also being supported through the Red Cross. Communities are trained on how to construct, use and maintain a tippy tap.

Through mTrac, epidemiologic data for all notifiable diseases, like typhoid, is reported weekly into the national Health Management Information System.

“From day one of the outbreak, we have had very good visibility on where typhoid may be spreading. As such, where the Ministry of Health was initially only focused on Kampala and two spill over districts, UNICEF was able to use the data from mTrac to immediately identify 27 additional districts that were already reporting epidemic levels,” says Sean Blaschke, UNICEF Uganda Health Specialist.

The data availed enabled UNICEF to advocate for health teams to investigate the growing number of suspected cases outside Kampala.

UNICEF has set up a mechanism within U-report to flag and forward any community reported issues that require response from national and local governments and is monitoring their response. 

In addition, a specific U-report dashboard monitored by The Medical Concierge Group (TMCG) has been set up. All questions and messages related to typhoid are routed to it so that TMCG can directly answer question coming directly from the community. If it is something the Ministry of Health should know about, they then route it to the mTrac anonymous helpline.

U-report and TMCG partnered in February 2015 where the latter agreed to reply to health concerns from over 295,000 U reporters. So far, TMCG has answered 321 SMS messages directly on typhoid. The partnership provides access to a qualified medical doctor to anyone with a mobile phone, instantly and at no cost across all telecommunication networks in Uganda.

About U Report
Having launched in May 2011, there are over 295,000 U-reporters across all of Uganda’s 112 districts. The average age is 24 years of whom 36% are female and 64% male.

U-report enables those who register – known as U-reporters - to receive and respond to weekly SMS questions about Ugandan social development issues as well as send SMS messages on specific matters that concern them - all at no cost to themselves. Each month U-report results are publicized in national media channels and within parliament to ensure decision makers have access to information regarding their districts or ministries.

More partnerships will be built with NGOs, Government, youth organizations, Faith Based Organizations and private companies to further community development goals at the grass roots.

About mTrac
Supported by UNICEF and WHO, mTrac has been rolled out countrywide by the Ugandan Ministry of Health to all health facilities. With the recently concluded revision of all the Health Management Information Systems tools in Uganda, the mTrac system has been broadened to track stock data on six TRACER drugs and ARVs in addition to surveillance data.

The system currently has 12,013 district health officials, 18, 690 health workers and 7, 381 village health team members registered. In addition, the health services complaints hotline has continued to grow with over 400 actionable health reports received every month.



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