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UNICEF supported health programme to address under-five mortality in Uganda

By Proscovia Nakibuuka Mbonye

The Ministry of Health has scaled-up new public health interventions aimed at bringing health services closer to people in their homes and communities in Uganda.

The President of Uganda, Yoweri Kaguta Museveni launched the scale-up in Sheema District, Western Uganda to symbolise the roll out to 14 other districts. The others are Koboko, Yumbe, Maracha, Arua, Nebbi, Kamwenge, Kasese, Rubirizi, Bushenyi, Amuria, Soroti, Serere, Pallisa and Luwero.

Speaking at the event, the President applauded the Ministry of Health for prioritising disease prevention as opposed to treatment of preventable diseases. “Prevention is better than cure,” he stressed before calling on the public to eat healthy food, immunize their children, drink boiled water, observe proper personal hygiene especially handwashing with soap, sleep under insecticide treated nets, among others.

Among the interventions rolled out was the Global Fund funded Integrated Community Case Management (iCCM) programme. The iCCM programme introduced by the Ministry of Health in 2010, initially in 45 districts, aims at bringing effective, timely (within 24 hours) and quality treatment of diarrhoea, pneumonia and malaria closer to communities, using Village Health Team (VHT) members and Community Health Workers. Malaria, pneumonia and diarrhoea remain the three leading causes of under-five mortality in Uganda, contributing to more than 140,000 deaths every year – with malaria killing 42 children per day, pneumonia 52 children per day and diarrhoea 3 children per day.

The iCCM programme is also supported by UNICEF, WHO, Malaria Consortium, World Vison, and Clinton Health Access Initiative (CHAI).

Under the programme, VHTs are trained and supplied with medicines to manage common childhood illnesses as well as identify and refer severe illnesses and sick new-born babies. With this strategy, children especially those in the remote and impoverished areas of the country have an opportunity to access medical treatment of the three major killer diseases.

As a result of its successes in reducing malaria cases, iCCM has also been prioritised as one of the key interventions of the Uganda Malaria Reduction Strategic Programme 2014-2020. With financial support from the Global Fund, of approximately 4 million US dollars, the iCCM programme will now be scaled up to an additional 33 districts, in two phases between now and 2016, increasing the number of districts implementing the programme to 78 districts.

Mrs. Aida Girma, UNICEF Representative in Uganda commended the health ministry for the leadership in delivering the iCCM programme and pledged to provide support towards the scale-up that will ensure that common childhood illnesses, many of which are largely preventable do not continue to cause unnecessary suffering and death among children in Uganda.

“According to various child health experts, it is estimated that community case management such as this, which is being administered by VHTs, can reduce overall mortality of children under-five by 40 per cent. iCCM is therefore a highly effective strategy in saving many more children’s lives and ensuring their right to much healthier early years of life which will ensure more and more children live to see their  fifth birthday,” she added.

Girma said UNICEF is committed to spending about 750,000 US dollars annually to procure the non-malarial commodities for all the 33 districts that will be supported by the Global fund to roll out the iCCM programme. WHO and UNICEF are providing the necessary technical assistance to the Ministry of Health Global fund task force, the National Malaria Control Program as well as the Second Principal Global Fund Recipient and Sub-recipients who have been tasked with rolling out the Global Fund iCCM programme in the 33 districts.

Joseph Mukasa, the VHT Coordinator for Sheema District reaffirmed that with the introduction of the iCCM programme, the health of the people in his district has greatly improved. In the past six months he has reached over 300 people - and services provided include – rapid malaria tests, distribution of mosquito nets, and treatment of malaria, diarrhea, hygiene and sanitation promotion plus sensitisation of pregnant women on the benefits of antenatal care visits and delivering from health facilities. The latter has led to an increase in the number of women delivering from health facilities.

The other interventions launched at the event included the Constituency Health Task Forces (CHTF) an initiative to improve delivery of health services within 238 constituencies; The Public Health Protocols (PHP) and the Home-to-home, Door-to-door Integrated Testing of HIV/AIDS, malaria, Hepatitis B and other selected non-communicable diseases by VHTs and community health workers.

The President later commissioned seven ambulances, bodaboda (motor cycle) ambulances for VHTs, hospital beds, mattresses, cancer & hepatitis E screening machines plus UNICEF health innovations - birth cushions and solar suitcases.

The Minister of Health, Dr. Elioda Tumwesigye, thanked all donors for the support provided towards the improvement of the lives of Ugandans especially children and women. He applauded the President for providing additional resources that were used to build a modern maternity centre at Kabwohe Health centre IV, located in Sheema District. 

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