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Uganda Field Experience

Uganda Field Experience. By Hon. Dr. Alex Kamugisha Minister of State for Health (Primary Health Care) Uganda –Kampala GAVI Board meeting, Washington, 15-16 July 2003. UGANDA OVERVIEW. Uganda -population 24.7 m, 56 districts,

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Uganda Field Experience

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  1. Uganda Field Experience By Hon. Dr. Alex Kamugisha Minister of State for Health (Primary Health Care) Uganda –Kampala GAVI Board meeting, Washington, 15-16 July 2003

  2. UGANDA OVERVIEW • Uganda -population 24.7 m, 56 districts, • Annual per capita income is US $ 330 (’02/03) • IMR - 88 / 1000 live births, U5 MR - 152 / 1000 live births • Fertility rate: 6.9 % with a growth rate 3.4 % pa • Per capita on Health: U$ 15 • Immunization - key element of Minimum Health Care • DPT3 Coverage key indicator in HSSP, MTEF, PEAP • Uganda EPI providing BCG, OPV, DPT, measles & TT since 1983

  3. 1,000 people VILLAGE HC I PARISH 5,000 people HC II SUB- COUNTY 25,000 – 30,000 people HC III COUNTY HC IV 100,000 people D / HOSPITAL DISTRICT 200,000 – 1,000,000 people REGIONAL / REFERRAL NATIONAL ADMINISTRATIVE AND TIER OF HEALTH SYSTEM IN UGANDA

  4. GAVI support to Uganda • Ugandaapplied & obtained GAVI support for ISS, NVS & INS • Introduced pentavalent vaccine in June 2002 • ISS support used for….. • National launch by President • Grassroots mobilisation using parish mobilizers • Cold chain maintenance • Distribution of vaccines and logistics • Training of Health workers • Support supervision

  5. TRENDS IN IMMUNIZATION COVERAGE

  6. Revitalisation of EPI & new vaccine • Developed the new vaccine introduction plan with all stake holders (GVT/NGO/DPs) • Consensus meetings of ICC, National co-ordinating committee to roll out the introduction plan. • Developed Field guide for training health workers • National core team worked with districts/subdistricts to carry out micro-planning exercise

  7. Preparatory activities -Logistics • Cold chain - Assessed cold chains capacity and identified gaps at all levels, adjusted the fridges to maintain the recommended temperature ranges at the central vaccine store and in all the districts. • Forms • Adjusted data collection tools to include DPT-HepB + Hib vaccine • Surveillance • Established a Hib sentinel site based in the national hospital, at Mulago. • Developed an Injection safety policy & plan

  8. EPI - Advocacy & Communication • Sensitisation - • Media managers and operators • Communities by health workers and parish mobilizers • political, religious, cultural and civic leaders. • IEC materials, including radio and TV messages • Launching of revitalisation of EPI and introduction of new vaccine by the President • well attended by all strata of society • Raised profile of immunisation services

  9. Challenges • Demand/utilisation still low due to lack of awareness • High drop out rate • High turn over and shortage of staff • Transport means from district to periphery • Limited district ownership of EPI • High vaccine wastage • Weak management at lower levels • Pentavalent vaccine gap, last quarter 2003

  10. Lessons learnt • High political advocacy yields positive results • New vaccines especially Hib was a crowd-puller • Careful planning increased accessibility to services • Involving all key stake holder enhances ownership • Readily available resources facilitates service delivery • Community based mobilization is key in utilization of services (parish mobilizers) • Need for critical vaccines global/country reserves to avoid stock outs • Feedback to districts & recognition of perfomance

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