Health

Introduction

The Department of Health is headed by the District Health Officer whose mandate is guided by the District 5 Year Strategic Plan that focuses on the achievement of equity through increased access to Minimum Health Care Package (MHCP), Quality care, efficiency accountability and transparency.

 

The overall goal of the sector is to provide good quality services to the people of this district so as to make them attain good standards of health in order to live a healthy and reproductive life. The sector objective is to reduce morbidity and mortality from the major causes of ill health and premature health and disparities therein”. This district has 16 Health Units of different categories. Some of them are Government facilities while others are owned by Non -Government Organizations. The distribution is fair, but some of them lack the basic equipment to offer reasonable services. Many rural units require rehabilitation and equipping. Besides diseases, poor nutrition has contributed to worrying situation. Because of cross cutting nature of health issues, there is need for an integrated approach to health.

 

  1. are various NGOs both Local and International that are involved in AIDS prevention and control in the district. Such activities include blood screening and counselling, medical treatment, home care, pastoral education, health education, AIDS research and orphan support.

Health Infrastructure

This section classifies the distribution of health facilities within the district.

Table 4.1: Health infrastructure (categories)

Category

Ownership

Total

Government

PNFP

PFP

 

Hospital

0

0

0

0

HCIV

1

0

0

1

HCIII

3

1

2

6

HCII

1

1

7

9

No.of Staff

79

 

 

79

Total

5

2

9

16

Source: DHO’s Office

Table 4.2: Number of Health Units

 

Health Facility

Number

Hospital

0

HCIV

1

HCIII

6

HCII

9

Total

16

Domiciaries

1

No.of Staff

79

Traditional Healers

0

licensed drug shops

52

Dental & Medical clinics

1

Source: DHO’s Office

 

 

Accessibility to health Services

This section looks at the distance to access health facilities within a community by the household

 

Distance to the nearest Health Unit

Table 4.3: Distance to Nearest Health facility of Households by Sub –county

Sub County

< 5kms

Upto 5kms

Over 5kms

Bwamiramira

Yes

 

 

Kabasekende

Yes

 

 

Bubango

Yes

 

 

Kibaale T/C

Yes

 

 

Kyebando

Yes

 

 

Kasimbi

Yes

 

 

Matale

Yes

 

 

Karama

Yes

 

 

Nyamarwa

Yes

 

 

Mugarama

Yes

 

 

Nyamarunda

Yes

 

 

Source: DHO’S Office

Health Services Accessibility indicators

 

 Average Population served by each health unit:

 Percentage of population within 5km radius of health unit: 60%

 Number of licensed private clinics: Data not available

 Practicing Doctor: population ratio: 1:736,628

 Nurse: Population ratio: 1:7,362

 Clinical Officer: Population ratio: 1:30,308

 OPD Utilization: 0.7 percapita

 Deliveries in health facility: 46%

 Midwives: pregnant women (15-49) ratio: 1:12,271

 Number of mothers receiving complete antenatal services 19,588

Morbidity and cause of ill health

This section details the frequency of disease, illness, injuries, and disabilities in a population within the district

 

Top Ten Causes of Morbidity (2016)

The table below shows that malaria and coughs or colds remained the main cause of morbidity.

Table 4.4: Top Ten Causes of Morbidity in Kibaale

Cause of Morbidity

Males

Female

Total

Proportion

Malaria (Total)

17680

23048

40728

38.7%

No Pneumonia - Cough or Cold

13334

18972

32306

30.7%

Intestinal Worms

1883

2959

4842

4.6%

Skin Diseases

1390

1813

3203

3.0%

Gastro-Intestinal Disorders (non-Infective)

1097

2044

3141

3.0%

Diarrhea-Acute

1380

1712

3092

2.9%

Urinary Tract Infections (UTI)

895

1580

2475

2.4%

Typhoid Fever

745

1134

1879

1.8%

Other Sexually Transmitted Infections

535

1188

1723

1.6%

Pneumonia

698

775

1473

1.4%

Other Eye Conditions

647

822

1469

1.4%

Source: DHO’s Office

Health Manpower

This section categorises the staffing in the district within a health sector with intentions of determining the manpower gaps within the health sector.

Table 4.5: Staffing in District Health Office

Cadre

Approved

Filled

Not Filled

District Health Officer

1

1

0

Assistant DHO (Environ. Health)

1

1

0

Assistant DHO (MCH/Nursing

1

1

0

Senior Environment. Health Officer

1

0

1

Senior Health Educator

1

0

1

Bio-Statistician

1

1

0

Stenographer Secretary

1

1

0

Cold Chain Technician

1

1

0

Stores Assistant

1

1

0

Office Attendant

1

1

0

Driver

1

1

0

Sub-Total

14

11

2

Source: DHO’s Office

Table 4.6: Staffing in Hospital

Cadre

 

Approved

 

Filled

 

Not

Filled

Medical Officers

N/A

 

 

 

 

 

N/A

 

 

 

 

Hospital Administrator

N/A

 

 

 

 

Clinical Officers

N/A

 

 

 

 

Nursing officers

N/A

 

 

 

 

 

N/A

 

 

 

 

Health Inspectors

N/A

 

 

 

 

 

N/A

 

 

 

 

Enrolled Nurses

N/A

 

 

 

 

 

N/A

 

 

 

 

Enrolled midwives

N/A

 

 

 

 

 

N/A

 

 

 

 

Laboratory Personnel

N/A

 

 

 

 

 

N/A

 

 

 

 

Dental Assistants/Officers

N/A

 

 

 

 

 

N/A

 

 

 

 

Health Assistants

N/A

 

 

 

 

 

N/A

 

 

 

 

Nursing Assistants

 

 

 

 

 

Psychiatric Clinical Officers

N/A

 

 

 

 

Source: DHO’s Office

Table 4.7: Staffing in Government Health Units: Kibaale HC IV

Service Provider category

 

Approved

 

Filled

 

Not Filled

Senior Medical Officer

1

 

 

0

 

1

Medical Officer

2

 

 

1

 

1

Senior Nursing Officer

3

 

 

1

 

2

 

4

 

 

0

 

4

Public Health Nurse

 

 

 

 

 

 

Clinical Officer

2

 

 

2

 

0

Clinical Officer

1

 

 

1

 

0

Health inspector

2

 

 

1

 

1

Health inspector

1

 

 

0

 

1

1Public Heath Dental Officer

1

 

 

1

 

0

Laboratory Technician

1

 

 

1

 

0

Asst. Entomological Officer (Med.)

1

 

 

1

 

0

Nursing Officer (Nursing)

1

 

 

1

 

0

Nursing Officer (Nursing)

1

 

 

1

 

0

Nursing Officer (Psychiatry)

1

 

 

1

 

0

Assistant Health Educator

1

 

 

0

 

1

Anaesthetic Officer

1

 

 

0

 

1

Theater Assistant

2

 

 

2

 

0

Anaesthetic Assistant

2

 

 

0

 

2

Enrolled Psychiatric Nurse

1

 

 

1

 

0

 

Enrolled Nurse

3

 

 

3

 

0

Enrolled Midwife

3

 

 

3

 

0

Cold Chain Assistant

1

 

 

0

 

1

Office Typist

1

 

 

0

 

1

Laboratory Assistant

1

 

 

1

 

0

Stores Assistant

1

 

 

1

 

0

Accounts Assistant

1

 

 

0

 

1

Health Assistant

1

 

 

0

 

1

Health Information Assistant

1

 

 

0

 

1

Nursing Assistant

5

 

 

1

 

4

Driver

1

 

 

1

 

0

Askari

3

 

 

1

 

2

Askari

3

 

 

1

 

2

Total

54

 

 

27

 

27

 

 

 

 

 

 

 

Source: DHO’s Office

Table 4.8: Health Centre IIIs

Service provider category

Approved

Filled

Not filled

Senior Clinical Officer

3

2

1

Clinical Officer

3

3

0

Nursing Officer

3

3

0

Laboratory Technician

3

1

2

Enrolled Midwife

6

6

0

Enrolled Nurse

6

5

1

Laboratory Assistant

3

3

0

Health Assistant

3

2

1

Health Information Assistant

3

3

0

Nursing Assistant

9

8

1

Askari

6

0

6

Porter

6

0

6

TOTAL

54

36

18

Source: DHO’s Office

Table 4.9: Health Centre IIs

Service provider category

Approved

Filled

Not filled

Enrolled Nurse

1

1

0

Enrolled midwife

1

1

0

Health assistant

1

1

0

Nursing assistant

2

2

0

Askari

2

0

2

Porter

2

0

2

TOTAL

9

5

4

Source: DHO’s Office

Safe Water Coverage

This section will cover the percentage of people within a reasonable walking distance (1.5km for rural and 0.2km for urban) to an improved water source. A reliable water source is one capable of supplying its beneficiaries, a minimum of 20 litres per capita per day.

 

Household distance to nearest water source

Table 4.10: Distance of households to nearest Water Source by sub-county

Sub county

 

< 5kms

Up to 5kms

 

Over 5kms

Bwamiramira

 

Yes

 

 

 

Kabasekende

 

Yes

 

 

 

Bubango

 

Yes

 

 

 

 

 

Yes

 

 

 

Kibaale T/C

 

 

 

 

 

Kyebando

 

Yes

 

 

 

Kasimbi

 

Yes

 

 

 

Matale

 

Yes

 

 

 

Karama

 

Yes

 

 

 

Nyamarwa

 

Yes

 

 

 

Mugarama

 

Yes

 

 

 

Nyamarunda

 

Yes

 

 

 

 

 

 

 

 

 

Source: (DWO Office)

Latrine Coverage

This section will include the number of household within a community that have access to toilet facilities. It also looks at the type of latrine owned by the household.

Table 4.11: Latrine coverage for 3 years

 

Years

 

 

 

2014

 

 

 

2015

 

 

 

2016

 

Percentage

 

 

82.5%

 

84.4%

 

86.3%

 

                 

Source: (District Health Inspector)

Table 4.12: Achievement versus district targets

Latrine Coverage

Current Achievement (%)

Targets by 2016(%)

86.3%

100%

Handwashing

20%

60%

Primary School Pupil: Stance ratio

1:55

1:45

Primary School Hand Washing

70%

80%

Water Source Coverage

70%

80%

Water Source Functionality

70%

80%

Safe Water Coverage

70%

80%

Source: (DWO Office)

Table 4.13: Percentage distribution of toilet facilities by type 2016

Type of Facility

%

Covered Pit latrine

25

VIP Private

5

Uncovered Pit latrine

72

Flash toilet

3

Source: DHO’s Office

 

Immunization coverage during 2016/17 (With reference to mid-year population projections for 2016)

 Percentage coverage of BCG: 103%

 Percentage coverage of Polio (3): 97%

 Percentage coverage of DPT: 97%

 Percentage coverage of Measles: 86%

 Percentage coverage of TT Pregnant: 31%

 Percentage coverage of TT Non-pregnant: 10%

From the immunization percentages given above coverage of polio (3) and DPT is at 97% because the immunization coverages for these diseases were done and given at the same time.

Source: Records of the Bio-Statician Health

Table 4.14 shows the coverage for 3 financial years

Table 4.14: Percentage Coverage of Antigen by financial year

Antigen

2015/16(%)

2016/17(%)

Target 2017/18(%)

BCG

90%

95%

103%

Polio 3

95%

105%

122.6%

DTP 3

90%

95%

97%

Measles

80%

82%

86%

Source: DHO’s Office

Drug Inspection

Drug Inspection is important during the provision of health services in order to;

 provide safe, good quality, efficacious medicines and medical supplies to the general public in both public and private sectors.

 promote proper and rational use of drugs, records management among health workers through support supervision, on job training and sensitisation on compliance with National Drug Policy and Authority Act and National Standard Clinical Guidelines.

Table 4.15: Number of Licenced drug shops in the district

Type

Number

Private Pharmacies

0

Drug shops

52

Dental & Medical Clinics

1

Allied Clinics

6

Domiciaries

1

Traditional Healers

0

Source: District Health Inspector

Tuberculosis, Leprosy and Onchocerciasis

According to the Annual Health Sector Performance Report 2012/2013 by Ministry of Health, the National level Tuberculosis treatment success rate was 79% percent compared to 52% for the District.

During the same period, the following number of patients was registered in the district;

 Patients suffering from TB: 732

 Patients suffering from Leprosy: 0

 Patients suffering from Onchocerciasis: 0

Maternal and Child Health (MCH)

The section gives information relating to maternal and child health indicators for 2016/2017. The following are highlighted:

 Number of mothers receiving antenatal: 19,588

 Number of mothers receiving post-natal services: 3,174

 Number of supervised deliveries by skilled personnel: 6,300

 Number of mothers practicing family planning: 6,091

 Infant mortality rate: 53/1000 live births

 Under 5 mortality rate: 80/1000 live births

 maternal mortality rate: 336/10,000

 Total Fertility rate: 5.8 Children per woman

Source: Refer to UDHS 2015/16 /Census 2014-Bunyoro region/DHO’s office

AIDS control (Prevalence, Control and Treatment)

Introduction

According to the Health Sector Strategic Plan (HSSP III), HIV/AIDS is one of the communicable disease that account for over half of the total burden of disease are leading cause of ill health and mortality in Uganda. The overall objective for the communicable diseases cluster is to reduce the prevalence and incidence of communicable diseases by at least 50 percent as per the MDGs and NDP target.

       I. HIV/AIDS Prevalence Rates

       II. Number of HIV Counselling Centres

Table 4.16: Coverage of HIV/AIDS Counselling and Testing (HCT) services

Indicator

 

Coverage

 No and % of Health units up to HCII that have integrated HCT

 Stock out of HIV test kits: Nil(2015)

 Average no HCT outreaches per month=4

 % age of people who demand for HCT services and are counselled for HIV=50%

 %age that received HCT results

 

 

 

 

 

 

 

 

 13 out of XXX.

 

 100% HMIS

 100% coverage -HMIS

 50% -HMIS

 50%

Source: Bio-Statician-Kibaale

III. HIV/AIDS Counselling and Testing (HCT) Sites

The distribution of HIV/AIDS counselling and testing sites is important in ascertaining the level of accessibility of this health service within the district. Table 4.17 below indicates the distribution of HCT services by facility by location.

Table 4.17: Distribution of HCT Services by facility by location

Name of facility

Category

Location

Ownership

County

Sub County

 

Alustin Clinic HCII

HCII

Buyanja

Kasimbi

Private

Bubango HCII

HCII

Buyanja

Bubango

Private(EMESCO)

Buseesa Medical Centre Clinic

Clinic

Buyanja

Matale

Private

EM’S Health Clinic III

HCIII

Buyanja

Nyamarwa

Private

Emesco HCIII

HCIII

Buyanja

Kibaale T/C

Private

Kabasekende HCII

HCII

Buyanja

Kabasekende

Government

Kibaale HCIV(Kibaale)

HCIV

Buyanja

Kibaale T/C

Government

Kyebando HCIII

HCIII

Buyanja

Kyebando

Government

Matale HCII

HCII

Buyanja

Matale

Government

Mugarama HCIII

HCIII

Buyanja

Mugarama

Government

Nyamarwa HCIII

HCIII

Buyanja

Nyamarwa

Government

Police clinic

Clinic

Buyanja

Kibaale T/C

Uganda Police Directorate of Health

St. Luke Bujuni Kibaale HCIII

HCIII

Buyanja

Kibaale T/C

Private

Source: DHO’s Office

 

Table 4.17 above shows that there are 05 Sub Counties without a Government HCIII namely; Bwamiramira, Matale, Kabasekende, Kasimbi and Karama.

 

IV. Anti-Retroviral Therapy including treatment for children ART (Antiretroviral Therapy)

In this section, the agencies providing ART, their location, numbers of people (adults and children) accessing the ART are covered as in the table 4.18 below.

Table 4.18: ART Services as of July 2016 to June 2017

Agency

Sub County

Total Adults

Total Children

Total Overall

Ownership

Emesco HCIII

Kibaale T/C

673

42

715

Private

Kibaale HCIV

Kibaale T/C

4539

329

4868

Government

Kyebando HCIII

Kyebando

520

30

550

Government

Mugarama HCIII

Mugarama

542

31

573

Government

Nyamarwa HCIII

Nyamarwa

1255

79

1334

Government

St.Luke Bujuni

Kibaale T/C

118

1

119

Private

Total

 

7647

512

8159

 

Source: HMIS DDHS Office

4.12 Prevention of Mother to Child Transmission of HIV/AIDS

      • HIV Counselling and Testing

 Expected number of pregnancies: 13145

 Number of new ANC clients at PMTCT sites: 16,781

 Number of pregnant mothers pre-test counselled: Data not available

 Number of pregnant mothers tested for HIV: 503

 Number of pregnant women tested HIV positive: 25

 Number of partners tested for HIV: 32,627

 Number of partners tested HIV positive: 878

      • Anti-retroviral Drug Administration

 Number of HIV positive women given combivir and NVP during pregnancy: 113

 Number of HIV positive pregnant women received NVP only: 70

 Number of positive pregnant women receiving Triple therapy (ART): 183

      • Labour and Delivery care

 Number of HIV positive mothers: 152

 Total number of deliveries: 3170

 Number of HIV Positive deliveries: 6

 Number swallowed ARVs for prophylaxis: 152

 Number of HIV positive deliveries on HAART: 140

 Number of infants received ARV prophylaxis: 152

4.13 HIV testing for children aged 18 months to 5 years born to HIV positive mothers  Number of infants born to HIV positive mothers tested for HIV: 152

 Number of children born to HIV positive mothers tested HIV positive: 6