The last two decades have brought some needed improvements in health indicators in Uganda. For example, under-five mortality and maternal mortality have decreased by around 50% since 1995, thanks to widespread immunisation campaigns, increased antenatal care and access to health facilities. However, these rates remain very high and the Sustainable Development Goal (SDGs) and Uganda's own national still fall far short of targets.
Despite some improvement, most children still do not have adequate access to healthcare. Nationally, one in four families cannot afford to visit a health facility or buy medication for sick children. Health facilities are often in dilapidated condition and frequently run out of medicines and electricity. Indicators such as neonatal mortality (the probability of death within the first 28 days of life) have shown no progress at all, with the current rate of 27 deaths per 1,000 births exactly the same as in 1995. There remain serious issues around availability and quality of services for babies born prematurely or with complications. 29% of Ugandan children under five years old suffer from chronic malnutrition, known as stunting, which prevents their mental and physical development. It is clear that despite some progress, millions of children are being left behind.
Improving Maternal and Newborn Child Health (MNCH)
We support district authorities to improve access to quality MNCH services. By training health workers, equipping clinics with vital supplies, and educating parents and pregnant women, we aim to get more mothers to give birth at equipped institutions rather than at home.
The Baby Cap project in remote and mountainous areas of Bundibugyo, western Uganda, has provided the local hospital with lifesaving resuscitation equipment, oxygen cylinders and incubators; trained staff on specialised care for premature babies; and supported local health committees to spread information in the communities. As a result, the three-year project helped cut the institutional maternal mortality rate by 31%, and the neonatal mortality rate by 51%. Similar projects have helped Ntoroko district reduce the institutional perinatal mortality rate by 60% and reduce the number of children dying before their fifth birthday by 42%.
Innovative approaches, such as using motorbike ambulance taxis to reach the most inaccessible villages and bring care for pregnant women, are having a hugely positive impact in communities that were previously out of reach.
Saving Newborn Lives
The first minutes and hours of a baby's life are critical, and our programmes aim to promote simple steps that can save lives.
Promoting Adolescent Sexual and Reproductive Health (ASRH)
Adolescents in Uganda do not have adequate access to sexual and reproductive health services or information. At least one in four women in Uganda get pregnant as a teenager, contraceptive use is limited, and teenage pregnancy is a key factor in girls dropping out of school. We work with schools, clinics, youth peer groups, village health teams and other platforms to increase adolescent knowledge of sexual and reproductive health. Through this approach in northern Uganda, the percentage of youth accessing and using HIV/AIDS and SRH services increased from 63.8% at the start of the project to 75% at present.
Healthcare in humanitarian settings
In the refugee settlements, many women have to walk for miles to reach sparse clinics without beds or equipment. We have built, equipped and supported the running of two new Level III health
centres, which provide access to maternity, inpatient and laboratory services. More than 80,000 people have benefited from consultations so far. To ensure sustainability, the facilities are to be handed over to the Ministry of Health.
Boosting nutrition
Our Infant and Young Child Feeding (IYCF) programmes provide malnutrition screening, food and nutritional support to young children and their mothers. In the refugee settlements we runMother & Baby Areas (MBAs) which promote breastfeeding and good nutrition among pregnant and lactating women and caregivers for children under two years old. Practising optimal IYCF, including breastfeeding and complementary feeding, is the most effective way to reduce child malnutrition in emergency settings.
System strengthening
Sustainable long-term change will only be possible if basic health systems are in place and strengthened. We work to improve the capacity of health facilities, strengthen leadership and governance structures and community health committees, and national policy and technical working groups. We also support research and development. For example, we supported Makerere University School of Public Health to establish the Maternal and Newborn Child Health Centre of Excellence, the first of its kind in sub-Saharan Africa.