Study reveals health systems strengthening priorities in Uganda’s West Nile region

In July 2020, UNICEF commissioned Montrose to conduct a baseline study of its health systems strengthening interventions in the West Nile sub-region of Uganda through the “Child-Sensitive Social Protection” programme which aims to strengthen systems that address the health, nutrition needs and vulnerabilities of mothers and children. The programme, which is funded by the Swedish International Development Cooperation Agency (SIDA), commenced at the end of 2019 and will run until 2024. Implementation was delayed due to the onset of the Covid-19 pandemic.

The baseline study looked at the interventions in the West Nile districts and how these interventions strengthened district level systems to meet the needs of refugees and host communities through actions that established sustained improvements in the provision, utilisation, quality and efficiency of health services (broadly defined to include family care, preventive services and curative care), and that produced equitable health, nutrition and development outcomes for children, adolescents and women.

The study revealed that health services in the programme area are presently overwhelmed by the increased numbers of patients/clients, many of whom are refugees. At the same time, the existing planning, monitoring, registration, and reporting/data systems can be further improved and better utilised to ensure evidence-based planning and prioritisation by the district health teams with respect to supply chain management, capacity, numbers and distribution of staff, outreach and other community engagement activities. Not least, training of health service staff in handling improved systems can increase the overall efficiency of health services.

The desired outcomes of the programme after five years, at beneficiary level, include improved access and utilisation of health and nutrition services through the availability of high quality services at health facilities.

Another desirable outcome is strengthened community health structures where households are more aware of their responsibilities to prevent ill health, promote their health, understand early signs of sickness, and reach health services available to them. This empowers them to protect their children and themselves against sickness, and to seek medical assistance as early as possible.

The baseline report recommends social behaviour change communication to increase demand for health services at community and household level, promoting good care and health practices including healthy nutrition, and encouraging mothers and children to use health services. Demand creation through the Village Health Team structures will go a long way towards achieving positive health and nutrition outcomes of over 500,000 women and children in the West Nile region.