Health

 HEALTH Services

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 mandate of the department is drawn from the National, Health Sector Ministerial Policy Statement, The Health Sector Strategic Investment Plan (HSSIP) and The Local Government Act (LGA) to address the Sustainable Development Goals by ensuring Universal Health Coverage through implementation of the Primary Health Care and Uganda Minimum Health Care package.

The overall goal of the sector is to provide good quality services to the people of Manafwa 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. Manafwa district has 10 Health Units of different categories. Some of them are Government owned 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.

 

There 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.

 

POPULATION

  • According to 2014 census was 175079 Male   female ratio is 1:1
  • Urban to rural population is 1:6.
  • Average household size is 4.8
  • Population density is 661
  • Population growth rate is 3.8

 

Health Infrastructure

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

 

             Table 1: Health infrastructure (categories) in Manafwa District

Category

                              Ownership

                                   Total

Government

          PNFP

Hospital

0

0

0

H/C IV

2

0

2

H/C III

3

1

4

HC II

2

2

4

Total

7

3

10

Number of staff houses

18

6

24

The distribution of Health facilities by subcounty and ownership is presented in Table 2.

Table 2 Number of Health infrastructure (categories) in Manafwa District by Sub County and Ownership

S/N

 

Sub County

 

HC II

HC III

HCIV

Hospital

Govt

Private

Govt

Private

Govt

Private

Govt

Private

1

Manafwa T/C

0

1

0

0

1

0

0

0

2

Buwagogo

0

0

1

 

0

0

0

0

3

Weswa

0

0

0

0

0

0

0

0

4

Kaato

1

0

0

0

0

0

0

0

5

Buwangani T/C

0

0

0

0

0

0

0

0

6

Sisuni

0

0

0

0

0

0

0

0

7

Maefe

0

0

0

0

0

0

0

0

8

Bukhofu

1

0

0

0

0

0

0

0

9

Butiru

0

1

1

1

0

0

0

0

10

Bunabwana

0

0

0

0

0

0

0

0

11

Busukuya

0

0

1

0

0

0

0

0

12

Sibanga

0

0

0

0

0

0

0

0

13

Bugobero

0

0

0

0

1

0

0

0

14

Butta

0

0

0

0

0

0

0

0

15

Nalondo

0

0

0

0

0

0

0

0

16

BunyinzaT/C

0

0

0

0

0

0

0

0

17

Bunabuzale

0

0

0

0

0

0

0

0

18

Bukusu

0

0

0

0

0

0

0

0

19

Bukhadala

0

0

0

0

0

0

0

0

20

Butiru T/C

0

0

0

0

0

0

0

0

21

Khabutoola

0

0

0

0

0

0

0

0

22

Makenya

0

0

0

0

0

0

0

0

 

Total

2

2

3

1

2

0

0

0

 

The distribution of Health units which are private for profit is presented in Table 4.3

 

Table 3: Number of Health Units (Private for Profit)

S/N

Type

Number

1

Private pharmacies

0

2

Drug shops      

60

3

Clinics

15

4

Allied clinics 

15

5

Domiciaries

01

6

Traditional healers

03

7

Unlicensed clinics

 

8

Unlicensed drug shops

40

 

          Accessibility to health Services

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

Health Services Accessibility indicators

 

  • Average Population served by each health unit:                                  17900
  • Percentage of population within 5km radius of Public or private health unit: 15.7%
  • Percentage of population within 5km radius of Public health unit:        27.4%
  • Number of licensed private clinics :                                                    12      
  • Practicing Doctor: population ratio:                                                    1:89500
  • Nurse: Population ratio:                                                                    1:4972
  • Clinical Officer: Population ratio:                                                       1:10529
  • OPD Utilization:                                                                               74%  
  • Deliveries in health facility:                                                               42%  
  • Midwives: pregnant women (15-49) ratio:                                           1:482

Morbidity and cause of ill health

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

 

            Table 4: Manafwa District disease burden (2018/19) top ten diseases

S/N

Disease

Frequency

Percentage (%)

1

Malaria

52532

46

2

Cough or cold

33259

29

3

Intestinal worms

7364

6

4

UTI

6343

5

5

GIT disorder

4342

4

6

Acute Diarrhoea

4084

3

7

Skin diseases

2156

2

8

Trauma

1835

1.5

9

PID

1480

1

10

Pneumonia

1137

0.9

              Source: District Health Information System2, 2018

 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. The staffing in the District Health office is presented in Table 4.5 while the staffing in HCIV, HCIIIs and HC IIs is presented in Table 4.6, 4.7 and 4.8 respectively

 

Table 5: Staffing in District Health Office

Cadre

Approved

Filled

Not Filled

District Health Officer   

1

1

0

Assistant District Health Officer (Environment)

1

0

1

Assistant District Health Officer (Maternal Child Health/Nursing)

1

0

1

Senior environmental health officer

1

0

1

Senior Health Educator

1

0

1

Bio-statistician/Health Information Scientist

1

0

1

Cold Chain Technician

1

1

0

Stenographer Secretary

1

1

0

Stores Assistant

1

1

0

Office Attendant

1

1

0

Driver

1

1

0

Total

11

6

5

Source: District Health Information System2, 2018

 

 

Table 6: Staffing in Government Health Units HC IV

Cadre 

Approved

Filled            

Not Filled

 Senior Medical Officers

2

1

1

Medical Officer

2

1

1

Senior Nursing Officer

2

1

1

Clinical Officers

4

8

-4

Public Health Nurse

2

0

2

Ophthalmic Clinical Officer

2

0

2

Nursing officers

4

9

-5

Health Inspectors

2

0

2

Enrolled Nurses(2 are Phy.EN)

6

11

-5

Enrolled midwives

6

9

-3

Laboratory Personnel

4

8

-4

Dental Assistants/Officers

2

1

1

Health Assistants

2

3

-1

Nursing Assistants

10

4

6

Psychiatric Clinical Officers

0

0

0

Total

50

56

16

Source: District Health Information System2, 2018.

 

Table 8: Health Centre III

Service Provider category

Approved

Filled

Not Filled

Clinical Officers

8

9

-1

Nursing Officers

8

7

1

Enrolled Nurses

12

12

0

Enrolled Midwives

12

9

3

Laboratory Personnel     

8

7

1

Nursing Assistants

12

3

9

Total

60

47

14

Source: District Health Information System2, 2018

           

Table 9:  Health Centre II

Service Provider category

Approved

Filled

Not Filled

Nursing Officers

0

3

0

Enrolled Nurses

8

8

0

Nursing Assistants

12

5

7

Total

20

16

7

Source: District Health Information System2, 2018

 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.

 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 10: Latrine coverage for 3 years for Manafwa District

Years

2009

2010

2017

Percentage

62%

72%

75%

 

 

Table 11: Achievement versus district targets

Parameter

Current Achievements (83.1%)

Targets by 2017 (90%)

Latrine coverage

 

 

Hand washing

29%

45%

Primary school pupil : stance ratio

1:88

1:40

Primary school hand washing

6.1

 

Water source coverage

 

 

Water source functionality

85%

100%

Safe water coverage

68%

100%

Source: District Health Information System, 2018

 

Table 12: Number of Latrines by type

Type of Latrine

Number

Covered pit latrine

9485

VIP Private

7108(24.2%)

Uncovered pit latrine

14485

Flush toilet

13

Source: District Health Information System2, 2018

 Immunization coverage as of June 30 2018

 

Immunization

Percentage coverage

% coverage of BCG

96

% coverage of Polio:

115

% coverage of DPT

115

% coverage of Measles

85

% coverage of TT Pregnant

133

% coverage of TT Non-pregnant

23

Source: District Health Information System2, 2018

Drug Inspection

Objectives

The objectives of drug inspection are 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.

 

The number of licenced drug shops in the district is presented in Table 13.

 

Table 13: Number of Licenced drug shops in the district

Type

Number

Private Pharmacies

0

Drug Shops

20

Dental Clinics

1

Allied Clinics

3

Domiciaries

1

Traditional Healers

0

Source: District Health Information System2, 2018

 

 Tuberculosis, Leprosy and Onchocerciasis

 

  • District Coverage as compared to the National:          80  %  for     Against     % for National
  • Number of patients suffering from TB:                                119
  • Number of patients suffering from Leprosy:                          01
  • Number of patients suffering from Onchocerciasis:               00

          Maternal and Child Health (MCH)

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

 

  • Number of mothers receiving antenatal:                             6073(82%)    
  • Number of mothers receiving post natal services:            7685(42%)        
  • Number of supervised deliveries by skilled personnel:     3066(42%)        
  • Number of mothers practicing family planning:        11428 (34%)   
  • Infant mortality rate:         /1000 live births (DHS 2006)
  • Under 5 mortality rate:/1000 live births (DHS 2006)
  • Maternal mortality rate:    (1991 PHC)
  • Total Fertility rate:           (DHS 2006)

AIDS control (Prevalence, Control and Treatment)

 

According to the health sector strategic plan (HSSPIII), 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 of 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.

 

HIV/AIDS Prevalence Rates =   3.7% in the general population and 3% among pregnant women

Number of HIV Counselling Centres =  10

 

Table 15: 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
  • Average no HCT outreaches per month
  • % age of people who demand   for HCT services and are counselled for HIV
  • %age that received HCT results

6 out of 10   

 

 

42 Days

12

67%

67  %-

Source: District Health Information System2, 2018

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 a district. The table 4.16 below thus classify the level of the distribution.

 

Table 16: Distribution of HCT Services

 

Name of facility

Category

Location

Ownership

County

Sub county

Village

Bugobero

Level IV

Bubulo

Bugobero

Bunefule

Government

Bubulo

Level IV

Bubulo

Manafwa T/C

Wangutusi

Government

Bukewa

Level III

Bubulo

Buwagogo

Bukewa

Government

Butiru

Level III

Bubulo

Butiru T/C

Mango Tree

Government

Lwanjusi

Level III

Bubulo

Busukuya

Lwanjusi

Government

Butiru Chrischo

Level III

Bubulo

Butiru T/C

Butiru

PNFP

Source: District Health Information System2, 2018

 

 Anti-Retroviral Therapy treatment

 

 

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

 

Table 18: ART Services in Manafwa District as of December 2017

 

Subcounty/ Facility

Number of        Clients

Ownership

 

 

Bubulo H/C IV

741

Gov

 

Bugobero H/IV

728

Gov

 

Bukewa H/III

60

Gov

 

Butiru Chrischo

99

PNFP

 

Butiru H/CIII

121

Gov

 

Lwanjusi H/CIII

184

Gov

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: District Health Information System, 2018

 

Prevention of Mother to Child Transmission of HIV/AIDS

            HIV Counselling and Testing

  • Expected number of pregnancies:                                   7386     
  • Number of new ANC clients at PMTCT sites:                   6073                
  • Number of pregnant mothers pre-test counselled:          5627        
  • Number of pregnant mothers tested for HIV:                  5627
  • Number of pregnant women tested HIV positive:                71       
  • Number of partners tested for HIV:                                 133
  • Number of partners tested HIV positive:                            02       

  Labour and Delivery care

 

  • Number of HIV positive mothers:                              66
  • Total number of deliveries:                                      3036
  • Number of HIV Positive deliveries:                            66
  • Number swallowed ARVs for prophylaxis:                  66
  • Number of HIV positive deliveries on HAART:             66
  • Number of infants received ARV prophylaxis:            66
  •          

 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            51
  • Number of children born to HIV positive mothers tested HIV positive   01