P.O Box 916, Mbale Uganda | Tel: +256-772-441517 | E-mail: info@manafwa.go.ug
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 |
|
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