UPHOLD, Uganda

Situation:

UPHOLD is the Ugandan Programme for Human and Holistic Development and is supported by USAID and JSI. UPHOLD is committed to empowering families, communities and institutions to improve the quality and use of services in education, health and HIV/AIDS. UPHOLD accomplishes this through partnerships and people-centered approaches for a sustained client-friendly environment.

Response:

The Malaria Consortium is a partner of UPHOLD, providing communicable disease control. More specifically, UPHOLD is supporting the Ugandan Ministry of Health National Malaria Control Plan, to implement malaria prevention and control programmes, funded by the US President's Malaria Initiative (PMI).

The programme included a net re-treatment service for 600,000 nets including providing training materials; on-job training and support supervision in Malaria in Pregnancy for improved delivery of IPT, including coaching and demonstrations on explaining silent malaria to women, their partners and community members; organizing work flow, registers and stock cards; and exploring ways to increase IPT. A quality of assessment of ACT use following the new national policy for treatment, indicated 42% of fever episodes were being treated with ACT, although 27% of facilities reported being out of stock of ACT, Coartem. However over 79% of health workers were oriented on using ACT for uncomplicated malaria treatment, and they reported that ACT packing was user friendly and easy to administer, and generally the new treatment regime was viewed very positively.

In the Home Based Management of Fever (HBMF) strategy, community volunteer health workers are trained and supplied with pre-packaged antimalarial drugs for home treatment of fever under the supervision of health workers at the nearest health facility. Capacity was built in District Health Teams and a monitoring /evaluation system set up. Assessing HBMF indicated that 2.7 million children with fever were treated with HomapakTM over the previous year, 65% of them within 24 hours and 92% did not require further referral to the health services. Our study showed almost two thirds reduction in severe and moderate anaemia in children aged 6 - 24 months through implementation of this HBMF system.

Tuberculosis logistics management training was conducted in 4 districts and retraining in DOTS (Direct Observation of Therapy, by which patients are helped to take and complete their treatment successfully) in 2 districts.

Finally the Malaria Consortium's seconded staff member has supported UPHOLD in increasing ITN coverage in the under 5 year olds in 4 conflict and 5 non-conflict districts. During the year, 115,000 nets were distributed in these areas, to households with children less than 5 years old.

Points to note:

HBMF reporting rates were still very low in some districts (<50%). Weaknesses in the linkage between Community Medicine Distributors (CMDs) and the formal district health system have been identified as the main obstacle to timeliness and completeness of the HBMF reporting.

Partners supporting HBMF have proposed increasing the target of CMDs supervised per month to at least 80%, by increasing resources to enable the peripheral HWs to reach the CMDs.

For more information about UPHOLD, JSI and USAID please click the logos

Photo: William Daniels/Dolce Vita