Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698929038788.pdf (Uganda)
THE REPUBLIC OF UGANDA MINISTRY OF HEALTH IVIINISTERIAI S'TATEMENT TO PARI.IAMENT ON THE STATE OF THE HEATTH SERVICE DELIVERY IN UGANDA k#* Minister of Health 12th Ma,rch ,Z,AL} L Rt.

Hon Speaker, Hon.

Members, The health sector is mandated to provide the highest possible level of health services to all people in Uganda through delivery of promotive, preventive, curative, palliative and rehabilitative health services at all levels.

Rt.

Hon.
Rt.

Hon.

Speaker the Vision of the National Health Policy ll is "A heolthy and productive population that contributes to the socio-economic growth and notional development", and the Goal of the Health Sector Development Plan 2015/L6 - 2019120 is "To accelerote movement towords lJniversol Health Coverage with essential health and related services needed for promotion of o healthy ond productive life".
The Uganda Demographic Health Survey report 2Ot6 shows positive trends, with a progressive reduction of most of the mortality indicators over the previous ten to fifteen years.

ln particular, Under-five mortality rate showed a significant decline from 90 (2011) to 54 per L, 000 live births in 2015.

The lnfant Mortality Rate (lMR) stands at 43 per 1,000 (UDHS 20L6l,which is a significant improvement from IMR of 54 per 1,000 live births (UDHS 20L1ll.
The Maternal Mortality Ratio declined from 438 per 100,000 (UDHS z01-tl live births to 335 (UDHS 201.61.

According to the National Population Census Report, life expectancy has also improved from 45 years in 2003 to 53 years by 2015.

Hon.

Speaker the National Health Policy emphasizes delivery of the Uganda National Minimum Health Care Package which consists of interventions that address the high disease burden.
The Health System Structure ranges from the Community Level (Village Health Teams) to Tertiary Level (National Referral and Specialized Hospitals).

The majority of service providers from both the public and private sector focus on delivery of Primary Health Care under the District Local Governments.

Hon.

Speaker, by 1997, only 47o/o of the population who needed Health Care could access outpatient services (NHP 1999) and by 20t6, 86% of the population were within 5km of a health facility (NHS 20t6l.
The Uganda Master Facility List shows that we have a total of 5,937 health facilities in the country of which 45o/o dre 2 public or government, t5% are Private-Not-For Profit and 4oo/o are for the Private for Profit sector.
Table with breakdown of health facilities by level and ownership Centrol I Centrol 2 Kompolo EASTERN REGION Eost Centrol Mid Eostern North Eostern Koromojo Mid Northern West Nile Mid Western South Western GOW 340 301 26 337 351 150 r20 366 247 347 549 PNFP GRAND TOTAT 590 I68 I 37r 9t 107 45 2 lt9 55 124 I23 ffi 163 II3 6l 127 77 49 22 82 48 88 179 I 093 582 I 458 r 334 555 535 244 144 567 350 559 E5I 7 Health lnfrastructure Status The Ministry of Health Service Standards were developed based on the first National Health Policy which recommended that a general hospita!
should serve a population of 500,000, Health Center lV should serve 100,000 people, a Health Center III should serve 20,000 people and Health Center ll 5,000 people.

ln fulfilment of the NRM Manifesto Government committed to continue implementing the Health lnfrastructure Policy of having and functionalising Health Centre lVs in every political constituency, and health centre llls per sub- county.

Many Health Centre lls wil!

be upgraded and expanded in line with the policy.


3 current health infrastructure gap is as follows; 1.

2 3 4 5 No.

of Districts without a hospital at all No.

of Constituencies without a HC lV No.

of Sub Counties with no HC lll but have HC Ils that can be upgraded No.

of Sub Counties with no HC lll but have a HC lV or hospita I No.

of Sub Counties with no health facility at all 39 29 331 L88 132 L.I Health Centre llls Rt.

Hon.
Hon.

Speaker, Cabinet approved the Ministry of Health proposal for upgrading 285 HC lls in subcounties without HC llls with funding from the Uganda lnter-government Fiscal Transfer Reform Program.

A total of Ug.

Shs.

200 billion has been allocated to the health sector and work started this FY 2}t8lt9 with 125 HC lls and will be completed in 2019/20.

AnotherTl HC lls wil!

be allocated funds for upgrade in FY 20t9l20 and the remaining 89 HC lls wil!

be upgraded in FY 2O2O/21.


All the upgraded facilities will be equipped with solar lighting.

Under the Uganda Reproductive, Materna!

and child health lmprovement project, 41 HC lls will be upgraded to HC !lls and 40 HC llls functionalized in 55 districts.

A request for a loan of 10 Million Euros is being followed up for Health lnfrastructure Development in Karamoja region and this will include upgrading HC lls to llls and constructing HC Ills where they do not exist.

Rt.

Hon.
Rt.

Hon.

Speaker, beginning FY 2019120 MoFPED will enhance the Non-Wage Grant to Local Governments and provide funding for equipment of the HC llls.

For L32 HC llls in subcounties that don't have any health facility, Cabinet directed MoFPED to obtain a loan.

The construction is estimated at Ug.

Shs.

1,45.2 billion and equipping at Ug.

Shs.

45.2 billion.

Ministry of Health put in a request to MoFPED on June 6th 20L8.

O o o o o 4 1.2 Health Centre lVs Of the 290 constituencies 29 do not HC lVs.
The plan is to revamp existing HC lVs and construct new ones or upgrade HC Ills to lVs in constituencies without HC lVs.

The total cost for constructing the 29 HC lV is Ug.

101.5 billion and equipping is Ug.

Shs.

43.5 billion.

While the cost of functionalizing them comes to Ug.

Shs.

19.6 billion annually.

Cabinet advised that we conclude the HC llls before we can commence the HC IV construction.
5 1.3 District Hospitals According to the National Health Policy a general hospital serves a population of 500,000.

There are 147 hospitals of which 63 are government, 64 NGO and 20 are private.

However, there are disparities in geographical distribution and accessibility.

Government provides PHC Non-Wage Grant to PNFP Hospitals to serve populations in districts where they exist.

Rt.
Rt.

Hon Speaker, rehabilitation and equipping of t hospitals under Uganda Health Systems Strengthening Project (UHSSP) was completed by June 2017 i.e.

Mityana, Nakaseke, Kiryandongo, Entebbe Grade B, Nebbi, Anaka, lganga, Moyo and Moroto RRH and these hospitals were allocated additional funds for recruitment of specialists and medicines and recurrent costs.

Rehabilitation and equipping of Kawolo Hospital started on 1st May 2017 at a contract sum of USD L0.8 million (Shs.
39 billion) and is ongoing under the Spanish debt swap and was at80% by end of June 20!8.

Rehabilitation of Busolwe Hospital will commence when finance has provided a counterpart funding of Ug.

Shs.

6 billion.

The Spanish Government has put it as a condition to MoFPED before they release the committed grant of 6.4 Million USD.

This has been brought to the attention of MoFPED.


Contracts were signed for the renovation and expansion of Kayunga and Yumbe General Hospital on 5th January 20L8 and are progressing well.

Koboko, Rukunyu, Kaberamaido and Maracha HC lVs were upgraded to hospita!

status.

Ministry of Health awaits funding to match the status.

The current funding to these facilities still remains for HC lV which is inadequate to match the hospital status and services being offered.
Ministry of Health has written to MoFPED to provide Ug.

Shs.

3.52 billion for this purpose in this coming Financial Year.

18 districts have PNFP Hospitals which receive PHC non-wage grants to support them provide services as district general hospitals.

These are Agago, Amolatar, 6 Amudat, Budaka, Bushenyi, lbanda, Kaberamaido, Kalungu, Kiruhura, Maracha, Mayuge, Mpigi, Mukono, Napak, Ngora, Oyam, Rukungiri and Zombo.

Two (2) districts have private hospitals (Buhweju and Sembabule).
39 districts do not have any hospitals at all.

These are Alebtong, Amuria, Amuru, Bukedea, Bukomansimbi, Bulambuli, Buvuma, Buyende, Dokolo, Gomba, lsingiro, Kalangala, Kaliro, Kamwenge, Kibuku, Koboko, Kole, Kotido, Kween, Kyankwanzi, Kyegegwa, Luuka, Lamwo, Lwengo, Manafwa, Mitoma, Nakapiripirit, Namutumba, Namayingo, Ntoroko, Otuke, Pader, Rubirizi, Serere, Sironko, Kibale, Kakumiro, Rubanda and Omoro.
The population of most of these districts does not meet the recommended catchment population for a general hospital except lsingiro, Amuria and Serere.

ln addition there are districts that deserve special attention because of their geographical location, these are lsland and mountainous districts like Buvuma, Kalangala, Namayingo, Mayuge and Namisindwa.

When resources are available Ministry of Health will prioritize these districts first.
The estimated start up cost per hospital for construction, human resources, medicines and medical equipment is Ug.

Shs.

31.3 billion.

Below is a table showing the detailed breakdown of the costs.

7 Dweloprnrnt Equipmrnt Recurrent Ministry of Health will consider constructing hospitals where they are needed upon availability of resources.

1.4 Regiona!
1.4 Regiona!

Referral Hospital There are 13 Regional Referral Hospital (Arua, Gulu, Lira, Soroti, Moroto, Mbale, Jinja, Masaka, Mbarara, Fort Portal, Hoima, Kabale and Mubende).

Since FY 2OO8(O9 each of the RRHs has been receiving a development budget ranging from Ug.

Shs.

1 billion to 3 billion to enable them revamp and construct missing infrastructure.

Most of the RRHs have utilized this money well though progress is slow because of the cost of construction.
The hospitals have constructed staff houses, specialized wards, medical equipment maintenance facilities, private wings, etc.

Oxygen plants with adequate capacity to supply lower leve!

facilities have been installed in all RRHs and plans are underway to scale up oxygen supply to lower level units at an estimated investment Ug.

Shs.

50.5. billion over 5 years.

These costs include back up generators with the attendant accessories, cylinders, piping, distribution, maintenance and operational costs.
This will be done when funding is available.

In the meantime NMS is delivering to the facilities that have oxygen cylinders while others are using oxygen concentrators.

8 Some RRHs like Masaka, Mbale, Mubende, Gulu and Arua signed contracts for specialized units that are over and above what the MTEF provides annually without consultation.

This has resulted in slow progress and a number of projects stalling but also depriving the other RRHs of their annua!

release of Ugs.

Shs.


1 billion in their favour.

To complete these projects an additional amount of Ug.

Shs.

48.4 billion is required (Masaka - 10.4 bn, Mbale - 15 bn, Mubende - 4.5 bn, Gulu - 3.5 bn and Arua -7.7 bnl.

The population of Wakiso district has exceeded 3 million.

Ministry of Health discussed with Wakiso DLG the need to upgrade Entebbe Grade A and B as one hospital to a regional status.
This has been approved and MoH has written to MoFPED twice 2OL7 /L8 and 2018 119 to provide funding amounting to Ug.

Shs.7.8 billion for refurbishing Grade A and an additional Ug.

Shs 4.495 bn for wage, L.5 bn for Non-Wage and L.4 bn for development operationalizing it as a RRH (granting a vote status).

Rt.
Rt.

Hon Speaker, while the Regional Referral Hospitals are expected to provide secondary care to the population, a number of them have not been providing services sufficiently due to challenges of inadequate specialized human resources and equipment.

RRHs are expected to provide imaging, diagnostic, intensive care, dialysis, and specialized surgical and medical services on top of the general services being provided by the general hospitals.
However, the current status does not enable them to provide their mandate.

The Ministry of Health with a Grant from the Netherlands Government of 23 million Euros and counterpart funding from government of 23 million Euros released every quarter for the next 5 years, plans to refurbish RRH imaging departments and provide equipment such as CT Scans, X-ray machines, Ultrasound machines, intensive care, dialysis, theatre equipment, amongst others.
With JICA support Hoima and Kabale RRHs were expanded and equipped and works are expected to begin in Lira, Arua and Gulu RRHs this year.

9 1.5 National Referral Hospitals Rt.

Hon.

Speaker, the country has 5 National Referral Hospitals (Mulago NRH - Upper Mulago, Butabika National Mental Referra!

Hospital, Kiruddu, Kawempe and Naguru.

Construction of the Kawempe and Kiruddu National Referral Hospitals was completed and now are functional specializing in services as follows; .
Kawempe - Paediatrics, Obstetrics and Gynaecology, Adolescent Health and Emergency Medical Services.

.

Kiruddu - lnternal Medicine, Plastic Surgery, Endocrine surgery, dialysis, burns and Emergency Medical Services.

.

Naguru - Orthopaedics, Trauma and Emergency Medica!

Services.

o Mulago NRH - (Upper Mulago) - Handles all disciplines save for obstetrics and gynecology.

This hospital needs revamping and equipping estimated at about 80 bi!lion shillings.
o Butabika NMRH - This hospital provides mental health services however faces human resource challenges, inadequate medicines and equipment like X-ray and CT Scan.

The funding gap is estimated at Ug.

Shs.

6.2 billion for additional specialized medicines for Butabika and other Mental health units in the RRHs.
1.6 Specialized Hospitals L.6.L Mulago Specialized Hospital Lower Mulago Hospital which was part of the Mulago National Referral Hospital has been converted into Mulago Specialized Hospital to offer super specialized services to Uganda and the entire region.

The Rehabilitation work for Mulago Specialized Hospita!

is ongoing and the current progress of work is at 97%.

Currently we require Ug.

Shs.

35 bn (USD 9.6 million) for completion of the works.
Mulago Specialized Hospital will provide super specialized services including organ transplant (kidney, cornea, liver, bone marrow, stem cell, etc), laparoscopic services, neurospinal surgery, orthopedic 10 surgery, nuclear and endocrinological medicine among others.

The funding requirement to operationalize this hospital is Ug.

Shs.

17.8 bn for wage including additional expatriates and Ug.

Shs.

58.3 billion recurrent non-wage.


7.6.2 Mulago Specialised Women & Neonatal hospital Construction and equipping of 450 Bed Specialised Women & Neonatal hospital at Mulago was completed at a cost of Ug.

Shs.

100 billion (25 million USD) and !aunched by H.E.

the President in October 2018.

The hospital requires a total of Ug.

Shs.

53.8 billion to become fully operational however MoFPED provided only Ug.

Shs.4.8 bn in FY 20L8lL9 for recurrent Non-wage.

This 53.8 bn includes wage Ug.

Shs.


L1 bn, recurrent Non-wage Ug.

Shs.

29 bn and capital development Ug.

Shs.

13.8 bn.

The hospita!

is currently depending on Mulago NRH for human resources which has caused a strain on the operations of Mulago.

1.5.3 Regional Specialized Paediatric Surgical Hospital Entebbe The Construction of the Regional Specialized Paediatric Surgical hospital was commissioned in February 2Ot7 in Entebbe and will be completed by 2020.

The hospita!
The hospita!

will provide services to the nation and the region.

A GoU provision of Ug.

Shs L9 bn has been made so far and Ug.

Shs.

5 bn included in the budget for FY 2O19l2O leaving a funding gap of Ug.

Shs.

21 billion.

1.5.4 Uganda Cancer lnstitute s The EAC identified and approved UCI as centre of excellence for training, research and treatment of cancer in East Africa.

GoU acquired a loan of 38 million USD (Ug.

Shs.


152 billion) to address training of specialists, procurement of specialized cancer equipment and construction of a centre of excellence.

183 students have been funded to pursue different courses in cancer related disciplines including L4 specialist oncology fellowships and L0 PhDs.
The Uganda Cancer lnstitute has established and continues to develop training programs to train specialists locally including in Paediatric Oncology, Medical Oncology, Gynecologic Oncology, Hematology and Oncology Nursing.

L1, A Linac machine has been procured and will soon be installed, and a contract has been signed for construction of the centre of excellence.
The UCI commissioned a new Cobalt-5O Radiotherapy Machine and is constructing 5 more radiotherapy bunkers which will house 4 Linear Accelerators,2 brachytherapy) to improve the radiotherapy services.

This construction is expected to be completed by close of this year.

1.6.5 Uganda Heart lnstitute The Uganda Heart lnstitute (UHl) has attained the necessary technical expertise to position it as a world class cardiovascular care Center in addition to being a training and research hub.
Using this mandate, the lnstitute has registered major achievements in cardiac surgery, cardiac catheterisation interventions, high calibre research and fellowship training of super-specialists in the cardiac fields meriting specia!

recognition by collaborating Institutions of lnternational repute.

The lnstitute requires specific support in the area of infrastructure development to solve the challenge of space and funds for super-specialized sundries and supplies.
UHI has excelled in developing its human resource structure (over 30 super specialists trained locally) and attaining a robust international standard of care which are a pre-requisite for developing financial independence if it can be given initial support.

Ministry of Health has requested for Ug.

Shs.

331 billion for construction of a stand alone centre of excellence for the UHI.

This will be in addition to the current infrastructure in Mulago.
!2 2 Human Resources for Health The National Staffing level is at73% i.e.

45,029 out of the 61,,796 approved posts filled in the public sector (Source 2}t6/t7 AHSPR).

The target is to increase to at least 760/oin20L8lL9 and 80% by 2019/20.

ln FY 2Ot8lI9, a wage enhancement (150 bn) was provided to the Health Sector.
Overall, the stock of qualified health profession available for employment in the health sector increased from 90,412 (20t7l to 101,350 (June 2018) but recruitment is constrained by limitation of wage and failure to attract and this has mainly affected the specialists due to the low remuneration.

2.1 Consultants and Senior Consultants Currently there is a gap of 2L9 Clinical Specialists and 550 support cadres at Nationa!

and Regional referral levels in the public sector.


The 2Ot5 Human Resources for Health (HRH) audit, indicates that the vacant posts for consultants and senior consultants in the national and RRHs in the country is at 6t% while the gap for the specialized cadres is at 83%.

Ministry of Health requires Ug.

Shs.


5.4 billion to recruit specialists for the 13 RRHs and the 14 general hospitals which have been rehabilitated to fill in the gaps.A requesttothe MoFPED was made on the gthJanuary20lg and we await response.

The current structure of the lower health facilities and RRHs is constricted and plans are underway to review these structures with the MoPS.
Even if the current positions are filled the human resources available will still be inadequate to serve the ever increasing population.

A training, absorption and retention plan was developed to address this gap over the next 5 years.

The estimated total cost for training specialists is 14.37 billion and super specialists is 43.32 billion Uganda shillings.

Government needs to enhance the salaries of the medical personnel to attract and retain them.
13 Overall, the stock of qualified health profession available for employment in the health sector increased from 90,4L2 (20!71 to 101,350 (June 2018) but recruitment is constrained by limitation of wage and failure to attract and this has mainly affected the specialists.

Table Showing Disparities between clinical specialists and academicians Academicia ns Professor Ass.

Prot Se n io r lectu re r Salary/month 9,150,000 81596,507 7,725,507 Lectu rer Ass.
Lectu re r 7,0L3,324 5,237,000 Clin icia ns Sr consu lta nt Consu lta nt Med.

Officer Specia I G rade Principal MO Senior MO Salary/ Month 4,500,000 4,200,000 3,7501000 3,750,000 3,300,000 A professor and a senior consultant have comparable training and years of experience.

An Assistant lecturer earns more than a senior consultant as seen in the table above.

All consultants who were employed in the RRHs left this FY to join the universities for a more Iucrative academic career.
There is therefore urgent need to replace them at more competitive salaries of the RRHs are to function effectively.

2.2 Other Critical Cadres for Lower Health Facilities The Ministry of Health has awarded scholarships for health workers from hard to reach areas as well as for those persuing courses to fill critical gaps.
Under the Uganda Reproductive Maternal and Child Health Services tmprovement Project (URMCHIP), a total of 188 scholarships were awarded in FY 2OL7/18: These included 2L in Masters in Anaesthesia, 1,4 for Bachelor of Anaesthesia, 32 in Diploma in Anaesthesia; 15 for Masters of Anaesthesia and 78 for Theatre Assistants among others.

Another 529 scholarships were advertised under the URMCHIP for FY 2019/20 also targeting critical cadres including Biomedical Engineers and Cold Chain Technicians.
L4 3 Medicines and Health Supplies Overtime the GoU Essentia!

Medicines and Health Supplies (EMHS) allocation has been increasingfrom Ug.

Shs.202 billion in FY 2O1O(L1.

to Ug.

Shs.284 billion in FY 20L7/L8.

However, the budget increases for EMHS are not in tandem with the population growth over the years and thus the declining trends in the per capita a!locations.

This represents only 49% of the annual medicines need.
The average allocation of essential medicines and health supplies per level of facility in FY 2017/LB was as follows; .

Each Health Centre Il is allocated UGX.

5,395,450/= annually translating into Shs.

900,000/= for every two months for a population of approx 5,000. o Each Health Centre lll is allocated UGX.

!0,790,900/-, which translates into 1,800,000 /- for every two months.

.

Each Health Centre !V is allocated UGX.2l,58L,80O/= which translates into 3,500,0001- for every two months.
o Each General Hospital is allocated UGX.

77,6t0,810/= which translates into L3,000,0001- for every two months as a referral for a population of 500,000. o Each Regional Referral Hospital is allocated UGX.

240,584,615/= svs,y two months which translated into an average of L.4 bn annually.

15 3.1 State of Emergenry Medical Services in the Country.

Emergency Medical Services have 3 levels i.e.

Care at Scene of Emergency, Care during transportation and Care at the emergency unit at the Health facility.
The Ministry has approved the Strategic Plan for addressing emergency medica!

services gaps in the country and also endorsed the EMS Policy for presentation to cabinet.

A certificate of financial implications has been requested from Ministry of finance, Planning and Economic Development before presentation to Cabinet.

MOH has been training lay first responders and medical first responders in order to improve on the responsiveness to emergencies wherever they occur.
This is planned to be scaled up in the next 5 years.

Financing for the EMS Strategic Plan o USD LL7,670,700 (UGX 447.1,48 B) is required to finance the first 5 years of this policy .

First year and or second year annual expenditure for ambulance care is UGX 125 Billion (32.8M USD) for 225 Health sub-districts in Uganda .
Operationalizing existing 173 ambulances (@ 26585USD) is7,975,500 USD equivalent to UGX 30,305,900,000 o Establishing a Call and Dispatch system (Communication system) excluded o Ambulance stations and Spots excluded So the total need for first two yeors is UGX 7258 + 30,3 B = 755.3 n We also acquired a universal medical emergency response number 9!2 from Uganda Communications communication and we shall establish 14 Medical Call & Dispatch centres (L Ambulance command centre per region).
On transportation the country has 44L ambulance vehicles and majority are in private hands as per table below.

650/o of ambulances in the private sector are in Kampala metropolitan area.

This cannot be rationally distributed because they are privately owned.

L6 The recommended ambulance vehicle population ratio is 1: 100,000, meaning that Uganda as a country requires 400 ambulance vehicles for Basic emergency care response.
The government owns 173 ambulances showing a deficit of 225 type B ambulance vehicles.

This gap will be filled over the medium term.

The existing 173 ambulance vehicles need to be re-equipped and staffed to meet the minimum ambulance standards.

On average cost of Type B ambulance vehicle from purchase to functionality annually is 429,53!,800 UGX (113,051 USD).

We have also planned for 5 type B boat ambulances for lsland districts and each costs on average 350,000 to 400,000 USD.
We intend to liaise with colleagues in South Africa to establish the actua!

costs.

4 Health Financing The total Budget allocation to the Health Sector for FY 2O18lL9 is Ushs 2,308.36 billion up from Ushs 1,824 billion in FY 20L7/18.

This accounts for 7.4% of the national budget up from 6.40/oin2Ot7/78.

PROPORTION OF PHC NON WAGE REqUIREMENT FUNDED BY THE CURRENT BUDGET.
Average monthly requirement Annual requirement Current average monthly allocation per facility Proportion of requirement funded by current budget per facility 8,280,000 99,360,000 L,927,007 3,5 L9,333 42,232,000 1,039,882 3,519,333 L,299,333 42,232,000 1,039,892 15,592,000 519,94L 1,,049,333 L2,592,000 259,970 23% 30% 30% 40% 2s% L7 An additional funding requirement in FY 2OL8/19 is 39.5 Billion shs.

Detailed analysis is indicated in annex2 of the report.
4.1 Universal Health Coverage Currently, Cabinet is discussing the Draft National Health Insurance Bill, 2014 that seeks to create a National Health lnsurance Scheme.

Once enacted into law by Parliament that legislation will be a major milestone in the journey of attaining Universal Health Coverage because it wil!

reduce out of pocket expenditures currently at 40% of the total health expenditure that has been a hindrance for access to care.

Rt.

Hon.
Rt.

Hon.

Speaker, Hon, Members, working closely with partners, the Ministry of Health is also focusing on improvement of Reproductive, Maternal, Neonatal, Child and Adolescent health services to reduce avoidable deaths of mothers and Children and improve their health status.

Another critical area of focus is the improved supply of selected RMNCAH commodities, including Contraceptives, Pregnancy test kits, Blood grouping reagents, vaccines, etc.

There is an urgent funding gap of Ug.

Shs.


5.5 billion for vaccines for this Financial Year.

By end of March 2019, if these funds are not provided there will be stock out of vaccines nationwide.

Rt.

Hon Minister, the Ministry is also Focus health service delivery on: health promotion, disease prevention and community health interventions, reproductive health, maternal, neonatal and child health, prevention and control of communicable diseases and outbreaks as well Non-communicable diseases.
Strategic plans have been developed to guide implementation of key interventions under each program area.

o Hepatitis B testing and vaccination was concluded in the 41 districts of Northern, West Nile, Karamoja and Teso sub regions in the first phase of the exercise.

Phase 2 is ongoing in Eastern region including Busoga and 18 regions and the remaining parts of the country shall be covered by the end of 2019. r H.E.

the President Y.l( Musevei launched .the National Exercise Day on 8th June 2018.
Final draft for the NCDs multi-sectoral strategy that awaits costing.

Health educatlon is being conducted in all health facilities on howto prevent NCDs.

r ART coverage among HIV infected adults and children increased to 8e% (1,140,110 / !,34O,AO0) from 73% (L,O28,gOglt,4O2,628l in 2016/17 and 67.ry/a F98,197/!,461,144) in 2015[6.
This progressive trend implies that the country is on trackto achieve the second of the,triple g0-90-90 by 2O2O targets in the Fast Track Strategy for ending AIDS by 2030, i.e.8L%of all HIV infected people enrolled on ART.

r An additional Ug.

Shs.

50 billion is required to bridge the gap for ARVs in FY ZAL9(TO.

However, beeause of procurement proeesses the money is required now.

For God and my Country Hon.
Jane Ruth Aceng Minister of Health 12th March ,2OI9 19 ANNEX 1: Sub-counties, Town Councils & Divisions with no health facilities at all (132) Subcounty / Town Council / Division Awach County La bwor Districts Abim Agago Alebtong Amolatar Kapelebyong Apac Bud uda Buhweju Agago Moroto Ajuri Kioga Ka pelebyong Ma ruzi Lutsheshe Manjia Buhweju Bukedea Bukedea Bukomansimbi TC Bukomansimbi North Bukomansimbi Elgon Bulambuli Bulambuli Bughendera Bwamba Bundibugyo Bunya nga bu Bu nya nga bu Samia Bugwe North Buvuma lslands Busia Buvuma Bukhalu Bulegeni Muyembe Kamu Kagugu Ma bere Baganikere TC Buheesi TC Kyamukube TC Bulumbi Buwooya Lu bya Lwajje Lya baa na Magamaga Lira Palwo TC Patongo Anya nga Oteno Akwon Akoromit Ayabi TC Bu biita Nabweya Buwali Bumasheti Kajana TC Nyakaziba TC Rubengye Koena Aligoi Komuge Kwarikwar No.
t. 2.

3.

4.

5.

6.

7 8.

9.

10.

LL 12 L3 L4.

15 L6 L7 L8 19 20 2L 22 23 24.

25.

26.

27 28.

29.

30.

31.

32 33 34.


35 20 County I ba nda Bu ka nga Bu ra hya Buyaga West Buyaga East Districts I ba nda lsingiro Ka ba role Kagad i Bugangaizi West Kakumiro Bugangaizi East Bulamogi North West Buya nja Ka liro Kibaa le Kibuku Kibuku Kisoro Northern Division Kisoro Municipality Okwerodot Kole North Kumi Nothern Division Kumi Municipality Kwania Kween Kisoro Kole Kumi Kwania Kween Butemba Kyankwa nzi Kya ka Mwenge South Kyegegwa Kyenjojo No.

36.
36.

Subcounty / Town Council / oivision lgorora TC Kakamba Karago TC Kiko TC Rwankenzi TC Kabamba Kagad i Ruteete Bwanswa Kikwaya Kisengwe M pasaa na Kiita Nansololo Bubango Bwamiramira Ka ra ma Goli-Goli Lwamata Nabiswa Na ndere Nankodo Ayabi TC Binyiny Ka ptoyoy Byerima Butemba Kya n kwa nzi Nkandwa Ka bweza Butu ndu uzi Kyakatwire TC Ka nyega ra m ire Nyabirongo 37 38 39 40 4L 42 43 44 45 46 47 48 49 50 5L.

52.

53 54 55 56 57 58 59 60 61 62 63 64 65.

66.

67 68.

69.

70.

7L.

72.
2L Subcounty / Town Council / Division Nya ntu ngo County Districts Nya kiksi Kyamutunzi TC Lwengo TC Bugobero Buka nda la Bukhofu Bukusu Buna bwa na Bunyinza TC Butta Buwangani TC Kha butoola Maefe Nalondo Siba nga Weswa Kijomoro Ajira Mwenge Central Mwenge North Bukoto Mid-West Bubulo West Lwengo Manafwa Ma racha Ma racha Kigurya Division Masindi Municipality Bungokho North Busujju Obongi Kasa m bya Mukono Nakaseke North Masindi Mbale Mityana Moyo M ubende M ukono Na kaseke Bubulo East Namisindwa Busiki Namutumba No.
73.

74.

75.

76.

77 78.

79.

80.

8L.

82.

83.

84.

85.

86.

87 88.

89.

90.

91.

92.

93.

94.

95.

96.

97 99.

99 100 101 702 103.

Lwasso Na ma basa Bbanda TC Zigoti TC Obongi TC Kiga ndo Katosi TC Kinoni Kitto Ngoma Bukhweka LO4.

Bukia bi Lwakhakha TC Magale Mukoto Nabweyo Na ngonde L05.

L06.

LO7 L08.

L09.
22 Subcounty / Town Council / Division Poron County Bokora Districts Napak Lorengechora Abindu Division Thatha Division Butungama Nebbi Municipality Nebbi Ntoroko Ntoroko Ntungamo Western Ntungamo Municipality Ntunga mo Division Rukoni West Got Apwoyo Lu ngu lu Minakulu Kate re ra Masheruka Buhugu Bukya bo Bukyambi Busu Ia ni Bu nyafa Tubur Ku ru Lodonga TC Akaa Ala ngi Athuma Ruhama Nwoya Oyam South Kate re ra Sheema North Budadiri East Budadri West Soroti Aringa Aringa South Okoro Nwoya Oyam Ru birizi Sheema Sironko Soroti Yumbe Zombo No.
1L0.

LTL.

LLT.

L L3.

LL4.

115.

L 16.

1"L7.

1L8.

1L9.

L20 12L.

122.

L23 124.

125.

126.

L27.

L28.

L29.

1,30.

L31,.

L32.


23 Annex 2: HC lll Construction Budget Estimates Development Estimated unit cost per HC lll-ln Billions-UGX Total costs for Constructing L32 HC llls - UGX ln Billions Remarks lnfrastructure 1.L Equipment Total 0.35 L.45 L45.2 Outpatient Department, maternity ward ( beds) and general ward (10 beds), sanitary facilities for patients and health providers, placenta pit and medical waste pit & 4 staff housing units.
Based on the MoH Medical Equipment list 46.2 LgL.4 24 Table 1.
SUMMARY OF NATIONAL AMBULANCE CENSUS Dec 2018 Ka m pa la Metropolita n Area Ankole/ Kigezi Bunyo ro/ Toro Central Region Busoga sub region Bugis ul9ukedi/Sebei sub region 26 43 20 18 8 8 Acholil Lango sub region 19 6 9 2 17 2 3 6 31 26 7 26 L1, LL L2 West Nile sub region T2 L2 37 1, L 4 L 5 0 0 0 0 2 2 51 2 LL7 108 9 5 7 7 4 15 4 L 2 0 2 0 4 2 L 0 0 0 0 89 37 77 27 38 74 34 51 23 34 4L 35 62 s0 28 19 19 13 44r 15 3 26 4 4 6 L2 9 6 94 Teso sub region 10 Karamoja sub region 10 9 7 4 7 4 Total 173 68 L72 15 96 LL 53s 25