Promoting Health
"The well-being of our people is a cornerstone of development" – Kabaka Ronald Muwenda Mutebi II
THE HEALTH ISSUES IN UGANDA
The leading causes of ill health and death in Uganda are malaria, HIV/AIDS, TB, respiratory disease, diarrhoea, epidemic-prone and vaccine-preventable diseases. While infectious diseases have historically been the main public health focus, factors like rapid urbanization and changing lifestyles are driving a significant rise in non communicable diseases (NCDs) across the country.
The primary NCDs include cardiovascular diseases, cancers, chronic respiratory diseases, diabetes and mental health disorders. Maternal and perinatal conditions also contribute to the high mortality. Uganda has made significant progress reducing maternal mortality and under-five mortality. However, challenges remain tied to the availability, accessibility, and affordability of essential health services. This contributes to 75% of Uganda’s preventable disease burden.
Underlying Factors Affecting Health
- Disparities in health status: These are closely linked to socioeconomic, gender, and geographical inequalities.
- Health system challenges: These include a lack of resources for recruiting and retaining health workers, particularly in remote areas, challenges in ensuring quality of care, unreliable health information, and frequent stock-outs of essential medicines and supplies.
- Malnutrition: Stunting rates are a concern, though they have been declining in children under five.
- Inadequate healthcare access: Travel time to health facilities can be a barrier, particularly for the rural poor.
- Environmental factors: Air pollution, with a significant number of deaths linked to related diseases, and limited access to safe water and sanitation facilities contribute to health problems.
- Weaknesses in the healthcare system: Informal payments for services at public facilities, lack of essential drugs, and limited availability of ambulances contribute to poor quality of care, according to a 2009 Guardian article.
PROGRESS AND CHALLENGES
- Life expectancy has increased significantly.
- Under-five and maternal mortality rates have decreased, although the maternal mortality ratio fell short of the MDG target.
- Efforts are underway to strengthen the health system, including addressing human resource challenges, improving information systems, and tackling antimicrobial resistance.
- Uganda has embraced the One Health approach to address public health threats, particularly zoonotic diseases.
- A National Health Insurance Scheme Bill was passed in 2021, aiming to improve health financing and universal health coverage, though some challenges remain.
While some progress has been made, significant health challenges persist in Uganda, particularly in communicable diseases, NCDs, maternal and child health, and disparities in access to care, according to the WHO.
KABAKA FOUNDATION UK SPECIFIC INTERESTS
PREVENTION AND HEALTH PROMOTION
To help people live longer and healthier lives by reducing the chance of illness in the first place, or preventing the progression of symptoms once people become ill. KF UK is interested in the following areas of prevention
Primary Prevention – To seek to reduce exposure to risk factors, such as smoking or engaging unprotected sex, or to mitigate the impact of risk factors once exposure has occurred – for example, vaccinations to increase resistance to disease if exposure occurs.
Secondary Prevention – To seek opportunities to emphasise early disease detection by identifying disease before symptoms have progressed and stopping the disease worsening, if possible. Community dental health can be improved by organising a series of Mobile dental camps and school-based prevention hubs in rural areas.
Tertiary Prevention – action to help people manage symptoms and prevent further disease progression once the disease has already developed. This can be thought of as harm reduction and helping people manage their disease.
Signposting – To signpost people to places where they can get further accurate and reliable information, or inquire for local services.
PROCUREMENT AND PROVISION OF MEDICAL EQUIPMENT
- Engage procurement department of local health facilities in the Diaspora and Uganda
- KF to organise reputable channels of cooperation, seek and receive support
- Investigate Delivery channels
- Establish Communication links within Uganda
CONTINUING PROFESSIONAL DEVELOPMENT OPPORTUNITIES
- Twinning with health facilities Policies
- Medical holidays
- Professional further education and Research for health professionals
IMPROVING MEDICAL INFORMATION SYSTEMS
SUPPORTING THE BLOOD COLLECTION DRIVE AND LOCAL STORAGE SOLUTIONS
In order to effect On-Site Testing and Local Storage Solutions, KFUK will strive to reduce reliance on national referral centres by building local capacity for basic blood screening by training local workers/volunteers and commissioning short-term storage units. KFUK is interested in “Slum Lab Technician” Training in effort to improve rapid diagnostic testing (malaria, HIV, HBV) using WHO-approved kits. Modular Cold Storage Units using solar-powered blood refrigerators would be effective. Such a project would require public private partnerships to be effective including the Red Cross and the Ugandan Blood Transfusion Service.
The term “primary prevention” refers to intervention measures to prevent the occurrence (incidence) of new disease, disability, or injury (Leavell & Clark, 1965). This intervention must be implemented prepathogenesis and directed at individuals or groups at risk. Primary prevention efforts include health promotion and specific protection and are generally aimed at populations, not individuals (see Fig. 1). The application of primary.
