1.0 Preamble

We are grateful to the NRM government, Ministry of Health, the District Council, and all health sector partners for their continued support towards the wellbeing and health of Kabarole District’s population and the country at large. This aligns with the Sustainable Development Goals and the National Development Plan IV (NDP IV).

2.0 Service Delivery

The district has adopted the integrated service delivery model, optimizing health worker deployment and creating client-focused one-stop centres. This replaces stand-alone clinics like ART clinics, now transformed into chronic care clinics serving ART patients, diabetes, hypertension, sickle cell, and cancer patients.

Following staff layoffs under partner support, integration addresses gaps in service delivery.

Non-communicable diseases account for 30-35% of OPD visits, mainly diabetes, hypertension, and mental health related to substance misuse. Outreach clinics are brought closer to communities for proactive care.

Communicable diseases like malaria have seen improvements, with positivity rates down to 18-20%. The district promotes Long-Lasting Insecticidal Nets (LLINs) and upcoming malaria vaccination schedules.

HIV/AIDS prevalence is 11.8%, with impressive testing coverage aligned to UN AIDS 95-95-95 targets; challenges remain with viral suppression especially in children under five and adolescents.

The PMTCT program maintains a low 1% positivity rate among children, though prevention efforts are challenged among teenagers facing HIV, teenage pregnancy, poverty, and school dropout risks.

3.0 Human Resource

The district utilized UGX 775.5 million wage allocation to recruit additional health staff strengthening service delivery:

• 2 Doctors
• 2 Anesthesia Officers
• 10 Enrolled Nurses
• 10 Midwives
• 9 Askaris
• 2 Porters
• 1 Nursing Officer
• 2 Records Officers
• 5 Clinical Officers
• 2 Senior Clinical Officers
• 2 Lab Technicians
• 4 Lab Assistants

4.0 Infrastructure

Supported by UGIFIT, URMCHIP, and ENABEL projects, the district completed and is progressing on several health infrastructure projects:

• Kiko HC III: Fully functional
• Kidubuli HC III: Completed, awaiting electricity extension
• Iruhuura HC III: Completed, power installation pending
• Kicwamba HC III: Completed, power installation pending
• Nyabuswa HC III: Completed, awaiting commissioning
• Kituule HC III: 80% complete, finishing next financial year

Priority projects funded with UGX 3,029,000,000 include solar boreholes, maternity ward upgrades, electricity extensions, incinerators, and floor upgrades.

5.0 Medical Supplies and Logistics

Drug funding projections for FY 2023/24 and 2024/25 by facility level are as follows:

• HC II: Quarterly UGX 1,458,620; Annual UGX 5,834,480 (Projected FY24/25 Quarterly UGX 2,456,662; Annual UGX 9,826,648)
• HC III: Quarterly UGX 5,956,846; Annual UGX 23,827,384 (Projected FY24/25 Quarterly UGX 8,320,481; Annual UGX 33,281,924)
• HC IV: Quarterly UGX 10,289,322; Annual UGX 41,157,288 (Projected FY24/25 Quarterly UGX 10,289,322; Annual UGX 62,157,288)

ENABEL supported Ruteete HC IV with equipment for theatre operations, enabling over 40 cesarean sections to date.

6.0 Health Financing

For FY 2024/25, UGX 4.5 billion was allocated for wages and non-wage PHC allocations across health centers and hospitals. Notable quarterly releases support ongoing service delivery and infrastructure development.

• Ruteete HC IV: UGX 93 million
• Iruhuura HC III: UGX 21 million
• Kijura HC III: UGX 30 million
• Nsorro HC II: UGX 123 million allocated for staff housing and sanitation improvements, slated for upgrade to HC III

7.0 Environmental Health and Sanitation

• Environmental staff recruitment improved staffing from 60% to 85%, with capacity building in infection prevention, WASH FIT, and the 3-star approach.
• Construction of three incinerators at Ruteete HC IV, Kijura HC III, and regional incinerator at Kicwamba HC III supported by IRC and MOH.
• Installation of a chlorine production plant at Ruteete HC IV, improving sanitation in 95% of health facilities and 88% of schools.
• Construction of latrines meeting person-to-stance ratio and menstrual hygiene requirements across health facilities.

8.0 Health Service Delivery Impact

• 43% of 347 villages declared Open Defecation Free (ODF) in FY 2024/25, up from 0% in 2022/23.
• Latrine coverage increased to 94.3%: 2.8% safely managed, 56% basic/improved, 35.2% limited, and 6% open defecation.
• Sub-county sanitation campaigns scaled to cover 45% of the district, with active participation in National Sanitation Day celebrations.