A number of fundamental health challenges threaten the well-being of Ugandans, including under-5 mortality, malnutrition, HIV/AIDS and reproductive health. Access and coverage is still lower than the global averages and targets despite several interventions that exist to improve maternal, newborn and child health. The weak health systems in Uganda to implement and support these interventions and the poor quality of services along a continuum of care-from pregnancy to childbirth and post childbirth means that pregnant women and children unnecessarily face the burden of illness, mal-nutrition and mortality
The Uganda’s persistently high maternal mortality rate of 438 per 100,000 live births is attributed to a weak health system, characterized by inadequate capacity to recruit, train and motivate health personnel at Health Facility levels and inadequate medicines and medical supplies that affect delivery of quality health services, especially for rural populations. Although Maternal and Child Survival is a high strategic priority as indicated in the National Development Plan and the National Health Policy, Uganda is far from achieving the SDG targets of reducing maternal mortality ratio to less than 70 per 100,000 live births, neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
Uganda has the second youngest populations in the World, with children under 18 years accounting for 56.7% and young people (10-24 years) accounting for 31.4% of her population. The demand for Sexual and Reproductive Health and Rights (SRHR) and HIV services is growing since many are becoming sexually active and of reproductive age, coupled with the current unmet need for SRHR and services across all age groups.
With a generalized HIV prevalence estimated at 6% nationally with pockets of higher HIV prevalence especially among key and priority populations (KPs and PPs), implies that Uganda is still far from the SDG targets of ensuring universal access to sexual and reproductive health-care services, including family planning, information and education and universal health coverage. Targeting key and priority populations (KPs and PPs), people in reproductive age, adolescent and young people with information, services and support to Sexual and Reproductive Health and Rights (SRHR) will be a critical game changer in improving the health status of the Ugandan population.
MUCOBADI will refocus on sustainable improvement of people’s health by: Improving both the ’supply‘ of health services (the availability and quality of services) and the ’demand for‘ services (uptake), Taking an integrated approach which strengthens the health systems and addresses the greatest health needs among the most affected, focusing on improvements in the health of women of child-bearing age, children under five and adolescents, engaging families and communities in promoting positive health-related behaviour (both preventative and health-seeking), tackling social barriers, engaging a range of health service providers including government, private sector as well as empowering health rights holders to hold service providers to account while recognizing that government is the duty-bearer in the provision of health care and articulation of health policy.
To increase uptake and utilization of quality HIV care and prevention services among the Key Priority and Most at Risk Populations (MARPs)
- Reduce HIV incidences among key and priority populations (KPs and PPs) through risk reduction interventions and safer sex environments;
- Provision and referral for health care services (STI, HIV testing, ART, Pre-Exposure Prophylaxis, Post Exposure Prophylaxis and contraception) to key and priority populations (KPs and PPs) through peer led programmes
- Enhance skills development and income generation for key and priority populations (KPs and PPs) to address the predisposing social-economic factors.
To improve coverage and access to high impact maternal and child mortality reduction services in high-burden populations of Uganda.
- Increase access to and use of lifesaving RMNCH commodities to under-served and high burden communities through social marketing and community and Health Care linkages
- Create awareness and develop skills to up-scale community-led efforts against malnutrition and safe motherhood
- Reduce out of pocket expenditure for the poor by piloting voucher systems and social marketing of subsidized health commodities
To increase availability and access to safer sexual and reproductive health services among Adolescents and Young people at facility, community and household levels.
- Expand access to and utilization of prompt, affordable, quality, inclusive and integrated adolescent-friendly SRHR services and HIV testing, linkage and retention into care
- Promote behavioral change among adolescents through peer approaches and meaningful engagements.
- Strengthen the capacity of adolescent community structures to deliver quality and inclusive adolescents SRHR and HIV services.