TITLE:MEASURING HEALTH POLICY INDICATORS IN UGANDA

TITLE: MEASURING HEALTH POLICY INDICATORS IN UGANDA

A presentation at the PARIS21 Workshop for East Africa and the Horn: 23-26 July 2001

THEME: SUPPORTING POLICY WITH STATISTICS -DEVELOPING A STRATEGIC APPROACH

By: Prof. F.G. OmaswaDirector General of Health Services Uganda

INTRODUCTION

Health Reforms: New National Health Policy Health Sector Strategic Plan Implementation of HSSP through SWAP

OFFICE OFTHE MINISTER

OFFICE OFTHE MINISTER

PERMANENTSECRETARY

PERMANENTSECRETARY

HEALTH SERVICESCOMMISSION

HEALTH SERVICESCOMMISSION

POLICY ANALYSISUNIT

POLICY ANALYSISUNITRESOURCE

CENTRE

RESOURCECENTRE

DIRECTORATE OFCLINICAL AND COMMUNITY

HEALTH SERVICES

DIRECTORATE OFCLINICAL AND COMMUNITY

HEALTH SERVICESDIRECTORATE OF PLANNING

AND DEVELOPMENT

DIRECTORATE OF PLANNINGAND DEVELOPMENT

DEPARTMENTOF NATIONAL

DISEASE CONTROL

DEPARTMENTOF NATIONAL

DISEASE CONTROL

DEPARTMENTOF COMMUNITY

HEALTH

DEPARTMENTOF COMMUNITY

HEALTH

DEPARTMENTOF CLINICAL

SERVICES

DEPARTMENTOF CLINICAL

SERVICES

DEPARTMENTOF

PLANNING

DEPARTMENTOF

PLANNING

DEPARTMENTOF QUALITYASSURANCE

DEPARTMENTOF QUALITYASSURANCE

DEPARTMENTOF FINANCE ANDADMINISTRATION

DEPARTMENTOF FINANCE ANDADMINISTRATION

DIRECTORGENERAL

DIRECTORGENERAL

--- National Drug Authority

--- National Medical Stores

--- Uganda Blood Transfusion Unit

--- Uganda Health Research Organization

--- Uganda AIDS Commission

--- Referral Hospitals

Uganda Virus Research Institute---

Murchison Bay Hospital ---

The National Chemotherapeutic Council ---

Medical & Dental Practitioners Council ---

Nurses & Midwives Council ---

Pharmacists Council ---

Allied Health Professionals Council ---

COMMISSIONER NURSING

COMMISSIONER NURSING

PRIORITIES

Uganda National Minimum Health care Package- Burden of Disease Study (1995)

Organization and Management of National Health system- Health Reforms (Restructuring of MOH and Decentralization)

Health Service Infrastructure- Health Sub-Districts

LIST OF UGANDA MINIMUM HEALTH CARE PACKAGE Control of Communicable Diseases Integrated Management of Childhood illness Sexual and Reproductive Health and Rights Immunisation Environmental Health Health Education and Promotion School Health

LIST OF UGANDA MINIMUM HEALTH CARE PACKAGE Cont. Epidemic & Disaster Prevention,

preparedness and Response Improving Nutrition Interventions against disease targeted

for elimination or eradication Strengthening Mental Health Services Essential Clinical Care

HEALTH CARE DELIVERY

DISTRICT STRUCTURE FOR HEALTH CARE DELIVERY

MONITORING OF THE HSSP Consensus on HSSP Indicators (20) Review of HMIS to meet the information

needs of the HSSP Developed Indicator Manual Collection, Analysis, Interpretation & Use

at all levels

MONITORING OF THE HSSP Cont. Joint Missions Quality Assurance Support Supervision Visits District Monthly reports Weekly Reporting of Disease of Epidemic Nature

by Districts MoH Quarterly Review meetings Senior Staff meetings Top Management meetings

Community Based Health Care Information System

Revitalisation of Uganda Community Based Health Care Association (UCBHCA)

Community capacity Building

(Parish Development Committees) Emphasis has been put on Community

empowerment to enable them actively use data to contribute to policy and planning

EXAMPLES OF SOME OF THE ANALYSES FOR THE HEALTH POLICY INDICATORSIncluding The PEAP Indicators : OPD Utilisation rates, DPT3 Coverage, and Level of staffing norms

TRENDS IN COMPLETENESS OF HEALTH UNITS REPORTING

0.0

20.0

40.0

60.0

80.0

100.0

1997 1998 1999 2000

Year

% c

om

ple

ten

es

s

HSSP TARGET

OPD ATTENDANCE 1997-2000

0

2000000

4000000

6000000

8000000

10000000

1997 1998 1999 2000

Year

OP

D A

tte

nd

ance

s

Government and NGO OPD Utilisation per person

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

1997 rate 1998 rate 1999 rate 2000 rate

YEAR

GO

VE

RN

ME

NT

AN

D N

GO

OP

D U

TIL

ISA

TIO

N P

ER

PE

RS

ON

HSSP Target = 0.6

HSSP Target

DPT3 COVERAGE 1997-2000

0

10

20

30

40

50

60

70

80

90

100

1997 1998 1999 2000

YEAR

IMM

UN

ISA

TIO

N C

OV

ER

AG

E

HSSP TARGET

DAILY TREND OF EBOLA NEW CASES IN UGANDA AS OF 15TH JANUARY 2001

0

2

4

6

8

10

12

14

16

18

HIV infection rates among ANC attendees, Mbarara hospital

0

5

1 0

1 5

2 0

2 5

3 0

3 5

Rat

es

(%

)

1 9 8 9 1 9 9 0 1 9 9 1 1 9 9 2 1 9 9 3 1 9 9 4 1 9 9 5 1 9 9 6 1 9 9 7 1 9 9 8 1 9 9 9 2 0 0 0

ye a r s

HIV infection rates among ANC

attendees at selected sites

0

5

10

15

20

25

30

35

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

years

rate

s (

%)

Nsambya Rubaga Mbarara Jinja Tororo Mbale

CHOLERA TREND IN UGANDA 1997-2000

05000

100001500020000

1997 1998 1999 2000

YEAR

CAS

ES

Under 5

5 and above

All ages

ANAEMIA TREND IN UGANDA 1997- 2000

050000

100000150000200000250000

1997 1998 1999 2000

YEAR

CAS

ES

Under 5

5 and above

All ages

MEASLES TREND IN UGANDA 1997- 2000

0

10000

20000

30000

40000

50000

60000

70000

1997 1998 1999 2000

YEAR

CA

SE

S Under 5

5 andaboveAll ages

Could this be due to mass immunisationcampaign??

CONCLUSION

There is now increased use of data in policy formulation

There is now increased use of data in planning

There is now increased use of data in Monitoring and Evaluation of the Health sector