Uganda Healthcare system• 8.2 % of the national budget is dedicated to healthcare.• The public healthcare system is structured by a referral system. • Health Centre I (HC I)- a satellite health facility with no deﬁnite physical structure; it is where health facility out-reach teams meet the community for EPI, Health Education etc activities • HC II- the closest structural Health facility to the community; it delivers the MAP (Minimum Activity Package of the NMHCP). It is at parish level of the politico- administrative system and serves a population of up to 5000. • HC III- The facility that delivers the Intermediate Referral Activity Package (IRAP) of the NMHCP It handles referrals from the HC II as well as referring to HC IV. By level, it equates the sub-county level of the Local Government administration. • HC IV- Is a mini hospital and delivers the CAP (Complimentary Activity Package). It
•Private health sector•NGOs (Red Cross, OXFAM, Save the Children, etc...)•Traditional medical practitioners (herbalists, spiritual healers, etc...)•Informal practitioners (illegal trade of drugs, people without formal training treating patients.
Challenges• There is 1 hospital bed per 1,000 people.• Approximately 1 doctor per 1,000 people.• Constant lack of medical supplies.• Less than 40% of Northern Uganda live farther than 5km to the nearest health center. Compared to Kampala which is 100%.
12 year old Nancy Lamwaka one the thousands of victims of LRA war but now tormented by a new disease called nodding disease. March 2012Gender Based ViolenceMain Issues:Domestic violenceSexual abuse of girlsSexual violenceViolence during pregnancySex traffickingSex workersWomen far from homeSexual Discrimination
According to the 2006 Uganda Demographic and Health Survey nationwide data showing that about 60 per cent of women in Uganda have experienced physical violence since age 15. Fact: Domestic violence rates are high and under-reported.The majority of gender-based violence against women in Uganda is committed by an intimate partner. "Our culture says that you don’t wash your dirty linen in public. So they (women) would rather keep domestic abuses to themselves. Some working class women also think reporting domestic violence would make them lose respect in the community, especially considering the lavish weddings that they had.” Domestic violence is tolerated and considered a normal part of marriage as long as it does not resultin serious injury (meaning that no blood is shed). Some described domestic violence as acceptable or even positive if the wife is lazy, quarrelsome, unclean, a bad cook or disobedient.
SEXUAL VIOLENCE• The Uganda Demographic and Health Survey found that 39 per cent, more than one in three, women and girls aged 15-49 had experienced sexual violence during their lifetime.• This includes those whose sexual initiation was against their will. Almost half, 44 per cent, of women who experienced sexual violence experienced this violence at the hands of a current husband or partner, while 22 per cent experienced sexual violence by a former husband or partner.
February 2012: atleast 600 Ugandan Girls forced into Malaysia’s sex trade They are lured in by being promised high paying jobs
The 2011 Ingrid Turinawe attack inspired protestWomen are attacked for: Pursuing democracy, Wearing pants In Uganda, on Friday, the police attacked Ingrid Turinawe. She was in her car, driving to a protest meeting. The police dragged Turinawe out of her car, and in full view of smart phones and video cameras, groped and mauled her. Basically, the attitude is that it’s Ingrid Turinawe’s fault. Women who pursue democracy and autonomy must learn to expect State sexual terrorism. In patriarchal circles, it’s calle.d the ‘price of freedom’, or, more simply, the ticket in. Today, women protested, stripping off their tops, the police attacked, and six women were detained. As Barbara Allimadi, one of the organizers, explained: “We were there to show we’ve had enough, we will not tolerate this kind of behavior.” Others agreed: “We respect our bodies and we expect to be respected.”
Death During Childbirth In Uganda, 16 Women Die Everyday from Childbirth-Related Complications Of the 1000 women who die every day, 570 live in sub-Saharan Africa, 300 in South Asia and ﬁve in high-income countries. There is an under-ﬁve mortality rate of 128 out of 1,000 births
WHY?Mothers’ DeathsFever, Anemia, Fistula, Incontinence, Infertility and Depression.Children’s DeathsAcute respiratory infections (ARIs), Diarrhoea, Malaria,Malnutrition and Neonatal complications WHY? Lack of access to family planning services 42% of women under 18 are mothers Lack of prenatal services Only 42% of women receive prenatal services Lack of education Lack of skilled health-care professionals Functional medical facilities Access HIV treatment
Difﬁcult Access to Healthcare Facilities in Rural Areas When she felt the labour pains at midnight, the nearest health facility from her home was 12 kms (7.4 miles) away. Her husband had to act fast.The only ambulance that used to serve the district broke down three years ago.The ambulance was donated to the district by UNICEF and was serving 17 healthcentres with a population of 161,000.
Achieving the Millennium Development Goal for child survival demands focused and coordinated action to improvenutrition, to strengthen health systems, and to reduce inequalities in access to and use of effective interventions toprevent and treat pneumonia, diarrhoea, malaria, and the causes of neonatal deaths.”— Dr. Jong-wook Lee, Director General WHO, 2003-2006
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