HEALTH

The health sector is headed by the district director of health services supported by other staff e.g. there are assistant district health officer, district health inspector, drug inspector etc. there are three health sub district i.e. bunya east, bunya west and bunya south.

 Vision:

The overall mission of the department of health of mayuge district is “attainment of a good standard of health by its entire people in the district, in order to promote a healthy and productive life amongst them”.

Mayuge district has a projected population of 416,089 people. Of these 95,700 are women in child bearing ages, 17,892 are children under one year and 84,049 are children under five years.

The district has three sub counties of bunya south, west and east. There are 42health facilities in the whole district.

Human resource
Staffing in the health department stands at 51%. The district has a low retention and attraction capacity for health workers. The department still lacks key personnel such as doctors and nurses.
Drugs
There were delays in delivery of drugs from NMS. Two health units did not get the drugs i.e. bufulubi HC II, which is to receive from prisons, busira HC II was a new unit and communication had not been made to NMS, but that was rectified. The drugs delivered at district from NMS were immediately delivered to facilities.
NMS has developed basic kits that will be used to deliver medicines and supplies for health center II’s and III’s. So these will not be ordering medicines. It is only hospitals and health centre IV’s that are supposed to place in orders every month.
HMIS
83% HMIS reports have been submitted to the ministry of health on time on monthly basis. Completeness increased slightly from 79% last financial year to 84% however, this is still below our target of 100%. A number of strategies have been made to strengthen the health management information system and the M& E section of the department.
Disease burden

In the financial year 2016/2017, malaria accounted for 24.4% of the inpatient diagnosis’s among children less than five years of age. While in adults, malaria remained the highest among the causes of morbidity accounting for122.4% of inpatient diagnosis.
Tetanus remained the one killer in the financial year accounting for 21% of deaths in children and adults respectively. Other leading causes of death were pneumonia, abortions, diarrhea acute, septicemia, severe malnutrition and tuberculosis.

Immunization
62% of all children under one year of age have been given DPT3. This leaves 38% of the children un immunized. This has majorly been due to lack of supplies such as vaccines and gas from NMS and breakdown of refrigerators. Most of the un immunized children are in sub counties of bunya south and bunya west. Mapping has been done with the help of partners to identify where these un immunized children are in order to come up with interventions targeting those specific areas.
Deliveries in unit
Deliveries in health facilities have slightly increased from 20.2% last year to 7%. However this is still below the planned target of 35%. The improvement in the deliveries in health facilities has been due to improvement in data collection and management and team work from all stake holders.
Referral system
At some point in the year, the department had only one functional vehicle (ambulance) for kigandalo sub county HC IV, which is in the garage. The ambulance for malongo HC III had broken down and was taken for repair. This made the referral of patients for further management very difficult.
The pick up for the DHO’s office was down making delivery of supplies to health units difficult in case they are available, however it is now functional.
NTDs programme
Health sector mobilized and sensitized stakeholders on neglected tropical diseases. Teachers and community medicine distributors were trained and they carried out mass drug administration on the following NTDs; schistosomiasi ,lymphatic filariasis, trachoma, soil transmitted helminthes.

Achievements
• Busaala HC II was completed and is now functional.
• Baitambogwe OPD was renovated and a pit latrine constructed at the facility.
• Four sites have accredited to provide art services in the district.
• There has been no stock pout of TB drugs and laboratory reagents and supplies
• DSS project offered one microscope to mayuge HC III and wabulungu HC III each.
• Mayuge managed to hold TB cases up to 75% treatment success rate of the about 45% to 60% cases detected.
• A5_ stance pit latrine was constructed at bwonda HC III by the UPDF.
• Conducted support supervision workshops.
• Were able to carry out a staff audit
• Also worked with the army in the treatment of patients.
• Wandegeya HCII was also opened.
• Constructed staff house at buyungu HC II which is complete.
• A new refrigerator was acquired for malongo HC III.
• Sprayed flees in kigandalo, bukatube and kityerera sub counties.
• At least 95% of health facilities received some drugs.
Challenges
1. Inadequate funding has been one of the biggest challenges for the department. The department entirely depends on PHC alone for all activities.

2. Attraction and retention of workers is also another challenge worth to mention.
3. Sometimes the quality of drugs ordered is not what is supplied. The new PUSH system has worsened the situation as the drugs sent to HC II’s and HC III’s are not enough leading to stock outs.
4. Some health workers are interested in going for further training in order to develop their careers yet they have to also serve in their respective facilities.
5. The records assistants and askaris recruited lacked the necessary skills to perform their duties well.
6. Absenteeism of health workers especially support staff has been observed in some health units.
7. Kityerera health centre IV lacks an ambulance for referral patients.
8. The department vehicles are very old and difficult to maintain. The department also lacks a motorcycle for data collection from units.
9. Bukaleeba HC IV has no latrine and is not worth operating.
Recommendations
1. The district recruits staff to fill the gaps in the department next financial year.
2. Health unit in charges place in their orders in time to reduce on stakeouts.
3. Increase monitoring and supervision of health facilities to check on the rampant absenteeism.
4. The district health office should be provided with at least one new car and a motorcycle in order to perform its duties properly.
5. Bukaleeba HC II is closed until a latrine is constructed.
6. NMS should revise the quantity of every item in their standard kit.

Health infrastructure.

The district, has 01 NGO aided hospital in buluba and 01 health II in buyemba, 05 government aided health center III, 03 COU aided center II, 01 community health center II and 02 government aided health center IV.
Accessibility of health services
The accessibility of health services by the population has been reducing following the government’s effort to construct a health center II at every parish. The distance to the nearest health facility is currently1-3km and every health facility approximately serving 8165 persons. It is also worthy to note that 69% of the population is within a 5km radius of a health center and 27% of the deliveries in the district occur in health facilities.
HIV/AIDS (prevalence, control and treatment)
The aids prevalence rate in the district is 6.5%. There are 38 counseling centers in the district and this is boosted by outreaches carried out by AIC on a monthly basis.
In the effort o control the prevalence of HIV/AIDS, the district has set up Aids control structures at all levels like DAC and DAT at the district headed by the CAO and LCV respectively, SAC and SAT headed by SAS and LCIII at sub county level. There are also 15 centers offering PMTCT services and these include buluba hospital