Working Group Description

Coordination and leadership The UNHCR health sector is coordinated at Central level in Kampala and Field level by a team of skilled professionals that oversee refugee and immediate host population health service delivery. In each of the refugee hosting district, there is a Public health Officer that is responsible for the day to day health coordination with districts and partners to ensure integration; provision of technical support and guidance. The UNHCR health sector works in collaboration with the Ministry of Health at both Central and field level through the respective District Health Offices where refugee settlements are located to ensure integration in to the national health care system. The Ministry of Health (through DHOs at field level) and UNHCR co-chair the monthly refugee health coordination meetings at Kampala and in the respective districts. The refugee health and nutrition health response is guided by the Uganda National Integrated Health Response Plan for Refugees & Host Communities and UNHCR Public Health Strategic Plan 2018-2022. Health service delivery is in line with Uganda Health Policy and Health Sector Development Plan, guidelines, strategies and standard operating procedures. In addition, UNHCR in Uganda supported or is part of:  UNHCR signatory of Compact between Ministry of Health and Partners for Implementation of the Health Sector Development Plan 2015/6-2019/20  Uganda National Integrated Health Response Plan for Refugees & Host Communities  MoU with Ministry of Health and MoU between UNHCR, MOH and Medical schools which are aimed at strengthening the Comprehensive Refugee Response Framework. Currently UNHCR Partnerships: a. Ministry of health – Policy direction, oversight, coordination and technical support. UNHCR is a member of Health Policy Advisory Committee and MOH created a desk to UNHCR team at the ministry of Health. b. Health Donors Group –influencing of policy direction and funding for refugee and host population health services c. Bilateral agencies – funding of the CRRF for health through the NGOs or UN agencies d. UN agencies though UN Delivering As One initiatives for refugees hosting districts e. District Local Governments – decentralized health services implementation, support supervision and field level coordination. UNHCR is co-lead and health partners are members of the District Health Team f. International and National NGOs – implementation, coordination and resource mobilization for service delivery. Health Care to Refugees and Host Community In line with the NDP, ReHOPE and CRRF, Public health sector contributes to the integration of social services. In this, the integration of Public health is defined and pursued in the four prongs as follows:  Accreditation & alignment of health facilities & Refugee health workers -recognized by MoH  Building the capacity of the District Health Care systems  Strengthening strategic coordination & leadership with MoH at central and districts  Re-orientation of the roles of IPs more to support and less direct service delivery UNHCR in Uganda works through implementing partners and District local governments to deliver health services. The refugees within the settlements share health and water facilities with the immediate host population. Each of the health facilities in the settlement is established in line with the Ministry of the health guidelines and reports to the Ministry of Health through the District. Health partners are part of the District Health Management Team (DHMT) and facilities are supervised by the DHO. Refugees benefit from the referral facilities which are located within or outside the district at no cost. Current Status In 2017, UNHCR supports 95 health facilities across 12 refugee hosting districts that provided a total of 2,129,027 medical consultations in 2017 out of which 22% were to host population. The Crude mortality rate was at 0.1 against a standard of 0.75 deaths for every 1000 population in a month and Under-five mortality rate stood at 0.2/1000/month against a standard of 1.5. The Food Security and Nutrition Assessment in 2017 reported weighted GAM 3.8% in South West and 10.8% in West Nile There were 19,704 live births and approximately 94% of all deliveries were at the health facilities. There were 19 maternal death across all refugee settlements which were all investigated and documented. The coverage of PMTCT in 2017 was 100% and 93% of all newborns to HIV positive women were given ARVs within 72 hours after delivery. The total number of HIV positive patients on ARV treatment are 12,019. The top causes of morbidity included malaria (37%), respiratory tract infections (24%), skin infections (5%), watery diarrhoea (5%), and intestinal worms (3%). Since February 2018, we have had an outbreak of Cholera in Kyangwali and Kyaka with a total of 2,106 cholera cases and 44 cholera related deaths reported. Each of the settlements generate Analyzed weekly reports, surveillance reports of disease of outbreak potential and Monthly Health Information Reports. Gap analysis matrices and 3W matrices are updated on a monthly basis and disseminated.