Public Health Sector Readiness to Provide Malaria Case Management in Uganda

Background: Malaria continues to be a global health burden, low and middle-income countries particularly in the World Health Organization Africa Region account for the highest disease burden in the Public Health Sector.  Readiness to provide appropriate care and management of malaria is pivotal in malaria control and elimination however there are research gaps in understanding the degree of readiness for Public Health Sector in Uganda. The purpose of this study was to measure the readiness of the public health facilities in Uganda to provide management for malaria. 

Methods: The study is a retrospective study based on health facility data available on the national health management information system; secondary data collected that is available in Ministry of health district reports; end-user verification surveys (EUV) done between 2016-2019 in collaboration with the United States President’s Malaria Initiative and Service Availability and Readiness Assessment (SARA) Uganda survey done in 2014 in collaboration with the World Health Organization. Analysis was done by region in Uganda. The indicators analysed were on treatment and availability of malaria commodities.

Results: The hospital and HC IV distribution across the regions in Uganda indicates northern region has 35 facilities compared to 51 and above facilities in other regions. The key health workers (nurses, doctors and clinical officers) approved positions filled in the different regions shows eastern region has the lowest at 68% and highest at 112% of the positions in the central region. In average, malaria treatments and diagnostics were available in 60% and 83%, respectively, in all regions. Stock out of commodities for case management (Rapid Diagnostic Tests and medicines) were the highest in 2016 and 2017.  Western region has the highest malaria testing rate (90.3%).

Conclusions. The survey found that Uganda's Public Health Service is not yet at 100 percent readiness, which is the benchmark level. However, the government should put emphasis on test and treat policies and evaluating health services on a regular basis. Furthermore, more efforts are needed on reducing stock outs of malaria case management commodities, notably RDTs, which are critical for giving fast and accurate test results.