USAID HIV interventions were largely integrated into maternal and child health, nutrition and family planning programs in over 73 districts.
A total of 478,148 individuals are on HIV treatment through support provided by RHITES (including 47,996 new clients during the year). This has resulted in 94.8 percent of people living with HIV/AIDS with treatment in the districts supported by RHITES.
To sustain these gains, strengthening health systems remains critical. USAID invested in human resources, supply chains, community systems, governance, and financial management – all critical elements for delivery of comprehensive and quality HIV services. For instance, USAID helped the government of Uganda to develop a 10-year plan for the management of human resources for health (HRH). National HRH staffing remained relatively stable at 76 percent (target 80%)
TB Prevention and Treatment
Despite encouraging progress, TB remains one of the world’s leading causes of death. Uganda has an estimated 30 TB deaths and 223 new TB infections every day. Yet as dangerous as TB is, it is preventable and curable.
The United States supports TB diagnosis and treatment at hospitals, health centers, and through community health workers, with assistance from USAID and PEPFAR. The United States is also the largest contributor to the Global Fund, the single-largest donor to the TB response in Uganda and worldwide.
In 2021, despite the COVID-19 pandemic, 90 percent of people living with HIV in U.S. government-supported regions started TB preventive therapy. Moreover, 99 percent of diagnosed TB patients had a documented HIV status. Among the newly-identified HIV positive people, 96 percent had started anti-retroviral treatment (ART) while 94 percent of those also diagnosed with TB were initiated on TB treatment. A total of 296,600 persons living with HIV were enrolled on preventive TB therapy compared to 91,598 in the previous year. USAID achieved these results by engaging private sector health workers in reporting detected TB patients and finding those missing their treatment appointments.
Voluntary Family planning helping Ugandans to determine when and how often to have children
To prevent maternal deaths and unintended pregnancies, USAID supports voluntary family planning. In 2021, USAID was a major donor of contraceptives, contributing 24 percent of the overall national need. USAID support enables couples and individuals to determine whether, when, and how often to have children. This ability is vital to safe motherhood, healthy families, and prosperous communities.
With a very young and rapidly growing population, approximately 55 percent of Ugandans are under the age of 18. Yet, only 55 percent of the population has access to family planning. An unmet need for family planning remains particularly high among younger women, especially those living in rural areas who have little or no education.
In 2021, USAID provided family planning counseling and services to 2,813,548 couples with the help of 8,289 USAID-trained community health workers.
In the same year, 98.2 percent of health service delivery points offered modern contraceptive methods, compared to 94.5 in 2020. This success is attributed to USAID’s efforts to provide on-the-job family planning mentoring and training to health workers. USAID increased the availability of a variety of modern contraceptives by procuring $11 million worth of contraceptives, including oral contraceptives, implants, injectables, and male condoms. To improve contraceptive ordering at the facility level, 112 health workers were trained on web-based reporting.
USAID worked with community influencers to identify and mitigate the root causes of social norms – including gender inequalities, cultural practices, cultural values, and religious beliefs – that inhibit family planning access and use. The influencers used existing cultural, religious, and community platforms to raise awareness of and demand for family planning. USAID distributed printed and audiovisual information, education, and communication materials that contributed to family planning demand creation. Via text messaging and a hotline, USAID helped mobilize and engage communities through peer leaders, village health teams, and discussions on family planning services.
Maternal and Child Health
The U.S. government is committed to ending preventable maternal, newborn, and child deaths in Uganda. USAID programs provide a comprehensive range of services focused on maternal and child health, including focused antenatal and postnatal care; safe delivery services; neonatal care; nutrition; reaching every child with immunization; and water, sanitation and hygiene (WASH).
In 2021, USAID continued to assist the Ministry of Health with Maternal Perinatal Death Surveillance and Response. Reports show improvement from 77 percent from 2020 to 89 percent completion rates in 2021 across the 73 supported districts.
In the same year, 59 percent of expectant mothers in USAID-funded districts attended at least four antenatal care consultations, representing a 20 percent increase from the previous year. A total 21,788 babies born not breathing were resuscitated in U.S. government-supported facilities. Additionally, there was a 15 percent increase in the number of fully immunized children under one year of age, from 675,514 to 778,204. By updating postpartum hemorrhage guidelines, mentoring health workers to improve their postpartum hemorrhage management skills, and increasing the availability of blood, USAID activities addressed the leading cause of death among pregnant women across 73 supported districts.
Without proper nutrition and food security, Uganda cannot realize its full economic or health potential. The U.S. government invested in nutrition improvement at many levels, working with the Government of Uganda to strengthen nutrition policies and health systems. In 2021, USAID implemented an integrated approach to deliver nutrition services through community activities with emphasis on the “first 1,000 days” for children under 5 years old.
USAID’s nutrition-specific interventions reached 811,381 pregnant and lactating women, and 3,937,612 children under 5.
10,436 people received nutrition training in USAID districts of operation.
The Feed the Future Meals for Nutrition Uganda (MENU) activity reached 260,481 farmers with biofortified crop seeds on 13,000 acres and produced 10,306 metric tons for sale and domestic consumption.
Water and Sanitation for Health (WASH)
Poor water quality is linked to diarrhoea disease and other poor health outcomes. Working in partnership with the Ministry of Water and Environment, U.S. assistance 197,137 low-income Ugandans to access and afford the minimum and basic water services.
In the Karamoja region, USAID facilitated the signing of three resource-sharing agreements between conflicting communities, enabling 122,800 people to share water and pasture for livestock.