In Summary

We bring you some of the innovations and interventions that happened this year.

The biggest challenge for Uganda is inadequate resources. For instance, the health sector has been faced with a challenge of under-funding for a long time. In April 2001, the African Union countries met and pledged to set a target of allocating at least 15 per cent of their annual budgets to improve the health sector and urged donor countries to scale up support.
This is in fulfillment of the Sustainable Development Goals, otherwise known as the Global Goals, as a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity.
In 2017, health financing was at a paltry 7.8 per cent of Uganda’s annual budget and suffered a further setback in the 2017/18 financial year when it was reduced to six per cent.But this aside, the sector made some strides and as the year ends, we look back at some of them.

IVF miracle for cancer survivor
Honoranta Nakato, 44 had been childless for a long time. She had conceived only once but even then, she had a miscarriage. All her attempts had failed but she did not lose hope. During her struggle to get children, she also battled breast cancer in which she lost her left breast.
The secondary school teacher from Kayunga after completing her cancer treatment and a six month’s review at the cancer institute, sought the help of Dr Edward Tamale Ssali, an obstetrician and gynaecologist and head of Women’s Hospital International and Fertility centre in Bukoto where she underwent IVF treatment. On September 9, 2018 Nakato gave birth to normal quintuplets; three girls and two boys by C-section. All her babies were above 1.5kg birth weight.
While the babies were kept in the nursery, she would also do kangaroo mother care to keep the babies warm and also help them gain more weight.

Her biggest challenge was breastfeeding the children since she only had one breast but was lucky that one of her sisters was a breastfeeding mother so she donated breastmilk. Nakato and her babies remained in the hospital for about five weeks where they had to be monitored in case of any illness. Rhoda Kirabo, Rowena Kirabo, Rodney Kirabo, Raymond Kirabo and Rachael Kirabo, despite their sex difference looked so much alike but she would easily identify them. By the time they were discharged; they had gained enough weight to be out of hospital.

Bloodless malaria test
A Ugandan inventor on June 14 won a major prize for a device which tests for malaria without drawing blood. Brian Gitta, 24, won the Royal Academy of Engineering’s Africa Prize worth $33,000 (about Shs122m) for a device that detects malaria by shining a red beam of light on the patient’s finger.
The Matibabu (Swahili for ‘treatment’) is low cost, reusable and because the procedure is non-invasive, does not require specialist training. It is used in such a way that it is clipped onto a person’s finger and using light and magnetism, a red beam of light scans the finger for changes in colour, shape and concentration of the red blood cells. A result is produced within a minute and sent to a mobile phone linked to the device.
It was a perfect example of how engineering can improve healthcare. The device clips onto a patient’s finger and does not require a specialist to operate. Its red beam detects changes in the colour, shape and concentration of red blood cells - all of which are affected by malaria.

Ministry dispels Ebola outbreak
Several media reports had reported that there was an Ebola outbreak in the country following an outbreak of the disease in the eastern Democratic Republic of Congo (DRC).
The districts identified to be at risk included Ntoroko, Kasese, Kabarole, Bundibugyo, Bunyangabu, Kanungu, Kisoro, Rukungiri, Rubirizi, Kikuube, Arua, Maracha, Nebbi, Zombo, Yumbe, Moyo, Adjumani, Koboko, Lamwo, Kabale, Kamwenge, Kyegegwa, Kyenjojo, Isingiro, Buliisa, Kagadi, Pakwach, Kampala and Wakiso.
In November, the State Minister for Health in charge of Primary Healthcare, Joyce Moriku told a sitting of Parliament that there were no reported cases of Ebola in Uganda. Several measures were put in place to ensure the disease does not spread and these includeded:
• At Entebbe International Airport, all travelers from Democratic Republic of Congo were screened at the Health desk for Ebola signs and symptoms.
• The Ministry of Health also instructed leaders in the suspected districts to reactivate the District Task Forces in preparations for any possible outbreak. These taskforces were assigned to conduct a rapid risk assessment on importation of Ebola Virus Disease (EVD) cases through their districts, review and update district EVD preparedness and response plans, and establish ground crossing requirements (temperature screening/verbal screening/hand washing/IEC materials) to limit the risk of EVD importation while avoiding unnecessary interference in trade and travel.
They were to also ensure adequate community information and heightened surveillance by front line health workers in all health facilities.
• An Isolation facility was set up at Mubende Regional Referral Hospital to attend to any suspected cases. The hospital staff were oriented on handling suspected patients including infection control and supportive care.

Mulago Maternal and Neonatal Hospital
The state of the art women’s health facility at Mulago hospital is a nine-storey building sitting on 24,000 square metres of land. The hospital is a 450-bed facility with 11 operating rooms, 40 beds for intensive care units, 170 beds for high risk delivery section, 80 beds for oncology department, 50 beds for nursery section and 25 beds for recovery section. Others include emergency departments, laboratories, a blood bank, morgue, radiology, examination and physiotherapy departments. These will help to handle and offer services such as high risk antenatal care, delivery, postnatal and gynaecology, surgical, ureteric re-implantation, in-vitro fertilisation, recurrent pregnancy as well as complex fistula surgeries. However, according to health minister Ruth Aceng, the hospital will only handle referred cases from other hospitals.
There was a public outcry on the exhorbitant costs for the services offered and health minister Jane Ruth Aceng said a committee was put in place to develop a criteria for poor patients who are unable to afford but require the services. All patients accessing services from this facility are required to appropriately follow the referral guidelines and have referral notes and all Ugandan nationals must carry their National IDs.

Hepatitis B fight
In August, the government was applauded for its efforts towards the fight against Hepatitis B. More than 23 million adults and adolescents have been screened for the disease across the country while 17.6 million adults and adolescents have been successfully vaccinated against Hepatitis B, since the mass vaccination campaign was rolled out in 2015.
Minister of Health Dr Jane Ruth Aceng noted that, “All regional referral and general hospitals have been prepared as treatment centres. Currently six treatment centres have been equipped and these are; Mulago National Referral Hospital, Arua Regional Referral Hospital, Soroti Regional Referral Hospital, Mbale Regional Referral Hospital, Jinja Regional Referral Hospital and Adjumani General Hospital.

Rotavirus vaccine
The government in June rolled out Rotavirus vaccine into the routine immunisation schedule to protect children under five years of age from diarrhoea. This is the 11th vaccine that is provided free to infants and children at all health facilities and selected community outreaches within the country. Rotavirus ranks highest among the top five causes, accounting for 40 per cent of diarrhoea cases among children in Uganda. Every year, an estimated 10,637 children under five years of age die due to Rotavirus diarrhoea.Rotavirus vaccine is administered orally and requires two doses at six and 10 weeks of age.

Hi-tech laboratories to diagnose viral load
The Uganda National Health Laboratory Services (UNHLS) at Butabika on December 6, received another boost in its effort to become the regional centre of excellence in laboratory services.
The National Heme Path Flow Cytometry Laboratory for cancer diagnosis will help improve diagnosis of particularly blood cancers, especially lymphomas and leukemia. The new reference laboratory is critical in helping doctors plan the most appropriate course of treatment and in monitoring the effectiveness of therapy.
The Hepatitis B Viral load laboratory was commissioned on the same day to strengthen the country’s response to viral Hepatitis B. The government issued two statutory instruments to advance the fight against Hepatitis B, and also committed Shs10b annually towards addressing the burden of Hepatitis B.