Health
The District health department aims at providing quality health care services to the population of Zombo District operates within the overall Goal: “To accelerate movement towards Universal Health Coverage with essential health and related services needed for promotion of a healthy and productive life”
The Universal Health Coverage makes it possible to ensure that all people receive essential and good quality health services they need without suffering financial hardship.
Mission “To facilitate the attainment of a good standard of health by all people of Uganda in order to promote a healthy and productive life.
The health department hopes to contribute to the improvement in the quality of life of the people of Zombo district, thus contributing to the development of the district as a whole, as stated in the overall vision of the district “A literate, healthy, productive and empowered people of Zombo District by 2040”
Health Sector Key Performance Indicators and Targets
Objective |
Key Result Area |
Indicator |
Baseline |
Annual Targets |
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2015/16 |
2016/17 |
2017/18 |
2018/19 |
2019/20 |
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To accelerate movement towards UHC with essential health and related services needed for promotion of a healthy and productive life.
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HEALTH IMPACT |
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Health impact trends |
Maternal Mortality Ratio (per 100,000) |
438 (UDHS 2011) |
425 |
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320 |
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Neonatal Mortality Rate (per 1,000) |
26 (UDHS 2011) |
26 |
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16 |
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Infant Mortality rate (per 1,000) |
54 (UDHS 2011) |
50 |
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44 |
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Under five mortality rate (per 1,000) |
90 (UDHS 2011) |
64 |
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51 |
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Total Fertility Rate |
6.2 (UDHS 2011) |
5.9 |
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5.1 |
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Adolescent Pregnancy Rate |
24% (UDHS 2011) |
23% |
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14% |
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To contribute to the production of a healthy human capital for wealth creation through provision of equitable, safe and sustainable health services.
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HEALTH & RELATED SERVICES OUTCOME TARGETS |
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Communicable disease prevention & control |
ART Coverage |
42% ( HMIS 2013/14) |
57% |
65% |
72% |
80% |
80% |
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HIV+ pregnant women not on HAART receiving ARVsforeMTCT during pregnancy, labour, delivery and postpartum |
72% (HMIS 2013/14) |
85% |
87% |
90% |
95% |
95% |
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TB Case Detection Rate (all forms) |
80% (HMIS 2014/15) |
83% |
85% |
87% |
90% |
95% |
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IPT3 or more doses coverage for pregnant women |
50% (HMIS 2013/14) |
64% |
71% |
79% |
86% |
93% |
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In patient malaria deaths per 100,000 persons per year |
30 (HMIS 2013/14) |
13 |
5 |
5 |
5 |
5 |
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Malaria cases per 1,000 persons per year |
460 (HMIS 2013/14) |
373 |
329 |
285 |
242 |
198 |
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Under-five Vitamin A second dose coverage |
26.6% (HMIS 2013/14) |
58% |
60% |
62% |
64% |
66% |
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DPT3HibHeb3 coverage |
93% (HMIS 2013/14) |
95% |
95% |
95% |
97% |
97% |
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Measles coverage under 1 year |
87% (HMIS 2013/14) |
90% |
92% |
95% |
95% |
95% |
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Essential clinical and rehabilitative care |
Bed occupancy rate (Hospitals & HC IVs) |
59% (HMIS 2013/14) |
62% |
70% |
80% |
85% |
90% |
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50% (2013/14) |
55% |
60% |
65% |
70% |
75% |
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Average length of stay (Hospitals & HC IVs) |
Hospital4 (HMIS 2013/14) |
4 |
3 |
3 |
3 |
3 |
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HC IV3 (HMIS 2013/14) |
3 |
3 |
3 |
3 |
3 |
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Contraceptive Prevalence Rate |
30% (UHDS 2011) |
39% |
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50% |
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Couple years of protection |
4,074,673 (HMIS 2013/14) |
4.3 M |
4.4 M |
4.5 M |
4.6 M |
4.7 M |
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ANC 4+ coverage |
32.4% (HMIS 2013/14) |
37.5% |
40% |
42.5% |
45% |
47.5% |
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Health Facility deliveries |
44.4% (HMIS 2013/14) |
54% |
56% |
58% |
60% |
64% |
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HC IVs offering CEmOC Services |
37% (HMIS 2013/14) |
55% |
55% |
57% |
59% |
60% |
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HEALTH INVESTMENT OUTPUT TARGETS |
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Health Infrastructure |
New OPD utilization rate |
1.0 (HMIS 2013/14) |
1.1 |
1.2 |
1.3 |
1.4 |
1.5 |
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Hospital (inpatient) admissions per 100 population |
6 (HMIS 2013/14) |
7 |
8 |
9 |
10 |
10 |
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Population living within 5km of a health facility |
75% |
77% |
80% |
82% |
84% |
85% |
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Medicines and health supplies |
Availability of a basket of commodities in the previous quarter (% of facilities that had over 95%) |
To be determined |
86% |
100% |
100% |
100% |
100% |
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Improving quality of care |
Facility based fresh still births (per 1,000 deliveries) |
16 (HMIS 2013/14) |
15 |
14 |
13 |
12 |
11 |
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Maternal deaths among 100,000 health facility deliveries |
132 (HMIS 2013/14) |
114 |
110 |
106 |
102 |
98 |
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Maternal death reviews |
33.3% (HMIS 2012/13) |
38% |
45% |
52% |
59% |
65% |
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Under five deaths among 1,000 under 5 admissions |
17 (HMIS 2013/14) |
17.6 |
17.3 |
16.9 |
16.5 |
16.1 |
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ART Retention rate |
79.7% (HMIS 2013/14) |
83% |
84% |
84% |
84% |
84% |
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TB Treatment Success Rate |
80% (2013 Cohort) |
82% |
84% |
86% |
88% |
90% |
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Responsiveness |
Client satisfaction index |
69% (USSP Survey 2014) |
71% |
73% |
75% |
77% |
79% |
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Health Information |
Timeliness of reporting (HMIS 105) |
85% (HMIS 2013/14) |
88% |
90% |
93% |
95% |
97% |
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To increase financial risk protection of households against impoverishment due to health expenditures. |
Health Financing |
Out of pocket health expenditure as a % of Total Health Expenditure |
37% (NHA 2011/12) |
37% |
35% |
33% |
31% |
30% |
General Government allocation for health as % of total government budget |
8.7% (AHSPR 2013/14) |
10% |
12% |
14% |
15% |
15% |
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To address the key determinants of health through strengthening intersectoral collaboration and partnerships. |
Social and economic determinants of health |
Children below 5 years who are stunted |
33% (UDHS 2011) |
31% |
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29% |
Children below 5 years who are under weight |
14% (UDHS 2011) |
14% |
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10% |
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Health promotion & environmental health |
Latrine coverage |
73% (AHSPR 2013/14) |
74.6% |
76% |
78% |
80% |
82% |
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Villages/ wards with a functional VHT |
72% (AHSPR 2013/14) |
75% |
80% |
85% |
85% |
85% |
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Human Resources |
Approved posts in public facilities filled with qualified personnel |
69% (AHSPR 2013/14) |
69% |
70% |
72% |
76% |
80% |
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Number of health workers (doctors, midwives, nurses) per 1,000 population |
Doctors 1:24,725 (HSSIP MTR 2013) |
1:24,725 |
1:24,500 |
1:24,300 |
1:24:000 |
1:23,500 |
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Midwives 1:11,000 (HSSIP MTR 2013) |
1:11,500 |
1:11,000 |
1:10,500 |
1:10,000 |
1:9,500 |
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Nurses 1:18,000 (HSSIP MTR 2013) |
1:18,500 |
1:18,300 |
1:18,000 |
1:17,500 |
1:17,000 |
Key Challenges faced by the Department
The key challenges faced by the district health department include but are not limited to the following;
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Low staffing in the Department
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Inadequate staff accommodation, as such many staff stay away from their work places which results to late reporting for duty or even absence.
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Inability to attract some cadres of health workers especially midwives, anaesthetic officers, laboratory technologists even when opportunities to fill the positions arise.
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Lack of transport facilities (motorcycles) especially for environmental health staff and HC IIIs
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Lack of facilities for specialized health services in a hospital or HC IV setting due to the lack of a public owned HC IV or District hospital.
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Low service coverage due to unevenly distributed health facilities. Services such as MCH are inaccessible to majority of the targeted population.
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Poor health seeking behaviours and attitudes of the people is a key challenge. The people only seek professional health services after all have been exhausted. This is causing high infant and maternal mortality rates.