Title : Monitoring and evaluation of Uganda’s international health regulations 2005 implementation at sub-national level in eight districts, 2022
Abstract:
Background:
Uganda is signatory to the International Health Regulations (2005) which mandates us to have the capacity to detect, assess, report and respond to potential public health emergencies. Following the World Health Organization (WHO) Joint External Evaluation (JEE) 2017, Uganda developed a National Action Plan for Health Security (NAPHS) 2019 – 2023. NAPHS implementation occurs at national and sub-national level where public health emergencies occur.
Methods:
We evaluated progress in eight districts (Nebbi, Pakwach, Zombo, Madi-Okollo, Arua, Maracha, Koboko and Yumbe) in West Nile region using an innovative modification of the JEE 2.0 tool. Thirty-eight indicators from 17 technical areas of the JEE tool and performance reports were included. Technical teams from different ministries held interviews with the district staff and collected statistical data on sub-national implementation of NAPHS, resources, outputs, beneficiaries. On a scale of 1 (no capacity) to 5 (sustained capacity), questions per area were aggregated from 0 to 100%. As a proxy for immunization, we evaluated progress with COVID-19 vaccine roll-out scores in each district.
Results: For each technical area, performance varied across the eight districts. Indicators with score 5 in Arua (35/38), Yumbe (31/38), Pakwach (21/38), Madi-Okollo (20/38), Maracha (18/38), Koboko (17/38) and 15/38 each in Zombo and Nebbi districts. Financing of IHR scored 5 in each 50% (4/8), while only 1 (12.5%) had score of 5 in financing for public health emergencies. All (100% score 5) districts had a functional mechanism is established for coordination and integration of relevant sectors in IHR. Regarding antimicrobial resistance, only Arua district had 5 in all four indicators. In 5 districts (62.5%) had sustainable mechanisms for responding to infectious and zoonotic diseases in place. Full COVID-19 vaccination capabilities were optimum (score 5) in seven of eight districts.
Conclusion: Efforts to strengthen Uganda’s health security capacity at sub-national levels is recommended.
