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NIRA & Makerere University Collaborate to Improve Death Registration Rates in Uganda

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By Balam Ankunda

In a bid to address the low death registration rates in Uganda, the National Identification and Registration Authority (NIRA) has joined forces with the Makerere University Center for Health and Population Research (MUCHAP) to scale up death registration in Iganga and Mayuge districts.

This strategic partnership that aims to significantly increase death registration within the country is supported by the Centers for Disease Control and prevention Foundation (CDC F) – Bloomberg Philanthropies’ Data for Health Initiative program whose aim is to rapidly improve civil registration and vital statistics in number of low- and middle-income countries.

Recognizing the importance of accurate vital statistics, the initiative kicked on off on May 29, in the districts of Iganga and Mayuge with a two-day training program for district leader, community leaders and other stake holders in select parts the MUCHAP demographic surveillance area.

The training brought together key stakeholders, including Village Health Teams (VHTs), Local Councils (LCs), Health Assistants, Assistant COA’s, Sub Country Chiefs, and health inspectors, who play critical roles in the registration process.

The training equipped participants with the necessary knowledge and skills to initiate and streamline the death registration process within their respective communities.

With Uganda currently facing considerable challenges in death registration, the partnership between NIRA and MUCHAP offers a promising solution to this pressing issue.

Dr. Dan Kajungu, the Executive Director of MUCHAP, expressed enthusiasm about the collaboration, highlighting the significance of timely death registration within a week of occurrence. He added that the project leverages on the vast experience of the Makerere University population cohort of Iganga Mayuge HDSS.

The Executive Director of MUCHAP-Dr. Dan Kajungu (Left) and NIRA District Registration Officer-Aloysius Ochola (Right) during death registration training at MUCHAP Offices in Iganga District on Monday 29th May, 2023.
The Executive Director of MUCHAP-Dr. Dan Kajungu (Left) and NIRA District Registration Officer-Aloysius Ochola (Right) during death registration training at MUCHAP Offices in Iganga District on Monday 29th May, 2023.

Dr. Kajungu noted “the cohort has been doing similar work for close to 20 years, this will guarantee a successful initiative” The population cohort is one of the establishments that the University has set up to drive impactful research that directly addresses community needs.

By integrating the health and demographic surveillance system (HDSS) with NIRA’s Mobile Vital Registration System (MVRS), the partnership aims to expand the scope of their work and enhance death reporting and registration practices.

Recent studies have revealed that approximately 67% of deaths occur within the community, while the remaining 33% take place in health facilities.

The Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) population cohort covers seven sub-counties and records around 600 deaths and 2,000 births annually. Accurate data on causes of death and birth statistics is crucial for informed decision-making and effective resource allocation.

Addressing the challenges surrounding death and birth registration, Wandera Sadat, the Resident District Commissioner (RDC) of Iganga, emphasized the need for public sensitization. He acknowledged that death and birth registration have existed, but the process lacked proper streamlining. Many deaths occurring in rural areas go unreported, leading to a dearth of crucial data.

“We really need to know the cause of deaths,” Wandera Sadala stated. “Malaria alone claims 18 lives daily. Understanding the impact of other diseases is equally important. If someone dies and we fail to report it, we will never have accurate statistics.”

Shalom Kisakye, Senior Registration Officer at NIRA, explained that the partnership with MUCHAP initially focuses on registering deaths in Iganga and parts of Mayuge for two months. However, they plan to expand to other districts and ensure continuous registration as per their mandate.

Kagoya Mariam, the Health Inspector in charge of Nakalama Subcounty in Iganga district, expressed her surprise at learning that death registration is mandatory. She admitted that previously, most people only sought death registration if there were court orders involved. However, the recent training has enlightened her about the broader significance of death registration.

Dr. Kajungu Dan (extreme left) and NIRA officials pose for a group photo with VHT's, LC1 Chairpersons and scouts after training on death registration at MUCHAP offices in Iganga District on 29th May 2023.
Dr. Kajungu Dan (extreme left) and NIRA officials pose for a group photo with VHT’s, LC1 Chairpersons and scouts after training on death registration at MUCHAP offices in Iganga District on 29th May 2023.

“I did not know it is mandatory for death registration,” Kagoya admitted. “Most people come for death registration only if there are court orders, but today I have learned that registration helps us know which diseases are affecting the community. Death registration also helps us know the population we have for better planning purposes. People have not been sensitized enough.”

This revelation highlights the lack of awareness regarding the importance of death registration in the community. Many individuals, like Mukisa Musa, a local resident of Iganga Central Division, have now come to recognize the value of death registration.

Mukisa expressed his newfound understanding of the significance of death registration. His comments demonstrate the impact of the recent training on community members’ awareness and knowledge.

“I have learned about the importance of death registration,” Mukisa shared. His statement reflects the positive impact of the partnership between NIRA and MUCHAP in educating individuals about the significance of death registration.

The RDC Iganga District, Wandera Sadala addressing participants during the training on death registration at MUCHAP Offices in Iganga District on 30th May 2023.
The RDC Iganga District, Wandera Sadala addressing participants during the training on death registration at MUCHAP Offices in Iganga District on 30th May 2023.

The collaboration between NIRA and MUCHAP holds great promise in addressing the low death registration rates in Uganda. By streamlining the registration process and improving data collection, this initiative aims to provide accurate statistics on deaths and enhance societal decision-making for a better future.

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Mak’s GMI Labs Authorized to Conduct DNA Paternity Testing

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Some of the equipment used to store samples at the Makerere University Biomedical Research Centre (MakBRC), College of Health Sciences (CHS). Kampala Uganda, East Africa.

The Genomics, Molecular, and Immunology Laboratories (GMI Labs), operating under the auspices of the Makerere University Biomedical Research Center (MakBRC), have achieved another significant milestone in their journey of diagnostic excellence. The labs, renowned for their pivotal role in infectious and non-infectious disease research, have received official approval from the Director General Health Services at the Ministry of Health (MoH), Uganda, to conduct DNA Paternity Tests.

Situated at the Dept of Immunology & Molecular Biology under the School of Biomedical Sciences at the College of Health Sciences, Makerere University, the GMI Labs have been at the forefront of cutting-edge research, diagnostic testing, and training initiatives. Their remarkable contributions during the COVID-19 pandemic, where they conducted nearly a million PCR tests, underscored their unwavering commitment to public health and scientific advancement. The labs’ exemplary performance and reliability were further highlighted by their successful management of two critical COVID-19 prevalence surveys. The findings of these surveys served as foundational data for crucial decisions guiding the country’s lockdown strategies and phased reopening, earning commendation from the President and the Ministry of Health.

This latest authorization from the Ministry of Health marks a significant expansion of the GMI Labs’ diagnostic capabilities. With the approval to conduct DNA Paternity Tests, the labs are now equipped to offer a crucial service addressing the need for accurate and reliable genetic testing for determining biological parentage. In a letter dated 22nd November 2023, the Director General Health Services emphasized the laboratory’s rigorous adherence to international standards, proficiency in molecular biology techniques, and their proven track record in delivering precise and credible results. This approval further solidifies the labs’ position as a trusted institution for advanced genetic diagnostics in Uganda.

Prof. Moses L Joloba, the Director of the GMI Labs, expressed immense pride in the team’s dedication and expertise that led to this authorization. He highlighted the labs’ commitment to upholding the highest standards of ethical practice, confidentiality, and accuracy in DNA paternity testing, ensuring the delivery of dependable results crucial for legal, personal, and familial purposes.

The inclusion of DNA Paternity Testing within the GMI Labs’ list of services aligns with their overarching goal of advancing healthcare through state-of-the-art diagnostics, research, and education. This milestone represents not only a significant achievement for the labs but also a valuable resource for individuals seeking reliable and comprehensive genetic testing services. As the GMI Labs continue their unwavering commitment to excellence in healthcare and research, this new capability reaffirms their pivotal role in advancing the frontiers of molecular diagnostics and genetic testing in Uganda, working closely with reputable institutions such as Makerere University Hospital and other top-notch health facilities.

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MNCH e-Post Issue 121: Learning from Nsambya Hospital Human Milk Bank to inform national scale-up & save preterm babies

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A Screenshot of Prof. Peter Waiswa during his interview with NTV. MNCH e-Post Issue No. 121, MakSPH, Makerere University, Kampala Uganda, East Africa.

Welcome to this exclusive interview with Prof. Peter Waiswa, lead expert from the Makerere University Centre of Excellence for Maternal, Newborn, and Child Health. Dr. Victoria Nakibuuka from St. Francis Nsambya Hospital, and Dr. Jesca Nsungwa from Ministry of Health Uganda. In this video, they discuss a groundbreaking innovation in Uganda’s healthcare landscape: the country’s first-ever human milk bank at St. Francis Hospital Nsambya. This initiative represents a significant stride towards improving the survival rates of premature and vulnerable infants by ensuring access to essential breast milk, even when mothers are unable to produce enough. Watch Video

Click here to View the full MNCH e-Post Issue 121

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METS Newsletter October 2023

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Front Row (Left to Right): The hosts - Dr. Alice Namale and Ms. Evelyn Akello with Commissioner Allan Muruta and representatives from US Centers for Disease Control and Prevention (CDC) and Makerere University School of Public Health (MakSPH) enjoy a photo moment on 5th October 2023. Photo: METS. Plot 20A Kawalya Kaggwa Close, Kololo Kampala Uganda, East Africa.

The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere University School of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).

Highlights of the METS October 2023 Newsletter

  • Strategies for Enhanced Disease Surveillance and Public Health Response in Uganda
    • The MoH Department of Integrated Epidemiology Surveillance & Public Health Emergencies (IES&PHE) Head, Commissioner Allan Muruta (Dr) visited METS to acquaint himself with the various surveillance activities supported by the Program.
    • Commissioner Muruta emphasized the need to build the capacity of districts and regions to conduct surveillance activities by training the relevant staff and establishing surveillance focal points at health facility levels.
    • He further emphasized the importance of linking laboratory data to the District Health Information System (DHIS2) and ensuring that different systems are interoperable.
  • Improving quality of data for HIV testing services (HTS) through regular assessments
    • MoH has been conducting Data Quality Assessments and Improvement (DQAI) activities to inform program planning, monitoring, and performance management. HIV testing services (HTS) inter was conducted in 16 regions, 81 districts, and 111 health facilities in partnership with 26 Implementing partners.
    • The HTS DQA has improved data management, infrastructure, and understanding of indicators. Specific staff assignment at each HTS entry point has proven effective, and use of the UgandaEMR system for reporting has yielded positive results.
  • Shaping Uganda’s Healthcare Data Landscape
    • METS has maintained a strong collaboration with the Ministry of Health (MoH) providing invaluable technical support in developing various strategic guidelines for the country. These guidelines include the Uganda Health Information Exchange and Interoperability (HIE) Guidelines, the Uganda Health Data Protection and Confidentiality (HDPC) Guidelines, and the Uganda Health Data Sharing, Access, and Use Guidelines.
    • HIE and HDPC guidelines have received the endorsement of the Health Information, Innovation and Research (HIIRE) Technical Working Group (TWG), awaiting presentation to the senior management team at the MoH for final approval.
  • Empowering Health Professionals: PrEP Training in Hoima District
    • MakSPH-METS has taken a proactive stance in supporting Monitoring and Evaluation (M&E) for key populations through the development, management, and conducting trainings on the use of the PrEP tracker system across various agencies.
    • METS conducted a 5-day training on the KP/PrEP Tracker system in Hoima district. Moving forward, facility staff will be able to enter data on PrEP services into the system in a timely manner, analyze the data, and use it for program improvement.
  • Gallery
    • HIV testing services (HTS) Data Quality Assessments and Improvement DQAIs
    • Interagency cervical cancer on-site mentorships
    • Orientation in KP tracker-Soroti
    • TDY from CDC headquarters visit to METS
    • M&E orientation meetings for new Implementing Partners
    • Planning meeting for Cross Border Data Sharing-Busia

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