Health
Research Links Social Support to Improved Contraceptive Decision-Making for Women
Researchers at Makerere University School of Public Health (MakSPH) are urging the Ugandan government to boost healthcare funding to enhance reproductive health services. Dr. Dinah Amongin, an obstetrics and gynecology expert at MakSPH, has expressed concern about the lack of access to family planning methods, which forces women to use less preferred options due to unavailability.
Dr. Amongin notes that within just six months to a year of using contraception, some women encountered issues and switched methods. This highlights the need for the Ministry of Health to improve the availability of various contraceptive options. A rights-based approach to contraception ensures that women have access to a range of methods, preventing situations where desired options are unavailable at health facilities.
“Stockouts are a significant issue, and this extends to parliamentary discussions on health sector budgets. As we focus on human capital development and improving maternal and newborn health outcomes, we must consider crucial components like preventing unwanted pregnancies through family planning. The budget allocation for the health sector directly impacts this issue. When women cannot access their preferred contraceptive methods due to stockouts, it reflects a failure in our legislative and budgeting processes. This situation forces women to switch to fewer desirable methods, which is not acceptable,” says Dr. Amongin.
Adding that; “These are things we need to continue discussing as a country but we must invest into family planning. We can talk about human capital development but until we step up and actually support women to prevent unwanted pregnancies, support them in their decisions of whether she wants to use a method for contraception or not. That is her choice. We must make sure access to the methods of her choice is actually addressed.”
Dr. Amongin’s comments follow a recent study on the I-CAN/Nsobola/An atwero social support intervention, piloted in Mayuge and Oyam districts in 2023. The study highlights that social support significantly improves women’s ability to make informed contraceptive choices, potentially leading to better reproductive health outcomes.
Part of the Innovations for Choice and Autonomy (ICAN) project, the study shows that self-injection with DMPA-SC (Sayana Press) could increase contraceptive use, especially among women with limited access to healthcare. Despite the rollout of this method in 2017, its use remains low in Uganda. Sayana Press as popularly known is a subcutaneous depot medroxyprogesterone acetate (DMPA-SC). It is a hormonal birth control shot, administered under the skin and is an all-in-one contraceptive that puts women in charge of their reproductive health.
Social support boosts self-efficacy, enhances privacy, and reduces access barriers, making self-management easier. Family planning helps manage the number and timing of children, lowering maternal and infant mortality rates and reducing complications from pregnancy. Conversely, unmet contraceptive needs can lead to unintended pregnancies and their associated risks.
In Uganda, 52% of pregnancies are unwanted or mistimed, with over 43% due to unmet family planning needs. The country’s youthful population complicates the issue, with 50% under 17 years old, at least according to the recent National Population Census. Notably, 10% of girls, one in every 10 girls you encounter, has already had sex before she turns 15 years, and 20% of boys, two in 10 boys have engaged in sexual intercourse by the same age.
Methods of contraception include oral contraceptive pills, implants, injectables, patches, vaginal rings, intra uterine devices, condoms, male and female sterilization, lactational amenorrhea methods, withdrawal and fertility awareness-based methods.
Global statistics show that 77.5% of women aged 15–49 had their family planning needs met with modern methods in 2022, up from 67% in 1990. In sub-Saharan Africa, the proportion of women who have their need for family planning satisfied with modern methods (SDG indicator 3.7.1) continues to be among the lowest in the world at 56 per cent. Nevertheless, it also increased faster than in any other region of the world, having more than doubled since 1990, when this proportion was only 24 per cent.
Among 1.9 billion women of reproductive age (15-49 years), an estimated 874 million women use a modern contraceptive method and 92 million, a traditional contraceptive method. The number of modern contraceptive users has nearly doubled worldwide since 1990 (from 467 million). Yet, there are still 164 million women who want to delay or avoid pregnancy and are not using any contraceptive method, and thus are considered to have an unmet need for family planning.
Slow progress is due to factors like limited method choices, restricted access, fear of side effects, cultural opposition, and gender-based barriers.
Between 2015 and 2019, there were 121 million unintended pregnancies annually worldwide – 48 per cent of all pregnancies. Despite decreases in the rate of unintended pregnancy in all regions over the past three decades, nearly one in 10 women in sub-Saharan Africa, Western Asia and Northern Africa, and Oceania (excluding Australia and New Zealand) continue to experience an unintended pregnancy every year
In Uganda, where healthcare services are stretched thin and women juggle numerous responsibilities, accessing contraceptives can be challenging.
Dr. Amongin emphasizes that self-injection methods like DMPA-SC, also known as Sayana Press could ease the burden on women facing long queues and logistical challenges at health facilities. “This method allows for discretion and reduces the need for frequent visits, which is crucial for women with busy lives,” she says.
Researchers argue that the health sector’s budget should include substantial funding for family planning. The high cost of inaction is evident: neglecting family planning leads to unplanned pregnancies, which ultimately burdens families and the nation. Addressing this issue early in the life cycle is crucial to prevent these long-term consequences.
“This is the gist of the matter behind all our research, that a woman’s preference needs to be respected. The health facilities must stock commodities so that when a woman is in need, she actually gets it,” noted Dr. Amongin.
Dr. Peter Waiswa, an Associate Professor at MakSPH, stresses the importance of informed choice in family planning. ICAN studies across Kenya, Malawi, Nigeria, and Uganda show that self-injection benefits all women, including young adolescents. “Supporting young people to make informed choices helps prevent unintended pregnancies,” says Prof. Waiswa.
“We spent four years trying to understand which women benefit from injecting themselves. And we found that all women benefit from it, including younger children. Because younger children in Uganda, whether we hide our heads in the sand or not, especially those 12 years and above are having sex and some of them using contraceptives,” Professor Waiswa says.
What is factually true is that by age 18, 60% of Ugandans have reported having sexual intercourse. Despite the benefits, dropout rates from family planning methods remain high due to side effects and lack of support. Dr. Waiswa also, a Public Health specialist, critique and dreamer for better health systems for mothers, newborns and children in Africa calls for better education and support to address these issues.
“As a way of being supported in a safe space whereby people are not asking questions, they are not fearing parents, they are not fearing other people, then they can use the methods. What we did in Mayuge and Oyam, we trained women who are users of family planning. To identify people who need to use family planning but are not currently using and then they go and see whether they can use or not. And we found that when people are supported, those groups which are currently not being reached can be reached by family planning,” argues Prof. Waiswa.
A 2021 study found that contraceptive discontinuation significantly impacts the effectiveness of family planning services, leading to higher fertility rates, unwanted pregnancies, and induced abortions.
Analysis of data from PMA 2020 show that 6.8% of women discontinued contraceptive use, with discontinuation linked to factors such as age, marital status, method type, and health concerns. The study suggests prioritizing interventions to encourage contraceptive use among young people and promoting partner involvement and awareness, as many contraceptive methods are not discreet.
Prof. Waiswa is concerned of the high dropout rate from family planning methods, where many women discontinue use due to side effects, a need for better education and support.
“We need to see how to educate women so that they are informed when they are choosing a method to use. They need to have enough information because when they discontinue, the method can be ineffective, can cause side effects, but also these methods are expensive, so they waste money. There are a lot of those who change to other methods. We are learning a lot on the use of family planning why we still have a large unmet need,” says Prof. Waiswa.
Ms. Roseline Achola, Technical Specialist for Sexual and Reproductive Health and Self-Care at the Ministry of Health, hailed the MakSPH study on self-injection contraception. She noted that the findings will help her enhance support for self-care initiatives. However, she expressed that only 29% of women willing to self-inject as indicated in the study is still low, highlighting a need to address barriers to increase acceptance as well as managing sexually active adolecents. “We must discuss how to handle minors seeking contraception to prevent unintended pregnancies,” she says.
On Friday August 23, 2024, the Daily Monitor reported, an increase in young girls adopting family planning to combat teenage pregnancies and school dropouts. Quoting data from the Uganda Health Information System, statistics show that between March 2023 and March 2024, 2,476 girls under 15 had their first antenatal care visit, and 1,755 gave birth. The highest number of pregnancies among this age group was in Oyam district.
In this period, Lango subregion saw 52 pregnancies among this age group, with Oyam district recording the highest at 10 cases. The 2021 UNFPA fact sheet indicates that Busoga region, particularly Kamuli and Mayuge districts, has the highest rates of teenage pregnancies, with 6,535 and 6,205 cases respectively.
“As the country, it’s clear that adolescents are limited to access to contraception because of so many reasons. For us as a Ministry, any woman between the age of 15 to 49 is a woman of reproductive age and that tells you that she is capable of getting pregnant and when such a girl of probably 15 years goes to a facility to seek for contraception, it rings a message that actually she is sexually active. So how do we handle her? So that is a matter of discussion for the country.
It is a matter that the nation needs to decide on, because we all know the girls are getting pregnant, the girls want to use contraception, but they have no access because of the fact that they are children,” wondered Achola.
Unintended pregnancies and Uganda’s abortion paradox
Abortion in Uganda, is largely illegal except in specific circumstances. It contributes to maternal death due to unsafe practices. Between 2010 and 2014, WHO reported that 30.6million abortions conducted were safe and 25.1million were unsafe. 97% of these occurred in developing countries. In East Africa, the total number of abortions per year according to the Lancet are around 2.65million.
The Ministry of Health’s HMIS data show a rise in abortion cases, with 96,620 reported between July 2020 and June 2021in both government and private health facilities.
Another recent study on the quality of post-abortion care by MakSPH researchers Assoc. Prof. Lynn Atuyambe, Dr. Justine Bukenya, Dr. Arthur Bagonza and Mr. Sam Etajak highlights the need for accurate post-abortion care data to improve healthcare planning and policymaking.
Dr. Arthur Bagonza, a Public Health Consultant and Research fellow with specialization in health systems at MakSPH and one of the uality of post-abortion care has called for accurate abortion data to improve healthcare planning and policymaking. He notes that health workers often avoid documenting abortion data due to legal fears and calls for reforms to restrictive laws to ensure accurate reporting without legal repercussions.
“All assessed health facilities reviewed in our study achieved a 100% timeliness rate for report submissions. However, significant disparities were observed in data accuracy between different levels of health facilities, with lower-level facilities (HC IIs and HC IIIs) showing higher rates of data discrepancies,” says Dr. Bagonza.
According to Dr. Amongin, the high incidence of early sexual activity among Uganda’s youth is a pressing public health issue.
“We know as a country many women continue to die following unsafe abortions; abortions for pregnancies that they did not want. And these abortions are highest among adolescents and also other women categories.
We would want to ensure that we actually enhance access to contraceptives, but making it easier for them to have it and putting the power in the hands of a woman to as much extent as we can. So that a woman can practice what we call self-care, but of course she also will need the support of the healthcare system. But we want this power in women’s hands because of all the challenges that the women actually can encounter in accessing these methods,” she said.
On her part, Achola insists that abortion should not be a last resort for women and urges them to abstain or use protective means in order to avoid unwanted pregnancies. She notes that as long as abortion remains illegal in Uganda, many health workers will avoid addressing it, leading people to unsafe alternatives.
“I can’t be happy because abortion means we have failed to give people a method of their choice to prevent that pregnancy. Or the people are not able to access contraception to prevent unintended pregnancies. Abortion is not the last resort, it’s not a solution because it has its own complications as well,” says Achola.
Despite this, Achola, notes most of the women who walk in health facilities with post-abortion complications must be attended to. “Whereas we don’t encourage people to do abortions, as Ministry of Health we are mandated to handle all complications for anyone who walks in our facilities because our priority is to save life. We want to urge women to avoid certain things. Why should you wait for unintended pregnancy to occur and then abort?”
Dr. Charles Olaro, a Senior Consultant Surgeon and the Director Health services – Curative in the Ministry of Health highlights the financial burden on individuals seeking health services and suggests exploring private sector opportunities and community-based approaches to improve access. “We need to balance values and rights while addressing access barriers,” he notes.
According to Dr. Olaro, the autonomy and agency of women in sexual and reproductive health, particularly in African cultures remain a challenge where social norms may require women to defer decisions to their partners.
He notes that there is a high burden of abortion and self-harm, with a significant portion of maternal mortality attributed to sepsis, which is often a result of unsafe abortions in Uganda.
“We still need evidence to ensure that access barriers are addressed. And this is a question I keep on asking Makerere University, yes, we have a young population but how are these people accessing contraceptives. Other issue we have to deal with is complex. I know we have to do a balance between values and rights, but we will be able to look at that when they gain the success to do it.”
Dr. Olaro points out that individuals often face a financial burden in health services, spending more on prescriptions than on the medications themselves. He suggests exploring private sector opportunities and a community-based approach to improve access to healthcare.
NB: The PMA surveys are spearheaded by Associate Professor Fredrick Makumbi and Dr. Simon Kibira of MakSPH, with support from the Uganda Bureau of Statistics and the Ministry of Health. The initiative also receives funding from the Bill & Melinda Gates Foundation, The Children’s Investment Fund Foundation (CIFF), and is supported by the Bill & Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins University and Jhpiego.
Kampala, 24 August 2024 – Uganda’s Ministry of Health on Thursday August 22nd launched its Climate Change Health National Adaptation Plan (H-NAP), a comprehensive strategy aimed at bolstering the nation’s health system resilience against the impacts of climate change.
Adapting to climate change presents a substantial financial burden, with Africa projected to need up to $2.8 trillion by 2030 to fulfill its commitments under the Paris Agreement, according to the African Development Bank.
Uganda’s Health National Adaptation Plan (H-NAP), a critical step in this effort, requires an estimated $63 million by 2030.
Unveiled at Sheraton Hotel in Kampala by Third Deputy Prime Minister Hon. Rukia Isanga Nakadama, the H-NAP marks a milestone in Uganda’s response to the escalating climate crisis, particularly within the health sector. This ambitious plan underscores the urgent need to address climate-related health challenges and strengthen the country’s resilience.
Uganda has committed to addressing climate change as a signatory to key global agreements, including the UNFCCC, Paris Agreement, and Kyoto Protocol. In line with these frameworks, the Ugandan government has established supportive policies and laws, such as the National Climate Change Policy (2015), the Climate Change Act (2021), the Nationally Determined Contributions (2022), and Vision 2040.
Rt. Hon. Rukia Nakadama congratulated the Minister of Health and partners for developing the Climate Change Health National Adaptation Plan. She affirmed that the government would integrate climate resilience into the Parish Development Model, Uganda’s strategy for improving household incomes and welfare. The PDM focuses on multi-sectoral community development and addresses key aspects of livelihood enhancement, including human, natural, social, financial, and physical resources.
“In the Parish Development Model there is a need to integrate Climate change interventions. In addition, the National Development Plan III and the newly developed National Development Plan IV highlights Climate change as a cross-cutting issue requiring mainstreaming for all sectors,” said Rt. Hon. Nakadama.
Drawing on the latest climate science and projections, Uganda’s health sector adaptation plan pinpoints critical areas where enhancing resilience is urgent, with the goal of strengthening the adaptive capacity of the health system to climate change and related hazards.
“It is moments like this that make me optimistic and excited about a healthier future. We have gathered at a transformational moment in unprecedented times. I am sure all of you have seen and felt the effects of our changing world. Unpredictable weather events have brought both droughts and extreme flooding as you have heard. Outbreaks of cholera, malaria, yellow fever, measles, and more have become increasingly common,” said William Asiko, The Rockefeller Foundation Vice President for Africa.
Asiko noted that climate change is now the greatest threat of health and wellbeing of billions of people worldwide and that to meet that threat head-on, human beings must “innovate,” “rethink,” and “adapt our health systems from the threats.”
Rebuilding systems is a huge task, especially when lives are at stake, said Asiko, before adding that overcoming these obstacles has been The Rockefeller Foundation’s mission for over a century. “The fight for global health, has always been at the health of our work,” he stated.
The 2022 report on climate change from the United Nations noted that at least 3.3 billion people’s daily lives are “highly vulnerable” to climate change, and people are 15 times more likely to die from extreme weather than in years past, the Intergovernmental Panel on Climate Change (IPCC) report said.
Uganda’s Ministry of Health data show that malaria remains the leading cause of illness among pregnant women and children under five. Uganda also faces critical challenges, with 81% of the population lacking access to safe water, and only 35% having basic sanitation. This results in approximately 19,700 child deaths annually due to diarrheal diseases—equivalent to 54 children that die every day from poor sanitation.
Malnutrition further contributes to infant and child deaths, with 12% of infants born underweight. Adding to this burden are pollution-related deaths; in 2021 alone, over 1,000 people in Kampala died due to poor air quality, this is according to a scientific publication by researchers at the Makerere University School of Public Health (MakSPH).
The World Health Organisation (WHO) estimates that more than 13 million deaths worldwide, each year are due to preventable environmental causes. Just to mention that air pollution from fossil fuels alone, kills 13 people every minute from lung cancer, heart disease or stroke.
These alarming statistics underscore the urgent need for Uganda’s Health National Adaptation Plan (H-NAP) to address these interconnected challenges and build a more resilient health system.
Dr Christine Musanhu, the Acting WHO Representative in Uganda contends that; “We urgently need to take concrete and timely measures, to protect the health of our populations and build a resilient future.”
According to Dr. Musanhu, climate change is not just an environmental issue; but a profound threat to the health, well-being, and development of mankind.
“Our actions today, will have a long-term effect on protecting future generations from the health consequences of climate change. In collaboration with the Ugandan government, I therefore call upon all partners, to mobilize efforts to join our quest to protect the environment,” she said.
Following numerous disasters globally, WHO has been at the forefront of efforts, to build climate change-resilient health systems. Some of the key, WHO-supported global developments in this area include the: WHO Climate Resilient Health Systems Framework, a comprehensive framework, to guide countries in making their health systems resilient, to the impacts of climate change.
The Uganda’s H-NAP covers ten components based on the WHO framework aimed at building a climate resilient low-carbon health system which is capable of anticipating, responding to, coping with, recovering from. and adapting to climate-related shocks and stress, while minimising the greenhouse gas emissions and other negative environmental impacts to deliver quality care and protect the health and well-being of present and future generations of Uganda.
Professor Barnabas Nawangwe, the Vice Chancellor Makerere University called for determination and solidary in implementing the H-NAP to safeguard the population and generations to come against the uncertainties of climate change.
“The success of the National Adaptation Plan depends on the strength of our collaborations. It requires the concerted efforts of government ministries, health agencies, civil society organisations, the private sector, and the academic community. I wish to reiterate Makerere University’s commitment to being a key partner in this endeavor,” said Professor Nawangwe.
Hon. Dr. Jane Ruth Aceng, Minister of Health of the Republic of Uganda said; “moving forward, any infrastructure projects in the health sector will be made to withstand the impact of climate change. In addition, Uganda will move forward to address the issue of greenhouse gas emissions by introducing solar lighting and solar refrigeration where applicable.”
On his part, Mr. Alfred Okot Okidi, the Permanent Secretary in the Ministry of Water and Environment, says as a ministry mandated to coordinate climate change related issues in Uganda, they assess sector budgets to ensure they are climate smart. He noted communities must be protected from the dangers of climate change. He also called on citizens to play their roles in ensuring they mitigate climate change risks.
“We have been encouraging our population to take care of their individual responsibilities. This is not just a government responsibility but a responsibility for everyone. Climate change affects us irrespective of where we come from, our department etc. I want to applaud the Ministry of Health for coming up with this H-NAP because health is one of those components that had not been taken seriously at the global level in respect to climate change,” said Mr. Okidi.
On her part, Dr. Rhoda Wanyenze, a Professor and Dean, MakSPH said the School and Makerere University as whole will be working around research, teaching and partnering with various institutions to provide required evidence especially around supporting Uganda to be able to comfortably predict climatic issues, to ensure quality decisions.
Uganda’s National Climate Change Action Plan (2030) show that all sectors of the economy are vulnerable to climate change effects.
Mrs. Margaret Mwebesa Othieno, the Commissioner of Climate Change at the Ministry of Water and Environment said she was happy to have the Ministry of Health coming on board.
“We are very happy to see that sectors are coming on board. I would also like to say that Uganda is the second country to have the Health -National Adaptation Plan after Nepal. So, to us, this huge and I would like to congratulate the Ministry of Health and all other partners that have supported these efforts. Climate change is everybody’s business. We shouldn’t leave it only to a few sectors,” said Mrs. Othieno Mwebesa.
On behalf of the Government of Uganda, Rt. Hon. Nakadama urged all the Development Partners and stakeholders to continue supporting the implementation of the Climate Health National Adaptation Plan both at national and sub-national levels. She committed that her office would spearhead the mobilisation of the population towards climate resilient systems.
“The Office of The Prime Minister will coordinate the multisectoral engagements for Ministries, Departments and Agencies (MDAs) and also create awareness of the Climate Change Health Adaptation Plan,” said Rt. Hon. Nakadama.
Health
Rockefeller Foundation, 11 Other Agencies Honored with 2024 Climate and Health Champion Awards
The Ministry of Health Uganda has recognised 12 outstanding agencies and eight individuals for championing climate change and health resilience in Uganda. They received the 2024 climate and health champions awards.
The awards were presented at the launch of the Climate Change Health National Adaptation Plan-H-NAP (2025-2030) to address the significant threat climate change poses to public health and enhance the resilience of the health sector against climate-related impacts in the country, by the Rt. Hon. Lukia Isanga Nakadama, the 3rd Deputy Prime Minister of Uganda and the woman Member of Parliament for Mayuge District while presiding over the ceremony as the Chief Guest at Sheraton Hotel, Kampala on Thursday August 22, 2024.
Speaking at the launch of the H-NAP, Dr. Diana Atwine, the Permanent Secretary Ministry of Health noted that climate change is a cross-cutting phenomena and that many institutions and individuals have been engaged in activities that directly or indirectly promote building of a climate resilient health system in Uganda.
The Ministry of Health handed the award to The Rockefeller Foundation, an American private foundation and philanthropic medical research and arts funding organization. The Foundation provided technical and financial support to Uganda to conduct the vulnerability assessments of the health sector and develop the Health National Adaptation Plan. With this funding, Makerere University School of Public Health (MakSPH) was asked to generate evidence through field research whose results were used to develop the H-NAP.
The Foundation was recognized for its technical and financial support towards Uganda’s climate and health response. Mr. William Asiko, Vice President and head of The Rockefeller Foundation’s Africa Regional Office received the award on behalf of The Foundation.
Other organisations that received the awards were the Office of the Prime Minister for its continued support to climate health emergencies. The Ministry of Water and Environment’s Department of Climate Change also received an award in recognition of the collaborative efforts on climate and health policies and governance in the country.
The World Health Organisation (WHO) Uganda country office also was recognized for its technical and financial support. Also, MakSPH received an appreciation award for its contributions to building a climate-resilient system in Uganda for its technical support in developing the H-NAP. Professor Rhoda Wanyenze, the Dean, received the award on behalf of the School.
Regenerate Africa’s Executive Director Mr. Charles Kabiswa, received the Appreciation Award in recognition of Regenerate’s technical and financial contribution towards building a climate resilient health system in Uganda. Regenerate Africa is a non-profit organisation that aims to contribute to, and accelerate Africa’s transition to a regenerative economy.
Clinton Health Access Initiative (CHAI), Seed Global Health Uganda, Pathfinder Uganda, Amref Africa, Tree Adoption Uganda and Reproductive Health Uganda equally received awards as a token of appreciation for the advocacy and distinguished support to the health sector.
Individual awards went to the Hon. Dr. Jane Ruth Aceng, Minister of Health as a special recognition for her technical, political leadership towards a climate resilient health system. Other officials recognized in the Ministry include; Dr. Diana Atwine, the Permanent Secretary, Dr. Henry Mwebesa, the Director General, Dr. Danie Kyabayinze, Director Health Services -Public Health, Dr. Herbert Nabaasa, Commissioner Health Services -Environmental Health Department and Dr. Didacus Namanya, a Health Geographer/ Climate Change Focal Person at the Ministry of Health for their technical leadership and advocacy.
Among those awarded was Dr. John Bosco Isunju, a Lecturer and Lead on the Climate Change Vulnerability and Adaptation Assessment (VAA) and H-NAP for his technical support and advocacy.
Uganda’s H-NAP was developed to guide climate change adaptation efforts in the health sector and was informed by the Climate Change Vulnerability and Adaptation Assessment (VAA) conducted in 716 selected health facilities across Uganda.
Climate change is by far the greatest threat to human health. Existing scientific evidence from the intergovernmental Panel on Climate Change (IPCC) Assessment Reports and other sources show that environmental determinants of health such as water, food, air among others have been and will continue to directly and indirectly affected. At the same time, all other components of the health system such as the health infrastructure, health workforce, essential products and supply chains are also being negatively affected by climate change.
Uganda is already experiencing the effects of climate change, which is characterized by floods, and landslides with shorter or longer rains, harsher droughts, and warming up in different parts of the country.
Droughts affect the availability of safe and adequate water supply for domestic consumption, and floods contaminate water with disease causing pollutants, which can result in water-related diseases such as typhoid and cholera.
The vulnerability assessment conducted in 2023 had their results shared at national stakeholder’s validation meetings and at the COP28 in Dubai.
The VAA reported that nearly half (47.6%) of healthcare facilities are vulnerable to drought, while 39.7% face the risk of floods in Uganda. Additionally, 31.1% are exposed to storms, 12.0% are at risk from rising water levels, and 11.7% are susceptible to landslides. Lightning poses a threat to 8.9% of facilities, heat waves affect 2.0%, and cold waves impact 0.1%.
Other findings from the VAA assessment reveals that a significant 76.5% of healthcare facilities in Uganda that are affected by drought reported considerable impacts on their health workforce. Additionally, 73.6% experienced disruptions in water, sanitation, and hygiene (WASH) services, while 32.6% faced challenges related to infrastructure, technologies, products, and processes.
This H-NAP that has been launched covers ten components based on the WHO framework aimed at building a climate resilient low-carbon health system which is capable of anticipating, responding to, coping with, recovering from. and adapting to climate-related shocks and stress, while minimising the greenhouse gas emissions and other negative environmental impacts to deliver quality care and protect the health and well-being of present and future generations of Uganda.
The H-NAP proposes a range of short-term and long-term interventions across ten components: climate- transformative leadership and governance, climate-smart health workforce, integrated risk monitoring, and sustainable financing among others. Specific actions include; developing guidelines for mainstreaming climate and health, training health workers, enhancing disease surveillance systems, and revising infrastructure standards for climate-proofing.
Stakeholders at the H-NAP launch noted that its success relies on strong collaboration between government ministries, health agencies, civil society organizations, and the private sector, ensuring a coordinated and effective response to climate change.
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