Over the last twenty years, Uganda has experienced slow progress in reduction of child and maternal mortality rates (MDG 4 and 5). We have the tools and knowledge to change that trajectory to bring an end to preventable deaths; with greater participation of all partners and stakeholders, a change in focus, and commitment to hold ourselves accountable. Uganda has developed this evidence-based country plan to address the slow progress on MDG 4&5 targets. The plan examines why the country is making slow progress in attaining the targets; reviews the maternal, newborn and child mortality and morbidity situation in Uganda; sets an agenda for how to accelerate progress; establishes the time horizon for the acceleration to the MDG targets; and proposes five strategic shifts in doing business differently or greater impact. The plan is aligned with Uganda’s Vision 2040, and is anchored in the National Development Plan (NDP) 2010/11 – 2014/15.
The purpose of this plan is to activate collective action towards achieving equitable accelerated improvements in maternal, newborn and child mortality in Uganda. This is a movement to child and maternal survival and partners and civil society organizations will be working together to assure the promise renewed. Our vision and our responsibility is to end preventable deaths in the context of attaining targets for MDGs and beyond by ensuring a strategic shift to doing business and universal coverage of high impact health interventions using all three delivery platforms (communities, population-scheduled and individual clinical services).
This plan proposes five strategic shifts; as the priority for a forward-looking, compelling and integrated sustainable RMNCH agenda for keeping the promise of the MDGs and remain beyond 2015. The five shifts will form the focus for action and introduce a paradigm shift that will overcome the obstacles to prevent avoidable death. The five strategic shifts are:
- Focus Geographically – Increase efforts in districts where half of U5 deaths occur, proiritising budgets and committing to action plans to end preventable deaths
- High Burden Populations – Refocus district to scaling up access for the underserved population groups; Delivery of integrated servcie packages at the 3 service delivery platforms
- High Impact Solutions – Target delivery and PNC as the biggest opportunities for impact; Scale and sustain supply of high impact interventions; Invest in operations research to accelerate results
- Education, Empowerment, Economy, Environment – Educating girls and women; Empower women to make decisions; Address environmental Factors e.g. sanitation & hygiene
- Mutual Accountability – Mutual accountability for result at all levels of the health system; Unify maternal and child survival voice with shared goal and M&E; Update Roadmap to reflect state of knowledge and progress
The Lives Saved Tool (LiST) was used to identify and prioritize a handful of existing and doable evidence-based and focused interventions that have the greatest impact on reducing mortality and improving health. These priority interventions are anchored in existing strategies and plans of the Ministry of Health. They will be implemented alongside the on-going interventions, which are necessary to sustain the current gains. The key results and targets of this plan are outlined in the matrix below. The cost of the plan is US$ 682 million; and it will avert an additional total of 137,573 deaths.