Malaria is one of the largest causes of morbidity and mortality in Uganda. The disease leads to serious losses in productivity and quality of life.
Malaria is highly endemic in 95% of Uganda, with approximately 90% of the estimated 37.5 million population at risk from Plasmodium falciparum (100% of cases). P. vivax is also present but is not currently responsible for reported cases of malaria. In some areas of northern Uganda, the entomological inoculation rates (infective biting rates by the mosquitoes that transmit malaria) have been among the highest recorded in the world.
The remaining 5% of the country consists of areas with lower instances of transmission such as in the highlands of the south and west, on the eastern border with Kenya as well as the north eastern border with South Sudan. These areas, however, are prone to sporadic epidemics of the disease. Throughout the country, the mean temperature and rainfall allow for high levels of vector propagation and continual malaria transmission.
Worldwide, children and pregnant women are the worst affected by malaria. This means that controlling malaria in Uganda is a significant challenge, as over half of the population is under 15 years of age. Malaria, diarrhoea and pneumonia continue to be the most common causes of death in children under five years in the country. According to the Ministry of Health, malaria accounts for 25 to 40% of outpatient visits to health facilities and is responsible for nearly half of inpatient paediatric deaths.
The Uganda Government is responsible for the Malaria Control Programme (MCP) that focuses on policy and implementation, and the coordination of the Roll Back Malaria (RBM) partnership. The MCP was established in 1995 by the Ministry of Health to direct and guide the implementation of the National Malaria Control Strategy, through: setting standards and quality assurance; resource mobilization; capacity development and technical support; epidemic control, including indoor residual spraying (IRS); coordination of malaria research and monitoring and evaluation.
A core part of the MCP is prevention, advocacy and treatment. Since 2006, the Government has made a significant effort with the support of its partners to increase prevention measures. Over 40% of the population had access to an insecticide treated net (ITN) in 2011. ITNs and long-lasting insecticidal nets (LLINs) continue to be distributed free of charge.
Yet, the country faces many challenges in improving the public health system. Uganda has poor health status indicators, with low quality of health care compounded by an inefficient delivery system. Weaknesses in donor aid coordination and a lack of leadership at the district level create further challenges in controlling malaria.
However, commentators on the future of health care in Uganda highlight a strength of the Ugandan health system: the network of health services at a community level through the village health teams.
In 2014, the Global Fund will support the Uganda Malaria Indicator Survey that will provide national and regional-level coverage and impact data on the main malaria interventions as well as biomarkers for anaemia and parasite prevalence in children under five years of age.
Another major donor and partner in malaria control in Uganda is the United States of America President’s Malaria Initiative (PMI). It aims to assist Uganda in achieving the following targets by the end of 2014:
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This is a project that is being implemented by ABT Associates with funding from PMI and DFID. The ceremony was officiated by the Minister of Health in Charge of Primary Health Care, Hon. Sarah Opendi.Read more