In year 2019, under-five mortality rate was registered at 0.33 (against the target of 1.5 per population). The common cause of death included malaria (30%), lower respiratory tract infection (20%), neonatal death (18%), malnutrition (5.2%) and watery diarrhea (2%). Under-five mortality rate was the highest in Kyangwali refugee settlement at 0.41, followed by Kyaka II refugee settlement at 0.34, Nakivale refugee settlement at 0.29 and Rwamwanja refugee settlement at 0.27. A total of 826,202 consultations were made, of which 20% were host population. Consultations per clinician per day stood at 58 (against the target of 50), compared to 47 consultations per clinician per day in 2018. On an average, each refugee visited the health facility 1.8 times in 2019, compared to 1.3 times in 2018. This was attributed to an influx of new arrivals in Kyangwali and Kyaka II refugee settlements.
In 2019, continuous mosquito nets distribution was done following a mass hang-up campaign conducted in 2018, which ensured community protection from mosquitoes and the availability of anti-malarial treatment for proper treatment of malaria cases. About 78.5% of the refugee households owned at least one mosquito net compared to 83% of the host population households. For children with fever among refugees, 95% of them were tested and treated with anti-malarial treatment compared to 87.7% among the host population.
UNHCR supported the community health workers with equipment such as bicycles, rain coats, umbrellas, torches, registers, gumboots, mega phones and stationary, to help them conduct home visits, mobilize communities for health programmes, refer the sick to the health facilities and conduct health sensitization in their communities.
Refugee settlements participated in the national measles and rubella campaign with the coverage rate of 98.6% among refugees. Preventive measures such as vaccination of children against immunizable diseases such as polio, measles, diphtheria, pertussis and tetanus were conducted. This also ensured that the risk of disease outbreak was reduced among the refugees and host populations in the refugee settlements. A total of 59,358 children received measles vaccine, of which 73% were refugees with a programme coverage of 95% compared to 82% in 2018. Over 36,992 children received polio vaccines, of which 80% were refugees with a coverage of 80% and a drop-out rate of 2.5%.
There was minimal shortage of essential medicines, with the average tracer medicines availability at 80%, enabling continuous treatment for those that needed it. Availability of trained laboratory personnel and laboratory supplies was vital in investigation of the diseases. Referral services were also provided to secondary and tertiary health facilities as well as national level referral hospitals.
About 80% of the settlements reported acceptable quality of care.
Minimal Initial Services Packages were given to new arrivals at point of collection, transit centres, reception centres and comprehensive primary health care facilities in the settlements. As a part of Ebola Virus Disease preparedness, community and health workers trainings were conducted, in addition to surveillance, infection prevention and control. The cholera outbreak was successfully managed with 198 cases and no death. The success was attributed to the established epidemic preparedness and response interventions for both cholera and other diseases of epidemic potential.