Access to comprehensive Primary Health Care (PHC) and medical referral care services was freely availed to all people of concern. Crude and Under Five Mortality rate remained better than SPHERE minimal standards. CMR and U5MR were 0.23/1000/month (standard: 0.75/1000), and 0.66/1000/month (standard: 1.5/1000/month) respectively. Compared to 2019, there was a slight increase of the mortality indicators amongst the Congolese refugees in Nyarugusu camp. Lower Respiratory Tract Infection is the leading cause of Mortality followed by Neonatal deaths and Malaria. Infectious diseases are the top ten causes of morbidities. Sub-optimal living conditions, challenging WASH conditions, infectious disease burden and limited access to health care could be among the causes of the above described morbidity and mortality pattern.
UNHCR health, shelter and WASH sectors along with partners presented some of the interventions to ensure people of concern are secured during the COVID-19 pandemic. UNHCR along with partners installed handwashing facilities in all health facilities, rearranged isolation room at each health facility as well as conducted temperature screening of all POCS entering the camps and in health facilities. Partners at health facilities increased the number of clinic days and proposed specific timetable with specific date and time for each village, and ensured sitting arrangements at the out-patient department adhered to social distancing guidelines. UNHCR in coordination with shelter sector installed two RHUs at Congolese refugee zone for screening at the entrance of the health facility. A total of 160,774 consultations were made with a facility utilization rate of 2.04%. The average consultation/clinician/day in Congolese population is 23, which is within the SPHERE standards of less than 50 consultation per clinician per day. The proportion of consultations for Tanzanian nationals was 8.5%. A total of 4,967 Congolese refugee patients were provided with in-patient care at Nyarugusu camp health facilities during the same period.
The above health service provision was achieved through five health facilities which were maintained and functional including one main hospital, one primary health centre with 24 hr-Inpatient/Outpatient department (OPD) and maternity services along with three health post providing OPD services supported by UNHCR through its partner. Camp health facilities availed health promotion,
outpatient consultations, routine immunization, in-ward-patients care, minor surgical procedures, medical referrals, reproductive healthcare (BEmONC and CEmONC), HIV/AIDS prevention and treatment, mental health, communicable and non-communicable disease management and nutrition assistance.
Nevertheless, access to health services remains a challenge especially for newly arriving asylum-seekers who walk long distances to seek services. Capacity building was done on COVID -19, drug supply and pharmacy management system and new IRHIS to improve the quality of data and reporting at all health facilities in Nyarugusu camp. Essential drugs and medical supplies were availed continuously for health services of people of concern by UNHCR, in collaboration with other sister UN agencies and other partner organizations. Despite the remaining challenges regarding drug management and availability of stocks, the drug supply management, especially the warehouse and pharmacy drug management, has slightly improved if compared to 2019. Essential medicines and medical supplies were availed continuously for health service delivery to people of concern by UNHCR, other sister UN agencies, and operational partners. The parameters of drug management have been improved and stock supplies of essential medicines significantly maintained from 2019. The inventory verification exercise was conducted twice by MFT and routine monitoring done by public health team.