Since the inception of Health Sector Strategic Plan I (HSSPI) in the Fiscal Year 2000, delivery of Healthcare services in the country has not improved greatly mainly due to constraints in Human Resources, Medicines and Health Supplies, Leadership and Management, and Health Infrastructure.
The health sector has been characterised by inadequate staffing in terms of numbers and competencies and this has affected delivery of essential health services. The staffing level currently stands at 47.8% on average but varies greatly between and within the districts. This is partly due to the apparent lack of staff housing which has led to health workers not being attracted to the hard-to-reach areas.
Functional Health Infrastructure in the country is either lacking at designated health facilities or has severely deteriorated due to inadequate budget allocations for capital development and maintenance activities.
The deterioration of the health facility structures has partly led to the low productivity and performance of health workers due to low staff motivation. Uganda has registered improvements in Health Nutrition and Population (HNP) outcomes, but the results remain by and large poor compared to other countries in the region. Maternal Mortality Rate (MMR) is estimated at 435 deaths per 100,000 live births, Infant Mortality Rate (IMR) at 76 deaths per 1000 live births and stunting in children under five at 32%.
While physical access (residing within 5 km radius of a health facility) has improved, reaching a national average of over 72% of the population, utilization and effective coverage of key interventions present a mixed picture mainly due to the limited staff housing especially in the hard to reach areas which has led to the absence of Health Workers.
A number of partners are willing to invest in Infrastructure for Health, but most of this support is targeted to Medical Buildings and Equipment in the relatively easy to reach parts of the country. For the hard to reach areas like Karamoja, very few partners are willing to invest there especially in Staff Housing which is a demotivating factor for staff retention.
This project proposal focuses mainly on Health Infrastructure improvement for the delivery of the Minimum National Health care package were staffing houses will be constructed at HC II and HC IIIs in the karamoja Region districts of Kaabong, Abim, Kotido, Moroto, Amudat, Napak and Nakapiripirit.
The project development objective (PDO) is to deliver the Uganda National Minimum Health Care Package (UNMHCP) 1 in the hard-to-reach areas, through provision of Staff housing at HCIIs and HCIIIs in the Karamoja sub-region.
Project Scope : A total of Sixty Eight (68), 2-bedroom staff units shall be built in the seven districts of Karamoja Region (Abim, Kaabong, Kotido, Moroto, Napak, Amudat and Nakapirpirit districts).
The Project shall be implemented through the existing Institutional arrangements of Government.
Schedule : It is proposed that the project shall be implemented in 36 months, starting April 2016 to October 2019.
This period is broken down as follows:
1. Project Preparation (including preparation of Updating of the Project Document and Project Approval): 3 Months (April 2016 – June 2016).
2. Preparation of Engineering Designs and Tender documents and Procurement of Contractors: 4 Months (July 2016 – October 2016).
3. Implementation of the Works: 29 Months (November 2016 – October 2019).
It is expected that by improving the staff housing in the Karamoja region, the project shall contribute to the delivery of the UNMHCP through improved staff recruitment and retention.
The estimated cost of the project is € 4,939,112 (Euros Four Million Nine Hundred Thirty Nine One Hundred Twelve Only) which includes Euro 4,200,000 to be funded through a grant from the Governmentof the Italian Republic and Euro 739,112 to be financed by the Government of Uganda over the three year period.