1 / 17

Approaches to service delivery and the implications for public administration

Approaches to service delivery and the implications for public administration. Dr. Vincent Bagambe ( MoH-Global Fund, Uganda). Presentation Overview. Global Statistics on HIV Burden of HIV in Uganda Drivers of the epidemic Goals & Strategies for HIV Response

pricky
Download Presentation

Approaches to service delivery and the implications for public administration

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Approaches to service delivery and the implications for public administration Dr. Vincent Bagambe (MoH-Global Fund, Uganda)

  2. Presentation Overview • Global Statistics on HIV • Burden of HIV in Uganda • Drivers of the epidemic • Goals & Strategies for HIV Response • Achievements/response to the epidemic • Challenges • Priorities for the period 2015-2025

  3. Summary of Global HIV/AIDS epidemic Statistics Source: UINAIDS 2014

  4. Summary of Global HIV/AIDS epidemic Trends Source: UINAIDS 2014

  5. Uganda’s Response in the Regional and Global Context Trends in new HIV infections for 10 top sub-Saharan African countries: 2005-2013 Source: UNAIDS 2013

  6. Burden of HIV • Uganda has been affected by the HIV/AIDS epidemic since the early 1980’s • HIV prevalence among adults aged 15-49 years is now 7.3% • Women disproportionately more affected than men (8.3% Vs 6.1%) • Estimated No. of people living with HIV (PLHIV) by 2015: 1,544,000

  7. BURDEN OF DISEASE IN UGANDA: HIV/AIDS STATISTICS IN 2015

  8. Drivers of HIV Transmission • Behavioural factors • Multiple sexual partnerships, • Cross-generational, early and transactional sex • Alcohol and substance abuse • Structural/Policy related Factors comprise of: • Inequitable access to health services, • Governance, Accountability, Coordination, and • Stigma and discrimination.

  9. Drivers of HIV Transmission • Socio-economic factors • Harmful socio-cultural practices e.g. polygamy & widow inheritance • Gender norms (women can’t negotiate for safer sex • Gender-based violence, • Violation of rights of women and girls, • Economy & mobility (migrant work, poverty and wealth)

  10. Impact of HIV on Uganda • AIDS Deaths: • About 1,973,000 people died of AIDS related causes between 1990 & 2012 • Economic Impact • Reduced labor supply, by reducing population growth • Reduced productivity and investment due to morbidity • Increased spending on HIV/AIDS: from 0.6% of GDP in 2004 to 1.5% in 2007 & to 3.0% in 2012 • Social Impact • Increased household poverty • increased OVC: 21% of Ugandan children are either orphaned or vulnerable (OVC)

  11. Overall Goal and Sub-Goals

  12. Key Achievements to date, towards HIV response • Uganda decreased HIV prevalence from a peak of 18% in 1992 to a low of 6.1% in 2002; • But got a resurgence to 6.3% in 2004/05 & to 7.4% in 2011 • New infections increased from 95,000 in 2002 to 160,000 in 2011 • Strengthened delivery systems • 72% individuals within 5 kms of a health facility • HIV testing taken beyond health facilities to outreaches • Strategic information management has improved • DHIS2 and Open MRS system • Aids Indicator Surveys regularly done

  13. Key Achievements to date, towards HIV response • Access to HCT services Increased from 24% in 2006 to 50% in 2011 (5M people) • Increased SMCs from 400,000 in 2012, to 1,023,357 (at 1295 sites) in 2014 • Increased ART facilities from 475 in 2011 to 1,603 by June 2014 • Improvements in lab infrastructure: 100 regional hubs and Early Infant Diagnosis testing centres established

  14. TREATMENT – UGANDANS ACCESSING ART Coverage improved: Access points for ART increased to 100% hospitals, 100% HCIVs and 63% HCIIIs now providing ARTs; BUT Eligible PLHIV increased: to 821,721 (2014 at CD4-350) and +1.3m (2015 at CD4-500) Source: MoH (2013)

  15. Challenges • Inadequate budgetary provision to support critical HIV services (e.g. WHO guidelines) • Poor infrastructure with mostly dilapidated buildings • Inadequate staffing especially for the rural based health facilities • Poor supply chain management, hence stock outs/expiries of drugs &essential commodities • Inaccessible laboratory monitoring services • Weak M&E systems,

  16. HEALTH FINANCING REMAINS INADEQUATE : 2007/08-2010/11 & 2011/12-2014/15 WHO Recommendations Abuja Declarations Source: UAC (2011)

  17. Prioritization period 2015-2025 • Scale up ART to reach 80% coverage with treatment for the MARPs, irrespective of CD4 count; • Expand eMTCT coverage with ARVs to 95% among HIV infected pregnant women • Promote SMC to attain 80% coverage by 2025 • Increase accessibility to and use of condoms in high-risk sexual encounters (80%); • Scale up HTC to 50% of eligible population annually; • Promote BCC focusing on sex workers, MSM, fishing communities, truckers and uniformed personnel as well as young people in and out of school

More Related