KASESE DISTRICT AND RWENZORI REGION – AN OVERVIEW
Geographical location.
Rwenzori Rural Health Services operates currently in Kasese District; one of the Districts that comprises the Rwenzori Region in western Uganda. The region derives it’s name from the Rwenzori Mountains which is the highest mountain in Uganda with it’s highest peak at 5,110m above the sea level. Being Block Mountain, it gives the area fascinating scenery characterized by the snow-capped mountain tops, that the western arm of East Africa Albert tine Rift valley, the rolling hills and flatlands. The Rwenzori Region boarders the Democratic Republic og Cong in the west, Mubende District in the East, Kibaale District in the North, Ibanda and Kiruhura districts in the south.Climate Conditions: The Rwenzori Region Lies astride the equator and therefore it has an equatorial climatic characterized by hill rain fall totals and high temperature conditions. However, the terrain of the area has given the region varying climatic conditions ranging from temperate to semiarid. Some parts of Kabarole, Kasese and Bundibugyo, especially in the mountain areas, receive more than 2,250mm as mean annual rainfall while the low lands receive bout 1,200mm as mean annual rainfall.
Kasese District Source: Kasese Status Report 2007:
Kasese became a District in 1974. The district vision is to have a poverty free society. More information about Kasese District, Visit the District website: www.kasese.go.ug
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Health situation Kasese District - Uganda
Development challenges facing the health sector.
(Source of information: District Development Plan 2007/2008)
Healthy people are expected to be more productive thus leading to positive development. Similarly, developed people have the will and are financially capable of seeking for health whenever desired thus rendering developed communities healthier than less developed ones. Health and development are therefore mutually reinforcing. Kasese district however has a number of health related issues posing a challenge to its development.
The district has 97 public, private for profit and private not-for-profit health units. This is a big number yet the Ministry of Health limits the district quota for health workers that are recruited per year due to the budgets ceiling on the wage bill. This therefore creates a chronic shortage of health workers in the district. The rate of attrition of the health workers due to either seeking greener pasture, going for further studies or death, among others, further compounds the health manpower problem. On a similar note, the district is remote in comparison to a number of other districts in the country thus health workers are unwilling to work in the district.
The big number of health facilities, coupled with the manpower shortage renders the supervision function of the district health managers inappropriately done. This therefore negatively affects the quality of services being delivered thus propagating further the poor health situation of the people.
This therefore calls for the need for the district to institute some innovative means of attracting and retaining health workers. Communities at every opportunity should couple this with halting the unplanned construction of health units that in the long run lead to poor service delivery and poor health as well as inadequate supervision and resources.
Involvement of men in health issues is low, as evidenced by the proportion of males involved in health interventions that require community participation. This may partly be attributed to an attitudinal problem on the part of men. Since men are the major sources of money required while health seeking, there are not being positive towards health matters which undermines the women's and children’s social, economic and physical well-being, which impinges on development.
On a similar note, poor health seeking behavior by men predispose them more to illness, thus rendering them less productive, which have negative consequences on the development of the district.
Low male involvement in family planning matters has also contributed to the high fertility rate in the district that leads to large families, which can not be sustained adequately by available resource. Hence the social service delivery system is straining further.
(District development plan+DDP+Chapter three 2007/2008, page 123)
Challenges in summary.
The health sector has limited funding to satisfactory implementation of departmental interventions. Much of the minimal funds available are spent on creating awareness on health issues to enable empowerment of communities for positive behavioral change towards desired healthy lifestyles. Behavior change however does not match awareness about health issues, hence the continued occurrence of preventable illness. This has led to the continued drainage of the scarce resources on illness that would have been prevented through appropriate behavior change. On a similar note, insufficient funding has led to a chronic shortage of medical equipment, drugs and health supplies at the health units.
The incidence of HIV/AIDS and other communicable diseases in the district is very high, given the fact that the most productive age group (15-49 years) is the most affected with morbidity and mortality due to HIV/AIDS. Since these children lack parents, they are more predisposed to poor health therefore constraining the already severely constrained health sector further.
Low motivation of health workers is also negatively affecting the quality of services delivery at health facilities. This is due to a number of reasons including insufficient salary, poor working conditions due to inadequate equipment, dilapidated health infrastructure, lack of accommodation, etc. The majority of the contributors to the low motivation of the health workers are unfortunately way beyond the capacity of Kasese district as whole and the district directorate of health service in particular to address in short term, thus requiring a lot of input from external sources that would require a lot of political and civil support through increased lobbying. This support however is still insufficient in the district.
The district is bordered by the Democratic Republic of Congo (DRC) on its western side. Due to breakdown in the social service delivery structure in the eastern part of Congo, the population there seeks for services from health facilities neighboring the Congo, especially in Kasese.
(Source - District development plan chapter three 2007/2008, page 124.)
Situation analysis:
Small Catchment area in Kasese District:
Total population: 150,533
Males: 73,899
Female: 76,634
HH: 27,428
Total Population: 150,533
Doctors to population ratio: 1 per 31,300
Midwife nurse to population ratio: 1 per 2,196
Development challenges facing the health sector.
(Source of information: District Development Plan 2007/2008)
Healthy people are expected to be more productive thus leading to positive development. Similarly, developed people have the will and are financially capable of seeking for health whenever desired thus rendering developed communities healthier than less developed ones. Health and development are therefore mutually reinforcing. Kasese district however has a number of health related issues posing a challenge to its development.
The district has 97 public, private for profit and private not-for-profit health units. This is a big number yet the Ministry of Health limits the district quota for health workers that are recruited per year due to the budgets ceiling on the wage bill. This therefore creates a chronic shortage of health workers in the district. The rate of attrition of the health workers due to either seeking greener pasture, going for further studies or death, among others, further compounds the health manpower problem. On a similar note, the district is remote in comparison to a number of other districts in the country thus health workers are unwilling to work in the district.
The big number of health facilities, coupled with the manpower shortage renders the supervision function of the district health managers inappropriately done. This therefore negatively affects the quality of services being delivered thus propagating further the poor health situation of the people.
This therefore calls for the need for the district to institute some innovative means of attracting and retaining health workers. Communities at every opportunity should couple this with halting the unplanned construction of health units that in the long run lead to poor service delivery and poor health as well as inadequate supervision and resources.
Involvement of men in health issues is low, as evidenced by the proportion of males involved in health interventions that require community participation. This may partly be attributed to an attitudinal problem on the part of men. Since men are the major sources of money required while health seeking, there are not being positive towards health matters which undermines the women's and children’s social, economic and physical well-being, which impinges on development.
On a similar note, poor health seeking behavior by men predispose them more to illness, thus rendering them less productive, which have negative consequences on the development of the district.
Low male involvement in family planning matters has also contributed to the high fertility rate in the district that leads to large families, which can not be sustained adequately by available resource. Hence the social service delivery system is straining further.
(District development plan+DDP+Chapter three 2007/2008, page 123)
Challenges in summary.
The health sector has limited funding to satisfactory implementation of departmental interventions. Much of the minimal funds available are spent on creating awareness on health issues to enable empowerment of communities for positive behavioral change towards desired healthy lifestyles. Behavior change however does not match awareness about health issues, hence the continued occurrence of preventable illness. This has led to the continued drainage of the scarce resources on illness that would have been prevented through appropriate behavior change. On a similar note, insufficient funding has led to a chronic shortage of medical equipment, drugs and health supplies at the health units.
The incidence of HIV/AIDS and other communicable diseases in the district is very high, given the fact that the most productive age group (15-49 years) is the most affected with morbidity and mortality due to HIV/AIDS. Since these children lack parents, they are more predisposed to poor health therefore constraining the already severely constrained health sector further.
Low motivation of health workers is also negatively affecting the quality of services delivery at health facilities. This is due to a number of reasons including insufficient salary, poor working conditions due to inadequate equipment, dilapidated health infrastructure, lack of accommodation, etc. The majority of the contributors to the low motivation of the health workers are unfortunately way beyond the capacity of Kasese district as whole and the district directorate of health service in particular to address in short term, thus requiring a lot of input from external sources that would require a lot of political and civil support through increased lobbying. This support however is still insufficient in the district.
The district is bordered by the Democratic Republic of Congo (DRC) on its western side. Due to breakdown in the social service delivery structure in the eastern part of Congo, the population there seeks for services from health facilities neighboring the Congo, especially in Kasese.
(Source - District development plan chapter three 2007/2008, page 124.)
Situation analysis:
Small Catchment area in Kasese District:
Total population: 150,533
Males: 73,899
Female: 76,634
HH: 27,428
Total Population: 150,533
Doctors to population ratio: 1 per 31,300
Midwife nurse to population ratio: 1 per 2,196