Health Systems Organisation in Uganda Focus on Malaria Control

1. Regional Planning Meeting on District Planning Guidelines for Malaria Control(MCEA Office : 17TH to 19TH January 2005) Health Systems Organisation in Uganda Focus on Malaria Control Dr. Frederick K. Kato. Senior Medical officer National Malaria Control Programme Ministry Of Health, Uganda.

2. Main Administrative Levels in Uganda • The national referral hospitals and the regional referral hospitals are administratively directly under the Central Government; all other health care facilities are under the District Local Government. • The Malaria Control Programme is administratively under the Department of National Disease Control but functionally it falls under other departments as well (e.g. Department of Community Health Services for the home based management of fever and Department of Clinical Health Services for the facility based management of both severe and uncomplicated malaria).

3. Central Government Core Functions Policy formulation Setting standards Quality assurance Resource mobilisation Capacity development Technical support Provision of nationally coordinated services e.g. epidemic control Coordination of health research Monitoring and evaluation of overall sector performance District Local Government Core Functions Implementation of the national health policy Planning and management of district health services Provision of disease prevention, health promotion, curative and rehabilitative services with emphasis on the minimum health care package and other national priorities Control of other communicable diseases of public health importance Vector control Health education Ensuring provision of safe water and sanitation Health data collection, management, interpretation, dissemination and utilisation Core Functions of Central Government and District Local Governments

4. Note: The Malaria Control Programme is under the Department of National Disease Control

5. There are 8 drivers. All are not on the Ministry of Health payroll • The position of Medical Officer under Senior Medical Officer Malaria Case Management is filled by a Senior Medical Officer in charge of Malaria in Pregnancy • There are staff seconded from Malaria Consortium (an administrator and an information officer) and from Health Promotion (a health educator and assistant)

6. Organisational Structure of Malaria Control at National Level The Inter-Agency Coordination Committee for Malaria (ICCM) presided over by the minister for health advises the MoH Top Management on all aspects of malaria prevention and control. Technical Working Groups advise the ICCM on technical matters of malaria control The National Malaria Control programme (NMCP) headed by the Programme Manager is responsible for malaria control in the country Focal persons within the NMCP coordinate specific aspects of malaria control. Zonal coordinators based in regional referral hospitals assist these focal persons when necessary.

7. Organisational Structure of Malaria Control at District Level • The District Health Team (DHT) headed by the District Director of Health Services (DDHS) is responsible for implementation of malaria control in the district. It is answerable to the Social Services Committee of the District Local Council to the centre. Health sub-districts serve to decentralise district malaria control services and bring them nearer to where they are most needed.. • A malaria focal person within the DHT coordinates malaria control activities within the district. • Health facilities headed by Directors or Medical Superintendents (for hospitals) or health unit in-charges (for health centres) are responsible for the clinical management of patients with uncomplicated malaria or severe malaria. They are answerable to the health facility Management Committees and to the DDHS. • Community resource persons (e.g. drug distributors) assist to deliver malaria control services within communities. They are answerable to the communities which they serve and to the health facilities in whose defined catchment area they are located.

8. Malaria Control : Organisational Structure Ministry of Health Top Management Inter Agency Coordination Committee for Malaria Malaria Control Programme/Unit Technical Working Groups District Health Committee District Health Team Health Facility Management Committee Health Facility Management Team Village Health Committee? Village Health Team There is no regional/federal administrative level in Uganda. However , in order to assist the Central Government fulfill some of its functions the Malaria Control Programme has grouped districts into clusters or zones with ‘zonal coordinators of malaria control activities’ based on regional referral hospitals .