The Karamoja region of Uganda has the highest maternal mortality rate in the country. Reproductive, maternal, newborn, child, and adolescent health (RMNCAH) are key priorities, especially due to HIV prevalence and poor nutrition in the region. Health care needs are dire as 32% of deaths in the region are largely due to preventable and treatable diseases such as diarrhea, pneumonia, and malaria. Only 83% of pregnant women in the region in 2017 knew their HIV status.

This is why it is crucial to strengthen Karamoja’s systems at the district, facility, and community levels for maternal and child health, HIV/AIDS, and nutrition services. IntraHealth International worked to do just that through the UNICEF-funded District Health Systems Strengthening on RMNCAH, HIV/AIDS, and Nutrition in Karamoja project.

In partnership with UNICEF, IntraHealth:

• Strengthened the capacities of district health teams and district local governments to plan, implement, and monitor high-quality, equity-focused interventions
• Improved the capacity of health facilities to provide a full range of essential services
• Increased community awareness, demand, acceptance, and utilization of available services.

Using the District Health Systems Strengthening (DHSS) approach, the project created a district-level one health operational plan, initiated regular performance reviews, mapped operational partners, strengthened health management committees and hospital boards, improved quality at the facility level, and integrated service delivery at the community level.

This project focused on 8 districts in Karamoja: Moroto, Kotido, Kaabong, Abim, Amudat, Napak, Nabilatuk, and Nakapiripirit. The project also supported facility-level activities in the newly created district of Karenga, curved out of Kaabong.

Selected Initiatives:

• IntraHealth engaged community gate-keepers, who are the custodians of norms and decision-making within their communities, promoting and maintaining behavior change.
• IntraHealth’s gender-transformative approaches addressed gender norms that affect access to information, resources, mobility, and decision-making, and offered client-focused, gender-sensitive services, especially for young adolescent girls.
• IntraHealth fostered a multisectoral approach through collaboration with the education, agriculture, water, gender, and governance sectors to leverage resources and facilitate health-seeking and health-promoting behaviors.