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. Eighty-three percent of pregnant women in the region are HIV-positive, and 64,000 children have impaired growth and development, in part because 84% of households cannot afford a nutritious diet. 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.

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 is working 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 is working to:

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

Using the District Health Systems Strengthening (DHSS) approach, the project will create a district-level one health operational plan, initiate regular performance reviews, map operational partners, strengthen health management committees and hospital boards, improve quality at the facility level, and integrate service delivery at the community level.

This project focuses on 8 districts in Karamoja, Uganda: Moroto, Kotido, Kaabong, Abim, Amudat, Napak, Nabilatuk, and Nakapiripirit. However, the project support facility level activities in the newly created district of Karenga curved out of Kaabong.

Selected Initiatives:

• IntraHealth engages 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 address gender norms that affect access to information, resources, mobility, and decision-making, and offers client-focused, gender-sensitive services, especially for young adolescent girls.
• IntraHealth fosters 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.