uganda nutrition quarterly bulletin
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1
UGANDA NUTRITION QUARTERLY BULLETINTHE REPUBLIC OF UGANDA
MINISTRY OF HEALTH
Volume 1 | Issue 2 | June 2020
2
Highlights …………………………………..................… 3
Nutrition Reporting (Completeness) …...............……. 4
Nutrition Reporting (Timeliness) ……................……... 9
Assessment of Nutrition Status …..................……….. 11
SAM and MAM admissions …………..................……. 14
Performance Outcomes for IntegratedManagement of Acute Malnutrition .............................. 16
IFA and Vitamin A supplementation ............................. 23
Poor Birth Outcomes ................................................... 25
In this issue
2
3
Welcome to the 2nd Issue of the Nutrition Quarterly Bulletin! This issue focuses on the 2nd quarter (April to June 2020) of the fiscal year (FY) 2020/21. The rationale of preparing the Nutrition Quarterly Bulletin is to show performance on key nutrition indicators on the following aspects; reporting, Severe acute malnutrition (SAM) and Moderate acute malnutrition (MAM) admissions, SAM and
Dear Stakeholders
Key Highlights
MAM nutrition outcome indicators (cure, death, defaulter and nonresponse rate), Iron folate, vitamin A supplementation and deworming among others. This analysis is intended to help the Ministry of Health and all stakeholders appreciate performance of nutrition service delivery in the country to facilitate approaches for improvement towards achieving better outcomes as well as advocacy.
Number and proportion of children identified with SAM and admitted into treatment during quarter 1 and 2 (Jan-June 2020)
SAM admissions : 19,825Estimated SAM burden: 219,731
MAM admissions : 84,974Estimated National MAM burden: 456,365
Achievement : 3,632,820Number of children, 6-9 months of age in Uganda : 6,500,930
Achievement : 1,802,004Number of children, 12-59 months of age in Uganda : 5,752,140
Number and proportion of children identified with MAM and admitted into Supplimentary Feeding Program (SFP) during quarter 1 and 2 (Jan-June 2020)
Number and proportion of children aged 6-59 months who received vitamin A supplements (1st and 2nd dose) Jan – June 2020
Number and proportion of children aged 12-59 months who received deworming tablets (Jan-June 2020)
9%
55.9%
19%
31.3%
3
4
99 96 99 96 100
93 96 94 95
84
93 98 98 96 100
85
79 80
86 85
77 76 73
89
79
53
91 89
76
90
0
20
40
60
80
100
120
Ank
ole
Bus
oga
Teso
Bug
isu
Lang
o
Nor
th C
entr
al
Ach
oli
Kam
pala
Toor
o
Sout
h C
entr
al
Buk
edi
Kar
amoj
a
Kig
ezi
Bun
yoro
Wes
t nile
% R
epor
ting
rate
REPORTING RATE FOR OPD 105 MONTHLY REPORT AND IPD 108 MONTHLY REPORT FOR Q1 AND Q2-ALL REGIONS
• Overall, the average national reporting rate for the 105 Outpatient Monthly Report (where Vitamin A supplementation, SAM outcomes, LBW, IFA and Deworming interventions are reported) increased from 94.2% in Q1 to 97% in Q2 .
• Similarly, IPD 108 reporting rate where SAM outcomes for ITC are reported increased from 80.3% in Q1 to 86.1% in Q2.
• Although reporting performance on key nutrition data elements has improved, IPD reporting rate still remains low.
• Average reporting rate across all regions for IPD 108 monthly report is lower than for OPD 105 report.• Bukedi is the worst performing district in both Q1 and Q2 in terms of IPD monthly reporting.• Lango and West Nile are the best performing regions in OPD monthly reporting in quarter one whereas
Bugisu, Tooro, Kigezi and tooro are the best.
National Nutrition Reporting Performance (*): Completeness1 in Q1 - FY 2020/21
0
20
40
60
80
100
120
% R
epor
ting
rate
98 99 99 100
99 97 99
91
100
89
97 99 100
98 100
84
89 93 90
84 84
78 78
95
87
62
95 93
79
95
Ank
ole
Bus
oga
Teso
Bug
isu
Lang
o
Nor
th C
entr
al
Ach
oli
Kam
pala
Toor
o
Sout
h C
entr
al
Buk
edi
Kar
amoj
a
Kig
ezi
Bun
yoro
Wes
t nile
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
OPD 105 monthly Reporting rates
IPD 108 monthly reporting rate
Target
KEY
4
*Reporting Performance refers to the completeness and timeliness of the reports submitted by various districts to the national DHIS2 system.
• Completeness refers to the percentage of reports registered as complete based on the number expected for the case of completeness.
• Timeliness refers to the quality of submitting reports within the set national standard date of submission i.e. not later than 15th of every month.
5
100
90.9
68.8
96.4
91.4 100
98.6
100
100
100
98.2
100
96.4
94 100
100
87.5 60
73.8
76.9
93
91.7
85.4
93.7
71.1
100
79.2
100 49
.2
94.4
020406080
100120
Isin
giro
Dis
tric
t
Kita
gwen
da D
istr
ict
Kye
gegw
a D
istr
ict
Kam
wen
ge D
istr
ict
Lam
wo
Dis
tric
t
Adj
uman
i Dis
tric
t
Kob
oko
Dis
tric
t
Aru
a D
istr
ict
Yum
be D
istr
ict
Moy
o D
istr
ict
Mad
i-Oko
llo D
istr
ict
Obo
ngi D
istr
ict
Hoi
ma
Dis
tric
t
Kiry
ando
ngo
Dis
tric
t
Kik
uube
Dis
tric
t
% R
epor
ting
rate
REPORTING RATE FOR OPD 105 MONTHLY REPORT AND IPD 108 MONTHLY REPORT FOR Q1 AND Q2-HUMANITARIAN CONTEXT
• Generally, OPD reporting rate is higher than IPD reporting rate.• All humanitarian districts achieved the target OPD monthly reporting rate for both Q1 and Q2 apart
from Kyegegwa district in Q1.• Generally, there was increase in both OPD and IPD monthly reporting rate in almost all the refugee
hosting districts for instance kyegewa having the highest increase from 68% to 91.5% for OPD monthly report and 40% increment in Q2 for IPD monthly reporting.
• In terms of OPD reporting rate Kyegegwa was the worst performing district in Q1 and Q2 while for IPD monthly reporting Kiryandongo was the worst performing district in Q1 and Q2.
Humanitarian Context Nutrition Reporting Performance (*): Completeness Of Reports
99.5
97 95.8
100
98.9
100
100
99.5
100
100
100
100
97.3
94.9 100
97.7
95.8
100
88.1
87.2
100
94.4
78.9
100
100
100
100
100
46
88.9
Isin
giro
Dis
tric
t
Kita
gwen
da D
istr
ict
Kye
gegw
a D
istr
ict
Kam
wen
ge D
istr
ict
Lam
wo
Dis
tric
t
Adj
uman
i Dis
tric
t
Kob
oko
Dis
tric
t
Aru
a D
istr
ict
Yum
be D
istr
ict
Moy
o D
istr
ict
Mad
i-Oko
llo D
istr
ict
Obo
ngi D
istr
ict
Hoi
ma
Dis
tric
t
Kiry
ando
ngo
Dis
tric
t
Kik
uube
Dis
tric
t020406080
100120
% R
epor
ting
rate
Districts per quarter
Q1 2020
Q2 2020
Districts per quarter
OPD Monthly Reporting rate
IPD Monthly Reporting rate
Target
KEY
*Reporting Performance refers to the completeness and timeliness of the reports submitted by various districts to the national DHIS2 system.
• Completeness refers to the percentage of reports registered as complete based on the number expected for the case of completeness.
• Timeliness refers to the quality of submitting reports within the set national standard date of submission i.e. not later than 15th of every month.
6
• Generally Reporting performance in terms of completeness is relatively good.• All hospitals submitted their OPD and IPD monthly reports apart from Gulu which did not submit the
IPD monthly report in April and June.• There was improvement in OPD monthly reporting rate in Q2 compared to Q1.(in Q1 one RRH did not
submit the report compared to none in Q2).• In terms of IPD monthly reporting there was a decline in Q2 with Gulu RRH not submitting a monthly
report twice compared to only 1 month in Q1.• Note: Gulu regional referral didn’t submit IPD reports in both Q1 and Q2, more strategic efforts are
needed for support.
Regional Referral Hospital Nutrition Reporting Performance: Completeness (*) Q2 - FY 2020/21
Masaka RRH
Hoima RRH
Lira RRH
Mbarara RRH
Mubende RRH
Soroti RRH
CUF (Naguru) RRH
Fort Portal RRH
Jinja RRH
Kabale RRH
Gulu RRH
Arua RRH
Mbale RRH
Moroto RRH
OPD Monthly Report Reporting rate
Data
Period Apr 2020 Apr 2020May 2020 May 2020June 2020 June 2020
IPD Monthly Report Reporting rate
SubmittedKEY 1 Did not report
*Reporting Performance refers to the completeness and timeliness of the reports submitted by various districts to the national DHIS2 system.
• Completeness refers to the percentage of reports registered as complete based on the number expected for the case of completeness.
• Timeliness refers to the quality of submitting reports within the set national standard date of submission i.e. not later than 15th of every month.
7
0
20
40
60
80
100
120
100
99K
aabo
ng
100
100
Kar
enga
100
100
Abi
m
100
98M
orot
o
9510
0A
mud
at
100
100
Nab
ilatu
k
100
100
Nak
apiri
pirit
8899
Kot
ido
98 100
Nap
ak
% R
epor
ting
rate
KARAMOJA NUTRITION REPORTING PERFORMANCE-OPD AND IPD MONTHLY REPORTING RATE FOR Q1 AND Q2
• There was an improvement in the average nutrition performance for Karamoja in terms of completeness for both Outpatient and IPD Monthly reports in Q2 compared to Q1 (OPD monthly reporting rate improved from 97.5 in Q1 to 99.3 in Q2 whilst IPD monthly reporting rate improved from 90.8% to 96.6%).
• However, in Q2 there was a decline in OPD reporting rate of 13%, 22%, 9% and 6% for Abim, Moroto, Amudat and Kotido respectively.
• Moroto was the worst performing district in terms of IPD reporting rate in Q2.
Karamoja Region Nutrition Reporting Performance: Completeness (*) Q2 - FY 2020/21
0
20
40
60
80
100
120
% R
epor
ting
rate
100
100
Kaa
bong
100
100
Kar
enga
8710
0A
bim
78 82M
orot
o
8691
Am
udat
100
100
Nab
ilatu
k
100
100
Nak
apiri
pirit
8296
Kot
ido
100
100
Nap
ak
Districts per quarter
Q1 2020
Q2 2020
Districts per quarter
OPD Monthly Reporting rate
IPD Monthly Reporting rate
Target 80
KEY
*Reporting Performance refers to the completeness and timeliness of the reports submitted by various districts to the national DHIS2 system.
• Completeness refers to the percentage of reports registered as complete based on the number expected for the case of completeness.
• Timeliness refers to the quality of submitting reports within the set national standard date of submission i.e. not later than 15th of every month.
8
100
90.9
68.8
96.4
91.4 10
0
98.6
100
100
100
98.2
100
96.4
94 100
100
87.5
60 73.8
76.9
93
91.7
85.4 93
.7
71.1
100
79.2
100
49.2
94.4
0
20
40
60
80
100
120
Isin
giro
Kita
gwen
da
Kyeg
egw
a
Kam
wen
ge
Lam
wo
Adju
man
i
Kobo
ko
Arua
Yum
be
Moy
o
Mad
i-Oko
llo
Obo
ngi
Hoi
ma
Kiry
ando
ngo
Kiku
ube
99.5
97 95.8 100
98.9
100
100
99.5
100
100
100
100
97.3
94.9 100
97.7
95.8 10
0
88.1
87.2 10
0
94.4
78.9
100
100
100
100
100
46
88.9
0
20
40
60
80
100
120
Isin
giro
Kita
gwen
da
Kyeg
egw
a
Kam
wen
ge
Lam
wo
Adju
man
i
Kobo
ko
Arua
Yum
be
Moy
o
Mad
i-Oko
llo
Obo
ngi
Hoi
ma
Kiry
ando
ngo
Kiku
ube
REPORTING RATE FOR OPD 105 MONTHLY REPORT AND IPD 108 MONTHLY REPORT FOR Q1 AND Q2-ALL REGIONS
• Generally OPD monthly reporting rate in terms of completeness is good across all refugee hosting districts.
• There was an improvement in nutrition performance reporting in terms of OPD and IPD monthly reporting in Q2 compared to Q1.
• Kiryandongo is the wort performing district in terms of IPD monthly reporting rate (for all 3 months it had less than 60%).
Humanitarian Context/Refugee Hosting Districts (Nationals) Nutrition Reporting Performance: Completeness Q2 - FY 2020/21
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
OPD Monthly Reporting Rates
IPD Monthly Reporting Rate
TargetKEY
9
“Reporting performance on timeliness is still low in across all regions. More strategic efforts are required for improvement”.
• Generally, there was an improvement in OPD monthly reporting rate on time (timeliness) in Q2 (76%) compared to Q1 (54%).
• Average reporting rate on time for both IPD and OPD in quarter 1 across all regions is less than target( 80%) apart from Kigezi and West Nile region.
• Kampala is the worst performing region in terms of timely reporting for both IPD and OPD for both Q1 and Q2.
• Kigezi and West Nile are the best performing regions for Q1and Q2 respectively.
National Nutrition Reporting Performance: Timeliness for Q2 - FY 2020/21
60.3
54.6
80.4
56
62.2
37.2
20.4
48.8
88.9
69.4
42.9
63.9
54.9 58
.9 62.3
50
36.4
74.2
47.6
38.1
28.5
15.2
40.2
80
45.2
33.8 41
.5
53 50.6
41.4
0
20
40
60
80
100
120
Bug
isu
Ach
oli
Wes
t Nile
Bun
yoro
Buk
edi
Bus
oga
Kam
pala
Kar
amoj
a
Kig
ezi
Lang
o
Nor
th C
entr
al
Teso
Sout
h C
entr
al
Toor
o
Ank
ole
% R
epor
ting
rate
REPORTING RATE ON TIME FOR OPD 105 AND IPD MONTHLY REPORT ACROSS ALL REGIONS IN Q1 AND Q2
0
20
40
60
80
100
120
% R
epor
ting
rate
91.2
78.3
95.8
85.3 89
80.9
33.8
93.2 98
.2
82.1
65.1
87.1
68.1
86
77.5
78.7
60.6
88.1
62.2
55.8
68
49.6
79.9 88
.5
64.8
53.4
78.5
67.9 71
.5
62.3
Bug
isu
Ach
oli
Wes
t Nile
Bun
yoro
Buk
edi
Bus
oga
Kam
pala
Kar
amoj
a
Kig
ezi
Lang
o
Nor
th C
entr
al
Teso
Sout
h C
entr
al
Toor
o
Ank
ole
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
OPD 105 reporting rate on time
IPD 108 reporting rate on time
Target
KEY
10
• Generally, IPD and OPD monthly reporting rate in terms of timeliness is relatively fair.• There was an improvement in timeliness reporting for both OPD and IPD monthly report in Q2
compared to Q1.• The best performing RRHs in both IPD and OPD reporting rate in terms of timeliness include Hoima,
Masaka, Kabale and Mbale• The worst performing RRH in terms of timely submission of OPD reports in Q2 include Lira, Jinja and
Soroti while in terms of IPD monthly report it is Arua, Gulu and Naguru.
Regional Referral Hospital (RRH) Nutrition Reporting Performance: Timeliness Q2 - FY 2020/21`
Submitted report on timeKEY 2 Did not report
on time
Hoima RRH
Arua RRH
Gulu RRH
Fort Portal RRH
Masaka RRH
Mbarara RRH
Kabale RRH
Lira RRH
Moroto RRH
Jinja RRH
Mbale RRH
Mubende RRH
Soroti RRH
CUF (Naguru) RRH
OPD 105 Monthly Reporting rate on time
Data
Organisation unit / Period Apr 2020 Apr 2020May 2020 May 2020June 2020 June 2020
IPD 108 Monthly Reporting rate on time
11
66.7
55.6
47.6 57
.9
15.4
61.1
53.8
7.6
78.4
59.3
55.6
46.7
40.7
4.8
66.7
33.3
7.4
76.2
0
20
40
60
80
100
120
Kaab
ong
Kare
nga
Abim
Mor
oto
Amud
at
Nab
ilatu
k
Nak
apiri
pirit
Ko�d
o
Nap
ak
emit no etar gnitropeR
%
KARAMOJA NUTRITION PERFORMANCE - TIMELINESS (OPD 105 AND IPD 108 MONTHLY REPORTING RATE ON TIME)
• Generally there was an improvement in timely submission of the OPD and IPD monthly reports in Q2 compared to Q1.
• The average OPD monthly reporting rate on timeliness for Karamoja increased by 25% in Q2 ( 48.8% in Q1 to 93.2% in Q2).
• In Q1 all the districts in Karamoja did not meet the target (80%) for both timely reporting for OPD and IPD monthly reports.
• The average IPD monthly reporting rate on time for Karamoja improved by 39.7% (40.2% in Q1 to 79.9% in Q2). Although there was an improvement in IPD reporting rate on time it is still low.
• In Q2 worst performing district was Nabilatuk for OPD monthly report and Amudat for IPD monthly report on time.
• The best performing district in Q2 was Karenga ie all the health facilities in this district submitted both the IPD and OPD monthly report on time.
Karamoja Nutrition Reporting Performance: Timeliness for OPD Q1 and Q2 - FY 2020/21
Kaab
ong
Kare
nga
Abim
Mor
oto
Amud
at
Nab
ilatu
k
Nak
apiri
pirit
Ko�d
o
Nap
ak
0
20
40
60
80
100
120
emit no etar gnitropeR
%
96.3 100
95.2
89.5
82.1
77.8
100
89.4 10
0
70.4
100
93.3
74.1
57.1
100
77.8 81.5
95.2
Districts per quarter
Q1 2020
Q2 2020
Districts per quarter
OPD reporting rate on time
IPD reporting rate
Target
KEY
12
98 98.7
100
84.8
95.5
86.4
100
92 92.4
84.5 88
.2 91
100
83.8
36.5
0
20
40
60
80
100
120
Obo
ngi
Adju
man
i
Kobo
ko
Arua
Kam
wen
ge
Kita
gwen
da
Yum
be
Kiku
ube
Moy
o
Isin
giro
Lam
wo
Hoi
ma
Mad
i-Oko
llo
Kiry
ando
ngo
Kyeg
egw
a
emit no etar gnitropeR
%
NUTRITION PERFORMANCE ON TIMELY REPORTING FOR OPD AND IPD MONTHLY REPORTS IN Q1 AND Q2
• Generally, there was an improvement in both OPD and IPD monthly reporting rates on time for all refugee hosting districts in Q2 compared to Q1 apart from Kyegegwa district.
• However, nutrition performance on timely reporting is still low in refugee hosting districts.• Six refugee hosting districts did not meet the target for timely reporting for both Q1 and Q2 (Adjumani,
Arua, Kikuube, Moyo, Kiryandongo and kyegegwa.• Kyegegwa was the worst performing district in terms of timely reporting for both OPD and IPD monthly
reports for Q1 and Q2.
Refugee hosting districts Nutrition Reporting Performance: Timeliness for OPD and IPD in Q2 - FY 2020/21
0
20
40
60
80
100
120
Obo
ngi
Adju
man
i
Kobo
ko
Arua
Kam
wen
ge
Kita
gwen
da
Yum
be
Kiku
ube
Moy
o
Isin
giro
Lam
wo
Hoi
ma
Mad
i-Oko
llo
Kiry
ando
ngo
Kyeg
egw
a
emit no etar gnitropeR
%
95.8
77.2
94.4
73.2 83
.3
95.8 10
0
66.7 71
.1
88.5
82.1
100
97.2
44.4
23.3
Districts
OPD reporting rate on time
IPD reporting rate on time
Districts
Q1 2020
Q2 2020
Target
KEY
13
31%
48%41%34%
41%3%
14%
33%75% 41%
62%
0
100000
200000
300000
400000
500000
600000
Anko
le
Buso
ga
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Toor
o
Wes
t Nile
Sout
h C
entra
l
Buke
di
Kara
moj
a
Kige
zi
Buny
oro
NUMBER AND PROPORTION OF CHILDREN <10 YEARS ASSESSED FOR NUTRITION STATUS IN OPD IN Q1 AND Q2
• Generally, the percentage number of children assessed for nutrition status in OPD during Q2 is low (< 70%) apart from Karamoja region.
• There was a decline in number of children <10 years assessed for nutrition status in OPD across all regions apart from Karamoja region.
• Kampala is the worst performing region in terms of assessing nutrition status for children in both Q1 and Q2.
• Many regions had data entry issues in Q2 (Bunyoro, West Nile and Tooro ) i.e children assessed for nutrition status were more than those attending OPD.
Number of Children <10 Years Assessed for Nutrition Status in OPD in Q1 and Q2 for FY 2020/2021
68%
34%
41%42%28%
12%36%
2%
6%
34%90%35%
Anko
le
Buso
ga
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Toor
o
Wes
t Nile
Sout
h C
entra
l
Buke
di
Kara
moj
a
Kige
zi
Buny
oro
0
100000
200000
300000
400000
500000
600000
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
OPD attendance (<10years)
Children <10 assessed for nutrition status
KEY
14
Number and Proportion of Children Identified with Severe Acute Malnutrition (SAM) and Admitted for Treatment in Q1 and Q2 - National
46%79% 61% 23%
48%
53%
80%60%
34% 87%
64%
84% 71%
0
2000
4000
6000
8000
10000
12000
14000
16000
Anko
le
Buso
ga
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Toor
o
Wes
t Nile
Sout
h C
entra
l
Buke
di
Kara
moj
a
Kige
zi
Buny
oro
11% 153%
NUMBER AND PROPORTION OF IDENTIFIED SAM CHILDREN WHO ARE ADMITTED FOR TREATMENT IN Q1 AND Q2 - NATIONAL
82% 106%85% 58% 61%
25%
104%97.6% 64%
66% 61.3%
45.7%
87.5%78%
Anko
le
Buso
ga
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Toor
o
Wes
t Nile
Sout
h C
entra
l
Buke
di
Kara
moj
a
Kige
zi
Buny
oro
105%0
2000
4000
6000
8000
10000
12000
14000
16000
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
Children identified with SAM
Identified SAM children admitted into treatment
** Regions whose % is shaded red had data quality issues i.e. (more admitted SAM children than admitted)
KEY
“Majority of the identified with SAM children are not admitted into treatment. More strategic efforts required for improvement.”
• Generally, there was an increase in percentage number of children identified with SAM and admitted into treatment in Q2 compared to Q1 apart from Karamoja and Acholi. Karamoja and Acholi had a decline of 23% and 18.3% respectively, in Q2 compared to Q1.
• There was a decline in number of children identified with severe acute malnutrition in Q1 compared to Q2, probably due to COVID -19 response strategies such as reduced restricted movements and no touch policy.
• In Q2, Tooro was the best performing region while Acholi was the worst performing region.• Note: In Q2 Busoga, Lango and Kampala had data quality issues, the number of identified SAM
children was less than the admitted children. Lango region has consistently had data quality issues with regard to this indicator
15
84%58%
89% 65%69%
68%50% 43% 74%
0100020003000400050006000
Nap
ak
Kaa
bong
Kar
enga
Abi
m
Mor
oto
Am
udat
Nab
ilatu
k
Nak
apiri
pirit
Kot
ido
NUMBER AND PROPORTION OF IDENTIFIED SAM CHILDREN WHO ARE ADMITTED INTO TREATMENT IN Q1 AND Q2 - KARAMOJA
• Generally, there was a decline in the proportion of the identified SAM children admitted for treatment in Q2 apart from Abim and Nabilatuk.
• Kotido had the largest number of identified SAM cases and lowest number of SAM admissions in Q2• The percentage of SAM admissions is still very low implying that many children are not being treated
for SAM.
Number and Proportion of Children Identified with SAM and Admitted for Treatment in Q1 and Q2 - National
42%67%
75% 67%
234%
237% 54% 25%
12.6%
0100020003000400050006000
Nap
ak
Kaa
bong
Kar
enga
Abi
m
Mor
oto
Am
udat
Nab
ilatu
k
Nak
apiri
pirit
Kot
ido
Districts per quarter
Q1 2020
Q2 2020
Districts per quarter
Identified SAM children
SAM children admitted into treatment
** Regions whose % is shaded red had data quality issues i.e. (more admitted SAM children than admitted)
KEY
16
0.0
20.0
40.0
60.0
80.0
100.0
120.0
15.4
5.9
Sout
h C
entra
l
25.8
4.6
Acho
li
52.6 55
.5An
kole
1.8
0.3
Bugi
su
13.9
6.3
Buke
di
49.4
45.4
Buny
oro
9.7
5.9
Buso
ga
50.0
19.2
Kam
pala
82.2
99.4
Kara
moj
a
25.6
14.0
Kige
zi
2.2 6.
0La
ngo
10.1
5.0
Nor
th C
entra
l
0.9
0.1
Teso
4.0
0.1
Toor
o
53.3
26.4
Wes
t Nile
Perc
enta
ge
• Generally, there was a decline in proportion of children identified with moderate acute malnutrition and admitted into supplementary feeding care (12/15) in Q2 apart from Ankole, Karamoja and Lango.
• Supplementary feeding program is only functional in Karamoja region and refugee hosting districts located in Acholi, Ankole, Bunyoro, Karamoja, Tooro and West Nile.
• Karamoja is the best performing region in terms of proportion of children identified and admitted into supplementary feeding care.
• Regions such as south central, Bugisu, Busoga, Bukedi, Kigezi, Busoga, North central and Teso probably had data entry errors because supplementary feeding program is nonfunctional in the aforementioned regions.
The Nutrition performance for management of acute malnutrition outcomes is tagged to the following indicators; cure rate, death rate, non response rate and death rate. Cure rate, non-response and death rate indicators are used to assess quality of care whereas defaulter rate is used to accessibility to services.
Proportion of Children Identified with Moderate Acute Malnutrition (MAM) and Admitted into Supplementary Feeding Care in Q1 and Q2 - National
Nutrition Outcomes for Integrated Management of Acute Malnutrition in Q2
PROPORTION OF CHILDREN WITH MODERATE ACUTE MALNUTRITION (MAM) IDENTIFIED AND ADMITTED INTO SUPPLEMENTARY FEEDING CARE (SFC) Q1 AND Q2
% MAM children identified and admitted into SFC-Q1
% MAM children identified and admitted into SFC-Q2
KEY
Regions
17
• Generally, nutrition performance in terms of management of severe acute malnutrition is poor across all regions.
• There was an increase in number of children who died from severe acute malnutrition in Q2 (526) compared to Q1 (304).
• Majority of the region did not meet the sphere standard target for cure rate (>75%) for example (10/15) regions in April, (9/15) regions in May and (9/15)regions in June did not meet the sphere standard target.
• Karamoja region had the highest number of children who died during treatment in OTC. • Teso region did not report on severe acute malnutrition outcomes for two consecutive month sin Q2
(April and May 2020)• There was in increase in the number of regions that did not meet the Sphere target for defaulter (10%)
in May (11/15) compared to April (8/15) regions.• Similar to cure rate, there was a decline in nutrition performance in terms of non response rate with 2/15
regions not meeting the sphere standard compared to 5/15 regions in June.• Generally there was a decline in nutrition performance in terms of cure rate indicator, for instance the
number of regions that met the Sphere standard target for Cure rate in April were 10/15 compare to 9/15 regions in June 2020.
Management of Severe Acute Malnutrition Performance Outcomes for Q2 - National
Period Apr-20 May-20 Jun-20
Organization unit / Data Cure Rate
(OTC)
Death Rate
(OTC)
Defaulter Rate
(OTC)
Non-Response Rate (OTC)
Cure Rate
(OTC)
Death Rate
(OTC)
Defaulter Rate
(OTC)
Non-Response Rate (OTC)
Cure Rate
(OTC)
Death Rate
(OTC)
Defaulter Rate
(OTC)
Non-Response Rate (OTC)
Ankole 56.2 (50) 2.2(2) 41.6(37) 0 86.3(63) 0 12.3(9) 1.4(1) 89.7(32) 0 6.9(32) 3.4(1)
Busoga 14.3 (10) 1.4(1) 82.9(58) 1.4(1) 50(8) 0 18.8(3) 31.3(5) 39.1(23) 0 41.3(25) 19.6(9)
Teso 100(1) 0 0 0
Bugisu 0 0 0 100(5) 60(18) 3.3(1) 33.3(10) 3.3(1) 70.8(19) 0 29.2(5) 0
Lango 69.9 (49) 0 28.8(23) 1.4(1) 75(35) 0 25(12) 0 72.9(40) 0 27.1(13) 0
North Central 42.9(6) 0 57.1(8) 0 45.2(14) 3.2(1) 51.6(16) 0 68.8(11) 0 18.8(3) 12.5(2)
Acholi 52.9(166) 0.32(1) 10.5(33) 36.3(114) 66.3(106) 2.5(4) 21.9(35) 9.4(15) 56.5(70) 3.5(7) 32.9(37) 7.1(12)
Kampala 100(5) 0 0 0 65(13) 0 35(7) 0 66.7(2) 0 0 33.3((1)
Tooro 54.5(122) 1.8(4) 29.5(66) 14.3(32) 77.4(171) 1.4(3) 15.8(35) 5.4912) 90.6(244) 0.56(2) 6.7(16) 2.2(5)
West Nile 90.8(258) 0.7(2) 3.5(10) 4.9(14) 76.1(83) 1.8(2) 13.8(15) 8.3(9) 85.4(114) 0 9.8(12) 4.9(6)
South Central 73.1(38) 1.9(1) 17.3(9) 7.7(4) 75(12) 0 6.3(1) 18.8(3) 88.9(9) 11.1(1) 0 0
Bukedi 100(2) 0 0 0 100(9) 0 0 0 64.3(9) 21.4(9) 0 14.3(3)
Karamoja 47.7(389)) 21(171) 16.4(134) 14.8(121) 42.5(459) 16.1(5) 20.8(225) 20.6(223) 56.2(408) 7.1(46) 12.6(92) 24.1(169)
Kigezi 62.7(42) 1.5(1) 34.3(23) 1.5(1) 38.5(10) 7.7(2) 46.2(12) 7.7(2) 68.4(26) 2.6(1) 26.3(10) 2.6(1) Bunyoro 77.6(90) 0.86(1) 10.3(12) 11.2(13) 39.6(90) 0.44(1) 4(9) 55.9(127) 95.7(110) 0.87(1) 0 3.5(4)
Summary (poor outcomes) 10/15 1/15 8/15 3/15 8/15 1/15 11/15 4/15 9/15 2/15 6/15 5/15
*() is Number of children
Key 3
SAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <10% >10% Non response rate <15% >15% All Did not report
18
Management of Severe Acute Malnutrition Performance Outcomes (OTC) for Q2 – Regional Referral Hospitals
Period Apr-20 May-20 Jun-20
Organisation unit / Data
Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response
Rate (OTC)
Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response
Rate (OTC)
NUT: Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response
Rate (OTC)
Masaka RRH
Soroti RRH
Kabale RRH 93.3(14) 0 0 6.7(1) 33.3(3) 55.6(5) 11.1(1) 0 66.7(8) 33.3(4) 0 0
Hoima RRH 83.3(5) 16.7(1) 0 100(4) 0 0 0
Jinja RRH 12.3(8) 86.2(56) 1.5(1) 60(3) 40(2) 0 0 56.7(17) 43.3(13) 0 0
Moroto RRH
Lira RRH
Fort Portal RRH 8(2) 80(20) 12(3) 0 33.3(7) 61.9(13) 4.8(1) 0
Arua RRH 88.9(16) 5.6(1) 5.6(1) 0 90(9) 10(1) 0
CUF(Naguru) RRH 50 0 0 50
Mubende RRH 22.2(2) 77.8(7) 0 0 47.1(8) 52.9(9) 0 66.7(4) 33.3(2) 0 0
Mbale RRH 0 0 0 100(5) 78.3(18) 13(3) 4.3(1) 4.3(1) 77.3(17) 22.7(5) 0 0
Gulu RRH 100(2) 0 0 0 100(4) 0 0 0 71.4(5) 0 28.6(2) 0
Mbarara RRH 6.5(2) 93.5(29) 0 0 100(2) 0 0 0 100(2) 0 0 0
Summary (poor) 5/14 7/14 1/14 1/14 4/14 4/14 2/14 None 5/14 4/14 1/14 1/14
Key 3
SAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <10% >10% Non response rate <15% >15% All Did not report
“Majority of the Regional referral Hospitals are not reporting on the performance outcomes for management of severe acute malnutrition. More strategic efforts for improvement are required.”
• Generally, majority of the regional referral hospitals are not reporting on performance outcomes for the management of severe acute malnutrition for instance 5/14 regional referrals in April and May compared to 7/14 regional referral hospitals not reporting in May.
• Masaka, Lira , Soroti and Moroto Regional Referral Hospital have consistently not reported on management of severe acute malnutrition outcomes.
• Nutrition performance in terms of the indicators for management of severe acute malnutrition is relatively poor.
• There was a decline in the number of regional referral hospitals that meet the Sphere standard target in June compared to April for instance, 4/15 regional referrals met the target in April compared to only 3/14 regional referrals in June.
• There was a decline in the number of defaulters in June compared to April.
19
Management of Severe Acute Malnutrition Performance Outcomes (OTC) for Q2 – Karamoja
Period Apr-20 May-20 Jun-20
District Cure Rate (OTC)
Defaulter Rate (OTC)
Death Rate (OTC)
Non-Response Rate (OTC)
Cure Rate (OTC)
Defaulter Rate (OTC)
Death Rate (OTC)
Non-Response Rate (OTC)
Cure Rate (OTC)
Defaulter Rate (OTC)
Death Rate (OTC)
Response Rate (OTC)
Amudat 33.3(14) 57.1(24) 0 9.5(4) 62.5(5) 37.5(3) 0 0 100(21) 0 0 0
Abim 93.5(29) 3.2(1) 0 3.2(1) 69(29) 4.8(2) 2.4(1) 23.8(10) 56(14) 12(3) 0 32(8)
Kaabong 64.7(99) 16.3(25) 0 19(29) 61(100) 17.7(29) 0 21.3(35) 54.9(130) 11.8(28) 0 33.3(79)
Karenga 13.6(29) 1.4(3) 78.9(168) 6.1(13) 62(44) 16.9(12) 1.4(1) 19.7(14) 63.8(37) 19(11) 1.7(1) 15.5(9)
Kotido 49.5 15.9 0 34.6 39.5 42 0 18.5 60.8 18.3 1.3 19.6
Moroto 48.9(23) 29.8(14) 2.1(1) 19.1(9) 57.9(33) 12.3(7) 1.8(1) 28.1(16) 53.1(26) 14.3(7) 2(1) 30.6(15)
Nabilatuk 61.5(40) 21.5(14) 0 16.9(11) 55.2(48) 20.7(18) 0 24.1(18) 59.5(21) 18.9(22) 21.6(7)
Nakapiripirit 68.1(62) 17.6(16) 2.2(2) 12.1(11) 39.6(14) 9(10) 1.8(2) 49.5(55) 41.7(35) 0 50(42) 8.3(7)
Napak 60.(40) 30.3(20) 0 9.1(6) 58.3(28) 16.7(8) 0 25(12) 58.8(30) 15.7(8) 0 25.5(13)
Summary(Poor outcomes) 8/9 7/9 1/ 9 3/9 All 6/9 None 8/9 1/9 5/9 1/9 7/9
Key 3
SAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <10% >10% Non response rate <15% >15% All Did not report
“Karamoja region has poor performance indicators yet it has the highest number of admissions for severe acute malnutrition. More strategic efforts are needed for improvement.”
• Generally nutrition performance in terms of management of severe acute malnutrition in out patient therapeutic care (OTC) in Karamoja is poor.
• All the districts in Karamoja did not meet the sphere standard target for the cure rate indicator in May 2020. In April and June only one district met the Sphere standard target for cure rate indicator.
• There was an improvement in defaulter rate in June compared to April with four districts meeting the target for defaulter rate in June and two districts meeting the sphere target in April.
• Karenga had the highest death rate and number(168) of children who died in OTC. There is need to conduct data quality checks for this indicator to confirm what is being cited in the DHSI2.
• Amudat is the best performing district in terms of cure rate and non-response indicator.• Abim is the best districts in terms of providing quality access to services since it met the sphere target
for the defaulter rate indicator for all the 3 months in Q2.
20
• Generally, nutrition performance in terms of outcomes for management severe acute malnutrition (OTC) is relatively fair.
• There was an improvement in the number of districts meeting the target for cure rate indicator in June(13/15) compared to April (10/15).
• All the Humanitarian districts met the target for death rate (<10%) for the all the three months in Q2. • There was a slight decline in number districts that met the target for defaulter rate in June (11/15)
compared to April (10/15).• There was an improvement in non-response rate in June compared to April with only (1/15) districts
compared to (4/15 ) In April not meeting the Sphere standard target for non response rate (<15%)• Kitagwenda did not report on outcomes for management of severe acute malnutrition (OTC) for all the
months in Q2 while Yumbe and Obongi did not report for one month.
Management of Severe Acute Malnutrition Performance Outcomes for Q2 – Humanitarian Context
Period Apr-20 May-20 Jun-20
Organisation unit / Data Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response Rate (OTC)
Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response Rate (OTC)
Cure Rate
(OTC)
Defaulter Rate
(OTC)
Death Rate
(OTC)
Non-Response Rate (OTC)
Adjumani 72.2(13) 0 0 27.8(5) 60(12) 15(3) 5(1) 20(4) 76.9(20) 7.7(2) 0 15.4(4)
Koboko 77.8(14) 22.2(4) 0 0 42.9(3) 57.1(4)
61.5(8) 38.5(5) 0 0
Arua 85.3(58) 7.4(5) 1.5(1) 5.9(4) 88.4(38) 4.7(2) 2.3(1) 4.7(2) 89.3(33) 7.1(2) 0 3.6(1)
Yumbe 78.6(22) 0 3.6(1) 17.9(5) 70(21) 20(6) 0 10(3) 91.7(33) 8.3(3) 0 0
Moyo 100(7) 0 0 100(1) 0 0 0
Madi-Okollo 99.3(142) 0.7(1) 100(2) 90.9(10) 9.1(1)
Obongi 100(4) 0 100(6) 0 0 0
Kitagwenda
Kyegegwa 59.1(55) 6.5(6) 34.4(32) 88.4(107) 11.6(14) 95.1(145) 2.9(3) 2(3) Kamwenge 86.8(46) 13.2(7) 0 0 60(18) 10(3) 0 30(9) 80.5(33) 14.6(6) 0 4.9(2)
Hoima 83.3(5) 16.7(1) 100(6) 0 0 0 100(4) 0 0 0
Kiryandongo 75(12) 12.5(2) 12.5(2) 100(9) 96.2(25) 3.8(1)
Kikuube 77.7(73) 9.6(9) 1.1(1) 11.7(11) 35.5(72) 2(4) 0 62.6(127) 95.2(59) 4.8(3)
Isingiro 91.3(42) 4.3(2) 4.3(0) 0 85.5(59) 13(9) 0 1.4(1) 83.3(20) 12.5(3) 4(1)
Lamwo District 49.3(134) 10.3(28) 40.4(110) 80(92) 13(15) 0 7(8) 62.3(33) 24.5(13) 1.9(1) 11.3(6)
Summary 3/15 2/15 None 3/15 5/15 3/15 None 5/15 2/15 3/15 None 1/15
Key 3
SAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <10% >10% Non response rate <15% >15% All Did not report
21
• Nutrition performance in terms of management of moderate acute malnutrition is relatively poor.• The cure rate is generally poor, for instance only one district met the target for Sphere standards for
cure rate in April, May and June.• There was a slight improvement in the number of facilities attaining the sphere standard target for
defaulter rate from April to June.• Karenga and Kotido had very high number of deaths (more than 300) in SFC for period of April. There
is need to conduct data quality checks to verify the number of deaths in SFC.• Amudat is the best performing district in in terms of nutrition recovery.
Management of Moderate Acute Malnutrition Performance Outcomes for Q2 – Karamoja
Period Apr-20 May-20 Jun-20
Organisation unit / Data Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Kaabong 66.8(172) 15.9(36) 0.91(2) 16.4(45) 73.3(165) 12(27) 0 14.7(33) 65.8(239) 7.2(26) 0.28(1) 26.7(97)
Karenga 20.3(95) 7.7(36) 64.2(300) 7.7(36) 63.3(69) 14.7(16) 22(24) 47.8(44) 16.3(15) 35.9(33)
Abim 71.7(104) 14.5(21) 0.69(1) 13.1(19) 79.8(67) 1.2(1) 1.2(1) 17.9(15) 56.9(62) 1.8(2) 0 41.3(45)
Moroto 42.4(14) 36.4(12) 0 21.2(7) 39.5(17) 39.5(17) 0 20.9(9) 32.5(49) 5.2(9) 0 62.3(124)
Amudat 87.3(55) 12.7(8) 40.5(54) 33.6(46) 0 26(43) 79.2(19) 4.2(1) 16.7(4)
Nabilatuk 61(178) 15.4(45) 23.6(69) 59.6(367) 8.8(54) 0 31.7(195) 39.2(204) 5.9(17) 54.9(160) Nakapiripirit 55.2(133) 22(53) 0.41(1) 22.4(54) 45.3(102) 15.1(34) 0 39.6(89) 35.5(164) 18.2(84) 0 46.3(214) Kotido 7(46) 8.3(52) 80.6(504) 4(28) 62.2(130) 34.4(72) 0.96(2) 2.4(5) 56.2(186) 11(36) 0 32.9(85) Napak 50.8(32) 22.2(14) 27(17) 28.9(22) 35.5(27) 1.3(1) 34.2(31) 28.3(58) 15.2(29) 56.5(118) summary (outcomes) 8/9 5 /9 1/ 9 5/9 8/9 6/ 9 None 1/ 9 8/9 3/9 None all
Key 4
MAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <3% >3% Non- response rate
<15%
>15%
All Did not report
22
• Generally, nutrition performance in terms of outcomes for management of moderate acute malnutrition in refugee hosting districts is relatively good.
• Generally, there was an improvement in all the outcome indicators apart from death rate in April compared to June.
• There was a slight decline in number of districts meeting the Sphere standard target for death rate, for instance 14/15 districts met the target in April compared to all the districts (13/15) in June 2020.
• Kyegegwa, Kamwenge , Kiryandongo and Kikuube achieved the target for all the four outcome indicators in Q2
• Adjumani was the worst performing district in terms of defaulter rate indicator in April 2020.• Obongi and Adjumani were the worst performing district in terms of death rate and non response rate
respectively.
Management of Moderate acute Malnutrition Performance Outcomes for Q2 – Humanitarian Context
Period Apr-20 May-20 Jun-20
District Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Cure Rate (SFC)
Defaulter Rate (SFC)
Death Rate (SFC)
Non-Response Rate (SFC)
Adjumani 29.6(48) 1.9(3) 0 68.5(111) 84.5(93) 10(11) 0 5.5(6) 36.4(51) 7.1(10) 38.6(54) 17.9(25)
Koboko 100(2) 0 0 13.3(2) 6.7(1) 0 80(12) 100(1) 0 0 0
Arua 62.3(33) 13.2(7) 0 24.5(13) 51.3(61) 44.5(53) 0 4.2(5) 86.5(64) 1.4(1) 0 12.2(9)
Yumbe 91.3(21) 0 4.3(1) 4.3(1) 80(12) 20(3) 0 0 100(140) 0 0 0
Moyo
Madi-Okollo 71.4(5) 0 0 28.6(2) 100(47) 0 0 0 100(18) 0 0 0
Obongi 3.9(6) 96.1(196) 0 0 11.5(23) 0 84(168) 4.5(9) 94.6(70) 5.4(4) 0 0
Kitagwenda
Kyegegwa 87.9(29) 12.1(4) 0 0 100(16) 0 0 0 100(50) 0 0 0
Kamwenge 90(36) 10(4) 0 0 90.9(60) 7.6(5) 0 1.5(1) 91.3(63) 4.3(3) 0 4.3(3)
Hoima
Kiryandongo 100(19) 0 0 0 97.4(37) 0 2.6(1) 88.6(31) 5.7(2) 0 5.7(2)
Kikuube 94.9(74) 5.1(4) 0 92(81) 4.5(4) 0 3.4(3) 94.9(129) 3.7(5) 0 1.5(2)
Isingiro 95.7(90) 2.1(2) 1.1(1) 1.1(1) 94.8(92) 2.1(2) 0 3.1(3) 47.2(68) 9.4(10) 39.6(10) 3.8(4)
Lamwo 82.6(38) 17.4(8) 0 0 100(53) 0 0 0 97.8(44) 0 2.2(1) 0
Summary 4 /15 2 /15 1 /15 3 /15 3/15 2/15 1/15 1 /15 2/15 None 2/15 1/15
Key 4
MAM outcome
Sphere standard target
Key
Sphere standard target
Key
Cure rate > 75% <75% Defaulter rate <15% >15% Death rate <3% >3% Non- response rate
<15%
>15%
All Did not report
23
Vitamin A supplementation coverage in Q1 and Q2 - National
“Vitamin A supplementation coverage for both Q1 and Q2 of the fiscal year 2020/2021 was less than 66% (national target). Administration of this interventions during routine service delivery has remained low yet child health day campaigns did not take place due to COVID-19 outbreak responses.”
• Vitamin A coverage is low across all regions.• Karamoja has the highest coverage for vitamin A supplementation.• Kigezi is the worst performing region in terms of vitamin A • Low vitamin A coverage in Q1 and Q2 may correspond to very low Vitamin A supplementation
administration or poor recording of this intervention during routine service delivery coverage• Bugisu region specifically Mbale seems have an erroneous data entry showing that 992,924 children
receiving vitamin A in February 2020.
28.5%
46.9%
383
33.8%32.8%
45.8%
33.1%66.8% 28.1%
48.7%
31.9%
35.6%
53.8%
58.1%
33.5%
-
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
No.
of c
hild
ren
VITAMIN A SUPPLEMENTATION COVERAGE Q1 AND Q2
Total population AchievedKEY
24
• There was a slight improvement in the overall proportion of pregnant women reported to have received iron/folic acid supplementation nationwide at ANC 1st visit in Q2 compared to Q1 for instance the proportion was 66.8% (328, 555 out of 492,015 pregnant women who visited the health facility for their 1st ANC visit in Q2; and 65% (312,562 out of 480,698).
• More pregnant women were reported to have visited the health facility for antenatal care in Q2 compared to Q1; similarly, more pregnant women were reported to have received iron/folic acid during their ANC 1st visit in Q2 compared to Q1.
• Kigezi region was the best performing region in both Q1 and Q2 in terms of proportion of pregnant women receiving Iron/folic acid during the 1st antenatal care visit. Acholi region was the worst performing region.
Iron Folate Supplementation in Q1 and Q2-National
65%
65%70% 68%
64%
66%
73%57%
63%65%
58%
69%
80%80%
61%
0100002000030000400005000060000700008000090000
100000
Buso
ga
Anko
le
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Wes
t Nile
Toor
o
Sout
h C
entra
l
Buke
di
Kige
zi
Kara
moj
a
Buny
oro
PROPORTION OF PREGNANT WOMEN RECEIVING IRON/FOLIC ACID AT 1ST ANC VISIT IN Q1 AND Q2
70%
72%106%
68%64%
65%
55% 64%
67%76%
56%
72%84%
79%
67%
0100002000030000400005000060000700008000090000
100000
Buso
ga
Anko
le
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Wes
t Nile
Toor
o
Sout
h C
entra
l
Buke
di
Kige
zi
Kara
moj
a
Buny
oro
Regions per quarter
Q1 2020
Q2 2020
Regions per quarter
ANC 1st Visit for women
Pregnant Women receiving tablets of Iron/Folic Acid at ANC 1st visit
KEY
25
• Low birth weight (LBW) new born babies who survive have a greater risk of both short term and long-term adverse health consequences. LBW is thus a key indicator of progress towards the achievement of the one of the six global nutrition targets.
• The average proportion of babies born with low birth weight at national level in Q2 was at 6.2% (19140 out of 309,208 total deliveries nationwide). There was a significant improvement in Q2 when compared with the average proportion of babies born with low birth weight for all regions in Q1, that was, 7.1% (20,628 out of 289,415 total deliveries).
• The following regions had higher proportion of babies born with low birth weight in Q2 compared to the national average proportion: Lango, Kampala, West Nile, Tooro, south central, Bunyoro and Karamoja.
• Karamoja has the highest proportion of babies born with low birth weight in Q2.
Birth Outcomes: Babies Born with Low Birth Weight (LBW)
6.0%5.2%
5.6%5.2%
6.8%
10.0%
15.0%
5.8%
6.3%7.5%
7.1%
4.4%
5.0%
8.7%
7.0%
0
5000
10000
15000
20000
25000
30000
35000
40000
Buso
ga
Anko
le
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Wes
t Nile
Toor
o
Sout
h C
entra
l
Buke
di
Kige
zi
Kara
moj
a
Buny
oro
5.9% 5.5%
5.8% 3.6% 7.8%
4.9%3.1%
6.9%
8.9%7.9%
6.3%
5.6%
6.7%
10.8%
7.3%
0
5000
10000
15000
20000
25000
30000
35000
40000
Buso
ga
Anko
le
Teso
Bugi
su
Lang
o
Nor
th C
entra
l
Acho
li
Kam
pala
Wes
t Nile
Toor
o
Sout
h C
entra
l
Buke
di
Kige
zi
Kara
moj
a
Buny
oro
PROPORTION OF BABIES BORN WITH LOW BIRTH WEIGHT ACROSS ALL REGIONS IN Q1 AND Q2
Regions per quarter
Regions per quarter
Q1 2020
Q2 2020 Total deliveries
Babies born with low birth weight (<2.5kg)
KEY
26
• Health facilities should be supported with routine coaching, mentorship and supportive supervision on HMIS data collection and reporting through the DHSI2 to address issues of poor data quality and low reporting rates due to migration to the new DHSI2 and HMIS tools.
• Low SAM and MAM coverage in both Q1 and Q2, compared with estimated annual burden, indicates the need to scale up these services in the country. SAM treatment is currently only covered by partners in selected areas (refugee hosting districts, Karamoja and Regional Referral Hospitals) while MAM treatment is only functional in Karamoja and refugee hosting districts.
• There is need for routine checks of data quality through nutrition data quality assessments followed by immediate corrective actions.
• Lango, Kampala, West Nile, Tooro, south central, Bunyoro and Karamoja had high proportion of low birth babies compared to the national average. Multi sectoral interventions including improving maternal diet needs to be scaled up to address this issue.
• For some nutrition indicators (vitamin A coverage), the denominators need to be adjusted to include the refugees.
• There is need to improve management of acute malnutrition service delivery through routine coaching, mentorship and supportive supervision on integrated management of acute malnutrition as well as mortality audits.
• There is need to intensify vitamin A supplementation and deworming through routine service delivery and door to door delivery to address the low coverages for both Vitamin A and Deworming.
• The denominators for some nutrition indicators need to be appropriately customized in DHSI2 i.e. Vitamin A, iron/folic acid to prevent manual extraction and computing of data elements for these indicators
• There is need to customize the legends or traffic lights for performance outcome indicators for management of acute malnutrition in the DHSI2 as per the SPHERE standards cutoffs.
Key Recommendations
27
Ministry of Health1. Samalie Namukose2. Laura Ahumuza3. Tim Mateeba
Samalie NamukosePrincipal Nutitionist Nutrition Division,Ministry of HealthEmail: snamukose@gmail.com
Dr. George UpenythoCommissioner Health Services,Community Health Department, Ministry of HealthEmail: upenytho.george@gmail.com
Viorica BerdagaChief of Child Survival and Development, UNICEF UgandaEmail: vberdaga@unicef.org
UNICEF Uganda Country Office1. Sheilla Natukunda2. Florence Turyashemererwa
Editorial Team
Contact
Data Source: National DHIS2 System, Uganda
28
UGANDA NUTRITION QUARTERLY BULLETIN
Supported by
Volume 1 | Issue 2 | June 2020
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