Addressing Challenges in Kasese, Uganda: A Conversation with the District Health Officer

Addressing Challenges in Kasese, Uganda: A Conversation with the District Health Officer

(Left to right) Aaron Musiimenta, assistant regional behavior change communication officer; Tadeo Atuhura, STRIDES for Family Health communications specialist; Dr. Baseka Yusuf, district health officer; and Kevin Kisembo, principal nursing officer and STRIDES focal person. Kasese, Uganda. {Photo credit: Margaret Hartley/MSH.}Photo credit: Margaret Hartley/MSH.

The Kasese district in western Uganda is nestled between two national parks. Located hours from the capital city, Kampala, the region attracts tourists to view gorillas and mountain birds.

During my recent trip to Uganda, I met with Dr. Yusuf Baseka, the district health officer of Kasese, who described the health challenges his district faces, and his hopes for the future.

Although the national parks are beautiful and bring a much needed economic boost to the area, they also offer a challenge, Dr. Baseka explained.  The population growth and fertility rate of the district are very high. With the two national parks, there is no land for expansion. The town of Kasese is rapidly becoming a slum with unsanitary conditions that are difficult to address.

Another challenge in his district is that children are not going to or staying in school. They are leaving secondary school early and engaging in risky sexual behaviors. He explains, “We’ve seen a dramatic increase in young mothers, under 18 years, some as young as 12.” Their pregnancies offer unique challenges for the health system to address.

Inadequate medicines and medical supplies at the facilities present challenges for the district, too. There are frequent stock outs of everything from gloves and syringes to family planning supplies. The district receives all of its supplies from the National Medical Stores, which is government owned and operated. He said that there needs to be a focus on improving logistics to get the supplies to the district level and the health centers on a reliable basis, and that further commitment from the national government would help save lives.

There are 99 health facilities in Kasese District: 3 hospitals, 9 health center IVs, and 30 health center IIIs; the remaining facilities are health center IIs. These centers are trying to increase and improve the services they are permitted to offer. They also reach out to the communities to educate them on the benefits of using the health facilities instead of traditional providers.

Dr. Baseka manages innumerable health activities in his district of 720,000 people. He envisions solutions to further improve health care that he hopes will come to fruition in his region. First, he suggests that all health facilities should have onsite accommodations for health workers. This would help retain staff and decrease some of the daily burden. Also, a staff member would easily be accessible in emergencies.

He also suggests that waiting homes be built for pregnant women. Women who are pregnant could stay at the ward one to two weeks prior to their expected delivery and wait to give birth at a facility with a skilled health worker. He believes this would dramatically increase deliveries in the health center, saving mothers and newborn lives. Lastly, he suggests an increase in enrollment of health workers by the central government.

Dr. Baseka is very grateful for the support of STRIDES for Family Health and other programs offering their assistance in his district.

STRIDES for Family Health, supported by USAID and led by MSH, works with local partners in the Kasese district to increase contraceptive use and healthy timing and spacing of pregnancy, and decrease maternal and child mortality.

Dr. Baseka said that he is specifically appreciative of USAID. “I can see the changes and improvements beginning at all levels. We would not have been able to make those [changes] without the support.”

Margaret Hartley, knowledge exchange associate at MSH, was awarded the Gadue-Niebling-Urdaneta (GNU) Memorial Fellowship. She traveled to Uganda for four weeks, visiting local health centers and NGOs to meet with organizations MSH serves.

Editor’s note: MSH established the Gadue-Niebling-Urdaneta (GNU) Memorial Fund in memory of Cristi Gadue, Amy Lynn Niebling, and Carmen Urdaneta, to further the work to which these remarkable women dedicated their lives. Each year, the GNU Fellowship provides two MSH employees based in the US and globally with an international public health opportunity at another MSH location.