Uganda: Volunteer action leads to enforcement of the Public Health Act

Published: 22 May 2013 9:34 CET

Overall health indicators in Uganda are poor; life expectancy is low, and child, infant, and maternal mortality rates are high. Malaria is the leading cause of morbidity and mortality, killing between 70,000 and 110,000 people each year, most of whom are children under-five. HIV and AIDS is also a major health problem, with recent studies showing an increase in infection rates to 7.2 per cent.

In Kampala, 27 per cent of the population live in slums that make up ten per cent of the city’s area. Almost two-thirds of residents live in rented housing, few of which are equipped with adequate latrines. Owing to the nature of drainage systems in the city, the construction costs for toilets are prohibitive and, as a result, most landlords build houses without toilets.

In 2010, the Uganda Red Cross Society revisited its health programmes and introduced a comprehensive approach to addressing the health and hygiene needs in the country: the community-based health and first aid (CBHFA) approach.

Within a year, the National Society had trained 1,769 volunteers in 58 villages and communities. Volunteers conducted 6,753 home visits and reached 23,462 beneficiaries with messages on hygiene, malaria control, HIV, cholera and meningitis prevention, as well as road safety promotion.

The Uganda Red Cross Society’s Kampala East branch addressed health issues in Naguru parish. Members of the parish were mobilized and, after three days of CBHFA training, identified diarrhoeal diseases, in particular cholera outbreaks, malaria, HIV and AIDS as health priorities.

The volunteers themselves developed a plan to address these priorities. They held meetings with landlords and urged them to build pit latrines and provide for a proper drainage system in the village. Alongside dialogue with landlords, the communities also committed to weekly clean-up campaigns. Subsequently, volunteers met with the city council authorities and an agreement was reached for officials to follow-up on the issue with the landlords.

Owing to the advocacy role played by the Red Cross volunteers, the Public Health Act was enforced. A Red Cross officer explains: “Faced with two threats, arrest by the authorities and loss of revenue from tenants, landlords had no option but to act. Within three weeks, all designated homes had functional pit latrines.”

Through continued dialogue with community members – largely tenants and local authorities – a by-law was also passed so that new homes must have latrine facilities. Local leaders continue to help with enforcement of this by-law. As a result, the hygiene and sanitation conditions in Naguru parish have improved.

Further, in Naguru parish, community efforts to curb waste disposal and drainage problems have also been facilitated through clean-up campaigns.

The trained volunteers have become a part of the Government’s Village Health Teams. The Ministry of Health and other stakeholders are engaging the volunteers for polio and mass measles campaigns.

Further, advocacy efforts resulted in the government providing 5,000 long lasting mosquito nets for the Uganda Red Cross Society to distribute to the communities of Naguru parish, contributing towards effective malaria control.

By promoting public health initiatives, raising awareness about disease prevention and hygiene, the volunteers in Uganda are contributing towards making universal health coverage a possibility.

World Health Assembly