Uganda hosts approximately 1.1 million refugees making it Africa’s largest refugee hosting country and one of the five largest refugee hosting countries in the world. Most recently, throughout 2016-2018, Uganda was impacted by three parallel emergencies from South Sudan, the Democratic Republic of the Congo (DRC), and Burundi. In view of the on-going conflicts and famine vulnerabilities in the Great Lakes Region, more refugee influxes and protracted refugee situations are anticipated in the foreseeable future.
The unprecedented mass influx of refugees into Uganda in 2016-2018 has put enormous pressure on the country’s basic service provision, in particular health and education services. Refugees share all social services with the local host communities. The refugee hosting districts are among the least developed districts in the country, and thus the additional refugee population is putting a high strain on already limited resources.
The Government of Uganda serves as a model example in affording refugees in Uganda asylum and access to the same rights as its citizens, including the right to health. In line with the Comprehensive Refugee Response Framework (CRRF), embraced by the Government of Uganda in 2017, there is need for coordinated health service delivery. This entails a paradigm shift from a mainly humanitarian focus to developing integrated services for the long term.
As part of the overall health sector planning framework in Uganda, the Health Sector Development Plan (HSDP) 2015/16 - 2019/20 provides the strategic focus of the sector in the medium term, highlighting how it will contribute, within the constitutional and legal framework, to the second National Development Plan (NDP II), and to the second National Health Policy (NHP II) imperatives of the country, and so to the overall Vision 2040.The HSDP is the second in a series of six 5-year Plans aimed at achieving Uganda Vision 2040 of a healthy and productive population that contributes to socioeconomic growth and national development.
The Health Sector Integrated Refugee Response Plan in Uganda is presented against this background and operates as an addendum to the Heath Sector Development Plan (2015-2020), supplementing service delivery in the refugee hosting communities, to meet the needs of everyone in the targeted areas, including refugees. The interventions under the HSIRRP for refugee and host community are premised on a number of international, regional and national commitments and a number of policies, plans and frameworks by the government.
Namely, the Comprehensive Refugee Response Framework (CRRF) for Uganda was launched at a high-level meeting in Kampala in March 2017, with a view to harness a whole-of-society approach in responding and finding solutions to refugee crises in Uganda, building on existing initiatives and policies. The CRRF is part of a rich policy environment including the Refugee Act 2006 and the Refugee Regulations 2010, which states that refugees have access to the same public services as nationals, including health services. Further, Uganda’s Second National Development Plan (NDP II) aims to assist refugees and host communities by promoting socioeconomic development in refugee-hosting areas through the Settlement Transformation Agenda (STA).
The HSIRRP is expected to contribute to the national objective of improving the health status of host communities and refugees through building a resilient health system that can withstand shocks and guarantee sustainable and equitable access to essential health services. In addition, this would contribute to harmonious coexistence of the two communities through better coordination of partners, resource mobilization and integrated health service programming and provision. The strategic interventions under the HSIRRP are categorized into six pillars, namely:
(i) Service Delivery,
(ii) Human Resources for Health,
(iii) Medicines (Health Commodities and Technologies),
(iv) Health Management Information System,
(v) Health Financing, and (vi) Leadership, Coordination, Management and Governance.
Under each pillar, the issue, policy statement, strategic interventions and actions are described; including inputs, outcomes and indicators all of which are aligned to the Health Sector Development Plan and Uganda’s National Health Policy and their combined Monitoring and Evaluation frameworks.
This Plan also aims to bridge humanitarian and development programming and to advocate for predictable and sustainable financing for this emergency and protracted crisis. Under the coordination of the Ministry of Health, this Plan recognizes the comparative advantages of both humanitarian and development actors. It reinforces an interdependent approach over a five-year period that addresses both an immediate humanitarian crisis-response, as well as medium-and longterm investments towards consolidation and development.
Comprehensive implementation of the HSRRP will cost an average of 100 million US Dollars annually with expected contributions from government of Uganda through budget support for Refuge hosting districts and dedicated humanitarian funding from donors, and other partners.
The HSRRP has an M&E framework that is aligned to the HSDP M&E framework for monitoring implementation and attainment of set goals and targets. It will be reviewed and aligned with the NDP III that is currently under development