J.19_LQAS_Report_2016.pdf

Community Surveys based on LQAS Methodology in Uganda

Survey Report 2016

Key Indicators i

Community Surveys based on LQAS

Methodology in Uganda

Ministry of Local Government, Kampala, Uganda

March 2017 ii

Monitoring and Evaluation of Emergency Plan progress (MEEPP) Project is funded by the United States Agency for International Development (USAID)/Uganda through a contract number AID-617-C-10-00008 and is implemented by Social Scientific Systems (SSS) Inc., Silver Spring, Maryland USA. The views expressed in this publication do not necessarily reflect the views of USAID or the United States government.

The 2016 Lot Quality Assurance Sampling (LQAS) Surveys were conducted by the district local government teams with technical and financial support from USAID funded projects:

the Strengthening TB and HIV/AIDS TB Response in Eastern Uganda (STAR-E); the

Regional Health Integration to Enhance Services Project in South Western Uganda (USAID

RHITES–SW); the Monitoring and Evaluation of Emergency Plan Progress (MEEPP)

Project; and the Strengthening Decentralization for Sustainability (SDS) project. District level local governments also contributed financially to the survey processes. Ministry of

Local Government worked jointly with MEEPP in coordinating the field activities.

The views expressed in this report do not necessarily reflect the views of USAID or the

United States government.

Additional information about the survey may be obtained from MEEPP/SSS Inc., Plot 51 Mackenzie

Vale, Kololo, P.O. Box 12761, Kampala (URL: www.sss.meepp.net; Telephone: +256 312264872/3;

Email: BAmuron@s-3.com; SWandiembe@s-3.com).

Additional information about the survey may also be obtained from Ministry of Local Government, P.O. Box, 7037, Kampala (Telephone: +256 414 256533; Email: ps@molg.go.ug).

Suggested Citation

Ministry of Local Government and Social Scientific Systems (SSS) Inc. 2017. Community Surveys based on LQAS Methodology in Uganda, 2016. Kampala, Uganda and Silver Spring, Maryland, US:

MEEPP Project http://www.sss.meepp.net/ mailto:BAmuron@s-3.com mailto:SWandiembe@s-3.com mailto:ps@molg.go.ug iii

List of Acronyms & Abbreviations

AIDS Acquired Immuno-Deficiency Syndrome

ANC Antenatal Care

CSF Civil Society Fund

DHS Demographic Health Survey

DLG District Local Government

DLST District LQAS Supervision Team

EGPAF Elizabeth Glazer Pediatric AIDS Foundation

HCT HIV Counseling and Testing

HIV Human Immunodeficiency Virus

ITN Insecticide Treated Nets

IPTP Intermittent Preventive Treatment for Malaria

LATH Liverpool Associates in Tropical Health

LQAS Lot Quality Assurance Sampling

MGLSD Ministry of Gender Labour and Social Development

MEEPP Monitoring and Evaluation of Emergency Plan Progress

MoH Ministry of Health

MoLG Ministry of Local Government

MSH Management Sciences for Health

MTCT Mother to Child Transmission (of HIV)

PMTCT Prevention of Mother to Child Transmission (of HIV)

NLF

NU-HITES

National LQAS Facilitators

Northern Uganda Health Integration to Enhance Services

SDS Strengthening Decentralization System

SSS Inc. Social and Scientific Systems Inc.

STAR-E Strengthening TB and AIDS Response in Eastern Region

STAR-EC Strengthening TB and AIDS Response in Eastern Central Region

STAR-SW Strengthening TB and AIDS Response in South Western Region

STI/STD Sexually Transmitted Infections/ Sexually Transmitted Diseases

STRIDES STRIDES for Family Health

TWG Technical Working Group

UBOS Uganda Bureau of Statistics

USAID United States Agency for International Development iv

TABLE OF CONTENTS

List of Acronyms & Abbreviations ................................................................................................... iii

TABLE OF CONTENTS ............................................................................................................................. iv

LIST OF FIGURES ..................................................................................................................................... v

LIST OF MAPS ...................................................................................................................................... vi

FOREWORD 7

INTRODUCTION 1

1.1 Background Information

1.2 Objectives of the LQAS Surveys

1.3 Methodology

1.3.1 Survey Design and Implementation

1.3.2 Survey questionnaires

1.3.4 District mobilization, Training and Data Collection

1.3.5 Survey Response Rates and Data Processing

1.3.6 Analysis

CONSOLIDATED SURVEY RESULTS 2

2.1 HIV/AIDS SERVICES

2.1.1 HIV Counselling and Testing Program

2.1.2 Prevention of Mother to Child Transmission Program

2.1.1 Male Circumcision

2.1.3 Male Circumcision

2.1.4 HIV/AIDS Knowledge and Sexual behavior

2.2 Malaria Services

2.3 REPRODUCTIVE HEALTH/FAMILY PLANNING

2.4 CHILD HEALTH

2.5 ORPHANS AND OTHER VULNERABLE CHILDREN

2.6 EDUCATION

2.7 NUTRITION

2.8 WATER AND SANITATION

Appendices 43

Appendix I: National Level LQAS Survey 2016 Data Summaries

Appendix II: District Level LQAS Survey 2015-2016 Data Summaries v

LIST OF FIGURES

Figure 2.1.1: Percentage of individuals who were counseled and received an HIV test in the last 12 months and know their results (Indicator 1.2)

Figure 2.1.3: Percentage of mothers of children (0-11 months) who were counseled and received an

HIV test during the last pregnancy and know their results. (Indicator 2.3)

Figure 2.1.3: Percentage of mothers of children 0-11 months who were tested for HIV and received their results as couple (Indicator 1.4)

Figure 2.1.4: Percentage of mothers of children 0-11 months whose partners were tested for HIV and received their results as couple within ANC setting in 2016

Figure 2.1.5: Percentage of male youth 15-24 years who are circumcised (Indicator 3.8)

Figure 2.1.6: Percentage of individuals who both correctly identify at least two ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission

Figure 2.1.7: Percentage of individuals who know how HIV transmission occurs from an infected mother to the child (Indicator 2.1)

Figure 2.1.8: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months

Figure 2.1.9: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months (indicator 3.3)

Figure 2.1.10: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in last 12 months and used a condom at last higher risk sex (Indicator 3.4) 24

Figure 2.1.11: Percentage of Youth 15-24 years who have had sexual intercourse before the age of 15

(indicator 3.6)

Figure 2.2.1: Percentage of children 0-23 months that had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset of fever. (Indicator 6.1)

Figure 2.2.2: Percentage of mothers of children 0-23 months who received two or more doses of

IPTp2 during their last pregnancy (Indicator 6.2)

Figure 2.2.3: Percentage of children 0-59 months who slept under an ITN the night preceding the survey (indicator 6.3)

Table 2.3.1: Trends in use of modern family planning method among sexually active women aged 15-

49 years

Figure 2.3.2: Trends for mothers reporting at least 4 ANC attendances during last pregnancy

Table 2.3.3: Trends in Percentage of mothers of children 0-11 months who delivered their last baby in a health facility/delivered with professional assistance

Figure 2.4.1: Trends in the proportion of children aged 12 - 23 months who are fully vaccinated

Figure 2.4.2: Trends in diarrhea treatment with ORT within 24 hours of onset symptoms among <1 year olds

Figure 2.7.1: Trends in percentage of children aged 12-23 months receiving a minimum of acceptable diet

Figure 2.7.6: Trends for mothers who took iron supplementary tablets for at least 90 days during the last pregnancy

Figure 2.8.1: Trends in hand washing with soap after visiting the toilet vi

LIST OF MAPS

Map 1.1: Map of districts where LQAS surveys 2016 were conducted

Map 2.1.1: Percentage of mothers of children (0-11 months) who were counseled and received an

HIV test during the last pregnancy and know their results. (Indicator 2.3)

Map 2.1.2: Percentage of male youth 15-24 years who are circumcised (Indicator 3.8)

Map 2.1.3: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months (indicator 3.3)

Map 2.2.1: Percentage of children 0-23 months who had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset of fever. (Indicator 6.1)

Map 2.3.1: Sexually active women age 15-49 years who are using any modern method of contraceptives

Map 2.3.2: Mothers of children 0-11 months who attended ANC at least 4 times during last pregnancy

Map 2.4.1: Children 12-23 months who are fully vaccinated before the first birthday

Map 2.5.1: OVC 5-17 years who have their basic material needs met

Map 2.5.2: OVC 5-17 years living in a household that received external support in the last 12 months

Maps 2.6.1: Parents/guardians who talked to their children aged 6-12 years about HIV/AIDS in the last 12 months

Map 2.7.2: Children 12-23 months receiving vitamin A supplementation in the last six months

Map 2.7.3: Mothers with children 12-23 months who consumed the 3 major food groups in the last 24 hours

Map 2.7.4: Mothers of children age 0-11 months who took iron supplementary tablets for at least 90 days during the last pregnancy

Map 2.8.1: Individuals who wash their hands with soap after visiting the toilet

Map 2.8.3: Households with latrine or toilet

FOREWORD

The annual community surveys are conducted by the local government in many districts with support from United States Agency for International Development (USAID) through various project implementing partners. Data from these surveys complement other data sources at the district level in developing, implementing, and monitoring service delivery plans to achieve the government’s priority objectives. These surveys that began in 2007 in some districts are annually at household level, and thus, there is rich data for districts and development partners to explore trends of service delivery and coverage at district level. In 2016, the surveys were conducted in over 37,000 households from 51 districts.

These surveys cover services relating to HIV/AIDS, reproductive health and family planning, infant and child health, maternal health, child and adult nutrition, malaria, education, water, hygiene and sanitation and support services to Orphans and Vulnerable children. It is my expectation that district local government, development and implementing partners, the private sector, civil society, and policymakers in Uganda and beyond will make use of the survey results for evidence-based planning to improve service provision at the district and local community level.

I would like to thank the stakeholders who gave their time and resources to support these surveys. I would particularly like to thank USAID for providing funding and technical assistance through implementing partners of their various projects including Monitoring and Evaluation of Emergency Plan Progress

(MEEPP) project; the Strengthening TB and HIV/AIDS TB Response Project in Eastern Uganda (STAR-

E); Regional Health Integration to Enhance Services Project in South Western Uganda (RHITES-

SW); and the Strengthening Decentralization for Sustainability (SDS).

Finally, I would like to thank the staff of the district local governments and at the Ministry of Local

Government, and particularly those in the Policy and Planning Division for steering the process on behalf of the Ministry.

Thank you, Ministry of Local Government

INTRODUCTION 1

1.1 Background Information

ganda uses a decentralized service delivery framework that provides for a mixture of approaches to service delivery at the district level. These include direct service provision by the local government at the district level; private sector delivery; and civil society service delivery (MoLG

Handbook, 2013). Effective service delivery is about providing the services that meet the needs of the users in the most efficient and effective ways. Thus, sharing best practices that leads to effective and efficient service designs and implementation is necessary.

To improve service delivery there is need to evaluate the services delivered, the community needs and priorities and to involve the communities in decision-making processes for service delivery. For better planning and implementations that can lead to improved service delivery, use of strategic information is crucial. The local governments and other service providers often use the routine management information for planning and programme designs and the quinquennial national level surveys such as Uganda

Demographic and Health Surveys (UDHS). The Lot Quality Assurance Sample (LQAS) surveys provide valuable information that complements routine management information systems data in providing information on service performance at the community level. In Uganda, many districts have been implementing annual LQAS surveys since 2009 with support from development partners, notably

USAID. These surveys have provided district level planners with accurate local information to enable data driven decisions. In particular, by classifying the sub-counties or group of sub-counties (supervision areas) into performance categories, the LQAS survey results have helped in prioritization of the allocation of resources based on the outcomes of different supervision areas at district level.

1.2 Objectives of the LQAS Surveys

The 2016 LQAS surveys were conducted between May 2016 and September 2016. The surveys were aimed at providing data on the coverage of services at the district level and on the performance of the different sub-counties or group of sub-counties within the districts. The survey information is relevant to planning and budgeting at the district level by the local government. It is also useful to the other government agencies, development partners, the private sector, CSOs, NGOs, and others to be able to develop, implement, and monitor services delivery at the district level.

The surveys provided information on ten areas of service delivery including HIV/AIDS services, sexually transmitted infections, Tuberculosis, malaria, reproductive health and family planning, child health, education, nutrition, water and sanitation, and orphans and other vulnerable children (OVC) services.

The specific objectives of the 2016 LQAS surveys were to provide information on:

District level coverage of the different services

Classification of the sub-counties or group of sub-counties (supervision areas) into performance categories at the district level

U

The current report provides summaries of service coverage indicators at the national and regional levels.

District level coverages are included in the Appendix A1I. Supervision area level reports were generated as separate reports for each district.

1.3 Methodology

1.3.1 Survey Design and Implementation

The 2016 LQAS surveys were household-based and conducted in 51 districts. For ease of presentation, the districts have been grouped into 8 geographical regions (Table 1.1) following closely the groupings used in the 2011 Uganda AIDS Indicator Survey (MOH & ICF, 2012). Map 1.1 shows the coverage of the surveys and USAID partners/projects that supported the surveys.

Each district consists of 5-8 supervision areas (SAs), each of which consists of one or two administrative sub-counties. At the first stage, 19 villages (or 24 villages in some districts) were selected from each SA using probability proportional to the number of individuals in the SA according to the Uganda National

Household and Population Census 2014. At the second stage, within each selected village, a household was randomly identified as the starting point or the reference household. The interviewer then proceeded to the household directly to the left of this reference to list eligible respondents.

Table 1.1: Geographical coverage of the LQAS community surveys in 2016

Region Districts # of districts Service Areas Covered

Eastern

Budaka, Bududa, Bukwo, Bulambuli, Busia, Butaleja, Kapchorwa, Kibuku, Kween

Mbale, Pallisa, Sironko

12 HIV/AIDS (HCT, PMTCT,

HIV/AIDS Knowledge and

Sexual Behaviour)

Tuberculosis

Malaria

Sexually Transmitted

Infections (STIs)

Reproductive Health &

Family Planning

Child Health

Sanitation

Nutrition

Education

Orphan & other Vulnerable children (OVC)

WASH

East

Central

Bugiri, Buyende, Iganga, Kaliro, Kamuli, Mayuge, Namutumba

South western

Buhweju, Bushenyi, Ibanda, Isingiro, Kabale, Kanungu, Kiruhura, Mitooma, Ntungamo, Rubirizi, Rukungiri and Sheema, Mbarara, Central Gomba 1

Western Hoima 1

North East Kotido and Moroto 2

Northern

Agago, Alebtong, Amolatar, Amuru, Dokolo Gulu, Kitgum, Lamwo, Lira, Kole, Nwoya, Otuke, Oyam

West Nile Arua and Nebbi 2

Total 51

Map 1.1: Map of districts where LQAS surveys 2016 were conducted

A household member was eligible for the survey if he or she belonged to one of the following seven categories:

1. Youth 15 – 24 years

2. OVC 5 -17 years

3. Mothers of children 0 – 11 months

4. Mothers of children 12 – 23 months

5. Mothers of children 24 – 59 months

6. Women 15 – 49 years

7. Men 15 – 54 years

At the third stage of sampling, in each selected household only one eligible member in one specific category was selected basing on a random number table. Overall, in each village, seven eligible members, BUVUMA

HOIMA

ARUA

NAPAK

KAABONG

KALANGALA

LAMWO

NWOYA

RAKAI

APAC

GULU

PADER

KITGUM

KIBAALE

AMURU AGAGO

KOTIDO

MUBENDE

MASINDI

ABIM

KASESE

OYAM

WAKISO

NEBBI

YUMBE

AMURIA

MOYO

ISINGIRO

MPIGI

SERERE

OTUKE

GOMBA

RUBIRIZI

KIRUHURA

MOROTO

MAYUGE

NAMAYINGO

NAKASEKE

MUKONO

ADJUMANI

NAKAPIRIPIRIT

LIRA

KATAKWI

LUWERO

MASAKA

KIRYANDONGO

KYENJOJO

BULLISA

NAKASONGOLA

KABALE

KIBOGA

KAMWENGE

KUMI

KOLE

BUYENDE

SOROTI

KAMULI

SEMBABULE

AMUDAT

KYANKWANZI

BUIKWE

MBARARA

NTUNGAMO

KAYUNGA

MITYANA

KABAROLE

AMOLATAR

KYEGEGWA

BUGIRI

TORORO

NTOROKO

JINJA

ALEBTONG

PALLISA

RUKUNGIRI

KANUNGU

IGANGA

DOKOLO

BUSIA

ZOMBO

IBANDA

LWENGO

KWEEN

KALIRO

BUKEDEA

KABERAMAIDO

NGORA

KISORO

LUUKA

BUSHENYI

KOBOKO

SHEEMA

KALUNGU

LYANTONDE

MBALE

BUHWEJU

BUKWO

BUTALEJA

BUNDIBUGYO

NAMUTUMBA

BULAMBULI

MANAFWA

MITOOMA

BUDAKA

SIRONKO

MARACHA

BUKOMANSIMBI

BUTAMBALA

BUDUDA

KAMPALA

LQAS Survey - 2016

Key

Central

Western

Water Bodies

West Nile Northern

South Western

North East

East Central Eastern

Didn't Conduct LQAS one in each of the seven categories, from seven households were interviewed. In each district, at least 650 households and 90 villages were visited.

The number of households and respondents reached are presented in Table 1.2. Overall, 5,066 villages and 37,128 households were reached and 37,128 (21% Male and 79% Female) respondents interviewed.

Table 1.2: Sampling Summary in LQAS Surveys 2016

Number of individuals about which the information was collected

Region Total Male (15-

54 years)

Female (15-

49 years)

Youth (15-

24 years)

Children (0-

59 months) No. of households sampled

No. of villages sampled

Central 665 138 423 218 285 665 90

Eastern 8,659 1,773 5,484 2,843 3,711 8,659 1,175

East Central 3,976 856 2,566 1,285 1,710 3,976 540

Northern 9,982 2,085 6,363 3,509 4,278 9,982 1,360

South Western 10,122 2,061 6,399 3,069 4,338 10,122 1,374

Western 798 166 508 267 342 798 109

North East 1,596 309 993 526 684 1,596 228

West Nile 1,330 282 852 452 570 1,330 190

Total 37,128 7,670 23,588 12,169 15,918 37,128 5,066

1.3.2 Survey questionnaires

All districts used the same generic questionnaire that was used in the previous years of LQAS survey applications. Separate questionnaires were developed for each of the seven categories of respondents

Each district team translated key terms and phrases in the questionnaires, with support from MEEPP technical team into the districts’ dominant local languages. This was done to ensure that meanings of key terms and phrases are not lost in individual interviewer’s ad-hoc translations during data collection. This practice has been found efficient and enhances consistence of the data collected across the different regions. Mobile Data Collection (MDC) devices were used for data collection in all the districts surveyed.

1.3.4 District mobilization, Training and Data Collection

During 2016 surveys, mobilization meetings with districts teams were carried out on case by case basis.

In most districts, the meetings involved CAOs, District Planners, DHOs and LQAS focal person in the district. The surveys were led by the planning and health departments at the districts.

The data collectors were local government staff including the community development officers and health assistants. Field supervision during data collection was mainly done by senior staff from the planning and health departments including the District Health Officers and District Planners. The training of district participants was done for 3-5 days by MEEPP staff, selected National LQAS Facilitators (NLFs), district

LQAS focal persons, Ministry of Local Government staff and some USAID/IP staff. Five days were only needed where the district had new staff members who had never participated in LQAS surveys before.

Field supervision of the data collection process was done on a daily basis by MEEPP staff, NLFs, MoLG staff, staff from projects/partners supporting the surveys and the district senior team. All available NLFs were invited to participate in the LQAS survey in their district of residence.

Data collection took between 6 and 8 days depending on the number of SAs within a district, the nature of the terrain and the facilitation provided to the SA teams to travel to the sampled villages. The district level supervisors conducted reliability studies intended to check on the quality of data from the main exercise.

1.3.5 Survey Response Rates and Data Processing

Owing to the small sample size within each SA and data collection by the community based community workers, health or social workers, the surveys achieved 100% response rates. Electronic databases from various projects/partners were submitted to MEEPP for data processing.

1.3.6 Analysis

Traditionally, there are two primary reasons for using LQAS in monitoring social services delivery: first, to determine, within given levels of confidence, whether a specific SA has reached pre-determined service coverage target, and second, to prioritize allocation of resources based on the outcomes of the different supervision areas. The analyses and reports to meet these objectives have been summarized into district level reports and shared with districts (see Appendix AIII for an example).

In this report, estimates of district level coverage of services were based on data aggregated at district level through pooling across the SAs, with each SA treated as a “stratum”. The district level coverages were also pooled within regions to form regional level estimates of coverage, with each district considered as a “cluster”. Since the districts surveyed within each region were not selected at random, the results, therefore, might not necessarily represent all the other districts within the region.

For trends analysis, data from the previous LQAS surveys 2011 to 2016 were included. In many of the regions, most of the districts surveyed have remained the same over the years. In Northern Uganda LQAS surveys began in 2013.

Some results from UDHS 2016 report are included for ease of reference purposes.

CONSOLIDATED SURVEY RESULTS 2

2.1 HIV/AIDS SERVICES

2.1.1 HIV Counselling and Testing Program

HIV testing and counseling (HTC) is an essential step towards receiving HIV care and treatment among

HIV-infected persons and plays an important role in reducing HIV transmission through improved risk-reduction behavior. To assess coverage of prior HIV testing behavior, respondents were asked if they have ever tested for HIV and whether they know where to get an HIV test. They were also asked if they tested and received their HIV results within the last 12 months. The proportions of respondents (15-54 years) who tested and received HIV results in the past 12 months are summarized in Table 2.1.1 while the trends are presented in Figure 2.1.1.

In 2016, 93% of individuals aged 15-54 years knew a place where they could take an HIV test and 93.5%

(93.2% women and 93.8% men) of these have ever tested for HIV. Further, the percentage of individuals who were counseled and received an HIV test in the last 12 months had improved substantially from below 45% in 2011 to at least 54% in 2016 (Table 2.1.1). The overall HCT coverage was higher among women (60%) as compared to men (49%). The coverage among the youth (15-24 years) was 51%. These survey findings were similar to those obtained through UDHS 2016.

Table 2.1.1: Percentage of individuals who were counseled and received an HIV test in the last 12 months and know their results

Background characteristic

Men Women Total UDHS 2016 result n % n % n % %

Regions

Central 138 50.0 147 64.6 285 57.5 55.0

Mid-Eastern 1,773 41.1 1,938 55.2 3,711 48.5 48.9

East Central 854 46.0 853 58.0 1,707 52.0 53.7

Mid Northern 2,085 55.0 2,193 62.6 4,278 58.9 54.8

North East 309 59.5 375 64.0 684 62.0 53.1

South Western 2,061 48.2 2,277 59.6 4,338 54.2 53.8

Mid-Western 166 54.8 176 68.8 342 62.0 55.6

West Nile 282 61.7 288 60.4 570 61.1 52.8

Age group

15-24 3,331 41.9 4,295 57.5 7,626 50.7 48.2

25-34 1,754 59.1 1,975 67.8 3,729 63.7 59.4

35-54 2,583 52.1 1,977 56.4 4,560 54.0 52.1

Total 7,668 49.3 8,247 59.7 15,915 54.7 52.5

†Some figures recomputed with reported sample sizes in UDHS 2016 report as relative weights

Overall, there has been an upward trend in the proportion of individuals who test and receive results every

12 months (Figure 2.1.1).

Figure 2.1.1: Percentage of individuals who were counseled and received an HIV test in the last 12 months and know their results (Indicator 1.2)

2.1.2 Prevention of Mother to Child Transmission Program

. Effective treatment to reduce HIV transmission risk from an infected mother to her baby requires that

HIV positive pregnant women know their HIV status and are on ART or are initiated on ART. This includes testing for HIV during antenatal care (ANC) or at delivery. The national coverage of testing for

HIV in this setting has improved substantially from below 70% in 2011 to above 80% in 2016 (Table

2.1.2). This improvement was across all the regions except in East Central that experienced a decline of about 14% from 87% in 2017 to 73% in 2016.

Table 2.1.2: Percentage of mothers of children (0-11 months) who were counseled and received an HIV test during the last pregnancy and know their results

Background characteristic

Tested and received HIV results during ANC

Tested and received HIV results during last pregnancy n % n %

Regions

Central 94 80.9 95 80.0

Mid-Eastern 1,215 79.2 1,237 77.8

East Central 558 72.6 569 71.2

Mid Northern 1,413 88.4 1,426 87.6

North East 223 84.8 228 82.9

South Western 1,432 89.2 1,446 88.3

Mid-Western 113 89.4 114 88.6

West Nile 188 92.0 190 91.1

Age group

15-24 2,370 82.6 2,399 81.6

25-34 2,224 86.5 2,256 85.3

35+ 642 85.8 650 84.8

Total 5,236 84.6 5,305 83.5

31.0

48.8

57.7

60.3 58.8

58.7

44.8

38.1

53.8

10.0

20.0

30.0

40.0

50.0

60.0

70.0

2011 2012 2013 2014 2015 2016

P e rc e n ta ge

Central Eastern East Central

Northern Southwestern Western

Overall

Figure 2.1.2: Percentage of mothers of children (0-11 months) who were counseled and received an HIV test during the last pregnancy and know their results. (Indicator 2.3)

In general, there were several districts across the different regions that saw a decline in the proportion of women tested during ANC or at delivery (Map 2.1.1).

Map 2.1.1: Percentage of mothers of children (0-11 months) who were counseled and received an HIV test during the last pregnancy and know their results. (Indicator 2.3)

65.3 65.3

66.8 70.9

65.5

81.1

86.6

74.8 78.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

2011 2012 2013 2014 2015 2016

P e rc e n

Indicator 1.4: Percentage of mothers of children 0-11 months who were tested for HIV and received their results as couple

The proportion of pregnant women who tested together with their male partners during ANC has improved substantially since 2011, reaching 98% in southwestern and 87% in the East Central region

(Figure 2.1.3). Figure 2.1.4 shows the percentage of mothers of children 0-11 months whose partners were tested for HIV and received their results as couple within ANC setting in 2016. Overall, of all women tested for HIV in an ANC setting, only 43% had their male partners tested for HIV as well. This figure is higher than the 36% reported through routine data in HMIS in 2016.

Figure 2.1.3: Percentage of mothers of children 0-11 months who were tested for HIV and received their results as couple (Indicator 1.4)

Figure 2.1.4: Percentage of mothers of children 0-11 months whose partners were tested for HIV and received their results as couple within ANC setting in 2016

2.1.1 Male Circumcision

Indicator 3.8: Percentage of male youth 15-24 years who are circumcised

In 2010, Uganda Ministry of Health adopted Male Circumcision as one of its strategies in the National

HIV prevention program. Since then the proportion of circumcised adults has increased. In the past five years, the proportion of circumcised youth has impressively increased from about 26% in 2011 to 47% in

2015 (Figure 4.1). However, male circumcision coverage among the youth in the districts in Northern

Uganda is still very low. With exception of Eastern and East Central Uganda, over 70% of the circumcisions were done within the past 24 months.

Recommend uncircumcised male friend or relative 77% (79% among male youth and 76% among female youth).

62.3 74.2

87.8 87.2 87.0

95.2 83.2

91.1

97.6 99.0 97.7 97.7

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

110.0

2011 2012 2013 2014 2015 2016

P e rc e n

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

23.2 24.3 23.4

66.8 64.5

39.6 42.1

55.3

43.0

P e rc e n

2.1.3 Male Circumcision

Indicator 3.8: Percentage of male youth 15-24 years who are circumcised

In 2010, Uganda Ministry of Health adopted Male Circumcision as one of its strategies in the National

HIV prevention program. The national target was 80% coverage of safe male circumcision (SMC) by close of the year 2015. However, to date only 40% of the eligible population has been circumcised. This is similar to the estimate of 44% reported through DHIS 2 routine data. The coverage is particularly low in North East and Mid Northern Uganda, which also experienced a decline in the annual coverage of

SMC among the youth in 2016. Whereas, the overall coverage of SMC is still low, there are positive attitudes toward SMC by the youth (15-24 years) across the country, with 77% (79% among males and

76% among females) recommending uncircumcised male friends for circumcision (Table 2.1.3).

Table 2.1.3: Percentage of male adults 15-54 years who are circumcised

Background characteristic

% who reported to have been circumcised

% who would recommend that their uncircumcised friends and relatives should go for SMC n % n %

Region

Central 138 34.1 95 78.9

Mid-Eastern 1,773 79.6 1,237 84.5

East Central 854 54.6 570 86.3

Mid Northern 2,085 14.7 1,426 70.5

North East 309 15.5 228 43.0

South Western 2,061 29.0 1,446 77.7

Mid-Western 166 51.2 114 81.2

West Nile 281 45.6 190 81.6

Age group

15-24 3,330 42.3 5,306 77.2

25-34 1,754 42.6

35-54 2,583 36.9

Total 7,667 40.3 5,306 77.2

Result in Figure 2.1.5 show that SMC coverage has increased sharply in the Western and South Western

Uganda regions as compared to the other regions. However, at district level, most of the districts in South

Western have SMC coverages of less than 30% (Map 2.1.3).

Figure 2.1.5: Percentage of male youth 15-24 years who are circumcised (Indicator 3.8)

Map 2.1.2: Percentage of male youth 15-24 years who are circumcised (Indicator 3.8)

59.8

46.3

61.5

66.8 64.0 73.0

41.2

9.1 13.3

19.3 16.9

8.4

13.3

24.5 28.2

32.1 35.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

2011 2012 2013 2014 2015 2016

P e rc e n

Central

Eastern

East Central

Northern

Southwestern

Western

2.1.4 HIV/AIDS Knowledge and Sexual behavior

Knowledge

Percentage of individuals who know how HIV transmission occurs and ways of avoiding infection

The survey results indicate that over 95% of Ugandans are aware of HIV/AIDS, irrespective of age, gender and region of residence. Similarly, about 73% of the respondents, regardless of age and gender, were aware of at least three benefits of testing for HIV.

Abstaining from sex, being faithful to one uninfected partner, and using condoms are important ways to avoid the spread of HIV. The survey results show that 89% of the individuals (15-54 years) are aware that consistent condom use and limiting sexual intercourse to one uninfected partner are effective ways of preventing HIV (Table 2.1.3).

Table 2.1.3: Percentage of individuals who identify condom use and being faithful to one uninfected partner as means of reducing the sexual transmission of HIV

Background characteristic

Men Women Total UDHS 2016 result

N % n % n % %

Regions

Central 138 90.6 147 84.4 285 87.4 86.7

Mid-Eastern 1,773 93.8 1,938 90.2 3,711 91.9 85.9

East Central 854 90.6 853 85.2 1,707 87.9 86.5

Mid Northern 2,085 90.5 2,193 86.0 4,278 88.2 80.8

North East 309 86.1 375 83.5 684 84.6 76.1

South Western 2,061 91.1 2,277 86.1 4,338 88.5 85.7

Mid-Western 166 89.2 176 77.8 342 83.3 85.7

West Nile 282 90.1 288 84.0 570 87.0 66.2

Age group

15-24 3,331 87.0 4,295 83.2 7,626 84.9 81.2

25-34 1,754 94.9 1,975 91.6 3,729 93.2 86.2

35-54 2,583 94.1 1,977 88.8 4,560 91.8 83.2

Total 7,668 91.2 8,247 86.5 15,915 88.8 82.6

Closely related to the knowledge of the different ways of avoiding contracting HIV are the incorrect beliefs about AIDS. Common misconceptions include the idea that all HIV-positive individuals appear ill and the belief that the virus can be transmitted through mosquito bites, by sharing food with someone who is infected, or by witchcraft or other supernatural means. This defines the comprehensive knowledge about HIV. In this report, we define comprehensive knowledge about HIV prevention as knowing that both condom use and limiting sexual intercourse to one uninfected partner are HIV prevention methods, knowing that a healthy-looking person can have HIV, and rejecting all the aforementioned local misconceptions about

HIV transmission. Overall, comprehensive knowledge is still low, at 35%. This is considerably low especially among young people among which only 32% had comprehensive knowledge. There was a decline in the proportion that had comprehensive knowledge about HIV from 40% in 2015 to the current 32% (Figure 2.1.6).

Table 2.1.4: Percentage of individuals who both correctly identify at least two ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission

Background characteristic

Men Women Total n % n % n %

Regions

Central 138 26.1 147 26.5 285 26.3

Mid-Eastern 1,773 39.9 1,938 35.0 3,711 37.3

East Central 854 35.6 853 28.7 1,707 32.2

Mid Northern 2,085 36.4 2,193 26.8 4,278 31.5

North East 309 34.6 375 26.7 684 30.3

South Western 2,061 41.5 2,277 36.5 4,338 38.9

Mid-Western 166 35.5 176 25.6 342 30.4

West Nile 282 27.0 288 19.8 570 23.3

Age group

15-24 3,331 34.3 4,295 30.8 7,626 32.3

25-34 1,754 41.4 1,975 34.1 3,729 37.6

35-54 2,583 40.0 1,977 29.7 4,560 35.5

Total 7,668 37.9 8,247 31.3 15,915 34.5

Figure 2.1.6: Percentage of individuals who both correctly identify at least two ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission

23.5

29.9 30.9 30.8 29.9

30.9

34.6

38.8

44.9

48.4

38.8

26.9

37.4 34.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

2011 2012 2013 2014 2015 2016

P e rc e n

Indicator 2.1: Percentage of individuals who know how HIV transmission occurs from an infected mother to the child

The survey results show that the percentage of respondents who knew all the three ways/stages at which

Mother to Child transmission of HIV (MTCT) occurs (i.e. during pregnancy, delivery, and breastfeeding).

The proportion of individuals with comprehensive knowledge about EMTCT is still low at 55%. More efforts are required to improve knowledge about PMTCT.

Figure 2.1.7: Percentage of individuals who know how HIV transmission occurs from an infected mother to the child (Indicator 2.1)

Sexual behavior

Indicator 3.3: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months

Women and men who participated in the survey were asked about the number of partners with whom they had had sex in the 12 months preceding the survey. Results show that 23% of the men and 6% of the women had more than one sexual partner in the past 12 months. Further, 32% of men as compared to 18% of women had sex with a non-marital or non-cohabiting sexual partner within the past 12 months (Figure

2.1.8).

Results also show that only 60% of the individuals involved in high risk sex used a condom in the last sex act with a non-marital or non-cohabiting partner. The distributions of high risk sexual behavior among men are summarized in Table 2.1.5. Mid-Eastern and Mid-Northern regions had slightly lower percentages of men involved in risky sexual behaviour as compared to other regions.

28.9

40.1

43.0 49.4 42.1

50.5

36.9

62.5 66.5

62.1 69.0

61.9

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

2011 2012 2013 2014 2015 2016

Central Eastern East Central

Figure 2.1.8: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months

Table 2.1.5: Percentage of men (15-54 years) who reported multiple sexual partners and condom use

Men with 2+ partners and those who had sex with non-marital or non-cohabiting sex partner in last 12 months

% (of those with 2+ partners) who reported using a condom during last sexual intercourse with such a partner

UDHS 2016 results

N

% who had 2+ partners in the past 12 months

% who had sex with a person who was neither their wife nor lived with them

% who had 2+ partners in the past 12 months

% who had intercourse in the past 12 months with a person who was neither their wife nor lived with them

% (of those with

2+ partners) who reported using a condom during last sexual intercourse with such a partner

Central 76 39.5 49.0 58.6 20.3 34.2 60.0

Mid-Eastern 1,397 24.4 34.0 63.3 16.5 22.7 49.2

East Central 663 28.2 38.6 67.2 21.6 29.6 55.6

Mid Northern 1,583 18.6 25.4 68.0 15.9 22.4 62.5

North East 181 27.6 24.9 62.2 22.0 28.6 67.9

South Western 1,518 19.9 30.4 65.1 19.1 29.9 54.9

Mid-Western 115 37.4 47.0 37.0 24.6 33.2 40.7

West Nile 175 33.7 34.4 66.7 22.8 22.0 63.1

Total 5,708 22.9 31.5 60.0 20.6 29.3 57.0

20.6

2.3

22.9

5.6

29.3

14.8

31.5

17.6

57.0

37.3

60.0

59.8

0.0 20.0 40.0 60.0 80.0

Male

Female

Male

Female

U D

H S

LQ

A

S

Percentage

% (of those with 2+ partners) who reported using a condom during last sexual intercourse with such a partner

% who had intercourse in the past 12 months with a person who was neither their wife/husband nor lived with them

% who had 2+ partners in the past 12 months

Trend analysis shows that the percentage of individuals who had sex with a non-marital or non-cohabiting sexual partner increased from 20% to 25% between 2015 and 2016 (Figure 2.1.9). Whereas, for the most of the other regions, this indicator rebound to the 2014 figures, for the Southwestern and East Central

Uganda, there were worrying dramatic increases. This increase in risky behavior for HIV infection was the almost uniform across the country (Map 2.1.3). Unfortunately, the use of a condom in the last high risk sex act for HIV transmission improved only slightly from 54% to 60% (Figure 2.1.10). As noted previously, the increase in multiple partnerships with only a slight increase in condom use constitutes a high risk behavior and increase in HIV transmission. Close understanding of messaging about effectiveness of ART and VMMC on HIV transmission might be necessary to ascertain their influence on condom use and general risk compensation or behavioural disinhibition.

Figure 2.1.9: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months (indicator 3.3)

28.6

30.5 29.5

30.6

16.3

31.6

23.2 23.7 26.7

17.6

20.8

17.3

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

2011 2012 2013 2014 2015 2016

P e rc e n

Map 2.1.3: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in the last 12 months (indicator 3.3)

Figure 2.1.10: Percentage of individuals who had sexual intercourse with a non-marital or non-cohabiting sexual partner in last 12 months and used a condom at last higher risk sex (Indicator 3.4)

73.3 77.5

66.9 71.8

74.5

67.2

66.1

48.0 48.7 49.8

37.0 37.0

70.3

54.4

60.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

2011 2012 2013 2014 2015 2016

P e rc e n

Central Eastern East Central Northern

Southwestern Western Overall

Indicator 3.6: Percentage of Youth 15-24 years who have had sexual intercourse before the age of

15 years

The percentage of youth 15-24 years who had had sexual intercourse before the age of 15 years has decreased significantly over the past five years (Figure 2.1.11).

Figure 2.1.11: Percentage of Youth 15-24 years who have had sexual intercourse before the age of 15

(indicator 3.6)

9.5

11.7

7.3

13.1

10.5

13.0

11.0

9.0

5.3 5.4 6.2

4.5

3.5

4.9

8.6

9.0

6.4

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

2011 2012 2013 2014 2015 2016

P e rc e n

East Central

Northern

Southwestern

2.2 Malaria Services

Indicator 6.1: Percentage of children 0-23 months that had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset of fever

The percentage of children who were reported to have had a fever in the two weeks preceding the survey was as high as 38%. Of these 53% sought and received treatment with ACTs within 24 hours of onset of the fever (Figure 2.2.1). This was an increment of at least 10% from the 42% in 2015. Parents or caregivers in West Nile and Karamoja districts, however, performed poorly in ensuring that the children are taken for treatment within 24 hours of onset of the fever (Map 2.2.1).

Figure 2.2.1: Percentage of children 0-23 months that had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset of fever (Indicator 6.1)

50.0

61.0

45.5

52.1 56.0

53.7 58.0

34.4 40.3 39.5 43.3

41.0

38.5

45.3

53.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

2011 2012 2013 2014 2015 2016

P e rc e n

Central Eastern East Central Northern

Map 2.2.1: Percentage of children 0-23 months who had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset of fever. (Indicator 6.1)

Indicator 6.2: Percentage of mothers of children 0-23 months who received two or more doses of

IPTp2 during their last pregnancy

The percentage of mothers of children 0-23 months who received two or more doses of IPTp2 during their last pregnancy remained almost the same between 2015 and 2016, at 53% (Figures 2.2.2). Although, higher than the coverage that was reported in UDHS 2016 (i.e. 45%), a coverage of 53% is still low.

Figure 2.2.2: Percentage of mothers of children 0-23 months who received two or more doses of IPTp2 during their last pregnancy (Indicator 6.2)

52.4

37.3 37.4

42.0 39.8

43.4 42.7

46.7

58.1 60.4

42.8

54.0 53.2

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

2011 2012 2013 2014 2015 2016

P e rc e n

Indicator 6.3: Percentage of children 0-59 months who slept under an ITN the night preceding the survey

The use of insecticide-treated mosquito nets is a primary health intervention designed to reduce malaria transmission in Uganda, especially the most vulnerable groups that include the children under five (U5) and the pregnant women. The survey results show that, within the past three years, the percentage of U5 who slept under an ITN the night preceding the survey has remained almost the same at about 79%

(Figure 2.2.3).

Figure 2.2.3: Percentage of children 0-59 months who slept under an ITN the night preceding the survey

(indicator 6.3)

89.5

41.7 41.5

50.2

67.7 72.3

46.8

84.6

67.5

61.8 61.0

78.5

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

2011 2012 2013 2014 2015 2016

P e rc e n ta ge Central

Eastern

East Central

Northern

Southwestern

2.3 REPRODUCTIVE HEALTH/FAMILY PLANNING

Indicator 7.2: Percentage of sexually active women aged 15-49 years who are using any modern method of family planning

Use of effective modern family planning methods is currently promoted by Government and NGOs throughout the country as described in the National Development plan (NDP-2010/2011-2014/2015).

Results from the 2016 LQAS surveys show that use of modern family planning methods is still below

50% in over 80% of the 51 districts. Districts in Western and South Western performed well on this indicator while districts in Northern Uganda and Karamoja sub-regions performed poorly (Map 2.3.1).

Trend analysis in Table 2.3.1 shows that the percentages of sexually active women using modern contraceptives have remained the same, at 37%, since 2013.

Map 2.3.1: Sexually active women age 15-49 years who are using any modern method of contraceptives

Table 2.3.1: Trends in use of modern family planning method among sexually active women aged 15-49 years

Year 2011 2012 2013 2014 2015 2016

UDHS 2016

results

Central 39.6 42.3 42.0 38.6 41.2 34.7 41.2

Eastern 33.5 31.8 35.1 37.2 35.2 39.4 38.3

East Central 25.1 30.3 30.1 30.2 27.2 30.8 28.6

Northern 29.9 30.8 31.4 34.4 36.3

Southwestern 35.5 37.7 41.0 40.2 42.1 41.8 38.4

Western 38.9 34.7 38.0 34.9 40.0 43.3 34.1

Overall 30.3 30.8 37.0 36.1 37.1 37.4 34.6

Indicator 7.3: Percentage of mothers of children 0-11 months who attended ANC at least 4 times during last pregnancy

The attendance of at least four ANC visits has increased to an overall average of 60% at the national level. The coverage of at least four ANC was fairly across all the regions (Map 2.3.2). Similar results were reported in UDHS 2016 report (i.e. 60%).

Map 2.3.2: Mothers of children 0-11 months who attended ANC at least 4 times during last pregnancy

Figure 2.3.2: Trends for mothers reporting at least 4 ANC attendances during last pregnancy

2015 2016

Key

Water bodies

Not surveyed

50.1 - 65.0 65.1 - 81.3

29.5 - 35.0 35.1 - 50.0

47.9 48.6

50.2 49.7 52.4

60.3 46.1

51.9 53.9

58.8

65.6 66.9

42.4

60.3

20.0

30.0

40.0

50.0

60.0

70.0

80.0

2011 2012 2013 2014 2015 2016

P e rc e n

Indicator 7.4: Percentage of mothers of children 0-11 months who delivered their last baby in a health facility

In 2016, survey results show that 70% of the pregnant women delivered at the health facility while 79% were assisted by a trained health worker at delivery. Most of the districts in Eastern Uganda, however, had less than 60% of the women delivering at the health facility (See Map 2.3.3).

Map 2.3.3: Percentage of mothers of children 0-11 months who delivered their last baby in a health facility

Table 2.3.3: Trends in Percentage of mothers of children 0-11 months who delivered their last baby in a health facility/delivered with professional assistance

Percentage of mothers of children 0-11 months who delivered their last baby in a health facility

Percentage of mothers of children 0-11 months who were assisted by a trained health worker during delivery

Year 2013 2014 2015 2016 2013 2014 2015 2016

Central 79.0 82.9 82.9 84.2 79.2 82.9 82.8 87.4

Eastern 59.1 65.7 69.5 59.1 60.3 67.1 71.1 71.0

East Central 72.6 79.4 82.2 71.7 71.6 77.9 80.3 79.3

Northern 65.6 72.6 70.6 71.4 67.3 72.8 74.7 80.1

Southwestern 74.5 76.8 80.9 75.4 75.6 79.7 82.2 85.8

Western 66.6 76.3 78.7 76.3 71.4 76.6 78.5 80.7

Overall 70.0 75.8 77.7 70.0 71.2 76.4 78.4 79.2

UDHS 2016 73.0 74.0

2.4 CHILD HEALTH

Indicator 8.1: Percentage of children aged 12-23 months who are fully vaccinated before their first birthday

Immunization coverage has generally improved over the years across all regions. South western region has consistency attained higher coverage compared to the other regions while East Central has consistently lagged behind the other regions (Figure 2.4.1). The percentage of the children who are fully vaccinated before their first birthday reached 80% in 2016 in most of the districts across the country (Map

2.4.1). However, this figure is discrepant from its corresponding proxy reported in UDHS 2016 report

(i.e. the percentage of children age 12-23 months who had received all basic vaccinations, estimated at

55%). This is the only indicator so far where the LQAS survey 2016 results are significantly from three

UDHS 2016 results.

Map 2.4.1: Children 12-23 months who are fully vaccinated before the first birthday

Figure 2.4.1: Trends in the proportion of children aged 12 - 23 months who are fully vaccinated before the first birthday

Indicator 8.2: Percentage of children 0-11 months with diarrhea in the last two weeks receiving

ORT within 24 hours of onset of symptoms

The 2016 surveys showed the district coverage for this indicator has generally improved since 2015 except in East Central where most of the districts are still performing poorly (Figure 2.4.2).

Figure 2.4.2: Trends in diarrhea treatment with ORT within 24 hours of onset symptoms among <1 year olds

48.4 57.3

57.2

68.2

68.2

48.9

62.9

72.1 75.5

79.6 75.5

87.0

54.1

52.8

81.1

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

2011 2012 2013 2014 2015 2016

P e rc e n

Overall

17.6

8.8 7.2 11.2

10.0

16.4

25.1

20.7

17.9

27.3

14.5

19.5

22.6

40.6

10.8

34.8

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

2011 2012 2013 2014 2015 2016

P e rc e n

2.5 ORPHANS AND OTHER VULNERABLE CHILDREN

Indicator 9.2: Percentage of OVC 5-17 years who have their basic material needs met

Generally there was low coverage of basic materials for OVC, with a national coverage of 40%. In most districts the coverage of basic care remained the same as in 2015 and decreased (see Map 2.5.1).

Map 2.5.1: OVC 5-17 years who have their basic material needs met

Indicator 9.3: Percentage of OVC 5-17 years living in a household that receive external support in the past 12 months

One in four households in Uganda foster at least one orphan by providing for health, shelter, nutrition, education and other needs. However, many of these caregivers are overburdened and often lack the social economic capacity to provide adequate care and support for these children. Community organizations, religious bodies and other civil society members have stepped in by providing information, vocational skills training, basic education, medical care and counselling and micro-credit services (National OVC policy, 2004). This indicator measures external support to OVC households in the 12 months preceding the survey.