Health Policy and Planning Advance Access originally published online on
December 7, 2005
Health Policy and Planning 2006 21(1):53-64; doi:10.1093/heapol/czj007
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Published by Oxford University Press 2005.
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Original article
Integrating refugee and host health services in West Nile districts, Uganda
Christopher Garimoi Orach1,2,3 and Vincent De Brouwere2
1 Makerere University, Institute of Public Health, Kampala, Uganda, 2 Institute
of Tropical Medicine, Antwerp, Belgium and 3 Vrije Universiteit Brussel,
Brussels, Belgium
Correspondence: Dr Christopher Garimoi Orach, Makerere University Institute of
Public Health, P.O. Box 7072, Kampala, Uganda. Tel: +256 77 51 14 44; Fax: +256
41 53 18 07; E-mail: [email protected]
Refugees are a common feature in Africa and Uganda is no exception.However,
Uganda does not have the resources to provide healthcare to all its own
citizens, let alone to refugees. Refugeehealth services are therefore usually
set up and provided separatelyby international organizations such as the United
Nations HighCommissioner for Refugees (UNHCR). However, such services oftenend
up being the only available or reliable services in a particularlocation for
both host and refugee populations. Yet the hostpopulations are often denied
access to these services because,in theory, other services are being provided
by their government.The case study in the West Nile region of Uganda describes
howhost and refugee services were integrated in an attempt to addressthe
concerns of inequity of access to care for host populations,when reasonably
good health services were available to nearbyrefugee populations. The paper
identifies and discusses thechallenges
encountered and those remaining.
Key Words: integration, health service, refugees, host population, Uganda
1The West Nile region of northern Uganda comprises five districts,namely Arua,
Adjumani, Moyo, Yumbe and Nebbi. All now host refugeesexcept for Nebbi.
2Key informants comprised four officials from the Office ofthe Prime Minister
(Refugee Desk Officers Arua and Commissionerfor Refugee Services); two Officers
from the Ministry of Health(Commissioner for Community Health and Senior
Principal Planner).At the district level, interviews were conducted with five
districtpolicy and administrative officers, namely the Chairman, DistrictLocal
Council 5; Chief Administrative Officer (CAO); AssistantCAO In-charge of
Health; Chairman, Health Committee LC5; Secretaryfor Health LC5. Four members
of the district health managementteam (the DDHS, Refugee Reproductive Health
Co-ordinator, DistrictHealth Visitor and Assistant DDHS or Head, Health
sub-districtserving refugee and host population situated in Terego County)were
interviewed. Six UNHCR and NGO personnel comprising theUNHCR Health
Co-ordinator, AHA-NGO Country Representative, HealthProgramme Co-ordinator and
three Medical Officers were interviewed.
3Opio G. 2000. The influx of Sudanese refugees in northern Uganda.Adjumani
Settlement Commandant, personal communication, September.
4Exchange rate in 2003: 1US$ = 1900 Ugandan shillings; ratein 2004: 1US$ = 1800
Ugandan shillings.
5The health sub-district corresponds to grade 4 health centres,which provide
basic curative, preventive, promotive, maternityand laboratory services. In
addition, they provide emergencyobstetric and surgical interventions. The
health sub-districtis headed by a medical doctor.
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majid alemi junior.
________________________________
From: Majid Alemi Junior <[email protected]>
To: Majid Alemi Junior <[email protected]>
Cc: [email protected]
Sent: Monday, May 11, 2009 9:28:58 PM
Subject: Re: Koboko District Comprice Of one County. members coments. about
students progress in the district
More Details
Koboko district has 63 primary schools (both government and private), 17
secondary schools (12 of them private and 5 government aided), as well as one
technical institute (Koboko Technical Institute)
________________________________
From: Majid Alemi Junior <[email protected]>
To: [email protected]
Cc: [email protected]
Sent: Monday, May 11, 2009 9:19:11 PM
Subject: Koboko District Comprice Of one County. members coments. about
students progress in the district
Koboko District comprises of one county, 5 Sub-counties (including urban
council), 43 parishes (LCIIs) and 302 villages (LC1s). The district has one
Urban Council namely, Koboko Town Council. Recruitment of substantive Sub
County Chiefs has been conducted for all the Sub Counties that were been
managed by parish chiefs. New sub-counties were created Abuku from Lobule and
Dranya from Midia but to date have remained passive. A number of the parishes
are not operational and have no Parish chiefs to manage them.The District
covers a total land area of 820.8 km2. The area covered by the rivers and
streams is small. Forest and hills cover about 12% of the land area. Over 88%
of the land is arable and suitable for agriculture. Koboko District comprises
mainly of flat rolling plains occurring at 3,160 to 5,283 feet above sea level
with isolated undulating hills mainly in the western and northern parts of the
District towards the Sudan boarder, with a slight
slope towards the east. The area where the three international boarders meet
consists mainly of hills and rocks hosting remains of some the indigenous
savannah woodlands. majid alemi junior. Commodity Prices
Sorghum grains : UGX375 per kg
Simsim: UGX1100 per kg
Chicken (live) : UGX13500 per kg
Matooke: UGX575 per kg
More
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