Community to clinic

Strengthening diagnosis, treatment and surveillance reporting in Uganda

December 2018 – October 2019

The highest burden of meningitis is in the 26 sub-Saharan African countries known as the ‘meningitis belt’, where epidemics of meningitis are a threat.

MRF and our partner are supporting the Uganda Ministry of Health to build community to clinic approaches to defeating meningitis in Gulu district in the north of Uganda.

Objectives

  • To increase community awareness of signs and symptoms of meningitis and appropriate action to take if affected by the disease.
  • To strengthen community-based referral pathways.
  • To support health workers to recognise meningitis and to report suspected cases.

What problem is it solving?

Together, meningitis and neonatal sepsis were responsible for 8% of under five deaths in Uganda in 20171and represented the second largest infectious cause of death within this demographic2

Bacterial meningitis progresses quickly and can result in death within 12 hours if not recognised and treated promptly, so community level knowledge of the disease and rapid diagnosis and treatment are essential. As bacterial meningitis is epidemic-prone, there is also a need for effective surveillance systems that enable a timely public health response.

In 2018, MRF worked with the Uganda Ministry of Health and non-governmental organisation, Action for Community Development (ACODEV), to identify key needs relating to meningitis.

This assessment indicated:

  • Low levels of community awareness of meningitis
  • Challenges in distinguishing between the early symptoms of meningitis and malaria
  • Late decisions by families to seek health care and delayed referral from primary health care to the hospital
  • Challenges with diagnosis and treatment
  • Lack of data on the long-lasting impairments caused by meningitis and sepsis and a lack of aftercare for survivors

With funding from Irish Aid, ACODEV and MRF will support the Uganda Ministry of Health to build approaches to address several of these needs. The project will work with community health workers and health professionals at all levels of the health system to strengthen meningitis management and response in Gulu district in the north of Uganda. The project is designed to reinforce and build upon existing government-run systems. It also aims to provide learning and resources that can be applied at a national level in the future.

Targets

The project aims to reduce deaths and risk of impairments by:

  • Raising awareness of meningitis through radio campaigns and community activities, enabling families to make more informed decisions to seek appropriate care if they suspect meningitis.
  • Training community health workers to identify suspected cases of meningitis and make referrals to a health care.
  • Working with health workers to improve fast recognition of meningitis and application of protocols for diagnosis, treatment and referrals.
  • Reinforcing the reporting system for epidemic-prone diseases, which helps to control outbreaks.
  • Providing reference materials and job aids to health workers in clinics and hospitals across the district.

Key partners

1 Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA: IHME, University of Washington, 2015. Available from http://vizhub.healthdata.org/gbd-compare. Accessed 09/01/19
Global Health Estimates 2015: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2015. Geneva, World Health Organization; 2016. Accessed 16/12/18
We take action that benefits people directly. including, training health professionals and providing support and information services.
Since the charity was founded in 1989, we have awarded 161 research grants. The total value of our investment in vital scientific research is over £19.1 million (€24.7 million).
We call for positive change as a united voice against meningitis and septicaemia, and a dedicated champion for those it affects.
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Jessica Brown
International programmes coordinator

Hello, I'm Jessica.

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