Conference abstract

Rapid assessment of public health risks among refugees in Nakivale Refugee Settlement, Isingiro District, Uganda, 2015

Pan African Medical Journal - Conference Proceedings. 2017:6(15).20 Dec 2017.
doi: 10.11604/pamj-cp.2017.6.15.497

Contact the corresponding author
Keywords: Refugees, public health, risk, Uganda

Rapid assessment of public health risks among refugees in Nakivale Refugee Settlement, Isingiro District, Uganda, 2015

Ben Masiira1,&, Christine Kihembo1, Alex Riolexus Ario1

1Uganda Public Health Fellowship Program, Kampala, Uganda

&Corresponding author
Ben Masiira, Uganda Public Health Fellowship Program, Kampala, Uganda


Introduction: living conditions in refugee settings present a favourable environment for eruption of infectious disease outbreaks. At the end of April 2015, the Uganda Ministry of Health was alerted of an influx of refugees from Burundi into Uganda. Nakivale Refugee Settlement has been in existence since 1959 and had a population of 72,000 refugees of various nationalities by the time of this influx. We assessed the refugee settlement to detect potential public health risks among refugees and identify health service delivery gaps.

Methods: a standard World Health Organization check list was used. We assessed the scope of health service delivery, disease outbreaks in the last three months, safe water provision, human waste disposal, Integrated Disease Surveillance and Response (IDSR) strategy and shelter. We also reviewed common medical conditions and reporting of national priority infectious diseases. We assessed immunization status of children ≤ 5 years by observing for presence BCG immunization scar and interviewing mothers.

Results: at the time of assessment, the total number of refugees had increased from 72,000 to 82,000. The settlement was served by a total of seven Health Facilities (HFs). The health worker: patient ratio was adequate for Medical Officers (1/16,400), Midwives (1/3,280) and Nurses (1/2,000). Essential public health services such as immunization, family planning, maternal and child health services were provided. The top five medical conditions included: Malaria, respiratory tract infections, skin diseases, diarrhoea and intestinal worms. No stock-outs of vaccines or medicines and supplies were documented in the last month. The completeness of weekly reporting in the last 12 weeks was above the target of ≥ 85% at all HFs. Standard case definitions were available at only 15% (1/7) of HFs. A sample of 50 children ≤ 5 years revealed; 10% had a visible BCG immunization scar and 56% (28/50) had completed their immunization schedule. Running water and hand washing facilities were available at 71% and 85% of HFs respectively. Although there was access to safe drinking water, the reception center was congested (900 people in a center built to accommodate 400 people), had no handing washing facilities and open defecation was common.

Conclusion: this assessment revealed adequate human resources for health and good public health service delivery. However, the risk of water borne and vaccine preventable diseases was high. We recommended mass immunization campaign for children of ≤ 5 years, health education on hygiene, provision of hand washing facilities and standard case definitions for priority diseases.