Background

The Karamoja region of Uganda, heavily reliant on rain-fed agriculture, faces frequent food insecurity exacerbated by recurring droughts and local insecurity. In response to the 2022 drought in Karamoja and neighboring districts, the Ministry of Health, with collaboration from partners, initiated a health and nutrition emergency response. We evaluated this response, focusing on implementation challenges and best practices identified through a June 2023 Intra-Action Review (IAR).

Methods

The evaluation employed a qualitative IAR methodology across six thematic response areas of the national response plan: coordination, surveillance and information generation, outbreak prevention and control, essential nutrition, essential health service delivery and health-related logistics and supplies support. Participants included district health teams, nutritionists, and representatives from partner organizationsthat were involved in this response.

Results

Strong coordination by the District Disaster Management Committees and District Nutrition Coordination Committees facilitated cohesive response strategies. Regular meetings enhanced stakeholder communication and decision-making. However, initial unfamiliarity with response plans delayed effective implementation. Surveillance and information management benefited from advanced data platforms, improving data management. The Emergency Operation Centre monitored health trends and enabled rapid responses, despite challenges in data quality and passive surveillance. Security agencies supported safe delivery of supplies and other logistics. The availability of adequate stock of personal protective equipment in health facilities mitigated infection risks. Challenges included gaps in nutrition knowledge exemplified by misuse of nutrition supplements. Essential nutrition actions were extended through integrated outreaches yet faced challenges like high malnutrition rates and supply chain disruptions. There was continued delivery of essential health services. However, under staffing, gaps in mental health service delivery and ongoing insecurity threatened essential health service delivery.

Conclusion

This evaluation highlights the critical role of coordinated leadership, and strengthened health service delivery in responding to drought-induced emergencies in Uganda and similar contexts. Addressing gaps in stakeholder communication, and service accessibility is essential for enhancing resilience against future climate-related disasters. It is necessary for government and partners to invest in local capacity building, improved coordination mechanisms, and resilient health infrastructures to effectively mitigate the health impacts of such emergencies.