In Uganda's Busoga region, 40 percent of the women of reproductive age did not access healthcare in 2016. [1] Many turned to underqualified traditional birth attendants due to distant specialized secondary and tertiary healthcare facilities and limited expertise at primary facilities. In a collaborative effort, the Ministry of Health (MoH) and the World Health Organization (WHO) joined forces to strengthen the healthcare system, with a focus on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. Strategic measures included improvements in referral systems, capacity building for the workforce, and infrastructure upgrades. Ambulances procured through the project now facilitate an average of 100 successful emergency referrals each month. This initiative yielded significant advancements in maternal and child healthcare, evidenced by a rise in first-trimester antenatal care attendance from 18 percent in 2018 to 31 percent in 2022.[2] Additionally, regular antenatal visits (four times or more) increased from 37 to 49 percent. Notably, deliveries overseen by trained health professionals increased from 47 to 66 percent, and prompt post-natal care (within 2 days of delivery) showed substantial improvement, increasing from 73 to 97 percent for women and 86 to 98 percent for newborns.[3] The strengthening of Uganda’s health systems to address population-specific health needs and barriers to equity across the life course contributed to achieving the 13th WHO General Programme of Work (GPW 13) outcome of improved access to quality essential health services, and goal of 1 billion more people benefiting from Universal Health Coverage.

- Honourable Margaret Muhanga, State Minister of Health in Charge of Primary Health Care 

In 2020, WHO established a novel partnership for RMNCAH with Uganda's MoH and District Health Teams, laying the foundation for project implementation. Generous financial support from the Government of the Republic of Korea through the Korea International Cooperation Agency (KOICA) was secured to elevate the quality of RMNCAH services in the Busoga region.

Following an extensive assessment by WHO, encompassing needs evaluation, quantification, costing, procurement, clearing, distribution, and installation support, medical equipment valued at 1.5 million USD and seven ambulances were allocated to district health facilities in May 2021. These assets not only improved emergency referrals but also substantially reduced patient transfer times to tertiary care facilities, leading to enhanced healthcare delivery and improved patient outcomes.[4][5] Medical professionals demonstrated heightened proficiency in managing complex conditions, reducing dependence on referrals to specialized centres and mitigating care delays. With ambulances facilitating about 100 emergency transfers monthly, survival rates for mothers and newborns have been reported to increase.[6] Dr Frederick Isabirye, District Health Officer of Buyende District, noted, "it is three years now since we received ambulances, and we see that our maternal and child mortality rates have dropped to single digits. With the provided training, coordination has been streamlined between the ambulance team and the health facilities.”

-Dr Yonas Tegegn Woldemariam, the WHO Representative in Uganda

Employing a data-driven approach, the project implemented periodic assessments to continuously refine its strategies, with the World Health Organization (WHO) contributing technical expertise for evidence-based reviews, alongside ongoing monitoring and evaluation. This ensured the initiative's adaptability to evolving needs, leading to significant improvements in performance indicators, especially in the areas of RMNCAH. From 2018 to 2022, the project witnessed notable advancements: the percentage of antenatal care in the first trimester increased from 18 percent in 2018 to 31 percent in 2022; the proportion of women attending at least four antenatal care visits rose from 37 percent to 49 percent; pregnant women giving birth in health facilities went up from 47 percent to 66 percent; women receiving postnatal care within two days of delivery improved dramatically from 73 percent to 97 percent; and newborns receiving postnatal care within two days of birth increased from 86 percent to 98 percent.[7]

These advancements in maternal and child health establish a robust foundation for future projects, underscoring the importance of targeted interventions and collaborative efforts. As Uganda advances towards universal healthcare, WHO, in collaboration with the Ministry of Health, is actively exploring the possibility of expanding the project to encompass additional regions within the country.