Uganda Mortality Surveillance Project, November 2020

All-cause mortality surveillance before, during and after a pandemic can inform decision makers about the full magnitude of the health consequences of the COVID-19 pandemic with a focus on excess mortality, enables real-time capturing of mortality data, enables monitoring of mortality trends to assess population health and public health measures and contributes to Civil Registration and Vital Statistics (CRVS) system strengthening efforts in the country.

The goal of this project is to establish a sustainable RMS system within Uganda’s National Institute of Public Health, leveraging and integrated with existing data systems and processes that generates real-time weekly data on all-cause mortality at national and sub-national levels during the pandemic and beyond for routine epidemic and pandemic awareness.

The project is being implemented by teams from the Ministry of Health (Uganda National Institute of Public Health and Division of Health Information) and the National Identification and Registration Authority.

At health facility level, the project is being implemented in all the 15 MoH regions at regional referral hospitals (RRH) (Arua, Gulu, Lira, Soroti, Moroto, Mbale, Jinja, Masaka, Hoima, Mubende, Fort portal, Mbarara, Kabale, Naguru, and Entebbe).

At the community level, the project is implemented in 15 first phase districts (Kitgum, Amuru, Gulu, Oyam, Lira, Dokolo, Kapchorwa, Mbale, Tororo, Kayunga, Mukono, Wakiso, Masaka, Kyotera, and Rakai).

1. Developed training materials, surveillance tools, and standard operating procedures for data collection
2. Conducted pre-visits to the 15 first phase districts to introduce the project and select the relevant personnel to support the project
3. Conducted trainings on importance and how to collect daily/weekly counts of all-cause mortality data (15 Medical Records Officers (RRH Focal Persons), 450 Village Health Team members (Parish Coordinators) at community level and 15 District Village Health Teams (VHT) Coordinators)

1. Daily /weekly collection and reporting of all-cause mortality data at both health facility and community levels
2. Monthly review meetings with RRH Focal Persons and District VHT Coordinators
3. Weekly analysis of mortality data by central team
4. Weekly review meetings by the technical RMS team
5. Support supervision of the data collection teams on a quarterly basis by the central team
6. Bi-weekly dissemination of findings to stakeholders
7. Technical team doing assessment for software design and linkage of DHIS2 and NIRA databases
8. Mortality Surveillance Technical Working Group members nominated, awaiting confirmation from their institutions then meetings will commence

1. Established a rapid mortality surveillance (MS) system at both health facility (RRHs) and community levels
2. Extracted and analyzed baseline mortality data for 3 years (2018-2020) both aggregated data from DHIS2 and patient level data from 15 RRHs, and Lower level HCs in 4 districts
3. Memorandum of Understanding for alignment of DHIS2 and NIRA databases signed. Technical team doing assessment for software design and linkage

1. Use the lessons learned to develop and institutionalize the Country MS Strategy
2. Establish and functionalize the MS TWG
3. Use lessons learnt to scale up health facility component to all levels of Health facilities and the community component to all Districts in Uganda