In Eastern Uganda’s Mbale Region, stronger collaboration between communities, district health leaders, and the World Health Organization is improving access to routine immunisation and strengthening responses to public health emergencies. Across the 16 districts and one city that make up the region, many children living in remote and hard-to-reach areas have continued to miss life-saving vaccines due to limited access to health services. Through better use of local data, community-driven insights, and sustained field coordination, health partners have been able to identify these gaps and turn them into targeted action to reach children who had previously remained underserved.
A key breakthrough came when the African Network for Care of Children Affected by HIV/AIDS carried out extensive mapping of zero-dose and under-immunised children in Mbale, Tororo, and Kibuku districts. By conducting door-to-door visits, ANECCA teams identified children who had not been captured in the routine immunisation system and also highlighted health facilities that were struggling to provide essential vaccination services. This grassroots data offered a much clearer picture of the challenges faced by families in underserved communities and created the foundation for a more focused response.
When WHO’s field coordination team received the mapping results, it worked quickly with ANECCA and district leaders to convert the findings into practical interventions. Joint supportive supervision visits were organized at poorly performing health facilities, where health workers were helped to identify bottlenecks affecting immunisation delivery. Village Health Teams and community influencers were also mobilised to improve awareness and encourage families to bring children for vaccination. This shift from data collection to immediate action helped strengthen service delivery in the places where the need was greatest.
WHO also provided logistical support that enabled teams to reach some of the region’s hardest-to-access facilities, including in Budwale, Wanale, and Merikit, even during heavy rains and difficult travel conditions. This support ensured that communities facing the greatest geographical barriers were not excluded. Local partners acknowledged that such outreach would have been extremely difficult without WHO’s involvement, especially in areas where transportation and weather conditions often make health service delivery more challenging.
Building on the success of these efforts, WHO expanded its collaboration with District Health Teams in Pallisa, Sironko, and Butaleja districts, as well as Mbale City. Using the Reach Every District and Reach Every Child categorisation approach, the field team worked closely with district leaders to identify health facilities most in need of additional support. This method allowed resources and attention to be directed where the largest immunisation gaps existed, helping improve efficiency and impact.
Over time, the teams visited 28 health facilities and carried out detailed assessments using the WHO Open Data Kit. These assessments helped document service delivery gaps, review immunisation performance, and identify immediate corrective actions. Health workers received support in understanding vaccination monitoring charts, improving the accuracy of immunisation data, and increasing the number of static immunisation sessions offered during the week so that families had more opportunities to access vaccines. District Expanded Programme on Immunisation focal persons and assistant district health officers were actively involved throughout the process, helping to ensure strong local ownership and sustained follow-up.
At the same time, the Mbale Region also faced several public health emergencies that required rapid and coordinated WHO support. When measles outbreaks occurred in Butaleja and Bulambuli, the WHO coordinator joined the Regional Emergency Operations Centre to guide outbreak investigations, conduct root cause analyses, and coordinate response measures with partners such as Baylor Uganda. This support helped strengthen district emergency response systems and ensured that control measures were implemented quickly and effectively.
WHO’s role extended beyond measles outbreaks. Suspected anthrax outbreaks in Kween, along with floods and landslides in Kween, Kapchorwa, and Bukwo, also triggered additional deployments. In each case, WHO provided technical leadership, helped coordinate national, regional, and district-level actors, and supported a harmonised response in difficult terrain and rapidly changing emergency conditions. These interventions demonstrated how the same field coordination systems used to improve routine immunisation can also strengthen broader health emergency preparedness and response.
Overall, the experience in Eastern Uganda shows how integrated partnerships and data-driven coordination can make a significant difference in reaching children who are often missed by routine health services. ANECCA’s community-level mapping revealed where children were falling through the cracks, while WHO helped transform those insights into district-led action grounded in local realities. With District Health Teams and Village Health Teams ensuring that solutions remained practical and community-focused, the region has strengthened its health systems, improved access to essential services, and moved closer to ensuring that every child receives the life-saving protection they need.
