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Posts published in “Health”

South Sudan: UNHCR Position on returns to South Sudan – Update II

Source: UN High Commissioner for Refugees
Country: South Sudan

April 2019

This position supersedes and replaces UNHCR’s April 2015 Position on Returns to South Sudan – Update I


Since the signature of the Revitalized Agreement on the...

South Sudan: South Sudan Situation Report,18 April 2019

Source: UN Office for the Coordination of Humanitarian Affairs
Country: South Sudan


More than 75,000 children to receive education in emergency services
Nearly 20,000 people received Yellow Fever vaccine in Sakura, Nzara County
Food insec...

Uganda: Pilot study findings on the provision of hygiene kits with reusable sanitary pads: Testing the appropriateness and acceptability of AFRIpads reusable sanitary pads in southwestern (Ugandan) refugee context among schoolgirls

Source: UN High Commissioner for Refugees
Country: Democratic Republic of the Congo, South Sudan, Uganda


Over the past two years, Uganda has responded to an immense influx of refugees from its neighbouring countries. While new arrivals from South Sudan have slowly reduced, Congolese refugees are crossing the border in large numbers. As a result, Uganda is currently hosting the largest number of refugees in the country's history. It’s estimated that there will be 300,000 Congolese refugees in Uganda by the end of 2018 and the vast majority of them are women and children.

Globally, girls and women often lack the ability to manage their menstruation safely and with dignity due to a lack of adequate facilities, products and knowledge, which can be further exacerbated in refugee settings. In many cases, Menstrual Hygiene Management (MHM) is overlooked in emergency situations, which has an impact on areas like personal hygiene, education, gender equality and health. Reusable pads in this context have rapidly gained interest from development and humanitarian partners as a more sustainable, costeffective and environmentally friendly solution for MHM related challenges in emergencies.

Pilot intervention

In collaboration with AFRIpads, UNHCR Sub-office Mbarara implemented a three month pilot intervention in three southwestern settlements to test the appropriateness and acceptability of introducing reusable sanitary pads to schoolgirls in the refugee context. Product distribution (AFRIpads Menstrual Kit with 4 reusable sanitary pads, underwear, soap and bucket) was accompanied by a menstrual hygiene training as well as instruction for the appropriate use and care of AFRIpads. Data collection for the pilot evaluation was carried out at baseline and endline via individual interviews and focus group discussions.


Results from the baseline study indicated that schoolgirls in the southwestern refugee settlement context lacked access to the menstrual hygiene knowledge and products required for them to manage their menstruation in a healthy and dignified manner. Although UNHCR mandates that all women and girls of reproductive age are to receive distributions of disposable sanitary pads, soap and underwear, 71% of the girls reported not having enough menstrual products, 65% reported not having enough soap and 59% reported not having enough underwear. 44% percent also reported that they didn’t have enough information about menstrual hygiene. Access to water was not, however, reported to be a major challenge with 65% reporting they always had enough water to manage their menstruation (the remaining 35% reported “sometimes”) at baseline.

Participants generally reported being satisfied with the facilities available for changing, washing and drying their AFRIpads. The number of girls that reported missing school during their period was cut in half when using AFRIpads and the girls indicated a significant drop in the number of leaks they experienced (59% to 9%) as well as a significant decrease in itching or burning (73% to 24%). During the wet season, when drying times are longer, girls mentioned they need more AFRIpads to manage their cycles. However, respondents generally reported being satisfied with the infrastructure and facilities available to them to wash and change their pads at school.

Prior to the intervention, girls reported that their main challenge was not having enough products and 20% even admitted reusing disposable sanitary pads because they had no other options. Many refugee girls could not remember the last time they had received disposable pads from a general distribution. This underscores the ongoing logistical challenge that UNHCR currently struggles with in sustaining timely replenishments. After the intervention, not having enough products was no longer reported to be a top challenge, implying that the AFRIpads provided in the MHM kits met that challenge for many.

Access to enough soap and underwear remained top challenges even after the intervention, indicating that there is a larger, structural challenge in providing enough supplementary MHM necessities. It is important to note that access to enough soap and underwear is crucial, irrespective of the solution used (disposable or reusable). Reported access to water, however, went up at endline with 73% reporting they always had enough water to clean their AFRIpads.


Product uptake among the study participants was 99% and respondents reported high levels of satisfaction with all aspects of the AFRIpads. The girls retained the instructions provided during the MHM training and adherence to the use and care guidelines was also close to 100%. Even before AFRIpads were introduced, 52% of the participants indicated a preference for reusable pads over disposables.

At endline, 84% indicated they’d prefer to use AFRIpads over disposable pads (8% preferred a combination of both kinds of products and 8% chose disposable only). Reusable menstrual pads were clearly culturally and socially accepted in this refugee context.

Considering the difficulty of continuously distributing disposable pads throughout the settlements and the waste management challenge disposable pads create, AFRIpads reusable sanitary pads are an appropriate, highly preferred and effective solution to managing menstruation in a safe, dignified and culturally acceptable way.

South Sudan: South Sudan: Humanitarian Dashboard (as of 31 March 2019)

Source: UN Office for the Coordination of Humanitarian Affairs
Country: South Sudan


In March, inter-agency teams responded to humanitarian needs across the country. Notably, they reached Mugwo County in Central Equatoria and Koch, ...

Uganda: UNICEF Uganda Humanitarian Situation Report – March 2019

Source: UN Children's Fund
Country: Burundi, Democratic Republic of the Congo, Kenya, South Sudan, Uganda


  • Uganda remains free of Ebola Virus Disease (EVD) as of March 2019. UNICEF is supporting the Ministry of Health (MoH) in extending the National Ebola Preparedness Plan through to September 2019 due to the continued risk of disease importation from the Democratic Republic of Congo (DRC).

  • During the reporting period, 43,364 children (20,249 boys and 23,115 girls) were immunized against measles in refugee-hosting districts.

  • A total of 399 unaccompanied and separated refugee children (199 boys and 200 girls) in alternative care placements in West Nile benefitted from follow-up visits, placements, and referrals by UNICEF and partners.

  • UNICEF, in collaboration with MoH and Uganda’s Infectious Diseases Institute, conducted mentorship and coaching for 45 health workers in West Nile focusing on the elimination of motherto-child transmission of HIV/AIDS (e-MTCT) among refugees and host communities.

  • Concerns about the food security and the nutrition situation in Karamoja and Teso have been raised due to drier-than-usual conditions in March and forecasts of below-average rainfall for April.

Situation Overview and Humanitarian Needs

According to UNHCR and Office of the Prime Minister (OPM), Uganda is host to 1,223,033 refugees as of 28 February 2019, with 95 per cent living in settlements in 11 of Uganda’s 128 districts, and five per cent living in Kampala. Sixty per cent of the refugee population are children. Most refugees are from either South Sudan (801,555), the DRC (326,383), or Burundi (36,256). According to UNHCR, while the refugee influx from South Sudan to Uganda continues, there are recent reports of voluntary returns to South Sudan. UNHCR and OPM are following up with colleagues in South Sudan to ensure the safety of voluntary returnees. If such information is confirmed, the Uganda contingency plan for refugees from South Sudan will be revised accordingly.

Ebola Preparedness and Response Overview: Uganda remains Ebola Virus Disease (EVD) free as of March 2019, although the risk of EVD importation remains very high given the continuous spread of EVD in DRC and significant cross-border population movements from DRC into Uganda. Surveillance of border points and community-based surveillance for EVD continues, including coordinated cross-border contact tracing, to ensure prompt detection of EVD cases and timely initiation of management and control activities.

Measles Overview: Uganda continues to experience measles outbreaks in 38 districts (nine of which are refugee-hosting). Outbreaks are attributed to frequent stock-outs of measles vaccines at the district and health facility levels, compounded by irregular outreach activities. The basic causes are related to chronic underfunding of traditional vaccines, stagnated funding for primary health care services in the context of rapid population growth, and delayed implementation of measles Supplementary Immunization Activities (SIAs).

Climate change: Concerns about the food security and nutrition situation in Karamoja and Teso have been raised due to drier-than-usual conditions in March and forecasts of below-average rainfall for April. The impact of poor rainfall on food security and nutrition could be serious as 2019 could become a second failed season for Karamoja after a below-average season in 2018. SAM admissions in the last few months have shown a higher trend than in previous years.

The District Water Officers in Nakapiripit, Kaabong, Amudat and Moroto do report some water stress although figures are not provided yet. In Loro sub county in Amudat a number of boreholes have dried up, forcing people to move long distances in search for water; while in Nakapiripirt, the pressure from incoming cattle from the Pokots from Kenya, is being felt and some pastoralists migrated with their herds to Teso.

South Sudan: Measles outbreaks in South Sudan not yet under control

Source: Medair
Country: South Sudan

Juba, South Sudan. 16 April 2019. Just 15 weeks into 2019, more measles outbreaks have been declared in South Sudan than occurred in all of 2018. As of Wednesday, 10 April, there had been 11 active outbreaks and fou...

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