Uganda continues to make significant progress in strengthening the delivery of care for severe, lifelong non-communicable diseases (NCDs) through the PEN-Plus program. Working closely with the Ministry of Health, district hospitals, and international partners, PEN-Plus Uganda is expanding access to high-quality services for conditions such as Sickle Cell Disease, Type 1 Diabetes, severe rheumatic and congenital heart diseases, chronic respiratory diseases, and advanced diabetes complications.
The program now benefits 2,734 patients, reflecting strong demand for decentralized, equitable care for serious chronic conditions. As services expand, PEN-Plus continues to demonstrate how integrated, nurse-led models can transform outcomes for patients who have historically faced limited access to specialized treatment.
Between January and September 2025, PEN-Plus clinics enrolled 662 new patients, with Sickle Cell Disease representing the largest proportion of cases across both Atutur and Nakaseke hospitals. Sustained availability of essential medicines—particularly hydroxyurea for SCD and insulin for T1D—has ensured uninterrupted treatment, thanks to strong collaborations with partners and careful buffer stock management.
Sickle Cell screening efforts continue to expand through national laboratory systems and point-of-care technologies. Linkage to care remains strong, especially at Atutur, where nearly all children who screened positive were promptly enrolled for treatment and follow-up.
Home visits, enhanced phone tracing, and peer support groups have strengthened continuity of care. This approach has sharply reduced loss-to-follow-up, enabled early identification of high-risk patients, and safeguarded adherence, particularly among children and adolescents with T1D.
To date, 40 cardiac patients have been referred for specialized evaluation at the Uganda Heart Institute, with 14 successful surgeries completed. Two complex cases were successfully managed through cross-border referral to Rwanda, demonstrating the value of regional collaboration for highly specialized care.
A core pillar of PEN-Plus Uganda is the development of Master Trainers and strengthened clinical teams capable of delivering high-quality, decentralized NCD care.
Mentorship efforts—both onsite and virtual—have improved provider competencies in:
These capacity-building investments are positioning PEN-Plus sites to serve as regional training hubs, supporting the long-term sustainability and scale-up of the PEN-Plus model across the country
Significant progress was recorded toward finalizing the National Operational Plan (NOP) for PEN-Plus. A joint workshop led by WHO, the Ministry of Health, Makerere University, and UINCD produced substantial advancements in costing, planning, and alignment with national systems. A second workshop scheduled for November will finalize outstanding components.
In parallel, efforts to integrate HIV and NCD services into a unified chronic care model continue, including work on harmonized monitoring tools and enhancements to the national electronic medical record (eAFYA).
While progress is strong, several challenges require sustained attention:
The PEN-Plus team continues to address these issues through advocacy, reallocation of resources, workflow redesign, and strengthened collaboration with the Ministry of Health.
Over the next year, PEN-Plus Uganda will focus on:
These efforts represent a crucial stage in maturing the program and ensuring long-term impact for patients with severe chronic NCDs.
PEN-Plus Uganda is demonstrating what is possible when strategic collaboration, local leadership, and global solidarity converge. Yet the need remains immense. Severe chronic NCDs disproportionately affect children and young adults, and thousands more could benefit from decentralized, high-quality care.
We call on partners, researchers, donors, and policymakers to join us in expanding the PEN-Plus model, strengthening chronic care systems, and ensuring that no patient—regardless of geography or income—is left behind.
To collaborate, support, or learn more about PEN-Plus Uganda, please contact UINCD or visit our offices and our X (@uincd) account for updates.
© 2025 UINCD
