At Maziba Health Centre IV in Kabale district, a clinical officer Jovita Atuheire gently explains to Sarah—a patient presenting with general body weakness—that she has hypertension. Thanks to the integrated screening services supported by the World Health Organization (WHO) and World Diabetes Foundation (WDF), Sarah leaves the facility with a clear understanding of her blood pressure and blood sugar levels, and a plan for managing the hypertension.

Uganda and Ghana are currently the only two countries globally implementing the four-year Diabetes and Cardiovascular Disease (D-CARD) Africa Project. Launched in 2024, the initiative aims to integrate non-communicable disease (NCD) screening into existing health services—including HIV, TB, and malnutrition programs—to promote a holistic and sustainable approach to patient care. In Uganda, the project is being implemented in Kabale, Koboko, Lira, and Sembabule districts, targeting over 1.1 million people with high quality care at 10 primary health care facilities, at Health centre III and IV levels, in each district.

“This project has enabled people to access services at lower-level health facilities by strengthening early detection and management of diabetes and hypertension, with a strong focus on primary health care,” said Dr. Charles Oyoo, Commissioner for Non-Communicable Diseases at the Ministry of Health.

Recently, WHO handed over assorted medical equipment to Uganda’s Ministry of Health under the D-CARD Africa Project, to support the country’s fight against noncommunicable diseases. The equipment—comprising blood pressure machines, glucometers, and accessories, HbA1c analyzers and reagents, ECG machines, pulse oximeters, and related accessories—was distributed to 40 primary health care centers in the project focal districts. 

The D-CARD project has trained over 625 healthcare providers physically and through continuous medical education across the focal districts in the prevention, early detection, and management of diabetes and hypertension. The mentorship component was designed to enhance the capacity of health facilities to implement effective interventions, provide technical guidance on screening and clinical management, and promote data-driven decision-making in line with WHO protocols.

“The training emphasized the importance of screening every patient who visits the facility, regardless of their presenting complaint. This approach has greatly improved our ability to detect conditions like hypertension and diabetes early, allowing us to manage them before complications arise,” said Jovita Atuheire, a clinician at Maziba Health Centre IV, who participated in the one-week training held in May 2025.

The project has also facilitated the formation of patient-led support groups at participating health facilities. These groups, which emerged following the training of healthcare providers, have played a pivotal role in improving access to medicines adherence care, leading to improved treatment outcomes. One such group, the Maziba Health Centre IV NCD Group, comprises over 100 members living with diabetes and hypertension. Members support one another by checking-in regularly and reminding each other of upcoming clinic appointments.

Despite the provision of free medication at public health facilities, occasional stock-outs hinders hinder access to essential drugs. To bridge this gap, the Maziba patient group has established a community-based support mechanism to supplement the government supply chain.

“Each member contributes UGX 2,000 (about USD 0.54) every month to a shared fund. When prescribed medicines are out of stock at the facility, we use this fund to purchase them from nearby pharmacies,” explained Ezrah Twinobuhungiro, Secretary of the Maziba NCD group.

During a recent supervision visit to project-supported districts, Dr. Oyoo urged district leaders to support the formalization of patient support groups. He emphasized the importance of positioning these groups to benefit from government programs and structures such as Savings and Credit Cooperative Organizations (SACCOs) and the Parish Development Model (PDM).

The collaborative efforts of the D-CARD Africa project underscore the commitment of WHO and its partners to expanding access to quality non-communicable disease care at  Primary Healthcare  level and building resilient health systems across Uganda.

“We are proud to support initiatives, like the D-CARD Africa project, that prioritize early detection and integrated care for NCDs. Our focus is on building capacity through training, developing evidence-based treatment and management guidelines, and ensuring these tools are effectively implemented for a tangible impact in the lives of communities,” said Sanne Frost Helt, Senior Director Policy, Programme and Partnerships at World Diabetes Foundation.

The active involvement of district leadership remains a cornerstone for the sustainability of NCD interventions. Their engagement has been critical in strengthening community-based health systems and ensuring long-term impact.

“WHO commends the strong District Leadership demonstrated including at the  health facilities and the vital role of patient support groups, which serve as a foundation for community mobilization and early detection of non-communicable diseases,” said Sanjana Marpadga, Technical Officer with the WHO Global Diabetes Compact.

Diabetes and hypertension continue to pose a significant public health challenge in Uganda, with many individuals unaware of their status, delaying treatment and increasing the risk of severe complications and poor treatment outcomes. According to the 2023 Uganda STEPS Survey, 26.4% of adults aged 18–69 years have raised blood pressure, yet only 10.4% are aware of their condition, and just 3.5% have it under control. Similarly, 3.3% of adults aged 18 and above are living with diabetes, with over 59% of those aged 30 and above not receiving treatment. These conditions are major contributors to complications such as blindness, kidney failure, heart attacks, strokes, and lower limb amputations. 

Through the integration of services at chronic care clinics, the D-CARD project is helping to bridge these gaps by strengthening early detection, diagnosis and management of diabetes and hypertension, while also supporting routine screening for HIV, TB, and malnutrition.

WHO reaffirms its commitment to supporting the scaling up of integrated non-communicable diseases services across Uganda. Focus will be on formalizing patient support groups, expanding access to screening services, and ensuring uninterrupted access to essential medicines. Continuous training for health workers and improved data systems will drive evidence-based decisions, while multi-sectoral partnerships will mobilize resources for sustainability. Together, these actions will accelerate early detection and holistic management of diabetes and hypertension, safeguarding the health of millions and advancing Uganda’s journey toward resilient primary health care.