• Claudia Marotta, Peter Lochoro, Damiano Pizzol, Giovanni Putoto, Walter Mazzucco, Annalisa Saracino, Laura Monno, Francesco Di Gennaro, and Jerry Ictho.
• University of Palermo, Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", Palermo, Italy.
• Afr Health Sci. 2020 Sep 1; 20 (3): 1053-1065.

IntroductionSexual and reproductive health (SRH) and Human Immunodeficiency Virus (HIV) are crucial global health issues. Uganda continues to sustain a huge burden of HIV and AIDS.MethodsA cross-sectional health facility-based assessment was performed in November and December 2016 in Karamoja Region, northern Uganda. All the 126 health facilities (HFs) in Karamoja, including 5 hospitals and 121 Health Centers (HCs), covering 51 sub-counties of the 7 districts were assessed. We assessed the capacity of a) leadership and governance, b) human resource, c) service delivery, d) SRH and HIV service integration and e) users satisfaction and perceptions.Results64% of the established health staffing positions were filled leaving an absolute gap of 704 units in terms of human resources. As for service delivery capacity, on 5 domains assessed, the best performing was basic hygiene and safety measures in which 33% HCs scored "excellent", followed by the presence of basic equipment. The level of integration of SRH/HIV services was 55.56%.ConclusionHFs in Karamoja have capacity gaps in a number of health system building blocks. Many of these gaps can be addressed through improved planning. To invest in improvements for these services would have a great gain for Uganda.© 2020 Marotta C et al.

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