Uganda

Leadership, Management and Sustainability (LMS) Program

2005–2010

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The Leadership, Management and Sustainability (LMS) Program develops managers and leaders who achieve results in the areas of reproductive health, HIV & AIDS, infectious disease, and maternal and child health. LMS works with health organizations in the public and private sectors to create sustainable programs and systems through improved leadership and management. By strengthening management systems and increasing system-wide leadership, LMS improves the performance of health care organizations at all levels, develops human resources, and builds the capacity to anticipate and respond effectively to changing external environments.

Strengthening Pharmaceutical Systems (SPS) Program

2007–2012

Strengthening Pharmaceutical Systems is a follow-on to the Rational Pharmaceutical Management (RPM) Plus Program. MSH is pleased to announce that the US Agency for International Development has awarded us the Strengthening Pharmaceutical Systems (SPS) Leader with Associates Cooperative Agreement. SPS will focus on four key results:

• Improve governance in the pharmaceutical sector
• Strengthen pharmaceutical management systems to support public health services
• Contain the emergence and spread of antimicrobial resistance
• Expand access to and improved use of essential medicines

The five-year, $147.5 million cooperative agreement is led by Dr. Douglas Keene as Program Director and Dr. Maria Miralles as Deputy Director.

To help meet goals relating to the key result areas, the SPS Program is building on the successes of RPM Plus while expanding the range of technical areas to include financing, pharmacovigilance, pharmaceutical care, integration of new health technologies, and increased use of the private sector, among others. MSH will accomplish this enhanced program of activities by collaborating with a number of new partner organizations.

The SPS core partner team includes:

• BroadReach Healthcare
• Ecumenical Pharmaceutical Network
• The Lewin Group
• LMI Government Consulting
• University of Washington Department of Global Health
• WHO Collaborating Center in Pharmaceutical Policy: Harvard University/Boston University

In addition to the core team, MSH is joined by a select group of organizations that will serve as specialized resources for SPS. These organizations include:

• African Medical and Research Foundation
• American Society of Health-System Pharmacists
• Euro Health Group
• Infectious Disease Institute at Makerere University
• Joint Commission International
• London School of Hygiene and Tropical Medicine

As we work toward the overall goal of SPS, the SPS team is striving to advance the science and "art" of strengthening pharmaceutical management systems. The SPS Program provides a great opportunity for MSH and USAID to continue supporting developing countries in their quest to increase access to essential medicines and facilitate the scale up of vital treatment programs.

Advance Africa

2002–2004

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Advance Africa was a family planning/reproductive health service delivery project designed to increase access to and improve the quality of clinical and nonclinical programs in sub-Saharan Africa. The project worked to increase capacity for informed decision-making by clients and communities, and for the public sector to sustain quality family planning/reproductive health service delivery programs. Advance Africa also worked with USAID missions to scale up existing efforts by closing gaps in service delivery, and building partnerships among public and private health and nonhealth organizations. The project implemented innovative approaches to revitalize family planning programs within the broad context of Africa’s HIV/AIDS pandemic. MSH was the prime of a consortium of six international organizations that managed implementation of the Advance Africa project.

In its first year Advance Africa identified the need to clarify the factors that influence program performance. MSH developed tools to enable stakeholders to develop a common understanding and coordinated approach to data gathering and analysis, identify program gaps and barriers to filling gaps, select and plan interventions to address gaps and barriers, and identify criteria to evaluate the impact of interventions. In 2001, Advance Africa applied this framework to planning for the integration of voluntary counseling and testing and family planning in Uganda.

Management and Leadership Program

2000–2005

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The M&L Program was designed to improve the performance of leaders, managers, and organizational management systems, and improve organizations' ability to anticipate and respond effectively to the changing external environment. Working with public, private, and nongovernmental organizations at all levels of the health sector, M&L strengthened individual employee, organization, and national program performance. These improvements contributed significantly to the delivery of high-quality health services.

In 2003, Uganda was awarded millions of dollars in financial support from international donors to provide much-needed resources for scaling up the national HIV/AIDS response. To ensure successful management, accounting, and allocation of these funds without diverting existing programs, MSH provided the Ugandan government technical assistance through its M&L Program.

M&L began its work with the Ministry of Health to develop implementation plans for the start-up of the Global Fund's program. Significant spin-offs from this assistance led to improving overall management of other large-scale funding programs for HIV/AIDS and created effective systems to enable other Ugandan organizations to play effective roles in the national response. MSH also conducted an assessment of the human resources implications of scaling up HIV/AIDS services in Uganda and provided on-going counsel in this area to the Uganda AIDS Commission, Inter-Religious Council of Uganda, Joint Clinical Research Centre, and the Ministry of Health's National Tuberculosis and Leprosy Program.

In February 2004, USAID/REDSO requested that MSH's M&L Program conduct a human resources and leadership assessment of the Regional Centre for Quality of Health Care in Kampala, Uganda. The overall purpose of this technical assistance included identifying suitable approaches to strengthen the human resources management system and leadership practices in order to improve staff motivation and organizational performance.

FLEP of the Busoga Diocese of Uganda was a multi-service reproductive health agency that operated in five districts of Uganda. With M&L's technical assistance, FLEP established a responsive human resource management system. Service statistics from the first two quarters of 2002 compared to the same time period of the previous year showed that health services improved significantly. There was a 64 percent increase in family planning visits and these visits generated a 71 percent improvement in couple years of protection CYP.

International Network for Rational Use of Drugs Initiative on Adherence to Antiretrovirals (INRUD-IAA)

2006–2011

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The International Network for Rational Use of Drugs (INRUD) was established in 1989 to design, test, and disseminate effective strategies to improve the way drugs are prescribed, dispensed, and used, with a particular emphasis on resource poor countries.

Launched in September 2006, the INRUD-IAA initiative is funded by the Swedish International Development Cooperation Agency. The objectives of the five-year initiative are to—

• Develop and validate a set of indicators that can be used to monitor adherence to ART
• Investigate adherence rates and determinants for these rates for ART programs and individuals in two target countries
• Pilot interventions to improve adherence in individual patients and in programs in two countries
• Establish the process needed for national AIDS control programs to scale-up successful interventions as part of national policy in the two countries
• Work with the other three countries in the region to develop national adherence policies and implement interventions to improve adherence

 

Basic Support for Institutionalizing Child Survival (BASICS)

1999–2009

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As a technical assistance partner for newborn and child health to the USAID Bureau for Global Health, the Basic Support for Institutionalizing Child Survival (BASICS) Project develops and implements strategies to reduce preventable infant and childhood deaths in the developing world. MSH works as a partner in BASICS, which began its third phase in October 2004. Under this indefinite quantity contract (IQC), BASICS assists USAID/Washington Bureaus, USAID field missions, host-country governments, donor agencies, NGOs, PVOs, research institutions, and the private sector to scale up and increase the use of newborn and child health and nutrition interventions by families, communities, and health systems.

Since 1993, BASICS has worked to achieve substantial improvements in coverage and to expand effective newborn and child health interventions. BASICS focus areas include newborn health, essential nutrition actions like vitamin A supplementation, immunization, integrated management of childhood illness, treatment of diarrhea and pneumonia, and malaria control. In addition to strengthening the delivery of basic newborn and child health services, BASICS has expanded its technical scope to include pediatric HIV & AIDS, birth spacing, and child survival and nutrition in complex humanitarian crises. BASICS areas of expertise include assistance to countries on comprehensive strategies or selected interventions for newborn and child health, building partnerships, delivery of quality newborn and child health services, community-based treatment and private sector approaches to expand access to services, and capacity building and training.

In Uganda, BASICS supports Ministry of Health (MOH) activities to revitalize and strengthen routine immunization services and to accelerate the MOH's integrated management of childhood illness program by focusing on key family practices related to disease prevention, appropriate care seeking, appropriate home care, and growth promotion.

Rational Pharmaceutical Management Plus Program

2000–2008

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RPM Plus works in more than 40 developing countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program works to improve the availability and use of quality medicines, supplies, and basic medical equipment in the public and private sectors and to promote practical, sustainable changes in pharmaceuticals management by developing capacity within cooperating countries and fostering collaboration between countries.

Through RPM Plus, MSH conducted a comprehensive assessment of drug management for childhood illness in Uganda. The data revealed strengths and weaknesses of the national pharmaceutical supply system and indicated a need for capacity building in all areas of supply chain management, rational medicine use, and logistics information systems. RPM Plus also conducted an assessment of the capacity of the central drug supply system in Uganda for the World Bank. The US President’s Malaria Initiative (PMI) solicited RPM Plus support to strengthen the distribution of insecticide-treated bednets (purchased with Global Fund monies) to vulnerable populations, to assist with the handling and distribution costs of PMI-procured first-line malaria medication, and to help manage Uganda’s nationwide roll-out of the same medication (WHO-recommended artemisinin-based combination therapy).

Decentralized Personnel Management

2000

The consultant worked with World Bank staff to develop and test a survey questionnaire on decentralized personnel and payroll management in health and education.

Delivery of Improved Services for Health (DISH II)

2000–2003

DISH II focused on strengthening the management capacity of the Ministry of Health in Uganda in order to improve the availability of child health and reproductive health services. MSH provided technical assistance to develop management skills and capacity at the district level. At the national level, MSH played a leading role in designing and implementing the innovative Yellow Star Program for improvement and accreditation of primary health care facilities. MSH's logistics advisor helped to establish a functioning essential drugs and commodity logistics system and trained staff to manage the system. In 2001, fewer than five percent of district facilities faced stock-outs of contraceptives, largely due to improvements in inventory management and drug procurement practices.

Technologies for Primary Health Care (PRITECH) Assessment

1991

The MSH Orphans Assessment Team assisted Uganda in formulating strategies and policies to deal with its HIV/AIDS crisis affecting orphaned children. Using an enumeration study from Save the Children and recent census data, the team was able to determine the number of children orphaned (one or more parents) by HIV/AIDS. The baseline research helped the government identify a starting point and identify major problems exacerbating the crisis.

Technologies for Primary Health Care (PRITECH)

1983–1993

From 1983 to 1993, PRITECH—a major USAID effort to reduce infant and child mortality and morbidity associated with diarrheal disease—operated twenty-seven country and regional programs in Africa, Asia, and Latin America. As prime contractor, MSH managed the five subcontracts that comprised the consortium and provided over 2,500 person-months of assistance in some fifty countries. MSH has continued this successful experience through participation in BASICS and other worldwide projects. In Rwanda, PRITECH led a consultancy of regional health offices and health centers to develop information on how to establish oral rehydration therapy corners in health centers, estimate annual needs in oral rehydration salts (ORS) packets, gain advice on distribution methods, and investigate the possibility of local production of ORS.