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URC has provided technical assistance and leadership to the government of Uganda to improve public health services since the early 1990s; we continue these efforts today. URC’s programs in the country – anchored initially around programs to improve sustainable high-quality services for HIV/AIDS – have successfully helped build resilient health systems that offer evidence-based care supported by well-functioning management systems and a respectful environment for both providers and clients.
Stewardship for improved and sustained high-quality care: URC has played a pivotal role in the development and strengthening of the Uganda Ministry of Health’s (MOH) National Quality Assurance program. All of URC’s work in Uganda focuses on operationalizing improvement approaches throughout the health system and building a shared culture of quality.
The Health Care Improvement and ASSIST projects provided technical assistance on quality improvement to the MOH and its implementing partners; the RHITES-N, Acholi Activity continues to do so in northern Uganda. Likewise, the RHITES-EC Activity in east central Uganda supports the government’s goals of improved district stewardship and increasing access to and availability of high-quality comprehensive primary care services, including reproductive health and family planning, maternal, child, and neonatal health (RMNCH), malaria, HIV/AIDS, and tuberculosis (TB).
Evidence and implementation science: A key tenet of URC’s efforts to improve service delivery in Uganda is identifying opportunities for improvement in the health system and adapting activities based on results. The health system should rigorously monitor and report performance data and, where possible, introduce implementation science to find the best possible modality for sustained outcomes.
Under the Integrated Infectious Disease Capacity Building Evaluation, for example, URC developed and evaluated a cost-effective method to build capacity among non-physician clinicians for the treatment and prevention of infectious diseases. And RHITES-EC initiated a study on how to improve iron and folic acid supplementation among pregnant women.
Improved service delivery: URC has demonstrated that it is possible to deliver high-quality, priority health services consistently that consider the needs of both clients and health workers. Driven by continuous measurements and systemic improvements, HIV/AIDS, TB, and regional malaria and RMNCH services are complying with MOH guidelines and are emphasizing continuity of care. Applying these strategies to clinical services and management systems – such as supply chain and laboratories – has led to major improvements in delivery of public health services.
For example, the Food and Nutrition Interventions (NuLife) and the Program for Improved Nutrition (PIN) Projects supported the integration of nutritional assistance, counseling, and supplemental feeding in HIV/AIDS programs. And significantly, the eight-year Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) Project emphasized MOH stewardship and became a pacesetter in piloting and scaling up innovations in HIV/TB programming using short-cycle therapy (an intermittent treatment approach). SUSTAIN – working in 12 regional referral hospitals and an additional 312 health facilities – spearheaded major efforts in supply chain management, laboratory strengthening, and health workforce training and support. USAID recognized SUSTAIN in 2014 as one of its 10 best health systems projects.
Community and stakeholder engagement: A common thread throughout our work in Uganda has been the forging and nurturing of strong relations with national institutions as well as with regional and local stakeholders.
For example, Under Defeat TB, URC has provided grants to local non-governmental organizations to strengthen community linkages and provide new ways for active engagement in improved, equitable, and accessible care. And a major effort of RHITES-EC is strengthening the linkages between communities and health facilities through community engagement, continuity of care, and referral and counter-referral systems.
- Anemia Implementation Science Initiative
- Defeat TB
- Department of Defense HIV/AIDS Prevention Program (DHAPP) Uganda
- Regional Health Integration to Enhance Services in East Central Uganda Activity (RHITES-EC)
- Regional Health Integration to Enhance Services in Northern Uganda (RHITES-N, Acholi) Activity
- Food and Nutrition Interventions (NuLife)
- Integrated Infectious Disease Capacity Building Evaluation (IDCAP)
- Production for Improved Nutrition (PIN)
- Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN)
- USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project
- USAID Health Care Improvement (HCI) Project | Uganda