annual report for the year 2008/2009 · the period 2008 – 2010 and to appoint external auditors...

Annual Report for the Year 2008/2009 �

UGANDA PROTESTANT MEDICAL BUREAU

Annual Report for the Year 2008/2009

Uganda Protestant Medical Bureau


TABLE OF CONTENTSLiST OF ACrONymS ............................................................................................................................................2

ExECuTivE SummAry ......................................................................................................................................4

1.0 rEpOrT OF ThE BOArd OF dirECTOrS ............................................................................................6

1.1TRUSTEES............................................................................................................................................................................ 6 1.2ANNUALCOUNCILMEETING................................................................................................................................... 6 1.3POLICYDEVELOPMENT.............................................................................................................................................. 6 1.4JOINTMEDICALSTORE............................................................................................................................................... 7 1.5SUSTAINABILITYPLANNING.................................................................................................................................... 7 1.6PARTNERSHIPS................................................................................................................................................................. 7

2.0 hEALTh prOGrAmS ANd prOJECTS .......................................................................................................8

2.1PROGRAMAREA1:INSTITUTIONALCAPACITYBUILDING........................................................................ 8 2.2PROGRAMAREA2:ADVOCACYANDNETWORKING.................................................................................. 11 2.3PROGRAMAREA3:COORDINATION................................................................................................................... 14 2.4PROGRAMAREA4:QUALITYASSURANCE........................................................................................................ 16 2.5PROGRAMAREA5:HIV&REPRODUCTIVEHEALTH................................................................................... 21 2.5.1CDC-MUSPHHIVFELLOWSHIPPROGRAM................................................................................................................... 21 2.5.2TRAININGOFCOUNSELORS,LABORATORYWORKERSANDPASTORALWORKERS............................................................... 23 2.5.3REPRODUCTIVEHEALTHPROJECTIN10DISTRICTS............................................................................................................ 23

3.0 FiNANCE ANd AdmiNiSTrATiON ......................................................................................................27

3.1INCOME..................................................................................................................................................................................27 3.2STRATEGICPLAN2008-2013.............................................................................................................................................. 27 3.3LOCALFUNDING....................................................................................................................................................................27 3.4PROJECTFUNDING................................................................................................................................................................. 28 3.5ExPENDITURE........................................................................................................................................................................28 3.6ACHIEVEMENTSANDWAYFORWARD..................................................................................................................................... 28 3.7KEYPARTNERS............................................................................................................................................................... 28

4.0 pErFOrmANCE OF hOSpiTALS ...........................................................................................................29

4.1INPUTS....................................................................................................................................................................................29 4.2HUMANRESOURCES............................................................................................................................................................... 31 4.3HOSPITALOUTPUTS................................................................................................................................................................ 32

5.0 pErFOrmANCE OF hEALTh CENTrES ............................................................................................33

5.1INPUTS....................................................................................................................................................................................33 5.2HUMANRESOURCES:.............................................................................................................................................................. 33 5.3OUTPUTS................................................................................................................................................................................33

6.0 pErFOrmANCE OF hEALTh TrAiNiNG iNSTiTuTiONS .............................................................34

6.1INPUTS....................................................................................................................................................................................34 6.2HUMANRESOURCESANDKEYPERFORMANCEINDICATORS.................................................................................................. 34

ANNEx 1: mEmBErS OF ThE BOArd 2008/2009 .........................................................................................36

ANNEx 2: STAFF LiST AS AT 30Th JuNE 2009 ................................................................................................38

ANNEx 3: yELLOw STAr ASSESSmENT rESuLTS FOr A SAmpLE OF LOwEr LEvEL uNiTS .......39


2 Annual Report for the Year 2008/2009

List of AcronymsANC Antenatalcare

ARVs Antiretrovirals

CSC Communityscorecard

CHA ChristianHealthAssociation

CHAK ChristianHealthAssociationof Kenya

DHC Diocesanhealthcoordinator

EED EvangelischerEntwicklungsdienst

EPN EcumenicalPharmaceuticalNetwork

FBO Faithbasedorganization

FP Familyplanning

HIV/AIDS Human immunodeficiency virus/Acquired immune deficiency syndrome

HMIS Healthmanagementinformationsystems

HRH Humanresourcesforhealth

HSSP Healthsectorstrategicplan

HUMC Healthunitmanagementcommittee

ICASA InternationalconferenceonHIV/AIDSandSTIsinAfrica

ICMI InternationalChristianmedicalinstitute

ICT Informationcommunicationandtechnology

IRCU Interreligiouscouncilof Uganda

JMS Jointmedicalstore

JRM Jointreviewmission

MEDS Missionforessentialdrugsandsupplies

MERA MedicalresourcesforAfrica

MOH Ministryof health

NTLP NationalTBandleprosyprogram

PEAP Povertyeradicationactionplan

PMTCT Preventionof mothertochildtransmission

PNFP Private not for profit

SRH Sexualandreproductivehealth

UCMB UgandaCatholicmedicalbureau

UMMB UgandaMuslimmedicalbureau

UPMB UgandaProtestantmedicalbureau

ZCC Zonalcoordinationcommittee



Our vision“Transformed lives through Christian quality healthcare”

Our mission“Supporting members to witness for Christthrough the provision of quality health care”

who we Are“Anetworkof over270hospitals,healthcentersand health training institutions affiliated to 7 ProtestantChurchdenominations.UPMBservesasaNationalumbrellaorganizationwithafocuson: institutional capacity building, advocacy, quality assurance, coordination and hiv/reproductive health services in memberhospitalsandhealthcentres.Accessibilitytodrugsandmedicalsuppliesformemberunitsisensuredthrough the Joint Medical Store. Key targetgroupsservedbythememberunitsarethepoorandmarginalizedsectionsinUgandainruralareaswheretheirpresenceisstrong.”

LEvEL NumBEr

Hospitals 17

HealthCentreIV 5

HealthCentreII 55

HealthCentreII 193

HealthTrainingInstitutions(ForNurses,MidwivesandLaboratoryCadres)

7

Our Biblical FoundationACTS 1:7-8: “he said to them, “it is not for you to know the times or seasons that the Father has fixed by His own authority. But you will receive power when the holy Spirit has come upon you, and you will be my witnesses in Jerusalem and in all Judea and Samaria and to the ends of the earth”

Our Core values1. Christ Centeredness: The organization

recognizes the supremacy of Christbecause success comes from seeking toglorify Christ. In a Christ-like manner,compassion and service to others iscentral in the implementationof UPMBactivities.

2. We value people: UPMB treasures

human beings in the implementation of itsprogramsandstrivestoworkwithallpeoplewithoutdiscrimination.

3. Transparency: UPMB supportsconsultation and participation of all stakeholders at all stages of theirinterventions and accountability to thecommunities they serve. UPMB willcontinuously advocate for a responsiveand accountable health care system thatprovides quality health care services to the consumersatalltimes.

4. Stewardship: UPMB believes incompetenceinservicedeliveryatalllevelsand puts efficiency and effectiveness at theforefrontof programimplementationas a measure for quality service delivery.

5. Dynamism: Dynamism is a centralprinciple in the management of UPMBprogramswhichinvolvesbeinginnovativeandvisionary.

6. Team work:UPMBvalues the strengthof team work to achieve its goal. Itsfunctional teams are built within theorganization and among its partners toefficiently implement its programmes.


� Annual Report for the Year 2008/2009

Executive SummaryThisreportisacomprehensivedocumentationof the activities of the Uganda Protestant MedicalBureau secretariat during the financial year 2008/2009.The reportdetails the achievementsand challenges related to each of the strategicprioritiesof therecentlydevelopedstrategicplan2008–2013.

institutional Capacity Building

Capacitybuildingactivitiesincludedtechnicalandtrainingworkshopsforhealthworkersatall levels of the UPMB network. A trainingneedsassessmentwassuccessfullycarriedoutfor the lower level units and this combinedwith the training needs assessment forhospitals shall inform UPMB’s in-servicetraining policy and plan for the next fouryears. Other activities under this includedvarious in-service trainingsconductedundertheSRHproject.Healthunitstaff continuedtobenefitfromscholarshipsundertheJOCSandtheUPMBscholarshipschemes.

Advocacy and networking

Thesecretariatstaff maintainedadvocacyandnetworking activities at a high level using amore proactive approach than has been thecase in previous years. The major focus hasbeentoraiseawarenessaboutthecontributionof the private not for profit sub sector andcivil society in general to health servicedelivery and to improve access of this subsectortoavailableresources.Thenewstrategicplanplacesemphasisonbuildingcapacityforadvocacywithextrafocusatthedistrictlevel.

Coordination

Zonal coordination committees met at leasttwice during the year under review in allregions.Only80%of thecommitteesmetthetargetof meetingfourtimesayear.Membersof the committees continued to expressappreciationforthehighlevelof informationsharing and problem solving that the systemhasintroduced.

Ahealthunitmanagementcommitteefunctionalitystudycarriedoutduringtheyearhelpedtoidentifyobstacles to full functionality of health unitmanagement committees in the UPMB network.The management committees while establishedin over 90% of lower level units face challengesrelated to lack of resources, insufficient training and unclear terms of reference. The findings of thestudyshallbeusedtoreviseUPMBguidelinesandtrainingcurriculaforhealthunitmanagementcommittees.

Quality assurance

The quality assurance program saw targets with regard to support supervisionmet forhospitals,healthtraining institutionsandhealthcentersbythe end of the fourth quarter of the year. The secretariat also revised and disseminated servicedeliveryguidelinesforhospitalsandaccreditationguidelines for hospitals and health traininginstitutionsweredevelopedanddisseminated.

Aperformancemonitoringplanhasbeendevelopedand shall be followed by the development of monitoring&evaluationtoolsforalllevelssoastoensurethatfulloperationalisationof theplanisachieved.

hiv & reproductive health

Although the targets for funding for the HIVand reproductive health program were not met,UPMB secretariat successfully concluded a 3year sexual and reproductive health project thathadbeenimplementedin10districtsinUganda.Theprojectevaluationfoundthattherehadbeensignificant impact on behavior change, access to information and utilization of services inimplementingfacilities.Someof theweaknessesincludedthelackof ahealthsystemsstrengtheningapproachandpoormanagementatdiocesanlevelthathamperedimplementation.

UPMBisalsoparticipatingintheCDC-MUSPHHIV fellowship program by hosting a longterm HIV fellow. The fellow is contributing tostrengthening of monitoring and evaluationsystemsforHIVservicesinthenetworkaswellascarryingoutoperationalresearchgearedtowardsimproving HIV service delivery for adolescentslivingwithHIV.



anddevelopmentstrategies.Alreadyitisclearthattherearemodelhospitalsandhealthcentresthatare able to retain and motivate staff remainingrelativelystablethroughoutthiscrisis.Inter-facilityvisits are being encouraged as a mechanism toenhance learning and information sharing withregardtohumanresources.

New developments

UPMBsecretariathasbeenrunningaguesthouseandopticalunitfromwhichincomeisgeneratedtosupportitscoreactivities.InDecember2008,following extensive consultations with internalstakeholders and external experts, the Boardof directorsmadeadecisiontoclosedowntheUPMBguesthouse.Thisdecisionwasaimedatpaving thewayformoreviableandsustainableutilization of UPMB properties for incomegeneration. The UPMB building on Balintumaroadwassuccessfullyrentedouttoaninstitutionaltenant and the UPMB secretariat and opticalunit relocatedtorentedpremisesonBalintumaroad.Therevenuefromtherentalproceedsshallsupportthecoreworkof thesecretariat.

Finance and administration

TheUPMBsecretariatreceived79.5%of ittotalfunding from external sources majority donors,8.5% from local partners and 12.5% from localincomegeneratingunitsandotherlocalservices.Some of the achievements under finance and administration during the year include:strengthenedinternalcontrolstoenhanceservicedelivery and accountability to stakeholders,increased project funding through maintenanceof good relationships with donors and otherpartners and timely reporting to stakeholderswhichhasenhancedrelationships.

performance of hospitals and health centres

An analysis of annual returns from hospitalsand health centers show that outputs increasedoverall.Humanresourcesforhealthremainedthekeychallengesfacedbythememberhealthunits.Lower level units particularly require support for upgrading nursing assistants or recruitingprofessionalnurses.Effortsarealreadyunderwayto help improve human resource management

Some of the weaknesses included the lack of a health systems strengthening approach and poor management at diocesan level that hampered implementation


� Annual Report for the Year 2008/2009

• DrJGJagwe(Churchof Uganda)• Prof AM.Odonga(Churchof Uganda)• PastorMr.Settimba(SeventhDayAdventist

Church)

1.2 Annual Council meetingThe UPMB Annual Council met on 20thNovember 2008 to receive the annual report2007/2008 and the audited financial statements 2007/2008,toappointtheBoardof directorsfortheperiod2008–2010and to appoint externalauditorsfor2008/09.

The council appointed Kazibwe, Kenneth andSteven as external auditors for the financial year 2008/2009.

Thecouncilmadekeyresolutionspertainingto:• Remunerationof healthworkers• Standardizationof userfees• Technical personnel for diocesan health

offices• Improvementof workenvironments for

healthworkers.

1.0 report of the Board of directors

The Board of Directors of UPMB is thankful to Godfor seeing this organizationthrough the successes,setbacks, challenges andachievements of its 52ndfinancial year. Although the year was not withoutits difficulties, significant

progress was made with regard to plannedactivitiesandpriorityareasof focus.

The three governing entities of UPMB arethe Board of directors, the Annual GeneralMeeting/Annual Council and the Board of Trustees. This year the Board met four timesand the Annual Council together with theTrusteesmetonceasplanned.

1.1 TrusteesThemembersof theBoardof Trusteeswere:

Some of the Trustees participating in a corporate governance retreat



1.3 policy developmentThe Board of directors approved an advocacypolicy for UPMB. The policy elaborates criteriafortakingpublicpolicypositionsandhowthesepositionsaredetermined,italsoprovidesguidelinesforparticipationincoalitionsaswellasprovidinga framework for resources and management of advocacyprocessesintheorganization.

1.4 Joint medical Store Participation in the governance of the JointmedicalstorewhichUPMBco-ownswithUCMBwaskeptatahighlevel.UPMBrepresentationhasbeen maintained at the JMS Board of directorsand board committees. The Joint Medical storeachievedexpansionof itswarehousespaceduringthe year under review. The Board and technicalcommittees successfully guided the organizationthrough significant changes that took place at managementlevel.

1.5 Sustainability planningDuring the past three years the Board of Directors has been working with managementto come up with strategies to make the UPMBincome generating properties more productive.The improved productivity would ensure thatthere are adequate resources to ensure self sustainability of UPMB core activities as donorassistance wanes over time. Using informationcollated frombusinessmanagementconsultants,trends in financial performance of the guest house andopticalunitaswell as internalconsultationsatstaff andBoardlevel,adecisionwasmadeinDecember2008toclosetheUPMBguesthouse.This decisionwas intended to pave the way formoreviableutilizationof UPMBproperties.Tothisend,theUPMBcomplexonBalintumaroadwas successfully rented out to an institutionaltenantundertheoversightof theUPMBbuildingtaskforce committee in April 2009 resulting intherelocationof theopticalunitandtheUPMBsecretariat. This decision shall increase local

generated revenue by 50% over the next fouryears.Futureeffortsshallfocusondevelopmentof UPMBownedlandandregistrationof atradingarm to oversee the management of the incomegeneratingproperties.

1.6 partnerships• Specialgratitudeisextendedto

ourpartnersparticularlyEED,andICCOKerkinactiewhohavesupporteduswithcorefundingforstrategicactivities.

• TheJointmedicalstoreforsupporttocapacitybuildinginmemberunitsandcorefundingforstrategicactivities.

• TheBigLotteryFund/B.I.GthroughInteractWorldwideforsupporttowardsimprovingreproductivehealthamongdisadvantagedwomenandgirls.

• DIFAEMforsupporttowardstrainingof healthworkersandpastoralcareworkersinHIV/AIDS.

• TheDanishAgencyforDevelopmentforsupporttowardstrainingof enrolledcomprehensivenursesinPNFPtrainingschools.

Weareextremelygratefulforthesupport,goodwilland collaboration exhibited by the partnersmentionedaboveandmanyothersnotmentionedhere. Special appreciation is extended to theTrusteesfortheirwisecounselandstewardship,themembersof theboardandtheboardcommitteesfor giving their time and sharing their expertiseunselfishly with the organization, staff members andmemberhealthunitstaff fortheirhardworkandcommitment.Wecontinuetoencourageyouto maintain your contribution to the work thatwearedoingforthepeopleof Uganda.MaythegoodLordblessandkeepyou.

prof James TumwineBoard Chairperson



2.0 health programs And projects

2.1 program Area 1: institutional Capacity Building

2.1.1 Training needs assessmentThe tools for the training needs assessment forlower levelunits(healthcentresIIandIII)weredeveloped modeled on the approach of thesuccessful training needs assessment conductedin 2005. Data collection was carried out usingregional meetings and group discussions withdiocesan health coordinators, chairpersons of zonalcommitteesandhealthunitincharges.Dataanalysis and compilation was completed and areport produced. The key findings with regard todeliveryof theminimumhealthcarepackageand health services management revealed lowcompetenciesin:

• Newborncare,• Nutrition,• HIV/AIDSandTBcarewithDOTS,• Epidemicpreparednessandresponse,• Mentalhealth• Injuries,disabilitiesandrehabilitativecare• Planningandbudgeting• Qualityimprovement

UPMB plans to develop a training strategy anda three year training plan based on the resultsthat shall guide the development of in-servicetraining curricula. In addition a training needsassessment targetinghospitalsandHCIVsshallbeundertaken.

2.1.2 Charter for lower level unitsA recommended charter was developed for thelowerlevelunitstohelpimprovegovernance.Thecharterfocusesonmissionstatements,ownership,

upholding the not for profit status and prioritizing servicetothepoor.Thedraftwasdisseminatedtothezonalcoordinationcommitteesfordiscussionand input. Further consultation was undertakenwiththediocesanhealthcoordinatorsduringtheirtechnicalworkshopheldinKampalainJune2009.The charter shall be forwarded to the UPMBHealthcommitteeandBoardfordiscussionandapproval.Thisshallbefollowedbydisseminationtochurches/diocesesandhealthcenters.

2.1.3 Scholarship supportUPMBsecretariatmanagestwoscholarshipfundswhichsince2006havetogethersupportedatotalof 57primaryhealthcarecadreswithfunds to upgrade their skills and qualifications. Over90%of theseindividualshavereturnedtotheirsendinginstitutionstoprovideservicestocommunitiesinneed.

2.1.3.1 upmB scholarship fund beneficiaries 2008/09

The UPMB scholarship fund committee sat onthe9thNovember2008andawardednine(9)newscholarships.Prioritywasgiventohealthunitsthathad not previously benefited from the fund and thoseinremoteareasof thecountry.Duetothehighdemandfortraininginthenetwork,UPMBscholarship fund committee realized a deficit of 15millionshillingsthisyear.Effortsweremadetoraisethesefundssoasnottodisruptthestudiesof any health workers whose training UPMBhascommitteditself tosupport.Thecommittedfunds for financial year 2009/2010 will be used solely for the purpose of supporting studentsalready benefiting from the fund.


Annual Report for the Year 2008/2009 9

No Name Course to be pursued Position held/cadreRegion

currently serving in

Length of course

1 Nalumu Grace Dip comprehensive nursing Enrolled nurse Ruharo Mbarara 2 years

2 Bwambale Simon Enrolled comprehensive nursing Nursing assistant Ishaka

Bushenyi 2 years

3 Mbabazi Doreen Registered nurse Enrolled nurse Nyabugando HC III SRD 2 years

4 Acam Jane Advanced diploma in aneasthesia Enrolled MW Ngora, Kumi

5 Uyikuru Manasseh Diploma medical lab technology Med lab assistant Goli, Nebbi 1 year

6 Namiya Harriet Reg nursing Enrolled nurse Nabwendo, Mityana 2 years

7 Okee Samuel M Cert med lab assistant Lab attendant PAG, Lira 2 years

8 Asiimwe Moses Registered nursing Nursing assistant KinyamasekeKasese 2 years

9 Lubega Richard Dip clinical medicineEnrolled comprehensive nurse

Kabasara, Kibaale

3 and a half years

2.1.3.2 The Japan overseas Christian medical cooperative services scholarship fund beneficiaries 2008/09

No Name Course to be pursued Position held/cadre

Region currently serving in

Length of course

1st Intake Sept 24, 20081. Mr. Justus Twinomujuni Registered Nursing Enrolled Nurse Kisiizi Hospital 1.5 Yrs

2. Mr. Nsumba S. Mark Registered Comprehensive Nursing Enrolled Nurse Kiwoko Hospital 1.5 Yrs

3. Mr. Patrick Ondgom Diploma Medical Laboratory technician

Laboratory Assistant

P.A.G Health Center IV 2 Yrs

4. Mr. Moses Irebwat Certificate Medical Laboratory Technology

Laboratory Assistant Kumi Hospital 2 Yrs

2nd Intake Mar 17th 2009

5. Mr. David Ngania Kitiyo Diploma Comprehensive NursingEnrolled Comprehensive Nurse

Cure CHU 1.5 Yrs

6. Mr. Davis Makubuya Certificate Medical Laboratory Technology

Laboratory Assistant Cure CHU 2 Yrs

7. Ms. Jane Agamile Candiru Registered Nursing Enrolled Nurse Kuluva Hospital 1.5 Yrs


�0 Annual Report for the Year 2008/2009

2.1.4 Organizational capacity assessment of the upmB secretariat

Terms of reference for an organizationalcapacity assessment of UPMB were developedand disseminated to potential consultants. Aconsultant was identified in November 2008. The InternationalInstituteforruralconstructionwasawarded the consultancy and work commencedin May 2009. The assessment covered financial systems and policies at the secretariat as wellas capacity for advocacy at the secretariat anddiocesanlevels.

Capacity rating categories Mean score1

LegalstatusandProcedures 3.69

VisionandMission 3.82

Leadership 3.20

Constituency 2.91

ManagementandAdministration 2.95

HumanResourcemanagement 2.86

FinancialManagement 2.68

Programdevelopment 3.16Programmanagementandimplementation

3.10

Monitoringandevaluation 2.96

Networkingandadvocacy 3.18OrganisationSustainability(Program,Financial&Institutional)

2.78

ExternalRelations 3.14

2.1.5 Technical workshops for lower level units

A total of three technical workshops were heldfor lower level units. Two technical workshopsheld in Northern and Western Uganda focusedon evidence gatheringduring the trainingneedsassessmentexercise.Onetechnicalworkshopwasheld in Northern Uganda in June 2009 for theunitsof GuluandAmurudistrictswitha focusonimprovingskillsindevelopingworkplansandreportwriting.

2.1.6 Technical workshops for health training institutions

2.1.6.1 Joint pNFp consultation and training workshops

2.1.6.1.1 Joint technical workshop in quality of training

The UPMB and UCMB HTI desks organizedand conducted a joint technical workshop fromthe21st -22nd January2009atCardinalNsubugaleadership centre in Nsambya. The main goalof the workshop was to enhance the quality of training, management and accountability inthe health training institutions. 58 participantsincluding principal tutors and members of hospital management teams attended theworkshop.Various reports anddocumentswerepresented with emphasis on principles of quality improvement in health training. Resolutionscentered on meeting joint accreditation targetsfor the year 2009 and critically addressing theproblem of tutor shortage which currently is amajor bottleneck to the quality of training.

2.1.6.1.2 Joint consultative conference on the bursary fund initiative

The MOH-DP bursary fund initiative is a newprogram that aims to improve staffing levels in government and PNFP health facilities locatedinhardtoreachareasthroughstrategicbondingof studentsinnursing/midwiferyandlaboratorytraining schools. The program has partneredwithPNFPhealthtraininginstitutionsandaimsto produce 950 bonded graduates for hard toreach districts in three years. The concept hasbeen under discussion for the past two years.Implementation finally kicked off in May 2009 withDANIDAastheonlydevelopmentpartnerparticipatingintheinitiative.

Ajointconsultativeconferencewasheldon23rd–24thMarch2009attheUPMBconferencehallandattractedover60participantsfromthePNFPhealthtraininginstitutions.Theoverallgoalof thetechnicalworkshopwastoreachconsensusonthe

1MeanRange Description4.21 - 5.00 - Excellent3.41 - 4.20 - VeryGood2.61 - 3.40 - Good1.81 - 2.60 - Fair1.00 - 1.80 - Poor


Annual Report for the Year 2008/2009 ��

implementationguidelinesandregulationsaswellas to agreeonactions tobe takenby individualHTItoensuresuccessfulimplementationof theMOH-Developmentpartners’bursaryfund.

The conference objectives were largely met.Participants shared potential areas of difficulty and proposed or identified solutions. The conference cameupwithjointresolutionsanddeadlinesforactivities that needed to be completed beforeactual implementation of the bursary fundinitiativecouldbegin.

2.1.6.1.3 upmB hTi Technicalworkshop

A UPMB technical workshop was held for thehealth training institutions in February 2009.The workshop attracted 80% of the principaltutors under the UPMB umbrella and focusedon skills for grantwriting anddevelopmentof researchtopics.

2.1.7 Corporate governance seminar for upmB board of directors and board committees

A corporate governance seminar was held fortheUPMBBoardfromthe17th–18thApril2009.Themainthemeof theseminarwastheroleof the Board in impact measurement. Significant resolutionsweremadewithregardto improvingmonitoringandevaluationsystemsinUPMB.

2.2 prOGrAm ArEA 2: AdvOCACy ANd NETwOrKiNG

2.2.1 health sector joint review meeting October 2008

The 14th health sector Joint review meetingwas held from 24th – 26th October 2008. ThePPPHworkinggroupwasabletomeetandmakea contribution to the undertakings. The mainproposalsof theworkinggroupwereto:complete

ACHIEVEMENTS&CHALLENGES:INSTITUTIONALCAPACITYBUILDING• Amemorandumof understandingwassignedbetweengovernmentof Uganda,

healthdevelopmentpartnersandthethreereligiousmedicalbureaustoprovideaframeworkforimplementationof theMOH-HDPbursaryfund.

• Thedemandforscholarshipsupportfrommemberhealthunitscontinuestooutstripbyfartheavailableresources.



the PPPH policy approval process, disseminatethe official policy document and re-sensitise stakeholdersduringtheremainingperiodof HSSPII.Ingeneral,civilsocietyorganisationsweregivenmore prominence with the Executive Secretaryof the Catholic Medical bureau presenting civilsociety’sremarksduringtheclosingceremonyof themission.

2.2.2 religious leaders meeting on global funding initiatives in uganda

The three bureaus together with the Interreligiouscouncilof Ugandaheldaseriesof jointtask force meetings to discuss how to improveaccesstoglobalfundinginitiativesbyfaithbasedorganizations inUganda.Thisculminated intoareligious leaders’ conference held in December2008 in Entebbe. During this meeting religiousleadersfromtheCatholic,Protestant,PentecostalandMuslimfaithsinUgandamandatedtheinterreligiouscouncilof Ugandatotakestepstovieforpositionof principalrecipientof GlobalfundsinUganda alongside the Ministry of finance.

2.2.3 Action for global health conference on Aid Effectiveness, Berlin 2009

UPMB was invited to make a presentation onAID effectiveness and health: Theory and reality, from the perspective of civil societyorganizations working in the health sector inUganda. The Executive director made thispresentationwithspecialemphasisontheneedto review global aid effectiveness agendas andprinciples as they apply to the recognition of the roles that civil society organizations play.The conference ended with the call to G8governments to improve the effectiveness of development aid in order to increase access toprimaryhealthcareandtoensurethatthevoiceand involvement of civil society organizationsin thedevelopingworld isbuilt into theglobalarchitectureof developmentaid.

2.2.4 Africa Christian health associations biennial meeting

TheAfricaChristianHealthAssociationsheldaverysuccessful4thBiennialConferenceatthe

Speke Resort Munyonyo, Kampala, Ugandaon23th-27thFebruary 2009.The themeof theconference was “Building partnerships for health systems strengthening in Africa”.Theconference was attended by 76 participantsfrom Sub-Saharan Africa, Europe and USA.TheconferencewashostedbytheAfricaCHAsPlatform Secretariat in collaboration withUPMBandUCMBwithfundingsupportfromvariouspartners.

The key note address was given by Canon TedKarpf of theWorldHealthOrganization(WHO)inGenevainwhichheemphasizedtheimportantrolethatFBOsplayindeliveringPrimaryHealthCare (PHC) services that promote equity and access to the poor and vulnerable in Africa.He presented a draft Resolution on PHC to bediscussedat theWorldHealthAssembly inMay2009andappealedtotheCHAstogivefeedbackandadvocatethroughtheirMinistryof HealthforsupporttotheResolution.

During the conference, it was resolved that thePlatform Secretariat should be strengthened tobecome a resourceful hub for communication,information sharing and networking. ThePlatformwouldalsocontinuetofacilitatehostingforums on thematic areas that are of commoninterest in addition to planning for the 2011BiennialconferencetobeheldinAccra,Ghana.The Conference success was partly contributedtobytheexcellentlogisticsorganizationsupportby Dorothy Mukiibi of UPMB and the goodcommunication by Mike Mugweru, ACHAPlatform Secretariat Officer.

2.2.5 pre-world health assembly meeting on equity, justice and health

Civilsocietyorganizationsandsocialmovementsfromacross theglobemet inGeneva,on15-16May, 2009, at a Forum on Equity, Justice and Health,organizedbyPeoplesHealthMovement,Third World Network, and the World Councilof Churches toshareconcernsandrecommendactionsthatcivilsocietyviewsasbeingof criticalimportance for advances in global Health andhealth equity. UPMB participated in the meeting



represented by the Executive Director. Basedon the discussions, some overarching concernsas well as specific recommendations on the two resolutions on Primary Health Care and SocialDeterminantsof HealthwerepresentedtoWHOandmember countriesparticipating in the62ndWorld Health Assembly. The meeting came upwithrecommendationstomemberstatesinorderto promote and protect global health equity. The full statement can be accessed on: http://www.oikoumene.org/en/resources

2.2.6 62nd world health assembly meeting

In preparation for the world health assemblymeetingUPMBdevelopedadraftpetitiontargetinggovernmentstosupporttheresolutiononprimaryhealthcareincludinghealthsystemstrengthening.The draft petition was disseminated to Africa

• Monitoringtheachievementof thehealth-relatedMillenniumDevelopmentGoals.

The World Health Assembly adopted the‘Resolution on Primary Healthcare’ (PHC),signaling an opportunity for the internationalcommunity to mobilize itself in support of universal access toPHCand revive thehithertofailed objectives of the Alma-Ata Declaration,enshrined31yearsago.Resolutionsfromthe62ndWHAcanbeaccessedon:http://apps.who.int/gb/or/e/e_wha62r1.html

2.2.7 Joint bureau meetingsRoutine quarterly joint bureau meetings were held on the August 2008, 24th November 2008, 12thMarch2009and19th June2009.Threeof thesemeetings were hosted by UPMB. Various issuesof commoninterestwerediscussedincluding:theJointreviewmissionforthehealthsectorthatwasheld inOctober2008and implicationsof someof the decisions made as well as the upcomingAfrica Christian health associations’ conferencedue to be held in Kampala, February 2009 andco-hostedbyUPMBandUCMB.

2.2.8 Cross site visitsAlthough at least four (4) cross site visits wereplannedfortheperiodunderreview,nonewasheld.

ChristianhealthassociationsthroughtheACHAsecretariat. In Uganda, the petition was jointlypresented to the Honorable Minister of HealthbyUPMBandUCMB.

The62ndsessionof theWorldHealthAssemblytook place in Geneva during 18-22 May 2009.UPMBwasrepresentedbytheExecutiveDirectorwithsupportfromtheWorldCouncilof Churches.Atthissession,theHealthAssemblydiscussedanumberof publichealthissues,including:

• Pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits;

• Implementation of the InternationalHealth Regulations;

• Primary health care, including healthsystem strengthening;

• Social determinants of health; and

Bureau executive secretaries group photo after a joint meeting in June 2009

Howeverthroughsupportsupervisionvisitsandreviewof reports,ithasbeenpossibletoidentifyareas of weakness in particular dioceses andhospitals and also to identify dioceses/hospitalsthatareperformingverywellinthosesameareas.Duringthehospitalmanagersworkshop(heldinJuly 2009) each hospital identified areas of interest and potential host institutions. Efforts are nowbeing made to link weak performers to strongperformersthroughcrosssite(exchange)visits.


�� Annual Report for the Year 2008/2009

2.2.9 upmB newsletter, annual report and website

The annual report for 2007/08 was producedanddisseminated to stakeholdersby the endof November 2008. The UPMB June newsletterwas produced and disseminated. The websiteunderwent two updates. Problems wereexperiencedwithoverloadof thewebsiteduringtheimplementationof anonlinereportingsystem.To rectify this, a decision was made to changethehostof thewebsitefromcomputerfrontiersinternationaltoLUNARPAGES.

2.2.10 development of an advocacy and communication strategy

AC H I E V E M E N T S & C H A L L E N G E S :ADVOCACYANDNETWORKING:• UPMB participated in international level

advocacy gatherings and participated inraising the profile of the Africa Christian healthassociations’platform.

• The development of an advocacy andcommunicationstrategyprogressed

A consultant for this process was procured byJune 2009 following development and approvalof termsof referencefor thework.Areport isexpectedbeforetheendof August2009.

2.3 prOGrAm ArEA 3: COOrdiNATiON

2.3.1 Functionality of health unit management committees’ study

Consideringtheplannedinvestmentstobemadeintraininghealthunitmanagementcommitteesoverthenextfouryears,UPMBundertookanHUMCfunctionality study. The tools were developedwiththehelpof aconsultantanddisseminatedtodiocesanhealthcoordinators.KeyinformantsandFGDmemberswerepurposivelyselectedonthebasisof the information theyhaveonexistenceand operations of health unit managementcommittees (HUMCS). These included 362key informants and 964 FGD participants. Of the key informants, 139 were facility staffs, 191were from the community, while 32 did notindicatetheirtitles.ThesewereHealthfacilityincharges,chairpersonsandmembersof HUMCs.Submission of data from the field was achieved andareportproduced.

Presence of HUMC Yes 146 92.4%No 1 0.6%HUMC existence beneficial to the health facilityYes 307 84.8%No 6 1.7%Areas in which the HUMC has had most impact Planning and budgeting 240 66.3%Staff motivation 34 9.4%Financial management 28 7.7%Purchase of equipment and logistics 10 2.8%Fundraising 3 0.8%Others 5 1.4%HUMC has sufficient resources to perform its dutiesYes 29 10.8%No 250 69.1%HUMC members have received terms of referenceYes 138 38.1%No 167 46.1%HUMC members have received training after appointmentYes 111 30.7%No 201 55.5%Type of training provided to HUMC membersUPMB HUMC training 75 20.7%



Other workshop 80 22.1%On-job training 62 17.1%Appointing authority for HUMCCommunity 36 22%COU 36 22%COU& Community 31 19%Diocese 5 3%Elected 2 1Foundation and community 14 9%In charge 2 1%

The study concluded that while the majorityof health units have a health unit managementcommitteeinplace,functionalityishamperedbya combination of lack of resources, insufficient training and unclear terms of reference. Healthunitmanagementcommitteesareactiveinplanningandbudgetingbutlesssoinraisingresourcestorun the health units they oversee. Transparencyin appointment of health unit managementcommittees also needs to be streamlined. Thefindings of the study shall be used to revise the

UPMBguidelinesandtrainingcurriculaforhealthunitmanagementcommittees.

2.3.2 regional feedback meetings (Zonal coordination meetings)

Thenine(9)zonalcoordinationcommitteesmetin2008andwereabletodiscussandresolvepriorityissues. Zonal coordination committees meetingscontinuedduringthethird(January–March2009)and fourth quarter (April – June 2009) of the year underreviewandreportsweresubmitted.

Zone Focal Person Dates Venue

Central Zone A Mr. Gordon Kitaka 21st May 2009 UPMB

Central Zone B Ms Jane Nsubuga16th October 200824TH April 20092ND July 2009

UPMBUPMBLuwero

Western Zone B Rev.Kutegeka 7th October 200830th April 2009

Fort PortalKasese

South Western A Dr Patrick Kagurusi 8th May 2009 Mbarara

South Western B Rev. Dan Zoreka 30TH October 200814th May 2009

RukungiriKisoro

North Eastern A Rev.Chris KyeweMr. Kabujjeme Fred

17th July 200813th October 200817th February 200930th April 2009

JinjaJinjaJinjaJinja

North Eastern B Mr. Mangali

17th July 200816thNovember 200820th March 2009

KapchworwaSorotiKumi

Northern Rev.Solomon Okeny 22nd February 200828th April 2009

GuluLira

West Nile Mr. Alfred Okuonzi 18th January 200820th August 2008

AruaNebbi



2.3.3 Technical workshop for diocesan health coordinators

The technical workshop for diocesan healthcoordinatorswasheld inMay2009 inKampala.Thediocesanhealthcoordinatorsdiscussed:

1. Thesupportsupervisionframework,2. Thelowerlevelunitcharter3. The revised job description for

coordinatorsintheUPMBnetwork.Areportof theworkshopisavailable.

AChiEvEmENTS&ChALLENGES: COOrdiNATiON

• HUMCfunctionalitystudyprovidesvaluableinsightsintohowthehealthunitmanagementcommitteescanbeeffectivelysupportedtoensureaccountability,transparencyandcommunityparticipationinhealthservicedelivery.

• Problemsof ownershipforthehealthservicesatdiocesanlevelcontinuetohampersmoothimplementationof diocesanlevelactivitiessuchassupportsupervision.

2.4 prOGrAm ArEA 4: QuALiTy ASSurANCE

2.4.1 monitoring and evaluation

2.4.1.1 monitoring and Evaluation plan

A performance monitoring plan was developedby key staff. The performance monitoring planshall need tobe supportedby appropriate toolsand subsequent technical workshops shall focus onthe trainingandorientationof relevantstaff intheuseof thesetools.

2.4.1.2 performance improvement in hmiS

UgandaProtestantMedicalBureauwithsupportfrom Capacity Project carried out PerformanceImprovement strategies forHealthManagementInformation Systems across all the health

establishments. The exercise adopted a top-bottom approach (working through the UPMBsecretariat to reach out to the management of health units at all levels. The process startedwith a needs assessment whilst conductingKey Informant Interviews with staff directlyinvolved with HMIS at the UPMB head office. Themanagersforthehealthestablishmentswereengaged in the development of an assessmenttoolandwerelatercommissionedtocollectdataonthesetbaselineHMISperformancestandardsin their respective dioceses. Data analysis wasdone by Capacity Project and the findings were disseminatedataworkshopthatbroughttogetherall the Diocesan Health Coordinators, RecordsAssistants and the In-Charges of health unitsatall levels. Theassessment lookedatthetasksinvolved in gathering data, required resources, data processing/analyzing, reporting and data-enabled management decisions. In addition, theassessmentfocusedonthesupervisionneedsof the health facilities under UPMB Network. Itassessed the existing support supervision needs,the required skills of the supervisors and the ideal frequency for supervision. Consequently, the officers that directly interface with HMIS were identified and engaged in a series of planning and trainingprograms.

All the officers involved in the management of HMIS were brought on board and engagedin rigorous planning and training in HMISPerformance Improvement strategies. Capacityproject adopted the HMIS PerformanceImprovement best-practices used in SouthAmerica. The UPMB officers were taken through these approaches and later trained inthedevelopmentof theperformanceassessmenttool. With the support UPMB management, allthe Dioceses participated equally by sending representatives to working-meetings that wereheldatUPMBsecretariat.

2.4.1.3 The new online reporting system

The observed performance gaps in the HMISat UPMB were “data analysis”, “reporting” and“decisionmaking”.Asnotedearlier,dataanalysishas a direct influence on reporting which in return, determinesthenatureof managementdecisionsto be made. Fixing the gaps in data analysis



improved performance in reporting and data-oriented decision making. This is not to forgetthatothertwoperformanceareas(dataentryandresources)canbeimprovedupon.

Tonoteisthat,over90%of thehealthestablishmentof UPMBoperateswithoutcomputers.Asaresult,most of the officers dealing with data do not have computer-skills necessary for carrying out dataanalysis.Thereforetrainingindataanalysisalonewould not help to solve the performance gaps.It was observed that developing a web-baseddatabase that can automatically do data analysisand produce the required reports was the best solution. Capacity Project invested in buildinga web enabled HMIS system which allows dataofficers to input data and get the analysis by a clickof abutton.

Diocesan Health Coordinators and RecordsAssistantswillaccessthewebHMISsystemfromtheinternetcafesintheirnearesttownship.UPMBdioceses will provide the budget for internetaccess.Thisapproachwasseenascost-effective.

TheHMIShasbeentransformedfromthepaperwork to a web-based database. UPMB has 32diocesesoutof whichsomewillbeselectedforpiloting the online database. It will not be untilthe system is fully and efficiently functioning that the entire UPMB health establishment can bebroughtonboard.Thisistoallowdocumentingbest-practicesaswellasironingoutanypossiblesystemprogrammingerrors.

2.4.2 iCT needs assessment

The ICT audit begun in November 2008. Areportwassubmittedandsharedwiththerelevantcommitteesof theUPMBBoardbetweenJanuaryand June 2009. Various recommendations havebeenmadeandarecurrentlybeingimplemented.AnICTpolicyisexpectedtobedevelopedbasedontheemergingrecommendations.

2.4.3 health unit databases

InlinewithUPMB’sstrategytosupporttheproperimplementation of HMIS in member healthunits,300healthunitdatabaseswereprintedanddistributed to thememberhealthunitsover theperiodJunetoAugust2008.

2.4.4 Service delivery guidelines

Thenewsupportsupervisiontoolforthehospitalswas finalized with technical assistance from the Ministry of health quality assurance department. Thistooltogetherwithasupervisor’smanualhasbeen disseminated to all hospitals and level IVhealthcentres.

2.4.5 Support supervision

Hospitals,HCIVandHTI95%werevisitedduringNovemberandDecember2008. CURE children’s hospital was not visited

Denis of Capacity Project training UPMB data managers in Mbale



due to confl icting schedules during the cycle. Thenewlydevelopedtoolwasusedandfeedbackgiven to the hospitals/HC IV. Health traininginstitutions (HTI) were also visited during theexercise since each HTI is affi liated to a UPMB hospital. 100% of hospitals and HC IV werevisitedovertheperiodMay–June2009.

Staff at work in PAG Mission laboratory

Reportsweresharedduringthehospitalmanagers’workshopof July2009. Major fi ndings included:

• The need for training in governance forhospitalboardsandHCIVmanagementcommittees,

• The lack of human resource guidelinesand weak human resource managementpractices

• Weakinfectioncontrolpractices• Inadequate resources for emergency care

includingtraining• Lack of guidelines for the provision of

laboratory, radiology and pharmaceuticalservices

Onthepositivesidehowever,somehospitalswerefound to be implementing best practices withregardtotheweaknesseshighlightedabove.TheseincludedKuluva,KagandoandKisiizihospitalsaswellasBwindihospital.

Kuluva hospital is a model in infection control best practices


Annual Report for the Year 2008/2009 �9

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Annual Report for the Year 2008/2009 2�

HealthcentreslevelII–IIIFundsforsupportsupervisionof HCIIandIIIweredisbursedto46%of the28diocesesduringthe first quarter of the year. Funds disbursement waslatedueto:

i. Latereceiptof fundingfromdonors.ii. A new internal regulation that required

diocesan health coordinators to submitofficial diocesan health account numbers to which they are co-signatories beforefunds could be disbursed. It was foundthatmanydioceseswerenotringfencingthefundsforsupportsupervisionraisingconcerns of the potential for misuse.However working collaboratively withtheProvincialtreasurerof theChurchof Ugandaitwaspossibletogetalldiocesestocomply.

Fivediocesesthatperformedpoorlywithregardtoreportingandaccountingweretargetedfordirectsupervisionbyateamfromthesecretariat.Theseincluded:NorthernUganda,Langodiocese,NorthKaramoja,NorthKigeziandWestBuganda.

By the end of the fourth quarter (April – June 2009),disbursementof fundshadimprovedandreportsforQuarterone,twoandthreehadbeenreceived by the health department. (See Annexforsummariesof supportsupervisionresultsforhealthcentres)

2.4.6 Accreditation system

Draft accreditationguidelines forhospitalsweredevelopedanddisseminatedtoallhospitals.Finalresolutionsweremadewithregardtoaccreditationandthedeadlineforapplicationtobeaccreditedfor2010wassetas31December2009.Forthehealthtraininginstitutions,anaccreditationsystem was discussed and approved by a jointPrivate not for profit health training institutions workshop in October 2008. The deadline forapplicationforaccreditationbythehealthtraininginstitutionswassetas31stAugust2009.

ACHIEVEMENTS&CHALLENGES: QUALITY ASSURANCE

• Supportsupervisiontargetsweremetforhospitals,healthtraininginstitutionsandhealthcentres.

• Notenoughhasbeendonetohaltandreversethehumanresourcecrisisinmemberunits.

2.5 prOGrAm ArEA 5: hiv & rEprOduCTivE hEALTh

2.5.1 CdC-muSph hiv Fellowship program

The HIV/AIDS Fellowship Program is anInitiative by the School of Public Health at theMakerereUniversityCollegeof Health Sciencesin collaboration with the Centres for DiseaseControlAtlanta.TheProgram’smainobjectiveistoenhance leadershipandmanagementcapacityfor HIV and AIDS Programs in the country.There are two main categories of fellowshipthroughwhichtheProgramworkstoachieveitsobjectives;

• LongTermFellowship• MediumTermFellowship

TheUgandaProtestantMedicalBureau(UPMB)has hosted a Long Term Fellow for the pastone and half years. During her stay, Ms. RoseBaryamutumahascontributedtotheorganization’sresource mobilization efforts, building an M&Esystem forHIVandAIDSactivities inmemberhealth units, capacity building for secretariatstaff and those from member health units andfacilitatingthecollaborationbetweenUPMBandtheSchoolof PublicHealth.Sheisalsocarryingout a programmatic activity among adolescentsliving with HIV/AIDS, the findings of which will helpUPMBtoenhanceadolescentHIVservicesinitsnetwork.For more information about the Fellowshipprogram, please visit the program’s website at; http://www.musphcdc.ac.ug



2.5.2 Training of counselors, laboratory workers and pastoral workers

TheUgandaProtestantMedicalBureau(UPMB)with support from DIFEAM implemented acapacity building project for HIV prevention,treatment, care and support for health workersand religious leaders from affiliated member health Units between March-June 2009. The projecttargeted laboratory technicians/assistants andNurses/counselorsfromselectedMemberhealthunits. The laboratory Technicians/assistantsundertook a course entitled “HIV/AIDS skillsdevelopment course for Laboratory personnel”,while the course for Nurses/Counselors was“the use of antiretroviral Therapy in Resourcelimitedsettings”.Thecoursesweredesignedandfacilitated by the MILDMAY training Centrein close collaboration with UPMB. In total,the project trained 11 laboratory Technicians/Assistantsand13Nurses/Counselors.Inaddition17hospitalchaplainsweretargetedforacourseinHIV/AIDScare,pastoralcareandcommunicationskillsforreligiousleaders.

2.5.3 reproductive health project in 10 districts

Uganda Protestant Medical Bureau, InteractWorldwideandHealthLinkusinganawardfromtheBigLottery fund implemented aSexual andReproductiveHealthforathreeyearprojectperiodstartingApril2006.TheoverallprojectpurposewastoreachGirlsandWomenin10DistrictsinUganda, with Quality Sexual and ReproductiveHealth Information and Services through twooutcomes; (1) appropriate and accessible quality sexualandreproductivehealthservicesprovidedin the communities and health units and (2)greater knowledge and awareness of Rights inrelation to their sexual and reproductive healththereby contributing to greater gender equity and empowerment.

The project was well designed, using baselinedata to address real problems through clearinterventions which built on existing serviceswithin UPMB jurisdiction and based on the. Though the technical service scope of theprojectcoveredmostareas in theessentialSRHpackage, they were considered too broad to beimplemented in the project duration. The BCC

componentwascomprehensivelyconceptualisedtacklinganumberof behaviouralproblemsinthecommunity. TheRightscomponentwasweaklyconceivedinplanningandthereforeinterventionswerenotexpectedtohavemuchimpact.Likewise,the advocacy and rights promotion componentdid not have adequate emphasis or effort even thoughbothcomponentsareexpectedtobelongtermactivitiesbeyondtheprojectduration.

The project worked within the national SRHpolicy and service standards. Adequate effort was madetoinvolveMinistryof Healthtechnicalstaff within the advisory committee. Multi-sectoralweakness inherent in district health systemsprevented wider collaboration and the projectdesign should have made effort overcome thisbottleneckatalllevels.

Theprojectselectedfacilitieswith implementerswho have experience, prior work as well aspersonal relationships with target communities.At national level, favourable National policiessuch as the Reproductive Health policy was agood environment for open dissemination of SexualReproductiveHealthandRights(SRH&R)information to thecommunityespeciallyamongyouthsandwomen.

2.5.3.1 Technical assistance

• Documentationandlearningtechnicalassistance

The learning and documentation workshopwasoneof a seriesof workshopsorganizedbyUgandaProtestantMedicalBureau(UPMB)andfacilitatedbyHealthlinkWorldwide UK in collaboration with InteractWorldwide,UK.Theseworkshopswereaimedat

Group work at the documentation workshop



buildingcapacityintheUPMBmember-networkfor thesuccessful implementationof theSexualand Reproductive Health programme. The aimof the Documentation and Learning workshopwas to equip participants with the necessary knowledge, skills and attitude toundertakehighquality innovative documentation of their work; to be able to learn from practice and share thelearningwithotherstakeholders.

Theworkshop washeld from June 30th to July4th at Hotel Equatorial in Kampala. It attracted 23 participants who were reproductive health focalpersonsfromvariousUPMBmemberfacilities.

• CommunityscorecardtrainingIn 2008, Interact Worldwide organized aworkshop of its partners in Africa includingUPMB to discuss the Community Score Card(CSC) Methodology to be used in monitoringandevaluatinghealthinterventionsatthehealthfacilitiesandinthecommunity.ThreepeoplefromUganda:2staff fromUPMB(GraceNakazibweand Dr Martin Ruhweza) and Kyetume CBHCMr. John Kiyimba attended the workshop inAddis Ababa, Ethiopia in November 2008.It was agreed that Kyetume CBHC initiatesthe implementation of the CSC, and based onthe lessons and experiences gained, would bereplicated in the restof the facilitiesunder theUPMBnetwork.KyetumeCBHCProgramwasselectedtopilotthisapproachsincetheprogramCoordinator had participated in training of implementingtheCommunityScoreCard.

CSC is a participatory and interactive processby which community members (service users)provideorganized feedback to serviceproviders(duty bearers) such as in health workers i.e.Kyetume CBHC, local central government andnationalpolicymakers i.e.within thesexualandreproductive health and HIV/AIDS sectorsamongothers. It facilitatesabottomupprocessof community assessing the performance of service providers. It strengthens accountabilityandtransparency inhealthcaredeliverythroughjointplanningandnationalleveladvocacy.

Themainrecommendationfromthepilotstudyis thattheCommunityScoreCardmethodologyshouldusedintherestof UPMBnetworkbecause

itpromotesarightsbasedapproachthatevaluatesand develops an overall picture of the quality, availability and accessibility of health servicesofferedinanypartof thecountry.Theapproachincreasesthevoiceof thepoorandmarginalizedmembersof society,enablingthemtoparticipateandactivelygetinvolvedinthedeliveryof healthserviceswhichtheyusuallyareindireneedof.

2.5.3.2 youth friendly services promotion

UPMBconductedtrainingof 30healthworkersfrom implementing facilities including the focalperson, Diocesan health coordinator and oneyouth community volunteer. In addition UPMBprovidedtrainingincommunicationskillsandpeercounseling to 30 youths identified by each of the implementingfacilities.Participantswereprovidedwithprotocolsonyouthfriendlyservices.

Following the training, implementing facilitiessubmitted plans that were funded to establishyouthcorners.Youngpeoplehavebeenmobilizedand given information as well as SRH servicesasaresult.Indeedduringthehouseholdsurvey45.7%of theyoungpeoplereportedawillingnesstoreturntothefacilityforRHservicesbecauseof availability of a youth corner or a peereducator.Thebaselinesurveyhadrevealedthatthis category of people were not happy andcomfortable dealing with conventional medicalcadrese.g.nursesanddoctors.

reasons for adolescent’s willingness to return to the health facility

No Year 2 Year 31 Friendly Services 61.1% 52.4%2 Didn’t wait too long 38% 15.9%

3 Presence of a youth corner 18% 21.3%

4 Talked to peer educator 23% 24.4%5 Nice experience 19% 13%

6 Return for any health problem 65.8%

7 Pregnancy 55% 6.7%8 Treatment of STIs 7.0%


2� Annual Report for the Year 2008/2009

2.5.33 Behavior change and communication activities

TheprojectdevelopedIECmaterialsandmemoryaidsforuseduringcounsellingsessions,posters,flipcharts and illustrated booklets—pre-tested for comprehension and cultural acceptability,especially with client groups that have lowliteracy rates—this contributed to increasing clients understanding of key information andhelped providers remember important points.Illustrated take-home materials were producedforuseduringcounselling tohelpclients recallinstructionslaterandalsotodisseminateaccurateinformation,sinceclientsoftensharethematerialswiththeirpartners,relatives,andfriends.VideoshowsforyoungpeopleonSRH&Rissueswereveryhelpful in reinforcing the rightbehavioursatcommunitylevels.

2.5.3.4 monitoring and Evaluation• Annualprojectreview

Themainpurposeof thisreviewwastoinformdonors, partners and implementers on progressandachievementsmadebasingonmeasurementof specific indicators during year 3 of the project. Assessmentof progressof theSRHprojectwasbasedonthetwomainprojectoutcomesaswellasthesixcrosscuttingoutcomesoverthethirdyearof implementation. The review found that theUPMBSRHprojecthas led to improvement inhealthoutcomesincludingreductioninunwantedpregnancies,knowledgeof HIVstatusanduptakeof care, support and treatment services in the

A sample of the IEC materials and job aids developed during

Number of people reached through drama and video shows from eight of the implementing facilities

Name of unit Youth 10-24 years Adults > 25 years Total Male Female Male Female Kyetume 549 500 28 174 1,251North Kigezi 36 135 44 187 402Ruharo Mission 350 818 1052 2672 4892Kolonyi 2470 1878 2721 2439 9508Ishaka 282 570 799 1164 2815Goli 1515 2445 1363 2788 8111All Saints Kagoma 262 421 210 385 1278Kuluva 385 340 364 430 1519Total 5849 7107 6581 10239 29,776

Utilization of selected RH services (all age groups)



targetcommunities.Women,girls,boysandmenwere satisfied with client-provider interaction, confidentiality and choice of service offered by theimplementinghealthfacilities.Mostof themarewillingtoreturntothefacilityandthehealthworker they saw during the last visit to seekhealthcare.

2.5.3.5 End evaluation findings The project services combined supersededthe targeted number. There was evidence of increased facility utilisation with some serviceslikereferralof sexualandgenderbasedviolenceclientsclimbingfromzerotoover670reported.Providers and the community linked increasedutilisationstotheimprovementof ReproductiveHealth service capacity, scope and quality brought aboutbytrainingof healthworkers,rehabilitationand re-equipment of facilities and creation of awarenessanddemand.

utilisation of services over the project life

M F Total

No. Receiving RCT services 14,100 45,121 59,221

No. treated for Opportunistic Infections 6,343 15,221 21,564

No. treated for STIs (Syphilis, abnormal discharges etc)

2,329 5,599 7,928

No. started on Septrin Prophylaxis 1,834 14,936 16,770

No. started on ARVs 409 3,705 4,114

No. counselled for prevention of STIs and HIV/AIDS

11,550 30,568 42,118

The project covered significant ground in strengtheningprojectstaff intechnicalskillsandmobilised community based human resourcesto support the thin work force of the projectfacilities. The project also strengthened datacollection and aggregation though transmissiontoUPMBremainedweak.

There were problems in starting the projectin relation to funding and timeliness of disbursements. Improving project impact wouldrequire starting earlier with mobilization and

fundingandinvolvemorecoordinationwithotherimplementers, especially local health authorities.Individual consortium partner performanceshould have been expressed more clearly. Theoversight activities should have emphasized notonly financial accountability but also steering implementationespeciallywhen fundingdelayedandsomeplannedactivitiesneededadjustment.

Good practicesAnumberof goodpracticesintheSRHprojectwere identified and these included:

• Integrated approach builds on existingservices provided at the health facility andtherefore fits in the package offered and staff toimplementviewtheextracaseloadaspartof theroutinework.

• Use of existing community structures likeyouthgroups,TBAspromotessustainabilityand fosters acceptance of the SHR&Rinterventions. The local resource personshave easy entry to the communities arebelievedfasterthanoutsiders

• Awareness interventions that target groupsenable messages to reach many audiencesataminimalcost.Theuseof Music,DanceandDramaismultiprongedindeliveringkeyhealth messages, providing entertainmentandkeepingyoungpeoplebusyandmutuallysharingandlearningtogether.

• Youth Friendly Services ensure that youthwhohavereservationsof minglingwithadultscan access the SRH services with confidence and privacy a key component in buildingtrust for continued access to the services.Coupledwithnondiscriminationapproach,diversegroupsof peoplewerereachedandaccessedservices regardlessof sex,gender,race,ethnicityandreligiousbackground.

recommendations

• Improve the design and planning of youthfriendlyservices.

• Train and equip young people in dealing with fellowyouthsproblems,amongstthehealthcareproviderseither at counselling levelortreatment, there is need to have a youngpersoninvolvedintheservicedelivery.

• Strengthen Drama groups that act anddelivermessagesinthelocallanguages.IEC


2� Annual Report for the Year 2008/2009

materialswerealso limitedandyet theyarea silentmedia that can support deliveryof SRH&Rhealthmessages

• Involveallthestakeholdersinthedesigningandformulationof thecommunityprograms(opinion leaders, political leaders, localcouncils,clanleaders,religiousleaders)

• SGBV interventions need to strengthenedin that response and prevention strategiesneedtobehighlightedandappropriateandrelevant authorities brought on board in acollaborativemannertorealiseimpacts

• Timely funds remittance for the plannedactivitieswillreducedelays

• Thereisneedtoexplorewaysof motivatingand sustaining the volunteer spirit of thehealth resource persons at communitylevel.Incentivesarevariedandneednotbefinancial alone.

• Thereisneedtostrengthenthelinkbetweenthe programme headquarters (UPMB) and the implementation sites. Increasedmonitoringandsupportvisitsareimportantinensuringthatprojectactivitiesremainoncourse

• Effort should be made to increaseparticipation of beneficiaries in the planning, management and evaluation process as aprerequisite for appropriately adjusted and lastingsolutions.

• Subsequent projects should consider more human resource support at programmeheadquarters to cope with the increased demands of monitoring and reportingthat come with the project especially forspecialisedskillssuchasM&E,BCCetc

• Address health systems support issuesmore comprehensively, for example: a keychallengeinthisprojectwasthelackof RHcommodities due to weaknesses in the RHcommoditysupplychaininUganda.

ACHIEVEMENTSANDCHALLENGES:HIV&REPRODUCTIVEHEALTH

• UPMBisnowamemberof thePartnershipformaternalandnewbornhealthandtheWhiteRibbonAlliance.

• UPMBstartedimplementationincollaborationwithInteractWorldwideof afouryearstrategicprojectonmaternalandneonatalhealthinUganda,workingthrough31healthfacilitiesin20districts.Theprojectshalluseahealthsystemstrengtheningapproachtoimprovematernalandneonatalhealthindicatorsinthetargetcommunities.

• ThereisstillafundinggapfortheHIVprogram.



3.0 FiNANCE ANd AdmiNiSTrATiON

Finance and Administration as a department iscentralandkey inanyundertakingwith itsrolescenteredonnotonlyensuringtheavailabilityof both financial and human resources but also the efficient and effective use of such resources with anaimof achievingorganizationalobjectives.Inthe year 2008/2009 the department registeredsignificant improvement in terms of resource mobilizationandthisyearsreportfocusesontherealized income, expenditure, achievements andthewayforwardasadepartment.

3.1 income

TheUPMBsecretariatreceived79.5%of ittotalfunding from external sources majority donors,8.5% from local partners and 12.5% from itsincomegeneratingunitsandotherlocalservices.Overall, the total funding for the year increasedby22.4%incomparison to thepreviousyearasillustrated in the table below;

NO. INCOME SOURCE2008/2009AMOUNT(SHS)

2007/2008AMOUNT (SHS)

1 DONORS 982,990,004 679,163,611

2 LOCAL PARTNERS 104,900,000 130,000,000

3 IGUS AND MEMBER CONTRIBUTIONS 148,925,999 201,306,921

TOTAL 1,236,816,003 1,010,470,532

The level of funding from the 3 different sourcesoutlined above is further portrayed in the chartbelow;

3.2 Strategic plan 2008 - 2013EEDhascontinuedtosupportUPMBwithanapprovedcontribution of 59.35% and ICCO contributing12.2%.Incomefromlocalpartners,membershipandotherserviceswasbudgetedat29.55%.Eachfundingsource incomevis-a-vis targets is summarized in thetablebelow.

NO. INCOME SOURCE

AMOUNT(SHS)

ACTUAL (%)

TARGETED (%)

1 EED 285,458,800 35.5 59.35

2 ICCO 264,928,182 32.9 12.2

3

UPMB & LOCAL PARTNERS

253,825,999 31.6 28.45

TOTAL INCOME 804,212,981 100 100

Difaemalsoremitted24,900,000/=towardstheHIVprogram.

3.3 Local funding Asalocalpartner,theJointMedicalStoresupportedcapacitybuildingandsupportsupervisionof memberunits by remitting 80,000,000= which represents31.5%of thetotalincomereceivedfrompartnersandotherlocalservices.

Membership fees from member units were14,920,000= compared to 24,855,820= received inthe year 2007/2008 representing a 40% decrease inmembership fees. However in reference to the totalincome raised locally, this represents 5.8%. UPMBalso realized a gross income of 53,423,956= fromlocalserviceswhichis21%of thetotalincomeformpartnersandlocalservices.

The optical and guest house income generatingunits supported UPMB’s strategic core activities bycontributingUshs43,225,138/=andUshs37,356,905/=respectively. This put together represents a 31.8%of the total funds received from partners and localsources.

3.4 project fundingUPMBhadintheyearotherprojectsindependentof the strategic plan core activities. Upon closure of athreeyearSRHproject, InteractWorldwideenteredinto a four year partnership agreement with UPMBfor a strategic grant aimed at accelerating improvedMaternal and Neonatal Health in poor marginalizedcommunities which commenced in April 2009



towards the end of the fi nancial year. The table below illustratestheextentof fundingreceivedforthisandother specifi c projects.

PROJECT PARTNER AMOUNT(Ushs)

Support to the training of PNFP training institutions DANIDA 24,651,588

Accelerating improved MNH in poor marginalized communities

B.I.G 59,059,476

Reaching women and girls with SRH information and services

B.I.G 345,305,958

Supporting focused antenatal care activities IMA 3,586,000

TOTAL 432,603,022

3.5 ExpenditureThe expenditure for the year regardless of sourcehas been classifi ed into 3 categories namely; Health, Personnel and Administration as in the table below;

NO. DEPART-MENT



1 Health programs 515,675,847 589,275,599

2 Personnel costs 279,571,216 395,190;659

3 Administra-tion 192,544,319 175,882,377

TOTAL 987,791,382 1,160,348,635

Thelevelof spendingbydepartmentisasdepictedinthechartbelow.

3.6 Achievements and way forwardTheachievementintheincludebutarenotlimitedtothe following;

i. Strengthened internal controls to enhanceservice delivery and accountability tostakeholders.

ii. Increased project funding throughmaintenance of good relationship withdonorsandotherpartners.

iii. Timely reporting tostakeholderswhichhasenhancedrelationships.

iv. Improved service delivery by memberunits though support supervision andcommunication.

way forwardThe Finance and Administration department iscommitted to ensuring the following in the comingyear 2009/2010;

i. Implementationof thestaff retentionpolicytoguardagainststaff turnoveranditsaftereffects.

ii. Strengthenteamworkamongststaff soastoachieveorganizationalobjectives

iii. Effi cient and effective utilization of resources.

iv. Strengthen the drive towards self sustainability.

3.7 KEy pArTNErS

i. AUDITORS KazibweKenneth&Steven Certifi ed Public AccountantsP.OBox116Kampala

ii. LEGALCOUNSEL Kateera&KagumireAdvocatesP.OBox7026Kampala

iii. BANKERS StandredCharteredBankP.OBox7111Kampala

StanbicBankP.OBox7131Kampala

DFUBank P.OBox70Kampala

BarclaysBank P.OBox2971Kampala

HousingFinance P.OBox1539Kampala


Annual Report for the Year 2008/2009 29

4.0 pErFOrmANCE OF hOSpiTALS

4.1 inputs

Finances: Hospitals reported an increaseddependence on user fees (48%) and externaldonations of funds, goods and services (34%)compared to last year. As shown in the tablebelow, PHC conditional grant allocations (11%)to hospitals decreased overall this fi nancial year.

Expenditure patterns show a sharp rise inemployment costs last year from 52% of totalexpenditure to 59% of total expenditure.Most hospitals have made an effort to increaseremuneration of their workers. Medical goodsand services and primary health care togetheraccountedfor10%of expenditure.Administrationexpensesremainedlowat5%

4.0 pErFOrmANCE OF hOSpiTALS

4.1 inputs

Finances: Hospitals reported an increaseddependence on user fees (48%) and externaldonations of funds, goods and services (34%)compared to last year. As shown in the tablebelow, PHC conditional grant allocations (11%)to hospitals decreased overall this fi nancial year.

Expenditure patterns show a sharp rise inemployment costs last year from 52% of totalexpenditure to 59% of total expenditure.Most hospitals have made an effort to increaseremuneration of their workers. Medical goodsand services and primary health care togetheraccountedfor10%of expenditure.Administrationexpensesremainedlowat5%



Gov

ernm

entP

HC

Allo

catio

nsto

UPM

BM

embe

rHos

pita

ls

NoNa

me of

ho

spita

l.Di

strict

Hosp

ital a

lloca

tions

Train

ing S

choo

l allo

catio

ns

2006

-07

2007

-08

Alloc

ation

2008

/09Ac

tual re

ceive

d20

08/09

2006

-07

2007

-08

Alloc

ation

20

08/09

Actua

l rece

ived

2008

/09

1Am

aiLir

a15

4,258

,586

154,2

58,58

614

4,258

,586

2Am

udat

Naka

piripi

rit20

3,692

,072

203,6

92,07

219

3,692

,072

170,4

54,92

8

3Ish

aka

Bush

enyi

177,4

70,90

717

7,470

,907

167,4

70,90

721

9,988

,559

11,00

4,747

11,00

4,747

11,00

4,747

0

4Ka

baro

leKa

baro

le84

,583,7

5784

,583,7

5784

,583,7

5790

,013,4

06

5Ka

gand

oKa

sese

254,8

51,32

825

4,851

,328

244,8

51,32

8

22,00

9,492

22,00

9,492

22,00

9,492

0

6Ki

siizi

Ruku

ngiri

220,6

67,35

222

0,667

,352

210,6

67,35

218

6,250

,000

18,34

1,244

18,34

1,244

18,34

1,244

17,00

0,000

7Ki

woko

Naka

seke

135,5

76,96

613

5,576

,966

120,5

76,96

612

4,003

,075

18,34

1,244

18,34

1,244

18,34

1,244

9,073

,200

8Ku

luva

Arua

317,1

42,17

431

7,142

,174

307,1

42,17

428

9,925

,651

26,41

1,390

26,41

1,390

26,41

1,390

24,14

4,817

9Ku

miKu

mi29

6,882

,076

296,8

82,07

628

6,882

,079

290,3

79,81

8

10Ng

ora

Kumi

371,3

29,77

637

1,329

,776

361,3

29,77

634

0,282

,880

78,15

4,311

78,15

4,311

78,15

4,311

63,25

6,282

11Me

ngo

Kamp

ala13

5,828

,130

135,8

28,13

012

5,825

,130

78,88

2,070

44,01

8,984

44,01

8,984

44,01

8,984

20,72

8,000

12St

Step

hen’s

Kamp

ala35

,272,6

7435

,272,6

7445

,272,6

7433

,565,8

43

13Ru

sher

eKi

ruhu

ra21

0,013

,915

210,0

13,91

519

4,013

,915

14CU

RE

Child

ren’s

Mbale

99,74

2,075

99,74

2,075

99,74

2,075

74,80

6,557

15Ru

gara

maKa

bale

99,74

2,075

99,74

2,075

99,74

2,075

131,3

18,48

4

16Ru

haro

Mbar

ara

69,81

9,452

69,81

9,452

179,8

19,45

267

,661,8

62

17Bw

indi

Kanu

ngu

4,193

,860

TOTA

L2,8

65,87

0,318

1,846

,405,4

34(6

4.4%

)TO

TAL

218,2

81,41

211

3,474

,299

(61.5

%)



4.2 human resourcesAnanalysisof 33cadresof healthworkersshowsthat UPMB Hospitals continued to experiencegaps for key cadres such as medical officers, clinical officers, nurses and midwives (particularly of theenrolledcategory)andpharmacistsduringtheyearunderreview.

human resources - hospitals

Personnel Total Available 2007/08

Total available 2008/09 Total expected Gap (2008/09)

Medical Director/ Sup. 11 14 14 0Deputy Medical Director/ Sup. 6 5 0 -5Hospital Administrator 16 16 14 -2Principal Nursing Officer 4 8 14 6Senior Nursing Officer 17 19 70 51M/O Special Grade 8 11 14 3Principal Medical Officer 0 3 14 11Senior Medical Officer 5 5 14 9Medical Officer 44 34 56 22Nursing Officer (Nursing) 58 84 238 154Nursing Officer (Mid Wifery) 22 34 42 8Senior Clinical officer/ MA 8 10 14 4Clinical officer/ MA 44 43 70 27Anaesthetic Off/Asst 27 17 28 11Orthopaedic Off/Asst 16 9 28 19Physiotherapist 8 13 14 1Ophthalmic CO/Asst 11 13 14 1Registered M. wife 31 47 0 -47Registered nurse 57 44 0 -44Enrolled midwife 113 110 350 240Enrolled Comprehensive Nurse 24 148 0 -148Enrolled nurse 317 212 644 432Nursing assistant 222 157 210 53Nursing Aide 81 86 0 -86Lab Technologist 7 8 14 6Lab Technician 18 26 14 -12Lab Assistant 56 56 28 -28Records Assistant/Clerk 34 30 28 -2Pharmacist 4 3 14 11Dispenser 12 14 28 14Dental Surgeon 7 8 14 6Public Health Dental Officer 11 12 28 16Dental Attendant 12 15 14 -1

TOTAL STAFF 1,311 1,314 2,044 730



4.3 hospital outputs

ACTIVITY TOTAL 2007/08 TOTAL 2008/09OPD (Excluding ANC) 365,353 277,276

ANC 47,921 43,372Deliveries 16,562 20,716C-sections 3805 4205Outreach visits 1491 3977Immunizations 175,442 181,294

vOLumE OF OuTpuTS*Thestandardunitof outputsattemptstoattributethe final outputs of a hospital a relative weight based on previous cost analyses taking theoutpatient contact as the standard of reference.Thisyearmosthospitalsmaintainedorincreasedtheirindividualstandardunitsof output.Themain

∗ The parameter for the volume of outputs is the standard unit of output (SUOP) which converts all outputs to outpatient equivalents. SUO total for a given health facility =Σ(IP*15+OPD*1+Del*5+Imm*0.2+ANC/MCH/FP*0.5) The basis of this parameter rests on the evidence that the cost of man-aging one inpatient is 15 times the cost of managing one outpatient, one immunization 0.2 times more, one delivery 5 times more, one ANC/MCH/FP client 0.6 times the cost of managing one outpatient.

valueof this indicator lies in the information itgives individual hospital owners and hospitalmanagers about performance trends of theirhospital.

4.3 Efficiency

Average length of stay Bed occupancy rate(%)

2007/08 2008/09 2007/08 2008/09Amudat COU 8.5 10 36.6 54.5Ishaka SDA 2.3 2.3 51.2 57.1Kagando COU 6.7 96.8Kisiizi COU 6.9 5 71.2 54.6CURE CHU 7.8 9.2 60.4 71.7Kiwoko COU 7.6 5 35.6 33.3St Stephens COU 2.03 1 16.4 8.1Kuluva COU 6.6 5.6 90.8 71.9Kumi COU 8 7 82 77.4Mengo 4 4 31.6 46.6Ngora Fred Carr 3.3 4 64.8 41.1Kabarole 2.75 15 60.4 47.9Bwindi 4.2 4 26.8 36.5Rushere 3.0 63.3Rugarama 6 5.5 31.8 56.9

Differences between the hospitals in respectof patient age, specialty service and diagnosticgroup may affect average length of stay makingoutright hospital comparisons difficult. While bedoccupancyratesdifferduetoseveralfactorsincludingthenumberof bedsinagivenhospital.In general these efficiency indicators are important

forindividualmanagerstoplanfortheirhospitalsandassesstrendsoverappropriateperiodsof time.Bedoccupancyratesabove90%maysubjectthehospital to frequent bed crises with the hospital operatingveryclosetomaximumcapacity.



5.0 pErFOrmANCE OF hEALTh CENTrES

Outof 253healthcenters,113submittedcompleteandtimelyannualreturns.Thisrepresents45%of healthcenters.Thetargetof 100%reportingfromthelowerlevelunitsthereforeremainsunachievedthisyear.

5.2 human resources:

5.1 inputsFor the lower level units, government supportboth through the PHC conditional grant andthroughcreditlinesforessentialdrugsaccountedfor themainsourceof income(37%)User feescontributed20%of incomedownfrom31%lastyear.Employmentcostswentdownfrom38%to31%of expenditure.

5.3 Outputs

OuTpuTS FOr 39% OF upmB LOwEr LEvEL uNiTS

TOTAL Beds Outpatient attendances Inpatients Deliveries ANC Immunizations

1573 483,977 23,569 12,120 38,110 412,304

hEALTh CENTrES

Outof 253healthcenters,113submittedcompleteandtimelyannualreturns.Thisrepresents45%of healthcenters.Thetargetof 100%reportingfromthelowerlevelunitsthereforeremainsunachievedthisyear.

5.2 human resources:

5.1 inputsFor the lower level units, government supportboth through the PHC conditional grant andthroughcreditlinesforessentialdrugsaccountedfor themainsourceof income(37%)User feescontributed20%of incomedownfrom31%lastyear.Employmentcostswentdownfrom38%to31%of expenditure.



6.0 pErFOrmANCE OF hEALTh TrAiNiNG iNSTiTuTiONS

6.1 inputs

Finances

The health training institutions continued to beheavilydependentonstudents’ fees.TheMOH-DPbursaryfundinitiativeisthereforepotentiallyquite benefi cial to these institutions, is that it shall introduce a more predictable source of funding than school fees which usually come inunpredictable installments and many times quite late in the fi nancial year.

6.2 human resources and key performance indicatorsThe health training institutions fell short of the recommended qualifi ed tutor: student ratio of 1:20, with Kuluva School of enrolledcomprehensive nursing faring better than therest. Concerted efforts are already underway toaddress this issueadUPMB is supportingsomeof the schools to train tutors. The other quality indicator: success rate, remained constant ordecreased for all the institutions compared tothe previous year. Equity taken as fee per student decreased with the exception of Mengo Schoolof nursingandmidwiferyandKisiiziSchoolof enrolledcomprehensivenursing.

The health training institutions continued to beheavilydependentonstudents’ fees.TheMOH-DPbursaryfundinitiativeisthereforepotentiallyquite benefi cial to these institutions, is that it shall introduce a more predictable source of funding than school fees which usually come inunpredictable installments and many times quite late in the fi nancial year.

6.2 human resources and key performance indicatorsThe health training institutions fell short of the recommended qualifi ed tutor: student ratio of 1:20, with Kuluva School of enrolledcomprehensive nursing faring better than therest. Concerted efforts are already underway toaddress this issueadUPMB is supportingsomeof the schools to train tutors. The other quality indicator: success rate, remained constant ordecreased for all the institutions compared tothe previous year. Equity taken as fee per student decreased with the exception of Mengo Schoolof nursingandmidwiferyandKisiiziSchoolof enrolledcomprehensivenursing.



Key

per

form

ance

indi

cato

rs fo

r the

hea

lth T

rain

ing

inst

itutio

ns

Kisii

zi Me

ngo

Kaga

ndo

Ngor

aKu

luva

Kiwo

ko

2008

/0920

07/08

2008

/0920

07/08

2008

/0920

07/08

2008

/0920

07/08

2008

/0920

07/08

2008

/0920

07/08

Total

Nu

mber

of

Quali

fied

Tutor

s

23

44

44

43

44

21

Quali

ty:

Stud

ent

succ

ess r

ate10

0%10

0%95

%10

0%75

%86

%97

%10

0%10

0%10

0%

Quali

ty:

Quali

fied

tutor

:stu

dent

ratio

1:69

1:33

1:57

1:56

1:41

1:55

1:25

1:25

1: 60

1 :74

Acce

ss:

HTI

Utiliz

ation

Ra

te (%

)

100

7710

010

010

099

100

103

9993

8811

2

Equi

ty: F

ee

per S

tuden

t 91

0,004

1,073

,201

1,512

,108

1,643

,221

1,394

,239

1,162

,701

1,604

,759

1,550

,044

1,484

,111

1,166

,155

1,703

,805

975,4

76

Effic

iency

: Re

curre

nt Ex

pend

iture

pe

r Stud

ent

1,189

,713

1,096

,480

1,845

,512

1,715

,918

1,384

,934

966,3

242,0

53,91

52,0

20,53

31,9

27,56

41,4

30,48

21,9

46,27

81,0

67,03

8



Annex 1: Members of the Board 2008/2009

NO NAME POSITION1. Prof J Tumwine Board chair 2. Dr. D. Birabwa-Male Vice chair 3. Mr. R Korutaro Hon Treasurer/Chair, Finance committee4. Mr. Z. Kalega Chair Management committee5. Prof. M Kawooya Chair health committee6. Rev Canon G Bagamuhunda Representative of Church of Uganda7. Ms Amanda Onapito Representative of Church of Uganda8. Pr. S. Kajoba Representative SDACUU9. Ms Glenna Phipphen Pentecostal churches representative10. Dr. J. Opolot Member units Eastern region11. Rev. B. Baguma Member units Western region12. Dr. M. Mpalampa Member units Central region13. Dr P Kerchan Member units Northern region14. Dr Sheila Ndyanabangi Ministry of health representative15. Ms M Chota Ministry of health representative16. Prof E Kaijuka Co-opted member17. Dr. J. Nyanzi Mengo hospital representative(co-opted)

Membersof theBoardof Directorsduringtheyear2008/2009wereaslistedbelow:

STANdiNG COmmiTTEE mEmBErS

NO NAME POSITION /CONSTITUENCYFINANCE & AUDIT COMMITTEE

1. Mr. R .Korutaro Chairperson2. Mr Wilson Nakibinge Member3. Dr. D. Birabwa-Male Member4. Mr Richard Obura Member, Church of Uganda6. Mr. E Kibura Member, SDACUU

MANAGEMENT COMMITTEE1. Mr. Z. Kalega Chairperson2. Mrs Barbara Senkatuka Waligo Member3. Mr. Rodgers Asiimwe Member, member units4. Mr. J. Kambagira Member , member units

HEALTH COMMITTEE1. Prof. M Kawooya Chairperson2. Dr. D. Birabwa-Male Member3. Mrs M Kanakulya Member, COU4. Dr. S. Biraro Member5. Ms Lolita Largosa Member, SDACUU6. Ms Immaculate Naggulu Representative of HTIs7. Rev Dan Zoreka Representative of ZCCs



Other committeesSCHOLARSHIP FUND COMMITTEE

NAME POSITION/CONSTITUENCY1. Dr Seth Tibenda Chairperson & representative of lower 2. Mr. Z. Kalega Member3. Mr. R. Korutaro Member4. Prof. M Kawooya Member5. General Manager JMS Member, JMS6. Kumi hospital Member representing hospitals

UPMB BUILDING TASKFORCE COMMITTEE (AD-HOC)NAME

1. Mr R Korutaro2. Mr Z Kalega3. Dr D Birabwa-Male4. Prof E Kaijuka5. Rev Can Bagamuhunda



Annex 2: Staff list as at 30th June 2009

1. Dr.LornaB.Muhirwe : ExecutiveDirector

health department.

2. Ms. Grace Nakazibwe : CBHC officer3. Ms. Gloria Angulo : Project officer

F&A department

4. Ms.MirembeCissy : Finance&AdminstrationManager5. Ms. Nakyanzi Dorothy : Administration officer6. Ms.RebeccaSekawungu : Accountant7. Ms.EstherNakinga : Accountsassistant8. Mr.KakoozaPeter : Driver9. Mr.LwasaPeter : Driver10. Mr. Lubowa Emmanuel : Office attendant

Optical unit

11.Mr.ApuuliWilson : Ophthalmicassistant12.Mr.KatumbaEric : Technician13.Ms.EmilyNakyanzi : Opticalreceptionist/storekeeper

Guest house unit

14.Mr.WaiswaDavid : AsstGHsupervisor15.Ms.TinoGladysOmuddu : Headhousekeeper16.Ms.ZaweddeBetty : Waitress17.Ms.NalukwagoHarriet : Cook18.Mr.HagenaBenon : Laundryattendant19.Mr.OpendiTomasi : Nightguard


Annual Report for the Year 2008/2009 �9

Ann

ex 3

: Yel

low

sta

r ass

essm

ent r

esul

ts fo

r a s

ampl

e of

low

er le

vel u

nits

mad

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t Nile

dio

cese

Unit

Infra

stru

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e &

Equi

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t Ma

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sIn

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Prev

entio

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C/IP

CTe

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Clien

t ser

vices

Tota

l

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

Kei

60%

50%

60%

100%

75%

88.90

%69

.70%

Erep

i40

%10

0%66

.70%

66.70

%60

%10

0%10

0%10

0%50

%75

%80

%88

.90%

77.80

%87

.50%

St.Lu

ke K

atiyi

60%

100%

33%

66.7%

60%

60%

0%10

0%50

%10

0%50

%90

%45

%84

.8%An

yavu

60%

60%

67%

66.70

%80

%80

%10

0%10

0%10

0%10

0%10

0%10

0%84

.40%

84.40

%An

yiribu

60%

60%

83.30

%83

.30%

80%

100%

100%

100%

100%

100%

77.80

%10

0%81

.30%

90.60

%

Neb

bi d

ioce

se

UNIT

Infra

stru

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e &

Equi

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t Ma

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sIn

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Prev

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C/IP

CTe

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kills

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Tota

l

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

1st

2nd

Goli

100%

100%

100%

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Azur

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60%

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100%

67%

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89%

72%



Address:

Plot 8�� Balintuma Road, MengoP.O. Box ��2�, Kampala - Uganda

Gen: +2�� 2��Fax: + 2��

E-mail: [email protected]

annual report for the year 2008/2009 · the period 2008 – 2010 and to appoint external auditors...

Documents