draft strategic plan jan 15

Strategic Plan2013 – 2017

April, 2013

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TABLE OF CONTENTS

Baylor-Uganda Strategic Plan (2013 -2017) ii

ACRONYMS AND ABBREVIATIONS

AIDS Acquired Immune Deficiency SyndromeART Anti-Retroviral TherapyARV Anti-RetroviralBIPAI Baylor College of Medicine International Paediatric AIDS Initiative HIV Human Immuno-deficiency VirusM&E Monitoring and EvaluationNGO Non-Governmental OrganisationPIDC Paediatric Infectious Diseases clinicPLWHA People Living with HIV&AIDSPMTCT Prevention of Mother to Child Transmission of HIVSP Strategic PlanSTD Sexually Transmitted DiseaseSTI Sexually Transmitted InfectionTB TuberculosisToC Theory of Change VCT Voluntary Counselling and Testing

Baylor-Uganda Strategic Plan (2013 -2017) iii

Baylor Uganda Vision

Mission

Values

Baylor-Uganda Strategic Plan (2013 -2017)

A health and fulfilled life for every HIV and AIDS infected and affected child and their families in Africa.

Baylor-Uganda is committed to provide high-quality, high-impact, highly ethical pediatric and family-centered health care, health professional training and clinical

research, focused on HIV/AIDS, Tuberculosis, malaria, malnutrition and other conditions impacting the health and families worldwide.

Care, integrity, excellence, innovation, teamwork and accountability

iv

Executive Summary

Baylor-Uganda Strategic Plan (2013 -2017) 5

1.0 Introduction

This document presents the strategic direction for Baylor Uganda (2013-2017), which is shared by the Board, stakeholders and staff members. The primary purpose of the strategic plan is to provide a pathway for those responsible for making strategic decisions and mobilizing resources within Baylor Uganda.

The secondary purpose of the document is to communicate our strategy to peadiatric HIV&AIDS services through strengthened programming, advocacy, research and information sharing within the country and the region.

Baylor Uganda will use this strategic plan to define unmet needs and priorities in peadiatric HIV&AIDS services in Uganda and the region; as well as allocate new resources, as they become available.

This plan has been developed through a process of self-assessment and drawing from the evaluation of the previous Strategic Plan (2007-2012), with a focus on Baylor Uganda’s goal and core objectives. The self-assessment and the evaluation considered Baylor Uganda’s current practices, the effectiveness of strategies employed to date and the challenges that lie ahead. The process was highly participatory and transparent to ensure that all stakeholders collectively own the resultant Plan.

The document is organized as follows: Section 1 provides the Background Information in terms of the burden of peadiatric HIV&AIDS in Uganda and the mandate of Baylor Uganda to address the challenge peadiatric HIV&AIDS for effective response. Section 2 presents the review of the previous Strategic Plan (2007-2012) in terms of achievements, challenges and lessons, and the findings of the SWOT analysis, which informed development of this Strategic Plan. Sections 3 and 4 present the Strategic Direction in terms of Vision, Mission, Objectives, Strategies and Baylor Uganda Theory of Change (ToC). Finally Section 5 focuses on institutional arrangements for implementing, funding and monitoring the Strategic Plan. The Logical Framework Matrix is presented as an Annex and gives a summary of interventions proposed in this Strategic Plan.

Background

Baylor College of Medicine Children’s Foundation-Uganda (Baylor – Uganda) is a child health, not - for - profit NGO committed to delivering high quality, high impact and highly ethical paediatrics and family HIV&AIDS prevention, care and treatment services, health professional training and clinical research in Uganda. It is affiliated to Baylor College of Medicine International Paediatric AIDS Initiative (BIPAI) based in Houston, Texas, USA. It emerged from a technical capacity building support and partnership between BIPAI, Mulago Hospital Paediatric Infectious Diseases clinic (PIDC) and Makerere University Department of Paediatrics and Child health in August 2003. PIDC existed since 1988 as a Mulago hospital clinic offering Paediatric HIV&AIDS services. In November 2004, PIDC was officially initiated into the BIPAI network at their annual networking meeting in Gaborone, Botswana.

In 2005, BIPAI signed memoranda of understanding with Ministry of Health, Mulago Hospital and Makerere University Department of Paediatrics and child health to support the expansion of


paediatric and adolescent HIV services in Uganda. It was then that Baylor College of Medicine Children’s Foundation – Uganda (Baylor – Uganda) was formed and registered as a Non-Government Organization.

The Vision: A health and fulfilled life for every HIV&AIDS infected and affected child and their families in Africa.

The Mission: Baylor-Uganda is committed to provide high-quality, high-impact, highly ethical pediatric and family-centered health care, health professional training and clinical research, focused on HIV/AIDS, Tuberculosis, malaria, malnutrition and other conditions impacting the health and families worldwide.

Core Values: These values include: care, integrity, excellence, innovation, teamwork and accountability.

Baylor-Uganda as Model for peadiatric HIV&AIDS services in UgandaThere are several local organizations with mandate in the area of HIV&AIDS operating in Uganda. But Baylor-Uganda is a very unique model for peadiatric HIV&AIDS in line with government priorities. It is the major provider of peadiatric HIV&AIDS services in Uganda accounting for 23% of the total population of children served. Among other factors, its uniqueness lies in the following features: (a) delivery of family centred comprehensive peadiatric HIV&AIDS psychosocial and clinical services in its centres of excellence (b) unique focus on health systems strengthening for delivery of quality peadiatric HIV&AIDS (c) national and district level advocacy to tackle systemic barriers to addressing policy gaps in peadiatric HIV&AIDS service delivery; and (d) conduct of operations research to inform programming and policy.

a) Delivery of family centred comprehensive peadiatric HIV&AIDS services Through its centre of excellence in Mulago, Baylor-Uganda provides comprehensive peadiatric HIV&AIDS services to families using the child as the entry point. This takes into account the family members including mothers and other household members. Right from prevention of mother to child transmission of HIV, the services cover EID, HCT and management of OIs, psychosocial support, ANC and PNC, targeting children and adolescents as the primary focus. Using its community systems strengthening strategy, beneficiaries are identified by community resource persons who include VHTs, referred and followed up for service uptake. Baylor-Uganda has equally established partnerships with community based organizations to strengthen the referral network.

b) Health systems strengthening for delivery of quality peadiatric HIV&AIDSAt national level, Baylor-Uganda works with the Ministry of Health to strengthen the national level peadiatric HIV&AIDS response through supporting the human resource function to plan and implement paediatric HIV&AIDS policies and programmes. To this end, a desk was established to promptly respond to peadiatric issues at national level. At District level, Baylor-Uganda supports Local Governments health care delivery structures through provision of infrastructural development, human resources for health, equipment and supplies; and training of health workers. A sub granting mechanism is also used to support implementation of peadiatric HIV&AIDS interventions.


c) Policy advocacy for peadiatric HIV&AIDS service delivery Baylor-Uganda peadiatric HIV&AIDS policy advocacy agenda focuses on strengthening the HIV response at national and district local government levels. This is through participation in national events, technical working groups and development of national strategic plans/frameworks. The advocacy initiatives focus on service awareness creation, lobbying for increased service access, best practice benchmarking and provision of key information, education and communication materials.

d) Clinical researchBaylor-Uganda develops and conducts research to investigate particular elements within the clinical care services. The research findings are used to inform programming and the peadiatric HIV&AIDS advocacy agenda.

Baylor-Uganda Institutional FrameworkAs of 2012, Baylor-Uganda had an established national office located at Mulago National Referral Hospital; which also doubles at the centre of excellence for delivery of peadiatric HIV&AIDS services. In terms of governance, Baylor-Uganda is made up of the following key organs: i) Board of Directors and ii) the Secretariat. The Board of Directors is comprised of 7 individuals who meet quarterly to provide policy and strategic direction. The Board has sub-committees which support its routine functions. The Secretariat is responsible for the overall day-to-day management of Baylor-Uganda’s work and the implementation of the Strategic Plan. It is composed of an Executive Director(ED) who has the implementing and controlling role. The ED sets the climate and tone of the strategic planning process, establishes the planning group, and ensures the Action Plans are completed on time and have appropriate control and measurement systems in place.Directors, Programme Managers and support staff. It has regional offices in Rwenzori region where it has consolidated its programmes after the rationalization process. However, other interventions are running in different districts of Uganda.

Contextual issues of peadiatric HIV&AIDSThe HIV prevalence in Uganda is currently 7.3% and incidence stands at 130,000 new infections per year; maternal and neonatal morbidity and mortality remained high (MMR=435/100,000 Live births)1. Prevalence of HIV among children below 5 years is 0.7% of children are HIV-positive. Thirteen percent of women and 12% of men age 15- 24 had sexual intercourse before age 15. About 4% of young women and men age 15-24 are HIV-positive. HIV prevalence among young women is markedly higher than among young men, except for youth age 15-17 where there is nearly no difference in HIV prevalence between women and men. Among young women age 15-24, HIV prevalence is higher among those living in urban areas, while among young men age 15-24 HIV prevalence is higher among those living in rural areas.

1 National HIV indicator survey 2011


Baylor Uganda’s response to date

A participatory evaluation of Baylor-Uganda work since 2007 was carried out between March and October 2012. The external evaluators concluded, among other things, that the overall implementation and achievement of objectives in the programmes were consistent with the planning documents. The lessons from this evaluation have been used to improve Baylor-Uganda programming work.

Achievements and challenges

Despite the challenges faced in peadiatric HIV&AIDS service delivery and policy advocacy, tremendous strides have been made by Baylor-Uganda in its attempt to scale up the access to quality services in Uganda.

Below is a summary of Baylor-Uganda’s key achievements during the implementation of the Strategic Plan 2007-2012: Baylor-Uganda has been at the forefront of the planning for the annual National Paediatric

HIV&AIDS conferences. Each of these has brought together policy makers, NGO representatives, activists and scholars to share best practices and lobby for increased services.

The children’s advocacy team has been instrumental in raising awareness for paediatric HIV&AIDS during national events like the World AIDS day and high level advocacy meetings.

The advocacy team has participated in the development and review of key documents-The Positive Living Communications strategy and the Community Mobilisation Strategy for Paediatric HIV&AIDS in Uganda.

Overall there were 5,749 health workers were trained in the different courses aimed at equipping service providers at the community, health facility, regional and national level with skills to support expansion of paediatric services

ART adherence assessment increased from 53% to 92% between September 2009- June 2010 ART access in eligible patients increased from 43% to 87% between Dec 2009 to June 2010 Growth monitoring in children < 5 years increased from 28% to 87% between June 2009 to June

2010 Improved access to ITNs by 60-80% of the targeted population during the period June 2008 and

June 2011 Baylor-Uganda provided substantial support to towards the improved data management at the

health facilities. It supported printing of over 100,000 ART revised cards for use at the supported sites.

Reduced morbidities among children followed from over 30% at enrolment to less than 10% after 12 months of follow-up. This shows significant increase in quality of life of children living with HIV&AIDS.

There was a reduction in mortality among patients enrolled and followed-up on the program from over 15% to less than 2% after 12 months.

There was improvement in growth monitoring, TB assessment and ART adherence assessment during the period June 2008-June 2011 to levels above 80% in service centres

Baylor-Uganda has been able to achieve such an impressive set of results due largely to the dedication of programme staff and management, the partnerships it has developed as well as strategic


alliances with other actors responding the peadiatric HIV&AIDS service delivery needs in the country.

Challenges faced by Baylor-Uganda (2008-2012)

a) Restrictions and delay in the release of funds by CDC, and also delayed financial disbursements to health facilities from the districts affected timely delivery of services like conducting outreaches in the communities.

b) Inadequate human resources for health could not be addressed entirely by NEP and continued to affect delivery of quality and integrated services.

c) Rationalization of USAID implementing partners was not characterized by a systematically structured exit strategy that allowed both the incoming and outgoing partners to exchange ground at the project sites.

d) Logistical and infrastructural support to the districts increased the recurrent costs for health facilities which are not catered for in their annual budgets.

e) Implementation of project activities was associated with considerable institutional overheads which were not reflected in the approved budgets that were funded by CDC.

f) Limited use of condoms among discordant couples and limited disclosure of one HIV status among couples continue to affect the uptake of prevention of sexual transmission of HIV related activities including adherence to treatment.

g) Limited funding and failure to use the child status index tool affected the provision of quality OVC services.

Lessons learnt

The following were the major lessons learnta) It is very challenging to strengthen district health care delivery systems when there is limited

government funding and support to sustain the gains made under project mode of operation.b) Working through established district structures delivers sustainable results. However, the civil

service culture can slow down implementation processes even when they are meant to facilitate service delivery. Any strategy for systems strengthening should be cognisant of this limitation.

c) Community involvement is central in the success of HIV&AIDS programs. Community mapping makes it easier to locate patients in the community and also to identify and engage community structures.

d) Mentorship to health workers contributes in transferring knowledge into skill. It also improves systems that facilitate identification, enrolment and initiation on HAART of HIV+ children


Strategic Analysis

The strategic analysis was informed by the contextual assessment of peadiatric HIV response as well as from the evaluation of the Baylor-Uganda Strategic Plan (2007 – 2012). Several stakeholders’ meetings and interviews were also held as part of the process of developing the Strategic Plan. This section presents summary outcomes from this process in the form of the SWOT analysis, stakeholder analysis and the options analysis and the strategic implications on prioritizing Baylor-Uganda programmes.

SWOT AnalysisBelow are the key strengths, weaknesses, opportunities and threats identified and an analysis of their strategic implications:

Strengths Strategic ImplicationsVisualized as a national leader in peadiatric HIV&/AIDS care, treatment and prevention

Further strengthen advocacy and programming to reflect this image.

The Baylor-Uganda linkage to BIPAI has significant local and international value

Use image to leverage resources

Tested capacity building support initiatives for health workers in improving knowledge and skills in the management of children with HIV&AIDS

Review training curricular and training approaches to reflect the dynamisms in peadiatric HIV&AIDS management and the skills needs of health workers

Strengthened capacity of health facilities to deliver integrated services for HIV&AIDS

Seek more government budget support to sustain the gains so far made

Vey committed and competent staff at national and regional levels

Regularly review the staff development plan to match the service delivery needs

An established Children’s Clinical Centre of Excellence (COE) in Mulago and regional centres of excellence

Use the centres to develop more innovative programmes to address peadiatric HIV&AIDS service delivery

Strategic location of the national centre of excellence in Mulago National Referral Campus

Draw from the expertise in Mulago Hospital and training institutions to improve the quality of peadiatric HIV&AIDS services

Long-term support and partnership commitment from the MoH and collaborating partners including Mulago hospital, Makerere University Department of Peadiatric, etc

Further strengthen ties to further improve leveraging of resources and advocacy

Weakness Strategic ImplicationsBaylor Uganda does not have an organizational wide M&E framework

This strategic plan should be used as the foundation for developing an organizational wide M&E plan

Inadequate human and financial resources to support and sustain the necessary growth in the operations

Strengthen resource mobilization efforts in order to develop and deliver quality paediatric HIV&AIDS services

Inadequately developed training and research Review the training and research elements to reflect the same levels as clinical services.

Lack of provision for institutional overheads in CDC funded projects

Strategically engage other partners supported by CDC to advocate for a policy shift towards inclusion of institutional overheads in supported projects

Opportunities Strategic Implications


The There is still global commitment to a scaled-up HIV&AIDS response specifically in sub-Saharan Africa

Strategically identify specific gaps in the response to paediatric HIV&AIDS in order to attract programme support

There is now a national renewed vision for combination HIV prevention approach targeting key populations.

Ensure programming maximizes delivery of services to key populations

Access to a pool of highly qualified technical support within the Mulago Hospital staff and Makerere University faculty; and in the BIPAI network

Strengthen programming and research which tap into these skills

Existing and growing demand for paediatric HIV&AIDS care

Design appropriate programmes that address un-met need for peadiatric HIV/AIDS care and treatment services

Multiple stakeholders in HIV&AIDS care keen on partnership

Develop a partnership and coordination framework to bring together all partners advocating for peadiatric HIV&AIDS activities to further strengthen advocacy and programming

Threats Strategic ImplicationsUncertain long-term financial support due to international donor support and direct government funding threatened by competing needs globally, regionally and in-country

Widen the resource base through developing a resource mobilization plan

There are challenges in HIV prevention among HIV positive adolescents.

Design specific programs for children living with HIV transitioning into adolescence

Stakeholder AnalysisStakeholders play a critical role in strategic plan implementation by providing support in the form of funding, materials, technical assistance, advocacy, participating in programmes and providing goodwill and a facilitating environment. Baylor-Uganda will continue to collaborate with its partners and other stakeholders in the implementation, monitoring and evaluation of the strategic plan. Below is a summary of key stakeholders and their roles:

Baylor-Uganda partnering CSOsBaylor-Uganda works in partnership CSOs which support health worker training, programming as well as peadiatric HIV&AIDS research. These include but not limited to IDI, TASO, ChildFund and Save the Children Uganda. Baylor-Uganda will continue its partnership with these CSOs while identifying other strategic partners during the strategic planning period.

Line Ministries Baylor-Uganda supports Ministry of Health and Ministry of Local Government service delivery systems at policy and service delivery levels. This is through health systems strengthening and HIV&AIDS decentralized coordination mechanisms. Baylor-Uganda further support efforts by Ministry of Gender, Labour and Social development through the social protection component of the Social development sector Strategic investment Plan 2 focusing on the well fare of children and adolescents. Baylor-Uganda will further strengthen these relations continuously endeavor to influence the relevant Ministries to give high priority to peadiatric HIV&AIDS services.


Development partners These include multi nationals, international NGOs and global health initiatives – e.g. CDC, UNICEF etc. These stakeholders provide funding and material support to Baylor-Uganda programmes. Baylor-Uganda will endeavor to attract and maintain the support of a number of donors to its programmes. Its sustainability strategies rely on the diversification of the funding base so that more donors are attracted into its fold.

Baylor-Uganda Strategic OptionsBased on the results of the environmental scan and experience from implementation of the last Strategic Plan, Baylor-Uganda identified the following strategic options to find the strategic direction it needs to pursue in the next five years.

Expansion in scope and scaleBaylor-Uganda has taken strategic decisions to widen its scope and scale of interventions to meet the ever increasing demands from its constituents. This option is based on a better understanding of the evolving peadiatric HIV&AIDS service needs in the country, the rapidly changing response landscape, the results of the evaluation of the 2007-2012 Baylor-Uganda strategic plan, the SWOT analysis and feedback from a wide range of stakeholders. The cost of not taking the expansion option would imply that Baylor-Uganda will remain under funded and with an un-recognizable impact both in service delivery and resource utilization.

Shift from project to programme approachInitially Baylor-Uganda operated as a project but with the changing peadiatric HIV&AIDS service needs in the country, the scope and scale of work led into its transformation to a programme based planning. This has had the effect of creating more directorates to facilitate effective implementation of the Baylor-Uganda mandate. The shift will further strengthen the programme and institutional sustainability that will see Baylor-Uganda becoming a more dynamic and adaptive organization taking leadership in peadiatric HIV&AIDS service delivery in Uganda.


Baylor-Uganda Strategic Direction

In view of the results of the SWOT analysis and the strategic directions agreed to by Baylor-Uganda stakeholders, the strategy indicates the intended operational direction and emphasis of Baylor-Uganda work during this period 2013 to 2017. This section outlines in details what Baylor-Uganda expect to achieve over the next five years and what strategies will be adopted to realize the expected results in the short and intermediate terms. The organizational theory of change developed through participatory approaches involving Baylor-Uganda staff defines the programming logic which will be adopted during the next five years.

Baylor-Uganda theory of change (ToC)Baylor-Uganda’s ToC illustrates how its interventions will generate the desired changes given the assumptions about how these changes will happen. The overall goal of this strategic plan is to contribute to the HIV&AIDS response in Uganda as follows:

To contribute towards the reduction of morbidity and mortality due to HIV&AIDS and related diseases

The main strategies which Baylor-Uganda will adopt to achieve the above goal are identified under the following directorates:

(A) Directorate of Clinical and Community Services RationaleIn order to address the increasing HIV prevalence and incidence; and contribute to reduction of maternal and neonatal morbidity and mortality, this programme area will scale up combination prevention, maternal and child health, care and support and retention in care especially for children, mothers and adolescents. Given the higher HIV prevalence among young adolescents living in urban areas, specific interventions will be designed to address this age category. A family centred approach where the children will be used as a portal of entry into the household will be applied to addressing maternal and child health issues through comprehensive services2. With high levels of HIV&AIDS related stigma being registered in communities, Baylor-Uganda will provide psychosocial care to enable them cope given that HIV affects all dimensions of a person’s life i.e. physical, psychological, social and spiritual wellbeing. Orphans and vulnerable children will be supported through vocational and life-skills interventions.

Strategic objectives (SO)SO 1.1: Support psychosocial wellbeing of children infected and affected by HIV&AIDS and their families

SO 1.2: Strengthen the capacity of community systems and structures to provide psychosocial support to children and families infected and affected by HIV&AIDS

SO 1.3: Increase access to and utilization to peadiatric HIV&AIDS; and MCH services

2 Comprehensive services include; addressing children’s rights, nutritional support, support to formal and informal education, livelihood improvement

through vocational and life skills, HIV testing and counseling, adherence support, peer support, mentorship and training of mentees and ongoing counseling to support psychosocial issues, follow-up, linkage and referral; capacity building of community structures


Strategies Strengthen service delivery at the COE and Baylor supported sites Sub granting to districts Consolidating the regional service delivery approach Decentralization of services Infrastructure improvement Strengthening and improving accreditation of all Health centres III and some health centre --

provide comprehensive HIV services. National accreditation of all laboratories commensurate to their level of services. Community systems strengthening (VHTs, OVC committees, family support systems, PHA

networks, Health workers etc). Provision of adolescent and child friendly services Capacity building for health workers

Expected results Increased access to biomedical combination preventions. Increased access of HIV care and treatment. Increased client retention in care and treatment Improved access and utilization to MCH services Improved quality of laboratory services.

(B) Directorate of Research and Knowledge ManagementRationaleBaylor-Uganda will generate new knowledge through operational research in order to position itself as the foremost and authoritative source of knowledge related to peadiatric HIV&AIDS; and maternal and child health in Uganda from a civil society perspective. This knowledge will be used to improves the quality of peadiatric HIV&AIDS care; and maternal and child health interventions in addition to informing policy making and practice.

Strategic objectivesSO 2.1: Improve evidence-based knowledge for the management of peadiatric HIV&AIDS; and MCH services

Strategies Organize and expand the research unit to directorate level Development of human resource capacity for research Strengthening the resource and documentation center Expand the scope of research beyond clinical research Strengthen collaboration with other research entities Ease the process of IRB approvals by engaging BCM in adjusting requirements before

approval Initiation and development of an in-house IRB for Baylor Uganda Grants and proposal writing

Expected results Utilization of research results for improved programming and advocacy


Strengthened human resource capacity in research Functional resource and documentation center Increased funding for research

(C) Directorate of Capacity Building RationaleThis will deal with regular updating of health worker knowledge and skills for both internal staff and other service providers given the changing disease patterns and priorities; changing technologies and changing policies and guidelines. Baylor-Uganda will contribute towards production of more health workers so as to address scarcity of human resources for health in the country through innovative approaches including but not limited to mentorships, coaching, internships and experiential trainings. Trainings will also be designed to contribute to the financial sustainability of Baylor-Uganda.

Strategic objectiveSO 3.1: To improve knowledge and skills of healthcare providers in peadiatric HIV&AIDS; and MCH service delivery

Strategies Customized training programs Provision of training consultancy services Establish a training centre

Expected results Increased income generation from commercial courses Increased uptake of training courses Improved peadiatric HIV&AIDS; and MCH service delivery

(D) Directorate of Institutional Development RationaleInstitutional Development Programme provides supportive functions to other directorates in addition to executing specialized roles. It brings together all directorates to ensure systematic, coordinated and effective execution of organizational mandate. The overall objective of this programme area is to; improve the performance of Baylor-Uganda to coordinate, implement, monitor and evaluate the strategic plan.

This program area will address eight key components including; resource mobilization, human resource development, finance, grants and logistics management, public relations and advocacy, continuous quality improvement; and monitoring and evaluation.

Resource mobilisation Baylor-Uganda will strengthen its resource mobilization unit increase funding through appropriate packaging of its priority areas and explore financial support from other funding partners beyond the traditional donors. Internal revenue generation will be enhanced through tailored trainings, consultancy services and specialized clinical services for the high income earners.

Human resource development


Effective implementation of this strategic plan will require significant improvements in the organization’s institutional capacity (technical, operational and management capacity). Baylor-Uganda will review its organizational structure, reskill and retool its human resources to deliver on the new mandate. Human resource capacity shall be enhanced through short term tailor-made courses.

Finance, This will be strengthen through policy reviews, streamlined budgeting and financial management

Audit function; this needs to be an independent unit not to be subsumed under finance department

GrantsGrants management will be improved through regular reviews based on experience gained during implementation.

Logistics managementHere the organization is most interested in being efficient, effective and accountable,Collaboration’ describes the various ways in which councils and other public bodies come together to combine their buying power, to procure or commission goods, works or services jointly or to create shared services. Its major benefits are economies of scale and accelerated learning.

Partnering’ means the creation of sustainable, collaborative relationships with suppliers in the public, private, social enterprise and voluntary sectors to deliver services, carry out major projects or acquire supplies and equipment

Strategies;

Examine opportunities for collaborative procurement of partnerships – Joint approaches should always be examined. See Rethinking Service Delivery for guidance on the governance of joint projects.

Build continuous improvement into contracts – Structure incentives for continuous improvement into contracts, including linking payment for performance against Key Performance Indicators.

Follow best practice in the partnership procurement process – Partnership procurement processes should follow the step-by-step guidance to best practice set out in Rethinking Service Delivery and the service-specific guidance contained in the 4ps procurement packs.

Adopt a structured approach to project and risk management – Baylor Uganda should adopt an approach to procurement management based on the core principles of effective project management, including a dedicated project manager, and apply risk management techniques to projects and programmes.

Streamline procurement processes – The organization should seek to reduce the total time and cost to procure partnerships by streamlining the process, eliminating unnecessary red tape and reducing dependency on external advisors. In particular they should seek to reduce the time from notice to contract award.


Manage relationships as well as the contract – Rethinking Service Delivery contains important guidance on the building and management of relationships with suppliers, which is a vital ingredient to the successful delivery of services within the framework of a partnership.

Quality improvementThis docket will aim to continuously improve the quality of goods and services delivered by Baylor-Uganda in all programmes and departments. Standard operating procedures, guidelines and quality improvement indicators will be developed for effective monitoring and evaluation.

Monitoring and Evaluation System (M&E)The sector shall strengthen the knowledge and information management through developing and operationalizing an organizational wide M&E plan. The management information system will be strengthened by redesigning the thematic area databases, training of the staff and realigning the reporting and feedback mechanisms. In all cases, efforts shall be geared towards creation of user friendly ICT systems for access by the different stakeholders within the organization.

A strengthened monitoring and evaluation system shall be the basis upon which strategic plan implementation will be tracked to specifically focus on the objectives and the set targets. It shall also be a management tool for performance measurement over the next five years.

Public relations and advocacyHarmonized internal and external communication will be enhanced through the public relation function. This will aim at ensuring correct information flow within and outside the organization. As a civil society peadiatric HIV&AIDS; and maternal and child health advocate in the country, Baylor-Uganda will drive a national advocacy program that allows it to accentuate the voice of civil society in peadiatric HIV&AIDS; and maternal and child health. The content of the advocacy program will draw on the linkages, processes and new knowledge generated through research.

Strategic objectives SO 4.1: To improve the performance of Baylor-Uganda in coordinating, implementing, monitoring and evaluating the strategic plan

SO 4.2: Improve the resources requirements to implement the strategic plan

Strategies Development of human resource strategic plan Programme communications, lobbying and social mobilization Review of policies, guidelines, standard operating procedures, systems and structures Staff capacity development Strengthening the grant, finance and logistics management functions Regular review of the M&E system Strengthen the risk management frame work and internal audit functions Strengthen continuous quality improvement systems

Expected results Increased financial resources to deliver on the strategic plan targets


Effectiveness in achievement of the strategic plan targets Efficiency of resource use Strengthened M&E system Improved organizational image

The results generated under each strategy include both short- and longer-term effects reflected at different levels such as individuals, households, organizational, systems and communities. These are detailed in the outcome map (Appendix X where is it ??????)

Target groupsIn order to equitably deliver peadiatric HIV&AIDS; and maternal and child health services, Baylor-Uganda will target the following categories of beneficiaries:

1. Excluded groups (e.g. people with disabilities, sex workers, orphans, children heading households)

2. Adolescents 3. Children affected and infected by HIV&AIDS4. Mothers of exposed children

Implementation Arrangements

Coordination of strategic plan implementation Baylor-Uganda secretariat will be strengthened to co-ordinate implementation of this strategic plan. It will be supported by the Board through the technical working groups/committees.

Sustainability The sustainability of Baylor-Uganda will mainly be at three levels namely: Institutional; Programmes; and Financial sustainability. Each of the levels is described in detail as follows.

Institutional SustainabilityDuring the strategic planning period, Baylor-Uganda will set into motion processes to establish and strengthen most of the elements required for a sustainable organization. To achieve this, Baylor-Uganda will restructure the organogram, retool and reskill the human resource in line with the strategic plan mandate.

Programme SustainabilityProgramme sustainability will involve venturing into new programmes to address emerging needs in HIV&AIDS; and maternal and child health services and application of an evidence-based approach across all its programme areas. The monitoring and evaluation system shall be strengthened to guide the implementation of this strategy.

Financial SustainabilityResources will be mobilized to implement this strategy through engaging more development partners and strengthening internal revenue generation. Cost containment strategies and risk management interventions will be developed to sustain the organization.


Monitoring and evaluation Systematic monitoring is important to track and analyze activity implementation and provide feedback on performance. Baylor-Uganda will monitor and evaluate its programs through a reliable and functional M&E system to capture achievements of its interventions. The monitoring and evaluation system shall be strengthened through development of a comprehensive management information system to bring together the various directorates.

Evaluation of this strategic plan will be carried out to make a comparative assessment of the results (outcomes and impacts) of the interventions at mid and end term. Annual reviews and experience sharing shall be conducted to provide regular updates.


Resource requirements Budget to be developed after identification and costing of activities

Appendix 1: Baylor-Uganda Theory of Change


Appendix 2: Results-Based Logical Framework


draft strategic plan jan 15

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