Connect with us

Health

First-Ever Harmonized Health Facility Assessment by MakSPH and MoH Reveals Improvements in Uganda’s Overall Health Services

Published

on

By Julius Tukacungurwa & Davidson Ndyabahika

The first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by MakSPH and the Ministry of Health (MoH) has illuminated significant advancements in Uganda’s healthcare landscape. This ground-breaking survey, which serves as a robust benchmark for evaluating health services across the country, offers a comprehensive overview of service availability and readiness within Ugandan health facilities. 

The HHFA, a successor to the esteemed Service Availability and Readiness Assessment (SARA) tool endorsed by the WHO, probes into four critical modules: service availability, service readiness, quality of care and safety, and management and finance. 

Focusing initially on service availability and readiness, the HHFA embarked on a cross-sectional analysis of 642 facilities in April 2022, spanning National Referral Hospitals (NRHs), Regional Referral Hospitals (RRHs), General Hospitals (GHs), primary healthcare facilities at levels II, III, and IV.

The findings, while highlighting disparities in service availability and facility capacity across different healthcare sectors, underscore a promising trajectory towards enhancing overall health services nationwide.

Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH), led the team that conducted the survey. He presented the report which was subsequently launched by Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero on Tuesday 12th.March.2024 during the 10th Annual National Health Care Quality Improvement Conference at Imperial Resort Beach Hotel, Entebbe.

Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH) speaks to the press during the launch of the report in Entebbe. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Dr. Christopher Garimoi Orach, a Professor of Community Health at Makerere University School of Public Health (MakSPH) speaks to the press during the launch of the report in Entebbe.

The findings of the HHFA report indicate that Reproductive Maternal Newborn Care and Adolescent Health (RMNACH) services were available in most health care facilities across the country. In Uganda, healthcare facilities offer a wide range of essential services, including pediatric care, antenatal and postnatal care, malaria prevention during pregnancy, and newborn care, with over 95% providing these services according to the report. Findings also show that continuous antenatal care is available in about 79% of facilities, while skilled delivery services are offered in 89%. Additionally, family planning, emergency obstetric care, immunization, and adolescent health services are widely accessible, with percentages ranging from 77% to 91%.

During the launch event, Dr. Aceng underscored the significant steps made by the health sector in meeting crucial performance benchmarks. These include a notable 47% reduction in Maternal Mortality between 2016 and 2022, a commendable 12% decrease in Under 5 Mortality over the same period, and a promising 7% decline in Infant Mortality rates as highlighted in the Uganda Demographic Survey (UDHS) Report 2022.

“As you might know, overall, the health sector has made good progress towards achieving the key performance indicator targets. I wish to appreciate each one of you for the job well done,” said Dr. Aceng. 

Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero speaks at the launch on March 12, 2024. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero speaks at the launch on March 12, 2024.

Adding that; “The Ministry of Health continues to make big investments in the national health system. Mulago National Referral Hospital, Mulago Specialised Women and Neonatal Hospital, and several Regional Referral Hospitals have received infrastructure development including installation of modern medical equipment.

There is also deliberate effort to improve access to health service, delivery to the community through purposeful upgrade of some HC IIs to corresponding equipping and general review of the human resource requirements in the health sector. There is also deliberate effort to improve access to health services, delivery to the community through purposeful upgrade of some HC lIs to HC Ills with corresponding equipping and general review of the human resource requirements in the health sector.”

Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Looking on is Professor Garimoi Orach Christopher. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Looking on is Professor Garimoi Orach Christopher.

The also study highlights a significant increase in Uganda’s general service index, rising from 48% in 2018 to 59% presently. Utilizing a similar survey methodology, researchers observed notable improvements in the availability of health interventions across various domains. Particularly in Reproductive Maternal Adolescent Health services, higher provision rates were evident, especially at higher-level health facilities. Moreover, delivery assistance at Health Centres IIIs and above by skilled attendants has become standard practice, with nine out of ten cases receiving skilled care. 

Immunization services have also witnessed widespread availability, notably in hospital settings. However, while all surveyed facilities now offer malaria treatment services, access to non-communicable disease management, such as cancer diagnosis and treatment, remains limited, and readiness to provide transportation services for community members in need is inadequate.

According to Professor Orach, the Ministry of Health should strengthen and improve diagnosis and treatment of cancers generally across the country, especially at the National and Regional Referral Hospitals so that many more people at community levels can access the services. He also notes that the Ministry needs to quickly do everything possible to strengthen the transportation systems for patients from communities to reach and access health services.

Professor Orach presenting findings of the Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Professor Orach presenting findings of the Uganda’s Minister of Health Hon. Dr. Jane Ruth Aceng Ocero signs off the launch of the Harmonized Health Facility Assessment in Uganda Report, 2023.

The research noted that salary enhancement is a step in the right direction for improving how health workers perform. “We need to enhance that by ensuring that, ‘the health system, which is a complex system’, when we enhance salaries, we still need to continue to monitoring the health workers, we still need to continue to provide other requirements for the performance of health services, like drugs should be available,” noted Professor Orach. 

Adding that; “Transport should be available, other ways of ensuring that their performance can be up to the expected standard. So, in other words, that’s an important step and we must thank the government for what they’ve done here for we should still support them in other ways and monitor them closely to ensure, guidelines are available for services, that drugs are available, so that they can continue to provide good services.” 

“Our findings also show that for instance, the private health practitioners are not carrying out a lot of immunization, but government health facilities and private not for profit facilities are providing immunization services. This means that the private health practitioners don’t focus on immunization since it may not be bringing them money, they sought the ministry to engage with them to ensure that they’re brought on board so that they can provide their services in an integrated manner,” he noted. 

During the event, Associate Professor Peter Waiswa from the Health Policy, Planning and Management Department at MakSPH delivered a keynote address on ‘Understanding Health Systems Strengthening in a resource limited set-up.’  Professor Waiswa has had research work in maternal, new-born and child health in low and middle-income countries.

Stakeholders during the launch of the report in a group photo. Launch of the first ever Harmonized Health Facility Assessment (HHFA) jointly conducted by the School of Public Health, Makerere University, Kampala UgandaH and the Ministry of Health during the 10th Annual National Health Care Quality Improvement Conference, 12th March 2024, Imperial Resort Beach Hotel, Entebbe Uganda, East Africa.
Stakeholders during the launch of the report in a group photo. 

According to Dr. Diana Atwiine, the Permanent Secretary of the Ministry of Health, this health facility assessment and report will significantly enhance MoH’s institutional capacity for strategic planning and policy development in Uganda’s health sector.

“The Makerere University School of Public Health (MakSPH) Team led by Prof. Christopher Garimoi Orach is appreciated for spearheading the entire process of undertaking the HHFA and developing the report. The MoH is very grateful for the diligent work well-done by the various actors that included the technical officers, research assistants and the administration staff to have the final report meticulously developed,” said Dr. Atwiine. 

Dr. Henry G. Mwebesa, Director General of Health Services, emphasizes the pivotal role of robust health systems in achieving lasting health advancements. He underscores that the findings will facilitate the country’s ability to track health service progress, advancing towards Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). This data supports evidence-based decision-making, fortifying national health system planning and policy-making.

“This HHFA report is recommended for use by the various key stakeholders including health service managers, district leaders, ministry of health officials, both government, private sector, civil society organizations and development partners at different levels to inform and improve planning and implementation of effective health services delivery in Uganda,” says Dr. Mwebesa. 

Photos by Julius Tukacungurwa.

View on MakSPH

Health

Digital Mobile Technologies to Study Tuberculosis: A Multi-Discplinary Program

Published

on

An aerial view of the Makerere University School of Public Health construction site on the Main Campus. To the Right is the Infectious Diseases Institute (IDI) and in the background are Dag Hammaskjold Hall (Green roof) and University Hall (Brown tiles).

A TRAINING PROGRAM SPONSORED BY FOGARTY INTERNATIONAL CENTER NATIONAL INSTITUTES OF HEALTH, USA

INFORMATIONAL SESSION

Makerere University School of Public Health under D43 multi-disciplinary training program in digital mobile technologies to study tuberculosis that was recently funded by the NIH, through the University of Georgia (UGA) has an opportunity for funding of a masters’ research thesis. This is available to two (02) first year students of the Graduate programmes offered at Makerere University who have progressed to concept proposal development stage of their graduate program. These should be in good academic standing and have or are about to complete year 1 in Academic Year 2023/24. The support will start at the beginning of Academic Year 2024/25, i.e., end of August 2024 when the students are starting their year 2.  Students of geography and or digital health related courses are encouraged to apply, females too.  Students will be provided with secondary data to address the following, or similar, issues relating to tuberculosis (TB):

  1. Characterizing mobility patterns between urban and rural areas of Uganda using archived cell-phone (CDR) metadata
  2. Correlation between self-reported geolocated mobility patterns of TB patients and CDR data
  3. Differences in mobility patterns of TB patient’s pre-diagnosis and post-diagnosis
  4. Gender differences and relationship between IGRA and TST in a prospective cohort
  5. Patterns of change in serial IGRA test results by sex, age, HIV status
  6. Temporal changes in contact, mobility and geographic networks in TB converters and non-converters
  7. Ecological Momentary Assessment (EMA) of social contacts and location patterns of movement by residents at risk for TB infection

Interested students are encouraged to attend an information session on Wednesday 17th July 2024 at MakSPH Annex Kololo where details about the research questions and funding opportunity will be provided to prospective applicants. Prospective applicants will be required to work with their mentors and training grant personnel to develop a 2-5-page concept that will be vetted for possible funding by training faculty of the training program.

Interested students should register their attendance with the training Coordinator, Mr Ivan Mutyaba by sending an email expressing interest in attending the session to imutyaba@musph.ac.ug by close of business on Thursday, 11th July 2024.

Continue Reading

Health

METS Newsletter June 2024

Published

on

Makerere University School of Public Health (MakSPH) Dean, Prof Rhoda Wanyenze (Left), MoH Director General, Dr. Henry Mwebesa (Right) and other stakeholders join Dr. Amy Boore (2nd Right) to cut cake at her farewell event. Golden Tulip Hotel, Kampala Uganda, East Africa.

The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere University School of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).

Highlights of the METS June 2024 Newsletter

  • Tracking Trends in HIV Outcomes: The Implementation of HIV Case-Based Surveillance
    • METS in partnership with the Ministry of Health (MoH) and various implementing partners, is spearheading the HIV Case-Based Surveillance (CBS) initiative across Uganda. By February 2024, CBS had been activated in 504 health facilities, with 349 sites (69%) actively transmitting data.
    • Trends of New HIV Diagnosis: An analysis trends over a 20-year period (2000-2022) revealed an increase in new HIV diagnosis over time, peaking in 2014 and 2018, before starting to decline. Diagnoses among females consistently exceeded those among males each year.
    • Case-Based Surveillance (CBS) complimenting other HIV surveillance programs: CBS provides valuable insights into infection patterns and highlights the need for targeted interventions, particularly among females. Next steps include continued scale up of CBS implementation to reach 80% of ART sites; improving data transmission from facility to the national repository to achieve at least 90% of the CBS activated sites; and strengthening data analytics and use of the data for program improvement.
  • Enhancing HIV Prevention Data Collection Through Bootcamps
    • METS in collaboration with HISP Uganda held a workshop in Mbarara to update the Health Management Information System (HMIS) tools for PrEP (Pre-Exposure Prophylaxis) in the HIV Prevention Tracker. The workshop focused on digitizing paper forms to efficiently collect data on key and priority populations.
  • Electronic Medical Records (EMR) upgrades in Eastern Uganda
    • The two-week activity kicked off with a week-long training session at Northeast Villa in Kumi focused on the enhancements of UgandaEMR+, including improved point-of-care (POC) functionalities and data visualization techniques.
    • The initiative successfully trained over 15 AIDS Information Centre (AIC) staff members, including M&E leads, IT personnel, data officers, and M&E managers, in the practical use of UgandaEMR+. Additionally, the two facilities, Ochero HCIII and Kapelebyong HCIV, were upgraded and their staff trained on the new system.
  • Tribute to Dr. Joshua Musinguzi (9/09/1963 – 7/06/2024)
    • Dr. Joshua Musinguzi’s efforts to minimize HIV incidence and death strategically focused on translating knowledge into policies and actions, which has helped Uganda manage the HIV epidemic.
  • Gallery
    • Bidding farewell to Dr. Amy Boore, Program Director, Division of Global Health Protection – CDC
    • Analysing the UgandaEMR Clinical Laboratory Module
    • UgandaEMR+ training for USAID SITES
    • Training for clinicians at Ruharo Mission Hospital on SARI and ILI
    • HIV Treatment Services (HTS) Implementers Meeting

View on METS

Continue Reading

General

Job Opportunity at MakSBSREC: Assistant Administrative Officer

Published

on

The Davies Lecture Theatre (Right), School of Biomedical Sciences (Blue) and other buildings at the College of Health Sciences (CHS), Mulago Campus, Makerere University, Kampala Uganda, East Africa.

Makerere University is pleased to announce a vacancy for the position of Assistant Administrative Officer (REC Administrator) within the School of Biomedical Sciences Research Ethics Committee (MakSBSREC). This is an excellent opportunity for qualified individuals to contribute to the ethical oversight of research involving human participants.

Position Details:

  • Job Title: Assistant Administrative Officer (REC Administrator) – MakSBSREC
  • Reports to: Chairperson MakSBSREC
  • Engagement: Full-time
  • Duration: 1 Year, renewable upon satisfactory performance
  • Duty Station: Kampala

Qualifications, Desired Skills, and Experience:

  • Bachelor’s degree in Social Sciences and Humanities, Medicine and Surgery, Ethics and Human Rights, or any related field.
  • Master’s degree in Bioethics (an added advantage).
  • Up-to-date training in Human Subject Protection or Good Clinical Practice.
  • Proficiency in English (both spoken and written).
  • Prior experience in regulatory work in research studies or projects.
  • Excellent communication, organizational, and interpersonal skills.
  • Ability to work independently with minimal supervision and meet deadlines.

How to Apply:

Qualified and interested candidates are invited to submit a soft copy of their application documents and a motivation letter to deansbs.chs@mak.ac.ug with the subject line “Application for the position of Assistant Administrative Officer (REC Administrator)”. Address your application to the Dean, School of Biomedical Sciences.

Deadline for submission: July 2, 2024, by 5:00 pm Ugandan time.

Please provide a reliable 24-hour phone contact. Only short-listed candidates will be contacted for interviews.

View on CHS

Continue Reading

Trending