Across a range of projects targeting HIV and AIDS and TB, MSH has worked to bridge the communication gap between providers and their clients in Uganda, especially among marginalized groups. In partnership with USAID, MSH has strengthened the Ugandan supply chain system through stronger policies, strategies, and implementation capacity, resulting in increased access to essential medicines, and helped identify priority health system needs. With the Uganda Health Ministry and district health management teams, MSH established a training process for improving the performance of health facilities. 

Highlights

• Reached more than 2.7 million people with HIV testing services; supported nearly 22,000 pregnant women living with HIV to access antiretroviral therapy; trained and provided on-site mentorship to more than 12,500 health workers and 458 paraprofessional counselors; trained and supported more than 500 female sex workers as peer educators to reach 6,400 of their peers annually with a series of key HIV and health messages; and trained almost 950 peer educators in groups at higher risk of HIV exposure to reach an annual average of 9,000 of their peers with key HIV and health messages.

• By building providers’ capacities, increased the number of one year olds receiving three doses of DPT vaccination from a US government-supported immunization program from 211,567 at baseline to 1,095,860 by year six of MSH-supported project work. Nutrition programs reached 614,338 children and in the final project year achieved average a malnutrition cure rate of 73 percent.

• Supported 286 health service providers in 45 facilities to identify problems affecting service delivery, test interventions, and mobilize colleagues to improve services. In these facilities, the use of oxytocin to prevent postpartum hemorrhage increased from 40 to 91 percent, and partograph use increased from 20 to 78 percent.

• Helped to revise the National Medicines Policy and redesign the community-level medicines supply chain system for reproductive, maternal, newborn, and child health commodities.

• Combined medicines management training with sustained, supportive supervision for both pharmacy managers and health facility workers. As a result, medicine availability, appropriate use, and prescribing increased significantly.

• Pioneered a model to accredit and regulate nearly 1,000 private drug shops in 13 districts, dramatically improving access to affordable, quality medicines and services, including malaria prevention and treatment, family planning, and HIV and AIDS information.

• Used performance-based contracts to disburse $10 million to 52 for-profit and nonprofit contractors, which rapidly scaled up priority reproductive, maternal, newborn, and child health services to reach 1.7 million underserved clients across 15 districts over four years.

• Helped increase the number of health facilities offering integrated HIV and TB services by 83 percent over six years, to more than 150 facilities.

• Increased TB case detection and treatment success rates in 49 districts and in Kampala to meet national targets for reducing the burden of TB and multidrug-resistant TB and for integrating TB and HIV services. The work produced a significant increase in the number of TB cases detected in Kampala, from 8,344 to 43,801 over five years.

• Implemented QuanTB, an electronic system that tracks TB medicine stock, warns of impending stock-outs and wastages, and helps pharmaceutical managers plan shipments.

• Supported an increase in laboratory capacity for TB testing through the acquisition of GeneXpert machines and other lab equipment and training of staff. GxAlert electronic reporting improved from 0 percent in 2015 to 40 percent by the end of 2017, and MDR-TB patient linkage improved from 80 to 95 percent in the same period.