Uganda

This presentation was part of the International Conference on Global Health session, “Answering the Call: Innovations in Human Resources by African Faith-Based Organizations.” From the perspective of the Uganda Catholic Medical Bureau experience, the presentation discusses why the private not-for-profit sector is important in service provision and training; why nurses are in the midst of the human resource crisis; obastacles to increasing the training capacity; and what the PNFP health training institutions are doing to address their weaknesses. [adapted from author]

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author’s description]

A scarcity of trained medical personnel impedes Uganda’s ability to deliver healthcare effectively. The role of the Clinical Officer (CO) was established to assist the provision of primary healthcare to rural communities. The primary aim of this study was to explore the role that the CO performs in delivery of primary and secondary healthcare in Uganda. A secondary aim was to determine the resources and facilities that are available to COs in order to carry out these duties. A further aim was to determine the confidence of COs at performing surgical and obstetric procedures. [from introducti

To help build the health workforce, the Capacity Project assisted Uganda’s Ministry of Health to craft and implement a comprehensive agenda for human resources for health… Improved human resources information systems (HRIS) will help the Ministry to plan for recruitment, training and retention of health professionals. [from author]

This presentation was given as part of the Christian Health Association’s Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It provides an excellent overview of the challenges of Malaria and HIV/AIDS ; discusses the human resource needs in light of these challenges; and how to build and maintain capacity. [from author’s description]

This paper looks at the HRH crisis as experienced by the Uganda Catholic Medical Bureau network giving the trend, examining the reasons, the destinations of attritional cases and what the network is trying to do to improve human resource stability. [from abstract]

While the availability and use of trained midwives can shape the quality of care received in pregnancy and childbirth, a number of other underlying health systems structures and processes are important. The management of health workforces, the mix of public and private provision and the impact of reforms affect quality of care across countries…[This study] examined how the structure and operation of a health system influences maternal health care provision and outcomes in Bangladesh, Russia, South Africa and Uganda. [author’s description]

Facilitator-led training of 20 healthcare providers in IMCI requires 11 days of lectures/practice and 6 facilitators, while the QA Project’s computer-based training requires 9 days and 4 facilitators. This study compared the cost-effectiveness of the two methods and found that both courses had equal effects on participants’ knowledge and skills, and retention after three to four months. The computer course was about 25 percent less expensive, excluding the cost of developing the software and for the computers used in the training. [publisher’s description]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the key features of the Problem-Based Learning/Community-Based Education and Service innovations to the health curricula at Makerere University, why they implemented these improvements and the benefits they have seen from the program.

A goal of the health management information system (HMIS) is to provide reliable, comprehensive information about the health system to health managers, to enable them take decisions that will improve the services provided to the consumers. This study assessed the utilisation of HMIS data for decision making at the grassroots level in Bufumbira East Health Sub-District (HSD) of Kisoro District. [from abstract]

This presentation was part of the ECSA Workforce Observatory Meeting in Arusha. It discusses quality control issues in data entry for a human resource information system.


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This study reviews the experience of decentralization in four developing countries: Ghana, Uganda, Zambia and the Philippines. It uses two analytical frameworks to describe and compare the types and degrees of decentralization in each country. The first framework specifies three types of decentralziation: deconcentration, delegation and devolution. The second framework uses a principle agent approach and innovative maps of decision space to define the range of choice for different functions that is transferred from the centre to the periphery of the system. [from abstract]

Uganda Catholic Medical Bureau (UCMB) affiliated hospitals, like many other health institutions, are stressed by limited resources and increasing costs. This calls for a need to finance the increasing costs through efficiency gains on fixed inputs. Determining optimal staffing levels and skill mix would ensure efficiency gains on personnel whose costs account for 31-65% of UCMB’s total recurrent expenditure. It would also match the staffing to the workload. A descriptive cross sectional study was carried out in four UCMB hospitals with the main objective of setting standard workloads for each staff category.

After a curriculum review, Makerere University’s longstanding traditional curriculum was converted to a problem based learning curriculum with a focus on Community Based Education and Service (COBES). As a component of COBES, radiography, medical, nursing, dentistry and pharmacy students are sent to community health facilities where they are expected to participate in community services and other primary healthcare activities.

Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda’s success in combating HIV/AIDS has been attributed to a number of factors, including political, religious and societal engagement and openness – actors that combat stigma and assist prevention efforts. Our study aimed to explore perceptions of Uganda-based key decision-makers about the past, present and optimal future roles of FBOs in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination. [from abstract]

This paper challenges the decision by the Government of Uganda to export health workers to developed countries. It argues that while the Ugandan National Health Policy emphasises strengthening the numbers of health personnel in order to be able to provide a minimum health care package and to redress the imbalances in distribution of skilled staff, it is totally contradictory to start exporting the few personnel available.

The Family Life Education Program (FLEP) of the Busoga Diocese of Uganda is a multiservice reproductive health agency that operates in five Districts of Uganda, two of which (Jinja and Kamuli) fell within the scope of the Delivery for Improved Services for Health (DISH II) project funded by the United States Agency for International Development (USAID) from 1999 to 2002. This evaluation note describes the implementation of a Human Resource Management (HRM) intervention, which led both to improved management systems and improved service delivery. [adapted from author]

This document explores some FBO health networks and facility-based services in Uganda and Tanzania. A pilot project in the Kasese District of Uganda illustrates how protestant, catholic and muslim health care providers and communities can work together from household-to-hospital levels to improve health outcomes. [from author]

There is a growing acknowledgment of the importance of the continuum of care and support services to people living with HIV/AIDS outside of health facilities. Greater reliance on communities to provide care and support to people living with HIV/AIDS as well as non-complex maintenance and adherence support for treatment of those who are under antiretroviral treatment is seen as a way to alleviate the burden placed on traditional health systems in countries highly affected by HIV/AIDS. This report presents findings from the field-test of the Partners for Health Reformplus guidelines developed for costing home-based care (HBC) programs, with cases drawn from nine HBC programs in Uganda.

The Health Sector Strategic Plan (HSSP) aims to ensure access to basic health care by the Ugandan population. This requires availability of well-trained health professionals. This study demonstrates that the Private-Not-For-Profit Health Training Institutions - the majority in Uganda - have remained grossly under-funded, which poses a threat to achievement of the HSSP. It is recommended that government increases and guarantees its support to these Health Training Institutions as a way of maintaining quality of health worker training. [from abstract]

This guideline is for human resources planners and managers in the health sector and sets out the steps required to extend the health workforce by incorporating lay workers (field officers), especially in the delivery of antiretroviral therapy (ART) to home-based clients.

These guidelines target all health workers at the different levels of the health care delivery system and apply to both the formal and informal workplaces within the health sector. This document covers the basic principles that are required to ensure workplace safety and health including hazard identification, risk management, prevention and management of exposures and incidents. [from foreword]

The report presents findings from a baseline survey of 155 primary health care facilities (dispensaries, with and without maternity units) that was carried out in Uganda in the latter part of 2000. The analysis compares service delivery performance in three ownership categories: government, private for-profit, and private nonprofit. Among the topics it explores at the facility level are staffing, availability of drugs and other inputs, remuneration, outputs, and financing. The findings are highly relevant for public policy in Uganda and in other countries in Africa that are undertaking civil service reform and promoting private-public partnerships in health care.

IMCI was launched in Uganda in June 1995 and has so far been implemented in most districts. However, reports indicate that counselling is poorly performed and that health providers find IMCI counselling the most difficult component to implement. The study was carried out to assess IMCI-trained health providers’ counselling of caregivers and to determine factors that facilitate or constrain counselling. [from abstract]

Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers responses to the changes in their working environments by taking a realistic evaluation approach. [abstract]

This presentation was given at the second annual AAMC Physician Workforce Research Conference, “2020 Vision: Focusing on the Future.” It discusses out migration and brain drain from sub-Saharan Africa and gives an overview of the issues related to this problem, particularly in respect to a project done in Uganda.

For long now, doctors in Uganda have been complaining that their terms of service, particularly remuneration, are not commensurate with the years that they spend training and the amount of work that they do. This issue has persistently been raised at several fora over the years but with no definite resolution. But how should doctors be paid? This paper attempts to answer this question. In the developed world, policy makers attempt to answer the question of cost containment. In Uganda, due to limited financial resources, the overriding question is where will the extra resources to adequately pay doctors be found? [from introduction]

The purpose of this policy document is to seek to ensure that Human Resources for Health, and their related functions are given the prominence, importance and resource allocations they require as the most crucial factor for health service delivery. It addresses a number of salient Human Resources for Health issues, identified through studies and broad consultation that require urgent attention to promote good performance, productivity and cost-effective practices.

Staff shortages could harm the provision and quality of health care in Uganda and therefore staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace. Results from interviews and surveys show that HIV/AIDS is an important contextual factor that impacts working conditions in various ways.

To help build the health workforce in Uganda, the Capacity Project is assisting the Ministry of Health to strengthen its human resources management and ability to gather and use accurate data for strategic planning. Drawing on key policy questions developed by the Health Workforce Advisory Board, the Capacity Project installed a certification and licensing information system at the four health professional councils and a human resources management system at the Ministry of Health.