USAID Health Care Improvement Project (HCI) | Uganda

Overview

With PEPFAR funding through USAID Uganda and the USAID Office of HIV/AIDS, URC supported the Ministry of Health (MoH) to implement its national Quality of Care (QoC) Initiative to improve the quality of HIV treatment processes (including palliative care and chronic care) and increase the number of people on antiretroviral therapy (ART). HCI supported the MoH to improve clinic efficiency and outcomes for ART patients and built the capacity of district-level health care managers to provide coaching to their staffs and to support quality improvement (QI) at the facility level as a long-term strategy for sustaining health care improvement activities. 

HCI also offered support to develop a national QI strategy that will guide the implementation and institutionalization of QI in the health sector.  Additionally, with support from USAID's Maternal and Child Health office, HCI piloted interventions to reduce newborn and maternal mortality in two districts and supporting Uganda’s roll-out of Helping Babies Breathe.

Key Activities

  • Supported the MoH in building a QI system throughout the health sector, integrating QI into strategic and operational plans at all levels
  • Helped the MoH develop QI curricula and build staff skills at central, regional, district, and facility levels to use QI approaches to improve care
  • Provided on-site support to district management teams and facility teams in analyzing and improving the systems they use to provide HIV care
  • Supported the MoH to improve palliative care and pain management for HIV patients at referral, ambulatory care, and community levels
  • Supported the MoH, through a demonstration collaborative, to improve the quality of essential newborn care, including neonatal resuscitation, management of the sick newborn, and postpartum follow-up in the first month after birth
  • Applied the Chronic Care Model to HIV care in one district, integrating facility- and community-based care and applying the same approach to manage other chronic conditions.

Achievements

  • The percentage of HIV-positive patients screened for TB at 32 sites rose from less than 59% in 2005 to nearly 100% in 2010.
  • At 57 sites, the percentage of pregnant women in antenatal care who tested positive for HIV and enrolled in care and treatment rose from 2% in 2005 to 97% in 2010.
Resources 
Duration
2007 to 2012
Funders 
US Agency for International Development (USAID)
Partners 
Palliative Care Association of Uganda (PCAU)
Hospice Africa Uganda
African Palliative Care Association
Strengthening TB and AIDS Response (STAR-E)
Regions/ Countries 
Geographic Scope 
National level and facilities in 49 districts