African Centre for Global Health and Social Transformation (ACHEST) convened a half day meeting for the Parliamentary Committee on Health titled; Achieving SDGs in Uganda through UHC: Implications for Parliamentarians on 6th November 2018 at Imperial Royale Hotel, Kampala Uganda.
The objectives of the meeting were: Call for multisector action in Uganda; Gain a common vision on Universal Health Coverage (UHC); and Commit to integrated, people centered quality health services.
A wide array of presentations were made including: An overview of UHC by Prof. Francis Omaswa: Implementing SDGs in Uganda by Dr. David Okello: Community Health Systems, presented by Dr Peter Eriki: Quality Assurance Health Services presented by Prof. Francis Omaswa; Health Workforce presented by Dr. Elsie Kiguli-Malwadde and: Financing SDGs and UHC presented by Dr. Patrick Kadama.
Prof. Francis Omaswa while giving an overview of Universal Health Coverage said, “Treat sick people, but stop people from falling sick. Having better Health Systems is a political choice; we should get health to become a political choice where a country decides how they want the health of their people to be like.”
Health should be a social contract between the government and the people. Prof. Omaswa stressed.
The African Centre for Global Health and Social Transformation (ACHEST) built the capacity of 55 members of Civil Society Organization (CSO) leaders together with Health Systems Advocacy partners (HSAP) (27 females, 28 males) from 31 organizations on Global Health Diplomacy.
With funding from the Dutch Government, ACHEST organized and hosted the first Regional HSAP Workshop training on Global Health Diplomacy that ran from 18th to 20th September 2018 at Lake Victoria Resort, Entebbe Uganda. The Training brought CSO participants from five African countries; Zambia, Tanzania, Uganda, Malawi and Kenya who are actively contributing to the components of the HSAP project. Some expert representatives from the UN Women, WHO-Country office, Prime Minister’s Office in Uganda, East African Secretariat, and Netherlands Embassy in Uganda, CEHURD and HSAP Coordinating Centre in the Netherlands participated and made presentations on topical issues at the workshop.
The workshop provided an opportunity and space for participants to discuss selected issues in Global Health Diplomacy that specifically focused on SRHR, Health Work Force: Community Health Systems, Commercialization of health, Health promotion and Access to SRHR Commodities. Presentations and discussions were held on Global Trade and Health for developing countries and the WTO dynamics, (TRIPS), overview and lessons from Uganda Health Financing Facility for RMNCAH, country implementation for SDGs, Regional Progress in Domestication of Convention on Elimination of all forms of Violence and Discrimination against Women.
The need for the training workshop was based on the fact that the field of global health is often thought of purely in medical or public health terms, but there are important geopolitical and policy dimensions of global health that underlie programmatic responses.
"The delivery of health services in Uganda is the responsibility of the local government. The ministry of health budgets and parliament approves; the money goes to the districts and it is the role of the local government to ensure that the community health systems initiative works." Prof. Francis Omaswa, the Executive Director of the African Centre for Global Health and Social Transformation (ACHEST) noted this while giving a key note speech at a half day meeting organized by Goal in partnership with ACHEST and HEPS.
The aim of the meeting held on 29th August 2018 at Piato Restaurant in Kampala was to consolidate stakeholder feedback on the draft framework for action from the symposium on the successes of community participation in improving health worker performance.
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage. Vincent Mujuni, the Deputy Programme Director Accountability Can Transform Health Programme (ACT Health) pointed while presenting the draft framework.
Dr. Patrick Kadama, the Director Policy and Practice at ACHEST while making a submission advised that having village registration, a system of people recognition will help the community health workers know who they are serving and who they are accountable to, that way, the health worker performance improvement and community participation will gain a lot of traction.
Dunstan Balaba, the Chief Adminstrative Officer of Tororo district warned that Accountability through Community barazas’ should be to both the people and the government. Attendance to duty alone is not enough, but delivery of quality service is what the people need.
Dr. Enid Mbabazi, a Coordinator at the Office of the Prime Minister (OPM) while closing the meeting informed the meeting that OPM is conducting stakeholder identification in a bid to form a Think Tank Lab where institution representatives will come together to find practical solutions for improving health workforce performance through a multi-sectoral approach.
Dr. Richard Mugalu, the District Health Officer (DHO) and the Deputy President of the DHOs noted that the issue of a muti-sectoral approach looks easy in boardrooms, yet it is one of Uganda’s problems and if not perceived well, there is fear that this will be misconstrued and implemented in silos by different sectors that are at different levels.
The meeting will incorporate feedback received into a finalized petition and present to the Chairman of the Parliamentary Forum on Quality of Health Service Delivery for presentation on the floor of parliament.
Dr. Elsie Kiguli-Malwadde, Director of Education and Health Workforce Development at the African Centre for Global Health and Social Transformation (ACHEST) who is the Secretary General of the Network Towards Unity for Health (TUFH) represented ACHEST at the Annual TUFH conference which took place at the University of Limerick, Ireland from 15-20th August 2018.
The theme of the conference was; “Community Empowerment for Health: A Multi-Sectoral Approach.”During TUFH 2018 Conference, participants discussed empowerment of underrepresented sectors and communities, intersectoral opportunities, and the ways educational institutions can be encouraged to become more socially accountable.
Presenters’ demystified empowerment as listening and shared decision-making with emphasis laid on communication and partnership, without which empowerment cannot be possible.
The conference was based on four Subthemes that included; 1) Empowering Communities 2) Empowering Under represented Sectors in Society 3) Intersectoral Opportunities and Challenges and 4) Engaging Educational Institutions.
Dr. Kiguli-Malwadde who was part of the organizing committee of the conference moderated several sessions and spoke at the opening and closing ceremonies. She also presented a workshop on Empowering Women in health workforce leadership and was a panelist at the TUFH talks, 3 minutes presentations by participants (like TED talks) that was followed by questions from a panel and later the audience.
The conference came up with a declaration found at: http://tufh2018.com/wp-content/uploads/2018/07/Empowering-Communities.pdf
The African Centre for Global Health and Social Transformation (ACHEST) sent a delegation of four people that included; Prof. Francis Omaswa, the Executive Director and three directors that included; Dr. Patrick Kadama, Dr. Elsie Kiguli-Malwadde, and Mr. Robert Odedo, to participate at the 2nd Annual African Forum for Research and Education in Health (AFREhealth) Symposium. The Symposium was held at Durban, KwaZulu-Natal, South Africa from August 06 - 08, 2018.
The African Forum for Research and Education in Health (AFREhealth) is an interdisciplinary health professional initiative, which seeks to improve health care in Africa through research, education and capacity building. AFREhealth is an initiative that was launched during the MEPI/NEPI (Medical/Nursing Education Partnership Initiative) symposium in Nairobi in August 2016. AFREhealth aims to drive transformation in medical education, policy and health professionalism that is relevant to Africa, by Africans for Africans.
The symposium with the theme: Towards Achieving Universal Health Coverage in Africa - Creating Synergies and Capacity through Education, Research and Quality Health Services brought together 350 people from 20 countries around the globe. University of KwaZulu-Natal Developing Research Innovation, Localization and Leadership in South Africa (UKZN DRILL) hosted the Symposium in collaboration with the African Forum for Research and Education in Health (AFREhealth).
The Sub-themes of the symposium included; 1) Training the Health Professions for Universal Health Coverage 2) Building Research Capacity in Africa 3) Achieving the SDGs and the 90-90-90 targets for HIV/AIDS 4) Financing health care in Africa and 5) North-South & South-South partnerships for health system development.
ACHEST convened a workshop on Migration of Health Worker force with specific interest on the Implementation of the Global Code on Migration of Health Workforce where Dr. Patrick Kadama, Mr Robert Odedo, Dr. Elsie Kiguli-Malwadde and Dr. Ibadat Dhillon made presentations on the Case Studies from Uganda and Nigeria chaired by Prof. Francis Omaswa.
The development partners including PEPFAR and HARSA communicated their decision to direct 70% of their grants to African indigenous NGOs; these will be organizations with roots and headquarters in African countries.
The African Centre for Global Health and Social Transformation (ACHESTs) Executive Director Prof. Francis Omaswa and the Health Systems Advocacy Project Officer in Kenya Ms. Noel Likalamu attended the Annual Scientific Conference on Achieving Sustainable Development Goals through Innovative Partnership from 21st to 23rd August 2018 in Kisumu, Kenya.
Tropical Institute of Community Health organized the conference that brought together more than 300 participants including ministers of health from three countries and health leaders. Professor Francis Omaswa was one of the key speakers at the conference and made two presentations on; Non Communicable Diseases (NCDs) and Human Resources for Health Innovations.
While presenting on the two topics he highlighted two important issues. On NCDs, he pointed to the pressures society and governments have to pay more attention to repairing and restoring lost and broken individual and community health, which are stronger than those to promote and protect existing health are.
On Human Resources for Health Innovation to promote strategies that will leave no one behind and address inequality, he advised that Uganda should abolish user-fees for the minimum service package to promote a fair distribution of the burden of health financing on households (PHC). In addition, institutionalize a Total Quality Management approach through systematic entrenchment of continuous quality improvement and performance culture in services delivery at all levels.
ACHEST disseminated Information Education and Communication material at the conference that included; “Strong Ministries for Strong Health Systems” handbook and African Health Leaders handbook.
A collaboration program between ACHEST and the Tropical Institute of Community Health was hatched during the meeting.
frican Centre for Global Health and Social Transformation (ACHEST) in partnership with Center for Health, Human Rights and Development organized a dissemination meeting on 15th August 2018 at Imperial Royale Hotel to disseminate findings of an exploratory study titled, "Business Unusual?-Conceptualization and Implementation of the World Bank Global Financing Facility (GFF) in Uganda."
A study conducted by CEHURD, the chair of the Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH) Coalition that ACHEST supports highlighted some of the challenges with the current design of GFF which includes among others; Results Based Financing requires a strong Health System and technical capacity on the part of service providers which are not in place. The selection criteria for the beneficiary facilities based on the RBF concept of good performance could further undermine the poorly performing facilities and limited involvement of CSOs could undermine the monitoring of GFF performance implementation.
The objective of the meeting was to share the final report, discuss recommendations and strategies for addressing the capacity needs, gaps as well as opportunities for engagement in the implementation, monitoring and evaluation of the GFF project in Uganda following the approval of Uganda's investment case by the World Bank.
As part of the advocacy strategy under the Health Systems Advocacy Partnership; African Centre for Global Health and Social Transformation (ACHEST), Amref Health Africa and Health Action International (HAI) represented by Coalition for Health Promotion and Social Development (HEPS) organized a fact finding visit for representatives of the Parliamentary Forum on Quality of Health Care Services.
The six days (4th to 9th July 2018) fact-finding mission was based on four objectives and these included:
(1): To follow up on health worker absenteeism in an earlier research finding; (2): to ascertain stock levels for SRH commodities in the selected facilities; (3): to find out governance issues affecting the delivery of quality health care service; (4): and to assess the working conditions of health workers and its impact on quality of health service care provided.
The field visit followed a petition by a group of CSOs to the speaker of Parliament on the status of health care services that was tabled on May17th 2018. The HSAP partners in Uganda therefore found it appropriate to support the legislators to carry out targeted visits to four sampled districts in the Central, Northern and Eastern regions and in the districts of; Bukedea, Lira, Mubende and Mityana.
The African Centre for Global Health and Social Transformation (ACHEST) participated, exhibited and disseminated Information, Education and Communication materials at the National Social Accountability Dialogue organized by World Vision Uganda in partnership with the Korean International Cooperation Agency (KOICA) at Hotel Africana on 1st August 2018.
The dialogue whose theme was “Scaling up Social Accountability for Improved Reproductive maternal, Newborn, Child and Adolescent Health” brought together more than 300 social accountability actors that included; religious leaders, Civil Society Organizations (CSOs), local government representatives, Ministry of health representatives, development partners among others to chat ways of improving health care.
Dr. Patrick Kadama, the Director of Policy and Practice at ACHEST noted that building the capacity of indigenous CSOs and positioning them will go a long way in scaling up Social Accountability for Improved Reproductive, Maternal, Neonatal, Child and Adolescent Health. Dr. Kadama noted this while making a submission during the dialogue.
Dr. Kadama also expressed his dissatisfaction with the delayed passing of the East African Community Sexual and Reproductive Health Rights Bill. He implored the Ugandan Policy makers at the East African Legislative Assembly and the responsible line ministries to fast track the process of passing the Bill into law.
The objectives of the dialogue were: 1) to lay strategies to scale up accountability towards improving Reproductive, Maternal Neonatal Child and Adolescent Health; 2) to Share best practices in social accountability and 3)to strengthen partnerships and networks in social accountability.
ACHEST exhibited its work at this meeting and disseminated a number of IEC materials some of which included; fact sheets on Health Systems Advocacy partnership, the African Health Journal, the work by the CSO coalition on RMNCAH among others.
Dr. David Okello, the Director of Non Communicable Diseases and Healthy Ageing at the African Centre for Global Health and Social Transformation (ACHEST) attended a Resource Mobilization workshop on domestic funding for Health Research, organized by Uganda National Health Research Organization (UNHRO) in collaboration with IAVI held at Serena Hotel on 12th June 2018.
The workshop brought together a cross section of stakeholders from research institutions, academia, advocacy groups, government stakeholders; development partners, health science journalists and a strong contingent of members of the parliamentary committee on health. The aim of the workshop was to support and reinforce the call for national domestic funding for Health Research.
Dr. Okello made a presentation at the workshop titled: Resource Mobilization for Health Research. In his presentation, he highlighted key issues among others; the importance of Health Research, who should be involved in Health Research, how Health Research should be managed and where funding for Health Research should be obtained.
“More than ever before, advocacy and lobby with MoH and partners is needed to support the noble efforts of UNHRO in coordinating health research, which could provide the necessary innovative interventions to address the health challenges of the country.” Dr. Okello noted.
Dr Sam Okware provided a brief on the challenges facing UNHRO, with emphasis on poor funding support.
There was consensus from the delegates on the need to strengthen the coordinating role of UNHRO. The institution should be better resourced and given a dedicated vote for budget to enable it to do its work well.
The parliamentarians expressed concern that compared to other research institutions, UNHRO was largely not visible and many do not know about its roles. A strong call was made to UNHRO to come out boldly to sell its image to parliament in particular and to the media and the public.
Dr. Patrick Kadama , Director Policy and Strategy together with Dr. Peter Eriki, Director Health Systems represented the African Centre for Global Health and Social Transformation (ACHEST) at the 65th ECSA Health Ministers ’ Conference, held at Kilimanjaro Hyatt Regency Hotel, Dar es Salaam, from 19th – 21st March 2018.
The 3 days conference hosted by the United Republic of Tanzania, through the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDEC) in collaboration with the ECSA Health Community brought together Ministers of Health, Senior Officials from Ministries of Health in the Member states, partners, Health training institutions and health Research institutions.
The conference was themed “Multi-sectoral Collaboration for Health towards Achievement of the SDGs” and covered the following sub themes: Governance and Leadership Practices in the Health sector; Mitigating the Impact of emerging and re-emerging diseases; Multi-Sectoral responses to Non-communicable Diseases and; Accountability for Women’s, Children’s and Adolescent Health post-2015.
The Right Honorable Majaliwa Kassim Majaliwa (M.P), Prime Minister of The United Republic of Tanzania opened the conference and reiterated the commitment of Tanzania in continuing to host the ECSA Health Community in Arusha, Tanzania and to continue supporting the organization in every way.
Dr David Okello, a retired World Health Organisation (WHO) expert, who in the past 5 years was serving as Head of Mission and Representative of WHO to Zimbabwe where he was responsible for the activities of WHO in the country joined the African Centre for Global Health and Social Transformation (ACHEST) on 17th January 2018 to add his wealth of expertise to the pool of the existing health Think Tanks.
Prior to this, Dr Okello served as WHO Representative in Nigeria, Kenya and Swaziland; and for a period of about one year in 2006 was also responsible for overall oversight of the WHO Country office in South Africa. The work of WHO Country Representative involved working with top Government officials to provide policy advice on matters of health and development, and directing the work of WHO – including in-country coordination of WHO technical support using resources available in the country offices and in liaison with the Regional Office and the Global HQ.
Dr Okello is a public health veteran, with more than 35 years of national and international experience. He joined WHO’s Africa Regional Office in 2000 and has served during different periods of his career in WHO as Director of WHO Cluster on AIDS, TB and Malaria (ATM) in the African Region, the Coordinator of the Inter-Country Support Team for the East and Southern African countries and as Regional Advisor on Health Research Policy, Coordination and Development. As Director/ Aids TB and Malaria Programme, he supervised WHO’s work in contributing to the reduction of disease burden due to HIV/AIDS, Tuberculosis and Malaria in the countries of WHO Africa Region.
On 12th January 2018, African Centre for Global Health and Social Transformation (ACHEST) held a half day Stakeholders Consultation Workshop for harmonizing Laws on Regulation of Health Professionals aimed at strengthening Councils Capacity to oversee and regulate quality of Private Health Practices in Uganda at Hotel Africana, Kampala.
The objectives of the workshop included: to present and discuss program results, engage stakeholders to discuss the way forward on the harmonization of regulation of health professionals in Uganda and; Generate consensus on the harmonization recommendations to the Minister of Health. The Professional Council representatives were from; The Uganda Medical and Dental Practitioners Council, the Uganda Nurses and Midwives Council, the Uganda Allied Health Professionals’ Council and the Uganda Pharmacy Council.
“The regulation of health professionals belonging to the same disciplines, but subscribing to different regulatory bodies continues to pose a challenge of enforcing and maintaining the desired quality and professional standards.” Dr. Sarah Byakika, Commissioner Planning at the Ministry of Health remarked while giving the opening remarks on behalf of the Director General, Ministry of Health.
Prof. Francis Omaswa, the Executive Director of ACHEST while speaking on the topic: Harmonization from Training to Practice called for strengthening of the professional colleges so that the professionals themselves supervise the different practices. The surgically related professionals should be working together with the Allied Health Professionals; Anesthetic people should be working together with the doctors to achieve quality services. If the harmonization of all this is not done, we are headed for disastrous times ahead. Prof. Omaswa warned.
During the meeting, the Legal Consultant, Robert Kirunda made a presentation on the Legal reforms and progress towards harmonization and advised that, “The laws made should ensure that the professional health practitioners are comfortable to practice while the patients are adequately protected as they seek health services.”
Prof. Joel Okullo, the Chairperson for Uganda Medical and Dental Practitioners Council applauded the USAID/Uganda Private Health Support Program for the great work done through ACHEST in contributing towards building capacity of Health professional Councils in Uganda. “The capacity of the councils has been strengthened and the councils have since gained international recognition to the point that other countries are now benchmarking from Uganda.”
The program launched in December 2015 has achieved its objectives that include updating and revision of all three Health Professionals Councils’ regulations, Streamlining laws, Consolidating and Digitizing Professional and Facility Licensing Systems and Creating Critical Tools for Quality Assurance. Harmonization of the reviewed Acts for all the councils to promote streamlined regulation of health professionals aimed at improved quality of care in Uganda remains one of the key deliverables of the project.
To achieve the harmonization process, the meeting agreed to constitute a small working group constituted by representatives from the four councils to be coordinated by the Registrars’ forum, chaired by the Ministry of Health.
Dithan Kiragga, the Chief of Party for USAID/Uganda Private Health Support Program commended ACHEST for the work well done and noted that, this has been one of the best USAID funded projects implemented with great success.
Compiled by Loice Epetiru,
Communications Specialist, African Centre for Global Health and Social Transformation (ACHEST)