Health Ministerial Policy Statement

MPS: Health

Table of Contents

PRELIMINARY iii Foreword Abbreviations and Acronyms iv

Executive Summary x

Vote: 014 Ministry of Health 1

Vote: 114 Uganda Cancer Institute 25 Vote: 115 Uganda Heart Institute 37

Vote : 116 National Medical Stores 45

Vote: 134 Health Service Commission (HSC) 50

Vote: 151 Uganda Blood Transfusion Service (UBTS) 58

Vote: 161 Mulago Hospital Complex 64

Vote: 162 Butabika Hospital 70

76 Vote: 163 Arua Regional Referral Hospital

Vote: 164- Fort Portal Regional Referral Hospital 83

Vote: 165- Gulu Regional Referral Hospital 88

Vote: 166- Hoima Regional Referral Hospital 93

Vote: 167- Jinja Regional Referral Hospital 98

Vote: 168- Kabale Regional Referral Hospital 106

Vote: 169- Masaka Regional Referral Hospital 113

Vote: 170- Mbale Regional Referral Hospital 120

Vote: 171- Soroti Regional Referral Hospital 124

i

Vote: 172- Lira Regional Referral Hospital 129

Vote: 173- Mbarara Regional Referral Hospital 136

Vote: 174-Mubende Regional Referral Hospital 144

Vote: 175-Moroto Regional Referral Hospital 152

Vote: 176-China-Uganda Friendship Referral Hospital( Naguru) 161

Vote 304 Uganda Virus Research Institute 170

Vote: 501- 580 –Local Governments 175

ii

FOREWORD

Rt. Hon. Speaker and Hon. Members, in line with the Public Finance Management Act 2015, Section 13, I present to you the Ministerial Policy Statement (MPS) of the Ministry of Health for FY 2017/18 for debate and eventual approval. The Ministerial Policy Statement has been prepared in line with section 15(a-i) of the Public Finance Management Act 2015.

During the current FY 2016/17, the Ministry continued to execute its mandates and contributed towards attaining our mission guided by the Constitution of the Republic of Uganda, the NRM Manifesto, the Vision 2040, the Health Sector Development Plan II and the Medium Term Expenditure Framework.

I wish to unreservedly express my gratitude to the following:-

H.E the President of Uganda who has been at the fore front of promoting good health and sourcing for investors to the Health Sector, the office of the Rt. Hon. Speaker, the Office of the Hon. Minister of Finance, Planning and Economic Development and the Presidential Advisory Committee on Budget and Health Committee for their continuous support and guidance.

I also wish to register my special thanks to fellow Cabinet members for their guidance towards the Health Sector Policy Development over years. In addition, I wish to thank Members of Parliament most especially the members of the Health and Budget Committees for their support. My appreciation is also extended to the Health Sector Development Partners who have continued to offer financial and technical support to the sector.

The participation of Local Governments, Private (PNFP and PFP) Sectors and Civil Society Organizations have continued to play a critical role in the implementation and delivery of health services in the country.

Rt. Hon. Speaker, we remain committed to continue facilitating the attainment of a good standard of health for all the people in Uganda. We have remained committed to ensuring that we improve our service delivery despite many challenges especially related to underfunding which deserves the due attention of Parliament.

For God and My Country

Dr. Jane Ruth Aceng MINISTER OF HEALTH

iii

Abbreviations and Acronyms

ABC Abstinence, Be faithful and use Condoms ACP AIDS Control Programme ACT Artemisinin Combination Therapies ADB African Development Bank AFP Acute Flaccid Paralysis AHSPR Annual Health Sector Performance Report AI Avian Influenza AIDS Acquired Immuno-Deficiency Syndrome AIM AIDS Integrated Management AMREF African Medical Research Foundation ANC Ante Natal Care ARC Alliance for Rabies Control ARCC African Regional Certification Commission ART Anti-retroviral Therapy ARVs Antiretroviral Drugs AWP Annual Work Plan AT Area Team AZT Azidothymidine BCC Behavioural Change and Communication BEmOC Basic Emergency Obstetric Care BFP Budget Framework Paper BOP Best Operational Practices CAP Consolidated Appeal Process CB-DOTS Community Based TB Directly Observed Treatment CBDS Community Based Disease Surveillance CBGPM Community Based Growth Promotion Monitoring CCM Country Coordination Mechanism CDC Centre for Disease Control CDD Control of Diarrheal Diseases CDP Child Days Plus CFR Case Fatality Rate CHC Community Health Clubs (for Environmental Health) CL Credit Line CLTS Community Led Total Sanitation CMD Community Medicine Distributor CME Continuing Medical Education COCTU Coordinating Officer for the Control of Trypanosomiasis in Uganda CORPS Community Owned Resource Persons CPD Continuing Professional Development CQ Chloroquine CSO Civil Society Organization CYP Couple Years of Protection DANIDA Danish International Development Assistance DBFP District Budget Framework Paper DCCAs District Cold Chain Assistants DDT Dichlorodiphenyltrichloroethane DfID Department for International Development (UK) DGHS Director General of Health Services (of the Ministry of Health)

iv

DHO District Health Officer DHT District Health Team DISP District Infrastructure Support Programme DLT District League Table DOTS Directly Observed Treatment, short course (for TB) DPs Development Partners DPOs Disabled Persons Organisation DPT Diphtheria, Pertussis (whooping cough) and Tetanus vaccine DTLS District TB/Leprosy Supervisor DTS Dried Tube Specimen DVS District Vaccine Stores EAC East African Community EAIDANet East African Integrated Disease Surveillance Network ECN Enrolled Comprehensive Nurses ECSA East Central and Southern Africa EDP Epidemic and Disease Prevention, Preparedness and Response EGPAF Elizabeth Glaser Pediatric Foundation EHD Environmental Health Division EHMIS Environmental Health Management Information System EHP Environmental Health Programme EMHS Essential Medicines and Health Supplies EMLU Essential Medicines List of Uganda EmOC Emergency Obstetric Care ENT Ear, Nose and Throat EPI Expanded Programme on Immunization EPR Emergency Preparedness and Response EQC External Quality Control ESD Health Sub-District ERT Energy for Rural Transformation FDS Fiscal Decentralization Strategy FP Family Planning FY Financial Year GAIN Global Alliance for Improvement of Nutrition GAM Global Acute Malnutrition GAVI Global Alliance for vaccines and Immunisation GDF Global Drug Fund GBV Gender Based Violence GFATM Global Fund for HIV/AIDS, TB & Malaria GH General Hospital GoU Government of Uganda GPS Global Positioning System HAB Household Assessment Book HAF Human Resources for Health Action Framework HBMF Home Based Management of Fever HC Health Centre HCT HIV/AIDS Counseling and Testing HDP Health Development Partners HDPG Health Development Partners’ Group HIV Human Immuno-Deficiency Virus

v

HMBC Health Manpower Resource Centre HMIS Health Management Information System HP&E Health Promotion and Education HPA Hospital Performance Assessment HPAC Health Policy Advisory Committee HPSI Health Promoting School Initiatives HPV Human Papilloma Virus HR Human Resource HRH Human Resources for Health HRHIS Human Resource Information System HSD Health Sub-Districts HSS Health Systems Strengthening HSSP Health Sector Strategic Plan HSV 2 Herpes Simplex Virus type 2 IANPHI International Association of Public Health Institution ICCDE International Certification Commission for Dracunculiasis Eradication ICN International Council of Nursing ICT Information Communication Technology ICU Intensive Care Unit IDA International Development Agency IDB Islamic Development Bank IDPs Internally Displaced Persons IDSR Integrated Disease Surveillance and Response IEC Information Education and Communication ILO International Labour Organisation IMCI Integrated Management of Childhood Illness IMR Infant Mortality Rate IMSCC Inter-Ministerial Standing Coordinating Committee (education and health) IMT International Monitoring Team IPF Indicative Planning Figure IPT Intermittent Preventive Treatment IRS Indoor Residual Spraying ISH Integrated Sanitation and Hygiene ISS Integrated Support Supervision IST In-service training IT Information Technology ITNs Insecticide Treated Nets IVM Integrated Vector Management IYCF Infant and Young Child Feeding JAF Joint Assessment Framework JCRC Joint Clinical Research Centre JICA Japan International Cooperation Agencies JMC Joint Monitoring Committee JMS Joint Medical Stores JRM Joint Review Missions KCC Kampala City Council KIU Kampala International University LC Local Council LGDP Local Government Development Project

vi

LGMSDP Local Government Management and Service Delivery Programme LLITNs Long Lasting Insecticide Treated Nets LRA Lords Resistance Army LTIA Long Term Institutional Arrangements MAAF Ministry of Agriculture, Animal Industry and Fisheries MCP Malaria Control Programme MDA Mass Drug Administration MDGs Millennium Development Goals MDR Multi-drug Resistant MIS Medicines Information System MMR Maternal Mortality Rate MNT Maternal Neonatal Tetanus MNTE Maternal Neonatal Tetanus Elimination MOES Ministry of Education and Sports MOFPED Ministry of Finance, Planning and Economic Development MOH Ministry Of Health MOPS Ministry of Public Service MOU Memorandum of Understanding MPM Medicines and Pharmaceuticals Management MPS Ministerial Policy Statement MTC Medicines and Therapeutics Committee MTEF Medium Term Expenditure Framework NACME National Committee on Medical Equipment NCC National Certification Committee NCRL National Chemotherapeutics Research Laboratory NDA National Drug Authority NCD Non Communicable Diseases NDP National Development Plan NDQCL National Drug Quality Control Laboratory NEMA National Environmental Management Authority NGOs Non-Governmental Organisations NHA National Health Assembly NHIS National Health Insurance Scheme NHP National Health Policy NHS National Health System NMCP National Malaria Control Strategic Plan NMS National Medical Stores NPA/AI National Plan of Action for Avian Influenza NRH National Referral Hospital NRTL National Reference TB and District Laboratories NTDs Neglected Tropical Diseases NTF National Task Force NTLP National Tuberculosis and Leprosy Control Program

vii

NW & SC National Water and Sewerage Cooperation OH &S Occupational Health and Safety OOB Output-Oriented Budgeting OPD Outpatients Department ORS Oral Rehydration Salt ORT Oral Rehydration Therapy PAF Poverty Action Fund PAD Patent –Ductus-Arterosus PC Partnership Committee PCV Pneumococcal Conjugate Vaccine PEAP Poverty Eradication Action Plan PEP Post Exposure Prophylaxis PEPFAR President’s Emergency Plan for AIDS Relief (USA) PHAST Participatory Hygiene and Sanitation Transformation PHC Primary Health Care PHP Private Health Practitioners PMI Presidential Malaria Initiative PMTCT Prevention of Mother to Child Transmission PNFP Private Not for Profit PPM Public Private Mix PPPH Public Private Partnership in Health PPS Private Patient Services PRDP Peace and Recovery Development Plan PSI Population Services International PWD Persons with Disabilities QAD Quality Assurance Department QMS Quality Management Systems REACH Regional East African Community Health RED Reach Every District (strategy) RIA Regulatory Impact Assessment ROM Result-Oriented Management RRH Regional Referral Hospital RUM Rational Use of Medicines SARs Severe Acute Respiratory Syndrome SER Socio- Economic Rehabilitation SGBV Sexual Gender Based violence SH School Health SHSSPP Support to the Health Sector Strategic Plan Project SIDA Swedish International Development Agency SOC Integrated Sustainable Outreach Services SOPs Standard Operating Procedures SP Sulfadoxine/Pyrimethamine SRH Sexual and Reproductive Health and Rights

viii

STI Sexually Transmitted Infection SURE Securing Ugandan’s Rights to Essential Medicines. SWAP Sector-Wide Approach TASO The AIDS Support Organization TB Tuberculosis TCMP Traditional and Complementary Medicine Practice/practitioners THETA Traditional Healers and Medical Practitioners Together Against HIV/AIDS TRM Technical Review Meeting TTIs Transfusion Transmissible Infections UBOS Uganda Bureau of Statistics UBTS Uganda Blood Transfusion Services UCG Uganda Clinical Guidelines UDHS Uganda Demographic and Health Survey UGFATM Uganda Global Fund for AIDS, TB and Malaria UMCA Uganda Medicines Control Authority UMR Under 5 Mortality Rate UNBS Uganda National Bureau of Standards UNCRL Uganda National Chemotherapeutics Research Laboratory UNEPI Uganda Expanded Programme on Immunisation UNF Uganda National Formulary UNFPA United Nations Fund for Population Activities UNHRO Uganda National Health Research Organisations UNICEF United Nations Children’s Fund UPE Universal Primary Education URA Uganda Revenue Authority URCI Urban Rabies Control Initiative USAID United States Agency for International Development USD US dollar USE Universal Secondary Education Ugshs Uganda Shillings UVRI Uganda Virus Research Institute VBDC Vector Borne Diseases Control VHF Virus Haemorrhagic Fever VHT Village Health Teams VPH Veterinary Public Health WFP World Food Programme WHO World Health Organisation WISN Workload Indicator Staffing YCF Young Childhood Feeding YSP Yellow Star Program ZTLSs Zonal TB/Leprosy Supervisors

ix

EXECUTIVE SUMMARY

The Health Sector is now implementing the Health Sector Development Plan (HSDP) 2015/16 - 2019/20. The HSDP seeks to leverage opportunities and honor obligations presented by emerging developments at the National, Regional (East African Community - EAC), the Common African Position of the African Union and global levels.

The health of the Ugandan population is central to the socio-economic transformation of the country. Over the last two decades, the Government of the Republic of Uganda has increased access to health services two fold. By 1997, only 47% of the population who needed health care could access outpatient services. This figure has since improved to over 90% by 2015.With improvement to accessibility and availability of services; it’s now pertinent that we address quality service delivery and Universal Health coverage.

His Excellency, The President in his 23 Strategic Guidelines and Directives for the Minimum program for Uganda to attain the middle income status by 2020 and vigorously implement the NRM manifesto of 2016-2021, clearly highlighted some of the issues that need to be addressed. These were further discussed in the health Sectoral meeting and the priorities were agreed upon. These priorities have now been harmonized with the HSDP and will form the working document for the next financial year 2017/2018.

x

SUMMARY OF KEY ACHIEVEMENTS FOR THE SECTOR DURING FY 2016/17.

1. Human resource attracted, retained, trained and developed

The health sector staffing improved slightly from 69% (41,783) in 2014/15 to 71% (42,530) in 2015/16. This was a net increase of 747 health workers during the year. Interviews for recruiting 850 Health Workers are ongoing.

2. Improving Child and Reproductive Health

. The Infant Mortality Rate stands at 43 per 1,000 (60 HS 2016) which is a significant improvement from IMR of 54 per 1,000 live births (UDHS 2011).

. Under Five Mortality Rate there has been a significant reduction from 90 per 1,000 live births (UDHS 2011) to 64 per 1,000 live births (UDHS 2016).

. Health facility deliveries increased from 53% (958,077/1,787,840) in 2014/15 to 55% in 2015/16 and this was above the HSDP target (54%) for FY 2015/16.

. The Maternal Mortality rate stands at 336 per 100,000 live births (UDHS 2016). This is a significant reduction from the 438 per 100,000 as estimated in UDHS 2011.

3. HIV/AIDs controlled,

Conducted the Uganda Population HIV/AIDS Impact Assessment (UPHIA). Data is being analysed and will provide HIV and Hepatitis B prevalence and trend observations by May 2017.

Accredited ART sites increased from 1,734 in June 2016 to 1,801 in December 2016. ART coverage increased from 56% in 2015 to 63% in 2016 (from 898,197 clients in June 2016 to 940,347 clients by December 2016). Currently 940,347 people are on treatment. Regarding EMTCT, the number of new infections dropped from 22,000 in 2012 to 3,400 in 2016. The country launched Test and Treat guidelines on 29th November, 2016 and all who test positive will be put on treatment (ARVs). Alongside the above, the country is also implementing comprehensive HIV preventive interventions including behavior change communication based on Abstinence, Behavior Change and Condom use (ABC), safe male circumcision, management of STDs and campaign against teenage pregnancy.

4. Malaria controlled

The prevalence of malaria reduced from 42% to 19% as per the Malaria Indicator Survey of 2015. MoH developed a Malaria Reduction Strategy (2015-2020) in which we plan to reduce the malaria prevalence rate to 3% by 2020. There has been marked progress with the

xi

interventions to address this. For instance, bed net coverage was 92% in 2014. However due to wear and tear, this dropped to 75% in 2016. Government is now undertaking another mass distribution with the objective of reaching 100%. Indoor residual spraying is ongoing in 14 districts of eastern and northern Uganda and the ten previously sprayed districts that had an epidemic. The country has successfully introduced Intravenous Artesunate to replace quinine. This has reduced mortality due to severe malaria.

5. Tuberculosis controlled

TB treatment success has improved from 76% in 2014/15 to 80 % in FY 2015/16. However, the TB survey of 2015 estimates the annual numbers of new TB cases to be 87,000 compared to previous WHO estimates of 60,000. Ministry of health has put in place measures to address the high TB burden using the contact tracing strategy. For diagnosis of TB, gene Xpert machines have been designated as the first line of diagnosis. There are currently 112 gene Xpert machines distributed in 79 districts. An additional 19 machines have been procured and distribution is ongoing. In addition, a new point of care test TB LAM which diagnoses TB from urine of infected persons has been introduced for use in lower health facilities. The country is providing treatment for over 800 cases of multi-drug resistant TB at a cost of USD 4,000 per patient.

6. Health Infrastructure

The following infrastructure investments are ongoing;

. Construction, expansion, rehabilitation and equipping of Mulago National Referral Hospital and its transition into a super-specialized facility and is expected to be completed by June 2017.

. Construction of a 320 bed Specialized Maternal and Neonatal Health Care Unit at Mulago National Referral Hospital commenced in June 2015 and is expected to be completed by end of 2017.

. The Uganda Heart Institute (UHI) has newly installed cardiac catheterization facility and a theatre that can handle at least 1000 operations/ procedures per year when fully operational.

. The Cancer institute is being expanded and developed into a centre of excellence for cancer treatment for East Africa. In preparation for this, it is also constructing a six chamber bunker for linear accelerators to provide radiotherapy services to patients in the East African region.

The Cancer Institute is in advanced stages of replacing the old cobalt-60 radiotherapy machine. Once the renovation of the existing bunker is completed by end of March 2017, the installation process will commence and will be completed by end of June 2017.

xii

. The Ministry has signed a MoU with FINASI to construct a super specialized facility at Lubowa. The project is expected to commence this year and will operate under PPP arrangement.

. A specialized Regional Centre for Pediatric Surgery is scheduled to be constructed in Entebbe beginning this year and the ground breaking ceremony took place on the 10th of February 2017.

7. Blood collection services.

Blood collection increased from 238,000 in 2014 to 247,711 in 2015/16. The number of units collected between July and December 2016 is 119,691. The annual requirement is now 260,000. In order to cover the shortfall, Government has put up regional blood banks in Nakasero, Gulu, Mbarara Fortportal, Arua, Kitovu and Mbale. In addition, there are 8 Blood collection and distribution centres (Angal, Lira, Soroti, Jinja, Hoima, Masaka, Rukungiri, Kabale). Government has plans to construct regional blood banks in Arua, Moroto and Lira. The Rotary Club constructed a state of the art blood bank at Mengo hospital which the Ministry of Health will utilize to enhance blood collection in the country.

8. Control and Preparedness of Diseases outbreaks: -

The Ministry developed a five-year multi-hazard preparedness and response plan. As part of the plan, a countrywide training was carried out on integrated disease surveillance and response. We enhanced the capacity of screening at points of entry like the airport. Established an Emergency and Operations Centre 3 years ago and started a field epidemiology training program to increase the numbers of field epidemiologists. To date 10 have graduated and 30 are still training. MoH is also running a three months basic epidemiology training program for frontline health workers.

The Ministry developed VHT guidelines for identification of unusual occurrences and trained them on surveillance. Improved on detection by upgrading the capacity of the laboratories and the sample transporting network.

Under the program of the global health security agenda, there are committees that are addressing anti-microbial resistance, biosafety and biosecurity. A multi-sectoral one health framework was developed to guide a holistic response by different Ministries where epidemics cut across.

A number of outbreaks that occurred in the last 2 years were controlled in record time eg the rift valley fever, yellow fever, cholera and red eyes

9. Community Health extension system

Both the Policy and Strategy on Community Health Extension Workers were finalized and approved by the Ministry’s Top management. The Policy is slated to be presented to Cabinet. MoH and Partners have developed training manuals and identified potential

xiii

training institutions including the Health Manpower Development Centre in Mbale. Accreditation of these institutions will begin shortly.

A national coordination committee has been put in place to coordinate this planning.

10. Medicines and health supplies

The National Medical Stores continues to deliver Essential Medicines and Health Supplies (EMHS) worth Ushs 238 billion to all government health facilities. By end of December 2016, the following items were procured and distributed;

. ACTS, ARVS and Anti TB drugs amounting to Ushs 68 billion. . Specialised items amounting to Ushs 16.10 billion. . Reproductive health supplies amounting to Ushs 6.5 billion. . Immunisation supplies amounting to Shs 17 billion. . Laboratory commodities amounting to Shs 5 billion. . Hepatitis B Vaccines and test kits and other immunisation supplies worth Ushs 8 billion to 39 districts in Northern and Eastern parts of the country

Other achievements include;

. NMS developed an IT innovation for real time monitoring of the Last Mile Delivery of EMHS to districts. (NMS Smartcare and Delivery Monitoring tool)

. Emergency supplies for response to Cholera, meningitis and nodding disease syndrome were delivered timely across the country whenever required.

. Continued with Last mile delivery of medicines and health supplies to the door step of health facilities

11. Heart Services

The following outputs were achieved; 4,980 Echocardiography (ECHO), 4,172 Electrocardiography (ECG), 171 Closed Heart Surgeries and Cath-lab procedures, 32 Open Heart Surgeries, 91 Pace-maker Programming and 68 outreaches. Five (5) publications on Rheumatic HD were also made.

xiv

SECTOR PRIORITIES FOR FY 2017/18

The Sector Priorities for the financial year 2017/2018 are as follows:

1. Scale up Public Health Interventions to address the high burden of preventable diseases in our country.

i. Scaling up of Health promotion and education and effective communication to the population.

ii. Scaling up interventions to address the high burden of HIV/TB, malaria, Nutritional challenges, Environmental Sanitation and Hygiene, Immunization, Hepatitis B and Non Communicable Diseases.

iii. Introduce Community Health Extension workers (CHEW’s) to educate the communities on prevention of diseases and link the communities to the Health services.

2. Improvement of Reproductive, Maternal, Neonatal, Child and Adolescent health services to reduce on mortality and morbidity and improve their health status.

3. Human resources (attraction, motivation, retention, training and development). Mobilize additional resource for recruitment and incentives.

4. Infrastructural developments; constructions, rehabilitation and remodeling focusing mainly on HCIIIs, HCIVs and Districts with special needs like islands, difficult to reach areas, large populations and socio-demographic peculiarities.

5. Mobilization of additional resources for medicines and health supplies especially laboratory supplies, reagents and Blood collection supplies.

6. Effective and well-structured Support Supervision to the Local Governments and strengthened regulatory authorities and professional councils in the Health sector.

xv

MAJOR CHALLENGES AND FUNDING GAPS FACED BY THE HEALTH SECTOR a) Inadequate funding to Scale up Public Health Interventions to address the high burden of preventable diseases in our country. i. Scaling up of Health promotion and education and effective communication to the population. Shs 5 Billion required annually

ii. Scaling up interventions to address the high burden of HIV/TB, malaria, Nutritional challenges, Environmental Sanitation and Hygiene, Immunization, Hepatitis B and Non Communicable Diseases. Shs 275 Billion required annually

iii. Introduce Community Health Extension workers (CHEW’s) to educate the communities on prevention of diseases and link the communities to the Health services. Shs 30 Billion is required as startup costs b) Inadequate operational funds for Primary Health Care services (PHC).

The Ministry requires additional 35 billion for PHC to be provided to enable the health facilities operate at a reasonable level, currently some facilities at HC II level receive less than UGX.100,000 monthly to cater for utility bills, maintenance, sundries, cleaning and outreaches which is inadequate. Analysis of the UBOS price indices shows that prices of goods and services in general have increased by 44% between 2008/09 and 2012/13 while those of utilities alone (rent, fuel, water and electricity) increased by 20.4%. c) Scaling up Public Health Interventions including Immunization, Nutrition, Environmental health, effective communication to the citizens, prevention and control of Non Communicable Diseases & Hepatitis. d) Inadequate funding for Human resources (attraction, motivation, retention, training and development). e) Infrastructural developments; constructions, rehabilitation and remodeling focusing mainly on HC IIIs, HC IVs and general hospitals in districts with special needs like islands, difficult to reach areas, areas with large populations and some teaching Hospitals.

Health Centre IVs.

The Ministry plans to revamp and make functional all the HC IVs and upgrade HC IIIs to HC IVs in counties where they do not exist. Of the 290 counties only 29 do not have HC IVs. The existing HC IIIs in these counties shall be upgraded. The total cost for this upgrade is Ushs 164.6 Billion.

xvi

Health Centre IIIs

The Ministry plans to upgrade HC IIs in 225 Sub Counties to HCIIIs and construct new HC IIIs in the 93 sub counties that have no government health facility at all.

Priority will be given to the 93 sub counties without any government health facility and subsequently the 225 sub counties will be considered in a phased manner. The cost for construction of 318 HC IIIs is Ushs.898.7 billion while for the 93 sub counties with no health facility at all is Ushs 247 billion. f) Medicines and health supplies especially lab supplies and reagents. An additional Shs.100 Billion is required for essential medicines, health supplies and lab reagents, blood supplies for FY 2017/18. An additional supplementary funding of Ushs 27 billion was provided for malaria drugs and blood collection supplies in FY 2016/17 and should be maintained in FY 2017/18. g) Uganda National Health Laboratory Services (UNHLS) needs additional UGX 3 billion aimed at the provision of quality, accessible and comprehensive laboratory services in Uganda. Already CDC has provided the infrastructure in Butabika for this purpose. The funds are for operationalizing the new UNHLS home. h) HMIS Tools require additional UGX 3 billion. This stationery is key to the running the health management information system (HMIS) and facilitate patient record management and reporting on the services offered by the Health Facilities across the country. i) Contribution to International Health Organizations and the East African Community requires an additional UGX 2 billion. j) Health Worker’s Uniforms require UGX 9 billion annually. This Financial Year, Ushs 3 billion was allocated and nurses and midwives will be prioritized. This is a professional requirement for proper identification and protection of all health workers. k) Startup capital for the National Health Insurance scheme requires UGX 5 billion to cater for development of regulations, accreditation, staffing, equipment and sensitization. l) Hepatitis B interventions: The intervention is currently in 39 districts with a high prevalence. The Ministry of Health will continue to cover the entire country in a phased manner. The estimated cost for the remaining districts is Ushs 200.6 billion and this can be phased starting with at least Ushs 49 billion to cover more 20 districts in FY 2017/18.

xvii

Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

V1: Vote Overview (i) Vote Mission Statement To provide the highest possible level of health services to all people in Uganda through delivery of promotive, preventive, curative, palliative and rehabilitative health services at all levels.

(ii) Strategic Objective a. To provide inclusive and quality health care services through policy formulation and providing strategic direction, planning and coordination of health care provision in Uganda. b. To address the key determinants of health through strengthening of inter-sectoral collaborations and partnerships. c. To enhance the health sector competitiveness in the region and globally.

(iii) Major Achievements in 2016/17 Clinical and Public Health:7KH1DWLRQDO3DOOLDWLYH&DUHFRPPXQLFDWLRQVWUDWHJ\ZDVGUDIWHGDZDLWLQJ dissemination.The World Hepatitis Day was commemorated in Dokolo where public awareness about hepatitis B in the community was created and mass screening/ vaccination was done. 200 health workers were trained on the use of 6HOH[LRQPDFKLQHVHQDEOLQJTXLFNHYDOXDWLRQRI+HSDWLWLV%3RVLWLYHFOLHQWVIRUWUHDWPHQW7RROVXVHGLQVHQVLWLVDWLRQ screening and vaccination were disseminated to the health workers in 39 districts.

Planning and Policy Support Services: Under Planning and Policy Support Services, the following documents were SUHSDUHGDQGGLVVHPLQDWHG$+635IRU)<2015/16,Health Sector Policy Issues Paper for FY 2017/18 for LGs ,Budget Frame Work Paper 2017/18. In addition, Regional Planning Meeting were held in Masaka, Lira, Mbale and Jinja Regions. Also the department held the Health Sector Annual JRM and Piloted regional JRM in Rwenzori and West Nile to discuss sector performance,Planning guidelines were printed and used to guide LG planning for FY 2017/18. NHA study data collection is ongoing and a report is expected in June 2017. The report is expected to provide LQIRUPDWLRQRQWRWDOKHDOWKH[SHQGLWXUHWKHILQDQFLQJVRXUFHVGLVHDVHEDVHGH[SHQGLWXUHDQGKRXVHKROGH[SHQGLWXUH for FY 2015/16. Aide Memoire for the JRM was Prepared to guide HDPs and GOU joint planning and budgeting.

Quality Assurance:8QGHUWRRNDQDVVHVVPHQWRIWKH0R+&OLHQW&KDUWHUDQGIRUWKH355+VDQGFRQGXFWHG3UH-50 field visits to 16 districts.

Finance and administration7KHWRSPDQDJHPHQWFRQGXFWHGHOHYHQSROLWLFDOVXSSRUWVXSHUYLVLRQRIVHFWRUDFWLYLWLHVLQ various districts in Referral and General Hospitals and these include;Ntoroko, Bundibugyo, Kasese, Hoima, Mpigi, Kabale, Bukomansimbi, Luuka, Dokolo, Mukono and Soroti), 4 National ward rounds carried out (Kalangala, Mpigi, Maracha and Lwengo,5 Health Sector events presided over (National World Sickle Cell day celebration, 54th Independence National Assembly, Health Assembly I Sembabule, World Cancer Day, Safe Motherhood day).The department also paid utilities for the Ministry, paid welfare and allowances for staff, maintained ministry fleet and paid staff salaries,pension and gratuity.

GAVI:%HWZHHQ-DQXDU\DQG6HSWHPEHU2016, the country received the following dozes of vaccines, DTP-HepB-Hib (598,500),HPV (723,000), (PCV2,923,200),Two Consultancy firms (Icon and Joadah) were formally engaged to provide consultancy services of reviewing the designs and supervision of constructions and civil works for the staff houses.CRQWUDFWVZHUHDZDUGHGDQGVLJQHGIRUWKH&RQVWUXFWLRQRI19 medicines stores in 19GLVWULFWVDOOVLWHVZHUH handed over to consultants and contractors. Construction of 26 health staff houses in 15 districts has commenced .96% payment for vaccine co-financing obligation by GoU for 2016 was achieved following a front loading arrangement RI)XQGVLQ)<16/17.

1 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Uganda Health Systems Strengthening Project: Renovations of 9 Hospitals was completed and these were handed over. The Hospitals include: Moroto, Anaka, Nebbi, Kiryandongo, Mityana, Nakaseke, Iganga, Entebbe and Moyo,Renovation of 22 HCIVs was completed. Renovation of 4 HCIVs is average 98% complete. These include Pakwach, Atiak, Obongi and Padibe HCIVs. &RQWUDFWVZHUHVLJQHGLQ-DQIRUProcurement to replace rejected HTXLSPHQWDQGWKHHTXLSPHQWZLOOEHGHOLYHUHGDQGGLVWULEXWHGE\0D\ Plans have been made for redistribution of medical equipment especially Deflibrators, Anaesthesia machines and ventilators. Procurement of 2 mobile workshop vehicles for Jinja and Masaka RRHs catchment areas: The two mobile workshop vehicles were delivered to Kampala and are awaiting registration .

Global fund: Under the Malaria grant;Implementation of 24m LLINs mass campaign is ongoing (12.3M LLINs are GF SURFXUHG &DPSDLJQZDVODXQFKHGLQ$SDF'LVWULFWRQ17.2.2017,Procured and delivered 13M doses of ACTs and trated 14M malaria cases .Supported In-Door Residual Spray for 10 Northern Uganda malaria Epidemic districts.

TB grant:Procured all drugs for TB treatment,Supported activities for MDR-TB program,Funds for adherence enablers (food and transport) disbursed to treatment sites.Cartridges procured for GeneXpert machines,MDR cases diagnosed and put on treatment at 92%

HIV grants:Reduced stock-outs; over 95% of the grant supports commodities ,Community Based Activities related to RMNCH and SGBV were transferred to TASO (USD 517k), Achieved A2 rating by Global Financing( GF), also registered reduced stock-outs; over 95% of the grant supports commodities ,Community Based Activities related to RMNCH and SGBV were transferred to TASO (USD 517k),MoH has had meetings with MoFPED to leverage additional domestic Funds in 2016-2017; Budget & beyond (10BN realised. Supported 75 RPMTs activities in 12 Regions. Procured Autoclaves & delivery sets for 150 HFs,Procured 83 M/Cycles for Laboratory Hub Riders,Supported Special Initiatives (studies) including PLACE, Mortality among HIV+s,³No Objection received for all procurements (CHMIS, UHMG fork lift & shelves, M/Vehicle for Support supervision & Data tools),Supported trainings of HWs in WAOS at Manpower development Centre-Mbale.

EAPHL:.$UFKLWHFWXUDOGHVLJQVIRU&RQVWUXFWLRQRI0EDOHDQG/DFRU+RVSLWDOODERUDWRULHVLVLQSODFH6LWHIRU FRQVWUXFWLRQRI0XODJR+RVSLWDOLVRODWLRQXQLWLGHQWLILHG1HHGVDVVHVVPHQWIRU5HIXUELVKPHQWRI(QWHEEHLVRODWLRQ Centre carried out to define scope of work.

MKCCAP;.Completion of consultancy services on Referral and Counter Referral strategy and development of DPEXODQFHVHUYLFHVV\VWHPIRU.DPSDOD0DLQZRUNVRI.DZHPSHDQG.LUXGGX+RVSLWDOVFRPSOHWHG

Italian support to Karamoja Districts: Sites in 3 districts were handed over on 20th June 2016, and construction is in advanced stages in phase 1 as follows:- Kaabong,(80.3%) Abim (89%) and Kotido (50%) ,Kaabong: Kalapata (2), Lokolia (2), Kapedo (2),Kotido: Kacheri (4), Rengen (2), Nakapelimoru (2), Panyangara (2), Lokitelaebu (4), Napumpum (2),Abim: Orwamuge (4), Alerek (2), Nyakwae (4),Phase 2,The sites in the other four districts of Amudat (16.2%), Nakapiripirit (11.7), Napak(16.5%) and Moroto(14.5%) handed over to the Contractor in December 2016.

(iv) Medium Term Plans

2 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

1. Prioritizing Health Promotion, Prevention and early intervention with focus on improving hygiene and sanitation, Integrated Community Case Management of common conditions using the Village Health Teams and introduction of the Community Health Extension Workers¶Strategy. 2. Strengthening inter-sectoral collaboration to address the social determinants of health e.g. safe water, education, housing, nutrition, etc. 3. Reducing referrals abroad. The sector developed a proposal to reduce referrals abroad. In the short term, the major focus is to improve diagnostics in Uganda Cancer Institute, Uganda Heart Institute and Mulago Hospital. 4. Improving health systems governance through capacity building and functionality of Hospital boards, Health Unit Management committees and management structures at all levels. 5. Having synergies and partnership with the private sector through Public Private Partnership arrangement. 6. Improving health worker performance through performance contracts for manager 7. 0RYLQJIURPIXQGLQJLQSXWVWRSXUFKDVLQJVHUYLFHVWKURXJKSURJUDP%DVHG%XGJHWLQJ5HVXOWV%DVHG)LQDQFLQJ 8. Improving resource tracking of both on & off budget funds to ensure alignment and harmonization

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 6.821 8.981 2.513 7.650 8.033 8.434 8.856 9.299 Non Wage 58.462 51.463 14.469 45.555 54.666 60.133 69.152 69.152

Devt. GoU 19.395 72.337 11.384 29.275 38.058 45.669 54.803 54.803 Ext. Fin. 422.910 874.789 321.872 878.415 658.487 444.224 124.913 82.442 GoU Total 84.678 132.782 28.365 82.480 100.757 114.236 132.812 133.255 Total GoU+Ext Fin (MTEF) 507.588 1,007.571 350.237 960.895 759.243 558.460 257.724 215.697 Arrears 1.772 2.242 0.000 3.023 0.000 0.000 0.000 0.000 Total Budget 509.360 1,009.813 350.237 963.918 759.243 558.460 257.724 215.697 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 509.360 1,009.813 350.237 963.918 759.243 558.460 257.724 215.697 Total Vote Budget 507.588 1,007.571 350.237 960.895 759.243 558.460 257.724 215.697 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 67.687 577.939 0.000 645.626 56.924 654.589 0.000 711.512

211 Wages and Salaries 14.795 13.971 0.000 28.766 13.073 22.226 0.000 35.298

212 Social Contributions 14.765 0.249 0.000 15.014 15.076 1.167 0.000 16.243

213 Other Employee Costs 1.032 0.178 0.000 1.210 1.182 0.000 0.000 1.182

3 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

221 General Expenses 6.860 35.523 0.000 42.383 4.609 32.652 0.000 37.262

222 Communications 0.231 0.704 0.000 0.936 0.378 1.833 0.000 2.211

223 Utility and Property Expenses 1.121 0.044 0.000 1.165 0.885 0.866 0.000 1.751

224 Supplies and Services 11.403 403.133 0.000 414.536 10.169 515.403 0.000 525.572

225 Professional Services 0.695 4.800 0.000 5.495 0.347 10.442 0.000 10.790

227 Travel and Transport 10.943 115.186 0.000 126.129 7.280 65.914 0.000 73.193

228 Maintenance 4.992 0.362 0.000 5.354 3.224 0.537 0.000 3.761

273 Employer social benefits 0.550 1.804 0.000 2.354 0.400 3.548 0.000 3.948

282 Miscellaneous Other Expenses 0.300 1.986 0.000 2.286 0.300 0.000 0.000 0.300

Output Class : Outputs Funded 16.931 0.000 0.000 16.931 13.479 13.666 0.000 27.145

262 To international organisations 0.300 0.000 0.000 0.300 1.960 0.000 0.000 1.960

263 To other general government units 16.631 0.000 0.000 16.631 11.519 13.666 0.000 25.185

Output Class : Capital Purchases 48.163 296.851 0.000 345.014 12.078 210.160 0.000 222.238

281 Property expenses other than interest 0.600 1.463 0.000 2.063 0.000 1.551 0.000 1.551

312 FIXED ASSETS 47.563 295.387 0.000 342.950 12.078 208.459 0.000 220.537

314 INVENTORIES (STOCKS AND STORES) 0.000 0.000 0.000 0.000 0.000 0.150 0.000 0.150

Output Class : Arrears 2.242 0.000 0.000 2.242 3.023 0.000 0.000 3.023

321 DOMESTIC 2.242 0.000 0.000 2.242 3.023 0.000 0.000 3.023

Grand Total : 135.024 874.789 0.000 1,009.813 85.504 878.415 0.000 963.918

Total excluding Arrears 132.782 874.789 0.000 1,007.571 82.480 878.415 0.000 960.895

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 01 Health Monitoring and Quality 0.733 0.997 0.305 0.659 0.996 1.000 1.000 1.000 Assurance 03 Quality Assurance 0.733 0.997 0.305 0.659 0.996 1.000 1.000 1.000

02 Health infrastructure and 154.622 245.086 8.520 133.690 106.231 16.476 16.351 16.351 equipment 1027 Insitutional Support to MoH 2.341 2.428 0.204 2.550 4.581 0.376 0.251 0.251

1185 Italian Support to HSSP and PRDP 0.074 5.970 0.034 5.919 0.000 0.300 0.300 0.300

1315 Construction of Specialised Neonatal 20.168 28.470 0.750 39.293 0.000 1.500 1.500 1.500 and Maternal Unit in Mulago Hospital 1344 Renovation and Equiping of Kayunga 0.000 11.999 0.285 43.067 38.900 0.000 0.900 0.900 and Yumbe General Hospitals 1393 Construction and Equipping of the 0.000 0.900 0.000 0.050 11.050 1.400 0.500 0.500 International Specialized Hospital of Uganda

4 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

1394 Regional Hospital for Paediatric Surgery 0.000 1.800 0.000 1.000 1.000 12.900 12.900 12.900

1440 Uganda Reproductive Maternal and 0.000 0.000 0.000 41.811 50.700 0.000 0.000 0.000 Child Health Services Improvement Project 03 Health Research 2.597 1.002 0.483 1.040 1.500 1.500 1.500 1.500

04 Research Institutions 2.355 0.760 0.362 0.800 1.260 1.260 1.260 1.260

05 JCRC 0.242 0.242 0.121 0.240 0.240 0.240 0.240 0.240

04 Clinical and public health 43.514 40.443 8.975 38.431 31.159 24.739 23.550 22.184

06 Community Health 3.124 3.147 1.171 2.094 3.090 3.090 3.140 3.140

07 Clinical Services 19.863 8.621 1.619 6.920 6.130 6.130 8.120 5.630

08 National Disease Control 6.911 7.244 2.412 5.547 6.250 6.250 7.250 6.190

09 Shared National Services 9.644 13.585 3.595 12.125 7.919 8.699 4.470 6.654

11 Nursing Services 0.217 0.216 0.091 0.215 0.220 0.220 0.220 0.220

1148 Public Health Laboratory strengthening 2.036 0.000 0.000 0.000 0.000 0.000 0.000 0.000 project 1413 East Africa Public Health Laboratory 0.000 5.690 0.087 8.802 7.550 0.350 0.350 0.350 Network Project Phase II 1441 Uganda Sanitation Fund Project II 0.000 0.000 0.000 2.728 0.000 0.000 0.000 0.000

05 Pharmaceutical and other Supplies 280.951 680.641 324.647 763.020 582.763 473.067 163.015 120.544

0220 Global Fund for AIDS, TB and Malaria 244.160 593.259 316.475 670.589 516.410 399.888 81.646 120.544

1141 Gavi Vaccines and HSSP 36.790 87.381 8.173 0.000 0.000 0.000 0.000 0.000

1436 GAVI Vaccines and Health Sector 0.000 0.000 0.000 92.431 66.353 73.179 81.369 0.000 Development Plan Support 49 Policy, Planning and Support 26.944 41.645 7.306 27.078 36.594 41.678 52.308 54.118 Services 01 Headquarters 19.230 22.170 6.427 23.088 25.362 25.404 25.442 30.052

02 Planning 4.360 3.731 0.519 2.510 3.730 2.720 2.720 2.720

10 Internal Audit Department 0.375 0.397 0.120 0.360 5.922 11.974 22.886 19.766

12 Human Resource Management Department 0.000 1.576 0.239 1.120 1.580 1.580 1.260 1.580

Total for the Vote 509.360 1,009.813 350.237 963.918 759.243 558.460 257.724 215.697

Total Excluding Arrears 507.588 1,007.571 350.237 960.895 759.243 558.460 257.724 215.697

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 01 Health Monitoring and Quality Assurance Programme Objective : To Improve quality of health care and patient safety Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: Conduct regular health sector performance review, monitoring and evaluation. Sector Outcomes contributed to by the Programme Outcome 1. Coherent and integrated inter-sectoral frameworks Performance Targets

5 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of health facilities attaining Star 3(>75) status 10% 20% 30% under the health facility quality of care assessement program; ‡Proportion of quarterly intergrated visits to LGs by centre; 100% 100% 100%

N/A Programme : 02 Health infrastructure and equipment Programme Objective : To improve the quality and accessible health infrastructure and equipment Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: Development and management of health sector infrastructure and equipment. Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of the functional health centre IVs(offering 57% 59% 60% ceaserian and blood transfusion section) SubProgramme: 0216 District Infrastructure Support Programme Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 4 4 4

Output: 82 Staff houses construction and rehabilitation Percentage Completion of Construction and Rehabili 100% 100% 100%

SubProgramme: 1027 Insitutional Support to MoH Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 4 4 4

SubProgramme: 1185 Italian Support to HSSP and PRDP Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 4 4 4

SubProgramme: 1187 Support to Mulago Hospital Rehabilitation Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 12 0 0

Output: 80 Hospital Construction/rehabilitation Number of hospitals constructed 2 0 0

Number of hospitals renovated 1 0 0

6 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

SubProgramme: 1243 Rehabilitation and Construction of General Hospitals Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 4 4 4

Output: 80 Hospital Construction/rehabilitation Number of hospitals constructed 2 2 2

Number of hospitals renovated 2 2 2

SubProgramme: 1344 Renovation and Equiping of Kayunga and Yumbe General Hospitals Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 12 12 12

Output: 80 Hospital Construction/rehabilitation Number of hospitals constructed 0 0 0

Number of hospitals renovated 2 2 2

SubProgramme: 1393 Construction and Equipping of the International Specialized Hospital of Uganda Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 12 12 12

SubProgramme: 1394 Regional Hospital for Paediatric Surgery Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 12 12 12

Output: 80 Hospital Construction/rehabilitation Number of hospitals constructed 1 1 1

SubProgramme: 1440 Uganda Reproductive Maternal and Child Health Services Improvement Project Output: 01 Monitoring, Supervision and Evaluation of Health Systems Number of support and monitoring visits conducted 12 12 12

Output: 81 Health centre construction and rehabilitation Number of health centre Ivs renovated 80 80 80

Programme : 03 Health Research Programme Objective : 7RLPSURYHUHVHDUFKIRUHQKDQFHGLQQRYDWLRQVLQYHQWLRQVDQGDSSOLFDWLRQV

Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: Undertake basic, epidemiological, applied, interventional and operational research; Chemotherapeutic research; Coordinate research activities Sector Outcomes contributed to by the Programme Outcome 1. Competitive healthcare centres of excellence Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20

7 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Actual Target Actual Target Projection Projection

‡Proportion of reseach informed policy and guidelines 100% 100% 100%

SubProgramme: 04 Research Institutions Output: 52 Support to Uganda National Health Research Organisation(UNHRO) No. of conservation gardens established 15 20 30

No. of therapies and formulations evaluated. 40 65 80

SubProgramme: 05 JCRC Output: 51 Specialised Medical Research in HIV/AIDS and Clinical Care (JCRC) No. of researches in HIV/AIDS conducted 2 4 8

Programme : 04 Clinical and public health Programme Objective : To improve the quality and accessible clinical and public health services

Responsible Officer: Permanent secretary MOH Programme Outcome: To support provision of integrated public health services and control of epidemic and endemic diseases as well as to coordinate infrastructure development, pharmaceutical policy implementation, supply chain planning and management, integrated curative services interventions Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Institutional/Facility based Maternity Mortality per 106 102 98 100,000 facility based deliveries ‡Proportion of epidemics/disease outbreaks contained; 100% 100% 100%

‡Couple Years of protection(Estimated number of couples 4500000 4600000 4700000 protected against preganacy during a one year period) ‡DPT3 Coverage 95% 97% 97%

‡Institutional/Facility based Infant Mortality rate per 1000 16.9 16.5 16.1

SubProgramme: 06 Community Health Output: 01 Community health services provided (control of communicable and non communicable diseases) No. of technical support supervision visits reports 4 4 4 produced No. of districts monitoring reports on communicabl 4 4 4

Percentage of health workers and service providers 30% 40% 50%

Percentage of villages declared Open Defecation Free 20% 30% 40% (ODF) in the 38 districts

8 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

SubProgramme: 07 Clinical Services Output: 04 Technical support, monitoring and evaluation of service providers and facilities No. of districts supervised quarterly on EPI, RH, 122 122 122 CH, Nutrition, Comprehensive HIV/AIDS e.t.c) SubProgramme: 08 National Disease Control Output: 03 National endemic and epidemic disease control services provided No. of weekly surveillance reports released 52 52 52

No. of coordination meetings held 12 12 12

No. of quarterly Technical support supervision con 4 4 4

Output: 05 Immunisation services provided % of children under 1 year reached with the third 100% 100% 100%

% of children under one year immunized against mea 100% 100% 100%

Output: 09 Indoor Residual Spraying (IRS) services provided No. of districts provided with IRS services 20 20 20

Output: 11 Coordination of clinical and public health emergencies including the response to the nodding syndrome No of bi-quarterly support supervision visits repo 8 8 8

SubProgramme: 09 Shared National Services Output: 51 Medical Intern Services Proportion of medical interns whose allowances are 100% 100% 100%

SubProgramme: 11 Nursing Services Output: 11 Coordination of clinical and public health emergencies including the response to the nodding syndrome No of bi-quarterly support supervision visits repo 8 8 8

SubProgramme: 1413 East Africa Public Health Laboratory Network Project Phase II Output: 01 Community health services provided (control of communicable and non communicable diseases) No. of technical support supervision visits reports 4 4 4 produced Output: 03 National endemic and epidemic disease control services provided No. of quarterly Technical support supervision con 4 4 4

SubProgramme: 1441 Uganda Sanitation Fund Project II Output: 01 Community health services provided (control of communicable and non communicable diseases) No. of technical support supervision visits reports 4 4 4 produced No. of districts monitoring reports on communicabl 4 4 4

Percentage of health workers and service providers 50% 80% 100%

Percentage of villages declared Open Defecation Free 80% 90% 90% (ODF) in the 38 districts

9 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Programme : 05 Pharmaceutical and other Supplies Programme Objective : To improve the quality and accessible medicines, equipment and other health supplies Responsible Officer: Permanent Secretary Ministry of health Programme Outcome: Development of policy and guidelines for Medicines , equipment and other health supplies Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of health facilities without drug stock out for 75% 80% 85% 41 tracer medicines in previous 3 months SubProgramme: 0220 Global Fund for AIDS, TB and Malaria Output: 01 Preventive and curative Medical Supplies (including immuninisation) No. and percentage of districts/reporting units 100% 100% 100% reporting no stock-out of first-line anti-TB drugs during the reporting period. No. and percentage of public health facilities with no 100% 100% 100% reported stock-outs of ACTs any time during the UHSRUWLQJSHULRG 1RDQGSHUFHQWDJHRI$57FHQWUHVZLWKRXWVWRFN 100% 100% 100% RXWVRI$59VODVWLQJPRUHWKDQZHHNGXULQJWKH reporting period % of co financing requirement paid 100% 100% 100%

SubProgramme: 1436 GAVI Vaccines and Health Sector Development Plan Support Output: 01 Preventive and curative Medical Supplies (including immuninisation) % of co financing requirement paid 100% 100% 100%

Output: 02 Strengthening Capacity of Health Facility Managers Number of districts in which waste disposal was fa 116 116 116

Number of Health facilities supported to conduct o 2982 2982 2982

Output: 03 Monitoring and Evaluation Capacity Improvement % of districts in which schools in a catchment are 95% 95% 95%

Number of districts with integrated and updated mi 116 116 116

Number of stakeholder meetings held 1 1 1

Output: 75 Purchase of Motor Vehicles and Other Transport Equipment Number of vehicles procured 57 0 0

Output: 77 Purchase of Specialised Machinery & Equipment Number of 054 GreenLine SDD procured 205 0 0

Number of PQS compliant cold boxes procured 1155 0 0

Number of VLS 094 Green Line SDD procured 186 0 0

10 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Programme : 06 Public Health Services Programme Objective : 7R8QGHUWDNH£3ROLF\'HYHORSPHQW&RRUGLQDWLRQ3ODQQLQJ,PSOHPHQWDWLRQRYHUVLJKW Monitoring and Evaluation of Communicable Disease Control Programs in Uganda.

Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: To support provision of integrated public health services and control of epidemic and endemic diseases. Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection N / A N/A Programme : 07 Clinical Health Services Programme Objective : Develop and coordinate standards guidelines and policies on infrastructure, medicines and health supplies, and integrated curative services. Provide support supervision referral hospitals and the districts. Coordination of medical board, interns and tertiary health issues. Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: To provide capacity building including mentorship to health workers on health infrastructure, pharmaceuticals and curative services; Provide emergency response (Assessment, case definition and case management); Coordination of infrastructure development, pharmaceutical policy implementation, supply chain planning and management, integrated curative services interventions Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection N / A N/A Programme : 49 Policy, Planning and Support Services Programme Objective : To improve the Health policy,strategic direction, planning and coordination

Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: Policy development ,financial management, auditing, human resource development, planning, budgeting, administrative and nursing services. Sector Outcomes contributed to by the Programme Outcome

11 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

1. Coherent and integrated inter-sectoral frameworks Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of national and HLG with comprehensive 100% 100% 100% annual health plans and budgets ‡Timeliness and completeness of monthly HMIS reporting 93% 95% 97%

SubProgramme: 01 Headquarters Output: 02 Ministry Support Services No of days between authorization of request and 15 15 15 actual payment Percentage execution of the procurement plan 100% 100% 100%

Output: 03 Ministerial and Top Management Services Proportion of Top management resolutions executed 100% 100% 100%

Proportion of quarterly internal audit report 100% 100% 100% recommendations implemented Proportion of auditor General report 100% 100% 100% recommendations implemented SubProgramme: 02 Planning Output: 01 Policy, consultation, planning and monitoring services Comprehensive annual sector workplan and budget 1 1 1 submitted Quarterly budget performance reports produced 4 4 4

Number of quarterly comprehensive internal audit 1 1 1 report SubProgramme: 10 Internal Audit Department Output: 01 Policy, consultation, planning and monitoring services Number of quarterly comprehensive internal audit 4 4 4 report SubProgramme: 1145 Institutional Capacity Building Output: 01 Policy, consultation, planning and monitoring services Comprehensive annual sector workplan and budget 1 1 1 submitted Quarterly budget performance reports produced 4 4 4

Number of quarterly comprehensive internal audit 1 1 1 report

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

12 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 014 Ministry of Health

Program : 08 02 Health infrastructure and equipment

Development Project : 0216 District Infrastructure Support Programme

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

Six (6) X-ray machines procured Draft bid document and requisition for x-ray machines for Adjumani, Abim, Busolwe, Payment for shipping and clearing costs for donated items Kiboga, Tororo & Kaberamaido hospitals was made. submitted to the Accounting officer for onward transmission to PDU/Contracts committee to start procurement process. Total Output Cost(Ushs Thousand) 4,791,000 7,434 0

Gou Dev¶t: 4,791,000 7,434 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1027 Insitutional Support to MoH

Output: 08 02 72 Government Buildings and Administrative Infrastructure

Ministry of health headquarters renovated Renovations of MOH entrance at the reception Ministry of Health Headquarters renovated Staff canteen constructed area was completed and these were handed following the fire and office accommodation over. Modifications and painting of the modernized. Boardrooms on 3rd and 4th floors completed. Carpeting of the Hon MoH and Permanent Secretary¶s offices completed. Reception area on level 1 and boardrooms on Level 3 $ 4 expanded and completed. Roof leakages on /HYHOGRQH/HDNDJHVRQOqYHODWWKHPDLQ entrance undertaken and completed. Plumbing works in resorts done Total Output Cost(Ushs Thousand) 100,000 27,472 1,542,000

Gou Dev¶t: 100,000 27,472 1,542,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 02 75 Purchase of Motor Vehicles and Other Transport Equipment

2 Vehicles procured Clearance to purchase the vehicles from Two motor cycles procured Taxes for the vehicles procured paid Ministry of Public Service obtained. Advertisement was placed in the New vision on 12/1/2017. Procurement process underway and contract will be completed by April 30, 2017. Total Output Cost(Ushs Thousand) 628,000 10,603 20,000

Gou Dev¶t: 628,000 10,603 20,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

13 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Taxes on Specialised and other equipment and donations paid Taxes amounting to UGX 149M for vehicles donated by UNICEF for National Malaria Control Programme are being processed and the payment process will be completed by 28/2/2017. Total Output Cost(Ushs Thousand) 1,200,000 0 0

Gou Dev¶t: 1,200,000 0 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1123 Health Systems Strengthening

Output: 08 02 75 Purchase of Motor Vehicles and Other Transport Equipment

Procurement of mobile workshop vehicles for Masaka and The two mobile workshop vehicles were Jinja RRHs delivered to Kampala and are awaiting registration which will be completed by mid- February 2017. Total Output Cost(Ushs Thousand) 1,500,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 1,500,000 0 0

A.I.A: 0 0 0

Output: 08 02 76 Purchase of Office and ICT Equipment, including Software

Roll out of the Human Resource Management Informaton Roll out of Human Resource Information System, System completed in 31 districts. Set up of electronic job for the Health Service Finalise and roll out the Electronic Job Bureau for the Health Commission completed now awaiting Service Commission launching and roll out Total Output Cost(Ushs Thousand) 2,500,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 2,500,000 0 0

A.I.A: 0 0 0

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

Procurement of medical equipment requiring pre-installation Installation of x-rays was completed in 19 works for the health facilities supported by UHSSP; Hospitals. Dental units were installed in 18 out of 19 Hospitals. Installation at Moyo Hospital Procurement of medical instruments for Emergency Obsetric will be completed by mid-February 2017. and Neonatal Care Installation of laundry equipment was completed in 6 out of 19 Hospitals. The Procurement of safe delivery kits and implants outstanding works will be completed by March 2017. Total Output Cost(Ushs Thousand) 21,830,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 21,830,000 0 0

A.I.A: 0 0 0

Output: 08 02 78 Purchase of Office and Residential Furniture and Fittings

Procurement of office furniture for health facilities renovated Contracts for procurement of medical by UHSSP equipment have been awarded and the equipment will be delivered and distributed by May 2017. Total Output Cost(Ushs Thousand) 5,780,000 0 0

14 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Gou Dev¶t: 0 0 0

Ext Fin: 5,780,000 0 0

A.I.A: 0 0 0

Output: 08 02 80 Hospital Construction/rehabilitation

Finallise renovation of the 9 Hospitals under Phase II. Renovations of Hospitals was completed and these were handed over. The Hospitals include: Moroto, Anaka, Nebbi, Kiryandongo, Mityana, Continue with renovation of 26 HCIVs including maternity Nakaseke, Iganga, Entebbe and Moyo. and operating theatres Renovation of 21 HCIVs was completed. Renovation of 5 HCIVs is 98% complete.

Procurement of office furniture for the renovated health facilities Total Output Cost(Ushs Thousand) 81,680,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 81,680,000 0 0

A.I.A: 0 0 0

Development Project : 1185 Italian Support to HSSP and PRDP

Output: 08 02 82 Staff houses construction and rehabilitation

Twenty staff houses in Karamoja Region 75% of works finalized 45% of construction of 68 staff houses completed. 4 supervising consultant reports Produced Total Output Cost(Ushs Thousand) 5,420,000 0 5,619,000

Gou Dev¶t: 300,000 0 0

Ext Fin: 5,120,000 0 5,619,000

A.I.A: 0 0 0

Development Project : 1187 Support to Mulago Hospital Rehabilitation

Output: 08 02 80 Hospital Construction/rehabilitation

15 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Rehabilitation of Lower Mulago Hospital completed Rehabilitation work for lower Mulago Hospital is ongoing and the current progress of work is at 70%. Construction of the Kawempe and Kiruddu Hospital ongoing.

For Kawempe Hospital the overall progress of work is at 93%. Main block is 95% completed; Services block 92% complete; staff accommodation block 95% complete and the external work is 96% complete. The hospital is presently being used by Mulago hospital. The Contractor is currently handling the defects.

For Kiruddu Hospital the overall Progress of work is at 96%. The main block is 96% complete; Services block is 94% complete; Accommodation block is 95% complete and the external work is 90% complete. The hospital is presently being used by Mulago Hospital. The Contractor is currently handling the defects.

Procurement of medical equipment and furniture for Kawempe and kiruddu hospitals on-going. Contracts have been signed and delivery and installation expected in the quarter January to March 2017.

Procurement of the main medical equipment and furniture for Mulago hospital on-going. Contracts have been signed and delivery and installation expected during the quarter April to June 2017.

Total Output Cost(Ushs Thousand) 44,130,000 6,009,386 0

Gou Dev¶t: 16,800,000 0 0

Ext Fin: 27,330,000 6,009,386 0

A.I.A: 0 0 0

Development Project : 1243 Rehabilitation and Construction of General Hospitals

Output: 08 02 80 Hospital Construction/rehabilitation

Kawolo and Busolwe General hospitals;- Expanding and 1. Contract for Civil Works for Kawolo rehabilitation of the Outpatient department, expanding and submitted to the Solicitor General for approval. renovating the theatre and maternity, constructing 4 units of 2. Contract for Design Consultancy services staff houses and mortuary. due for signature by the Accounting officer

Total Output Cost(Ushs Thousand) 10,280,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 10,280,000 0 0

A.I.A: 0 0 0

Development Project : 1315 Construction of Specialised Neonatal and Maternal Unit in Mulago Hospital

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

16 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Specialised Equipment and machinery procured Lists and specifications for the required Medical Equipment and Furniture developed and tendering process commenced

Preparation of LOTS has been finalized and forwarded to the bank for a ³no objection´

Received a "No Objection" from IsDB for the 4 LOTS. Adverts placed both in the local Newspapers and Financial Times for the procurement of the Equipment

Total Output Cost(Ushs Thousand) 4,000,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 4,000,000 0 0

A.I.A: 0 0 0

Output: 08 02 80 Hospital Construction/rehabilitation

Maternal and neonatal hospital construction undertaken Certificate No 5 for Civil works contractor Construction of Maternal and neonatal Hospital processed and paid by the bank completed by February 2018 Supervision of civil works undertaken Certificates numbers 6 & 7 submitted to the bank and paid Total Output Cost(Ushs Thousand) 20,012,100 372,570 37,893,000

Gou Dev¶t: 13,710,000 372,570 4,450,000

Ext Fin: 6,302,100 0 33,443,000

A.I.A: 0 0 0

Development Project : 1344 Renovation and Equiping of Kayunga and Yumbe General Hospitals

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

Medical equipment for full re-equipping of Kayunga and Yumbe Hospitals including delivery beds, x ray machines, lab equipment, surgical equipment, Hospital beds, bedside lockers procured. Total Output Cost(Ushs Thousand) 0 0 6,700,000

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 6,700,000

A.I.A: 0 0 0

Output: 08 02 80 Hospital Construction/rehabilitation

Kayunga and Yumbe hospitals constructed/rehabilitated and Nil 50% of the Civil works for rehabilitation and equipped expansion of Kayunga and Yumbe Hospitals completed Total Output Cost(Ushs Thousand) 11,099,000 0 32,885,000

Gou Dev¶t: 5,759,000 0 5,000,000

Ext Fin: 5,340,000 0 27,885,000

A.I.A: 0 0 0

Development Project : 1393 Construction and Equipping of the International Specialized Hospital of Uganda

Output: 08 02 80 Hospital Construction/rehabilitation

17 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

-Project Designs developed Completed project designs

Payment of Advance

Mobilisation on site

Commencement of Engineering, Procurement and construction works Total Output Cost(Ushs Thousand) 900,000 0 0

Gou Dev¶t: 900,000 0 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1394 Regional Hospital for Paediatric Surgery

Output: 08 02 80 Hospital Construction/rehabilitation

Commencement of construction works for the Regional Ground breaking scheduled for February 2017 50% of civil works completed Hospital for Pediatric Surgery Total Output Cost(Ushs Thousand) 1,800,000 0 800,000

Gou Dev¶t: 1,800,000 0 800,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1440 Uganda Reproductive Maternal and Child Health Services Improvement Project

Output: 08 02 75 Purchase of Motor Vehicles and Other Transport Equipment

34 vehicles procured to support roll out of Birth and Death Registration, Result Based Financing in 60 districts and support supervision in under resourced Local Governments Total Output Cost(Ushs Thousand) 0 0 2,847,330

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 2,847,330

A.I.A: 0 0 0

Output: 08 02 76 Purchase of Office and ICT Equipment, including Software

Birth,Death Registration mobile services procured for National Identification Registration Authority (NIRA) procured Firm to develop and install RBF soft ware procured Total Output Cost(Ushs Thousand) 0 0 2,695,472

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 2,695,472

A.I.A: 0 0 0

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

RMNCH equipment including infant Resuscitation devices, Resuscitation tables, Glucometers, delivery beds, post-natal tables and MVA kits procured and distributed to Bundibugyo, Kalangala, Buikwe, Moyo, Otuke, Serere, Lwengo, Kaabong among others.

18 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Total Output Cost(Ushs Thousand) 0 0 4,000,000

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 4,000,000

A.I.A: 0 0 0

Output: 08 02 81 Health centre construction and rehabilitation

Maternity units constructed in HCIIIs in 56 districts which include: Tororo, Kabale, Mayuge, Kiruhura, Buhweju, Mitooma, Yumbe, Zombo, Koboko, Alebtong, Soroti, Lira, Otuke, among others. Total Output Cost(Ushs Thousand) 0 0 11,522,195

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 11,522,195

A.I.A: 0 0 0

Program : 08 04 Clinical and public health

Development Project : 1413 East Africa Public Health Laboratory Network Project Phase II

Output: 08 04 72 Government Buildings and Administrative Infrastructure

1.Continuation of construction of Mbale and Lacor labs 1. Still with architectural drawings for Mbale 30% of Construction of Mbale and Lacor labs 2.VHF Isolation unit and staff accomodation facility in place at and Lacor. completed. 30% of civil works completed of the Mulago Hospital VHF Isolation unit and staff accommodation 3.MDR treatment centers at Mbale and Moroto remodelled and 2. HVAC installation for NTRL ongoing facility at Mulago Hospital. MDR treatment equiped centers at Mbale and Moroto remodelled. Entebbe 4.Entebbe isolation centre remodelled and equiped isolation centre remodelled. 5. Total Output Cost(Ushs Thousand) 2,450,466 0 4,395,000

Gou Dev¶t: 0 0 0

Ext Fin: 2,450,466 0 4,395,000

A.I.A: 0 0 0

Output: 08 04 75 Purchase of Motor Vehicles and Other Transport Equipment

1. 2 ambulances in place 1. Bid evaluation done for 4 double cabin pick 2 ambulances and 4 double cabin pickups ups procured 2. Bid documents for 2 ambulances to be developed in third quarter Total Output Cost(Ushs Thousand) 367,000 0 520,000

Gou Dev¶t: 0 0 0

Ext Fin: 367,000 0 520,000

A.I.A: 0 0 0

Output: 08 04 76 Purchase of Office and ICT Equipment, including Software

1. ICT equipment ; computers,VC equipment, internet Bid evaluation done. Awaiting delivery Computers.,ICT equipment including Video available at Moroto and Fort Portal Hospitals conferencing equipment in place Total Output Cost(Ushs Thousand) 539,534 0 600,000

Gou Dev¶t: 0 0 0

Ext Fin: 539,534 0 600,000

A.I.A: 0 0 0

19 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Program : 08 05 Pharmaceutical and other Supplies

Development Project : 0220 Global Fund for AIDS, TB and Malaria

Output: 08 05 72 Government Buildings and Administrative Infrastructure

Medicines Warehouse at Kajansi Constructed Obtained clearance from PPDA to use Construction of medicines ware house in kajjansi procurement method of design and completed build.Construction expected to commence in Taxes on the Global Fund activities paid mid march Total Output Cost(Ushs Thousand) 4,000,000 0 48,214,788

Gou Dev¶t: 1,000,000 0 0

Ext Fin: 3,000,000 0 48,214,788

A.I.A: 0 0 0

Output: 08 05 75 Purchase of Motor Vehicles and Other Transport Equipment

2 M/Veh. (One Station Wagon & One field Motor Vehicle Procurement of 2 M/Vehicles for Finance & -procure 7 delivery trucks for NMS and JMS Procured M&E Officers initiated 4 Film Vans, Station Wagon for QPPU, 2 Cars for M&E officers procured. Procure for other vehicles for controls and assurance Total Output Cost(Ushs Thousand) 799,708 0 3,415,896

Gou Dev¶t: 550,000 0 0

Ext Fin: 249,708 0 3,415,896

A.I.A: 0 0 0

Output: 08 05 77 Purchase of Specialised Machinery & Equipment

Assorted Medical, Dental & Surgical Equipment for TB, HIV, Procurement of 2 Film Vans sent to LFA/GF autoclaves, GeneXpert Machines, Microscopes, Malaria and HSS for no-objection. Forl Lift, Medicine Shelves and racks, medicine boxes, xray machines procured

Total Output Cost(Ushs Thousand) 60,653,836 5,557,363 31,857,132

Gou Dev¶t: 0 0 0

Ext Fin: 60,653,836 5,557,363 31,857,132

A.I.A: 0 0 0

Development Project : 1141 Gavi Vaccines and HSSP

Output: 08 05 72 Government Buildings and Administrative Infrastructure

Consultancy services for civil works procured The contractors started the works and they are at different levels ranging from ring beam to 20 district medicines stores constructed roofing,26 semi detached houses for HWs constructed, 13 districts in hard to reach areas, each has 2 staff houses constructed

Solar systems functional for the 26 houses

12 cold chain equipment procured and installed Total Output Cost(Ushs Thousand) 57,779,897 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 57,779,897 0 0

A.I.A: 0 0 0

Development Project : 1436 GAVI Vaccines and Health Sector Development Plan Support

20 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Output: 08 05 72 Government Buildings and Administrative Infrastructure

30 storage facilities of floor area 180 square meters for vaccines and dry commodity storage in 30 districts constructed

Staff houses constructed Total Output Cost(Ushs Thousand) 0 0 6,188,906

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 6,188,906

A.I.A: 0 0 0

Output: 08 05 75 Purchase of Motor Vehicles and Other Transport Equipment

57 (48-districts, 9-regional technicians) vehicles for programme management and District Health Offices that did not receive vehicles for support supervision & distribution of logistics to the Lower Level Health Units (LLHUs) procured Total Output Cost(Ushs Thousand) 0 0 4,596,775

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 4,596,775

A.I.A: 0 0 0

Output: 08 05 77 Purchase of Specialised Machinery & Equipment

205 054 GreenLine SDD procured;186 VLS 094 Green Line SDD procured; 1155 PQS compliant cold boxes to replace the defective/obsolete ones and cater for the increased needs procured; 5,710 BERLINGER Fridge-Tag2 devices procured Total Output Cost(Ushs Thousand) 0 0 15,355,562

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 15,355,562

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 05 Pharmaceutical and other Supplies Output: 08 0502 Strengthening Capacity of Health Facility Managers Change in Allocation (UShs Bn) : 13.937 Increased donor provision

Output: 08 0503 Monitoring and Evaluation Capacity Improvement Change in Allocation (UShs Bn) : 9.135 Increase in donor budget

Output: 08 0551 Transfer to Autonomous Health Institutions

21 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Change in Allocation (UShs Bn) : 1.500 Non wage contribution to the global fund activities

Output: 08 0453 Support to Local Governments Change in Allocation (UShs Bn) : 0.450 USF counterpart provision for improving sanitation and hygiene at local governments

Output: 08 0472 Government Buildings and Administrative Infrastructure Change in Allocation (UShs Bn) : 1.945 increased funding for the new projects coming on board in FY 2017/18

Output: 08 0475 Purchase of Motor Vehicles and Other Transport Equipment Change in Allocation (UShs Bn) : 0.153 Donor allocation to procure vehicles under EAPHLP

Programme : 08 49 Policy, Planning and Support Services Output: 08 4904 Health Sector reforms including financing and national health accounts Change in Allocation (UShs Bn) : -0.298 Budget cut

Output: 08 4951 Transfers to International Health Organisation Change in Allocation (UShs Bn) : 0.160 Increased allocation towards Annual requirement for WHO and ECSA Subscription

Programme : 08 01 Health Monitoring and Quality Assurance Output: 08 0103 Support supervision provided to Local Governments and referral hospitals Change in Allocation (UShs Bn) : -0.182 Budget cut

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

1. Inadequate staffing at all levels. Current staffing at 70% though staffing norms below the service delivery needs. 2. Inadequacy of human resource and funds for the maintenance of medical equipment nationwide. 3. High burden of disease due to preventable causes e.g. malaria, diarrhoeal diseases, skin diseases, eye conditions. 4. Monitoring and management of various disease outbreaks are not equitably funded. Mostly donor funded. 5. Stocks outs of key commodities especially at tertiary and secondary level. 6. Funding gaps for ARVs, Antimalarials and chemistry, hematology laboratory and x-ray reagents and films.

Plans to improve Vote Performance

22 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Increased infant immunization is extensively described in the Child Survival Strategy. The critical inputs to improved performance are the availability of adequate quantities and a reliable supply and storage cold chain system for the vaccines and immunization supplies. Equally important is the availability of a motivated health workers and community sensitization through village health teams (VHTs). Accordingly the Sector undertakes to fully implement the Child Survival Strategy.

To counter stock outages and supply side deficiencies, the Sector will continue to adopt a Last Mile delivery mechanism to be implemented by the National Medical Stores, to ensure that medicines are delivered by NMs to the final consumer, the health unit, rather than to the stores at the District Headquarters. In addition, the Sector will develop regional storage capacity for medicines to improve the availability of stock within the regions, and to reduce regional disparities.

To address insufficient availability of qualified health staff at task, the sector shall, continue Implementing the motivation and retention strategy for health workers and recruit additional staff within available resources.

In order to address inadequate health infrastructure and equipment, capital investment plans will continue to be geared towards consolidating existing infrastructure

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Reduce HIV/AIDS prevalence Issue of Concern : Rising HIV/AIDS prevalence Planned Interventions : 1. Elimination of Mother to Child Transmission, 2. Safe male circumcision, 3. Behavior change promotion Budget Allocation (Billion) : 5.000 Performance Indicators: % of children exposed to HIV from their mothers accessing HIV testing within 12 months % ART coverage among those in need Issue Type: Gender

Objective : Improve sexual and reproductive health Issue of Concern : Reduction of maternal and neonatal mortality Planned Interventions : 1. Procuring and distributing EMoC medicines, supplies, and equipment 2. Supporting the mobilization of blood for emergency obstetric and new born care 3. Conducting maternal and perinatal death audits to address gaps and improve quality of care. Budget Allocation (Billion) : 6.000 Performance Indicators: 1. EMoC medicines, supplies, and equipment available in all target facilities. 2. Availability of safe blood for emergency obstetric and new born care Issue Type: Enviroment

Objective : Infection control Issue of Concern : Safe waste disposal Planned Interventions : 1. Roll out Village Health Teams to educate people about safe waste disposal 2. Construct incinerators in health facilities Budget Allocation (Billion) : 2.000 23 Ministry of Health Ministerial Policy Statement

Vote:014 Ministry of Health

Performance Indicators: Number of incinerators in health facilities constructed Number of village health teams rolled out to educate people on safe dispoasal

Table 11.2: AIA Collections

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Assistant Commissioner 4 17 17 21 U1E 2,328,850 9,315,400 27,946,200

Commissioner 0 3 3 3 U1SE 2,628,075 0 31,536,900

Personal Secretary 0 1 1 1 U4 700,306 0 8,403,672

Principal Medical Officer 3 17 17 20 U2 1,992,454 5,977,362 23,909,448

Program Officer IT Support 0 5 5 5 U4 1,042,202 0 12,506,424

Research Officer RO) 0 1 1 1 U4 1,175,632 0 14,107,584 (SC) Senior Research Officer (SRO) 0 1 1 1 U3 1,204,288 0 14,451,456 (SC) Stenography Secretary 2 3 3 5 U5 462,852 925,704 5,554,224

Vote Total 9 48 48 57 11,534,659 9,315,400 138,415,908

24 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

V1: Vote Overview (i) Vote Mission Statement Provision of state of the art cancer care and prevention by advancing knowledge, fostering the use of research as a resource in training and professional development

(ii) Strategic Objective To offer super specialized services in areas of cancer treatment, research and prevention through conducting research into all aspects of common cancers in Uganda, provision of optimal evidence based clinical care, and provision of training for health care professionals using endemic cancers as model disease training.

(iii) Major Achievements in 2016/17

Ongoing activities such as furnishing and equipping the new cancer ward and other departments and works at Mayuge satellite cancer Centre were monitored. 182 established staffs were paid their three monthly salaries by the 28th day of every month during the period as per guidelines. 7 retired staff paid their monthly pensions by the 28th day of every month. 172 UCI staff on establishment were paid a quarterly motivational allowance. Staff welfare was handled and Staffs were assisted whenever they were in need and UCI in position of helping (such as burial of beloved ones). Telephone bills and internet charges were met during the period All UCI generators and vehicles which include Director¶s vehicle, 2 mammography vans and a pickup were maintained in sound conditions during the period. Management, Statutory and performance reports like activity/budget progress reports, final accounts and responses to various queries/requests were compiled and submitted for consideration by management and further submitted to key authorities like MoFPED, Office of the Auditor General, Accountant General¶s Office and Public Service among others. Security to UCI property was provided by both UCI security team and Uganda Police in which all UCI structures, equipment and the Community cancer surveillance site at Mayuge were provided security during the period. Wards, offices and compound were regularly cleaned to the highest standard of hygiene and were fumigated and disinfected to deal with pests and rodents were during the period.

,7ZDVZHOOPDLQWDLQHGDQGVXSSRUWHGWRKDYHRWKHUVHUYLFHVUXQVPRRWKO\GXULQJWKHSHULRG Nine (9) of the 11 submitted proposals were reviewed by the UCI REC; Four (4) monitoring visits conducted by the REC to monitor research projects;

25 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Two trainings conducted - Annual National Research Ethics Conference (ANREC) and How to conduct a monitoring visit; UCI Scientific review committee was constituted. One training for UCI staff held with the African Palliative Care Association; Four studies initiated and supported 1) User requirements for an electronic medical records system for a cancer hospital 2) response to erlotinib in the treatment of NSCLC at the UCI 3) Defining the Molecular profile of breast cancer in Uganda and its clinical implications 4) Assessment of knowledge attitudes and practices of nurses handling of cytotoxic anticancer drugs at the UCI. One UCI staff supported to attend a conference in France about cancer registry Ten (10) collaborative studies planned or initiated. Twelve (12) collaborative research meetings were conducted to lender support in research activities Several (119) staff supported to attend palliative care trainings with Africa Palliative care association. Three (3) Fellowship programs initiated (medical oncology, pediatric oncology and gynaecological oncology fellowships). Awaiting approval from NCHE and UMDPC and the vetting and award of in-post staff scholarships under the ADB support to Uganda Cancer Institute was supported. Establishment of a comprehensive community cancer control program in Mayuge ongoing, training of staff, visitation of site conducted, meetings with local opinion leaders conducted. Monitoring visits to Mbarara/Mayuge/Arua conducted to assess records and data management. A Community Cancer registry at Mayuge District was established; training conducted in Mayuge and staff allocated to Mayuge site

Five (5) cancer registry related meetings attended 23,901 in-patient days and 18,776 outpatient days of comprehensive oncology clinical care provided at Uganda Cancer Institute. 1,957 new patient cases received and attended to at Uganda Cancer Institute. 138 Lumbar Punctures carried out at Uganda Cancer Institute 471 Bone marrow Procedures performed at Uganda Cancer Institute 308 minor surgical Operations and FNAC carried out at Uganda Cancer Institute 268 Biopsies performed at Uganda Cancer Institute 80 Gynae Operations performed at Uganda Cancer Institute 59 Head and neck surgical Operations carried out at Uganda Cancer Institute 26 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

8,415 X-rays performed at Uganda Cancer Institute 516 CT simulations conducted by the Imaging department of Uganda Cancer Institute 619patient days of social support provided at Uganda Cancer Institute 124,056 laboratory investigations (CBCs, Chemistries, Blood transfusions, Platelet transfusions, HIV tests, Urine Analyses, Stool Analyses, Bone marrow Processing, Peripheral films, B/S for malaria and Cytology) conducted in Uganda Cancer Institute¶s Laboratory department 17,269 Chemotherapy for infusion reconstituted in Uganda Cancer Institute¶s pharmacy 1,549 patient days of social support provided at Uganda Cancer Institute 14,580 Drug combinations dispensed to patients at Uganda Cancer Institute 33,940 meals prepared and served for general inpatients at Uganda Cancer

Institute

Three (3) radio talk shows and five (5) TV talk shows were conducted during the UMA health fair week, Three Cervical cancer interviews were conducted and One (1) article about prostate cancer risk factors published in print media (new vision and observer).; Conducted one (1) broadcasted interview with Bukedde TV at Kajjansi during cancer education & screening outreach. Contributed in articles on various cancers & role of nutrition in cancer prevention & care in the Health times magazines September 2016 release.; Conducted fourteen (14) community based health education sessions; Three community based health education sessions in partnership with UCCF.; Educated 21,346 individuals out of whom 2684 clients were screened for cancers.; Two (2) long distance outreaches were held in Western Region (Kabarole District) and in eastern region (Mayuge District) in collaboration with Hind feet project & Airtel Uganda. Twenty two (22) short distances outreaches were conducted.; Follow up calls made to 113 people with suspected cancers and made 120 referrals. One (1) consultative and training meeting held at UCI with representatives of regional referral hospitals and permanent secretaries updating them on cancer burden, progress on developments in establishing the Uganda national cancer control program and soliciting their opinions.; Twenty (20) consultative and advocacy meetings held in 20 district local governments.; Six (6) Health management teams in six (6) districts trained.; Selected health care workers trained in six (6) districts on cancer prevention, screening and referrals.;

27 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Five (5) School drama groups formed in collaboration with the 3C UCCF school program and performed at Kings College Budo. 26 static cancer awareness and screening clinics and two (2) Support supervision visits conducted

One (1) Cancer health education and screening needs assessment research project was initiated. 1,732 Patient days of cancer care provided in the radiotherapy department 153 New patients seen 391 HDR planning sessions 391 HDR (brachytherapy) sessions conducted

1,089 Patients followed up

(iv) Medium Term Plans Construction of a nuclear department at the Uganda Cancer Institute equipping the bunkers with state of the art Linear Accelerators and radiation equipment construction and equipping of satellite cancer centers in regions to decongest the main Institute and bring services closer to the people Continue with improving service delivery by constructing an oxygen plant Restructuring the services at the Institute for improved service delivery

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.047 2.349 1.051 3.309 3.475 3.649 3.831 4.023 Non Wage 1.904 1.991 0.915 3.166 3.799 4.178 4.805 4.805

Devt. GoU 8.927 10.522 3.618 11.940 15.522 18.626 22.352 22.352 Ext. Fin. 0.000 26.445 0.000 31.963 22.621 12.958 0.000 0.000 GoU Total 12.878 14.862 5.584 18.415 22.796 26.454 30.988 31.180 Total GoU+Ext Fin (MTEF) 12.878 41.307 5.584 50.378 45.417 39.412 30.988 31.180 Arrears 0.000 0.000 0.000 0.048 0.000 0.000 0.000 0.000 Total Budget 12.878 41.307 5.584 50.426 45.417 39.412 30.988 31.180 A.I.A Total 0.847 1.700 0.436 1.860 1.950 2.051 2.150 2.260 Grand Total 13.725 43.007 6.020 52.286 47.367 41.463 33.138 33.440 Total Vote Budget 13.725 43.007 6.020 52.238 47.367 41.463 33.138 33.440 Excluding Arrears

(VI) Budget By Economic Clasification

28 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 5.836 13.301 1.700 20.837 7.763 7.801 1.860 17.424

211 Wages and Salaries 3.716 0.000 0.330 4.046 4.713 0.000 0.326 5.038

212 Social Contributions 0.026 0.000 0.000 0.026 0.065 0.000 0.000 0.065

213 Other Employee Costs 0.179 0.000 0.000 0.179 0.215 0.000 0.000 0.215

221 General Expenses 0.737 3.926 0.414 5.077 0.982 4.701 0.531 6.215

222 Communications 0.052 0.000 0.000 0.052 0.118 0.000 0.090 0.208

223 Utility and Property Expenses 0.205 0.000 0.096 0.301 0.414 0.000 0.037 0.451

224 Supplies and Services 0.141 0.000 0.140 0.281 0.288 0.000 0.182 0.470

225 Professional Services 0.117 9.375 0.350 9.842 0.152 3.100 0.263 3.515

227 Travel and Transport 0.411 0.000 0.300 0.711 0.646 0.000 0.337 0.983

228 Maintenance 0.253 0.000 0.070 0.323 0.171 0.000 0.094 0.265

Output Class : Capital Purchases 9.026 13.144 0.000 22.170 10.652 24.162 0.000 34.814

281 Property expenses other than interest 0.513 4.333 0.000 4.846 0.200 3.200 0.000 3.400

312 FIXED ASSETS 8.513 8.811 0.000 17.324 10.452 20.962 0.000 31.414

Output Class : Arrears 0.000 0.000 0.000 0.000 0.048 0.000 0.000 0.048

321 DOMESTIC 0.000 0.000 0.000 0.000 0.048 0.000 0.000 0.048

Grand Total : 14.862 26.445 1.700 43.007 18.463 31.963 1.860 52.286

Total excluding Arrears 14.862 26.445 1.700 43.007 18.415 31.963 1.860 52.238

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 57 Cancer Services 12.878 43.007 5.584 52.286 47.367 41.463 33.138 33.440

01 Management/support services 3.380 3.319 1.520 4.441 4.401 4.649 5.031 5.523

02 Medical Services 0.475 2.568 0.379 3.276 4.121 4.443 4.910 4.648

03 Internal Audit 0.012 0.026 0.011 0.025 0.030 0.035 0.040 0.050

04 Radiotherapy 0.084 0.126 0.057 0.615 0.672 0.752 0.806 0.867

1120 Uganda Cancer Institute Project 8.878 8.400 2.919 8.809 9.002 11.402 20.352 20.352

1345 ADB Support to UCI 0.048 28.567 0.699 33.963 27.141 18.182 0.000 0.000

1476 Institutional Support to Uganda Cancer 0.000 0.000 0.000 1.157 2.000 2.000 2.000 2.000 Institute

29 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Total for the Vote 12.878 43.007 5.584 52.286 47.367 41.463 33.138 33.440

Total Excluding Arrears 12.878 43.007 5.584 52.238 47.367 41.463 33.138 33.440

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 57 Cancer Services Programme Objective : Establish a National Planning and Legal Framework for Comprehensive Management and Control of Cancer

Strengthen Infrastructural Capacity for Cancer Prevention and Control

Strengthen Research Capacity to Promote and Provide the highest Patient Care by demonstrating Superior Outcomes at a Reasonable Cost

Develop Mechanisms for Broadening the Resource Base, enabling the Scaling-Up of Cancer Services

Establish strong Information Systems for consistent Management of Data monitoring WKH,QFLGHQFHRI&DQFHU

Responsible Officer: Dr Victoria Walusansa Programme Outcome: percentage of patients under effective treatment, % reduction in cancer incidence, % change in disease presentation (from stage III & IV to II & I) Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

30 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

‡Percentage of patients under effective treatment, % 50% 60% 70% reduction in cancer incidence, % change in disease presentation (from stage III & IV to II & I) SubProgramme: 02 Medical Services Output: 01 Cancer Research Number of cancer research studies initiated and co 4 6 9

Number of peer reviewed publications and presentat 20 30 45

Number of training workshops conducted by UCI 12 18 27

Output: 02 Cancer Care Services Number of inpatient stays 60000 63000 66150

No.of investigations undertaken 195180 204939 215186

Number of outpatient visits 42000 44100 46305

Number of new cancer patients registered 5060 7590 11385

Output: 03 Cancer Outreach Service Number of outreach visits conducted 32 48 72

Number of clients examined 61600 92400 138600

Number of clients screened 61600 92400 138600

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 114 Uganda Cancer Institute

Program : 08 57 Cancer Services

Development Project : 1120 Uganda Cancer Institute Project

Output: 08 57 72 Government Buildings and Administrative Infrastructure

The radiotherapy bunker and department constructed, continued with construction of the radiotherapy Basement store for UCI to house addition bunkers and it is currently at 40% with the procurement and supplies repaired Engineering designs developed, retainer wall erected (cast) and internal walls Construction of support areas for the radiotherapy pouring is ongoing. bunkers initiated. Works supervised, Master plan for UCI designed Radiotherapy bunkers constructed and supervised Construction of modern kitchen, Structural designs and artistic impressions for the service support building developed Renovation of engineering workshop area, Water pipeline channeling, streamlining and plumbing for UCI carried out: Installation of worktable for pharmacy,

Remodeling 75RVa generator hou Total Output Cost(Ushs Thousand) 4,434,085 2,143,675 8,709,000

Gou Dev¶t: 4,434,085 2,143,675 8,709,000

Ext Fin: 0 0 0

31 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

A.I.A: 0 0 0

Output: 08 57 76 Purchase of Office and ICT Equipment, including Software

Customer care management and Call center system procured Contract for installation of digital signage was and installed, signed with SETTY (U) limited while the process for procurement and installation of Procurement of ten (10) Desktops and nine (9) laptops for key customer care system was initiated. LPOs for staffs, supply and delivery of; Network Heavy duty printer/photocopier, Desktop computers and Procurement of one heavy duty photocopier, printer and UPS APC SMART 2000VA LCD 230V for the conference room issued and Installation of LAN to connect the UCI main to radiotherapy, currently pending delivery

P Total Output Cost(Ushs Thousand) 898,000 56,747 0

Gou Dev¶t: 898,000 56,747 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 57 77 Purchase of Specialised Machinery & Equipment

Assortment of equipment and utensils for Kitchen services The Ultra sound equipment was supplied by procured, 100 seater capacity tent and chairs procured Medequip, delivered and installed. kitchen equip were supplied, procurement of Tables, chairs, curtains and benches for outreach services mammography equipment is at evaluation procured, stage, procurement of physiotherapy equipment was initiated, LPOs for supply of; 28 colour A digital Mammography machine, A heavy duty Ultrasound coded refuse bins and 20 oxygen concetrators machine with fou were issued to successful supply bidders, LPO for supply of flags and stands was issued Total Output Cost(Ushs Thousand) 2,580,000 546,321 0

Gou Dev¶t: 2,580,000 546,321 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1345 ADB Support to UCI

Output: 08 57 72 Government Buildings and Administrative Infrastructure

Development of structural designs for the multipurpose Contract for structural designs and supervision Current occupants of land where the multipurpose building contracted. of construction of multipurpose building building will be housed relocated Capital works and related activties for the project monitored drafted and submitted to the bank for Multipurpose building for the East Africa consideration Oncology Institute Constructed Structural designs for the Multipurpose building developed and construction supervised Total Output Cost(Ushs Thousand) 10,600,935 0 22,067,420

Gou Dev¶t: 626,168 0 712,000

Ext Fin: 9,974,768 0 21,355,420

A.I.A: 0 0 0

Output: 08 57 76 Purchase of Office and ICT Equipment, including Software

Mayuge Connected to UCI (data and voice) Office furniture was procured and installed for Assorted ICT Equipment for Training and operationalizetion of the project offices Telemedicine procured and installed Total Output Cost(Ushs Thousand) 195,000 0 934,560

Gou Dev¶t: 0 0 0

Ext Fin: 195,000 0 934,560

32 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

A.I.A: 0 0 0

Output: 08 57 77 Purchase of Specialised Machinery & Equipment

Equipment Mayuge and Arua satellite Cancer centers procured specifications were developed and submitted to Assorted medical Equipment for Outreach Centres the Bank for no objection (Arua & Mayuge) procured, supplied and installed in the two cancer centres Total Output Cost(Ushs Thousand) 2,974,073 0 1,872,000

Gou Dev¶t: 0 0 0

Ext Fin: 2,974,073 0 1,872,000

A.I.A: 0 0 0

Development Project : 1476 Institutional Support to Uganda Cancer Institute

Output: 08 57 77 Purchase of Specialised Machinery & Equipment

Blood bank refrigerator (80m), Centrifuge (35 m), Heavy duty generator (245 m), Ward file trolleys (15m), file trolleys for patient files (2.1 m), Micro- Laryngoscopy scope (150 m) One 40.ft Container (56 m), 4 box trolleys (8 m), 30 padlocks (2.7 m), 2 ladders (1.4 m), 20 plastic pallets (4 m), 20 wooden pallets (3.4 m) & Fleet Requirements(Tires and Batteries Purchased Sterilizer/ autoclave, digital colposcopes (2), LEEP machines (2), Cryotherapy equipments (2), Coldcoagulators (2), Brachytherapy Applicators procured Total Output Cost(Ushs Thousand) 0 0 897,000

Gou Dev¶t: 0 0 897,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 57 Cancer Services Output: 08 5701 Cancer Research Change in Allocation (UShs Bn) : 1.081 Additional funds to enhance research at UCI

Output: 08 5719 Human Resource Management Services Change in Allocation (UShs Bn) : 3.715 Additional wage for additional recruitment to improve service delivery and research activities

Output: 08 5772 Government Buildings and Administrative Infrastructure Change in Allocation (UShs Bn) : 15.741 Constructional purposes for ADB supported project structure, support areas for radiotherapy bunkers and construction of bunkers Output: 08 5777 Purchase of Specialised Machinery & Equipment

33 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Change in Allocation (UShs Bn) : -2.785 Operationalization of the Bunkers and construction of the multipurpose for ADB supported building

Output: 08 5784 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 0.100 Face uplift of the OPD to create more clinical rooms and chemotherapy administration areas

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Problem of under-staffing arising form a low wage bill for the Institute mainly for key cadres and outdated staff structure

Plans to improve Vote Performance

Increasing collaborations with partners to improve cancer services Restructuring the institute activities Continue pursuing the finalization of the UCI Act with assenting by president

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Non-discrimination of HIV patients during service delivery band stigma of positive staffs Issue of Concern : Unequaled service provision topatients especially those with HIV associated cancers and stigma for staffs who are positive living Planned Interventions : Non-discrimination of patients with HIV associated cancers. Budget Allocation (Billion) : 0.030 Performance Indicators: Number of patients with HIV associated cancers. Issue Type: Gender

Objective : Non-discrimination in service delivery to all genders including sex and age Issue of Concern : Inequitable receipt of cancer services by patients Planned Interventions : equitable provision of cancer services to patients of all sexes and ages Budget Allocation (Billion) : 0.040 Performance Indicators: percentage of patients by sex and age Issue Type: Enviroment

Objective : Improper disposal of bio-waste leading to environmental pollution Issue of Concern : poor disposal of bio-waste arising from cancer care services and investigations Planned Interventions : Improved bio-waste disposal and management

34 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Budget Allocation (Billion) : 0.120 Performance Indicators: percentage of bio-waste not disposed of properly

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 1.860

Total 0.000 0.000 1.860

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Assistant Security Officer 0 6 6 6 U6 386,972 0 4,643,664 lower BIOSTATISTICIAN 1 1 1 2 U4 1,320,107 1,320,107 15,841,284 (SC) Cancer Registrar 0 1 1 1 U4 817,267 0 9,807,204

CONSULTANT 1 7 4 8 U1E 3,065,630 3,065,630 36,787,560 (SC) Counselor 0 2 2 2 U4 Sc 1,089,533 0 13,074,396

DARKROOM ATTENDANT 1 1 1 2 U8-SC 354,334 354,334 4,252,008

DISPENSER 3 1 1 4 U5-SC 924,091 2,772,273 11,089,092

DRIVER 3 1 1 4 U8-UP 299,859 899,577 3,598,308

Economist 0 1 1 1 U4 Up 798,667 0 9,584,004

Health Educator 2 2 0 4 U4 SC 1,238,733 2,477,466 14,864,796

ICT Technician 0 1 1 1 U4 Up 798,667 0 9,584,004

Information Scientist 0 1 1 1 U5 Sc 625,067 0 7,500,804

Logistics Officer 0 3 1 3 U5 447,080 0 5,364,960 lower MEDICAL OFFICER 8 10 10 18 U4 1,320,107 10,560,856 15,841,284 (SC) MEDICAL OFFICER SPECIAL 7 5 5 12 U2-SC 2,463,611 17,245,277 29,563,332 GRADE PERSONAL SECRETARY 0 3 3 3 U4- 745,816 0 8,949,792 LWR PHYSIOTHERAPIST 1 1 1 2 U5-SC 924,091 924,091 11,089,092

Principal Nursing Officer 1 3 3 4 U3 SC 1,460,240 1,460,240 17,522,880

Principal Pharmacist 0 1 1 1 U2 SC 1,728,187 0 20,738,244

PRINCIPAL RADIOGRAPHER 1 2 2 3 U3SC 1,885,742 1,885,742 22,628,904

RADIOGRAPHER 2 1 1 3 U5-SC 898,337 1,796,674 10,780,044

Radiophysicist 0 2 2 2 U4 Sc 1,089,533 0 13,074,396

35 Uganda Cancer Institute Ministerial Policy Statement

Vote:114 Uganda Cancer Institute

Senior Anesthetic Officer 0 1 1 1 U4 Sc 1,089,533 0 13,074,396

Senior Biostatistician 0 1 1 1 U3 Sc 1,204,288 0 14,451,456

Senior Consultant 0 3 3 3 U1SE 3,447,065 0 41,364,780

Senior Economist 0 1 1 1 U3 Up 1,131,209 0 13,574,508

Senior Health Educator 0 1 1 1 U4 Sc 1,089,533 0 13,074,396

SENIOR MEDICAL PHYSICIST 0 1 1 1 U3-SC 1,885,742 0 22,628,904

SENIOR NURSING OFFICER 7 9 9 16 U4 1,320,107 9,240,749 15,841,284 (SC) Senior nutritionist 0 1 1 1 U3 SC 1,204,288 0 14,451,456

Senior Pharmacist 0 1 1 1 U3 SC 1,204,288 0 14,451,456

Senior physiotherapist 0 1 1 1 U3 SC 1,204,288 0 14,451,456

Surgeon 0 3 3 3 U4 Sc 1,175,632 0 14,107,584

Vote Total 38 79 72 117 40,637,644 0 487,651,728

36 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

V1: Vote Overview (i) Vote Mission Statement The Uganda Heart institute Exists to serve as a centre of excellence for the provision of comprehensive medical services to patients with cardiovascular and thoracic disease and to offer opportunity for research and training in cardiovascular and thoracic medicine at an affordable cost so as to facilitate service delivery and enable continuous development of the Institute in itself

(ii) Strategic Objective To provide the necessary infrastructure for comprehensive clinical care, teaching/training, research and visiting faculty which are all necessary to enable the Institute exercise its mandate as a centre of Excellency which can reverse the trend of referrals. (iii) Major Achievements in 2016/17

HEART RESEARCH Out Put 085801 5 Proposals were done 5 Publications done HEART CARE Out Put 085802 32 open Heart surgeries performed 171 closed heart surgeries performed 4980 ECHO¶s performed 4172 ECG¶s performed

415 patients admitted in the General Ward $WWHQGWRSDWLHQWVLQ&&8,&8 6565 outpatients were attended 13899 laboratory contacts attended Procure Assorted Surgical, Laboratory and cath-lab sundries and consumables

HEART OUT REACH SERVICES Out Put 085803 8 Regional Referral Hospitals visited 60 specialist groups visited Capital Development Performance Procured a Station wagon and 2 double cabin vehicles for UHI activities have been delivered. Procurement process for one double cabin at final stages(UGX 0.504bn).

37 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Procured assorted medical machinery and equipment for wards, theatre, cath-lab, ICU/CCU and the Outpatient Department(UGX 1.53bn) Procured assorted ICT equipment; 15 desk top computers, 15 UPS¶s, 2 mother boards, 1 laptop (UGX 0.20bn) Assorted Office furniture procured; 4 Secretariat chairs procured, 30 conference tables procured, 28 Conference chairs procured, 25 staff chairs procured, 13 office cabinets procured, 8 office safes procured, 15 Metallic office cabinets procured, 2 book cages procured , (door mats, shredders and Air conditioners procured(UGX 0.159bn) First draft for the 10 years strategic plan produced and the process for the final document ongoing (UGX 0.04bn)

(iv) Medium Term Plans 1. Consolidate the valve and Coronary bypass surgery 2. Increase cardiac intervention by including three vessel disease

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 1.737 2.835 0.912 2.835 2.977 3.126 3.282 3.446 Non Wage 4.495 4.463 2.039 4.702 5.642 6.207 7.138 7.138

Devt. GoU 3.629 4.500 2.433 4.500 5.850 7.020 8.424 8.424 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 9.861 11.798 5.384 12.037 14.469 16.352 18.843 19.007 Total GoU+Ext Fin (MTEF) 9.861 11.798 5.384 12.037 14.469 16.352 18.843 19.007 Arrears 0.135 0.000 0.000 0.084 0.000 0.000 0.000 0.000 Total Budget 9.996 11.798 5.384 12.120 14.469 16.352 18.843 19.007 A.I.A Total 2.861 6.000 1.884 6.000 6.500 7.000 7.500 8.000 Grand Total 12.858 17.798 7.268 18.120 20.969 23.352 26.343 27.007 Total Vote Budget 12.723 17.798 7.268 18.037 20.969 23.352 26.343 27.007 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates

38 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 7.298 0.000 6.000 13.298 7.537 0.000 6.000 13.537

211 Wages and Salaries 3.016 0.000 1.329 4.344 3.016 0.000 1.149 4.164

212 Social Contributions 0.015 0.000 0.100 0.115 0.077 0.000 0.080 0.157

213 Other Employee Costs 0.032 0.000 0.029 0.061 0.210 0.000 0.029 0.239

221 General Expenses 0.597 0.000 0.598 1.195 0.612 0.000 0.599 1.211

222 Communications 0.102 0.000 0.095 0.197 0.100 0.000 0.095 0.195

223 Utility and Property Expenses 0.208 0.000 0.110 0.318 0.215 0.000 0.110 0.325

224 Supplies and Services 0.131 0.000 2.430 2.561 0.134 0.000 2.130 2.264

225 Professional Services 2.280 0.000 0.800 3.080 2.239 0.000 1.300 3.539

226 Insurances and Licenses 0.050 0.000 0.000 0.050 0.050 0.000 0.000 0.050

227 Travel and Transport 0.175 0.000 0.379 0.554 0.198 0.000 0.380 0.578

228 Maintenance 0.691 0.000 0.130 0.821 0.685 0.000 0.130 0.815

Output Class : Capital Purchases 4.500 0.000 0.000 4.500 4.500 0.000 0.000 4.500

281 Property expenses other than interest 0.400 0.000 0.000 0.400 0.000 0.000 0.000 0.000

312 FIXED ASSETS 4.100 0.000 0.000 4.100 4.500 0.000 0.000 4.500

Output Class : Arrears 0.000 0.000 0.000 0.000 0.084 0.000 0.000 0.084

321 DOMESTIC 0.000 0.000 0.000 0.000 0.084 0.000 0.000 0.084

Grand Total : 11.798 0.000 6.000 17.798 12.120 0.000 6.000 18.120

Total excluding Arrears 11.798 0.000 6.000 17.798 12.037 0.000 6.000 18.037

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 58 Heart Services 9.996 17.798 5.384 18.120 20.969 23.352 26.343 27.007

01 Management 0.927 6.730 1.071 6.470 8.005 8.477 8.811 8.696

02 Medical Services 5.428 6.549 1.875 7.131 7.077 7.803 9.051 9.820

03 Internal Audit 0.012 0.018 0.006 0.020 0.038 0.052 0.057 0.068

1121 Uganda Heart Institute Project 3.629 4.500 2.433 4.500 5.850 7.020 8.424 8.424

Total for the Vote 9.996 17.798 5.384 18.120 20.969 23.352 26.343 27.007

Total Excluding Arrears 9.861 17.798 5.384 18.037 20.969 23.352 26.343 27.007

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

39 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Programme : 58 Heart Services Programme Objective : a)Offer diagnostic services in cardiovascular and thoracic diseases.

b)Provide treatment for patients with cardiovascular and thoracic diseases in both medical and surgical.

c)Carry out research in cardiovascular and thoracic disease in Uganda.

d)Offer training in cardiovascular and thoracic medicine

e)Offer community with Health education and create awareness in Cardiovascular, thoracic and other related diseases.

Responsible Officer: Dr. Omagino O.O. John Programme Outcome: Quality and accessible Heart Services Sector Outcomes contributed to by the Programme Outcome 1. Competitive healthcare centres of excellence Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Annual(%) decrease in number of referrals for heart 40% 30% 20% conditions abroad; Proportion of patients in need of cardiac surgery operated SubProgramme: 02 Medical Services Output: 02 Heart Care Services No. of heart operations 100 120 150

No. of Outpatients 20000 20100 20300

No. of Thoracic and Closed Heart Operations 600 700 750

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 115 Uganda Heart Institute

Program : 08 58 Heart Services

Development Project : 1121 Uganda Heart Institute Project

Output: 08 58 75 Purchase of Motor Vehicles and Other Transport Equipment

3 double cabin vehicles for the Directo, Accounts and other Motorvehicle for the Director delivered and departments procured. paid, 3 double cabins being assembled and ready for delivery and payment Tax for motor vehicle importation Total Output Cost(Ushs Thousand) 620,000 503,874 0

40 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Gou Dev¶t: 620,000 503,874 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 58 76 Purchase of Office and ICT Equipment, including Software

10 Computers and 5 laptops procured 15 desk top computers, 15 UPS, 1 Laptop, 2 Procurement of ICT equipment: 5 desktop Mother boards, 1 rack saver delivered and paid computers, 5 laptops, 10 UPS, 5 Tablets, 5 LCD UPS procured. screens and Queue Management system.

5 Scanners and printers Soft ware for Records Television, decorder, paediatric mats with cartoons and other accesories for Paed cardiology procured.

Other ICT Equipment. Security gadgets and CCTV upgra Total Output Cost(Ushs Thousand) 800,000 197,451 150,000

Gou Dev¶t: 800,000 197,451 150,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 58 77 Purchase of Specialised Machinery & Equipment

Assorted specialised surgical instruments, procedural Spirometers for physiotherapy procured, 1 1 Clinical chemical Analyser, 1 Echo machine instruments, machinery and equipment procured Oxygen analyser procured, 1 TEE Probe Heavy Duty, 25 Infusion pumps, 4 Blood procured (108M), 2 Ventilator machines and 1 analysers, 1 Vital sign machine, 2 Stress test -Cath-lab, adult and Paed cardiology, laboratoty, Perfusion, Transport Ventilator procured (302M),1 ECG machine, 1 Heat exchanger machine, 1 Centrifuge, Phisiotherapy and Anaesthesia deparments assorted specialised machine 1 Pace Maker Programmer, 2 Blood Gas Analyser, equipment and machinery procu 1 Ventilator, 2 Cell Savor, Total Output Cost(Ushs Thousand) 2,480,000 1,533,099 4,200,000

Gou Dev¶t: 2,480,000 1,533,099 4,200,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 58 Heart Services Output: 08 5876 Purchase of Office and ICT Equipment, including Software Change in Allocation (UShs Bn) : -0.650 .Funds have been allocated to priority area of procurement of specialised machinery and equipment

Output: 08 5877 Purchase of Specialised Machinery & Equipment Change in Allocation (UShs Bn) : 1.720 The Institute's objective is reducing referrals abroad thus an increament in the procurement of specialised machinery

Output: 08 5878 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : -0.050 There was reduction in the out put because currently the Institutes priority is equipping in order to achieve the the objective of reduction in referrals abroad

41 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

1. Inadequate budget for superspecialised medicines, sundries and supplies 2. Inadequate space for clinical, teaching and research 3. Superspecialised skills gaps 4. Poor terms and conditions for attraction and retention of Super specialists Plans to improve Vote Performance

1. Look for alternative funding through grants, donations, collaborations and Public Private Partnership 2. Submitted the proposal for the construction of a Home to Ministry of Finance Planning and Economic Development for financing. Designs and BoQ for the construction is in place and the necessary approvals such as environmental impact assessments are all approved. The project now awaits funding. 3. Proposal was submitted to the Ministry of Finance Planning and Economic Development for super specialist support for a period of 3 years. In addition 12 specialist are undergoing specialist training abroad. The Uganda Heart Institute has also taken a robust fellowship training program for super specialist. 4. Expedite the appointment of Board to set the terms and conditions of service for the super specialist at the Uganda Heart Institute

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : 1. Enhanced HIV/AIDS Prevention by ensuring measures are in place to control spread to both staff and patients. 2. Ensure mechanisms are in place for positive living for staff Issue of Concern : Accidental injuries (needle or instrument pricks) Planned Interventions : 1. To be able to give staff protective gear. 2. To be able to screen and establish the status of those injured at work. 3. Provide prophylactic treatment for the sero-negative and full treatment for the positive. Budget Allocation (Billion) : 0.050 Performance Indicators: Performance Indicator: Availability of protective gear, testing kits and arrangements with Mulago Hospital and related partners for HIV/AIDS care Issue Type: Gender

Objective : 1. Heart services are offered regardless of age or gender to all patients in need. 2. To Encourage more male to join cardiac nursing super speciality. Issue of Concern : 1. Maternity leave which affects mostly the nursing division. 2. Gender imbalance in the cardiac nursing division. 3. Accessibility of Heart care services Planned Interventions : 1. Encouraging recruitment of some male cardiac nurses to fill the gap and creating room for breastfeeding mothers (staff). 2. Ensure access of Heart care services to all regardless of gender and age Budget Allocation (Billion) : 0.100 Performance Indicators: 1. Number of male nurses recruited. 2. Room available. 3. Percentage of the various categories of the community accessing Heart care services

42 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Issue Type: Enviroment

Objective : To ensure that medical waste is disposed off in an enviromentaly friendly manner and in line with the guidelines. Issue of Concern : Disposal of medical waste to be done in an environmentally friendly manner Planned Interventions : 1. Segregation of medical waste, recyclable and non-recyclable waste. 2. Procurement of appropriate disposal collection bags for each of the categories and ensure appropriate disposal. 3. Introduction of e-system Budget Allocation (Billion) : 0.500 Performance Indicators: 1. Availability of the various different colour of the collection bins 2.Availability of computers with appropriate software. Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Sale of drugs 0.000 1.853 0.000

Other Fees and Charges 0.000 0.000 6.000

Total 0.000 1.853 6.000

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Biomedical Engineer 0 1 0 1 U4 0 0 0

BIOMEDICAL TECHNICIAN 1 1 0 2 U5 769,542 769,542 9,234,504

Cardio Respiratory Physiotherapist 1 1 0 2 U5 0 0 0

Consultant Cardiac Anaesthesia 0 1 0 1 U1SE 0 0 0

Consultant Cardiac Intensivist 0 1 0 1 U1SE 0 0 0

Consultant Cardiothoraic Surgeon 2 2 0 4 U1SE 3,065,630 6,131,260 36,787,560

Laboratory Technologist 3 1 0 4 U4 0 0 0

Medical Officer 14 2 0 16 U4 1,322,163 18,510,282 15,865,956

Medical Officer Special Grade - Cardiac 0 2 0 2 U2 0 0 0 Anaesthesia Medical Officer Special Grade - Cardiac 0 1 0 1 U2 0 0 0 Intensivist MEDICAL OFFICER SPECIAL 2 1 0 3 U4 1,320,107 2,640,214 15,841,284 GRADE PAEDIATRIC CARDIOLOGY Nursing Officer 27 3 0 30 U4 1,874,720 50,617,440 22,496,640

NURSING OFFICER SPECIAL 10 6 0 16 U4 1,276,442 12,764,420 15,317,304 GRADE Principal Nursing Officer 1 1 0 2 U3 0 0 0

Security Guard 1 1 0 2 U8 0 0 0

43 Uganda Heart Institute Ministerial Policy Statement

Vote:115 Uganda Heart Institute

Senior Internal Auditor 0 1 0 1 U3 0 0 0

Senior Perfusionist Officer 0 1 0 1 U4 1,321,283 0 15,855,396

Vote Total 62 27 0 89 10,949,887 0 131,398,644

44 National Medical Stores Ministerial Policy Statement

Vote:116 National Medical Stores

V1: Vote Overview (i) Vote Mission Statement To effectively and efficiently supply Essential medicines and medical supplies to Public health facilities in Uganda.

(ii) Strategic Objective a. Procure, warehouse and distribute Essential medicines and health supplies to all public health facilities b. Maximise value offering to our customers. c. Strengthen management efficiency and effectiveness for improved service delivery. d. Enhance innovations for efficient service delivery. e. Broaden and sustain the resource base of corporation. f. Enhance organisational capacity for sustainable operations and growth of National Medical Stores. g. Strengthen partnerships and collaborations for improved stakeholder engagement.

(iii) Major Achievements in 2016/17 7KH&RUSRUDWLRQKDGUHFHLYHGDQGVSHQWVKV181ELOOLRQE\WKH(QGRI'HFHPEHU2016. This is 76.2 % of the appropriated budget of medicines and health supplies of shs 237.96ELOOLRQ7KHUHOHDVHZDVLQDFFRUGDQFHWROHYHOVRIFDUHIURP+HDOWKFHQWUH 11(Shs11.16 billion);Health centre iii(Shs 16.86);Health Centre iv(Shs 6.99 billion);General Hospitals (Shs 9.73 billion);Regional Referral Hospitals(Shs 11.52 billion);National Referral Hospitals(Shs11.37 billion);ACTS,ARVS and Anti-TB drugs (Shs 68 billion);Specialised Units(UBTS,UHI,UCI) (Shs16.10 billion);Emergency and donated items(Shs 1 billion);Reproductive health items(Shs 6.51 billion);Immunisation supplies including Hepatitis B Vaccine (Shs 17 billion);Laboratory items(Shs 4.98 billion) The procurement, storage and distribution of the medicines and health supplies was in adherence to the objective of strengthening mechanism for quality effective and efficient service delivery. (iv) Medium Term Plans

The vote performance will be improved through better planning and execution with an all-inclusive seamless Enterprise Resource Planning (ERP) whose procurement is underway.

The newly created monitoring and Evaluation section under the clients¶management department will help in the regular monitoring of health facilities without drug stock outs for the 41 tracer medicines in the previous 3 months as well as the proportion of medicines and supplies procured and distributed against the consolidated procurement plan.

Plans to engage more with stakeholders who are involved in the supply chain for medicines and medical supplies have been drawn through implementation of stakeholder management strategy. Efforts toprepare and reviewprocurement plans with the health facilitiesa key factor in getting procurement plans rightas well as a corner stone in the efficient and effective delivery of medicines and medical supplies. The innovation of Commodity Management Platform will improve on the alignment of facility orders with the procurement plans and also help in monitoring of facility budgets. Another two Regional offices were opened in West Nile (Arua) and Karamojong (Moroto) to improve service delivery in these regions. Better communication and liaison with stakeholders will inform better service delivery. Published delivery schedules done at the beginning of the financial year as the promise of delivery to health facilities and adherence to the schedule is of paramount importance in service realisation.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections

45 National Medical Stores Ministerial Policy Statement

Vote:116 National Medical Stores

2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Non Wage 218.614 237.964 181.225 237.964 285.557 314.113 361.230 361.230

Devt. GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 218.614 237.964 181.225 237.964 285.557 314.113 361.230 361.230 Total GoU+Ext Fin (MTEF) 218.614 237.964 181.225 237.964 285.557 314.113 361.230 361.230 Arrears 0.000 0.000 0.000 20.110 0.000 0.000 0.000 0.000 Total Budget 218.614 237.964 181.225 258.075 285.557 314.113 361.230 361.230 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 218.614 237.964 181.225 258.075 285.557 314.113 361.230 361.230 Total Vote Budget 218.614 237.964 181.225 237.964 285.557 314.113 361.230 361.230 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 237.964 0.000 0.000 237.964 237.964 0.000 0.000 237.964

224 Supplies and Services 237.964 0.000 0.000 237.964 237.964 0.000 0.000 237.964

Output Class : Arrears 0.000 0.000 0.000 0.000 20.110 0.000 0.000 20.110

321 DOMESTIC 0.000 0.000 0.000 0.000 20.110 0.000 0.000 20.110

Grand Total : 237.964 0.000 0.000 237.964 258.075 0.000 0.000 258.075

Total excluding Arrears 237.964 0.000 0.000 237.964 237.964 0.000 0.000 237.964

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 59 Pharmaceutical and Medical 218.614 237.964 181.225 258.075 285.557 314.113 361.230 361.230 Supplies 01 Pharmaceuticals and Other Health Supplies 218.614 237.964 181.225 258.075 285.557 314.113 361.230 361.230

Total for the Vote 218.614 237.964 181.225 258.075 285.557 314.113 361.230 361.230

Total Excluding Arrears 218.614 237.964 181.225 237.964 285.557 314.113 361.230 361.230

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

46 National Medical Stores Ministerial Policy Statement

Vote:116 National Medical Stores

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 59 Pharmaceutical and Medical Supplies Programme Objective : To provide supplies of medicines and other pharmaceutical supplies to the Ugandan Population Responsible Officer: Mr. Moses Kamabare Programme Outcome: Quality and accessible medicines, equipment and other health supplies Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of health facilities without drug stock out for 237.964 261.761 287.937 41 tracer medicines in previous 3 months; Proportion of medicines and supplies procured and distributed against the consolidated procurement plan N/A

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

N/A

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

47 National Medical Stores Ministerial Policy Statement

Vote:116 National Medical Stores

The sustained depreciation of the Uganda Shilling against the USD dollar and other major currencies has caused inflationary pressures and ultimately a rise in the cost of medicines and medical supplies. Majority of suppliers on framework contracts continue to supply in dollars as prescribed in their contracts and thus getting fewer medicines out of the same amount of money in Uganda shillings.The challenges of implementing the guideline to tender in Uganda shillings has discouraged global manufacturers from participating in tenders leaving their agents to quote very prohibitive prices.

There is need to avail a budget for Laboratory items, (shs 50 billion) to fill up gaps created by withdraw of funding by PEPFAR. Beds and mattresses (shs 30 billion) to procure beds and mattresses for all health facilities. Medical stationery has been estimated at (shs 2 billion) .This is required by all health facilities for proper information capture. More funds (shs 100 billion) to be availed towards procurement of ARVS to cater for the increase of patients to be put on ARTS in relation to the test and treat policy. There is a funding gap for maama kits of approximately shs16 billion. Anti Malaria drugs require shs 40 billion to cover the planned malaria treatment.Provision of approximately shs 500million for incineration of non viable stock will unclutter the health facilities stores and improve stores management. Availability of these items is a game changer in the Health sector's service delivery and a step towards strengthening mechanism for quality effective and efficient service delivery.

Plans to improve Vote Performance

The vote performance will be improved through better planning and execution with an all-inclusive seamless Enterprise Resource Planning (ERP) whose procurement is underway.This will cover the inbound and outbound along the medicines and health supplies supply chain.

The newly created monitoring and Evaluation section under the clients¶management department will help in the regular monitoring of health facilities without drug stock outs for the 41 tracer medicines in the previous 3 months as well as the proportion of medicines and supplies procured and distributed against the consolidated procurement plan.

Plans to engage more with stakeholders who are involved in the supply chain for medicines and medical supplies have been drawn through implementation of stakeholder management strategy. Efforts toprepare and reviewprocurement plans with the health facilitiesa key factor in getting procurement plans rightas well as a corner stone in the efficient and effective delivery of medicines and medical supplies. The innovation of Commodity Management Platform will improve on the alignment of facility orders with the procurement plans and also help in monitoring of facility budgets. Another two Regional offices were opened in West Nile (Arua) and Karamojong (Moroto) to improve service delivery in these regions. Better communication and liaison with stakeholders will inform better service delivery. Published delivery schedules done at the beginning of the financial year as the promise of delivery to health facilities and adherence to the schedule is of paramount importance in service realisation.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To avail ARVS to patients to the extent of funds availability to avert the HIV/Aids scourge.The lowering of ART accredited centres from HC IV to HCIII will enable increased accesibility.Implementation of the test and treat policy will buttress the efforts towards HIV/AIDS prevelance. Issue of Concern : Medicines and medical supplies budget is sufficient to cover the intended lowering of ART centers to accommodate more patients. Planned Interventions : ARVs worth 94 billion procured stored and delivered to accredited centers. Budget Allocation (Billion) : 94.000

48 National Medical Stores Ministerial Policy Statement

Vote:116 National Medical Stores

Performance Indicators: Increase number of patients on ARTS by getting them early on treatment this will be enhanced by availing health centres with more 300 CD4 count machines. Table 11.2: AIA Collections

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

49 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

V1: Vote Overview (i) Vote Mission Statement The Mission of the Health Service Commission is:

To build a fundamentally strong and competent human resource base for efficient and effective health services delivery.

(ii) Strategic Objective

The strategic objectives of the Commission are to:



1) Provide timely advice to H.E. the President and Government on matters relating to the state of the Health service as mandated by the law.



2) Recruit in efficient and effective manner health workers to meet Uganda citizens? health needs in accordance with the goals of the Health Sector Policy and Development Plan 2015/16-2019/20.



3) Carry out advocacy and make recommendations to improve the terms and conditions of service of the health workforce.



4) Enhance the institutional capacity of the Health Service Commission to deliver on its mandate.

(iii) Major Achievements in 2016/17

50 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

1. The Commission Ran Adverts 1, 2, 3, 4, 5, 6 and PEPFAR between November and December 2016. Short listing was done and interviewing on-going under Q3 2. Secretariat staff and members¶salaries paid and statutory allowances for the 7 members of the Commission. Paid for the utilities and other goods and services consumed by the Commission. 3. Support supervision to 22 Districts/Districts Service Commissions, 7 RRHs carried out. Technical Support Supervision to DSCs, Central Government Health Institutions and Departments under. 4. 438 Human Resource for Health Decisions processed of confirmation in appointment, corrigenda, redesignation, study leave, interdictions, abscondments and Retirement. 5. Support Supervision carried out in 44 Districts and 7 RRHs LQFOXGLQJPHQWRULQJFRDFKLQJRI'6&VDQG+5 Officers, sharing best HRH Management practices and building capacity of DSCs to mentor managers within their jurisdiction. 6. Provided technical input on the revised schemes of service for nursing and midwifery cadre. 7. Provided technical input on the Uganda Medical Internship guidelines. 8. Recruitment Analysis report for FY 2015/16. 9. Joint Recruitment Planning Workshop for the Recruitment of Health Workers under the jurisdiction of the Commission held. 10. Preparation of Job descriptions initiated. 11. Retreat for Members of the Commission was held. 12. E-recruitment System design completed.

(iv) Medium Term Plans

51 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

(i)Recruit health workers (Male and Female) of all categories for MoH Headquarters, Mulago National Referral Hospital, Butabika National Referral Mental (BNRMH) Hospital, Kampala Capital City Authority (KCCA), Regional Referral +RVSLWDOV 55+V 6SHFLDOL]HGHealth Institutions, QDPHO\8JDQGD+HDUWInstitute (UHI), Uganda Cancer Institute (UCI), Uganda Blood Transfusion Services (UBTS) and Uganda Prisons Health Services.

(ii)Process Human Resource for Health decisions on confirmation, corrigenda, redesignation and study leave undertaken and disciplinary controls H[HUFLVHG

(iii)Support Supervision in 84 Districts, 14 Regional Referral Hospitals and five (5) National Health Institutions and KCCA Health Units carried out.

(iv)Provide Technical Support Supervision to DSCs, Central Government Health Institutions and Departments under the jurisdiction of HSC on HRH issues.

(v)Carry Performance career enhancement training (Gender and equity inclusive) for Members and staff of the Health Service Commission.

(vi)Carry Monitoring and Evaluation and Research on human Resource for health.

(vii)Implementation of the e-recruitment information system and operationalization of the HSC Selections and Examinations Department.

(viii)Health Service Commission 3rd 5-Year Strategic Plan 2015/16 to 2019/20 disseminated.

(ix)Two (2) Vehicles and Office Chairs procured and offices reorganized

(x)The HSC HIV/AIDS Workplace Policy implemented.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 0.862 1.189 0.550 1.359 1.426 1.498 1.573 1.651 Non Wage 3.312 3.502 1.455 3.831 4.597 5.056 5.815 5.815

Devt. GoU 0.447 0.447 0.002 0.263 0.342 0.411 0.493 0.493

52 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 4.621 5.138 2.007 5.453 6.366 6.965 7.881 7.959 Total GoU+Ext Fin (MTEF) 4.621 5.138 2.007 5.453 6.366 6.965 7.881 7.959 Arrears 0.000 0.126 0.127 0.000 0.000 0.000 0.000 0.000 Total Budget 4.621 5.264 2.133 5.453 6.366 6.965 7.881 7.959 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 4.621 5.264 2.133 5.453 6.366 6.965 7.881 7.959 Total Vote Budget 4.621 5.138 2.007 5.453 6.366 6.965 7.881 7.959 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.691 0.000 0.000 4.691 5.189 0.000 0.000 5.189

211 Wages and Salaries 1.797 0.000 0.000 1.797 1.912 0.000 0.000 1.912

212 Social Contributions 0.110 0.000 0.000 0.110 0.247 0.000 0.000 0.247

213 Other Employee Costs 0.323 0.000 0.000 0.323 0.678 0.000 0.000 0.678

221 General Expenses 0.976 0.000 0.000 0.976 0.947 0.000 0.000 0.947

222 Communications 0.036 0.000 0.000 0.036 0.024 0.000 0.000 0.024

223 Utility and Property Expenses 0.736 0.000 0.000 0.736 0.782 0.000 0.000 0.782

225 Professional Services 0.040 0.000 0.000 0.040 0.040 0.000 0.000 0.040

227 Travel and Transport 0.455 0.000 0.000 0.455 0.394 0.000 0.000 0.394

228 Maintenance 0.218 0.000 0.000 0.218 0.166 0.000 0.000 0.166

Output Class : Capital Purchases 0.447 0.000 0.000 0.447 0.263 0.000 0.000 0.263

312 FIXED ASSETS 0.447 0.000 0.000 0.447 0.263 0.000 0.000 0.263

Output Class : Arrears 0.126 0.000 0.000 0.126 0.000 0.000 0.000 0.000

321 DOMESTIC 0.126 0.000 0.000 0.126 0.000 0.000 0.000 0.000

Grand Total : 5.264 0.000 0.000 5.264 5.453 0.000 0.000 5.453

Total excluding Arrears 5.138 0.000 0.000 5.138 5.453 0.000 0.000 5.453

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget

53 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

52 Human Resource Management for 4.621 5.264 2.133 5.453 6.366 6.965 7.881 7.959 Health 01 Finance and Administration 2.822 3.431 1.524 3.993 4.776 5.187 5.829 5.688

02 Human Resource Management 1.335 1.366 0.596 1.154 1.206 1.326 1.518 1.737

03 Internal Audit 0.018 0.021 0.011 0.041 0.041 0.041 0.041 0.041

0365 Health Service Commision 0.447 0.447 0.002 0.263 0.342 0.411 0.493 0.493

Total for the Vote 4.621 5.264 2.133 5.453 6.366 6.965 7.881 7.959

Total Excluding Arrears 4.621 5.138 2.007 5.453 6.366 6.965 7.881 7.959

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 52 Human Resource Management for Health Programme Objective : 7RSURYLGHDVWURQJDQGFRPSHWHQWKXPDQUHVRXUFHVIRUHIILFLHQWDQGHIIHFWLYHKHDOWK services delivery in line with Human Capital development as stated in NDP 11

Responsible Officer: MARY THEOPISTA WENENE Programme Outcome: Improved status of human resources for health in the health service Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of qualified health workers recruited against 100% 100% 100% the annual recruitment plan at national level SubProgramme: 02 Human Resource Management Output: 05 Technical Support and Support Supervision No. of Districts /DSCs provided with Technical 84 84 84 Support and Support Supervision Output: 06 Health Workers Recruitment and Human Resource for Health Management Services No. of Health Workers recruited in Central 800 850 900 Government Health Institutions

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

N/A

54 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 52 Human Resource Management for Health Output: 08 5201 Health Workers Recruitment services Change in Allocation (UShs Bn) : 0.041 Enhancement of Audit budget

Output: 08 5205 Technical Support and Support Supervision Change in Allocation (UShs Bn) : 0.075 Increase in the number of districts

Output: 08 5206 Health Workers Recruitment and Human Resource for Health Management Services Change in Allocation (UShs Bn) : 0.522 Increase in recruitment costs

Output: 08 5275 Purchase of Motor Vehicles and Other Transport Equipment Change in Allocation (UShs Bn) : -0.225 50% budget cut on development budget

Output: 08 5276 Purchase of Office and ICT Equipment, including Software Change in Allocation (UShs Bn) : 0.012 New staff received by the Commission

Output: 08 5278 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : 0.029 New staff and replacement of old furniture

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

55 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

1. Limited office space that is not fit for the purpose.

2. The capacity of the Commission to operationalize its mandate mainly in respect of the small size of the secretariat and limited budget allocation 3. Inadequate budget for monitoring and tracking of the Commissions decisions and implementation.

4. Inadequate, old tools and equipment including but not limited to, furniture, computers and accessories, shelves for registry.

5. Inadequate office space for the Members and staff of the Commission that affects the ambience especially during the interviewing exercise.

6. Delay in seeking and obtaining clearance to fill vacant posts.

7. Delay in submissions for recruitment on replacement basis

8. Inadequate budget to cater for all the activities of the Commission such as; Operationalisation of Examinations and Selections Systems Department, Implementation of E-recruitment/strengthening recruitment systems, Monitoring and tracking of the Commission decisions and implementation, Support Supervion to DSCs, RRHs, and National Referral Hospitals, Tools and equipment including but not limited to, Cabinets, furniture, computers and accessories, shelves for registry.

9)DLOXUHWRDWWUDFW+HDOWK:RUNHUVZLWKVSHFLDOWLHVHVSHFLDOO\IRU5HJLRQDO5HIHUUDO+RVSLWDOVDPRQJWKHP Pathologists, ENT Surgeons, Orthopaedic Surgeons, Psychiatrists, Radiologists, Anaesthetic Officers

10. Constricted Staff Structures. Across the Health Service, the Staffing Structures are very constricted both in terms of Numbers and Career Progression Opportunities. This implies that Health Workers who deserve to be promoted cannot be promoted leading to demotivation. 11. Inadequate knowledge on Gender and Equity planning and budgeting

Plans to improve Vote Performance

Lobby for increased funding to the HSC Increased Collaboration with Stake holders Operationalise the new structure of theCommission Ensure timely submission of clearances for Recruitment Meet with Institutions in Q1 for recruitment planning. Revision of the Structures for RRHs

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

56 Health Service Commission Ministerial Policy Statement

Vote:134 Health Service Commission

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Mitigate HIV/AIDS infections and ensuring safe living for the infected and affected Issue of Concern : Impact of HIV/AIDS Planned Interventions : Provision of basic care to the infected and affected Budget Allocation (Billion) : 15,000,000.000 Performance Indicators: Number of staff provided with care, 5 Issue Type: Gender

Objective : Adhere to Government policy of equal employment opportunities Issue of Concern : Equity in employment Planned Interventions : Follow order of merit when recruiting and selecting candidates Budget Allocation (Billion) : 20,000,000.000 Performance Indicators: Number of candidates recruited Issue Type: Enviroment

Objective : Efficient management of waste disposal Issue of Concern : Disposal of waste espcially paper Planned Interventions : Disposal bins at strategic points Budget Allocation (Billion) : 5,000,000.000 Performance Indicators: Number of disposal bins

Table 11.2: AIA Collections

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 ASSISTANT COMMISSION HUMAN 2 1 1 3 U1 E 1,690,780 3,381,560 20,289,360 RESOURCE MANAGEMENT DRIVER 8 10 6 18 U8 219,909 1,759,272 2,638,908

PERSONAL SECRETARY 3 1 1 4 U4 601,341 1,804,023 7,216,092

PRINCIPAL HUMAN RESOURCE 2 6 5 8 U2 1,212,620 2,425,240 14,551,440 OFFICER SENIOR HUMAN RESOURCE 3 4 4 7 U3 912,771 2,738,313 10,953,252 OFFICER SENIOR PERSONAL SECRETARY 2 1 1 3 U3 943,990 1,887,980 11,327,880

Vote Total 20 23 18 43 5,581,411 3,381,560 66,976,932

57 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

V1: Vote Overview (i) Vote Mission Statement To provide sufficient and efficacious blood and blood components through voluntary blood donations for appropriate use in health care service delivery.

(ii) Strategic Objective

To make available safe and adequate quantities of blood to all hospitals for the management of patients in need in all health care facilities (iii) Major Achievements in 2016/17 During the first quarter of the FY 2016/17, UBTS in Q1 conducted 542 blood collection sessions, a total of 62,569 blood units were collected against the target of 66,600 (97%) and only 9,900 of the total of blood collected were discarded (2.4%) and In Q2, we were able to collect 57,122 (93.5%) units of blood and 53,409 were issued to health care facilities.. Absorption of new staff to fill UBTS new structure is on going by respective commissions. Staff were trained for the AFSBT accreditation program and Blood Bank Information Safety System. Conducted supervision activities in hospitals for better Transfusion practices in Hospitals Mas education campaigns were done to improve public awareness on blood donation (iv) Medium Term Plans

We intend to implement UBTS objectives: Expand blood transfusion infrastructure to operate adequately within a decentralized health care delivery system; Lobby for funding to construct purpose built Regional Blood Banks in Moroto; Masaka and Arua.

7UDQVIRUPEORRGFROOHFWLRQFHQWHUVLQWREORRGGLVWULEXWLRQFHQWHUVWREULQJVHUYLFHVQHDUHUWRWKHKHDOWKFDUHIDFLOLWLHV0RUH funding for this undertaking will be required since we shall be required to procure blood storage fridges.

Increase annual blood collection necessary to meet the transfusion needs for all patients in need in the country by putting in place additional blood collection teams.

Expand blood transfusion infrastructure to operate adequately within a decentralized health care delivery system; Lobby for funding to construct purpose built Regional Blood Banks in Moroto; Masaka and Arua.

Transform blood collection centers into blood distribution centers to bring services nearer to the health care facilities. More funding for this undertaking will be required since we shall be required to procure blood storage fridges.

Increase annual blood collection necessary to meet the transfusion needs for all patients in need in the country by putting in place additional blood collection teams.

Operate an active nationwide quality assurance program that ensures blood safety- from vein to vein and work towards ISO certification (Accreditation program) which is already underway.

Promote appropriate clinical use of blood in the hospitals by dissemination of the revised clinical guidelines throughout the health care facilities and creation of more hospital transfusion committees to monitor blood use in the health care facilities.  Strengthen the organizational capacity of UBTS to enable efficient and effective service delivery and build on the partnerships to improve service delivery. (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections

58 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.044 2.715 1.076 2.715 2.850 2.993 3.142 3.300 Non Wage 6.355 5.793 2.768 6.553 7.864 8.650 9.948 9.948

Devt. GoU 0.183 0.370 0.034 0.370 0.481 0.577 0.693 0.693 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.583 8.878 3.878 9.638 11.195 12.220 13.783 13.940 Total GoU+Ext Fin (MTEF) 8.583 8.878 3.878 9.638 11.195 12.220 13.783 13.940 Arrears 0.000 0.000 0.000 0.281 0.000 0.000 0.000 0.000 Total Budget 8.583 8.878 3.878 9.918 11.195 12.220 13.783 13.940 A.I.A Total 0.000 0.057 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.583 8.935 3.878 9.918 11.195 12.220 13.783 13.940 Total Vote Budget 8.583 8.935 3.878 9.638 11.195 12.220 13.783 13.940 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 8.508 0.000 0.057 8.565 9.268 0.000 0.000 9.268

211 Wages and Salaries 3.077 0.000 0.000 3.077 3.204 0.000 0.000 3.204

212 Social Contributions 0.048 0.000 0.000 0.048 0.296 0.000 0.000 0.296

213 Other Employee Costs 0.021 0.000 0.000 0.021 0.543 0.000 0.000 0.543

221 General Expenses 1.156 0.000 0.000 1.156 1.141 0.000 0.000 1.141

222 Communications 0.012 0.000 0.000 0.012 0.012 0.000 0.000 0.012

223 Utility and Property Expenses 0.369 0.000 0.000 0.369 0.387 0.000 0.000 0.387

224 Supplies and Services 0.150 0.000 0.000 0.150 0.139 0.000 0.000 0.139

227 Travel and Transport 2.078 0.000 0.000 2.078 2.119 0.000 0.000 2.119

228 Maintenance 1.023 0.000 0.057 1.080 1.023 0.000 0.000 1.023

282 Miscellaneous Other Expenses 0.574 0.000 0.000 0.574 0.404 0.000 0.000 0.404

Output Class : Capital Purchases 0.370 0.000 0.000 0.370 0.370 0.000 0.000 0.370

312 FIXED ASSETS 0.370 0.000 0.000 0.370 0.370 0.000 0.000 0.370

Output Class : Arrears 0.000 0.000 0.000 0.000 0.281 0.000 0.000 0.281

321 DOMESTIC 0.000 0.000 0.000 0.000 0.281 0.000 0.000 0.281

Grand Total : 8.878 0.000 0.057 8.935 9.918 0.000 0.000 9.918

Total excluding Arrears 8.878 0.000 0.057 8.935 9.638 0.000 0.000 9.638

59 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 53 Safe Blood Provision 8.583 8.935 3.878 9.918 11.195 12.220 13.783 13.940

01 Administration 2.999 3.403 1.454 4.394 4.302 4.590 5.250 6.021

02 Regional Blood Banks 5.360 5.121 2.367 5.110 6.363 6.999 7.431 6.373

0242 Uganda Blood Transfusion Service 0.183 0.370 0.034 0.370 0.481 0.577 0.693 0.693

03 Internal Audit 0.040 0.040 0.023 0.044 0.049 0.054 0.409 0.853

Total for the Vote 8.583 8.935 3.878 9.918 11.195 12.220 13.783 13.940

Total Excluding Arrears 8.583 8.935 3.878 9.638 11.195 12.220 13.783 13.940

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 53 Safe Blood Provision Programme Objective : To make available safe and adequate quantities of blood to all hospitals for the management of patients in need in all health care facilities. Responsible Officer: Dr. Dorothy Kyeyune Byabazaire Programme Outcome: Quality and accessible Safe Blood Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Proportion of planned blood units collected 5% 7% 10%

‡Proportion of planned blood units collected 6% 7% 10%

N/A

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

N/A

60 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 53 Safe Blood Provision Output: 08 5301 Adminstrative Support Services Change in Allocation (UShs Bn) : 1.721 Expanded staff structure, allocation to cater for Pension and gratuity , Motor vehicle repairs, maintenance of infrastructure and equipment. Output: 08 5303 Monitoring & Evaluation of Blood Operations Change in Allocation (UShs Bn) : -0.601 To cater for Blood collection operations.

Output: 08 5304 Laboratory Services Change in Allocation (UShs Bn) : -0.214 To cater for increased costs of blood collection and ageing fleet.

Output: 08 5319 Human Resource Managment Services Change in Allocation (UShs Bn) : 0.024 Managing staff pay roll and records management.

Output: 08 5376 Purchase of Office and ICT Equipment, including Software Change in Allocation (UShs Bn) : 0.030 Increased IT requirements and to cater for infrastructure security ( CCTV)

Output: 08 5378 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : -0.030 To Complement for IT requirements.

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

61 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

&KDOOHQJHVDQG8QIXQGHGSULRULWLHV Despite the increase in funding for recurrent expenditure; UBTS has continued to experience a budget shortfall for capital development. UBTS has a funding gap of UGX 16.48 billions (NMS 7.48bn and Operations 7bn): 1&ORVXUHRIWKH3(3)$5SURMHFWLQ0DUFK31st 2016OHIWDEXGJHWGHILFLWRI86'2PLOOLRQ 8*;7.0ELOOLRQ WKDWLVVXSSRVHG to be filled by Government 2$SSURYHGVWUXFWXUHFDQQRWDEVRUEDOO120 project staff whose services are still needed by UBTS. There is need for an DGGLWLRQDOZDJHELOORI8*;873,304,676 per year 3$GGLWLRQDOIXQGLQJWR1DWLRQDO0HGLFDO6WRUHVRI8*;9.48 billion for procurement of medical supplies 4&RQVWUXFWLRQRI2 RBBs in Moroto and Arua ±12 billion 5&RQVWUXFWLRQRIDFHQWUDOL]HGVWRUHDWWKH+HDGTXDUWHUV±2.5 billion 63URFXUHPHQWRIFROGFKDLQHTXLSPHQW EORRGEDQNIULGJHVIUHH]HUVEORRGWUDQVSRUWDWLRQFRROER[HVHWF 5 billion 7,QWHUQDWLRQDO$FFUHGLWDWLRQRI8%76±the process is ongoing but requires additional resources 8/HJLVODWLRQIRUHVWDEOLVKPHQWRI8%76DVDQDXWRQRPRXV%ORRGDQG2UJDQ6XSSO\$XWKRULW\ 9([SHULHQFHIURPRWKHUQHLJKERULQJFRXQWULHVKDVVKRZQWKDWEORRGFROOHFWLRQIURPGULYHVUHTXLUHVDPRELOHEORRGFROOHFWLRQ buses purposely equipped to appropriately store and transport blood - procure at least 4 buses at approximately UgX 1.6 billions. Plans to improve Vote Performance

We have strengthened the Community Resource Persons approach as we scale down on the reliance of schools as our major donors of blood. UBTS will pilot the performance based reward system approach in order to get value for money and improve performance as well as motivation for staff. We hope to create offices in other parts of the country to take services nearer to the people. ie Moroto and Arua

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Total 0.000 0.000 0.000

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Accounts Assistant 4 6 6 10 U7 522,256 2,089,024 6,267,072

Donor Clerk 23 14 14 37 U7 506,342 11,645,866 6,076,104

Lab Technologist 11 3 3 14 U5 898,337 9,881,707 10,780,044

Lab Technician 10 4 4 14 U5 937,360 9,373,600 11,248,320

Nursing Officer 15 22 22 37 U5 911,088 13,666,320 10,933,056

Principal Lab. Technologist 0 1 1 1 U3 1,547,935 0 18,575,220

Senior Nursing Officer 18 5 5 23 U4 1,288,169 23,187,042 15,458,028

Systems Administrator 1 6 6 7 U4 1,248,057 1,248,057 14,976,684

62 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement

Vote:151 Uganda Blood Transfusion Service (UBTS)

Vote Total 82 61 61 143 7,859,544 2,089,024 94,314,528

63 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

V1: Vote Overview (i) Vote Mission Statement To offer state -of -the -art healthcare services

(ii) Strategic Objective

(iii) Major Achievements in 2016/17 75100 admissions 327000 inpatient days 16000 deliveries 325000 outpatients 20451 Emergencies 10703 antenatal attendances 496021 laboratory tests 4910 images (iv) Medium Term Plans 1. Remodeling and rehabilitation of upper Mulago 2. construction of staff houses 3. Streamlining the referral system (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 19.694 22.705 9.675 22.947 24.094 25.299 26.564 27.892 Non Wage 17.340 17.947 8.489 21.612 25.935 28.528 32.808 32.808

Devt. GoU 5.020 22.020 8.182 22.020 28.626 34.351 41.221 41.221 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 42.054 62.672 26.346 66.579 78.655 88.178 100.593 101.921 Total GoU+Ext Fin (MTEF) 42.054 62.672 26.346 66.579 78.655 88.178 100.593 101.921 Arrears 7.175 0.384 0.411 1.255 0.000 0.000 0.000 0.000 Total Budget 49.229 63.056 26.757 67.834 78.655 88.178 100.593 101.921 A.I.A Total 5.658 7.000 6.783 7.000 7.000 9.000 11.000 12.000 Grand Total 54.887 70.056 33.540 74.834 85.655 97.178 111.593 113.921 Total Vote Budget 47.712 69.672 33.128 73.579 85.655 97.178 111.593 113.921 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

64 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 39.054 0.000 6.500 45.554 42.961 0.000 6.500 49.461

211 Wages and Salaries 24.201 0.000 1.373 25.574 24.443 0.000 0.984 25.427

212 Social Contributions 2.067 0.000 0.072 2.140 2.133 0.000 0.062 2.195

213 Other Employee Costs 1.573 0.000 0.150 1.723 1.533 0.000 0.060 1.593

221 General Expenses 3.057 0.000 1.476 4.532 3.097 0.000 1.606 4.702

222 Communications 0.170 0.000 0.000 0.170 0.170 0.000 0.000 0.170

223 Utility and Property Expenses 3.261 0.000 0.000 3.261 6.861 0.000 0.000 6.861

224 Supplies and Services 0.779 0.000 1.007 1.786 0.779 0.000 1.007 1.786

225 Professional Services 0.225 0.000 1.943 2.168 0.225 0.000 2.043 2.268

227 Travel and Transport 0.766 0.000 0.200 0.966 0.766 0.000 0.497 1.263

228 Maintenance 2.955 0.000 0.278 3.234 2.955 0.000 0.241 3.197

Output Class : Outputs Funded 1.598 0.000 0.000 1.598 1.598 0.000 0.000 1.598

263 To other general government units 1.598 0.000 0.000 1.598 1.598 0.000 0.000 1.598

Output Class : Capital Purchases 22.020 0.000 0.500 22.520 22.020 0.000 0.500 22.520

312 FIXED ASSETS 22.020 0.000 0.500 22.520 22.020 0.000 0.500 22.520

Output Class : Arrears 0.384 0.000 0.000 0.384 1.255 0.000 0.000 1.255

321 DOMESTIC 0.384 0.000 0.000 0.384 1.255 0.000 0.000 1.255

Grand Total : 63.056 0.000 7.000 70.056 67.834 0.000 7.000 74.834

Total excluding Arrears 62.672 0.000 7.000 69.672 66.579 0.000 7.000 73.579

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 54 National Referral Hospital Services 49.229 70.056 26.757 74.834 85.655 97.178 111.593 113.921

01 Management 18.689 14.859 6.765 19.371 21.816 14.364 16.464 17.464

02 Medical Services 25.379 32.537 11.794 32.803 34.522 47.772 52.147 52.475

0392 Mulago Hospital Complex 5.020 22.520 8.182 22.520 29.126 34.851 42.721 43.721

04 Internal Audit Department 0.140 0.140 0.015 0.140 0.191 0.191 0.261 0.261

Total for the Vote 49.229 70.056 26.757 74.834 85.655 97.178 111.593 113.921

Total Excluding Arrears 42.054 69.672 26.346 73.579 85.655 97.178 111.593 113.921

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

65 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 54 National Referral Hospital Services Programme Objective : 7RSURYLGH6XSHUVSHFLDOL]HGKHDOWKFDUH6HUYLFHV Responsible Officer: Dr B.B Byarugaba Programme Outcome: Quality and accessible National Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Competitive healthcare centres of excellence Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of super-specialised cases managed. 60% 70% 80%

‡increase in diagnostic investigations carried out 90% 95% 100%

‡Average length of Stay

SubProgramme: 02 Medical Services Output: 01 Inpatient Services - National Referral Hospital No. of in-patients (Admissions) 179544 180000 185000

No. of laboratory tests carried out 1984084 2000000 2100000

Number of major operations done 45000 46000 470000

Output: 02 Outpatient Services - National Referral Hospital No of specialised outpatient cases attended to. 150000 160000 165000

No. of general out-patients attended to 730860 750000 760000

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 161 Mulago Hospital Complex

Program : 08 54 National Referral Hospital Services

Development Project : 0392 Mulago Hospital Complex

Output: 08 54 72 Government Buildings and Administrative Infrastructure

Remodelling and renovation of Doctors mess

Total Output Cost(Ushs Thousand) 500,000 0 0

Gou Dev¶t: 0 0 0

Ext Fin: 0 0 0

66 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

A.I.A: 500,000 0 0

Output: 08 54 75 Purchase of Motor Vehicles and Other Transport Equipment

Two staff vans to transport staff to the different locations of Kawempe and Kiruddu after the shifting process. Total Output Cost(Ushs Thousand) 700,000 700,000 0

Gou Dev¶t: 700,000 700,000 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 54 77 Purchase of Specialised Machinery & Equipment

Purchase of specialised Equipment(MRI,128 CT Scan,Fluoroscopy) Total Output Cost(Ushs Thousand) 16,000,000 3,545,986 0

Gou Dev¶t: 16,000,000 3,545,986 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 54 82 Staff houses construction and rehabilitation

Completion of Construction of 100 staff houses started in FY 2013/14,now at 70% complete Total Output Cost(Ushs Thousand) 4,020,000 3,936,149 0

Gou Dev¶t: 4,020,000 3,936,149 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 54 84 OPD and other ward construction and rehabilitation

Piping of Oxygen to Upper Mulago Demolition and Rebuilding of Outpatient department and I.C.U Introduction of an additional Floor on the theatre extension Block K Demolition of Mortuary and Construction of the new pathology dept (block H) Organ Transplant Unit on Block A level 6

Total Output Cost(Ushs Thousand) 1,000,000 0 22,520,000

Gou Dev¶t: 1,000,000 0 22,020,000

Ext Fin: 0 0 0

A.I.A: 0 0 500,000

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 54 National Referral Hospital Services Output: 08 5405 Hospital Management and Support Services - National Referral Hospital Change in Allocation (UShs Bn) : 3.439 Additional funding was given to cater for water

67 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

Output: 08 5419 Human Resource Management Services Change in Allocation (UShs Bn) : 0.226 Its as a result of the new HR Output

Output: 08 5484 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 21.020 Additional funds are to cater for the works not included in the ADB loan.

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

1. No Autonomy status for Mulago 2. No Law on Organ Transplant 3. Under staffing 4. 2YHUZKHOPLQJQXPEHURISDWLHQWV WKHLUDWWHQGDQWV 5. poor remuneration 6. Lengthy procurement procedures 7. Very low capital development Plans to improve Vote Performance

1. ,PSOHPHQWDWLRQRIWKHQHZVWUXFWXUHWRDGGUHVVXQGHUVWDIILQJ 2. Persue the Autonomy status for Mulago 3. Develop frame work contracts to address inefficiency in procurement

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Prevention through increased awareness Issue of Concern : Limited awareness among the youth Planned Interventions : Sensitize both the parents and youth about the ABC formula Budget Allocation (Billion) : 0.100 Performance Indicators: HIV prevalence rate Objective : Improvement in testing and counselling services Issue of Concern : Increased HIV prevalence Planned Interventions : Encourage every patient to test and counsel those who are positive to seek for early treatment Budget Allocation (Billion) : 0.100 Performance Indicators: HIV prevalence rate Issue Type: Gender

Objective : Equal access to health services Issue of Concern : Long waiting time to receive a service Planned Interventions : Recruitment of more midwives and maintenance of medical equipments

68 Mulago Hospital Complex Ministerial Policy Statement

Vote:161 Mulago Hospital Complex

Budget Allocation (Billion) : 2.160 Performance Indicators: Maternal mortality rate Issue Type: Enviroment

Objective : Promotion of Hygiene through proper waste disposal Issue of Concern : Cleanliness of the hospital as well as proper waste disposal Planned Interventions : Awarding of cleaning contract and proper treating of the waste to avoid damage to the environment Budget Allocation (Billion) : 0.466 Performance Indicators: Cleanliness of the wards, theatres and conveniences

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 7.000

Total 0.000 0.000 7.000

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

69 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

V1: Vote Overview (i) Vote Mission Statement To offer super specialized and general mental health services; conduct mental health training, mental health related research and provide support to mental health care services in the country

(ii) Strategic Objective To offer Specialized and general Mental Health Services

(iii) Major Achievements in 2016/17 a. 14,717 patients attended to in the Mental Health clinic b. 2,654 patients attended to in the Adolescent Mental Health Clinic c. 290 attended to in the Alcohol and Drug Clinic d. 15,809 attended to in general Outpatient e. 30 outreach clinics conducted in the areas of Nkokonjeru, Nansana, Kitetika, Kawempe Katalemwa and Kitebi f. 10 visit to regional referral hospitals mental health units. 152 patients resettled within kampala/wakiso g. Hospital infrastructure, grounds, vehicles machinery and equipment maintained h. 3,792 patients admitted i. All inpatients provided with 3 meals a day, uniforms and beddings j. Expansion of the Private Wing has been completed k. Training of health workers and students in mental health care

(iv) Medium Term Plans

The hospital`s medium expenditure plans for enhancing provision of Mental and General Outpatients Health care include Provision of Mental Health Training to male, female and disabled students, Provision of Technical support supervision, Research DQG$GYRFDF\LQWKH0HQWDO+HDOWKLVVXHVUHJDUGLQJPDOHIHPDOHDQGPDUJLQDOLVHGJURXSVRSHUDWLRQDOLVDWLRQRIWKHSULYDWHZLQJ to enable accessibility of private services for both male and female patients and construction of the Alcohol and Drug Unit for rehabilitation both male and female patients due to the increasing misuse of Alcohol and Drugs especially the youth .Availability of standby Ambulance for expectant mothers

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 3.142 3.799 1.667 3.799 3.989 4.188 4.398 4.617 Non Wage 3.933 5.432 2.630 5.445 6.534 7.187 8.265 8.265

Devt. GoU 1.711 1.808 0.075 1.808 2.351 2.821 3.385 3.385

70 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.786 11.038 4.372 11.052 12.873 14.196 16.047 16.267 Total GoU+Ext Fin (MTEF) 8.786 11.038 4.372 11.052 12.873 14.196 16.047 16.267 Arrears 0.039 0.007 0.000 0.000 0.000 0.000 0.000 0.000 Total Budget 8.825 11.045 4.372 11.052 12.873 14.196 16.047 16.267 A.I.A Total 0.501 1.000 0.307 1.500 1.700 1.700 1.700 1.700 Grand Total 9.327 12.045 4.679 12.552 14.573 15.896 17.747 17.967 Total Vote Budget 9.288 12.038 4.679 12.552 14.573 15.896 17.747 17.967 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 9.230 0.000 1.000 10.230 9.243 0.000 1.500 10.743

211 Wages and Salaries 3.961 0.000 0.490 4.451 3.961 0.000 0.736 4.697

212 Social Contributions 0.177 0.000 0.000 0.177 0.190 0.000 0.000 0.190

213 Other Employee Costs 0.184 0.000 0.068 0.252 0.184 0.000 0.091 0.275

221 General Expenses 2.236 0.000 0.106 2.342 2.236 0.000 0.158 2.394

222 Communications 0.022 0.000 0.002 0.024 0.022 0.000 0.004 0.026

223 Utility and Property Expenses 0.390 0.000 0.020 0.410 0.390 0.000 0.029 0.419

224 Supplies and Services 0.845 0.000 0.200 1.045 0.845 0.000 0.300 1.145

227 Travel and Transport 0.276 0.000 0.033 0.309 0.276 0.000 0.062 0.337

228 Maintenance 1.139 0.000 0.081 1.220 1.139 0.000 0.121 1.260

Output Class : Capital Purchases 1.808 0.000 0.000 1.808 1.808 0.000 0.000 1.808

281 Property expenses other than interest 0.130 0.000 0.000 0.130 0.030 0.000 0.000 0.030

312 FIXED ASSETS 1.678 0.000 0.000 1.678 1.778 0.000 0.000 1.778

Output Class : Arrears 0.007 0.000 0.000 0.007 0.000 0.000 0.000 0.000

321 DOMESTIC 0.007 0.000 0.000 0.007 0.000 0.000 0.000 0.000

Grand Total : 11.045 0.000 1.000 12.045 11.052 0.000 1.500 12.552

Total excluding Arrears 11.038 0.000 1.000 12.038 11.052 0.000 1.500 12.552

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections

71 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 55 Provision of Specialised Mental 8.825 12.045 4.372 12.552 14.573 15.896 17.747 17.967 Health Services 01 Management 7.099 10.222 4.290 10.710 12.189 13.042 14.329 14.549

02 Internal Audit Section 0.015 0.015 0.008 0.033 0.033 0.033 0.033 0.033

0911 Butabika and health cente 1.711 1.808 0.075 1.400 1.351 1.321 1.385 1.385 remodelling/construction 1475 Institutional Support to Butabika 0.000 0.000 0.000 0.408 1.000 1.500 2.000 2.000 Hospital Total for the Vote 8.825 12.045 4.372 12.552 14.573 15.896 17.747 17.967

Total Excluding Arrears 8.786 12.038 4.372 12.552 14.573 15.896 17.747 17.967

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 55 Provision of Specialised Mental Health Services Programme Objective : Quality and accessible Specialised mental health services Responsible Officer: Dr. David Basangwa Programme Outcome: Quality and accessible Specialised mental health services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of referred mental health cases managed; bed 10% 15% 20% occupancy rate SubProgramme: 01 Management Output: 02 Mental Health inpatient Services Provided No. of investigations conducted 28000 30000 32000

Output: 04 Specialised Outpatient and PHC Services Provided No. of out-patients in specialized clinics 35202 38722 44530

Output: 05 Community Mental Health Services and Technical Supervision No. of male and female patients seen in the outreach 3519 3870 4450 clinics No. of Technical support supervision visits conducted 24 28 28

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

72 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 162 Butabika Hospital

Program : 08 55 Provision of Specialised Mental Health Services

Development Project : 0911 Butabika and health cente remodelling/construction

Output: 08 55 80 Hospital Construction/rehabilitation

- Completion of the private wing Completion of private is at 98% and expansion Completion of the Alcohol and Drug Unit - 1st phase of the expansion of the Alcohol and Drug Unit of the alcohol and drug unit is bidding stage - Review of the strategic plan - Supervision of the construction ADU and private wing Total Output Cost(Ushs Thousand) 1,330,000 74,836 1,400,000

Gou Dev¶t: 1,330,000 74,836 1,400,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 55 Provision of Specialised Mental Health Services Output: 08 5575 Purchase of Motor Vehicles and Other Transport Equipment Change in Allocation (UShs Bn) : 0.200 Procurement of one double cabin pickup for support supervision and one motorcycle for following up patients, home visits and educating the community about mental health Output: 08 5576 Purchase of Office and ICT Equipment, including Software Change in Allocation (UShs Bn) : 0.020 This financial year the emphasis was on upgrading internet services but 5 computers and one photocopier will be procured in the next financial year Output: 08 5578 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : -0.290 In this financial year, extension of private wing was furnished and required a big budget. In the next financial year we will only be furnishing the alcohol and drug unit which will require less funds

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

,QDGHTXDWHVWDIIVWUXFWXUHZKLFKGRHVQRWPDWFKWKHFXUUHQWKRVSLWDOCVUHTXLUHPHQWVLQDGHTXDWHIXQGLQJ,QIODWLRQDQGLQFUHDVHG number of patients.

Plans to improve Vote Performance

73 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

Patient`s welfare (Food, Uniforms, Beddings); Maintenance of Medical Equipment and Hospital Infrastructure; Outreach and Community Services; operationalization of the private wing and completion of the Alcohol and Drug Unit.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To improve on HIV/AIDS counselling and testing services in the hospital Issue of Concern : Mental illness increases vulnerability of HIV/AIDS Planned Interventions : Provision of HIV/AIDS care Budget Allocation (Billion) : 0.700 Performance Indicators: Number of patients in the HIV/AIDS clinic Issue Type: Gender

Objective : To improve access to private mental health services to both female and male patients Issue of Concern : There has been an imbalance to access to private mental services Planned Interventions : Creating access for both male and female Budget Allocation (Billion) : 1.600 Performance Indicators: Number of patients attended to in the private wing Issue Type: Enviroment

Objective : Promotion of hygiene Issue of Concern : Mental illness predisposes to unhygienic behavioral practices Planned Interventions : Health education and sanitation services Budget Allocation (Billion) : 0.550 Performance Indicators: Cleanliness of the institution

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.280 1.500

Miscellaneous receipts/income 0.000 0.099 0.000

Total 0.000 0.379 1.500

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

74 Butabika Hospital Ministerial Policy Statement

Vote:162 Butabika Hospital

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Artisan 1 3 2 4 U8 0 0 0

ASKARI 40 5 3 45 U8 0 0 0

Biomedical Engineer 0 1 1 1 U4 0 0 0

Dhobi 6 1 1 7 U8 0 0 0

Driver 5 4 3 9 U8 0 0 0

ENROLLED NURSE 81 14 4 95 U7 0 0 0

KITCHEN ATT 24 4 4 28 U8 0 0 0

LAB. TECHNOLOGIST 1 1 1 2 U5 0 0 0

MED. RECORDS ASST. 1 3 2 4 U7 0 0 0

MEDICAL OFFICER SPECIAL GR. 0 7 1 7 U2 0 0 0 (PSYCH) MEDICAL SOCIAL WORKER 1 2 2 3 U4 0 0 0

MENTAL ATTENDANT 61 4 4 65 U8 0 0 0

Nursing Officer (Psychiatry) 48 17 10 65 U5 0 0 0

Occupational Therapist 1 2 1 3 U5 0 0 0

Princ.Psychiatric Clinical Officer 1 4 0 5 U3 0 0 0

PRINCIPAL CLINICAL OFFICER 0 1 1 1 U3 0 0 0

Principal Medical Social Worker 0 1 1 1 U2 0 0 0

Psychiatric Clinc Offic 3 5 5 8 U5 0 0 0

SEN. CONSULTANT (PSYCH) 1 4 1 5 U1 SE 0 0 0

Senior Nursing Officers 9 3 3 12 U4 0 0 0

Stores Assistant 0 1 0 1 U7 0 0 0

Vote Total 284 87 50 371 0 0 0

75 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

V1: Vote Overview (i) Vote Mission Statement Increasing access of the people within West Nile region to quality specialized health care services in a client centered manner, with professionalism, integrity, and accountability in order to increase their productivity.

(ii) Strategic Objective a. Scale up critical interventions b. Improve levels, and equity in access and demand c. Accelerate quality and safety improvements d. Improve efficiency and effectiveness of Services

(iii) Major Achievements in 2016/17

Half year performance indicators were above planned i.e. 5,728 Admissions, 905 Major Surgeries,1,881 deliveries,101.8%%HG2FFXSDQF\5DWH 4.5days ALOS. This is associated to refugee influx from Southern Sudan, confidence on hospital services and from lower facilities; (9,150)General OPD attaendance; increased specialized clinic attendance (38,354) against planned quarterly estimates. Lab tests (30,354) higher than planned due to +(3%WHVWLQJDQGWUHDWPHQW)XQFWLRQDOLVDWLRQRIRWKHUVSHFLDOL]HGFOLQLFVOLNHGLDEHWHVDQGFDQFHU 'HVSLWHLPSURYHGIXQFWLRQDOLW\RIORZHU3+&IDFLOLWLHV$1&DWWHQGDQFH 5,038) and Family planning contacts (1,280) increased due to integrated community out reaches, weekend coverage and media sensitization; Capital development: procurement of consultant for hospital store FRQVWUXFWLRQDQGPDVWHUSODQGHYHORSPHQWFRPSOHWHGZRUNVVWDUWHG6DQLWDWLRQV\VWHPZRUNVLQVWDIITXDUWHUVFRPSOHWHG

(iv) Medium Term Plans

1. Provision of general hospital services including cancer treatment. 2. Construction of staff accommodation 3. Continue maintenance of medical equipment in the region. 4. Procurement of a staff van. 5. )HQFLQJWKHHQWLUHKRVSLWDOODQG 6. Construction of a casualty department, 7. Purchase of office Furniture and equipment, 8. Construct an Administration block. 9. Installation of intercom.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.890 3.095 1.447 3.095 3.095 3.095 3.095 3.095 Non Wage 2.326 1.837 0.884 2.054 1.596 1.596 1.596 1.596

Devt. GoU 0.705 1.058 0.234 1.060 1.523 1.523 1.523 1.523

76 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.920 5.990 2.565 6.209 6.213 6.213 6.213 6.213 Total GoU+Ext Fin (MTEF) 5.920 5.990 2.565 6.209 6.213 6.213 6.213 6.213 Arrears 0.000 0.000 0.000 0.392 0.000 0.000 0.000 0.000 Total Budget 5.920 5.990 2.565 6.601 6.213 6.213 6.213 6.213 A.I.A Total 0.000 0.080 0.020 0.100 0.110 0.120 0.140 0.140 Grand Total 5.920 6.070 2.584 6.701 6.323 6.333 6.353 6.353 Total Vote Budget 5.920 6.070 2.584 6.309 6.323 6.333 6.353 6.353 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.932 0.000 0.060 4.992 5.149 0.000 0.075 5.224

211 Wages and Salaries 3.169 0.000 0.036 3.205 3.179 0.000 0.055 3.234

212 Social Contributions 0.105 0.000 0.000 0.105 0.337 0.000 0.000 0.337

213 Other Employee Costs 0.399 0.000 0.000 0.399 0.368 0.000 0.000 0.368

221 General Expenses 0.361 0.000 0.000 0.361 0.355 0.000 0.000 0.355

222 Communications 0.019 0.000 0.000 0.019 0.017 0.000 0.000 0.017

223 Utility and Property Expenses 0.269 0.000 0.000 0.269 0.272 0.000 0.000 0.272

224 Supplies and Services 0.126 0.000 0.024 0.150 0.127 0.000 0.020 0.147

225 Professional Services 0.002 0.000 0.000 0.002 0.002 0.000 0.000 0.002

227 Travel and Transport 0.266 0.000 0.000 0.266 0.263 0.000 0.000 0.263

228 Maintenance 0.215 0.000 0.000 0.215 0.229 0.000 0.000 0.229

Output Class : Capital Purchases 1.058 0.000 0.020 1.078 1.060 0.000 0.025 1.085

281 Property expenses other than interest 0.180 0.000 0.000 0.180 0.000 0.000 0.000 0.000

312 FIXED ASSETS 0.878 0.000 0.020 0.898 1.060 0.000 0.025 1.085

Output Class : Arrears 0.000 0.000 0.000 0.000 0.392 0.000 0.000 0.392

321 DOMESTIC 0.000 0.000 0.000 0.000 0.392 0.000 0.000 0.392

Grand Total : 5.990 0.000 0.080 6.070 6.601 0.000 0.100 6.701

Total excluding Arrears 5.990 0.000 0.080 6.070 6.209 0.000 0.100 6.309

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections

77 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.920 6.070 2.565 6.701 6.323 6.333 6.353 6.353

01 Arua Referral Hospital Services 4.964 4.743 2.217 5.365 4.527 4.532 4.552 4.552

02 Arua Referral Hospital Internal Audit 0.016 0.016 0.008 0.016 0.016 0.016 0.016 0.016

03 Arua Regional Maintenance 0.236 0.232 0.106 0.232 0.232 0.232 0.232 0.232

1004 Arua Rehabilitation Referral Hospital 0.705 1.078 0.234 0.694 1.548 1.553 1.553 1.553

1469 Institutional Support to Arua Regional 0.000 0.000 0.000 0.393 0.000 0.000 0.000 0.000 Referral Hospital Total for the Vote 5.920 6.070 2.565 6.701 6.323 6.333 6.353 6.353

Total Excluding Arrears 5.920 6.070 2.565 6.309 6.323 6.333 6.353 6.353

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To improve the health of the catchment population through provision of specialized curative, preventive, promotive and rehabilitative health services. Responsible Officer: DR ODU BERNARD Programme Outcome: Inclusive and quality healthcare services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

78 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

‡increase of specialised clinic outpatients attendences; % 11% 3% 3% increase of diagnostic investigations carried; bed occupancy rate SubProgramme: 01 Arua Referral Hospital Services Output: 01 Inpatient services No. of in patients (Admissions) 24000 24500 24800

Output: 02 Outpatient services Total general outpatients attendance 45000 42000 40000

Number of Specialised Clinic Attendances 150000 155000 160000

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1019936444 1019936444 1019936444

Output: 04 Diagnostic services No. of laboratory tests carried out 150000 150000 155000

No. of patient xrays (imaging) taken 9000 10000 10500

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 16000 16500 17000

No. of children immunised (All immunizations) 50000 55000 55500

No. of family planning users attended to (New and 5000 5500 6000 Old) SubProgramme: 1004 Arua Rehabilitation Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 1 1 1 existing facilities No. of reconstructed/rehabilitated general wards 1 1 1

Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 1 1 1

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 0.1 0.1 0.1

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 163 Arua Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Arua Rehabilitation Referral Hospital

Output: 08 56 72 Government Buildings and Administrative Infrastructure

79 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

1. Construction of a hospital store; 2. Improvement of the (1) Procurement process on construction Renovation of Records Office sanitation system in the staff quarters; 3. Repair of the walk hospital store completed and construction ways. 4.Development of the hospital Master Plan works started. (2) Works on the improvement of sanitation system in the staff quarters completed. (3) Procurement process completed for the development of the master plan. Total Output Cost(Ushs Thousand) 840,000 233,686 25,000

Gou Dev¶t: 830,000 233,686 0

Ext Fin: 0 0 0

A.I.A: 10,000 0 25,000

Output: 08 56 81 Staff houses construction and rehabilitation

12-unit storeyed staff house constructed.

Total Output Cost(Ushs Thousand) 0 0 600,000

Gou Dev¶t: 0 0 600,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

1. Staff motivation and retention partly contributed by lack of accommodation. 2. Inadequate budget overall including that for medicines and supplies. 3. A big number of staff to provide for against limited resources. 4. Lack of appropriate equipment to match the mandate of the hospital. 5. Very high expectation from a majority rural communities. 6. Difficulty in projecting the hospital service catchment population given the influx of refugees from South Sudan and people across the Congo boarder.

Plans to improve Vote Performance

1. Improve staff motivation and retention especially for a high population most whom are women. 2. Ensure a 24 hour staff presence at their places of work. 3. Ensure proper use and maintenance of the available equipment. 4. Increasing non tax revenue collection which supplements the funds received from the centre. 5. Rally other stakeholders in the running affair of the hospital including resourcing.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To provide equal access and opportunity for health care to all HIV affected persons, co-morbid conditions and promoting PLWAs clubs and Most At Risk Populations(MARPS). Issue of Concern : There is an increasing trend of HIV transmissions, mother to child transmission and low access to care for eligible patients.

80 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

Planned Interventions : Treatment for co-morbid infected people, decentralization of HIV counseling and testing to all service centers, promotion of HIV preventive strategies, intensification of HIV health education. Budget Allocation (Billion) : 0.059 Performance Indicators: Number of people counseled, tested and treated for HIV. Number of positive mothers and babies enrolled into care.

Issue Type: Gender

Objective : To provide equal access and opportunities to all gender during resources allocation and use, recruitment, promotions and duty allocations, and enhance reproductive health, male participation in maternal and child health and strategically plan and execute adolescent health. Issue of Concern : Inclusiveness in hospital processes, procedures and participation. Planned Interventions : Creation of adolescents clinics, Provision of breast feeding centers and encouraging male participation in maternal and child health.Equal representation in leadership positions. Budget Allocation (Billion) : 0.104 Performance Indicators: Number of adolescents registered in clinics;Functional breastfeeding corners; CPDs on gender policies. Issue Type: Enviroment

Objective : To encourage interventions that conserve and promote a safe and healthy environment . Issue of Concern : A non-safe and unhealthy hospital environment is very dangerous to the patients, staff and the surrounding community.. Planned Interventions : Rigorous internal and external hospital cleaning, provision of utilities (water, power etc.), hand washing and waste disposal facilities, fumigation of premises and provision of staff protective wear. Budget Allocation (Billion) : 0.100 Performance Indicators: A safe, clean and pest free hospital environment according to agreed standard. SOPs in place, Number of Infection control and occupational therapy committee recommendations implemented. Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Sale of drugs 0.000 0.000 0.028

Registration (e.g. Births, Deaths, Marriages, etc.) fees 0.000 0.000 0.006

Other Fees and Charges 0.000 0.000 0.066

Total 0.000 0.000 0.100

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Anaesthetic Officer 0 2 1 2 U5 937,360 0 11,248,320

Artisanmate Electrical 2 1 1 3 U8 277,660 555,320 3,331,920

81 Arua Referral Hospital Ministerial Policy Statement

Vote:163 Arua Referral Hospital

Assistant Medical Records Officer 0 2 1 2 U5 616,554 0 7,398,648

Assistant Office Supervisor 0 1 1 1 U6 412,618 0 4,951,416

Consultant Obst/Gyn 0 1 1 1 U2 2,933,920 0 35,207,040

Consultant Surgeon 0 1 1 1 U2 2,785,630 0 33,427,560

Dhobies 3 3 3 6 U8 277,660 832,980 3,331,920

Drivers 4 1 1 5 U8 318,316 1,273,264 3,819,792

Enrolled Midwives 14 6 2 20 U7 557,633 7,806,862 6,691,596

Human Resource Officer 0 1 1 1 U4 798,056 0 9,576,672

Laboratory Assistants 4 1 1 5 U7 460,868 1,843,472 5,530,416

Medical Officers 8 2 2 10 U4 941,806 7,534,448 11,301,672

Mortuary Attendant 1 1 1 2 U8 299,859 299,859 3,598,308

Plumber 1 1 1 2 U8 299,859 299,859 3,598,308

Principal Stores Assistant 0 1 1 1 U5 616,554 0 7,398,648

Security Guards 12 6 4 18 U8 277,660 3,331,920 3,331,920

Senior Accounts Assistant 0 2 1 2 U5 461,770 0 5,541,240

Senior Dispensor 0 1 1 1 U4 1,322,163 0 15,865,956

Senior Lab. Technologist 0 1 1 1 U4 1,234,008 0 14,808,096

Senior Radiographer 1 1 1 2 U4 1,320,503 1,320,503 15,846,036

Theatre Assistant 2 3 1 5 U6 623,409 1,246,818 7,480,908

Theatre Attendant 2 1 1 3 U8 299,859 599,718 3,598,308

Vote Total 54 40 29 94 18,073,725 0 216,884,700

82 Fort Portal Referral Hospital Ministerial Policy Statement

Vote:164 Fort Portal Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To increase access to all people in Rwenzori region to quality general and specialized health services.

(ii) Strategic Objective a. To enhance health education and promotion at community level. E7RUHGXFHPDWHUQDODQG&KLOGPRUWDOLW\DQGPRUELGLW\ F7RUHGXFHPRUELGLW\PRUWDOLW\DQGWUDQVPLVVLRQRIFRPPXQLFDEOHGLVHDVHV d. To reduce morbidity and mortality attributable to communicable diseases e. To enhance hospital capacity for effective service delivery

(iii) Major Achievements in 2016/17

7KHKRVSLWDOSHUIRUPDQFHZDVDERYHWKHVHWWDUJHWVZLWKLQWKHDYDLODEOHUHVRXUFHVDVLQGLFDWHG,QWKHILUVWVLFPRQWKRIWKH)< 2016/17 the hospital has achieved. Total No. of Patients admitted: 14,741; Total maternal deliveries 4,363; Major Surgeries - 1,708; BOR 86% and ALOS 4 days. No. of General outpatients - 18,976; No. of Specialized outpatients - 103,071. The Value of Medicines and Medical supplies received and dispensed by the hospital was worth 593,732,815.88 but this is only 51% of hospital half year requirements. In community prevention aspect there were Ante-Natal cases; Family planning contacts- 1,609; EID Cases 3,787, HCT 22,745 persons. To address child and maternal survival the hospital immunized 25285 persons in order to contribute to SDG 3. The equipment workshop ensured equipment inventory and functionality of HC in the region to as to enable theatres offer the much needed EmOC. The hospital procured a biometric machine to enable us reduce on staff absenteeism thus increasing staff productivity and SHUIRUPDQFHDQGWREHOLQNHGWR,336IRUVDODU\SD\PHQWLQWKHIXWXUH$VVRUWPHQWRIHTXLSPHQWSURFXUHGZKLFKLQFOXGHGR[\JHQ concentrators, insect killers and biometric machines. The hospital building and administrative structures maintained: The hospital carried Modification of two rooms for General and Private Inpatient Pharmacies. Co -funding the construction of ART patients shade, Window repair materials for Medical wards, 'RRUORFNUHSODFHPHQWVIRU+RVSLWDO'LUHFWRU3DWLHQW7RLOHWGRRUUHSODFHPHQWIRU0DWHUQLW\DQGPHGLFDOWRLOHWVDQGUHSDLUSOXV ODERXUFRVWV0XUUDPIRUKRVSLWDO5RDGZRUNV0DQKROHFRYHUVDQG&RQWDLQHUVODEDQGURRIUHSDLUHGDQG&RQWDLQHUVKHOYHVIRU Inpatient Pharmacy.

(iv) Medium Term Plans Construction of an Interns¶Hostel complete with an education centre that has internet connectivity, library and computer laboratory with capacity for 30SHUVRQV8VKV2,576,000,000 Construction of Incinerator with capacity to handle the volume of waste in the hospital Ushs: 500,000,000 Construction of ENT/EYE unit Ushs. 1,400,000,000 Re-Equipping of the Hospital 7.4Billion Construction of surgical ward, orthopaedic ward and theatre in ward Ushs: 4.2 Billlion Construction of staff housing 30 units Ushs: 7,560,000,000 

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

83 Fort Portal Referral Hospital Ministerial Policy Statement

Vote:164 Fort Portal Referral Hospital

Recurrent Wage 3.008 3.552 1.565 3.552 3.552 3.552 3.552 3.552 Non Wage 1.920 1.603 0.673 1.615 1.556 1.556 1.556 1.556

Devt. GoU 0.519 1.058 0.050 1.060 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.447 6.214 2.288 6.227 6.631 6.631 6.631 6.631 Total GoU+Ext Fin (MTEF) 5.447 6.214 2.288 6.227 6.631 6.631 6.631 6.631 Arrears 0.000 0.000 0.000 0.319 0.000 0.000 0.000 0.000 Total Budget 5.447 6.214 2.288 6.546 6.631 6.631 6.631 6.631 A.I.A Total 0.494 0.570 0.142 0.758 0.900 1.000 1.100 1.200 Grand Total 5.942 6.784 2.430 7.304 7.531 7.631 7.731 7.831 Total Vote Budget 5.942 6.784 2.430 6.985 7.531 7.631 7.731 7.831 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 5.155 0.000 0.570 5.725 5.167 0.000 0.758 5.925

211 Wages and Salaries 3.641 0.000 0.330 3.971 3.641 0.000 0.370 4.011

212 Social Contributions 0.109 0.000 0.022 0.131 0.136 0.000 0.024 0.160

213 Other Employee Costs 0.219 0.000 0.003 0.222 0.219 0.000 0.003 0.222

221 General Expenses 0.317 0.000 0.047 0.363 0.267 0.000 0.047 0.314

222 Communications 0.031 0.000 0.003 0.033 0.031 0.000 0.005 0.036

223 Utility and Property Expenses 0.275 0.000 0.042 0.317 0.335 0.000 0.052 0.387

224 Supplies and Services 0.131 0.000 0.108 0.240 0.128 0.000 0.230 0.359

227 Travel and Transport 0.214 0.000 0.010 0.223 0.230 0.000 0.020 0.250

228 Maintenance 0.218 0.000 0.006 0.225 0.179 0.000 0.006 0.186

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.060 0.000 0.000 1.060

281 Property expenses other than interest 0.022 0.000 0.000 0.022 0.022 0.000 0.000 0.022

312 FIXED ASSETS 1.036 0.000 0.000 1.036 1.038 0.000 0.000 1.038

Output Class : Arrears 0.000 0.000 0.000 0.000 0.319 0.000 0.000 0.319

321 DOMESTIC 0.000 0.000 0.000 0.000 0.319 0.000 0.000 0.319

Grand Total : 6.214 0.000 0.570 6.784 6.546 0.000 0.758 7.304

Total excluding Arrears 6.214 0.000 0.570 6.784 6.227 0.000 0.758 6.985

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

84 Fort Portal Referral Hospital Ministerial Policy Statement

Vote:164 Fort Portal Referral Hospital

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.447 6.784 2.288 7.304 7.531 7.631 7.731 7.831

01 Fort Portal Referral Hospital Services 4.724 5.445 2.134 6.034 5.787 5.887 5.987 6.087

02 Fort Portal Referral Hospital Internal Audit 0.012 0.019 0.006 0.016 0.012 0.012 0.012 0.012

03 Fort Portal Regional Maintenance 0.192 0.261 0.098 0.194 0.209 0.209 0.209 0.209

1004 Fort Portal Rehabilitation Referral 0.519 1.058 0.050 0.922 1.523 1.523 1.523 1.523 Hospital 1470 Institutional Support to Fort Portal 0.000 0.000 0.000 0.138 0.000 0.000 0.000 0.000 Regional Referral Hospital Total for the Vote 5.447 6.784 2.288 7.304 7.531 7.631 7.731 7.831

Total Excluding Arrears 5.447 6.784 2.288 6.985 7.531 7.631 7.731 7.831

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide general and specialized services which are inclusive to the catchment population in Rwenzori region Responsible Officer: Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection N / A N/A

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 164 Fort Portal Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Fort Portal Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

85 Fort Portal Referral Hospital Ministerial Policy Statement

Vote:164 Fort Portal Referral Hospital

Construction of storied 16 one bed roomed staff houses To start in Q3

Total Output Cost(Ushs Thousand) 542,000 0 882,428

Gou Dev¶t: 542,000 0 882,428

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Inadequate human resources for effective service delivery Low pay of HWs with difficulty to attract and retain doctors High utility cost with accumulation of arrears Unfunded priority of orthopaedic workshops Inadequate midwives and anaesthetists Poor referral system leading flooding of hospital by patients Low EMHS budget leading to stock outs

Plans to improve Vote Performance

Inadequate human resources for effective service delivery Low pay of HWs with difficulty to attract and retain doctors High utility cost with accumulation of arrears Unfunded priority of orthopaedic workshops Inadequate midwives and anaesthetists Poor referral system leading flooding of hospital by patients Low EMHS budget leading to stock outs

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To contribute towards Zero new infections, Zero HIV and AIDS related mortality and morbidity, and Zero discrimination. Issue of Concern : The new policy of test and treat require to scale up testing to all those who attend the hospital Planned Interventions : To put in place testing facilities at all points of patient contact in the hospital Budget Allocation (Billion) : 15,000,000.000 Performance Indicators: 50000 persons tested per annum

Table 11.2: AIA Collections

86 Fort Portal Referral Hospital Ministerial Policy Statement

Vote:164 Fort Portal Referral Hospital

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Sale of drugs 0.000 0.000 0.200

Other Fees and Charges 0.000 0.191 0.558

Total 0.000 0.191 0.758

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Assistant Procurment Officer 0 1 1 1 U5 591,555 0 7,098,660

Biomedical Engineer 0 1 1 1 U4 1,234,008 0 14,808,096 (SC) Consultant (Opthalamology) 0 1 1 1 U-ISE 3,065,630 0 36,787,560 (SC) Consultant (Pead.) 0 1 1 1 U-ISE 3,065,630 0 36,787,560 (SC) Dispenser 3 2 1 5 U5 0 0 0

ENROLLED MIDWIFE - FORT 17 3 3 20 U7 577,257 9,813,369 6,927,084 PORTAL REG. REF HOSPITAL LABORATORY TECHNICIAN 2 1 1 3 U5 937,360 1,874,720 11,248,320 (MEDICAL) - FORT PORTAL HOSPITAL MEDICAL OFFICER - FORT PORTAL 7 3 1 10 U2 1,981,189 13,868,323 23,774,268 REG. REF HOSPITAL MOSG (Medicine) 0 1 1 1 U3 2,463,611 0 29,563,332 (SC) MOSG (Public Health) 0 1 1 1 U3 2,463,611 0 29,563,332 (SC) MOSG (Surgery) 0 1 1 1 U3 2,463,611 0 29,563,332 (SC) Nursing Officer (Midwifery) 0 20 2 20 U5 SC 898,337 0 10,780,044

Nursing Officer (Nursing) 29 11 2 40 U5 SC 898,337 26,051,773 10,780,044

Nursing Officer (Public Health) 0 4 2 4 U5 937,360 0 11,248,320 (SC) Opthalmic Clinical Officer 0 2 1 2 U5 SC 898,337 0 10,780,044

PRINCIPAL HOSPITAL 0 1 1 1 U2 1,357,880 0 16,294,560 ADMINISTRATOR- FORTPORTAL REG.REF. HOSPITAL Senior Consultant (Internal Medicine) 0 1 1 1 UISE 3,924,620 0 47,095,440

SENIOR NURSING OFFICER - FORT 12 3 2 15 U4 1,322,163 15,865,956 15,865,956 PORTAL REG. REF HOSPITAL Vote Total 70 58 24 128 29,080,496 0 348,965,952

87 Gulu Referral Hospital Ministerial Policy Statement

Vote:165 Gulu Referral Hospital

V1: Vote Overview (i) Vote Mission Statement Gulu Regional Referral Hospital (GRRH) exists to provide specialized health care, preventive, promotive, curative and rehabilitative services to the eight districts of the Acholi sub-region; conduct training, research and support supervision to general hospitals and lower level health facilities in the region.

(ii) Strategic Objective 1. To improve maternal and child health in the catchment area 2. &RQWULEXWHWRVFDOLQJXSRIKHDOWKVHFWRUVWUDWHJLFLQWHUYHQWLRQVLQRUGHUWRLPSURYHWKHKHDOWKRIWKHFRPPXQLW\ 3. Prevention,management and control of communicable diseases 4. To improve effectiveness,efficiency and accountability of hospital operations 5. To support clinical departments by ensuring efficient, safe environmentally health system infrastructure for smooth deliver of health services 6. Prevention,management and control of non communicable diseases (iii) Major Achievements in 2016/17 timely payment of staff salaries as per stipulated guidelines started payment of the payments of gratuity of pension of centralized staff maintained medical requirements in the acholi sub region Repaired the hospital ambulance that had been down due to an accident along Kampala gulu high way, continued analyzing staff attendance and recommended the errant officers to health service commission VHWWOHGRULHQWHGQHZO\UHFUXLWHGVWDII (iv) Medium Term Plans

1. Acquire the police land for the construction of OPD and cancer institute=10bn 2. Purchase of x-ray and ENT machine=700m 33XUFKDVHODQGIRUH[SDQVLRQRIWKHKRVSLWDO 10bn 4. Compound design and leveling and walkways, construction of entrance road =450m. 5. Process land title for the available hospital land=45m. 6. Purchase of laundry =1400

7. Construction of more water tanks to increase water storage and installation of a second submissive water pump=50m

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.599 3.283 1.301 3.283 3.283 3.283 3.283 3.283 Non Wage 1.736 1.410 0.952 1.524 1.427 1.427 1.427 1.427

Devt. GoU 1.317 1.058 0.980 1.488 1.523 1.523 1.523 1.523

88 Gulu Referral Hospital Ministerial Policy Statement

Vote:165 Gulu Referral Hospital

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.652 5.751 3.233 6.295 6.233 6.233 6.233 6.233 Total GoU+Ext Fin (MTEF) 5.652 5.751 3.233 6.295 6.233 6.233 6.233 6.233 Arrears 0.549 0.000 0.000 0.084 0.000 0.000 0.000 0.000 Total Budget 6.201 5.751 3.233 6.379 6.233 6.233 6.233 6.233 A.I.A Total 0.156 0.300 0.000 0.600 0.600 0.600 0.600 0.600 Grand Total 6.357 6.051 3.233 6.979 6.833 6.833 6.833 6.833 Total Vote Budget 5.808 6.051 3.233 6.895 6.833 6.833 6.833 6.833 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.693 0.000 0.300 4.993 4.807 0.000 0.600 5.407

211 Wages and Salaries 3.332 0.000 0.100 3.432 3.332 0.000 0.200 3.532

212 Social Contributions 0.043 0.000 0.000 0.043 0.157 0.000 0.000 0.157

213 Other Employee Costs 0.293 0.000 0.000 0.293 0.293 0.000 0.000 0.293

221 General Expenses 0.124 0.000 0.058 0.182 0.135 0.000 0.141 0.276

222 Communications 0.012 0.000 0.002 0.014 0.012 0.000 0.004 0.016

223 Utility and Property Expenses 0.410 0.000 0.020 0.430 0.399 0.000 0.025 0.424

224 Supplies and Services 0.145 0.000 0.080 0.225 0.134 0.000 0.140 0.274

225 Professional Services 0.004 0.000 0.010 0.014 0.004 0.000 0.010 0.014

227 Travel and Transport 0.155 0.000 0.030 0.185 0.162 0.000 0.060 0.222

228 Maintenance 0.176 0.000 0.000 0.176 0.180 0.000 0.020 0.200

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

Output Class : Arrears 0.000 0.000 0.000 0.000 0.084 0.000 0.000 0.084

321 DOMESTIC 0.000 0.000 0.000 0.000 0.084 0.000 0.000 0.084

Grand Total : 5.751 0.000 0.300 6.051 6.379 0.000 0.600 6.979

Total excluding Arrears 5.751 0.000 0.300 6.051 6.295 0.000 0.600 6.895

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections

89 Gulu Referral Hospital Ministerial Policy Statement

Vote:165 Gulu Referral Hospital

FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 6.201 6.051 3.233 6.979 6.833 6.833 6.833 6.833

01 Gulu Referral Hospital Services 4.707 4.814 2.185 5.312 5.131 5.131 5.131 5.131

02 Gulu Referral Hospital Internal Audit 0.011 0.011 0.006 0.011 0.011 0.011 0.011 0.011

03 Gulu Regional Maintenance 0.166 0.168 0.062 0.168 0.168 0.168 0.168 0.168

1004 Gulu Rehabilitation Referral Hospital 1.317 1.058 0.980 1.388 1.523 1.523 1.523 1.523

1468 Institutional Support to Gulu Regional 0.000 0.000 0.000 0.100 0.000 0.000 0.000 0.000 Referral Hospital Total for the Vote 6.201 6.051 3.233 6.979 6.833 6.833 6.833 6.833

Total Excluding Arrears 5.652 6.051 3.233 6.895 6.833 6.833 6.833 6.833

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To ensure quality and accessible referral hospital services Responsible Officer: Dr Onyachi Nathan Programme Outcome: Quality and accessible Regional Referral Hospital Services Quality and accessible Regional Referral Hospital Services Quality and accessible Regional Referral Hospital Services Quality and accessible Regional Referral Hospital Service Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of specialised clinic outpatients attendences; % 85% 90% 85% increase of diagnostic investigations carried; Average length of stay; bed occupancy rate N/A

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 165 Gulu Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Gulu Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

90 Gulu Referral Hospital Ministerial Policy Statement

Vote:165 Gulu Referral Hospital

Completion of the First phase of 18 units on the staff house second slab of the next 18 units initiated. Completion of the second slab and initiation of the construction 3rd slab Total Output Cost(Ushs Thousand) 729,857 729,857 1,388,000

Gou Dev¶t: 729,857 729,857 1,388,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Inadequate medicines and medical supplies

High Staff turnover especially Doctors

Frequent breakdown of equipments

Plans to improve Vote Performance

(VWDEOLVKDQGIXQFWLRQDOLVHFRPPLWWHHVVXFKDVWKHWKHUDSHXWLFFRPPLWWHHWRUHGXFHGUXJZDVWDJHKDYHZHHNO\KHDGVRI departmental meetings to review performance. engage all stake holders ,go to community barazas for feedback of service delivery. Carry out service satisfaction surveys at exit points

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : increase hiv aware ness continue with train staff in tb hiv collaboration to be supported by home visits Issue of Concern : Increased clients for sex gender violence Planned Interventions : increase awarenes,support community department for prevention measures training Budget Allocation (Billion) : 0.003 Performance Indicators: Reduced number of treated patients as a result of sex gender violence and introduction of sgbv deparment to address concerns Issue Type: Gender

Objective : increased new hiv attendances,construction of the maternty washing bay to have the mothers confortable in sluicing blood Issue of Concern : loss of patiolled to care to other non clinical service providers Planned Interventions : vigilance and human resource allocation to reduce on waiting time for patients in care

91 Gulu Referral Hospital Ministerial Policy Statement

Vote:165 Gulu Referral Hospital

Budget Allocation (Billion) : 0.003 Performance Indicators: Recovered lost out patients on care ,flocking back to care Issue Type: Enviroment

Objective : train staff on infection control train staff on medical waste disposal especially not to pollute the enviroment .Assess the impact on disposing and incenerating drugs, Issue of Concern : use of poor waste disposal methods Planned Interventions : train and user train for the available facility Budget Allocation (Billion) : 0.004 Performance Indicators: staff and available human resource becoming responsive

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.600

Total 0.000 0.000 0.600

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 LABAROTORY ASSISTANT 1 3 3 4 U7 389,696 389,696 4,676,352

CONSULTANT 0 2 1 2 U1 2,555,683 0 30,668,196

LABORATORY TECHNOLOGIST 0 4 2 4 U5 569,040 0 6,828,480

MEDICAL OFFICER SPECIAL 0 2 1 2 U2 1,249,998 0 14,999,976 GRADE SENIOR CLINICAL OFFICER 0 7 2 7 U4 1,108,664 0 13,303,968

SENIOR ENROLLED NURSE 0 45 5 45 U5 569,040 0 6,828,480

Vote Total 1 63 14 64 6,442,121 389,696 77,305,452

92 Hoima Referral Hospital Ministerial Policy Statement

Vote:166 Hoima Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To increase access to quality general and specialized health services to all people of Bunyoro Region

(ii) Strategic Objective To provide specialized health care services to Bunyoro Region including: a. Offering Comprehensive, curative, promotion and rehabilitative care b. Offering tertiary training and continuous professional development c. Undertaking and conducting operational, professional and technical research in health d. Carry out disease surveillance in the region e. Evaluation and monitoring of implementation of health programs

(iii) Major Achievements in 2016/17 -28000 inpatients managed -200,000 outpatients treated -68,000 lab tests done -29,000 immunisations done

(iv) Medium Term Plans - Construction of a multi-storey ward complex block housing surgical, paediatric, medical, neonatal, gynae wards and ICU. -Construct mortuary -construct interns mess (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 1.696 4.139 1.245 4.139 4.139 4.139 4.139 4.139 Non Wage 2.099 1.398 0.582 1.503 1.233 1.233 1.233 1.233

Devt. GoU 1.220 1.058 0.258 1.060 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.014 6.595 2.085 6.702 6.895 6.895 6.895 6.895 Total GoU+Ext Fin (MTEF) 5.014 6.595 2.085 6.702 6.895 6.895 6.895 6.895 Arrears 0.015 0.260 0.182 0.395 0.000 0.000 0.000 0.000 Total Budget 5.029 6.855 2.267 7.097 6.895 6.895 6.895 6.895 A.I.A Total 0.000 0.060 0.000 0.120 0.120 0.120 0.120 0.120 Grand Total 5.029 6.915 2.267 7.217 7.015 7.015 7.015 7.015 Total Vote Budget 5.014 6.655 2.085 6.822 7.015 7.015 7.015 7.015 Excluding Arrears

(VI) Budget By Economic Clasification

93 Hoima Referral Hospital Ministerial Policy Statement

Vote:166 Hoima Referral Hospital

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 5.537 0.000 0.060 5.597 5.642 0.000 0.120 5.762

211 Wages and Salaries 4.227 0.000 0.060 4.287 4.237 0.000 0.024 4.261

212 Social Contributions 0.165 0.000 0.000 0.165 0.271 0.000 0.000 0.271

213 Other Employee Costs 0.283 0.000 0.000 0.283 0.283 0.000 0.000 0.283

221 General Expenses 0.182 0.000 0.000 0.182 0.178 0.000 0.042 0.220

222 Communications 0.016 0.000 0.000 0.016 0.016 0.000 0.000 0.016

223 Utility and Property Expenses 0.165 0.000 0.000 0.165 0.161 0.000 0.000 0.161

224 Supplies and Services 0.086 0.000 0.000 0.086 0.086 0.000 0.030 0.116

225 Professional Services 0.018 0.000 0.000 0.018 0.018 0.000 0.000 0.018

227 Travel and Transport 0.228 0.000 0.000 0.228 0.222 0.000 0.000 0.222

228 Maintenance 0.168 0.000 0.000 0.168 0.172 0.000 0.024 0.196

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.060 0.000 0.000 1.060

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.060 0.000 0.000 1.060

Output Class : Arrears 0.260 0.000 0.000 0.260 0.395 0.000 0.000 0.395

321 DOMESTIC 0.260 0.000 0.000 0.260 0.395 0.000 0.000 0.395

Grand Total : 6.855 0.000 0.060 6.915 7.097 0.000 0.120 7.217

Total excluding Arrears 6.595 0.000 0.060 6.655 6.702 0.000 0.120 6.822

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.029 6.915 2.267 7.217 7.015 7.015 7.015 7.015

01 Hoima Referral Hospital Services 3.697 5.729 1.963 5.852 5.364 5.364 5.364 5.364

02 Hoima Referral Hospital Internal Audit 0.006 0.015 0.002 0.015 0.015 0.015 0.015 0.015

03 Hoima Regional Maintenance 0.106 0.113 0.044 0.113 0.113 0.113 0.113 0.113

1004 Hoima Rehabilitation Referral Hospital 1.220 1.058 0.258 1.138 1.523 1.523 1.523 1.523

1480 Institutional Support to Hoima Regional 0.000 0.000 0.000 0.100 0.000 0.000 0.000 0.000 Hospital Total for the Vote 5.029 6.915 2.267 7.217 7.015 7.015 7.015 7.015

Total Excluding Arrears 5.014 6.655 2.085 6.822 7.015 7.015 7.015 7.015

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

94 Hoima Referral Hospital Ministerial Policy Statement

Vote:166 Hoima Referral Hospital

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide specialized and general health care and treatment, disease prevention, rehabilitation and health promotion services in Bunyoro Region comprising of the districts of Hoima, Masindi, Buliisa, Kiryandongo, Kibale, Kagadi and Kakumiro Responsible Officer: Dr. Mulwanyi Francis Wambuzi Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of specialized clinic outpatient attendances; % 10% 15% 20% increase of diagnostic investigations carried out; bed occupancy rate SubProgramme: 01 Hoima Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 30000 30000 30000

Output: 02 Outpatient services No. of general outpatients attended to 180000 180000 180000

No. of specialised outpatients attended to 60000 60000 60000

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1.0 1.0 1.0

Output: 04 Diagnostic services No. of laboratory tests carried out 100000 100000 100000

No. of patient xrays (imaging) taken 5000 5000 5000

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 14000 14000 14000

No. of children immunised (All immunizations) 30000 30000 30000

No. of family planning users attended to (New and 2400 2400 2400 Old) SubProgramme: 1004 Hoima Rehabilitation Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 0 0 0 existing facilities No. of reconstructed/rehabilitated general wards 0 0 0

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 0.1 0.1 0.1

95 Hoima Referral Hospital Ministerial Policy Statement

Vote:166 Hoima Referral Hospital

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 166 Hoima Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Hoima Rehabilitation Referral Hospital

Output: 08 56 80 Hospital Construction/rehabilitation

Perimeter fence around the hospital Processing tenders Sewerage system and lagoon constructed

Completed oxygen plant Total Output Cost(Ushs Thousand) 278,429 125,600 510,000

Gou Dev¶t: 278,429 125,600 510,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 83 OPD and other ward construction and rehabilitation

1 Storeyed ward complex block comprising of surgical, N/A paediatric & neonatal, male & female medical wards, gynae ward and intensive care unit Total Output Cost(Ushs Thousand) 580,000 132,586 0

Gou Dev¶t: 580,000 132,586 0

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

- Water and electricity tariffs were increased thus rendering the available budget inadequate to meet the existing consumption. -The opening of two new blocks ie. maternity block and OPD block constructed by JICA has increased utility and cleaning bills beyond the current budget provision. - Non-release of 200m for capital development in the 4th quarter of 2015/16 caused disruption in performance of some projects.

Plans to improve Vote Performance

- Improve on support supervision to ensure efficiency - Installation of bio-clocking system to monitor attendance and presence at work -Improve on welfare to motivate staff.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

96 Hoima Referral Hospital Ministerial Policy Statement

Vote:166 Hoima Referral Hospital

Issue Type: HIV/AIDS

Objective : Create a stigma free environment, Increase enrollment on ART and Improve care for HIV/AIDS patients Issue of Concern : HIV/AIDS patients are always stigmatized Planned Interventions : - Health education - Radio talk shows - Counseling - Focus on vulnerable groups like sex workers and truck drivers

Budget Allocation (Billion) : 0.100 Performance Indicators: - No of outreaches held ( 12 outreaches) - No of talk shows held ( 12 Talk shows) - No of patients counseled ( 30,000) patients - No of vulnerables recruited (400) Issue Type: Gender

Objective : Create an equal opportunity and non discriminatory gender environment Issue of Concern : Gender imbalance Planned Interventions : - Equal representation on all hospital committees Accord opportunities for training and deployment - Encourage aspiration for leadership positions irrespective of gender Budget Allocation (Billion) : 0.100 Performance Indicators: - No of committees equally represented - No of males and females undertaking training - No of male and females assigned leadership responsibilities

Issue Type: Enviroment

Objective : Create a clean , pollution free and green environment through deliberate policies and actions Issue of Concern : Environmental pollution and degradation Planned Interventions : - Institute an environmentally friendly disposal of wastes - Make the hospital environment green - Put in place policies that protect the environment - Educate staff and clients on the importance and practices of good environmental practices

- Budget Allocation (Billion) : 0.100 Performance Indicators: No of waste disposal points properly managed - No trees planted in the compound - No of green polices made - No of green heath education sessions given

- Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.030 0.000

97 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

V1: Vote Overview (i) Vote Mission Statement The Vision: A Centre of Excellence for Specialized Health Care. The Mission: To Provide Quality Specialized, Accessible and Affordable Health Care Services.

(ii) Strategic Objective a. To improve the quality and safety of hospital care by offering comprehensive specialised and general curative, promotive preventive and rehabilitative health care services. b. To contribute to scaling up critical HSSIP interventions. c. To strengthen research activities. d. To strengthen training of health workers. e. To strengthen collaboration with other hospitals and offer a supporting role to health facilities in the catchment area. f. To improve effectiveness and efficiency of hospital services. g. To strengthen hospital partnerships.

(iii) Major Achievements in 2016/17 Admissions 18838;Bed occupancy 87%;ALOS 5days;deliveries 3858;major surgeries 2608;General OPD 56887; causality cases 2453;special clinics 69685;radiology services 5113; laboratory services 146254; immunization services16340;FP 2773; ANC 13833. maintenance workshop construction completed; the Echo machine is on its way to be delivered to the hospital; Oxygen plant was installed and waiting for approval of bureau of standards; CCTV machine installation is going on,procurement process for tools is ongoing, (iv) Medium Term Plans a. Improve efficiency in service delivery such data management & diagnostic services. b. Fill existing gaps in human resources for health. c. Improve working environment to boost morale of health workers. d. Improve customer care & public relations. e. Improve the hospital security of assets and other resources f. Improve maintenance of medical infrastructure g. Improving waste management

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.740 4.578 1.652 4.578 4.578 4.578 4.578 4.578 Non Wage 2.251 1.486 0.582 1.808 1.351 1.351 1.351 1.351

Devt. GoU 0.594 1.058 0.113 1.488 1.523 1.523 1.523 1.523

98 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.586 7.123 2.347 7.874 7.452 7.452 7.452 7.452 Total GoU+Ext Fin (MTEF) 5.586 7.123 2.347 7.874 7.452 7.452 7.452 7.452 Arrears 0.488 0.298 0.000 0.505 0.000 0.000 0.000 0.000 Total Budget 6.074 7.420 2.347 8.379 7.452 7.452 7.452 7.452 A.I.A Total 0.202 0.290 0.098 0.250 0.250 0.250 0.300 0.300 Grand Total 6.276 7.710 2.446 8.629 7.702 7.702 7.752 7.752 Total Vote Budget 5.788 7.413 2.446 8.124 7.702 7.702 7.752 7.752 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 6.064 0.000 0.290 6.354 6.386 0.000 0.250 6.636

211 Wages and Salaries 4.593 0.000 0.061 4.654 4.604 0.000 0.084 4.688

212 Social Contributions 0.199 0.000 0.000 0.199 0.429 0.000 0.000 0.429

213 Other Employee Costs 0.343 0.000 0.000 0.343 0.342 0.000 0.000 0.342

221 General Expenses 0.128 0.000 0.056 0.184 0.135 0.000 0.037 0.172

222 Communications 0.018 0.000 0.001 0.019 0.017 0.000 0.005 0.022

223 Utility and Property Expenses 0.444 0.000 0.040 0.484 0.500 0.000 0.028 0.528

224 Supplies and Services 0.135 0.000 0.095 0.230 0.139 0.000 0.074 0.213

225 Professional Services 0.002 0.000 0.002 0.004 0.003 0.000 0.002 0.005

227 Travel and Transport 0.131 0.000 0.013 0.144 0.126 0.000 0.010 0.136

228 Maintenance 0.070 0.000 0.023 0.093 0.092 0.000 0.010 0.102

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

311 NON-PRODUCED ASSETS 0.001 0.000 0.000 0.001 0.020 0.000 0.000 0.020

312 FIXED ASSETS 1.057 0.000 0.000 1.057 1.418 0.000 0.000 1.418

314 INVENTORIES (STOCKS AND STORES) 0.000 0.000 0.000 0.000 0.050 0.000 0.000 0.050

Output Class : Arrears 0.298 0.000 0.000 0.298 0.505 0.000 0.000 0.505

321 DOMESTIC 0.298 0.000 0.000 0.298 0.505 0.000 0.000 0.505

Grand Total : 7.420 0.000 0.290 7.710 8.379 0.000 0.250 8.629

Total excluding Arrears 7.123 0.000 0.290 7.413 7.874 0.000 0.250 8.124

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

99 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 6.074 7.710 2.347 8.629 7.702 7.702 7.752 7.752

01 Jinja Referral Hospital Services 5.423 6.634 2.228 6.968 5.982 6.072 6.122 6.122

02 Jinja Referral Hospital Internal Audit 0.056 0.018 0.006 0.017 0.018 0.018 0.018 0.018

03 Jinja Regional Maintenance 0.000 0.000 0.000 0.090 0.180 0.090 0.090 0.090

1004 Jinja Rehabilitation Referral Hospital 0.594 1.058 0.113 0.900 0.870 0.870 0.870 0.870

1481 Institutional Support to Jinja Regional 0.000 0.000 0.000 0.653 0.653 0.653 0.653 0.653 Hospital Total for the Vote 6.074 7.710 2.347 8.629 7.702 7.702 7.752 7.752

Total Excluding Arrears 5.586 7.413 2.347 8.124 7.702 7.702 7.752 7.752

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : a. To improve the quality and safety of hospital care. b. To contribute to scaling up critical HSSIP interventions. c. To strengthen research activities. d. To strengthen training of health workers. e. To strengthen collaboration with other hospitals and offer a supporting role to health facilities in the catchment area. f. To improve effectiveness and efficiency of hospital services. g. To strengthen hospital partnerships.

Responsible Officer: Dr. Sophie Namasopo Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

100 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

‡increase of specialised clinic outpatients attendences; 10% 10% 10%

‡increase of diagnostic investigations carried; 10% 10% 10%

‡bed occupancy rate 100% 100% 100%

SubProgramme: 01 Jinja Referral Hospital Services Output: 04 Diagnostic services No. of laboratory tests carried out 222000 222000 222000

No. of patient xrays (imaging) taken 10000 10000 100000

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 16000 16000 16000

No. of children immunised (All immunizations) 15000 15000 15000

No. of family planning users attended to (New and 6000 6000 6000 Old) SubProgramme: 1004 Jinja Rehabilitation Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 1 1 1 existing facilities No. of reconstructed/rehabilitated general wards 2 1 1

Output: 83 OPD and other ward construction and rehabilitation No. of OPD wards constructed 0 0 0

No. of OPD wards rehabilitated 0 0 0

No. of other wards constructed 1 1 1

No. of other wards rehabilitated 1 1 1

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 520000000 600000000 6000000000

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 167 Jinja Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1481 Institutional Support to Jinja Regional Hospital

Output: 08 56 85 Purchase of Medical Equipment

101 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Patient mattresses covered with PVC material, clinical equipment, alternative source of water and alternative Umeme service lines (Jinja main & Dept of Paediatrics Nalufenya ) to improve the supply procured Tools for medical equipment maintenance workshop purchased Total Output Cost(Ushs Thousand) 0 0 520,000

Gou Dev¶t: 0 0 520,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5602 Outpatient services Change in Allocation (UShs Bn) : 0.057 additional funds for services because the output performance for specialized services is increasing as noted in the quarterly reports Output: 08 5605 Hospital Management and support services Change in Allocation (UShs Bn) : 0.088 Funds have been allocated to other outputs. For instance maintenance funds are now under the maintenance workshop, before these funds were being dejected from the non wage outputs Output: 08 5606 Prevention and rehabilitation services Change in Allocation (UShs Bn) : -0.007 Redistributed funds to other outputs

Output: 08 5607 Immunisation Services Change in Allocation (UShs Bn) : 0.000 There will be more outreach services under immunization

Output: 08 5619 Human Resource Management Services Change in Allocation (UShs Bn) : 0.024 Additional output funds were allocated by deducting from hospital management and support services and prevention services. Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.001 Additional output funds were allocated by deducting from hospital management and support services and prevention services. Output: 08 5671 Acquisition of Land by Government Change in Allocation (UShs Bn) : 0.019 Hospital land needs titles

Output: 08 5676 Purchase of Office and ICT Equipment, including Software

102 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Change in Allocation (UShs Bn) : -0.015 HR, Accounts, Records, and Admin Laptops procured

Output: 08 5677 Purchase of Specialised Machinery & Equipment Change in Allocation (UShs Bn) : -0.166 Procurement of the spare parts only this year of Echo machine

Output: 08 5680 Hospital Construction/rehabilitation Change in Allocation (UShs Bn) : 0.177 Private wing Construction completed, Perimeter wall fence constructed

Output: 08 5683 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 0.087 Pediatric department toilets, bathrooms constructed, sewage drainage overhauled

Medical Department wards renovated Output: 08 5685 Purchase of Medical Equipment Change in Allocation (UShs Bn) : 0.520 Assorted Clinical Equipment's will be Procured

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Unique physical location in two different places increases expenditure for operational activities Budget is not adequate for 2 locations. Newly built Medical equipment workshops require funding. Inadequate staff structure for two locations of hospital for both clinical and non-clinical staff. Land wrangles ongoing, medicines and health supplies are inadequate.

Plans to improve Vote Performance

The hospital will be committed to work within the provisions of the approved budget and the service delivery targets.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To contribute to elimination of Mother to Child Transmission and equal access to HIV/AIDS services to all HIV positive patients, and improve uptake of circumcision. Issue of Concern : Improve services on EMTCT, Emphasise access to HIV/AIDS services to all HIV positive patients, improve uptake of circumcision. Planned Interventions : Proportion of pregnant women testing for HIV during Antenatal. Proportion of HIV + pregnant women receiving ARVs for EMTCT. Budget Allocation (Billion) : 300,000,000.000 Performance Indicators: Proportion of HIV exposed infants receiving Neverapine Prophylaxis. Proportion of HIV exposed infants getting tested for HIV- DNAPCR 103 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Issue Type: Gender

Objective : To contribute to gender equality in provision of health services at Jinja Regional Referral Hospital Issue of Concern : Ensuring equality in accessing health services Planned Interventions : providing free services to all people, carry outreach immunisation for those not able to come to hospital, build ramps to cater for other abilities, translators for communication, employ staff with other abilities, Budget Allocation (Billion) : 400,000,000.000 Performance Indicators: Number of patients and clients by demographic characteristics attended to according to standard guidelines for service delivery Issue Type: Enviroment

Objective : To effectively manage Medical and non medical waste of Jinja Regional Referral Hospital Issue of Concern : Managing Medical and non medical wastes in a manner that will not negatively affect the environment Planned Interventions : clients and visitors adopt good practice for sanitation such as hand washing facilities and dust bins available. improving waste disposal mechanisms, close monitoring of cleaning services Budget Allocation (Billion) : 135,000,000.000 Performance Indicators: Clean environment and pollution free

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.250

Total 0.000 0.000 0.250

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Accountant 0 1 1 1 U4L 1,101,485 0 13,217,820

Accounts Assistant 1 1 1 2 U7L 541,465 541,465 6,497,580

Artisan 0 1 1 1 U8L 341,133 0 4,093,596

Assistant Commissioner Nursing 0 1 1 1 U1 2,250,162 0 27,001,944 (SC) Assistant Engineering Officer 0 1 1 1 U5SC 625,067 0 7,500,804

Assistant Procurement Officer 0 1 1 1 U5L 769,794 0 9,237,528

Assistant Records Officer 0 1 1 1 U5L 447,080 0 5,364,960

Bio-statistician 0 1 1 1 U4SC 1,089,533 0 13,074,396

Biomedical Engineer 0 1 1 1 U4SC 1,089,533 0 13,074,396

Consultant Public Health 0 1 1 1 US1E 2,905,088 0 34,861,056

104 Jinja Referral Hospital Ministerial Policy Statement

Vote:167 Jinja Referral Hospital

Engineering Assistant (Civil) 1 1 1 2 U7SC 623,216 623,216 7,478,592

Enrolled Nurse 75 18 10 93 U7SC 623,216 46,741,200 7,478,592

Information Technology Officer 0 1 1 1 U4SC 1,089,533 0 13,074,396

Kitchen Attendant 6 2 2 8 U8L 316,517 1,899,102 3,798,204

Mortuary Attendant 1 1 1 2 U8U 316,517 316,517 3,798,204

Pool Stenographer 1 1 1 2 U6U 599,305 599,305 7,191,660

Records Assistant (Human Resource) 1 1 1 2 U7SC 541,465 541,465 6,497,580

Security Officer 0 1 1 1 U6L 386,972 0 4,643,664

Senior Hospital Administrator 0 1 1 1 U3 1,180,090 0 14,161,080 LOWE R Senior Nutritionist 0 1 1 1 U3SC 1,334,004 0 16,008,048

Senior Physiotherapists 0 1 1 1 U4 1,343,007 0 16,116,084 (SC) Senior Principal Nursing Officer 0 1 1 1 U2SC 1,728,187 0 20,738,244

Steno/secretary 0 1 1 1 U6L 386,972 0 4,643,664

Technician 0 1 1 1 U7U 632,786 0 7,593,432

Theatre Assistant 1 3 3 4 U6SC 698,671 698,671 8,384,052

Theatre Attendant 2 4 4 6 U8U 341,133 682,266 4,093,596

Vote Total 90 50 42 140 23,643,064 0 283,716,768

105 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

V1: Vote Overview (i) Vote Mission Statement A center of excellence in the provision of general and specialized health services to the people of Kigezi sub region.

(ii) Strategic Objective

(iii) Major Achievements in 2016/17

(iv) Medium Term Plans In the medium term the hospital plans to complete the construction of the Interns hostel/resource center,completion of the furnishing of the private wing,purchase of 2KRVSLWDOYHKLFOHVDQGSXUFKDVHRIDWKUHHSKDVHJHQHUDWRU7KHKRVSLWDODOVRSODQVWR improve on service delivery by attending to more patients, improving community services, finalize the hospital master plan and implement the patients charter.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.971 2.719 1.099 2.719 2.719 2.719 2.719 2.719 Non Wage 2.659 1.417 0.563 1.553 1.520 1.520 1.520 1.520

Devt. GoU 0.535 1.058 0.312 1.488 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 6.165 5.194 1.974 5.760 5.761 5.761 5.761 5.761 Total GoU+Ext Fin (MTEF) 6.165 5.194 1.974 5.760 5.761 5.761 5.761 5.761 Arrears 0.000 0.000 0.000 0.253 0.000 0.000 0.000 0.000 Total Budget 6.165 5.194 1.974 6.013 5.761 5.761 5.761 5.761 A.I.A Total 0.390 0.200 0.000 0.500 0.550 0.550 0.600 0.650 Grand Total 6.555 5.394 1.974 6.513 6.311 6.311 6.361 6.411 Total Vote Budget 6.555 5.394 1.974 6.260 6.311 6.311 6.361 6.411 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.135 0.000 0.200 4.335 4.272 0.000 0.500 4.772

106 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

211 Wages and Salaries 2.855 0.000 0.000 2.855 2.866 0.000 0.241 3.107

212 Social Contributions 0.028 0.000 0.000 0.028 0.214 0.000 0.000 0.214

213 Other Employee Costs 0.110 0.000 0.000 0.110 0.107 0.000 0.000 0.107

221 General Expenses 0.250 0.000 0.000 0.250 0.216 0.000 0.020 0.236

222 Communications 0.008 0.000 0.000 0.008 0.014 0.000 0.001 0.015

223 Utility and Property Expenses 0.167 0.000 0.000 0.167 0.178 0.000 0.032 0.210

224 Supplies and Services 0.094 0.000 0.000 0.094 0.109 0.000 0.148 0.257

225 Professional Services 0.012 0.000 0.000 0.012 0.000 0.000 0.000 0.000

227 Travel and Transport 0.254 0.000 0.000 0.254 0.240 0.000 0.018 0.258

228 Maintenance 0.357 0.000 0.000 0.357 0.325 0.000 0.040 0.365

229 Inventories 0.000 0.000 0.200 0.200 0.000 0.000 0.000 0.000

273 Employer social benefits 0.000 0.000 0.000 0.000 0.002 0.000 0.000 0.002

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

281 Property expenses other than interest 0.000 0.000 0.000 0.000 0.100 0.000 0.000 0.100

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.388 0.000 0.000 1.388

Output Class : Arrears 0.000 0.000 0.000 0.000 0.253 0.000 0.000 0.253

321 DOMESTIC 0.000 0.000 0.000 0.000 0.253 0.000 0.000 0.253

Grand Total : 5.194 0.000 0.200 5.394 6.013 0.000 0.500 6.513

Total excluding Arrears 5.194 0.000 0.200 5.394 5.760 0.000 0.500 6.260

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 6.165 5.394 1.974 6.513 6.311 6.311 6.361 6.411

01 Kabale Referral Hospital Services 5.072 3.904 1.520 4.639 4.357 4.357 4.407 4.457

02 Kabale Referral Hospital Internal Audit 0.013 0.005 0.003 0.011 0.005 0.005 0.005 0.005

03 Kabale Regional Maintenance Workshop 0.545 0.426 0.140 0.375 0.426 0.426 0.426 0.426

1004 Kabale Regional Hospital Rehabilitaion 0.535 1.058 0.312 1.423 1.523 1.523 1.523 1.523

1473 Institutional Support to Kabale Regional 0.000 0.000 0.000 0.065 0.000 0.000 0.000 0.000 Referral Hospital Total for the Vote 6.165 5.394 1.974 6.513 6.311 6.311 6.361 6.411

Total Excluding Arrears 6.165 5.394 1.974 6.260 6.311 6.311 6.361 6.411

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

107 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide quality and sustainable, general and specialized health services to the people of Kigezi sub region. Responsible Officer: Kabuye Edward Jovita Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of specialised clinic outpatients attendences 15% 7.5% 5%

‡increase of diagnostic investigations carried out; 10% 8% 5%

‡bed occupancy rate 84% 85% 90%

SubProgramme: 01 Kabale Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 12000 12505 12510

Average Length of Stay (ALOS) - days 4 4 4

Bed Occupancy Rate (BOR) 85 86 87

Number of Major Operations (including Ceasarian se 1500 1550 1560

Output: 02 Outpatient services No. of general outpatients attended to 48000 49000 50000

No. of specialised outpatients attended to 2550 2600 2700

Referral cases in 2000 2015 2020

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1.2 1.3 1.5

Output: 04 Diagnostic services No. of laboratory tests carried out 120455 120460 120470

No. of patient xrays (imaging) taken 5500 6000 7000

Number of Ultra Sound Scans 2500 3000 35000

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 1 1 1

Timely payment of salaries and pensions by the 2 yes Yes Yes

Timely submission of quarterly financial/activity Yes yes Yes

108 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 4800 5000 5200

No. of children immunised (All immunizations) 3200 3400 3500400

No. of family planning users attended to (New and 3600 3010 3020 Old) Number of ANC Visits (All visits) 4000 4010 4020

Percentage of HIV positive pregnant women not on H 0.1% 0.01% 0.001%

Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 300 320 350

SubProgramme: 02 Kabale Referral Hospital Internal Audit Output: 05 Hospital Management and support services Timely payment of salaries and pensions by the 2 yes Yes Yes

Timely submission of quarterly financial/activity yes Yes Yes

SubProgramme: 03 Kabale Regional Maintenance Workshop Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 1 1 1

Timely payment of salaries and pensions by the 2 Yes Yes Yes

Timely submission of quarterly financial/activity Yes Yes Yes

SubProgramme: 1004 Kabale Regional Hospital Rehabilitaion Output: 72 Government Buildings and Administrative Infrastructure Number of buildings constructed 1 1 1

Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 1 1 1 existing facilities No. of reconstructed/rehabilitated general wards 2 2 2

Cerificates of progress/ Completion 3 3 3

Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 2 2 2

Cerificates of progress/ Completion 2 2 2

Output: 83 OPD and other ward construction and rehabilitation No. of OPD wards constructed 0 0 0

No. of OPD wards rehabilitated 0 0 0

No. of other wards constructed 0 0 0

No. of other wards rehabilitated 1 1 1

Cerificates of progress/ Completion 1 1 1

109 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 168 Kabale Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Kabale Regional Hospital Rehabilitaion

Output: 08 56 72 Government Buildings and Administrative Infrastructure

Construction of a four storeyed interns Hostel.(45 units). Phase After getting the approval from the Solicitor Doctors/Interns Hostel partially constructed 1 (ground floor) General the contract will be awarded and Hospital Furniture procured and delivered construction will begin. Total Output Cost(Ushs Thousand) 550,000 1,027 1,190,000

Gou Dev¶t: 550,000 1,027 1,190,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5601 Inpatient services Change in Allocation (UShs Bn) : -2.808 The money for the salaries was put under Hospital Management services

Output: 08 5602 Outpatient services Change in Allocation (UShs Bn) : 0.045 The increase was due to the allocation of money for pension and gratuity

Output: 08 5603 Medicines and health supplies procured and dispensed Change in Allocation (UShs Bn) : 0.031 The increase was due to the allocation of money for pension and gratuity

Output: 08 5604 Diagnostic services Change in Allocation (UShs Bn) : 0.036 The increase was due to the allocation of money for pension and gratuity

Output: 08 5605 Hospital Management and support services Change in Allocation (UShs Bn) : 2.744 This was due to the allocation of money for salaries from the In patients

Output: 08 5607 Immunisation Services

110 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

Change in Allocation (UShs Bn) : 0.051 The increase was due to the allocation of money for pension and gratuity

Output: 08 5619 Human Resource Management Services Change in Allocation (UShs Bn) : 0.020 This is a newly created item

Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.007 This is a newly created item

Output: 08 5672 Government Buildings and Administrative Infrastructure Change in Allocation (UShs Bn) : 0.640 There is additional money for the construction of the Interns /Doctors hostel,: monitoring and supervision by the Consultant Output: 08 5677 Purchase of Specialised Machinery & Equipment Change in Allocation (UShs Bn) : -0.085 Part of the money was put towards the construction of the Interns Hostel

Output: 08 5680 Hospital Construction/rehabilitation Change in Allocation (UShs Bn) : -0.041 There was need to allocate more money towards the renovation of the wards and putting up a pharmacy room for the In patients Output: 08 5681 Staff houses construction and rehabilitation Change in Allocation (UShs Bn) : 0.062 Some money had to construction of the attendants shed

Output: 08 5683 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 0.133 There was allocation of money construction of the water borne toilet

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

The challenges include:- under-staffing especially doctors, midwives anesthetists pharmacy staff and others; the staff structure not matching with the current staffing needs; low wage for recruitment leading to failure to offer certain services such as intensive FDUHDFFLGHQWVDQGHPHUJHQF\DQGQHRQDWDOFDUHORZVWDIIDWWLWXGHWRZDUGVZRUNLQDGHTXDWHHTXLSPHQWHJ&76FDQ05,DQG other important diagnostic equipment leading to too many referrals which is costly to the patients and the hospital; lengthy procurement procedures; budget cuts and very irregular hydro power leading high dependence on the generator yet it is also very old.

Plans to improve Vote Performance

Strengthen support supervision with task allocation; improve on time management by introducing the clocking machine; regular PHHWLQJVEXLOGVWDIIFDSDFLW\WKURXJKWUDLQLQJV VKRUWDQGORQJWHUP LPSURYHVWDIIZHOIDUH&RQVWUXFWLRQRID'RFWRUV,QWHUQV hostel will also contribute to performance improvement.; encouraging staff to work in the Private wing and lobbying implementing SDUWQHUVWRILOOLQJDSVLQVHUYLFHGHOLYHU\

111 Kabale Referral Hospital Ministerial Policy Statement

Vote:168 Kabale Referral Hospital

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: Enviroment

Objective : Inclusive and quality health care services Issue of Concern : Biological waste resulting from frequent filling up of pit latrines in the hospital. Planned Interventions : 1- Renovation and regular emptying of pit latrines. 2- construction a water borne toilet. Budget Allocation (Billion) : 0.017 Performance Indicators: Proportion of Pit latrines renovated and emptied. Target 100% (3)

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.500

Total 0.000 0.000 0.500

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

112 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To provide highest possible level of health services to all people in Masaka Region through quality general and specialized health services delivery

(ii) Strategic Objective

(iii) Major Achievements in 2016/17

During the first half of FY 2016/17 from July 2016 to December 2016, Masaka Regional Referral hospital accomplished the following achievements: INPATIENTS SERVICES 17,104 DGPLVVLRQVZHUHPDGH56,606 Patient days and carried out 4,772 deliveries. The Bed occupancy rate was 94% with an average 4 days of length.

1,865 Major surgical operations carried out and 3,641 Minor operations 481 Referrals in were 481 and 89 Referral s out were made OUPATIENTS SERVICES 63,138 General outpatient contacts were treated and 71,948 Specialized Outpatient Clinic attendees Private Patient Health services were provided treating 2,010 Patients. ESSENTIAL MEDICINES HEALTH SUPPLIES Essential Medicines and Health Supplies worth 408,903,904.24 supplied from National Medical Stores and dispensed to patients. DIAGNOSTICS 7KH/DERUDWRU\FDUULHGRXWH[DPLQDWLRQV4,926 Ultra sound examinations and 300 X-ray Examinations. The Hospital transfused 2, 234 units of blood. MANAGEMENT AND SUPPORT SERVICES +RVSLWDOPDQDJHPHQWFDUULHGRXW4XDUWHUO\DSSUDLVDOVRIVWDIIHQVXUHGWKDWVWDIILQSRVWDUHDOO SDLGWKHLUVDODULHVRQWLPHLQWHUQVZHUHSDLGWKHLUDOORZDQFHVIURP02+ Payment for goods and services provided to the hospital was made. 2 hospital board meetings held. (PHUJHQF\UHSDLUVRI%XLOGLQJVVHUYLFLQJRI3ODQWVDQG9HKLFOHVXQGHUWDNHQ 2 performance review meetings held 113 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

2 financial performance reports made Hospital supervision and rounds carried on a weekly basis 6 public relations activities performed PREVENTION AND REHABILITATION The hospital carried out 1,500 3K\VLRWKHUDS\VHVVLRQV2FFXSDWLRQDOWKHUDS\VHVVLRQV 100 Orthopaedic appliances formulated,

)DPLO\SODQQLQJVHUYLFHVZHUHSURYLGHGWR2,255 contacts, 7,600 ANC contacts, and 2,125 EMTCT contacts 6 Specialist outreaches carried out to problematic hospitals and Health centre IVs in the region , 5&79&7WHVWVZHUHFRQGXFWHG  IMMUNISATION 7KH+RVSLWDOSURYLGHG15,458 Vaccinations against childhood illnesses, carried out 55 Health Education sessions, 4 Radio talk shows, and 8 EPI Surveillance activities All cases of Epidemic potential were investigated and Contact tracing activities undertaken AUDIT The auditor made 2 Quarterly audit reports, audited procurements, carried out Quarterly stores, all GHOLYHULHVZHUHZLWQHVVHGYHULILHGDQGWDNHQRQFKDUJHDQG)L[HGDVVHWV5HJLVWHUDSSUDLVHG CAPITAL DEVELOPMENT PROJECTS With GOU funding the Construction of Maternity and Children¶s Complex completion rate is at 40% and Construction of foundation for staff Hostel is 40% completed Procurement of ECG machine at evaluation stage, Patients waiting Chairs Procured and delivered Construction of Oxygen Plant House started, Renovation of Dental clinic initiated, supervision of construction projects undertaken, Site meeting held and Payment affected for works done

(iv) Medium Term Plans

114 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

The following strategic interventions will be undertaken in the medium term:

Completingthe Construction of the Maternity and children¶s Complex in order to improve health delivery services.

Completing the equipping of the Maternity and Children¶s Complex

To complete the construction of a 40 Staffhostel in order to increase retention and attraction of staff.

To accelerate mobilisation and education of the Masaka Region Community to adopt healthy living lifestyles

To improve aggressively quality improvement initiatives in health care services delivery

The hospital intends to establish Adolescent friendly services.

To intensify initiatives that save life particularly emergency care

Establish a fully fledged diagnostic unit through a Public Private Partnership arrangement with Equator University of Science and Technology.

To continue with water harvesting on all new buildings and alternate source of power on service delivery areas.



To complete the 30 unit staff hostel in order to attract and retain staff.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.340 2.825 1.210 2.825 2.825 2.825 2.825 2.825 Non Wage 2.036 1.153 0.542 1.350 1.355 1.355 1.355 1.355

Devt. GoU 1.032 3.058 1.480 2.058 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.408 7.037 3.232 6.233 5.702 5.702 5.702 5.702 Total GoU+Ext Fin (MTEF) 5.408 7.037 3.232 6.233 5.702 5.702 5.702 5.702 Arrears 0.000 0.000 0.000 0.263 0.000 0.000 0.000 0.000 Total Budget 5.408 7.037 3.232 6.496 5.702 5.702 5.702 5.702 A.I.A Total 0.331 0.388 0.089 0.350 0.460 0.500 0.520 0.550 Grand Total 5.739 7.424 3.321 6.846 6.162 6.202 6.222 6.252 Total Vote Budget 5.739 7.424 3.321 6.583 6.162 6.202 6.222 6.252 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates

115 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 3.978 0.000 0.365 4.344 4.175 0.000 0.350 4.525

211 Wages and Salaries 2.906 0.000 0.096 3.002 2.899 0.000 0.130 3.029

212 Social Contributions 0.091 0.000 0.000 0.091 0.150 0.000 0.008 0.159

213 Other Employee Costs 0.014 0.000 0.000 0.014 0.155 0.000 0.000 0.155

221 General Expenses 0.247 0.000 0.029 0.276 0.303 0.000 0.024 0.327

222 Communications 0.010 0.000 0.002 0.012 0.009 0.000 0.001 0.009

223 Utility and Property Expenses 0.284 0.000 0.012 0.296 0.286 0.000 0.022 0.308

224 Supplies and Services 0.155 0.000 0.182 0.337 0.184 0.000 0.150 0.334

227 Travel and Transport 0.173 0.000 0.031 0.204 0.118 0.000 0.005 0.122

228 Maintenance 0.098 0.000 0.014 0.112 0.071 0.000 0.010 0.081

Output Class : Capital Purchases 3.058 0.000 0.022 3.081 2.058 0.000 0.000 2.058

281 Property expenses other than interest 0.000 0.000 0.000 0.000 0.055 0.000 0.000 0.055

312 FIXED ASSETS 3.058 0.000 0.022 3.081 2.003 0.000 0.000 2.003

Output Class : Arrears 0.000 0.000 0.000 0.000 0.263 0.000 0.000 0.263

321 DOMESTIC 0.000 0.000 0.000 0.000 0.263 0.000 0.000 0.263

Grand Total : 7.037 0.000 0.388 7.424 6.496 0.000 0.350 6.846

Total excluding Arrears 7.037 0.000 0.388 7.424 6.233 0.000 0.350 6.583

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.408 7.424 3.232 6.846 6.162 6.202 6.222 6.252

01 Masaka Referral Hospital Services 4.373 4.329 1.749 4.781 4.633 4.673 4.693 4.723

02 Masaka Referral Hospital Internal Audit 0.003 0.015 0.003 0.006 0.007 0.007 0.007 0.007

1004 Masaka Rehabilitation Referral Hospital 1.032 3.081 1.480 2.058 1.523 1.523 1.523 1.523

Total for the Vote 5.408 7.424 3.232 6.846 6.162 6.202 6.222 6.252

Total Excluding Arrears 5.408 7.424 3.232 6.583 6.162 6.202 6.222 6.252

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide Specialized and higher level health services through provision of curative, preventive, rehabilitative, and pro motive health services to all people of Masaka region Responsible Officer: Dr Tugumisirize Florence 116 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase in diagnostic investigations carried out 10% 13% 15%

‡Bed Occupancy rate 85% 85% 85%

‡increase of specialised clinic outpatients attendences 6% 8% 10%

SubProgramme: 01 Masaka Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 43000 43300 44550

Output: 02 Outpatient services No. of general outpatients attended to 108500 108950 108991

No. of specialised outpatients attended to 151447 151550 152000

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1500000000 1520000000 1525000000

Output: 04 Diagnostic services No. of laboratory tests carried out 553900 554000 554800

No. of patient xrays (imaging) taken 19964 23000 23800

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 15601 15750 15900

No. of children immunised (All immunizations) 34317 34517 34817

No. of family planning users attended to (New and 3500 3850 4000 Old)

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 169 Masaka Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Masaka Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

117 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

Monthly analysis of attendance to duty since we have procured the Machine will be done and displayed on a hospital notice board.



Trained heads of departments and ward/ unit-in charges in leadership



Hospital and unit Quality improvement teams formed and active



Maternal and neonatal mortality audits done



Regular Performance review meetings to be held

Training of staff on customer care to improve patient handling and satisfaction

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : to provide comprehensive HIV/AIDS Services to all eligible patients who report to Masaka Regional Referral Hospital Issue of Concern : HIV/AIDs increasing incidence Planned Interventions : comprehensive monitoring and enrolling all eligible patients to treatment Budget Allocation (Billion) : 0.300 Performance Indicators: % increase in number of new patients accessing Comprehensive care Issue Type: Enviroment

Objective : ensure odourless environment Issue of Concern : indiscriminate littering Planned Interventions : enhanced management of hospital waste Budget Allocation (Billion) : 0.060 Performance Indicators: Frequency and quality of cleaning services of Hospital Compound and clinics and improved waste disposal procedures Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.350

Total 0.000 0.000 0.350

(XII) Personnel Information

118 Masaka Referral Hospital Ministerial Policy Statement

Vote:169 Masaka Referral Hospital

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 CONSULTANT 5 6 1 11 U1SE 2,785,630 13,928,150 33,427,560

DISPENSER 2 1 0 3 U5SC 898,337 1,796,674 10,780,044

ENROLLED MIDWIFE 19 2 2 21 U7U 577,257 10,967,883 6,927,084

ENROLLED NURSE 31 9 3 40 U7U 577,257 17,894,967 6,927,084

LABORATORY ASSISTANT 3 1 0 4 U7U 569,756 1,709,268 6,837,072 (MEDICAL) MEDICAL OFFICER 9 1 0 10 U4SC 1,322,163 11,899,467 15,865,956

MEDICAL OFFICER SPECIAL 2 9 7 11 U2SC 2,150,009 4,300,018 25,800,108 GRADE MORTUARY ATTENDANT 1 1 0 2 U8U 327,069 327,069 3,924,828

PHARMACY ATTENDANT 1 1 0 2 U8L 292,166 292,166 3,505,992

PRINCIPAL CLINICAL OFFICER 0 1 0 1 U3SC 1,534,858 0 18,418,296

PSYCHIATRIC CLINICAL OFFICER 2 2 1 4 U5SC 911,089 1,822,178 10,933,068

SENIOR CONSULTANT 0 4 1 4 U1SE 3,774,120 0 45,289,440

SENIOR DISPENSER 1 1 0 2 U4SC 1,322,163 1,322,163 15,865,956

SENIOR NURSING OFFICER 36 5 3 41 U4SC 729,024 26,244,864 8,748,288

SENIOR PRINCIPAL NURSING 0 1 0 1 U2SC 2,000,000 0 24,000,000 OFFICER SENIOR PSYCHIATRIC CLINICAL 0 2 0 2 U4SC 1,321,674 0 15,860,088 OFFICER SENIOR RADIOGRAPHER 1 1 1 2 U4SC 1,234,008 1,234,008 14,808,096

THEATRE ASSISTANT 3 1 0 4 U6U 623,409 1,870,227 7,480,908

Vote Total 116 49 19 165 22,949,989 13,928,150 275,399,868

119 Mbale Referral Hospital Ministerial Policy Statement

Vote:170 Mbale Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To provide general and specialized, curative preventive, promotive, and rehabilitative services in the 14 Districts of Elgon catchment area

(ii) Strategic Objective

(iii) Major Achievements in 2016/17 6LWHIRUFRQVWUXFWLRQRIVXUJLFDOFRPSOH[KDQGHGRYHUWRFRQWUDFWRU3KDVHRQHRIFRQVWUXFWLRQRIZRUNV$GYHUWVUXQIRU renovation of ward 6/7, bids sold, evaluated bid to select best bidder, and contract awarded to the best bidder. awaiting certificates of works. paid staff salaries , pension and gratuity.Audited and monitored pay roll, supplies, cleaning and sanitation done, (iv) Medium Term Plans Complete surgical complex, procure medical equipment, purchase vehicles to replace aging vehicles, procure hospital beds and bedding. Control medical waste (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 3.372 3.946 1.791 3.946 3.946 3.946 3.946 3.946 Non Wage 2.654 2.480 1.829 2.743 2.086 2.086 2.086 2.086

Devt. GoU 0.501 5.058 1.237 3.058 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 6.528 11.484 4.858 9.746 7.554 7.554 7.554 7.554 Total GoU+Ext Fin (MTEF) 6.528 11.484 4.858 9.746 7.554 7.554 7.554 7.554 Arrears 0.000 0.271 0.271 0.698 0.000 0.000 0.000 0.000 Total Budget 6.528 11.754 5.129 10.444 7.554 7.554 7.554 7.554 A.I.A Total 0.000 0.350 0.000 0.350 0.350 0.350 0.350 0.350 Grand Total 6.528 12.104 5.129 10.794 7.904 7.904 7.904 7.904 Total Vote Budget 6.528 11.834 4.858 10.096 7.904 7.904 7.904 7.904 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 6.425 0.000 0.350 6.775 6.688 0.000 0.350 7.038

211 Wages and Salaries 4.130 0.000 0.180 4.310 4.135 0.000 0.180 4.315

120 Mbale Referral Hospital Ministerial Policy Statement

Vote:170 Mbale Referral Hospital

212 Social Contributions 0.211 0.000 0.000 0.211 0.484 0.000 0.000 0.484

213 Other Employee Costs 0.432 0.000 0.000 0.432 0.421 0.000 0.000 0.421

221 General Expenses 0.324 0.000 0.000 0.324 0.364 0.000 0.000 0.364

222 Communications 0.024 0.000 0.000 0.024 0.028 0.000 0.000 0.028

223 Utility and Property Expenses 0.467 0.000 0.000 0.467 0.463 0.000 0.000 0.463

224 Supplies and Services 0.153 0.000 0.170 0.323 0.149 0.000 0.170 0.319

225 Professional Services 0.000 0.000 0.000 0.000 0.015 0.000 0.000 0.015

226 Insurances and Licenses 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

227 Travel and Transport 0.209 0.000 0.000 0.209 0.209 0.000 0.000 0.209

228 Maintenance 0.444 0.000 0.000 0.444 0.415 0.000 0.000 0.415

273 Employer social benefits 0.032 0.000 0.000 0.032 0.006 0.000 0.000 0.006

Output Class : Capital Purchases 5.058 0.000 0.000 5.058 3.058 0.000 0.000 3.058

312 FIXED ASSETS 5.058 0.000 0.000 5.058 3.058 0.000 0.000 3.058

Output Class : Arrears 0.271 0.000 0.000 0.271 0.698 0.000 0.000 0.698

321 DOMESTIC 0.271 0.000 0.000 0.271 0.698 0.000 0.000 0.698

Grand Total : 11.754 0.000 0.350 12.104 10.444 0.000 0.350 10.794

Total excluding Arrears 11.484 0.000 0.350 11.834 9.746 0.000 0.350 10.096

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 6.528 12.104 5.129 10.794 7.904 7.904 7.904 7.904

01 Mbale Referral Hospital Services 5.721 6.658 3.743 7.348 5.993 5.980 5.980 5.980

02 Mbale Referral Hospital Internal Audit 0.007 0.027 0.006 0.027 0.027 0.041 0.041 0.041

03 Mbale Regional Maintenance 0.298 0.361 0.142 0.361 0.361 0.361 0.361 0.361

1004 Mbale Rehabilitation Referral Hospital 0.501 5.058 1.237 2.000 1.523 1.523 1.523 1.523

1478 Institutional Support to Mbale Regional 0.000 0.000 0.000 1.058 0.000 0.000 0.000 0.000 Hospital Total for the Vote 6.528 12.104 5.129 10.794 7.904 7.904 7.904 7.904

Total Excluding Arrears 6.528 11.834 4.858 10.096 7.904 7.904 7.904 7.904

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To construct surgical, emergency unit, cancer ward and equip with modern medical equipment

121 Mbale Referral Hospital Ministerial Policy Statement

Vote:170 Mbale Referral Hospital

Responsible Officer: Hospital Director, Dr. J.S.O Obbo Programme Outcome: Quality and accessible health services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡increase of specialised clinic outpatients attendences; % 15% 25% 25% increase of diagnostic investigations carried; Average length of stay; bed occupancy rate SubProgramme: 01 Mbale Referral Hospital Services Output: 01 inpatients services No. of in-patients (Admissions) 63000 63000 63000

Output: 05 Hospital Management and support services Timely submission of quarterly financial/activity 12 12 12

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 170 Mbale Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Mbale Rehabilitation Referral Hospital

Output: 08 56 83 OPD and other ward construction and rehabilitation

Major construction of surgical and cancer ward, construction Surgical complex constructed, , of bigger incenerator, Renovation of existing wards purchase of assorted medical equipments Total Output Cost(Ushs Thousand) 4,979,857 1,237,485 2,000,000

Gou Dev¶t: 4,979,857 1,237,485 2,000,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1478 Institutional Support to Mbale Regional Hospital

Output: 08 56 83 OPD and other ward construction and rehabilitation

Total Output Cost(Ushs Thousand) 0 0 830,429

Gou Dev¶t: 0 0 830,429

Ext Fin: 0 0 0

122 Mbale Referral Hospital Ministerial Policy Statement

Vote:170 Mbale Referral Hospital

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Low staffing levels, in adequate allocation of funds for pension and gratuity, LQDGHTXDWHVWDIIDFFRPPRGDWLRQ/RZ07)DOORFDWLRQWRYRWHWRGHYHORSPHQWSURMHFWV Plans to improve Vote Performance

VWUHDPOLQHSURFXUHPHQWSURFHVVVXEPLWYDFDQWSRVWVWR0LQLVWU\3XEOLFVHUYLFH

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.350

Total 0.000 0.000 0.350

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Askari 17 1 1 18 U8 292,166 4,966,822 3,505,992

Enrolled Midwife 19 7 7 26 U7 588,574 11,182,906 7,062,888

Enrolled Nurse 36 8 8 44 U7 596,407 21,470,652 7,156,884

Medical Officer 0 15 0 15 U4 1,322,163 0 15,865,956

Medical Records Assistant 2 4 4 6 U7 460,868 921,736 5,530,416

Nursing Officer(Midwifery) 28 2 2 30 U5 898,337 25,153,436 10,780,044

Nursing Officer(Nursing) 41 27 17 68 U5 937,360 38,431,760 11,248,320

Princ. Laboratory Technologist 0 1 1 1 U3 1,547,935 0 18,575,220

Psychiatric Clinical Officer 0 1 1 1 U5 937,360 0 11,248,320

Sen. Consultant Surgeon 0 1 1 1 U1 3,314,123 0 39,769,476

Vote Total 143 67 42 210 10,895,293 4,966,822 130,743,516

123 Soroti Referral Hospital Ministerial Policy Statement

Vote:171 Soroti Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To increase access to all people in the region to quality general and specialised health services

(ii) Strategic Objective

(iii) Major Achievements in 2016/17 Prevention and Rehabilitation services by end of Quarter 2 731-Physiotherapy 794-Family Planning 865- ANC Management Services by end of Quarter 2 Maintained clean environment Paid Salaries to date Facilitated officers to carryout their duties Ensured staff attendance Procured goods and Services Diagnostics by end of Quarter 2 123682- Lab Tests 2361-ultra sound scans 1465- blood transfusion Inpatients Services by end of Quarter 2. 6403- Inpatients 1064-Deliveries 366- Major Surgeries ALOS-5DAYS BOR- 106% Out Patients Services by end of Quarter 2 26404-General out patients 537- Surgical outpatients 580- Paediatrics 587-gyne 2438- eye out patients 1132-ENT Capital Developments by end of Quarter 2 Private wing block construction to 90% Staff house construction up to 89 %

(iv) Medium Term Plans Increase on MTF ceiling on procurement of medical and non medical equipment and Pensions .Increase staffing levels and staff supervision. Rehabilitation/Renovation of wards and Adm blocks Operationalise the newly constructed private wing building to generate revenue. Maintain efficiency in management of drug stocks

124 Soroti Referral Hospital Ministerial Policy Statement

Vote:171 Soroti Referral Hospital

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.520 2.791 1.699 2.791 2.791 2.791 2.791 2.791 Non Wage 1.932 1.352 0.749 1.474 1.380 1.380 1.380 1.380

Devt. GoU 0.782 1.058 0.709 1.488 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.235 5.201 3.157 5.753 5.693 5.693 5.693 5.693 Total GoU+Ext Fin (MTEF) 5.235 5.201 3.157 5.753 5.693 5.693 5.693 5.693 Arrears 0.169 0.254 0.000 0.117 0.000 0.000 0.000 0.000 Total Budget 5.404 5.455 3.157 5.870 5.693 5.693 5.693 5.693 A.I.A Total 0.000 0.045 0.000 0.045 0.085 0.100 0.125 0.150 Grand Total 5.404 5.500 3.157 5.915 5.778 5.793 5.818 5.843 Total Vote Budget 5.235 5.246 3.157 5.798 5.778 5.793 5.818 5.843 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.142 0.000 0.045 4.187 4.265 0.000 0.045 4.310

211 Wages and Salaries 2.859 0.000 0.045 2.904 2.890 0.000 0.020 2.910

212 Social Contributions 0.067 0.000 0.000 0.067 0.142 0.000 0.000 0.142

213 Other Employee Costs 0.200 0.000 0.000 0.200 0.246 0.000 0.000 0.246

221 General Expenses 0.197 0.000 0.000 0.197 0.182 0.000 0.000 0.182

222 Communications 0.019 0.000 0.000 0.019 0.018 0.000 0.000 0.018

223 Utility and Property Expenses 0.276 0.000 0.000 0.276 0.274 0.000 0.000 0.274

224 Supplies and Services 0.131 0.000 0.000 0.131 0.114 0.000 0.025 0.139

227 Travel and Transport 0.207 0.000 0.000 0.207 0.207 0.000 0.000 0.207

228 Maintenance 0.187 0.000 0.000 0.187 0.191 0.000 0.000 0.191

282 Miscellaneous Other Expenses 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

281 Property expenses other than interest 0.020 0.000 0.000 0.020 0.038 0.000 0.000 0.038

312 FIXED ASSETS 1.038 0.000 0.000 1.038 1.450 0.000 0.000 1.450

Output Class : Arrears 0.254 0.000 0.000 0.254 0.117 0.000 0.000 0.117

125 Soroti Referral Hospital Ministerial Policy Statement

Vote:171 Soroti Referral Hospital

321 DOMESTIC 0.254 0.000 0.000 0.254 0.117 0.000 0.000 0.117

Grand Total : 5.455 0.000 0.045 5.500 5.870 0.000 0.045 5.915

Total excluding Arrears 5.201 0.000 0.045 5.246 5.753 0.000 0.045 5.798

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.404 5.500 3.157 5.915 5.778 5.793 5.818 5.843

01 Soroti Referral Hospital Services 4.382 4.288 2.379 4.281 3.966 3.981 4.006 4.031

02 Soroti Referral Hospital Internal Audit 0.004 0.012 0.002 0.005 0.004 0.004 0.004 0.004

03 Soroti Regional Maintenance 0.236 0.141 0.067 0.141 0.286 0.286 0.286 0.286

1004 Soroti Rehabilitation Referral Hospital 0.782 1.058 0.709 1.348 0.761 0.761 0.761 0.761

1471 Institutional Support to Soroti Regional 0.000 0.000 0.000 0.140 0.761 0.761 0.761 0.761 Referral Hospital Total for the Vote 5.404 5.500 3.157 5.915 5.778 5.793 5.818 5.843

Total Excluding Arrears 5.235 5.246 3.157 5.798 5.778 5.793 5.818 5.843

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide specialized and general health care, conduct training, research and support supervision to other health facilities in the region.To improve quality of services. Responsible Officer: Batiibwe Paul Emmanuel Programme Outcome: quality and accessible regional health services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

126 Soroti Referral Hospital Ministerial Policy Statement

Vote:171 Soroti Referral Hospital

‡quality health 15 20 25

SubProgramme: 01 Soroti Referral Hospital Services Output: 02 Outpatient services No. of general outpatients attended to 84000 85000 86000

No. of specialised outpatients attended to 6800 6900 7000

Output: 04 Diagnostic services No. of laboratory tests carried out 160000 160100 160200

No. of patient xrays (imaging) taken 4000 4100 4200

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 4800 4900 5000

No. of children immunised (All immunizations) 15000 15100 16200

No. of family planning users attended to (New and 2800 2900 3000 Old)

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 171 Soroti Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Soroti Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

- Continuation with payment for the completed staff house payment was made against 2 certificates of Hospital continues to construct 24 units of staff works for staff house for the 2 quarters. house. Payments for supervision of works was also Supervision by supervising engineer will be made undertaken. Total Output Cost(Ushs Thousand) 929,857 709,087 947,424

Gou Dev¶t: 929,857 709,087 947,424

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

127 Soroti Referral Hospital Ministerial Policy Statement

Vote:171 Soroti Referral Hospital

Pensions sent from the centre which is not budgeted for, /RZIXQGLQJWRSURFXUHPHQWRIPHGLFDODQGWUDQVSRUWHTXLSPHQW 6PDOOFDSLWDODOORFDWLRQIRUWKHSD\PHQWRIFRPSOHWLQJVWDIIKRXVH Staffing levels which affect achievement of vote mandate.

Plans to improve Vote Performance

,QFUHDVHRQ07)FHLOLQJRQ3URFXUHPHQWRIPHGLFDODQGQRQPHGLFDOHTXLSPHQWDQG3HQVLRQHUV,QFUHDVHVWDIILQJOHYHOVDQG improvement in capital allocation.Improve on supervision of staff attendance by installation of Bio-metric machines

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.045

Total 0.000 0.000 0.045

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Lab Technician 0 1 0 1 U5 880,083 0 10,560,996

Medical Officer 8 2 0 10 U4 1,320,107 10,560,856 15,841,284

MOSG(Obs/Gyn) 0 1 0 1 U2 2,150,009 0 25,800,108

MOSG(Peadetrician) 0 1 0 1 U2 2,215,831 0 26,589,972

MOSG(Surgeon) 0 1 0 1 U2 2,150,009 0 25,800,108

Nutritionist 0 1 0 1 U4 1,248,057 0 14,976,684

Vote Total 8 7 0 15 9,964,096 0 119,569,152

128 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To be a Regional Center of Excellence in providing specialized and super specialized quality health services, conduct tertiary medical training, research and contributing to National Health policy.

(ii) Strategic Objective Improvement in the total health of the people within Lango Sub Program in order to Promote a productive population

(iii) Major Achievements in 2016/17

(iv) Medium Term Plans 1. Revamping the Hospital Sewerage system. 2. Procurement and installation of a Solar Powered security system. 3. Thorough site clearance for the JICA Development partner's construction project of a new OPD and attendant Wardrooms and offices. 4. Construction of the super structure for the 1st phase of the Staff Accommodation flat.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.622 3.227 1.306 3.227 3.227 3.227 3.227 3.227 Non Wage 2.271 1.383 0.707 1.547 1.360 1.360 1.360 1.360

Devt. GoU 0.538 1.058 0.280 1.488 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.431 5.669 2.294 6.262 6.110 6.110 6.110 6.110 Total GoU+Ext Fin (MTEF) 5.431 5.669 2.294 6.262 6.110 6.110 6.110 6.110 Arrears 0.051 0.304 0.277 0.242 0.000 0.000 0.000 0.000 Total Budget 5.482 5.973 2.570 6.504 6.110 6.110 6.110 6.110 A.I.A Total 0.000 0.040 0.000 0.040 0.050 0.060 0.070 0.080 Grand Total 5.482 6.013 2.570 6.544 6.160 6.170 6.180 6.190 Total Vote Budget 5.431 5.709 2.294 6.302 6.160 6.170 6.180 6.190 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total

129 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

Output Class : Outputs Provided 4.611 0.000 0.040 4.651 4.774 0.000 0.040 4.814

211 Wages and Salaries 3.308 0.000 0.040 3.348 3.300 0.000 0.038 3.338

212 Social Contributions 0.110 0.000 0.000 0.110 0.274 0.000 0.000 0.274

213 Other Employee Costs 0.212 0.000 0.000 0.212 0.209 0.000 0.000 0.209

221 General Expenses 0.235 0.000 0.000 0.235 0.192 0.000 0.000 0.192

222 Communications 0.011 0.000 0.000 0.011 0.003 0.000 0.000 0.003

223 Utility and Property Expenses 0.285 0.000 0.000 0.285 0.328 0.000 0.000 0.328

224 Supplies and Services 0.130 0.000 0.000 0.130 0.126 0.000 0.000 0.126

225 Professional Services 0.005 0.000 0.000 0.005 0.001 0.000 0.000 0.001

227 Travel and Transport 0.163 0.000 0.000 0.163 0.178 0.000 0.002 0.180

228 Maintenance 0.151 0.000 0.000 0.151 0.162 0.000 0.000 0.162

273 Employer social benefits 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

281 Property expenses other than interest 0.000 0.000 0.000 0.000 0.001 0.000 0.000 0.001

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.487 0.000 0.000 1.487

Output Class : Arrears 0.304 0.000 0.000 0.304 0.242 0.000 0.000 0.242

321 DOMESTIC 0.304 0.000 0.000 0.304 0.242 0.000 0.000 0.242

Grand Total : 5.973 0.000 0.040 6.013 6.504 0.000 0.040 6.544

Total excluding Arrears 5.669 0.000 0.040 5.709 6.262 0.000 0.040 6.302

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.482 6.013 2.570 6.544 6.160 6.170 6.180 6.190

01 Lira Referral Hospital Services 4.806 4.811 2.222 4.920 4.501 4.511 4.521 4.531

02 Lira Referral Hospital Internal Audit 0.009 0.015 0.004 0.008 0.008 0.008 0.008 0.008

03 Lira Regional Maintenance 0.128 0.128 0.064 0.128 0.128 0.128 0.128 0.128

1004 Lira Rehabilitation Referral Hospital 0.538 1.058 0.280 1.488 1.523 1.523 1.523 1.523

1477 Institutional Support to Lira Regional 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Hospital Total for the Vote 5.482 6.013 2.570 6.544 6.160 6.170 6.180 6.190

Total Excluding Arrears 5.431 5.709 2.294 6.302 6.160 6.170 6.180 6.190

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

130 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

Programme : 56 Regional Referral Hospital Services Programme Objective : To offer comprehensive, specialized, curative, promotive, and rehabilitative healthcare services in the region. Responsible Officer: Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Percentage (%) increase of specialised clinic outpatients 20% 35% 50% attendences ‡Percentage (%) increase of diagnostic investigations 15% 25% 40% carried ‡Percentage bed occupancy rate 5% 4% 3%

SubProgramme: 01 Lira Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 1100 1150 1200

Output: 02 Outpatient services No. of general outpatients attended to 26000 26100 26200

No. of specialised outpatients attended to 200000 200100 200200

Output: 04 Diagnostic services No. of laboratory tests carried out 150500 150800 151000

No. of patient xrays (imaging) taken 1200 1300 1400

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 172 Lira Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Lira Rehabilitation Referral Hospital

Output: 08 56 77 Purchase of Specialised Machinery & Equipment

Heavy duty photocopier and ptinter procured, Heavy duty washing machine procured, and general hospital medical equipment procured and delivered to lira reg referral hospital Total Output Cost(Ushs Thousand) 519,857 279,976 0

Gou Dev¶t: 519,857 279,976 0

131 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 80 Hospital Construction/rehabilitation installation of oxygen plant Revamping of the Sewarage system

Total Output Cost(Ushs Thousand) 78,571 0 578,000

Gou Dev¶t: 78,571 0 578,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 81 Staff houses construction and rehabilitation

Payment of retention for staff houses Super structure up to roofing level of a 16No. Units Staff house (Phase one of the Construction project). Total Output Cost(Ushs Thousand) 200,000 0 800,000

Gou Dev¶t: 200,000 0 800,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5601 Inpatient services Change in Allocation (UShs Bn) : -3.478 Transferring all management related costs to the Hospital Management and Support Services Key Output Output: 08 5602 Outpatient services Change in Allocation (UShs Bn) : -0.082 Transferring all management related costs to the Hospital Management and Support Services Key Output Output: 08 5605 Hospital Management and support services Change in Allocation (UShs Bn) : 3.781 (1) Incorporation of Pension and Gratuity expenses. (2) Consolidation of all management related cost to the management and support services. Output: 08 5606 Prevention and rehabilitation services Change in Allocation (UShs Bn) : -0.046 Transferring all management related costs to the Hospital Management and Support Services Key Output Output: 08 5607 Immunisation Services Change in Allocation (UShs Bn) : 0.008 Transferring all management related costs to the Hospital Management and Support Services Key Output Output: 08 5619 Human Resource Management Services

132 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

Change in Allocation (UShs Bn) : 0.025

Threshold set by the mother Ministry of Public Service. Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.010

As a new output, included in an inelastic resource basket. Output: 08 5680 Hospital Construction/rehabilitation Change in Allocation (UShs Bn) : 0.499 To revamp the overstretched Sewarage system which no longer matches with the current very high user population. Output: 08 5681 Staff houses construction and rehabilitation Change in Allocation (UShs Bn) : 0.600

Commencement of the two phased project in order to uplift the morale of the staffs. Output: 08 5683 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 0.110 Required to enable the entity benefit from the JICA development partners goodwill of a fully fledged OPD with its attendant sub-units.

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

(1) Overcrowding at the Outpatient and Inpatient centers yet the building capacities are limited.

(2) Limited staffing levels especially at Consultant and Senior Consultant Levels. Plans to improve Vote Performance

(1) Engaging district and lower facility leadership to revitalize service delivery

(2) Publicity towards the general public to avoid self referrals and seek primary healthcare from the lower facilities.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : (1) To provide HIV services to adolescents and the youth at specialized clinics (2) To strengthen HIV/AIDS prevention through radio talk shows , provision of HIV/AIDS, TB and malaria drugs. To continue strengthening HIV service provision at Lira Infectious Disease clinic to all persons without discrimination. Issue of Concern : To provide HIV services to adolescents and the youth at specialized clinics

Planned Interventions : Mass sensitization and Counseling. Budget Allocation (Billion) : 0.050 Performance Indicators: Number of radio talk shows held, Number of Community outreaches organized and successfully implemented, Number of young men who have undergone safe male circumcision.

133 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

Issue Type: Gender

Objective : (1) To improve Sexual and reproductive Health Services for young persons in Lira RRH Catchment areas (2) To eliminate mother to child transmission of HIV/AIDS and also to promote safe male circumcision and provide Tetanus Toxoid vaccine to voluntary male circumcision and women in reproductive age. (3) To focus on the reduction of maternal and neonatal mortality. To plan and procure medicine and other health supplies for emergency obstetric and new born care. Issue of Concern : 0817202453-(1) To improve Sexual and reproductive Health Services for young persons in Lira RRH Catchment areas (2) To eliminate mother to child transmission of HIV/AIDS and also to promote safe male circumcision and provide Tetanus Toxoid vaccine Planned Interventions : Provision of information on sexual reproductive health and counseling and support of teenage mothers on matters of Antenatal, Family planning and family support. Budget Allocation (Billion) : 0.020 Performance Indicators: Number of young persons reached, Number of counseling services sessions reported. Issue Type: Enviroment

Objective : (1)To encourage the use of fuel efficient stoves for cooking in the hospital.

(2) To promote green environment through sensitization of our clients and staff and planting of trees and grass within the hospital.

(3) To improve on the management of medical and other wastes disposal within the hospital. Issue of Concern : To encourage the use of fuel efficient stoves for cooking in the hospital and To improve on the management of medical and other wastes disposal within the hospital. Planned Interventions : Sensitization about the use of fuel efficient stoves. Procurement of heavy duty waste bins and Training in infection prevention and control. Budget Allocation (Billion) : 0.030 Performance Indicators: 100% usage of fuel efficient stoves, 100% infection prevented and controlled,

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.000 0.040

Total 0.000 0.000 0.040

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Pool Stenographer 0 1 1 1 U5 L 386,972 0 4,643,664

Accountant 0 1 1 1 U4 U 798,667 0 9,584,004

ANAESTHETIC OFFICER 0 2 2 2 U5 833,711 0 10,004,532

Assistant Procurement Officer 0 1 1 1 U5 U 625,067 0 7,500,804

134 Lira Referral Hospital Ministerial Policy Statement

Vote:172 Lira Referral Hospital

CLINICAL OFFICER 0 2 2 2 U5 845,442 0 10,145,304

CONSULTANT 0 7 7 7 U1 2,835,683 0 34,028,196

Dental Technologist 0 1 1 1 U5 753,862 0 9,046,344 SC Engineering Technician 0 1 1 1 U7 447,080 0 5,364,960 U ENROLLED MIDWIFE 0 4 4 4 U7 527,468 0 6,329,616

ENROLLED NURSE 0 4 4 4 U7 519,721 0 6,236,652

Laboratory Technologist 0 1 1 1 U5 SC 753,862 0 9,046,344

MEDICAL OFFICER 0 3 3 3 U4 1,396,677 0 16,760,124

MEDICAL OFFICER SPECIAL 0 8 8 8 U2 2,278,515 0 27,342,180 GRADE NURSING OFFFICER 0 2 2 2 U5 845,442 0 10,145,304

NURSING OFFICER 0 6 6 6 U4 SC 845,442 0 9,046,344

Senior Consultant (Obs & Gyn) 0 1 1 1 US1E 3,616,565 0 43,398,780

Senior Consultant (Surgery) 0 1 1 1 US1E 3,616,565 0 43,398,780

Senior Nutritionist 0 1 1 1 U3 SC 1,315,765 0 15,789,180

Senior Occupational Therapist 0 1 1 1 U3 1,131,967 0 15,846,036

SENIOR OPTHALMIC CLINICAL 0 1 1 1 U4 1,186,244 0 14,234,928 OFFICER SENIOR OTHOPEDIC OFFICER 0 1 1 1 U4 1,186,677 0 14,240,124

Senior Pharmacist 0 1 1 1 U3 SC 1,315,765 0 15,789,180

SENIOR PHYSIOTHERAPIST 0 1 1 1 U4 1,185,554 0 14,226,648

SENIOR RADIOGRAPHER 0 1 1 1 U4 1,357,206 0 16,286,472

SENIOR RECORDS ASSISTANT 0 2 2 2 U6 486,615 0 5,839,380

SENIOR THEATER ASSISTANT 0 1 1 1 U4 1,184,857 0 14,218,284

Vote Total 0 56 56 56 32,277,391 0 388,492,164

135 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To provide comprehensive, super specialized health services, conduct tertiary health training, research and contributing to the health policy.

(ii) Strategic Objective a. Offer comprehensive super-specialised curative, promotive, preventive and rehabilitative health care services. b. Provide outreach specialist support supervision services for District general Hospitals and lower level Health Facilities. c. Offer tertiary and continuing Professional Development to health workers. d. Contribute to the formulation of policies and guidelines of the Ministry of Health. e. Participate in the monitoring and evaluation of health services in the country. f. Undertake and conduct operational, technical and professional research. g. Provide quality assurance and support services to health care delivery system. h. To improve on the infrastructure of the entity through provision of adequate staff accommodation, improve working conditions and increase patient space within the next five years. i. To improve maternal child health care services and have safe deliveries, successful caesarean sections and eliminate fresh still births for mothers who come timely. j. To procure and maintain modern medical and non-medical equipment and furniture within the next five years to improve service delivery.

(iii) Major Achievements in 2016/17 Admissions: 17,879 Bed occupancy: 84% Average length of stay: 4 days Normal deliveries: 2,908 Caesarean sections: 1,629 Major surgeries: 5,646 General out patients: 20,818 Special clinics outpatient: 53,300 X-ray examinations: 2,315 Ultra sound: 4,620 Laboratory/pathological/blood transfusions: 54,660 Family planning contacts: 630 ANC/ PMTCT: 15,406 Management and support services: ,QDXJXUDWHGWKHERDUGKHOGWZRERDUGPHHWLQJV1,580 meals for malnourished children and TB patients, 4 contracts committee meetings, 16 other staff meetings, linen washed, utilities for the two quarters provided, serviced 4 vehicles, purchased 4 tires, end of year performance report, final accounts prepared, cleaned and maintained buildings and compounds.

Purchase of Motor Vehicles and Other Transport Equipment: Procurement process ongoing with the bid documents prepared. Clearance issued by Ministry of Public Service and solicitation of ELGGHUVDZDLWVFOHDUDQFHRIVSHFLILFDWLRQVIURPWKH&KLHI0HFKDQLFDO(QJLQHHU

Hospital Construction/rehabilitation: Solicitation bids issued for putting racks in medicines stores. Renovation of the former laundry/kitchen building to convert it into a multi-purpose building is ongoing and progress is at 80%

Staff houses construction/rehabilitation: The super structure of the 16 units of flat apartments is at roofing level.

Purchase of Medical Equipment: Procurement process of assorted medical equipment including monitors to set up high dependence units on departments at issue of bids.

136 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

(iv) Medium Term Plans In the medium term service delivery is to concentrate on the specialists clinics to meet our core mission of being a referral hospital and improve working conditions through construction of staff houses, provision of basic tools to deliver services and improve data capture at all points. In the medium term we also plan to renovate existing structures and fence the hospital to manage crowds and improve security. (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 3.264 3.399 1.270 3.399 3.399 3.399 3.399 3.399 Non Wage 2.926 1.261 0.566 1.261 1.461 1.461 1.461 1.461

Devt. GoU 0.783 1.558 0.530 1.978 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 6.973 6.219 2.366 6.639 6.383 6.383 6.383 6.383 Total GoU+Ext Fin (MTEF) 6.973 6.219 2.366 6.639 6.383 6.383 6.383 6.383 Arrears 0.356 0.000 0.000 0.194 0.000 0.000 0.000 0.000 Total Budget 7.329 6.219 2.366 6.833 6.383 6.383 6.383 6.383 A.I.A Total 0.941 0.725 0.365 1.200 1.400 1.500 1.600 1.700 Grand Total 8.270 6.943 2.732 8.033 7.783 7.883 7.983 8.083 Total Vote Budget 7.914 6.943 2.732 7.839 7.783 7.883 7.983 8.083 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.661 0.000 0.725 5.385 4.661 0.000 1.200 5.861

211 Wages and Salaries 3.407 0.000 0.470 3.877 3.399 0.000 0.600 3.999

212 Social Contributions 0.039 0.000 0.000 0.039 0.039 0.000 0.024 0.063

213 Other Employee Costs 0.096 0.000 0.000 0.096 0.090 0.000 0.007 0.098

221 General Expenses 0.178 0.000 0.040 0.218 0.273 0.000 0.033 0.307

222 Communications 0.014 0.000 0.000 0.014 0.020 0.000 0.001 0.021

223 Utility and Property Expenses 0.537 0.000 0.000 0.537 0.527 0.000 0.006 0.533

224 Supplies and Services 0.167 0.000 0.080 0.247 0.116 0.000 0.432 0.548

227 Travel and Transport 0.154 0.000 0.035 0.189 0.134 0.000 0.050 0.184

228 Maintenance 0.069 0.000 0.100 0.169 0.061 0.000 0.047 0.108

Output Class : Capital Purchases 1.558 0.000 0.000 1.558 1.978 0.000 0.000 1.978

137 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

312 FIXED ASSETS 1.558 0.000 0.000 1.558 1.978 0.000 0.000 1.978

Output Class : Arrears 0.000 0.000 0.000 0.000 0.194 0.000 0.000 0.194

321 DOMESTIC 0.000 0.000 0.000 0.000 0.194 0.000 0.000 0.194

Grand Total : 6.219 0.000 0.725 6.943 6.833 0.000 1.200 8.033

Total excluding Arrears 6.219 0.000 0.725 6.943 6.639 0.000 1.200 7.839

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 7.329 6.943 2.366 8.033 7.783 7.883 7.983 8.083

01 Mbarara Referral Hospital Services 6.546 5.361 1.711 6.027 6.233 6.333 6.433 6.533

02 Mbarara Referral Hospital Internal Audit 0.000 0.024 0.125 0.028 0.028 0.028 0.028 0.028

1004 Mbarara Rehabilitation Referral Hospital 0.783 1.558 0.530 1.228 1.523 1.523 1.523 1.523

1479 Institutional Support to Mbarara 0.000 0.000 0.000 0.750 0.000 0.000 0.000 0.000 Regional Hospital Total for the Vote 7.329 6.943 2.366 8.033 7.783 7.883 7.983 8.083

Total Excluding Arrears 6.973 6.943 2.366 7.839 7.783 7.883 7.983 8.083

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : Quality and accessible Regional Referral Hospital Services Responsible Officer: Dr. Barigye Celestine Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

138 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

‡increase of specialised clinic outpatients attendences 5% 3% 3%

‡increase of diagnostic investigations carried 5% 7% 7%

‡Bed occupancy rate 80% 85% 85%

SubProgramme: 01 Mbarara Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 29400 30870 32414

Output: 02 Outpatient services No. of general outpatients attended to 39900 41895 43990

No. of specialised outpatients attended to 126000 132300 138915

Output: 04 Diagnostic services No. of laboratory tests carried out 109600 115000 120834

No. of patient xrays (imaging) taken 13990 14690 15424

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 11500 12075 12679

No. of children immunised (All immunizations) 30000 31500 33075

No. of family planning users attended to (New and 3300 3465 3638 Old) SubProgramme: 1004 Mbarara Rehabilitation Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of reconstructed/rehabilitated general wards 2 3 4

No. of hospitals benefiting from the renovation of 1 1 1 existing facilities Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 16 16 16

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 0.5 0.5 0.5

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 173 Mbarara Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Mbarara Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

139 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

Continuation of construction of sixteen units staff quarters The super structure in place 16 units staff quarters Completion of 16 units staff quarters Total Output Cost(Ushs Thousand) 659,986 320,178 928,000

Gou Dev¶t: 659,986 320,178 928,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 85 Purchase of Medical Equipment

Procure maternity delivery beds, Patient monitors for obsetrics Procurement process at issue of bids Assorted medical equipment including monitors and gynecology, ICT equipment for data capture in OPD, for high dependence units Emergency and all wards, patient monitors for ICU and neuro surgery equipment Total Output Cost(Ushs Thousand) 500,000 131,932 300,000

Gou Dev¶t: 500,000 131,932 300,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5619 Human Resource Management Services Change in Allocation (UShs Bn) : 0.021 This is a new out put

Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.004 This is a new out put

Output: 08 5675 Purchase of Motor Vehicles and Other Transport Equipment Change in Allocation (UShs Bn) : 0.180 Staff transport has been a challenge and hiring is costly thus need to acquire a 30 sitter staff van

Output: 08 5680 Hospital Construction/rehabilitation Change in Allocation (UShs Bn) : 0.172 Most of the wards are in need of rehabilitation thus the need to start with maternity especially the labor suit that is in very bad shape and the surgical ward Output: 08 5681 Staff houses construction and rehabilitation Change in Allocation (UShs Bn) : 0.268 This was a multi year project which we wanted to concluded and only remain with retention money

Output: 08 5685 Purchase of Medical Equipment Change in Allocation (UShs Bn) : -0.200 Over years we have been allocating substantial amount of money and we have scale this output down to improve on others

140 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

The challenges of the vote include inadequate funding for Medicines and sundries under NMS meeting on average about 50% of our requirements leaving clients to purchase common user items. The staff structures have been stagnant for long leaving heavy word that compromises efficiency leaving the few available staff overburdened. The infrastructure is old, dilapidated and LQDGHTXDWHOHDGLQJWRRYHUIORRUFDVHV Plans to improve Vote Performance

In order to improve performance the entity has requested to fill all the existing vacancies within the available wage bill. Will continue to allocate and utilize available resources efficiently. AIA resources are allocated to cater for some of the critical supplies to benefit all the patients.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To reduce incidence of HIV infections Issue of Concern : Increased incidence of HIV in the community and most at risk populations Planned Interventions : Safe male circumcision, treatment, post exposure prophylaxis exposed persons, health education towards responsible behavior and personal protection, counseling and testing, treat sexually transmitted infections. Budget Allocation (Billion) : 0.400 Performance Indicators: Number cases, male circumcisions done, condoms issued, post exposure prophylaxis issued, number of people on HAART Objective : Elimination of mother to child infections Issue of Concern : Babies born with HIV when mothers are not diagnosed during antenatal and treatment given at birth Planned Interventions : Test every mother and husband during antenatal, those who are found positive are put on treatment and followed up until delivery. Budget Allocation (Billion) : 0.005 Performance Indicators: Number of mothers and farthers tested, number of mothers on treatment of full HAART and number of children tested negative born of positive mothers Objective : To give HAART TO all that are eligible Issue of Concern : To reach the tipping point and safeguard the population from new infections. Planned Interventions : Initiation of all clients whose CD4 count requires of HAART, counseling of positive clients to adhere and live positively Budget Allocation (Billion) : 0.400 Performance Indicators: Number of clients on full HAART, number of clients counseled, compliance levels of those clients on treatment Issue Type: Gender

Objective : To have equal access to health services despite gender, age and social economic status Issue of Concern : Access to maternal child health services

141 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

Planned Interventions : Provission of free maternal child health services, automatic waiver for services under the paying wing for all mothers and children who cant afford paying Budget Allocation (Billion) : 0.008 Performance Indicators: Number of deliveries conducted in the facility and children below five treated Objective : To offer ambulatory services to all critically ill patients referred out of the facility Issue of Concern : Inappropriate ambulatory services for critically ill patients Planned Interventions : Provision of free ambulatory services for critically ill poor patients and on cost sharing basis for those who can afford Budget Allocation (Billion) : 0.002 Performance Indicators: Number of patients offered ambulatory services on referral out of the facility Objective : To educate the community about the dangers of late service seeking behavior Issue of Concern : Delayed health seeking behavior that results into complications Planned Interventions : Health education at hospital, outreach services to the catchment area Budget Allocation (Billion) : 0.010 Performance Indicators: Reduced numbers of mothers in obstructed labor as a result of delaying, fewer mothers going to traditional birth attendants, a link between the hospital and the village health team members Issue Type: Enviroment

Objective : To eliminate facility based infections Issue of Concern : Facility based infections that result into sepsis Planned Interventions : Infection control and elimination of sepsis through provision of infection control materials, segregation of wastes and incineration and isolation of septic cases, autoclave, protective gear and proper cleaning. Budget Allocation (Billion) : 0.060 Performance Indicators: Number of septic cases registered, level of infections on wards, quantity of infection control materials procured. Objective : To have a clean and safe working environment Issue of Concern : Contamination resulting into cross infection Planned Interventions : Proper cleaning and decontamination, segregation of wastes and proper disposal, availability of running water, functional toilet facilities, full uniform for staff and linen for theater. Budget Allocation (Billion) : 0.060 Performance Indicators: Level of cleanliness, availability of running water, level of segregation of wastes, availability of color coded bins, staff in full uniform Objective : Proper waste disposal and management Issue of Concern : Environmental pollution and public safety Planned Interventions : Slushing of compound, disposal of expired drugs, inceneration of dangerous wastes, disposal of waste water into National Water and Sewerage Corporation waste line Budget Allocation (Billion) : 0.400 Performance Indicators: Clean compound, expired drugs disposed, dangerous wastes being disposed, bills for waste water disposal Table 11.2: AIA Collections

142 Mbarara Referral Hospital Ministerial Policy Statement

Vote:173 Mbarara Referral Hospital

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Other Fees and Charges 0.000 0.437 1.200

Total 0.000 0.437 1.200

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 ACCOUNTS ASSISTANT 1 1 1 2 U7U 461,904 461,904 5,542,848

Anaesthetic Officer 1 2 2 3 U5SC 0 0 0

Consultant Anaethesiology 0 1 1 1 U1SE 2,555,683 0 30,668,196

Consultant Orthopaedic 0 1 1 1 U1SE 255,683 0 3,068,196

Consultant Pathology 0 1 1 1 U1SE 2,555,683 0 30,668,196

CONSULTANT SURGEON 0 1 1 1 U1SE 2,555,683 0 30,668,196

CONSULTANT-PUBLIC HEALTH 0 1 1 1 U1SE 2,785,630 0 33,427,560

ENROLLED MIDWIFE 18 6 6 24 U7U 557,633 10,037,394 6,691,596

ENROLLED NURSE 33 19 19 52 U7U 510,102 16,833,366 6,121,224

MEDICAL OFFICER SPECIAL 0 1 1 1 U2 2,028,715 0 24,344,580 GRADE SENIOR ACCOUNTS ASSISTANT 1 1 1 2 U5U 569,040 569,040 6,828,480

SENIOR CONSULTANT 1 3 3 4 U1SE 3,152,263 3,152,263 37,827,156

SENIOR ENROLLED NURSE 14 4 4 18 U5U 894,742 12,526,388 10,736,904

Senior Hospital Administrator 0 1 1 1 U3L 902,612 0 10,831,344

SENIOR PRINCIPAL STORES 0 1 1 1 U4 824,075 0 9,888,900 ASSISTANT Vote Total 69 44 44 113 20,609,448 461,904 247,313,376

143 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

V1: Vote Overview (i) Vote Mission Statement To be a center of excellence in providing both specialized and general curative, preventive, health promotion and rehabilitative services to the community in our catchment area.

(ii) Strategic Objective a. To improve the quality and productivity of the people by enhancing good health through increasing awareness and uptake of disease prevention interventions. b. To reduce Maternal and Neo Natal Mortality. c. To contribute to the body of knowledge in health care through training, research and disseminating best practices. d. To combat HIV/AIDS, TB, Malaria and other infectious diseases. e. To strengthen collaboration with other stake holders. f. To build a formidable and highly motivated and committed health care work force.

(iii) Major Achievements in 2016/17 Finance: - 48% of the budget was released (1.98 billion out of 5.49 billion). - 74% of funds were spent by mid year Inpatient services: - 8046 inpatients were seen, - ALOS 4 days, - 91% BOR, - 664 ceasarian sections were done Outpatient services: - 60700 outpatients were seen, - 35679 specialized cases were seen, - 5548 emergencies were seen, - 227 HIV+ people initiated on ART Diagnostic services: - 50754 Lab test were done, - 1893 Xrays were done, - 1546 ultrasounds were done, - 90 postmortems were done Prevention and rehabilitation: - 13514 immunizations were done, - 1109 Family planning users seen, - 99 HIV+ mothers initiated on option B+ Other achievements: - Continued construction of medical - pediatrics - mortuary block up to 2nd floor level, - Construction of oxygen plant house initiated, - Installation of heavy duty laundry initiated (iv) Medium Term Plans The Major medium Term Plans are to accelerate disease prevention and health promotion interventions, Increase space available IRUSDWLHQWV ZDUGV DVZHOODVLQLWLDWHFRQVWUXFWLRQRIVWDIIKRXVHVDVZHOODVDQLQWHUQVPHVV (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections

144 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 2.074 3.439 1.098 3.439 3.439 3.439 3.439 3.439 Non Wage 1.363 0.929 0.343 0.936 1.086 1.086 1.086 1.086

Devt. GoU 1.800 1.058 0.529 1.060 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.237 5.426 1.971 5.435 6.047 6.047 6.047 6.047 Total GoU+Ext Fin (MTEF) 5.237 5.426 1.971 5.435 6.047 6.047 6.047 6.047 Arrears 0.000 0.000 0.000 0.083 0.000 0.000 0.000 0.000 Total Budget 5.237 5.426 1.971 5.518 6.047 6.047 6.047 6.047 A.I.A Total 0.000 0.060 0.011 0.130 0.140 0.145 0.150 0.155 Grand Total 5.237 5.486 1.982 5.648 6.187 6.192 6.197 6.202 Total Vote Budget 5.237 5.486 1.982 5.565 6.187 6.192 6.197 6.202 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 4.367 0.000 0.060 4.427 4.375 0.000 0.130 4.505

211 Wages and Salaries 3.494 0.000 0.030 3.524 3.513 0.000 0.065 3.578

212 Social Contributions 0.055 0.000 0.000 0.055 0.063 0.000 0.000 0.063

213 Other Employee Costs 0.091 0.000 0.000 0.091 0.090 0.000 0.000 0.090

221 General Expenses 0.186 0.000 0.000 0.186 0.145 0.000 0.000 0.145

222 Communications 0.013 0.000 0.000 0.013 0.014 0.000 0.000 0.014

223 Utility and Property Expenses 0.135 0.000 0.000 0.135 0.155 0.000 0.000 0.155

224 Supplies and Services 0.114 0.000 0.030 0.144 0.123 0.000 0.065 0.188

227 Travel and Transport 0.161 0.000 0.000 0.161 0.121 0.000 0.000 0.121

228 Maintenance 0.113 0.000 0.000 0.113 0.146 0.000 0.000 0.146

273 Employer social benefits 0.006 0.000 0.000 0.006 0.004 0.000 0.000 0.004

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.060 0.000 0.000 1.060

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.060 0.000 0.000 1.060

Output Class : Arrears 0.000 0.000 0.000 0.000 0.083 0.000 0.000 0.083

321 DOMESTIC 0.000 0.000 0.000 0.000 0.083 0.000 0.000 0.083

Grand Total : 5.426 0.000 0.060 5.486 5.518 0.000 0.130 5.648

Total excluding Arrears 5.426 0.000 0.060 5.486 5.435 0.000 0.130 5.565

145 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.237 5.486 1.971 5.648 6.187 6.192 6.197 6.202

01 Mubende Referral Hospital Services 2.939 4.337 1.397 4.496 4.563 4.568 4.573 4.578

02 Mubende Referral Hospital Internal Audit 0.010 0.010 0.005 0.010 0.009 0.009 0.009 0.009

03 Mubende Regional Maintenance 0.487 0.081 0.040 0.082 0.092 0.092 0.092 0.092

1004 Mubende Rehabilitation Referal Hospital 1.800 1.058 0.529 0.675 1.523 1.523 1.523 1.523

1482 Institutional Support to Mubende 0.000 0.000 0.000 0.385 0.000 0.000 0.000 0.000 Regional Hospital Total for the Vote 5.237 5.486 1.971 5.648 6.187 6.192 6.197 6.202

Total Excluding Arrears 5.237 5.486 1.971 5.565 6.187 6.192 6.197 6.202

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide specialized and general health care and treatment, disease prevention, rehabilitative and health promotion services. Responsible Officer: Dr. Peter Mukobi Programme Outcome: Quality and accessible regional referral hospital services. Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Bed Occupancy Rate (BOR) 85% 88% 90%

‡Percentage increase of diagnostic investigations carried 5% 5% 5% out. ‡Percentage increase of specialised clinic outpatients 5% 5% 5% attendences SubProgramme: 01 Mubende Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 18000 18500 19000

Average Length of Stay (ALOS) - days 4 4 3.5

Bed Occupancy Rate (BOR) 85 90 90

Number of Major Operations (including Ceasarian se 2200 2250 2300

146 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

Output: 02 Outpatient services No. of general outpatients attended to 122000 123000 124000

No. of specialised outpatients attended to 122000 123000 124000

Referral cases in 1800 1850 1900

Output: 04 Diagnostic services No. of laboratory tests carried out 102000 105000 107000

No. of patient xrays (imaging) taken 4150 4200 4250

Number of Ultra Sound Scans 2210 2250 2270

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 12 12 12

Timely submission of quarterly financial/activity 4 4 4

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 8330 8400 8500

No. of children immunised (All immunizations) 28000 28500 29000

No. of family planning users attended to (New and 1800 1900 2000 Old) Number of ANC Visits (All visits) 8330 8400 8500

Percentage of HIV positive pregnant women not on H 90% 90% 90%

Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 29288 30000 31000

SubProgramme: 1004 Mubende Rehabilitation Referal Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 0 0 0 existing facilities No. of reconstructed/rehabilitated general wards 1 1 1

Cerificates of progress/ Completion 1 1 1

SubProgramme: 1482 Institutional Support to Mubende Regional Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of 1 1 1 existing facilities No. of reconstructed/rehabilitated general wards 0 0 0

Cerificates of progress/ Completion 1 1 1

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .085 .100 .1

147 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 174 Mubende Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Mubende Rehabilitation Referal Hospital

Output: 08 56 80 Hospital Construction/rehabilitation

Continuation of construction of pediatric/mortuary building - Medical-Mortuary-Medical block constructed and supevision of works done.

Old building for Admin, Med, ANC & Paed wards renovated

Oxygen Plant procured Total Output Cost(Ushs Thousand) 1,058,257 529,129 675,000

Gou Dev¶t: 1,058,257 529,129 675,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5602 Outpatient services Change in Allocation (UShs Bn) : 0.075 Funding required to address enable improve quality and quantity of services provided at Outpatient level

Output: 08 5604 Diagnostic services Change in Allocation (UShs Bn) : 0.032 Increase in funding to enable increase in number of investigations and quality services

Output: 08 5606 Prevention and rehabilitation services Change in Allocation (UShs Bn) : 0.026 Funding required to address disease prevention and health promotion as a priority of the sector

Output: 08 5607 Immunisation Services Change in Allocation (UShs Bn) : 0.044 Funding required to improve immunization services to reduce immunizable diseases

Output: 08 5619 Human Resource Management Services Change in Allocation (UShs Bn) : 0.020 Funding required to functionalize the Human Resource Management functions

148 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.005 Funding required to enable the establishment of a functional registry

Output: 08 5685 Purchase of Medical Equipment Change in Allocation (UShs Bn) : 0.085 Funding required to enable the purchase of emergency medical equipment and assorted orthopedic workshop as well as physiotherapy equipment

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

Major Vote challenges include:

- Insufficient funds to accomplish projects on time thus increasing overall project costs - Lack of staff accommodation leading to poor retention of staff and demotivate - Insufficient space on wards leading to presence floor cases that affects customer satisfaction - Low remuneration of staff thus poor service delivery as a result of demotivation - Insufficient Medical Equipment thus affecting quality of services provided - Insufficient Budget allocation for medicines and health supplies thus frequent stock-outs of medicines Plans to improve Vote Performance

Increase in advocacy for improved budget allocations shall be done henceforth attempt to address the vote challenges most of ZKLFKFDQEHUHGUHVVHGE\EHWWHUDOORFDWLRQV

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Reduce transmission of HIV among Women, men, children and youth in Mubende Region Issue of Concern : - High sero-prevalence - Low male involvement - Poor stock levels of supplies Planned Interventions : - Routine static & community services -Promote male involvement in talk shows - Increased advocacy of increased funding Budget Allocation (Billion) : 0.084 Performance Indicators: - HIV sero-prevalence among women reduced from 3.4% to less than 3% Issue Type: Gender

Objective : To ensure equitable access to quality health services to all women, men and children in Mubende Region Issue of Concern : Equitable access to quality health care for all; women,men, children and the youth. Planned Interventions : Sensitization through radio talk shows, establish adolescent friendly services/clinics, ramps on new buildings, separation of male & female toilets Budget Allocation (Billion) : 0.010 Performance Indicators: 4 stakeholders meetings, 12 radio talk shows and 1 functional adolescent clinic, 1 new buildings with ramp. 149 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

Issue Type: Enviroment

Objective : To mitigate the environmental impact of health care interventions at Mubende Regional Referral Hospital. Issue of Concern : Environmental degradation as a result of hospital activities e.g poor incineration system and garbage collection and poor sanitation Planned Interventions : - Proper incineration system - improve garbage management - improve drainage system. Budget Allocation (Billion) : 0.002 Performance Indicators: -1 Functional incinerator in place - Garbage disposal bins in place in all areas - 1 improved drainage system Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Sale of drugs 0.000 0.000 0.039

Other Fees and Charges 0.000 0.000 0.091

Total 0.000 0.000 0.130

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Accounts Assistant 1 3 3 4 U6U 0 0 0

Anaesthetia 1 1 1 2 U5 753,862 753,862 9,046,344

Artisanmate 1 1 1 2 U8 209,859 209,859 2,518,308

Assistant Medical Records Officer 1 1 1 2 U5L 0 0 0

Clinical Officer 9 2 2 11 U5 753,862 6,784,758 9,046,344

Consultant Radiologist 0 1 1 1 U1 2,893,252 0 34,719,024

Dental Surgeon 0 1 1 1 U4 1,131,967 0 13,583,604

Dhobi 3 3 2 6 U8 0 0 0

Dispenser 1 3 3 4 U5SC 0 0 0

Domestic Assistant 1 2 2 3 U7 377,781 377,781 4,533,372

EN MID WIFE 10 10 10 20 U7 377,781 3,777,810 4,533,372

EN Nurse 30 10 10 40 U7 377,781 11,333,430 4,533,372

Engineering Assistant 1 1 1 2 U7 377,781 377,781 4,533,372

Engineering Technician 0 2 2 2 U6U 0 0 0

Kitchen Attendant 6 1 1 7 U8 209,859 1,259,154 2,518,308

150 Mubende Referral Hospital Ministerial Policy Statement

Vote:174 Mubende Referral Hospital

Medical Officer 6 4 4 10 U4 1,131,967 6,791,802 13,583,604

MOSG paediatric 0 1 1 1 U2 1,992,454 0 23,909,448

MOSG Public health 0 1 1 1 U3 1,315,765 0 15,789,180

NO 35 2 2 37 U5 753,862 26,385,170 9,046,344

Office Attendant 1 1 1 2 U8 209,859 209,859 2,518,308

Pharmacy Attendant 1 1 1 2 U8 0 0 0

Princ Lab Technologist 0 1 1 1 U3 1,315,765 0 15,789,180

Principal Anaesthetic Officer 0 1 1 1 U3 1,315,765 0 15,789,180

Psych Clinical Officer 3 1 1 4 U5 753,862 2,261,586 9,046,344

Records Assistant 1 2 2 3 U7 377,781 377,781 4,533,372

Sen Clinical Officer 2 1 1 3 U4 1,131,967 2,263,934 13,583,604

Sen Psych Clinical Officer 0 2 2 2 U4 1,131,967 0 13,583,604

Senior Accounts Assistant 0 2 1 2 U5 753,862 0 9,046,344

Senior Labaratory Technologist 1 2 2 3 U4SC 0 0 0

Senior Nursing Officer 7 8 7 15 U4 1,131,967 7,923,769 13,583,604

Stenographer/Secretary 0 1 1 1 U5 753,862 0 9,046,344

Stores Assistant 0 2 2 2 U7 377,781 0 4,533,372

Vote Total 122 75 72 197 21,912,271 0 262,947,252

151 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

V1: Vote Overview (i) Vote Mission Statement Vote Mission: To increase access of all people in Karamoja Region and Beyond to quality general and specialized health services

(ii) Strategic Objective To provide comprehensive, super specialized health service, contact tertiary health training, research and contributing to health policy and planning. (iii) Major Achievements in 2016/17 ‡ 6,163 in-patient admissions ‡ 5 days Average length of Stay ‡ 85% Bed Occupancy Rate ‡ 35,904 General Out Patient Attended ‡ 6,673 Specialized Out Patients attended ‡ 33,948 Laboratory tests carried out ‡ 3,228 Patients xrays(Imaging) taken ‡ $QWHQDWDOFDVHVDWWHQGHG ‡ 7924 Children immunized ‡ 396 Family planning users( New and old ‡ 0 Hospital Management Board meetings held ‡ 0 Monthly Senior staff meetings held ‡ WRSPDQDJHPHQWPHHWLQJV ‡ 0 quarterly general staff meetings held (iv) Medium Term Plans 1. Continue with construction of staff houses especially completing of the second 10 unit and third 10 units, procurement of furniture and medical equipment to fully operationalize the utilization of the new OPD. 2. Continue to lobby for construction of theater- maternity ward-pediatric ward- Medical and surgical ward private ward FRPSOH[$GPLQLVWUDWLRQEORFN(\HDQG(17ZDUGVDQGPRUWXDU\SURFXUHPHQWRI,&7HTXLSPHQWDQGVWDIIVKXWWOH 3. Continue to lobby for recruitment of more staff especially specialized staff to improve the quality of services. 4. Operationalize the community health department to scale up hospital based efforts of health promotion and disease prevention. 5. Make functional all the hospital sub-committees to strengthen management structures in the hospital. 6. Strengthen support supervision to lower level facilities. 7. Develop none monitory mechanism for motivating the staff like staff SACCO. 8. Strengthen all quality improvement efforts in the hospital by facilitating formation of quality improvement projects. 9. Continuously improve the work environment through enforcing rewards and sanctions measures through the reward and sanctions committee.

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 1.437 2.827 0.795 2.977 2.827 2.827 2.827 2.827 Non Wage 1.510 0.895 0.620 1.089 1.094 1.094 1.094 1.094 152 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

Devt. GoU 0.674 1.058 0.100 1.488 1.523 1.523 1.523 1.523 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 3.621 4.781 1.515 5.555 5.444 5.444 5.444 5.444 Total GoU+Ext Fin (MTEF) 3.621 4.781 1.515 5.555 5.444 5.444 5.444 5.444 Arrears 0.000 0.000 0.000 0.439 0.000 0.000 0.000 0.000 Total Budget 3.621 4.781 1.515 5.994 5.444 5.444 5.444 5.444 A.I.A Total 0.000 0.000 0.000 0.025 0.010 0.010 0.010 0.010 Grand Total 3.621 4.781 1.515 6.019 5.454 5.454 5.454 5.454 Total Vote Budget 3.621 4.781 1.515 5.580 5.454 5.454 5.454 5.454 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 3.723 0.000 0.000 3.723 4.067 0.000 0.025 4.092

211 Wages and Salaries 2.913 0.000 0.000 2.913 3.061 0.000 0.000 3.061

212 Social Contributions 0.052 0.000 0.000 0.052 0.080 0.000 0.000 0.080

213 Other Employee Costs 0.036 0.000 0.000 0.036 0.075 0.000 0.000 0.075

221 General Expenses 0.145 0.000 0.000 0.145 0.160 0.000 0.000 0.160

222 Communications 0.021 0.000 0.000 0.021 0.022 0.000 0.000 0.022

223 Utility and Property Expenses 0.118 0.000 0.000 0.118 0.162 0.000 0.000 0.162

224 Supplies and Services 0.127 0.000 0.000 0.127 0.161 0.000 0.016 0.177

225 Professional Services 0.005 0.000 0.000 0.005 0.005 0.000 0.000 0.005

227 Travel and Transport 0.137 0.000 0.000 0.137 0.179 0.000 0.000 0.179

228 Maintenance 0.169 0.000 0.000 0.169 0.161 0.000 0.009 0.170

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

312 FIXED ASSETS 1.058 0.000 0.000 1.058 1.488 0.000 0.000 1.488

Output Class : Arrears 0.000 0.000 0.000 0.000 0.439 0.000 0.000 0.439

321 DOMESTIC 0.000 0.000 0.000 0.000 0.439 0.000 0.000 0.439

Grand Total : 4.781 0.000 0.000 4.781 5.994 0.000 0.025 6.019

Total excluding Arrears 4.781 0.000 0.000 4.781 5.555 0.000 0.025 5.580

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections

153 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 3.621 4.781 1.515 6.019 5.454 5.454 5.454 5.454

01 Moroto Referral Hosptial Services 2.842 3.591 1.351 4.396 3.932 3.785 3.785 3.785

02 Moroto Referral Hospital Internal Audit 0.002 0.007 0.006 0.010 0.000 0.012 0.012 0.012

03 Moroto Regional Maintenance 0.103 0.125 0.058 0.125 0.000 0.135 0.135 0.135

1004 Moroto Rehabilitation Referal Hospital 0.674 1.058 0.100 1.200 1.235 1.235 1.235 1.235

1472 Institutional Support to Moroto Regional 0.000 0.000 0.000 0.288 0.288 0.288 0.288 0.288 Referral Hospital Total for the Vote 3.621 4.781 1.515 6.019 5.454 5.454 5.454 5.454

Total Excluding Arrears 3.621 4.781 1.515 5.580 5.454 5.454 5.454 5.454

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : To provide comprehensive, super specialized Health services, contact tertiary Health training, research and contributing to the Health policy and planning.

Responsible Officer: Dr. Nyeko John Filbert Programme Outcome: Quality and accessible regional health services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Percentage increase of speciliezed clinic out patient 20% 20% 20% attendance ‡Bed Occupancy 71% 71% 71%

‡Diagonostic services 20% 20% 20%

SubProgramme: 01 Moroto Referral Hosptial Services Output: 01 Inpatient services No. of in-patients (Admissions) 14557 18000 18000

Average Length of Stay (ALOS) - days 5 5 5

Bed Occupancy Rate (BOR) 71% 71% 71%

Number of Major Operations (including Ceasarian se 1476 1500 1500

Output: 02 Outpatient services No. of general outpatients attended to 75000 90000 90000

No. of specialised outpatients attended to 14600 16000 16000

154 Moroto Referral Hospital Ministerial Policy Statement

Moroto Referral Hospital No.Vote: of specialised175 outpatients attended to 14600 16000 16000

Referral cases in 2700 3240 3888

Output: 04 Diagnostic services No. of laboratory tests carried out 92941 111530 133836

No. of patient xrays (imaging) taken 6886 8263 9916

Number of Ultra Sound Scans 4066 4800 5760

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 1 1 1

Timely payment of salaries and pensions by the 2 20th of every 20th of every 20th of every Month Month Month Timely submission of quarterly financial/activity 30th of the 30th of the 30th of the Month after Month after Month after the end of a the end of the the end of the quarter, quarter quarter Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 4500 5400 6480

No. of children immunised (All immunizations) 21033 25239 30287

No. of family planning users attended to (New and 2000 2400 2880 Old) Number of ANC Visits (All visits) 4500 5400 6480

Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 21003 25239 30287

SubProgramme: 1004 Moroto Rehabilitation Referal Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 10 10 10

Cerificates of progress/ Completion 5 5 5

Output: 82 Maternity ward construction and rehabilitation No. of maternity wards constructed 1 1 0

No. of maternity wards rehabilitated 1 1 0

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 200000000 1500000000 200000000

SubProgramme: 1472 Institutional Support to Moroto Regional Referral Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 10 10 10

Cerificates of progress/ Completion 5 5 5

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) 200000000 200000000 150000000

155 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 175 Moroto Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Moroto Rehabilitation Referal Hospital

Output: 08 56 81 Staff houses construction and rehabilitation commencement of second phase of 10 of units staff house and Procurement process on going 10 units staff house constructed payment of retention for phase one Total Output Cost(Ushs Thousand) 769,857 99,733 1,200,000

Gou Dev¶t: 769,857 99,733 1,200,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5601 Inpatient services Change in Allocation (UShs Bn) : 0.061 Dilapidated structures have increased the cost of maintenance

Output: 08 5602 Outpatient services Change in Allocation (UShs Bn) : 0.046 New structures for OPD with additional funding for cleaning and utilities.

Output: 08 5678 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : 0.068 New OPD needs more furniture for the staff and also in the different meeting rooms and Board room. Board room is planned to become a revenue generating source for the hospital in the coming financial year Output: 08 5681 Staff houses construction and rehabilitation Change in Allocation (UShs Bn) : 0.430 Increased staffing levels have increased the need for accommodation. therefore the need to complete phase two quickly to meet these needs Output: 08 5685 Purchase of Medical Equipment Change in Allocation (UShs Bn) : 0.200 Need for new equipment like new Ultra-sound since the current one is old and breaks frequently and also need to start new departments like the orthopeadic department which are non existant in the hospital

156 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges

1. Inadequate funds for major capital development infrastructure activities like staff accommodation 2. Inadequate and stagnant NWR funding 3. Under staffing for both specialized and support staff 4. Absence of incentives to attract and retain both specialized and support health staff like hard to reach allowance, high cost of living and high cost of accommodation, and lack of social amenities 5. Poor infrastructure like roads, inconsistent and unstable electricity and water 6. High cost of utilities like fuel, electricity and water 7. Old, inadequate and dilapidated infrastructure especially wards, administration block and mortuary that are condemned and becoming public nuisance 8. Sparse population increasing the cost of service delivery 9. +LJKFRVWRIFOHDQLQJDQG,QIUDVWUXFWXUHDQGHTXLSPHQWPDLQWHQDQFHDWWULEXWHGWRKLJKWUDQVSRUWFRVWV Plans to improve Vote Performance

157 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

1. Continue head hunting for crucial carders at personal levels and institutional level. And the exercise of head hunting is ongoing. This has resulted into increasing the number of Anesthetic Officers and Medical Doctors already. 2. Continue to lobby for the Phase two of the World Bank project for construction of the hospital wards and other facilities like the Hospital pathology department (Mortuary) which are essential for the service delivery. 3. Start a Neonatal Care Unit for the region to reduce on the Neonatal Mortality in the region. 4. Start the hospital Orthopedic department for the region to reduce on the cost of treatment on patients who travel outside the region for such services. 5. Operationalize the community Health Department of the Hospital to support health promotion and prevention activities within the region through the support of the implementing Partners. 6. Formation of a task force for starting a nursing school in Moroto Regional Referral hospital given the status of the hospital and its growing potential of becoming the region¶VEHVWIDFLOLW\ 7. Working on an improved relationship with the district for mutual benefits of the people in the area as WKHKRVSLWDOJURZVLQVL]HDQGVHUYLFH 8. Construction of more staff houses the phase 2 of the ten units needed to be started and funds should be OREELHGIRUWKLVSURMHFWWRPLWLJDWHRQWKHFKDOOHQJHVRIVWDIIDFFRPPRGDWLRQ 9. Payment of top up for medical officer as an incentive to motivate and retain them, whereas this may be a worthwhile effort from management this however is not sustainable at the long run should we FRQWLQXHWRPDNHSRVLWLYHHIIRUWVRQDWWUDFWLQJPRUHPHGLFDORIILFHUVLQWKHKRVSLWDO 10. Staff attraction and retention policy needs to be developed to help the hospital to strategically plan for WKHQXPHURXVDFWLYLWLHVWKDWQHHGVWREHXQGHUWDNHQXQGHUWKLVSURMHFWVLQFHWKHFXUUHQWDSSURDFKHV seem to be unsustainable 11. Working with partners and stake holders to plan for scaling up of service provision in the hospital, it should be noted that various partners operating in the region in health sector have the potential to support the hospital to implement key strategic health interventions especially in the areas of nutrition, reproductive and child health and HIV/AIDS and public health interventions. 12. Capacity building for the existing staff, the hospital needs to build the capacity of the existing staff who have sacrificed to work in this region for better intervention for example in areas of multi-tasking since the number of staff is not growing as expected. 13. Plan for income generating activities within the hospital to supplement the hospital finances from the treasury through different projects like the private wing, private pharmacy, hospital guest house, hospital canteen, Hospital SACCO to mention but a few. 14. Plan for construction of interns mess for accommodation of Intern Medical Doctors to boost the number of Medical Officers, Nurses and Pharmacist for continuous and quality service provision.

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : HIV/AIDS services Issue of Concern : High and increasing prevalence especially among the youth and females, New incidence of Mother to child transmission of HIV and low access to care for eligible patients

158 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

Planned Interventions : Scaling up of counseling and testing services in all hospital service points, Talk shows, Treatment of the infected persons Scaling up activities in the youth corner for youth friendly services, Distribution of condoms, Tracing up of lost clients Budget Allocation (Billion) : 0.006 Performance Indicators: Number of people counseled and tested, Number of clients initiated on ART treatment Number client successfully traced and brought back on treatment Number of circumcisions conducted, Number of positive Mothers and babies enrolled into care,

Issue Type: Gender

Objective : Gender based Violence center Issue of Concern : Rampant sexual harassment of females and domestic violence, Inadequate skilled Birth attendants, Limited access and acceptability of family planning services, Inadequate equipment and personnel to handle Emergency Obstetric care. Planned Interventions : Provision of shelter to survivors, counseling, care and treatment of survivors. Increase the recruitment of Midwives and Obstetricians Lobby for construction of a better maternity ward, labor suit and theatre

Budget Allocation (Billion) : 0.007 Performance Indicators: Number of survivors counseled and treated Number Mid-wives and Obstetricians recruited. Number of Obstetric specific equipment procured. Issue Type: Enviroment

Objective : Conducive environment Issue of Concern : Reducing tree cover as a result of infrastructure development around the hospital Planned Interventions : Planting more drought resistant trees to both replace and increase vegetation cover, Planting more grass and watering during dry season Improving on waste disposal through proper incineration and waste disposal

Budget Allocation (Billion) : 0.009 Performance Indicators: Number of trees planted on the hospital compound, Area in square meter planted with grass, Number in kilograms of waste incinerated according to acceptable standards.

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Sale of non-produced Government Properties/assets 0.000 0.000 0.025

Total 0.000 0.000 0.025

(XII) Personnel Information

159 Moroto Referral Hospital Ministerial Policy Statement

Vote:175 Moroto Referral Hospital

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Accountant 1 1 1 2 U4 U 970,145 970,145 11,641,740

Accounts Assistant 1 1 1 2 U7 U 528,195 528,195 6,338,340

Artsan Electrician 0 4 2 4 U8 U 322,657 0 3,871,884

Assistant Engineering Officer 0 2 2 2 U5 SC 911,089 0 10,933,068

Assistant Medical Records Officer 1 2 2 3 U5 L 528,235 528,235 6,338,820

Clinical Officer 6 6 3 12 U5 SC 937,360 5,624,160 11,248,320

Consultant 1 9 4 10 U1 SC 2,785,630 2,785,630 33,427,560

Driver 0 1 1 1 U8 U 356,789 0 4,281,468

Enrolled Midwife 7 11 10 18 U7 U 564,163 3,949,141 6,769,956

Enrolled Nurse 17 23 10 40 U7 M 564,243 9,592,131 6,770,916

Medical Officer 6 4 2 10 U4 SC 1,322,163 7,932,978 15,865,956

Medical Social Worker 1 1 1 2 U4 L 794,023 794,023 9,528,276

Nursing Officer Nursing 4 16 3 20 U5 SC 937,360 3,749,440 11,248,320

Nursing Officer Psychiatric 7 13 2 20 U5 SC 936,360 6,554,520 11,236,320

Radiographer 0 2 2 2 U5 SC 937,360 0 11,248,320

Records Assistant 3 1 1 4 U7 L 484,657 1,453,971 5,815,884

Senior Anaesthetic Officer 1 1 1 2 U4 SC 1,322,163 1,322,163 15,865,956

Senior Hospital Administrator 1 1 1 2 U3 L 1,017,621 1,017,621 12,211,452

Senior LabaratoryTechnician 1 1 1 2 U4 SC 1,322,163 1,322,163 15,865,956

Senior Nursing Officer 6 6 4 12 U4 SC 1,322,163 7,932,978 15,865,956

Senior Principal Nursing Officer 0 1 1 1 U2 SC 1,895,091 0 22,741,092

Senior Public Health Dental Officer 1 1 1 2 U4 SC 1,332,163 1,332,163 15,985,956

Stores Assistant 1 1 1 2 U7 U 416,956 416,956 5,003,472

Theater Assistant 0 4 4 4 U6 652,017 0 7,824,204

Vote Total 66 113 61 179 23,160,766 970,145 277,929,192

160 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

V1: Vote Overview (i) Vote Mission Statement TO PROVIDE COMPREHENSIVE GENERAL AND SPECIALIZED REFERRAL HEALTH SERVICES, TRAIN HEALTH PROFESSIONALS, AND CONDUCT RESEARCH

(ii) Strategic Objective a. To provide a range of specialized curative, promotive, preventive and rehabilitative services. b. To contribute to regional human resource development through training of various cadres of health workers. c. To contribute to national and conduct operational level research. d. To contribute as requested to the Ministry¶s national policy and support supervision.

(iii) Major Achievements in 2016/17 The period July to December 2016 has been characterized with increase in patient load specifically specialized clinics, inpatient SHGLDWULFDQGPDWHUQLW\XQLWV

:LWKUHJDUGWR$,$IRUWKHSHULRG-XO\WR'HFHPEHUWKHUHOHDVHGDPRXQWVZDV8*;1250EXWWKHH[SHQGLWXUHWRWDOHGWR8*; 74,340,6377KLVZDVSDUWLDOO\DWWULEXWHGWRXQSUHVHQWHGFODLPVDVZHOODVV\VWHPIDLOXUH

Construction of the drug store continued with almost 60% of the works complete. Procurement of assorted specialized equipment, KRZHYHUWKHUHZHUHQRWDEOHGHOD\VLQH[HFXWLRQRIFRQVWUXFWLRQVZRUNVRQWKHUHWDLQLQJZDOOGXHWRGHOD\LQDSSURYDORIYDULDWLRQ order of the nature of the retaining wall.

(iv) Medium Term Plans Embark on the Construction of other blocks of the staff hostel to be able to accommodate staff on call and improve their productivity towards patient. This will furthercontribute to improved health outcomes and subsequently lead to a productive population (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 3.023 4.246 1.412 4.246 4.246 4.246 4.246 4.246 Non Wage 1.222 0.988 0.285 1.013 1.087 1.087 1.087 1.087

Devt. GoU 1.308 1.058 0.214 1.056 1.523 1.523 1.523 1.523

161 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 5.553 6.293 1.912 6.315 6.856 6.856 6.856 6.856 Total GoU+Ext Fin (MTEF) 5.553 6.293 1.912 6.315 6.856 6.856 6.856 6.856 Arrears 0.000 0.083 0.000 0.002 0.000 0.000 0.000 0.000 Total Budget 5.553 6.376 1.912 6.317 6.856 6.856 6.856 6.856 A.I.A Total 0.037 0.250 0.073 0.400 0.450 0.500 0.550 0.600 Grand Total 5.590 6.626 1.984 6.717 7.306 7.356 7.406 7.456 Total Vote Budget 5.590 6.543 1.984 6.715 7.306 7.356 7.406 7.456 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 5.235 0.000 0.250 5.485 5.260 0.000 0.400 5.660

211 Wages and Salaries 4.280 0.000 0.078 4.357 4.270 0.000 0.180 4.450

212 Social Contributions 0.012 0.000 0.000 0.012 0.039 0.000 0.000 0.039

213 Other Employee Costs 0.166 0.000 0.000 0.166 0.172 0.000 0.000 0.172

221 General Expenses 0.086 0.000 0.107 0.193 0.108 0.000 0.070 0.178

222 Communications 0.013 0.000 0.013 0.025 0.020 0.000 0.004 0.024

223 Utility and Property Expenses 0.192 0.000 0.010 0.202 0.263 0.000 0.016 0.279

224 Supplies and Services 0.315 0.000 0.030 0.345 0.188 0.000 0.090 0.278

225 Professional Services 0.000 0.000 0.000 0.000 0.001 0.000 0.019 0.020

226 Insurances and Licenses 0.003 0.000 0.000 0.003 0.004 0.000 0.000 0.004

227 Travel and Transport 0.131 0.000 0.000 0.131 0.128 0.000 0.000 0.128

228 Maintenance 0.038 0.000 0.012 0.050 0.067 0.000 0.020 0.087

Output Class : Capital Purchases 1.058 0.000 0.000 1.058 1.056 0.000 0.000 1.056

281 Property expenses other than interest 0.075 0.000 0.000 0.075 0.045 0.000 0.000 0.045

312 FIXED ASSETS 0.983 0.000 0.000 0.983 1.011 0.000 0.000 1.011

Output Class : Arrears 0.083 0.000 0.000 0.083 0.002 0.000 0.000 0.002

321 DOMESTIC 0.083 0.000 0.000 0.083 0.002 0.000 0.000 0.002

Grand Total : 6.376 0.000 0.250 6.626 6.317 0.000 0.400 6.717

Total excluding Arrears 6.293 0.000 0.250 6.543 6.315 0.000 0.400 6.715

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

162 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 5.553 6.626 1.912 6.717 7.306 7.356 7.406 7.456

01 Naguru Referral Hosptial Services 4.224 5.533 1.686 5.638 5.765 5.813 5.863 5.913

02 Naguru Referral Hospital Internal Audit 0.021 0.035 0.012 0.022 0.018 0.020 0.020 0.020

1004 Naguru Rehabilitation Referal Hospital 1.308 1.058 0.214 0.644 1.523 1.523 1.523 1.523

1475 Institutional Support to Uganda China 0.000 0.000 0.000 0.413 0.000 0.000 0.000 0.000 Friendship Hospital Referral Hospital- Naguru Total for the Vote 5.553 6.626 1.912 6.717 7.306 7.356 7.406 7.456

Total Excluding Arrears 5.553 6.543 1.912 6.715 7.306 7.356 7.406 7.456

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 56 Regional Referral Hospital Services Programme Objective : 7RSURYLGHFRPSUHKHQVLYHTXDOLW\6SHFLDOL]HGKRVSLWDOVHUYLFHV Responsible Officer: HOSPITAL DIRECTOR Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

163 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

‡increase in diagnstic investigations carried 5% 7% 10%

‡bed occupancy 100% 100% 100%

‡increase of specialised clinics outpatients attendences 10% 10% 10%

SubProgramme: 01 Naguru Referral Hosptial Services Output: 01 Inpatient services No. of in-patients (Admissions) 15213 16734 18408

Output: 02 Outpatient services No. of general outpatients attended to 156460 172106 189317

No. of specialised outpatients attended to 115758 127338 140072

Referral cases in 240 240 240

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1.0 1.0 1.0

Output: 04 Diagnostic services No. of laboratory tests carried out 134954 141702 148787

No. of patient xrays (imaging) taken 14248 14960 15708

Output: 05 Hospital Management and support services Timely payment of salaries and pensions by the 2 4 4 4

Timely submission of quarterly financial/activity 4 4 4

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 27500 30250 33275

No. of children immunised (All immunizations) 47393 52132 57345

No. of family planning users attended to (New and 3997 4397 4837 Old) SubProgramme: 1004 Naguru Rehabilitation Referal Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 1 1 -1

Output: 83 OPD and other ward construction and rehabilitation Cerificates of progress/ Completion 1 0 0

Output: 84 Theatre construction and rehabilitation No. of theatres constructed 0 0 0

Cerificates of progress/ Completion 1 0 0

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

164 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

FY 2016/17 FY 2017/18 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 176 Naguru Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Naguru Rehabilitation Referal Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

Retention fees paid for the staff hostel in Kireka. Works on wall on going, funds encumbered - Second block of an 8 unit - two bed roomed apartment staff hostel constructed Retaining wall construction done and supervised at the Kireka - Consultant¶s supervision fees paid staff hostel site. - Retention fees for the staff hostel¶s retention wall paid

Total Output Cost(Ushs Thousand) 645,000 48,769 527,000

Gou Dev¶t: 645,000 48,769 527,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 56 Regional Referral Hospital Services Output: 08 5603 Medicines and health supplies procured and dispensed Change in Allocation (UShs Bn) : -0.006 Gou Allocation to item has reduced due to reduction in self picks. To note is that the relative increase in the AIA allocation for medicines and related supplies(following the need for increased specialized medicines that are may not be accessed from NMS Output: 08 5605 Hospital Management and support services Change in Allocation (UShs Bn) : -4.438 Funds for salaries, welfare, training, death, etc have been transferred to the human resource function following its creation . Output: 08 5606 Prevention and rehabilitation services Change in Allocation (UShs Bn) : 0.027 Increased Prevention of diseases ,promotes and maintains positive mental and emotional health and subsequently contributes to a healthy and productive population Output: 08 5619 Human Resource Management Services Change in Allocation (UShs Bn) : 4.493 New sub programme created to promote the HR management function

Output: 08 5620 Records Management Services Change in Allocation (UShs Bn) : 0.004 New sub proramme created to promote records management in facilities

Output: 08 5672 Government Buildings and Administrative Infrastructure

165 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Change in Allocation (UShs Bn) : -0.165 The drug store will be completed awaiting expiry of the defects liability period

Output: 08 5676 Purchase of Office and ICT Equipment, including Software Change in Allocation (UShs Bn) : 0.031 There is need to intensify security by upgrading the CCTV cameras, equip ICT equipment in newly completed drug stores and upgrade software for medical equipments Output: 08 5677 Purchase of Specialised Machinery & Equipment Change in Allocation (UShs Bn) : 0.062 Specialized machinery were increased due to the need to procure biomedical engineering as well as civil and electrical equipments to allow for routine and preventive maintenance. Output: 08 5678 Purchase of Office and Residential Furniture and Fittings Change in Allocation (UShs Bn) : 0.038 With the completion of drug stores, there will be need to equip it with the relevant furniture for safe custody of the drugs and supplies. Output: 08 5683 OPD and other ward construction and rehabilitation Change in Allocation (UShs Bn) : 0.052 The infrastructure has grossly deteriorated due to influx of patients hence the need to renovate the affected areas.

Output: 08 5684 Theatre construction and rehabilitation Change in Allocation (UShs Bn) : 0.030 The interior of theater has largely depreciated and hence need for rehabilitation.

Output: 08 5685 Purchase of Medical Equipment Change in Allocation (UShs Bn) : 0.069 There is need to functionalise some departments specifically eye, laboratory and obstetrics and gynecology

(X) Vote Narrative For Past And Medium Term Plans Vote Challenges a. Under funding of development projects has limited the implementation of the master plan and strategic plans b. Human resource challenges i.e some key human resources are not provided for in the structure yet very critical e.g statistician, planner. F(VFDODWLQJSULFHVRIJRRGVDQGVHUYLFHVDJDLQVWDUHVWULFWHGEXGJHWFRQWLQXHWRFRPSURPLVHVHUYLFHGHOLYHU\ Plans to improve Vote Performance

Continue to partner with stakeholders like WHO, UNICEF, AHF-Uganda cares, training institutions in the implementation of programs

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Issue Type: Gender

Objective : Improve services for the disadavantages groups Issue of Concern : gender

166 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Planned Interventions : - procure equipment for physiotherapy, and occupational therapy -support social work activities such as settling displaced an dabandoned children Provide nutritional support to marginalised such as speciall meals to children and mothers Budget Allocation (Billion) : 0.065 Performance Indicators: -Number of physio and occupational therapy equpment - Report of Social work department on activities undertaken fo rthe marginalised groups Issue Type: Enviroment

Objective : Improve waste management, Protect the environment from noise pollution, minimise hospital acquired infections Issue of Concern : Environment Planned Interventions : - Procure services for waste Management

- Vaccination

-Procurement of protective gears

- Procure hand washing facilities and disinfectants

- close supervision of cleaners

-Functionalise the infection control committee

Budget Allocation (Billion) : 0.060 Performance Indicators: - Waste evacuated 3 times a week

- Record of meetings

-No. of staff vaccinated against yellow fever an hepatitis B

- No. of protective wear - Hand washing facilities in

- Monthly reports

Table 11.2: AIA Collections

Source of AIA(Ush Bn) 2016/17 2016/17 2017/18 Budget Actual by Dec Projected Rent & rates ±produced assets ±from private entities 0.000 0.072 0.000

Other Fees and Charges 0.000 0.118 0.400

Total 0.000 0.190 0.400

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

167 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Assistant Supplies Officer 0 1 1 1 U5L 616,554 0 7,398,648

Civil Technician 0 2 2 2 U5L 1,539,084 0 18,469,008

Consultant (Anesthesia) 0 1 1 1 U1SE 2,785,630 0 33,427,560

Consultant (ENT) 0 1 1 1 U1SE 2,785,630 0 33,427,560

Consultant (Psychiatry) 0 1 1 1 U1SE 2,785,630 0 33,427,560

Consultant (Radiology) 0 1 1 1 UISE 2,785,630 0 33,427,560

Consultant (Surgery) 0 1 1 1 U1SE 2,785,630 0 33,427,560

DRIVER 3 2 2 5 U8U 305,822 917,466 3,669,864

ELECTRICAL TECHNICIAN 0 1 1 1 U5 937,360 0 11,248,320 (SC) Engneering Assistant 0 2 2 2 U6U 1,122,184 0 13,466,208

ENROLLED MIDWIFE 19 1 1 20 U7U 560,730 10,653,870 6,728,760

ENROLLED NURSE 38 2 2 40 U7U 557,633 21,190,054 6,691,596

KITCHEN ATTENDANT 5 2 2 7 U8L 303,832 1,519,160 3,645,984

LABORATORY TECHNICIAN 0 1 1 1 U5 937,360 0 11,248,320 (SC) LABORATORY TECHNOLOGISTS 0 1 1 1 U5 898,337 0 10,780,044 (SC) MEDICAL RECORDS OFFICER 0 2 2 2 U4L 817,267 0 9,807,204

MOSG (ENT) 0 1 1 1 U2 2,150,009 0 25,800,108 (SC) MOSG (MEDICINE) 0 1 1 1 U2 2,150,009 0 25,800,108 (SC) MOSG (OBS & GYN) 0 1 1 1 U2 2,136,929 0 25,643,148 (SC) MOSG (Opthalmology) 0 1 1 1 U2 2,150,009 0 25,800,108 (SC) MOSG (Psychiatry) 0 1 1 1 U2 2,150,009 0 25,800,108 (SC) MOSG (Public Health) 0 1 1 1 U2 2,150,009 0 25,800,108 (SC) NUTRITIONIST 0 1 1 1 U4 1,276,442 0 15,317,304 (SC) OFFICE ATTENDANT 1 1 1 2 U8U 299,859 299,859 3,598,308

Office Supervisor 0 1 1 1 U5L 616,554 0 7,398,648

Office Typist 0 2 2 2 U7L 1,012,684 0 12,152,208

Pool stenographer 0 2 2 2 U6L 1,233,108 0 14,797,296

Principal Occupational Therapist 0 1 1 1 U3U 1,460,248 0 17,522,976 (SC) Principal Ophtalmic Officer 0 1 1 1 U3U 1,460,248 0 17,522,976 (SC) PSYCHATRIC CLINICAL OFFICER 0 2 2 2 U5 924,091 0 11,089,092 (SC)

168 Naguru Referral Hospital Ministerial Policy Statement

Vote:176 Naguru Referral Hospital

Security Officer 0 1 1 1 U5L 616,554 0 7,398,648

Senior Accounts Assistant 1 1 1 2 U5L 616,554 616,554 7,398,648

SENIOR NURSING OFFICER 9 6 6 15 U4U 1,276,442 11,487,978 15,317,304

Senior Nutritionist 0 1 1 1 U3 1,460,248 0 17,522,976 (SC) Senior Occupational Therapist 0 2 2 2 U4 1,276,442 0 15,317,304 (SC) SENIOR PHYSIOTHERAPIST 1 1 1 2 U4 1,276,442 1,276,442 15,317,304 (SC) Senior Records Officer 0 1 1 1 U3L 1,047,087 0 12,565,044

Senior Stores Assistant (Senior 0 2 2 2 U6U 1,233,108 0 14,797,296 Inventory Management Officer) Stores Assitant (Inventory Officer) 0 2 2 2 U7L 1,012,684 0 12,152,208

Supplies Officer 0 1 1 1 U4L 745,816 0 8,949,792

TELEPHONE OPERATOR 1 1 1 2 U7L 466,002 466,002 5,592,024

Vote Total 78 58 58 136 54,721,900 0 656,662,800

169 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement

Vote:304 Uganda Virus Research Institute (UVRI)

V1: Vote Overview (i) Vote Mission Statement To conduct scientific investigation on viral and other diseases to contribute to knowledge, policy and practice and engage in capacity development for improved public health

(ii) Strategic Objective To reposition UVRI into a dynamic, internationally competitive research institution, contributing as a centre of excellence in health research to the global challenges of addressing communicable diseases in order to achieve the SDGS and contribute to HFRQRPLFJURZWKDQGGHYHORSPHQWNQRZOHGJH (iii) Major Achievements in 2016/17

103 UVRI staff were paid salaries on time. Supported and supervised 20 HIV testing sites for proficiency HIV rapid testing. Conducted surveillance for 1319 sera samples from suspected measles cases country wide. Conducted an AFP (Acute Flaccid Paralysis) surveillance of 4191 stool samples. No wild Polio was confirmed in any of the samples tested. The Polio laboratory was also fully accredited. Fully contained the Polio Laboratory10 participants recruited from Mbale and Wakiso districts10% of the Electricity and water bills was paid. One International EDCTP conference was attended .UVRI premises, laboratories and offices were cleaned and maintained. Human resource audit was carried out and I.T support was given to UVRI field stations of Kyamulibwa, Arua and Rakai. Collected around 100 mosquitoes in the dry season and put in the laboratories for surveillance. Carried out Routine surveillance of arboviruses was carried out in in Kisubi (Zika Forest), Nkokonjeru (both in the community and an in Nkokonjeru St. Francis Hospital) and Sseganga in North Eastern Wakiso District. Carried out epidemiological and behavior research in HIV/AIDS, Malaria and acute Viral out breaks in 2 fishing communities of Kasensero and Dima landing site in Rakai district

(iv) Medium Term Plans 10HQWRUVXSSRUWDQGUHWUDLQ+,9WHVWLQJODERUDWRULHVLQWKHFRXQWU\WKDWIDLOSURILFLHQF\WHVWV(SLGHPLRORJLFDODQGEHKDYLRU research in HIV, Malaria and Acute viral outbreaks in 15 communities in the lake Victoria region. Collect data from 26 standalone HIV clinics and merge collected data with Rakai cohort data. 26WDIIHVWDEOLVKPHQWDW895,DQGVLWHVGHWHUPLQHGDQGGHYHORSMREGHVFULSWLRQVDQGDSSUDLVHVWDII7UDLQDQGPHQWRUVWDIILQ VFLHQWLILFZULWLQJSROLF\DQGUHVHDUFKFRPPXQLFDWLRQDQGNQRZOHGJHWUDQVODWLRQ 3.Develop and print annual report. 47UDLQVWDIILQ*&/3ELRVDIHW\VSHFLPHQKDQGOLQJDQGULVNPDQDJHPHQW&RQGXFWVFLHQFHDQGRSHQGD\IRUUHJLRQDOSULPDU\ schools to interest pupils in the science career. 52ULHQWJRYHUQPHQWDQGFRQWUDFWVWDIIRQVWDQGLQJRUGHUSURYLGHSHQVLRQHUVZLWKWKHLUWUDYHODOORZDQFH0DLQWDLQ,7 HTXLSPHQWSD\ZDWHUHOHFWULFLW\DQG,QWHUQHWELOOVDQGSURYLGH,7VXSSRUW$UXD/DERUDWRU\RIILFH 6.Map out areas of Arboviral activity and populations at risk of outbreaks in 48 hours, influenza disease,ILI and SARI VXUYHLOODQFHDWVHQWLQHOVLWHVDQGGLDJQRVHDWOHDVW1200 samples. 7,)06SD\PHQWSURFXUHPHQWDXGLWVDVVHWVUHJLVWHUDXGLWDVVHWVDQGXWLOLWLHVPDQDJHPHQWUHYLHZDQGDUHYLHZRIWKHWUDLQLQJ workshops, stores management and non-tax revenue. 86XUYHLOODQFHIRUSODJXHGLVHDVHVDQGLGHQWLI\VXVSHFWHGSODJXHFDVHVDQGRXWEUHDNVDQGFRQWDLQWKHP'HWHUPLQHLPPXQH profiles during epidemics: Plague, Yellow fever and highly pathogenic viruses for protection of communities. 9&RQGXFWILHOGYLVLWVDQGFROOHFWDQGWHVWDWOHDVW1000+HSDWLWLV%VDPSOHVIRU+HS%YLUXVIURPLQIHVWHGVLWHVLQ(DVWHUQDQG 1RUWKHUQGLVWULFWVLQ8JDQGD&ROOHFWDQGWHVWVDPSOHVDQGFRQILUPDOOVXVSHFWHGPHDVOHVFDVHVRXWEUHDNVDQG$)3FDVHVDQG report results within the expected TRT. 100DODULDDQG=LNDYLUXVYHFWRUGLVWULEXWLRQSDWWHUQVDQGHVWLPDWHWKHULVNRIGLVHDVH WUDQVPLVVLRQZLWKLQWKHVHQWLQHOVLWHV (v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

170 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement

Vote:304 Uganda Virus Research Institute (UVRI)

Recurrent Wage 0.000 0.952 0.198 0.952 1.000 1.050 1.102 1.157 Non Wage 0.000 0.709 0.105 0.501 0.601 0.661 0.760 0.760

Devt. GoU 0.000 0.000 0.000 0.400 0.520 0.624 0.749 0.749 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 0.000 1.661 0.303 1.853 2.120 2.335 2.611 2.666 Total GoU+Ext Fin (MTEF) 0.000 1.661 0.303 1.853 2.120 2.335 2.611 2.666 Arrears 0.000 0.000 0.000 0.031 0.000 0.000 0.000 0.000 Total Budget 0.000 1.661 0.303 1.883 2.120 2.335 2.611 2.666 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 0.000 1.661 0.303 1.883 2.120 2.335 2.611 2.666 Total Vote Budget 0.000 1.661 0.303 1.853 2.120 2.335 2.611 2.666 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Provided 1.661 0.000 0.000 1.661 1.453 0.000 0.000 1.453

211 Wages and Salaries 1.060 0.000 0.000 1.060 1.006 0.000 0.000 1.006

212 Social Contributions 0.000 0.000 0.000 0.000 0.039 0.000 0.000 0.039

213 Other Employee Costs 0.008 0.000 0.000 0.008 0.008 0.000 0.000 0.008

221 General Expenses 0.124 0.000 0.000 0.124 0.093 0.000 0.000 0.093

222 Communications 0.003 0.000 0.000 0.003 0.003 0.000 0.000 0.003

223 Utility and Property Expenses 0.177 0.000 0.000 0.177 0.080 0.000 0.000 0.080

224 Supplies and Services 0.005 0.000 0.000 0.005 0.037 0.000 0.000 0.037

227 Travel and Transport 0.268 0.000 0.000 0.268 0.173 0.000 0.000 0.173

228 Maintenance 0.015 0.000 0.000 0.015 0.014 0.000 0.000 0.014

Output Class : Capital Purchases 0.000 0.000 0.000 0.000 0.400 0.000 0.000 0.400

312 FIXED ASSETS 0.000 0.000 0.000 0.000 0.400 0.000 0.000 0.400

Output Class : Arrears 0.000 0.000 0.000 0.000 0.031 0.000 0.000 0.031

321 DOMESTIC 0.000 0.000 0.000 0.000 0.031 0.000 0.000 0.031

Grand Total : 1.661 0.000 0.000 1.661 1.883 0.000 0.000 1.883

Total excluding Arrears 1.661 0.000 0.000 1.661 1.853 0.000 0.000 1.853

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

171 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement

Vote:304 Uganda Virus Research Institute (UVRI)

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 03 Virus Research 0.000 1.661 0.303 1.883 2.120 2.335 2.611 2.666

01 Headquarters 0.000 1.449 0.275 1.347 1.364 0.364 0.364 1.521

02 Health Research Services 0.000 0.206 0.027 0.134 0.134 1.184 1.237 0.134

03 Internal Audit 0.000 0.007 0.001 0.002 0.102 0.162 0.261 0.261

1437 Institutional Support toUVRI 0.000 0.000 0.000 0.150 0.150 0.254 0.254 0.254

1442 UVRI Infrastructual Development 0.000 0.000 0.000 0.250 0.370 0.370 0.495 0.495 Project Total for the Vote 0.000 1.661 0.303 1.883 2.120 2.335 2.611 2.666

Total Excluding Arrears 0.000 1.661 0.303 1.853 2.120 2.335 2.611 2.666

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 03 Virus Research Programme Objective : To conduct scientific investigations on viral and other diseases for prevention, policy and capacity development Responsible Officer: Prof. Pontiano Kaleebu Programme Outcome: Quality and accessible virus research Services Sector Outcomes contributed to by the Programme Outcome 1. Competitive healthcare centres of excellence Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

172 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement

Vote:304 Uganda Virus Research Institute (UVRI)

‡Propotion of informed research policy and guidelines. 70% 75% 80%

‡Propotion of Reseach planned activities 85% 90% 95%

SubProgramme: 01 Headquarters Output: 04 Administration and Support Services Percentage execution of the workplan. 100% 100% 100%

Quarterly internal audit report produced 4 4 4

SubProgramme: 02 Health Research Services Output: 06 Arbovirology, Emerging and Remerging Disease Research No. of Research services coordinated and supervise 4 4 4

SubProgramme: 03 Internal Audit Output: 04 Administration and Support Services Percentage execution of the workplan. 100% 100% 100%

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

N/A

Table 9.2: Key Changes in Vote Resource Allocation

Major changes in resource allocation over and above the -XVWLILFDWLRQIRUSURSRVHG&KDQJHVLQ([SHQGLWXUH previous financial year and Outputs

Programme : 08 03 Virus Research Output: 08 0372 Government Buildings and Administrative Insfrastructure Change in Allocation (UShs Bn) : 0.250 This is a new capital development code. The funds allocated here are therefore being allocated for the first time in this output.

(X) Vote Narrative For Past And Medium Term Plans

173 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement

Vote:304 Uganda Virus Research Institute (UVRI)

Vote Challenges

I. High expenditure on power and water bills, most of the research infrastructure and equipment at the institute are dilapidated. 2.Insufficient wage and Human resource Bill. 3.Increased disease burden Non communicable Infectious diseases and merging and re-merging infections calling for diversified infections. Plans to improve Vote Performance

1.Expand the malaria and TB research capacity. 2.Expand research an surveillance on viral diseases e.g hepatitis, rota virus, human papilloma virus (HPV). 3.Establish research on non- communicable diseases (NCDs). Investigate factors associated with vial hemorrhagic fever (VHF) out breaks.4.Strengthen existing mentorship programs. 5.Support training for long and short term courses. Jointly conduct research training in areas of interest of UVRI staff. 6.Establish a Laboratory Informaton Managemet System (LIMS). 7.Ensure a functional stores management system and enough storage space. 8.Ensure enough and alternate power back up system. 9.Utilize the available liquid nitrogen capacity for more reliable long term storage. 10.Develop and operationalize a communication strategy

(XI) Vote Cross Cutting Policy And Other Budgetary Issues

Table 11.1: Cross- Cutting Policy Issues

Table 11.2: AIA Collections

(XII) Personnel Information

7DEOH9RWH6WDIILQJ3URILOHE\3RVW

Cleared Number Authorised for of Posts Gross Salary Annual Cost Annual Cost Filled Vacant Post Establishme filling in Estimate Scale Rate per of Filled of Estimated Posts Posts nt 2017/18 d for Month Posts 2017/18 Posts 2017/18 2017/18 Ac Director/deputy director 0 5 5 5 U1 2,543,627 0 30,523,524

Accountant 1 1 1 2 U4 UP 934,922 934,922 11,219,064

Technician 0 4 2 4 U5 635,236 0 7,622,832 (SC) Vote Total 1 10 8 11 4,113,785 0 49,365,420

174 501-850 Local Governments Ministerial Policy Statement

Vote:500 501-850 Local Governments

V1: Vote Overview (i) Vote Mission Statement

(ii) Strategic Objective

(iii) Major Achievements in 2016/17

(iv) Medium Term Plans

(v) Summary of Past Performance and Medium Term Budget Allocations

Table V1.1: Overview of Vote Expenditures (UShs Billion)

2016/17 MTEF Budget Projections 2015/16 Approved Expenditure 2017/18 2018/19 2019/20 2020/21 2021/22 Outturn Budget by End Dec

Recurrent Wage 0.000 280.355 70.089 291.312 305.877 321.171 337.230 354.091 Non Wage 0.000 45.851 11.463 47.066 56.479 62.127 71.446 71.446

Devt. GoU 0.000 9.500 2.375 9.622 12.509 15.010 18.012 18.012 Ext. Fin. 0.000 1.864 0.000 2.278 0.000 0.000 0.000 0.000 GoU Total 0.000 335.706 83.927 348.000 374.865 398.309 426.689 443.550 Total GoU+Ext Fin (MTEF) 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Total Budget 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550 Total Vote Budget 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550 Excluding Arrears

(VI) Budget By Economic Clasification

Table V6.1 2016/17 and2017/18 Budget Allocations by Item

2016/17 Approved Budget 2017/18 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin AIA Total Output Class : Outputs Funded 335.706 1.864 0.000 337.570 348.000 2.278 0.000 350.278

321 DOMESTIC 335.706 1.864 0.000 337.570 348.000 2.278 0.000 350.278

Grand Total : 335.706 1.864 0.000 337.570 348.000 2.278 0.000 350.278

Total excluding Arrears 335.706 1.864 0.000 337.570 348.000 2.278 0.000 350.278

175 501-850 Local Governments Ministerial Policy Statement

Vote:500 501-850 Local Governments

9,, %XGJHW%\3URJUDPPH$QG6XESURJUDPPH Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2016/17 Medium Term Projections FY 2015/16 Approved 6SHQW%\ 2017-18 2018-19 2019-20 2020-21 2021-22 Outturn Budget End Dec Proposed Budget 81 Primary Healthcare 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550

05 Health 0.000 326.206 81.552 338.378 362.357 383.299 408.676 425.538

1385 HEALTH DEVELOPMENT 0.000 11.364 2.375 11.900 12.509 15.010 18.012 18.012

Total for the Vote 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550

Total Excluding Arrears 0.000 337.570 83.927 350.278 374.865 398.309 426.689 443.550

(VIII) 3URJUDPPH3HUIRUPDQFHDQG0HGLXP7HUP3ODQV

Table V8.1: Programme Outcome and Outcome Indicators

Programme : 81 Primary Healthcare Programme Objective : To offer quality primary care health services to the people of Uganda Responsible Officer: Chief Administrative Officers Programme Outcome: Quality of health care and patient safety Sector Outcomes contributed to by the Programme Outcome 1. Inclusive and quality healthcare services Performance Targets Outcome Indicators 2015/16 2016/17 2017/18 2018/19 2019/20 Actual Target Actual Target Projection Projection

‡Infant mortality rate per 1000 48 46 44

‡Under-five mortality rate per 1000 53 52 51

‡Maternal mortality per 100000 363 348 320

N/A

(IX) Major Capital Investments And Changes In Resource Allocation

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

N/A

176