Quarterly Progress Report Quarter 1 – FY2013

(October 2012 – December 2012)

Submitted by:

Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU-CCP) & Uganda Health Marketing Group (UHMG)

USAID Cooperative Agreement 617-A-00-05-00011-00 TABLE OF CONTENTS

2 ACRONYMS

AIDS Acquired Immunodeficiency Virus CBV Community Based Volunteer CSW Commercial Sex Worker DADI District Assistant Drug Inspector DBTA District Based Technical Assistance DHO District Health Officer FP Family Planning GLC Good Life Clinic HCT HIV Counselling & Testing HIV Human Immunodeficiency Virus HRA Human Resource Administration KPI Kampala Pharmaceutical Industries MARPS Most At Risk Populations MFP Malaria Focal Person MiP Malaria in Pregnancy MNCH Maternal, Newborn and Child Health MMC Medical Male Circumcision MSI Marketing & Strategic Information NMCP National Malaria Control Program PCSBU Programs Consultancy Strategic Business Unit PEPFAR Presidents Emergency Plan for AIDS Relief PFSBU Products Facility Strategic Business Unit PHA People Living with HIV/AIDS PMI President’s Malaria Initiative PMTCT Prevention of Mother to Child Transmission RDTm Rapid Diagnostic tests for Malaria UHMG Uganda Health Marketing Group USAID United States Agency for International Development

3 INTRODUCTION

This report covers activities undertaken from October 2012 to December 2012, or the first quarter of fiscal year 2013 (FY13) of the AFFORD Health Marketing Initiative in Uganda, funded by the United States Agency for International Development (USAID) Cooperative Agreement 617-A-00-05-00011-00.

The award was made on September 21, 2005 to The Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). The AFFORD Health Marketing Initiative that ended its 5 year USAID funded project in September 2010 (AFFORD I) received a 3 year extension until September 2013 (AFFORD II) with the primary responsibility of strengthening UHMG into a sustainable entity.

During the project extension period AFFORD II has the primary responsibility to ensure that UHMG is strengthened to become sustainable and develops cutting edge competencies in technical, marketing, financial and institutional areas. AFFORD II through UHMG will continue to consolidate its activities and will focus on the 3 key result areas. Specifically, AFFORD II will build on the foundation of AFFORD I to achieve:

1) Increased organizational sustainability of UHMG;

2) Increased availability, affordability of health services and products; and

3) Enhanced knowledge for self-efficacy and correct use of health services and healthy practices.

This report focuses on the performance of the two strategic business units (SBUs) of UHMG—the Product Facility and the Programs Consultancy as well as the cross cutting activities including social marketing, communication, research, human resources and administration, and finance and investment that support the functioning of the two strategic business units. In addition, AFFORD II Capacity Building achievements are summarized below.

Result 1. UHMG Capacity Building AFFORD II Capacity Building is designed to help UHMG to achieve increased financial, institutional and market sustainability. Capacity Building focuses on five organizational and management domains: 1. Strengthening Performance Management and Quality Management systems 2. Improving data utilization processes 3. Developing innovative program, product and service strategies 4. Building business development systems 5. Strengthening financial systems

Highlights of Capacity Building achievements are summarized below.

CAPACITY EVIDENCE OF FY 2013 (Year 3) Achievements BUILDING ACHIEVEMENT OBJECTIVE

4 1. PERFORMANCE MANAGEMENT & QUALITY MANAGEMENT Establish performance Senior Management & supervisors  MD, Dir Finance and Sr. Mgrs track contract performance monthly management system for produce clear performance enhanced monitoring and indicators quarterly Performance monitoring tool developed to serve as Performance-based supervision by UHMG and  BOD Contract Scope of Work; tool has been applied by all UHMG Divisions in Qtr 1

 Summary review and documentation of all technical indicators conducted quarterly and reported to Sponsors and BOD Committees

Effective, documented quarterly and  KRA and KPI quarterly and annual review conducted and system annual review process is linked to documented staff motivation, performance and advancement  AFFORD worked with BOD and MD to review Manager KPIs, and Board Chair and RMA met MD for APR

 Managers hold staff accountable for performance to KRAs and KPIs

 HR Assessment conducted by AFFORD KPMG has been completed and report is prepared and follow-up meeting planned for Qtr 2

 Promotion, salary increases or recognition linked to achievement of KRAs and KPIs (occurs case by case)

MD, Directors & Operational UHMG operates as a commercial  BOD, MD and staff committed to improved stock management practices managers adopt a ‘private sector company that makes in PF, assisted by AFFORD/KPMG. Staff changes have ben made to sector’ management practice strategic decisions based on improve the outcomes. profitability as well as risk-reduction and stewardship of capital assets, Stock-counts are being conducted routinely; variances have been including product stocks  reduced significantly

 Debt analysis, documentation and circularization complete; recovery significant; reconciliation of irretrievable debt to be resolved during next quarter

 Profitability analyses conducted quarterly; Business Plan progress tracked quarterly by BOD

All strategies generated by  All key strategies have been developed by Senior Management and managers are vetted through operational staff through a consultative process, and vetted by the MD, organizational approval processes AFFORD and BOD, where needed.

 Strategies and their implementation are assessed on a continuing basis Quarterly Performance Reports by management and operational staff for effectiveness and cost- (programmatic and financial) efficiency submitted to BOD and Sponsors  Deliverables are produced and quarterly targets are being achieved or partially achieved, with BOD and AFFORD review against UHMG Business Plan and Annual Workplan

 BOD, MD and Senior Managers are taking corrective action to address target shortfalls

The product facility operates as a  PF Profitability analysis conducted quarterly; profitability improved over profit center & The programs unit FY2012. operates as a cost-recoverable consultancy business  Program Consultancy is expanding technical strategies (e.g., EMTCT) and is actively seeking new funding for programs (see Business Development section below.)

5 A Quality Management Hire internal auditor  Internal auditor is hired and working; external A-133-Type audit by Ernst system for enhanced & Young completed in December organizational responsiveness High level of compliance with  Recommendations of internal and external audits are being conceptualized, internal systems and external systematically pursued with BOD and MD support and AFFORD/KPMG implemented and sustained regulations according to compliance assistance by UHMG staff and Board and audit reports  Sr. Mgmt is consistently enforcing compliance requirements (ex: recent Orient staff on use of mandated staff changes in Stock Management team) protocols and standards; Orient & coach staff on compliance  Staff has been oriented and coached on compliance principles and practices, with AFFORD/KPMG assistance (Ex: Financial Management Staff monitored for compliance seminar in Dec. 2012) every quarter  Internal auditor with Dir. Finance and HR has conducted quarterly compliance audit review; AFFORD/KPMG has conduct quarterly progress review

Adapt MOH guidelines and  Staff is applying MOH quality assessment protocols in the field (e.g., with protocols for service quality Good Life Clinics) assessment  The PF is in the final stages of obtaining ISO Certification, with closure Products certified by international body (ISO) expected in next two quarters

Quality Management: Improve internal processes that  Marketing and Strategic Information (MSI) meets routinely with Product Improved internal inhibit or facilitate objective facility (PF) to facilitate distribution (e.g., Aquasafe, LTMs) communication and performance coordination  MSI meets with Programs Division on budgeting to facilitate local implementation (e.g., SMGL, Smart Choices, GLC Promotion)

 MSI meets regularly with finance to facilitate procurement (routine)

 Senior Level Management (SLM) has regular and open communication with Managing Director (MD) for improved vertical organizational communication (weekly meetings routine)

 The Board of Directors is advancing its vision of UHMG sustainability through a focus on meeting business targets (PF and new business development) as well as program targets.

2. DATA UTILIZATION Create a comprehensive Both strategic business units utilize  Sr. Mgmt is using monitoring and evaluation data in all quarterly reviews, monitoring and evaluation research data and monitoring tools including Retail Audit results, and Audience Reach results systems to form and assess quarterly to design and evaluate all organizational strategies major product, service and program initiatives

Tracking tools used by all managers  Managers utilize tracking tools to monitor activities on a quarterly basis, to monitor activities and progress, specifically: the Retail audit; Synovate Media Reach reporting; BCC specifically: product distribution, Survey; HMIS Data Collection amongst GLCs. sales, availability, program implementation, media campaign monitoring, community activities and activities at GLCs Work-plan Implemented  Technical staff develop program plans routinely and submit them to Research Advisor for feedback (Smart Choices; EMTCT; PMI; SMGL, GLC Strategy)  Technical staff routinely use program data and research findings to

6 inform programmatic decisions such as media plans, brand promotions, and field follow-up among GLCs.

3. INNOVATIVE STRATEGIES Ensure mutually beneficial All Program Division activities link to  Product & program linkages inform strategic decisions and outputs, for and effective linkages and relevant health products through example, the delivery of LTMs to trained service providers and how it synergy occurs between joint implementation plans and impacts UHMG CYPs UHMG’s business units reports

Ensure that all UHMG All strategies based on recent data  HIV/AIDS programs in place and judged cutting edge by stakeholders: e.g. programs are considered and information obtained from HIV Strategies for EMTCT, and MARPS (E.g.. Coordinated promotion and strategic and high quality by clients and their communities service delivery with STAR-EC, among fisher-folk in Mayuge) donors, clients and staff Increased involvement of clients and RH/FP programs linking to products and services, e.g., DFID “Smart communities in UHMG programs  Choices” Family Planning campaign conducted at scale

 Retargeted malaria ‘test and treat’ program coordinated with Stop Malaria Project

 Retargeted MCH program operational linking to products and services and integrating HIV services, products and practices, e.g., Saving Mothers Giving Life (SMGL); STAR-SW Antenatal Care campaign

Ensure that UHMG Marketing strategies developed,  Communication officers are create strategies and agency briefs with marketing strategies are documented and implemented limited external support, e.g., EMTCT, Condom Promotion, Test & Treat evidence-based and achieve for Malaria stated targets Increased market demand for services and products and targets Marketing and Brand Mgrs can routinely identify linkages between achieved  products and programs as evidenced by joint MSI-PF meetings Establish routine Operational database of key  MSI & PF are routinely using database of suppliers and customers communication with customers, used by product and customers and suppliers program managers Marketing events are taking place per Work-plan (relationship marketing) and  strengthen related Brand managers develop functional management systems communication strategy with  Sales increases slower than anticipated due in part to widespread customers availability of free products and services in the ‘private sector’ marketplace Ensure that all Product 3-month stock supplies on hand and  No stock-outs or shortages have occurred in RTP or UHMG product Facility operations are stock expiry at 0%. lines, except for Cotramox during Qtr 1 FY13. This was to sudden stock considered sustainable and depletion due to a large sale dependable by donors, Spot check reports on compliance of clients and UHMG staff procedures and systems; quarterly stock procurement plans in place  SOM is followed by Product Facility staff to manage stocks and procurement

Improve systems to track the A tracking system in place and used  Sr. Product Facility mgrs and Finance Team review supply chain system flow of in bound and out to manage logistics supply chain continuously bound stocks  Negative findings are being addressed w/in the quarter 4. BUSINESS DEVELOPMENT Increase and diversify Substantially increase number of  UHMG has applied for NICRA, and is following resource mobilization sources of revenue for both sources and amount of resources strategy, investment plan business units generated by both the program and product facility business units.  UHMG has been awarded at least 3 non-AFFORD contracts in the last year; several bid submissions have been developed in FY13 UHMG business practices improved,  The BOD provides active mentoring to the UHMG MD and SLM through through BOD support and the its committees and BOD Meetings, guided by the UHMG Business Plan assistance of AFFORD (KPMG & and USAID Workplans. While the BOD is actively interested in UHMG Friends Consult) outputs and quantifiable results, it tries to leave operational matters to UHMG MD and SLM. Only when intervention in operations is sought by

7 UHMG Mgt or needed does the Board act on operational matters.  Stock Mgt has been strengthened through AFFORD and KPMG assistance  HR Assessment completed through KPMG assistance  Procurement and IT Policies reviewed by KPMG, awaiting UHMG finalization  ISO Process for PF near completion

5. FINANCIAL MANAGEMENT Effectively manage and Timely financial reports for all  Finance unit delivers financial reports close to due date for all report on staff time and sources of funding programs finances across diversified funding sources Improved (accelerated) burn rate  Burn rate across AFFORD grant at close to 100% of workplan targets

Rare non-compliance with donor  Financial control procedures are monitored, and compliance financial requirements enforced

Improve working capital Improved debtor’s ratio  Aging debt reduced with AFFORD/KPMG assistance management by the Product Facility Improved stock management with no or minimal variances  Variances between system records, bin cards, and stock-on-hand reduced very significantly for RTP and UHMG products Improved working capital management position  75% of PF operating costs are being covered by revenues generated through PF net margins (excluding Marketing Costs)

Strengthen financial External audits verify that UHMG is  Finance Team has produced a documented response to each financial accountability and following international financial audit finding and recommendation compliance

8 1. PRODUCT FACILITY STRATEGIC BUSINESS UNIT

USAID BRANDS UHMG has three brands that it socially markets, donated by USAID. Generally, UHMG/AFFORD has experienced a declining sales trend of these products due to competing brands that have been brought in by other development partners for free distribution, and have found their way into the private sector. This has led to shrinking of the social marketing space.

The table below shows overall annual performance of RTP products under AFFORD. RTP Brands performance against annual targets: Annual AFFORD- Quarterly RTP Target AFFORD-RTP Qtr 1 AFFORD-RTP % Achieved against USAID brands (Units)* Target (Units) Actual (Units) Qtly Targets Protector 22,250,000 5,562,500 4,460,400 80 % Pilplan Plus 2,550,000 637,500 433,740 68 % Injectaplan 4,500,000 1,125,000 533,520 47 % *including DFID quantities; based on 4 Quarters (though UHMG will implement for 3Qtrs only in FY13)

A) Protector. The quarterly sales performance stands at 80% of quarterly targets. The quarterly sales of protector were as follows:

Months Oct 12 Nov 12 Dec 12 Qtr 1 Total Sales (Units) 2,510,040 984,660 965,700 5,562,500

Major customers for protector include wholesale Pharmacies like Zee Pharmacy, Super Medic, Zarin Pharmacy and NGO’S like Makerere University Walter Reed Project, Mild May among others.

B) Pilplan Plus. The quarterly sales trend is shown in the table as follows:

Months Oct 12 Nov 12 Dec 12 Qtr 1 Total Sales (Units) 147,930 90,720 195,090 433,740

The sales trend shows an improvement in the month of December 12. Route sales and sales to major distributors like Zarin Pharmacy, Astra Pharmacy, Super Medic and Multiple Super Investments contributed to the improved sale in December. However the general sales trend shows a decline in performance probably due to factors like other competing combined oral contraceptives in the market.

C) Injectaplan. The quarterly sales trend can be shown in the table below as follows:

9 Months Oct 12 Nov 12 Dec 12 Qtr 1 Total Sales (Units) 201,260 202,360 129,900 533,520

The quarterly sales trend for Injectaplan shows a declining sales trend over the quarter. The declining trend could be a result of the free government Depo being offered in public health centers2 and competition from long-term methods of family planning.

UHMG Cost recoverable Brands UHMG brands will be summarized in the table below as follows: UHMG Brands Qtrly Target Actual sales % Achieved (Units) * (Units) Moon Beads 28 1,487 0 19 % Aquasafe 5 1,350,000 51,520 41 % RestORS 2 500,000 70,650 54 % Zinkid 9 2,500,000 61,000 38 % Condom O 3 375,000 89,376 103 % Newfem 10,000 7,540 75 % Softsure 18,000 9,540 53 % Cotramox 1,975,000 9,600 0 % *including DFID quantities; based on 4 Quarters (though UHMG will implement for 3Qtrs only in FY13)

Zinkid. The achievement is still low and largely attributed to separate packaging of these two products. UHMG has tendered application for approval of RestORS/ Zinkid combination co-packaging from the National Medical stores. We anticipate that this approval will significantly contribute to increased sales volume of these products. Additional benefit of co- packaging is also expected in value sales as the possibility of a cross- subsidy of one highly demanded product like Zinkid will enable Restors to move too. Once the co-packaging is approved, significant orders will be expected from customers like Joint Medical stores. Currently major buyers have been wholesale pharmacies like Super Medic, Equus enterprises and Zee Pharmacy.

RestORS. The sales achievement has been consistent with the previous quarter. With a revision in price downward to Ug. Shs 160 per sachet, Restors is expected to be more affordable to most wholesale Pharmacies. The downward revision of the price is a result of the trip UHMG staff took to India where they renegotiated a lower supplier price for RESTORS. Major buyers have been wholesale pharmacies. With the revised price, we hope relief agencies like UNHCR. Red cross and other NGOs will be potential customers of UHMG in future.

Aquasafe. This product is still largely an Institutional product usually taken up by NGO’s. Major sales in the quarter were realized from Malaria Consortium, Kakira Sugar Ltd, Super Medic, African Humanitarian Action,

10 Uganda Rugby union among others. This product is now available in super markets like Capital shoppers and other in Kampala. However use of this product in major towns like Kampala, may not be extensive given the numerous safe water alternatives. Schools have also not been major buyers of the same despite the various merchandizing campaigns carried out. UHMG plans to refresh its strategy, we hope to register better sales in the coming period.

Condom O. The demand for this product has been fairly steady especially in the peri- urban areas and major towns. It is also increasingly becoming the brand of choice among NGO’s, Super Markets and corporate organizations like GIZ and Stanbic Bank have significantly contributed to increased demand. The television adverts could have had a significant impact on improved sales.

NewFem. Most purchases are made by pharmacies and in small quantities. It was introduced in January 2012 and little or no serious demand creation activities have taken place to stimulate demand to aid secondary shelf off take. However UHMG has observed increasing trends of acceptability as it goes through its brand growth cycle.

SoftSure. Sales of this product are usually in small quantities and hardly more than a carton for a single customer. Significant sales were realized mainly through customers like Humanitarian care. Brand promotion activities and detailing activities have been low in the quarter.

MoonBeads. This product is a slow moving product that is mainly used by a small section of women whose faith does not approve of hormonal methods. However its demand can be erratic especially from NGO’s like Humanitarian Care Uganda, International Medical Foundation how work with faith based groups and distribute moon beads for free. UHMG’s strategy to market it as a tool for knowing one’s cycle is slowly picking up with teaching institutions of medical workers.

Cotramox. There were no sales for the said product because UHMG got unanticipated windfall procurement from IRCU and STAR-W that lifted stocks available in the previous quarter. We are waiting to receive new stock in the third week of January.

COMMERCIAL OPERATIONS WITH NON UHMG PRODUCTS:

Local technical representation of Manufacturers: This business category is critical to meeting the sustainability objectives of the Commercial Division. It combines pursuing national representation of international manufacturers’ and competing for bids to supply medical and pharmaceutical products. This quarter, a realistic revenue target, based on projected revenue expectation of UGX 258 million/ month. UHMG competed on a bid to supply circumcision kits to USAID and was awarded a blanket offer. It is from this business (supply of Circumcision Kits) that UHMG was able to realize 157% of its projected quarterly revenue for this business category.

Currently the Commercial sales are contributed to by the following brands:

a) Cipla Range. These includeACT’s like Lumartem, Pylokit, Azithromycin, Nifelat and Bendex among others b) Ajanta Range. These include Dazel Kit, Artefan, Actinac and IV Fluids from Abacus. c) Medinomics Range. These include Aminosoft syrup, Dipi (Duo co texin), Aminofer Capsules and Extravert among others. d) VestaGaard. This includes the Mosquito nets of the Permanet Brand.

11 e) Hexagon Range. These include Sprinkles, Pentasure and Pentasure DM. f) Naari Range.These include Ova chek and U chek, which are feminine products. g) Adcock Ingram. These include Betapyn and Compral. These were introduced in August 2012. h) Others. These usually include a range of assorted Pharmaceutical products like Circumcision kits, and others vary with Customers orders and require to be procured whenever an order is received.

The Non UHMG Brands quarterly sales can be shown in the table below as follows: Months Quarter target Oct 12 Nov 12 Dec 12 UGX Sales (Ug. Shs) 740,000,000 910,846,544 174,299,442 902,409,376

The monthly set target of Ug. Shs 258 million for non-UHMG brands was set on the basis of the available product mix and future products from new suppliers. Sales can be shown be shown in the table as follows:

Third Party Logistics (3PL) Business: We have seen increasing demand for third party logistics management with accompanied demand for storage facility. As a response to increasing demand, UHMG has put up a temporary storage facility to work as an annex allowing for 100square meters of storage. Meanwhile, we have tendered for the construction of a new warehouse and construction start in the coming quarter. We received the first payment from ministry of health of UGX.288m, for the contract awarded to us as alternative commodity supply management serving the private sector and the balance amounting to UGX 530million to cover the period January to March 2012 will be paid by UNFPA. Additional funds amounting to $ 263,000 for the period July to September 2012 will be expected in the coming quarter we have been informed that part of the expected payment will come from UNFPA by second week of January 2013. Much as payments for 3PL business may take a while, UHMG has found this as a very profitable business, critical to its sustainability, expansion of the warehousing facilities will be foundational in increasing revenue through 3PL and obviously improve UHMG’s cash flow.

Business and system strengthening: ISO After the successful training sessions, implementation has begun with the draft system manuals in place. Training of the internal auditors has been planned for second week of January and thereafter, 2 weeks will be allowed before internal audits are completed. We plan to invite the external auditors by second week of February and seek certification by end of March 2013. Regional pharmacies The sales at the pharmacies have been on upward growth trends for both pharmacies and have been recorded under PF sales to avoid double reporting of sales. This will still be so until when the pharmacies start to operate an autonomous profit centers for which complete financial reports will be prepared periodically. The challenges still faced are price competitions and stocking of limited range of products. These will however be overcome with time as we institute more efficient operations, thus reducing on overhead expenses. Financial updates With the reported increase businesses coming from USAID, various customers and partners, PF has seen increased revenue streams which have greatly improved the cash flow of the division. A complete financial

12 report is provided under UHMG consolidated financial report. Most important though is to report that PF is fully implemented the business plan financial autonomy and is meeting 75% of the staffing cost and cost of operations from its revenue and plans to implement 100% cost autonomy by January 2013.

RETAIL AUDIT

During FY12, AFFORD/UHMG initiated for the first time an independent, scientific monthly Retail Audit to measure the presence and movement of its products in private sector outlets. This retail- level information complements sales data to provide an more accurate picture of market dynamics The study sample of 1,100 is drawn from a total universe of all registered private sector medical outlets in Uganda, numbering 9,111 (based on the outlet census of 2012). The distribution of outlets (clinics, pharmacies and drug shops) in the sample is proportional to the distribution of such outlets in the total universe, thus making the sample representative of the Ugandan health outlets as a whole. The results for the October through December period are shown below. The presence of the key products remains in the majority of outlets nationwide.

UGMG brand presence in private sector retail outlets (pharmacies, drug shops, clinics) nationwide (Source: WRI Retail Audit 2012)

October November Dec

Protector 82% 80% 79%

Pilplan Plus 73% 73% 72%

Injectaplan 70% 69% 69%

Zinkid 51% 50% 48%

Restors 43% 41% 41%

Condom O 13% 15% 15%

Aquasafe 11% 13% 13%

Softsure 6% 6% 6%

Cotramox 5% 6% 5%

Newfem 2% 2% 2%

13 Moon beads 1% 1% 1%

.

ACTIVITY PERFORMANCE MONITORING TABLE

Activity 1: PF strategies and business development Activity Description Targets/Outputs Q1 Q2 Q3 Q4 Q1 Comments  Carry out market surveys to  New products: Nutrition  Survey done for new AI reveal gaps, potentials and range, Analgesics, Anti X range covering oncology, opportunities of entry with biotic and test kits.  dialysis products and the bottom of the pyramid and x report being analysed for new volume movers brand action in second quarter

 Solicit for local product  Number of local X Received agreement with sourcing arrangement for sub contracts signed Ngapi for Venus distributorship with LTRs of  Number of local pharmaceuticals and will also multinationals purchase orders placed submit tender pre- after confirmation qualification bid to NMS as a  Limit local purchase to only sub-distributor of oncology confirmed orders from the products through Ngapi customers Limited local purchases done in accordance with confirmed orders  Supplier search to achieve  Increase in the This is Q2 activity sources of highly reputable profitability of the and quality products, with the product facility Directorate staff of the facility  Increased product range taking visits to suppliers both of commercial brands local and International. with detailers fully paid for by manufacturers  2 more suppliers to be signed

 Collect and analyze  Knowledge of the This is Q2 activity information on logistics and market and demand customer demand forecast trends/survey reports from both the public and  Quarterly rolling private sector target forecasts tool customers developed.

 Update the current marketing PF Website link X Products have been placed in tools used to promote the developed; price lists, categories to receive high product facility to reflect the FAQ, and order form focused push to the market new products that have been uploaded to facilitate with representatives introduced. These include the online transaction and allocated to a particular UHMG website and SMS information sharing range. Implementation has

14 platform. started partly and will rolled out fully in second quarter

Activity Manager:Philip Okello Apira

Activity 2: Strengthening Product Facility operations Activity Targets/Output Q1 Q2 Q3 Q4 Description s  Strengtheni . Ease of X The practice of ng of PF processing regional and reports e.g. pharmacies is regional consolidated being pharmacy sales strengthened operations reports, by monitoring debtors. their adherence to best practices in stock management and debt collection. PF attains  Clear X ISO increased operat implementatio operational ional n is ongoing autonomy status with further Train training in warehouse  ISO system audit staff to certific arranged for improve ation January 13. their skills in attaine Sales and stock and d warehouse warehouse staff will be managemen  Wareh trained t ouse specifically in staff their areas of needs in Regularly follow February and review SOM s SOM March for further respectively revision and  Sales ISO Manual of follow up of force SOM is also implementa empo being reviewed tion wered to and final document will Construct make be produced by another a February 13 600sqm differe warehouse nce in on UHMG their

15 land activiti es and contri bute to achievi ng overall sales objecti ves

Capacity of  Warehouse X Monitoring and warehouse staff supervision; staff monitored monthly stock A team of for counts, professional adherence variance , proactive to SOM best reporting members of practices staff developed Sales force empowered to make a difference in their activities and contribute to achieving overall sales objectives Warehouse  Warehouse X Management staff Review of SOM  Regularly monitored is continuous review SOM for Warehouse for further adherence construction revision and to SOM best discussed, follow up of practices architectural implementa drawing done tion and submitted  Extend the to KCCA for warehouse approval, capacity tender for through construction constructing advertised and an extension bids being from the evaluated existing warehouse

16 structure  Consult on business portfolio managemen t ISO  ISO X Implementatio Certificatio certification n of SOM is n attained ongoing, Finalize auditing for implementa certification tion and planned for auditing for march 13 certification within the year Other activities  Performanc X Regional Link and use e warehouses the managemen share data networked t system in terrestrially but of data place will be linked sharing links on the net in between the second quarter warehouses and the main warehouses Manage performanc e through adherence to SOM Activity Manager:Philip Okello Apira

Activity 3: Strengthening management and financial systems Activity Description Targets/Outputs Q1 Q2 Q3 Q4 Financial management X Streamline ledgers in the 80% done but continuous system and structure of the  Tally software Tally system designed to meet the Continuous reporting needs of the Continue to train users in tally product facility Implemented to optimize the its functionalities  Sound financial Continuous management and

17 Establish and implement reporting (both cash and working guidelines for the inventory) regularly Done credit policy in place disseminated

Install the commission  Debt management Done remuneration to the sales force procedures in place to enforce the management of cash flow strategies Continuous

Develop cost drivers and cost  Debt recovery up to Continuous absorption strategies to show 60% within the sales growth in capacity period

Recruit a credit controller in PF  Credit ceiling by aging analysis and debtor Done Management of the product days streams as business portfolio to allow for commensurate  Building Dollar bank remuneration of the balance for over sea performance while tracking the supplies payment profitability of the products  Renegotiate supplies payment terms

 Monthly stock counts and variance management

 Recruit a credit controller

 Product profitability tracking

Good relationships with  Accurate and timely X Monthly statements will be customers and suppliers statements for customers issued perceived resulting from and suppliers accurate and timely statements Working Capital management  Debt management X Done but continuous Debt management procedures procedures in place progress in place  Daily banking of cash and Debt recovery up to 80% within cash equivalent the sales period  Monthly stock counts and Credit ceiling by aging analysis variance management and control Daily banking of cash and cash equivalent Selling and invoicing in US Dollars Building Dollar bank balance for overseas supplies payment

18 Renegotiate supplies payment terms Monthly stock counts and variance management Activity Manager: Moses Kafeero

Activity 4: Sales and distribution Activity Targets/Outpu Q1 Q2 Q3 Q4 Description ts   A customer X Advert for Key Market relationship account segment officers manager was ation allocated to done, short will be Client listing done strength portfolio and ened,  Presence recruitment to where and be done in the percentage quarter 2 client of the sales relations revenue hip from key activitie account s will sales grow focus on to 20% of relations overall hip sales selling achieved among all key custome rs. Emphasi s will be placed on IPs, Instituti ons, NGO’s and corporat e organiza tions as these contribu te a significa nt portion of the

19 sales

  At least one X 2 (Two) CME’s Continu of each per held in ed month. October and Medical December. Educatio One in n Nsambya (CME’s) Hospital and and Kadic Hospital round for Hexagon table range of confere products. nces will be a to focus on especiall y the new product ranges develop ment

 PF to X Arua and Empowe expedite Mbale r the the Pharmacies regional sourcing for now fully pharma the regional operational cies in Pharmacies and active in Arua . distributing and  USAID, UHMG Mbale and other to products. operate as fully fledged sub distribut or for the product facility

 Another X Plan Uganda To Pharmacy has reversed extend to be the decision to the opened in open a distribut Gulu. Pharmacy in ion Gulu reach to A GLC cover GLC Coordinator

20 for all coordinator has been project assigned appointed commo the roles dity distribut ion in the project districts  To carry out social distribut ion in only the Good Life Clinics where an officer will be assigned to take care of the channel   Conti X Advert for Key Support nuously account and evaluate manager was evaluate the done, short the distributors listing done distribut on a and ors to quarterly recruitment to improve basis. be done in efficienc  Frequ quarter 2 y in ent distribut business ion and meetings relations hips

  Market X 2 (Two) CME’s Market survey for held in survey outlet October and for audits December. outlet conducted One in audits Nsambya and Hospital and gaps Kadic Hospital identific for Hexagon

21 ation in range of market products. share and reach for commer cial division

Sales  70% A product targets of targeted Budget outlets developed and stocking revised to 6.0 products billion distributed excluding by USAID and Commercial DIFD Project Division commodity  Annu sales. al Sales target of 6.0 Billion UGX achieved excluding USAID brands  Gross Margins of at least 30% for UHMG brands and 20% for commercial brands  Three skills trainings for the sales force  Retai n at least 95% Customers Activity Manager: Paul Kagumire

22 Activity 5: Supply chain management Activity Description Targets/Outputs Q1 Q2 Q3 Q4 Prepare a . CPT memo X CPT Memo was dynamic sent to and approved by procuremen approved by USAID and t plan for all USAID ordered placed products . Running Contracts were contracts in not place for key renewed/prepa suppliers red pending budget approval Monitor . Up to date X The procuremen procuremen procurement t on a t plan plan is in place weekly basis available for by entering discussion consumptio at the end n and of each receipts month data Procure . Finished X There is more packaging products than buffer materials available for stock in place and sale Procurement of instruction . Buffer stock packaging products for of three material did generic months in not happen products place for pending budget Put in place Protector, approval a secondary Pilplan Plus, packaging and contract Injectaplan with Kampala Pharmaceuti cal Industries Procure . No stock X There were no products outs of any stock outs of according to product due any product performanc to poor e of the performanc procuremen e t plan . No over stock due to bad procuremen t practices

23 Activity Manager: Rachel Apio (with R. Kitonsa for regulatory matters)

Planned Activities Next Quarter

As a way forward for improvements, the following being planned:  Restocking the key commercial fast moving items especially starting next year. These include ACT (AMFm), Examination gloves, Mosquito nets in all sizes among others.

 To continuously carry out research in respective regions in Uganda on viable commercial products. This should be coupled with seeking overseas suppliers for supply of these viable products. A product budget has already been developed and should be adhered to.

 Increased mobility for all regional sales representatives. These will help in secondary off take of socially marketed products from distributors to far to reach areas. Alongside this, other brands can be sold along. Route selling in the regions can be profitable and should be encouraged periodically.

 Launching Malact. The commercial Division should embark on developing and promoting its own ACT brand once NDA finalizes the approval. Sales figures have consistently shown that Anti Malarial drugs’ register high sales. This is because Malaria is one of the most rampant diseases in the country.

 The recruitment of a key accounts manager will be completed in January. This person will be responsible for managing business among the NGO’s and Corporate bodies.

 Continuously work with other local distributors like Ngapi Pharmacy to add new product ranges like the Venus range, which includes Ceftriaxone and Burn Care products.

2. PROGRAMS CONSULTANCY STRATEGIC BUSINESS UNIT

OVERVIEW

This report summarises challenges and achievements registered in the 1st quarter (October – December 2012). Q1 Activities focused on strengthening institutional capacity for sustainable services delivery and consolidation of quality services delivery in all core program interventions. Some of the key highlights are summarized below:

 Health workers (HW) from GLC were trained on Family Planning services delivery with focus on long acting family planning methods. AFFORD II target is 300, out of which a total of 237 were trained by the end of the quarter.  Roll out of PMTCT services in private sector. A total of 42 health workers were trained to deliver PMTCT services, based on option B plus.

24  Strengthened delivery of HIV, MCH, Malaria and FP services supported through all GLC through mentoring visits and services delivery through outreaches.  Mapping of GLC was completed in additional 45 districts to reach the target of 560 GLC for integrated services delivery.  Supported GLC to provide quality integrated services for Malaria, HIV/AIDS, Family Planning, Maternal/Newborn and Child Health through support supervision, provision of supplies and health products through social marketing.

Other activities supported during the quarter include;  Participation in commemoration of Safe motherhood day commemoration that was held on Oct 17th 2012, Kabarole district.  Participated in commemoration of World AIDS day both at the national and district levels.  Supported Saving Mothers Giving Life (SMGL) 4 districts to conduct radio campaigns to increase demand for health facility deliveries.  Supported PMI Washington and Uganda teams on field site visits in Eastern Uganda  Updated Programs Strategies to guide programs implementation. These strategies are: Private Health sector Sustainable Services Delivery, M& E, Resource Mobilisation and Health Communication Strategies.  Capacity building in strategic health communication. Directors of programs and MSI attended 2 weeks course in Leadership in Strategic Health Communication sponsored by AFFORD and organised by CCP Nigeria, in Partnership with CCP Baltimore.  M&E staffs were trained on spatial data analysis using Arc GIS software. One program staff participated in PMTCT services M&E training organised by MOH

2.1 MALARIA

Introduction UHMG/ AFFORD project Malaria supported services focus on provision of quality case management services, prevention of malaria in pregnancy and increased community awareness on dangers due to malaria, and increasing demand for utilisation of malaria control services. Case management for simple malaria is based on parasitological diagnosis, using rapid diagnostic tests and microscopy. Confirmed cases receive treatment, in line with policy guidelines for use of ACT, as 1st line medicines.

With regard to malaria in pregnancy, prevention services are provided through scale up of intermittent prevention treatment during pregnancy (IPTp), provision of LLIN through social marketing approaches and timely malaria in pregnancy case management services.

Malaria control interventions targeting the community and household levels aim at providing more awareness on the dangers of malaria, services available, how to access these services and demand generation for increased utilisation of these services. Over the last program year, UHMG/AFFORD project rolled out timely malaria case diagnosis and treatment campaign – the power of day one, with outstanding success. For this program year, UHMG in collaboration with Stop Malaria Project (SMP) is scaling up the successful malaria case management campaign – the power of day 1 – to reach the national scale, using multichannel approaches.

Key Activities carried out in Q1

25 A summary of malaria activities supported during the quarter are presented below.

Malaria Case Management:  Training of new health workers on case management across all GLCs

 Procurement and distribution of RDTS and ACTs

 Production and distribution of malaria case management job aids

 Support supervision of service providers and data collection from clinics and drug shops

Malaria in pregnancy  Training of new health workers on MIP integrated in ANC for GLC with ANC

 Distribution of Water vessels, AquaSafe and water cups, & SP through subsidy

 Printing and distribution of integrated RH registers

 Distribution of subsidized ITN through ANC

Demand generation activities  Produced and distributed malaria posters

 Support radio spots & talks-shows for malaria prevention

Support Supervision  Integrated support supervision to GLC and drug shops, in partnership with MoH and DHO were conducted.

Annual Work Plan Tracking Matrix Activity Indicator Annual Q1 Cum % Comment 1.1: Malaria Case Management Training of new health workers on Number of GLC supported 100 48 48% case management across all GLC Reorientation of drug shops members Number of drug shop 300 175 58% on case management supported Procurement and distribution of Number of RDT sold 150000 Planned Planned for subsidized RDT through social marketing for Q2 Q2 Procurement and distribution of Number of ACT doses sold 300000 Planned Planned for subsidized ACT through GLC/S for Q2 Q2 Production and distribution of malaria Number of job aids 3000 Planned Planned for case management job aids - PMI reproduced and for Q2 Q2 districts distributed 1.2: Malaria In Pregnancy Training of new health workers on Number of health workers 150 Planned for MIP integrated in ANC for GLC with trained Q2 ANC Printing and distribution of integrated Number of registers 500 Planned for

26 RH registers produced Q2 Distribution of Water vessels, Planned for acquasafe and water cups, & SP Number of Facilities Q2 through subsidy supported 150 Distribution of subsidized ITN through Planned for ANC Number of LLIN sold 6000 Q2 1. 3. Demand generation activities Produce and distribute malaria Number of posters posters distributed 1,000 Support radio spots & talk for malaria Number of radio spots prevention aired 400 Number of radio talk shows held 40 Support supervision of BCC activities by MOH Number of support visits 3 1.4: Support supervision Support supervision of service Number of GLC supported 560 169 30%. done in 5 PMI providers and data collection from Districts clinics and drug shops - PMI districts

Key accomplishments during the quarter

Malaria case management:

Training of new health workers on case management across all GLCs; During this quarter on-site capacity building on malaria case management to health workers of the Good Life Clinics and drug shops in the six (6) PMI districts of Kumi, Soroti, Katakwi, Serere, Ngora, and Apac was provided as part of support supervision and clinical audit exercise. In addition data was compiled for 48 GLCs and 175 drug shops using the UHMG quality improvement and monitoring tool. This was done with support from ministry of Health central level trainers, District Health Officer (DHO), Malaria Focal Persons (MFP) and District Health Educators (DHE) and UHMG staff.

Procurement and distribution of RDTS and ACTs; A total of 214 RDTs and 720 packets of ACTS were procured and supplied depending on GLC capacity to procure.

Production and distribution of malaria case management job aids; Job Aids and Clinical Guidelines 2010 were a given to all GLCs visited.

Support supervision of service providers; Support supervisor was done to six PMI districts of Soroti, Kumi, Katakwi, Serere, Ngora, and Apac but data collection was not done. PMI Uganda and Washington teams were in Uganda to assess progress of malaria control services supported. UHMG participated in the field review, taking the team through Soroti district supported sites. And two GLCs were visited and these included Soroti Medical Associate and Beacon medical centre.

27 Above, PMI Washington, Uganda & UHMG Staff at Soroti Medical Associates UHMG GLC

Demand generation activities Distribution of malaria posters was done during support supervision to six PMI districts Talks-shows for malaria prevention in PMI district, based on power of day activities were held. This was part of previous media plan activities spill over from last quarter.

Malaria service delivery by GLC summary

Indicator Annual Target Q1 Cum% output Suspected malaria cases <5 year 90,000 27,684 31 Suspected malaria cases >5 years 140,000 47,171 34 Lab tests (RDT) cases <5 year 24,000 7,704 32 Lab tests (RDT)>5 years 33,000 11,032 33 Lab tests (BS) cases <5 year 80,000 28,484 36 Lab tests (BS) >5 years 160,000 53,533 34 Confirmed cases (RDT) <5 year 10,000 3,641 36 Confirmed cases (RDT) >5 years 12,000 4,264 36 Confirmed cases (BS) <5 year 40,000 14,779 37 Confirmed cases (BS) >5 years 70,000 23,938 34 New ANC attendances 40,000 7,533 19 IPT1 35,000 6,311 18 IPT2 30,000 4,891 16 % of IPT2

Plans for Q2

UHMG will scale up the following activities during Q2  Malaria Case management i. Distribution of subsidized RDT to GLC and drug shops ii. Distribution of subsidized ACT to GLC and drug shops

28 iii. Orientation of GLC and drug shops using clinical audit tool iv. Distribution of malaria case management job aids for quality services delivery  Malaria in pregnancy i. Orientation of health workers on malaria in pregnancy interventions through mentoring visits support ii. Provision of IPTp commodities (Fansider, Aquasafe and water vessels)  Support drug shop associations and GLC to stock UHMG malaria control products and commodities through social marketing approaches.

2.2 MATERNAL, NEWBORN AND CHILD HEALTH (MNCH)

Introduction As the country moves towards the year 2015, UHMG endeavors to play its role of contributing towards the attainment of the targets set for MDGs 4 and 5, on the reduction of the maternal mortality (to 131 per 100,000 live births) and childhood mortality (to 70 per 1,000 live births) respectively. In addition UHMG support the increase of the national Modern Contraceptive Prevalence Rate from 26% (in 2011) to 45% (in 2015), which has positive dividends on the overall health of the population in general and women and children in particular.

Program support for quality MN&CH) services target key strategic objectives. i. To increase the availability, accessibility and utilization of quality MN&CH services; skilled care and products in the Good Life clinics. ii. To improve appropriate and timely health care seeking behaviour for maternal, newborn and child health services at community level through increase in knowledge for more demand and correct utilisation of MN&CH services and products. iii. Scale up of deliver at health facilities campaign, as part of saving mothers, giving life collaborative activities in the 4 SMGL districts of Kyenjojo, Kabarole, Kamwenge and Kibale.

Detailed strategies and activities to realize these key strategic objectives are summarised in MN&CH performance tracking matrix table below.

MN&CH Annual Work Plan Performance Matrix

Activity Key Indicator Ann. Q1 % Comments Target output cum. 2.1 Capacity building of Good Life clinics to provide quality and integrated MNCH services Conduct trainings for 50 service providers No. of Good Life Clinics with 100 0 NA Shifted to Q2 from the 50 GLCs on Goal oriented at least 1 service provider antenatal care and emergency obstetric oriented on Goal Oriented and newborn care Antenatal Care and Basic EmOC

29 Post training follow up of 188 IMCI No of health workers 188 0 NA Shifted to Q2 trainees at their workplaces mentored on a quarterly basis Procure and distribute basic MCH No. of GLCs equipped with 188 100 Activity is on supplies (MUAC tapes, Mama kits, basic MCH supplies 53% going delivery sets, basic resuscitation equipment, Misoprostol and Sterile gloves) to 150 GLCs Conduct quarterly Continuous Medical No. of health workers 100 20 20% Selected GLC Education sessions with the 50 Good Life reached through CME were visited clinics on selected topics in partnership sessions in Kampala with MOH Conduct quarterly community Integrated No. of integrated community 50 20 40% Kyenjojo & outreaches by 50 GLCs (1 per GLC) outreaches supported for Kabarole GLC ANC, FP, CH & IMCI Supported 2.2 Community sensitization and demand creation for MNCH services Formation of 50 mothers' clubs and Number of mothers clubs 50 0 NA Shifted to Q2 support monthly mothers' clubs activities oriented who are actively in 50 GLCs engaged in community MNCH services demand generation and submit timely monthly reports

Conduct community dialogue meetings No of pregnant women, new 5000 0 NA Shifted to Q2 to increase demand for MNCH services mothers reached through and promote health of target clients community dialogue meetings. 2.3 Scaling up the Safe Deliveries and Newborn Care through Health Facility Delivery Campaign

Radio programs Number of radio spots aired 1000 1500 150 1000 in SMGL % districts Number of talk-shows aired 100 65 65% 15 in SMGL districts TV ads - 1 TV station(1spot buy package Number of TV adds 100 50 50% Shifted to Q2 on NTV) Bill boards - 13 bill boards (block figure) No. of bill boards 13 36 280 Part-16 are % road stars Print Promotional materials, IECs and Job pieces of IEC, job aids printed 1000 700 70% Part-200 are Aids (lump sum) fact sheets

First Quarter Activity Highlights A summary of activities implemented during the quarter are highlighted below. i. Support Good Life clinics to provide quality and integrated MCH services through outreaches ii. Community mobilization and demand creation for MNCH services. iii. Support deliver at health facilities campaign in SMGL districts

Quarterly Achievements

Provision of Integrated MN&CH Services

30 Under this activity, services provided were delivered in an integrated manner. They included Antenatal care, de-worming of children, Family Planning HCT, health education and communication campaigns for disease prevention measures, growth monitoring and treatment of common ailments. Two outreaches were conducted this quarter; Kyenjojo district during the safe motherhood day October 17th 2012. Observations from these outreaches indicate that demand for HCT remains high. There is also an increasing demand for FP long term methods. Detailed services were captured by participating GLC and reported through district HMIS, services data from these outreaches is included in this report.

The table below summarizes data on clients served from the integrated outreaches

Services supported Output No of Location venues Depoprovera 3 1 Kyenjojo Pills IUD insertion 5 1 Kyenjojo Implant insertion 36 1 Kyenjojo HCT 151 2 Kyenjojo and Namuwongo Cervical cancer screening 42 1 Kyenjojo ANC checks 71 2 Kyenjojo and Namuwongo De-worming 126 1 Namuwongo Treatment of child hood illness 312 1 Namuwongo Total OPD attendance 797 1 Namuwongo

Community mobilization and demand creation for MNCH services

Safe motherhood Day National Commemoration UHMG participated in the National Commemoration of Safe Motherhood Day in Kyenjojo. Our involvement during this event included community mobilization using experiential teams to increase awareness and rally. We used Enter-education approach. Working in partnership with GLC in the district, UHMG used the 4 tent model, which an approach that easily provided a continuum of response (COR) thus allowing access to comprehensive care to communities.

Community Mobilization for Health Facility Delivery UHMG coordinates the SMGL communication working group. The on-going communication campaign mobilizing women to deliver in the hands of a qualified heath worker at a health facility launched last quarter continued to be aired using multichannel approach. The purpose of SMGL interventions is to implement activities that will increase health facility delivery, and to reduce Maternal and newborn mortality by 50%.

Quarterly Service Delivery Data Summary

From the activities implemented, the following Table summarizes progress made on the targets set for the 1 st Quarter (October to December 2012).

Service Delivery Outcomes

MONITORING MNCH INDICATORS

31 MATERNAL HEALTH Annual Q1 Cum% Number of mothers attending the first ANC visit at the GLC 40,000 7,533 18.8 Number of mothers attending the 4th ANC visit at the GLC 25,000 4,446 17.8 Number of mothers who received IPT 1 at the GLC 35,000 6,311 18.0 Number of mothers who received IPT 2 at the GLC 30,000 4,891 16.3 Pregnant women counselled, tested and received HIV results at GLC 30,000 7,274 24.2 Number of mothers delivering at GLC by skilled HW 28,000 4,952 17.7 N of women receiving post natal services 20,000 3,273 16.4 CHILD HEALTH Number of children who receive growth promotion services; 400,000 60,955 monitoring; immunization, de-worming and nutritional counselling 15.2 Children under 5 years treated for malaria & other common 200,000 54,586 childhood illness 27.3 Children under 5 years managed at GLC with severe malnutrition 1,000 525 52.5

Planned MN&CH activities planned for 2nd Quarter

A summary of activities to be carried out in the coming quarter are presented below: i. Support GLC to provide quality MN&CH Services a. Train 100 HW from 50 GLC on focused ANC care, emergency obstetric care (EMOC) and care of the newborn. Training approach will be facility based, and hospital placements, in order to reduce disruption in service delivery and increase on clinical skills of service providers. Job aids will be produced and provided to the health workers in the 150 GLC to help in quality services delivery. b. Procure and distribute basic MN& CH commodities and supplies for 50 GLC. These will include MUAC tapes, weighing scales, misoprostrol, and mama kits. The GLC will be provided with an essential list of essential medicines, equipment and instruments that they need to have in the clinics for quality services. c. Provide continuous medical education through support supervision and in service mentoring. d. Support 50 GLC focus to conduct quarterly integrated community outreaches ii. Support community sensitization and demand for MN&CH services e. Support formation of 50 mother clubs linked to 50 priority GLC f. Support community dialogues to increase demand and MN&CH services uptake. iii. Scale up ‘prepare to deliver at HF’ campaign nationally. g. Sponsor 1000 radio spots h. Support 35 radio talk shows i. Support 50 TV messages j. Produce 500 IEC materials and fact sheets

2.3 FAMILY PLANNING

Introduction

32 AFFORD/UHMG supports FP services as part of their contribution to realization of the national targets intended to raise use of modern family planning methods from 26% (2011 UDHS) to 45% by 2015. UHMG AFFORD II FP services are supported through a partnership between USAID and DFID. The objectives of this Accelerating the Raise in Contraceptive (ARC) prevalence project are: i. Increased availability, affordability of quality FP services and products in 300 GLC, building on 41 GLC supported in last program year. Activities aimed at realizing this result area are; a. Build the capacity of 300 GLC service providers in quality IUD and implant service provision. b. Support Family Planning Commodities security to all of GLC franchised providers 300 and limit any stock outs of essential Modern Family Services, including IUD and implant supplies. ii. Increased knowledge and demand generation for modern family planning services, especially in rural and hard to reach regions. Demand generation for modern family planning services increased utilization will be supported through several approaches. a. Interpersonal communication strategies b. Mass media campaigns

Family Planning Quarterly Performance Matrix

Indicator Q1 % outp ag Activity Description Annual ut e Comments Result 1: Increased availability, affordability of services and products Build the capacity of GLC in delivery of modern family planning services

Training service providers in IUCDs and # service providers trained 184 121 66% 116 implant insertion on LTFPM trained in PY2. Post Training mentoring and support # service providers retrained 300 10 3% On going supervision visits on LTFPM Conduct clinic support days & outreaches 300 clinic support days 300 For Q2 supported Strengthening infection control in newly # of clinics that received 300 121 40% Ongoing. enrolled GLC clinics and hospitals infection prevention logistics, disinfectants, injection boxes Strengthening quality improvement # of clinics that received the 300 121 40% Ongoing. activities for mid and long term methods IUD kits # of IUCD kits/ for participating clinics equipment distributed Produce and distribute job aids (MOH Flip # of guidelines disseminated 300 13 Ongoing. charts for health workers and MOH flip # of job aids disseminated charts for community health workers, WHO # of clinics that have received eligibility wheel for screening clients and job aides and guidelines. MOH policy guidelines) on reproductive # of clinics that have received health. and making good use of job aids and guidelines Hold bi annual meetings with GLCs & GLC 2 For Q2 promoters on how to improve the partnership/work relationships Distribution through social marketing of FP Conduct medical detailing NA NA Ongoing commodities visits and sales for FP

33 products, as well as distribution Provide GLC with FP equipment, supplies Procurement of IUD, infection and commodities prevention Equipment, logistics and supplies NA NA Ongoing

Recruit and train Good life clinic promoters # GLC promoters recruited 600 For Q2 and trained on LTFPM Facilitate GLC promoters and satisfied # GLC promoters facilitated 600 For Q2 users to penetrate rural communities with monthly short term and long term FP products # of new users identified in rural areas by the GLC promoters Support joint District coordination and 4 quarterly review meetings 4 For Q2 technical reviews of FP activities conducted per district (quarterly) Conduct Mass Media Campaign Radio talk shows 8 radio 89 stations 54 61% Ongoing Radio Spots 10,00 140 4,123 0 % Ongoing TV spots 132 Ongoing Road-stars 63 Ongoing Branding of GLC facilities 100 Ongoing Production and distribution of IEC, job aids and promotional materials 70,000 Ongoing Utilize UHMG SMS platform for info on availability of commodities NA NA For Q2

Monitoring and Evaluation # of data tools printed # of GLC report using the Adapt and print data collection tools data collection tools 1000 On going Monthly collection of data from the outlets 4 quarterly reports generated # of GLC reporting monthly # of quarterly reports generated 4 Ongoing Conduct mystery clients quarterly 4 quarterly medical audits # of mystery clients interviewed per quarter.  Extent to which issues identified in mystery client interviews Planned addressed 300 for Q2 # of client exit interviews 300 Planned conducted for Q2 and issues identified Conduct quarterly client exit interviews addressed

Key activities supported during the quarter

34 Training on long term FP methods A total of 121 service providers from 121 GLCs underwent a two weeks training on long term FP methods (5 days of in-class and 5days of practicum at Mulago Hospital, Naguru hospital and Kiswa Health Centre). Upon completion of the course, participants were oriented on UHMG health products, including a whole range of family planning commodities, which are sold through social marketing. Participants purchased some of the commodities for use in their health facilities. Subsequent to completion of LAM training Family planning commodities were provided to initiate LAM service delivery in their facilities 134 IUD and 210 implants provided.

GLC Health Workers’ mentoring for FP services Follow on support supervision intended to help health workers introduce LAM in their facilities was conducted in the central region including Kampala. Family planning commodities and registers were distributed, as part of the exercise. The following FP products were sold:  203 implants were provide at these GLC  109 IUD were provided  Infection control and IUD insertion equipment were supplied as well.  Data registers and reporting tools were provided.

Service provision (from HMIS reports October –December 2012):

Contraceptives New users Revisits Oral lofemenal 537 427 Oral Microglynon 2,242 1,838 Oral ovrette or another POP 487 241 Oral others 1,071 922 Female condoms 259 112 Male condoms 18,057 3,843 IUCDs 1,034 270 Injectable 3,469 3,539 natural 695 346 Other methods 1,036 341 Total family planning users 28,856 11,852

Surgical Methods Utilization Pattern during the quarter:

Female sterilization (tubal ligation) 44 Male sterilization 2 Implant new users 1,494 Implant revisits 386 Implant removals 293

Long-term Methods (LTMs) dispensed through UHMG (all outlets) during the quarter:

LTM Amount

35 IUD 1,695 Implants (all types) 2,900

LTMs dispensed exceed DFID targets, and will assist UHMG to meet its annual CYP targets.

Demand generation for increased services utilization Promotional activities for FP services and products to support GLCs-based FP service utilization were carried out.  Integrated outreaches by GLCs were done in Kyenjojo district in commemoration of Safe Motherhood day, in Kinawataka, and in Kalangala. The activity was carried out as outreaches by GLCs. At each of the sites, FP clients for both Short Term and Long term methods of Family Planning received services in total 21 implants 2 IUCD insertions and 93 depo-provera clients were served.  The Smart choices campaign is under way through multimedia approaches; radio talk shows, radio spots and TV adverts on Family planning. Details will be provided in the Strategic Health Communication Section.

Activities for the next quarter  Train and support GLC promoters to generate demand for FP and other UHMG supported services at the community level, in collaboration with GLC.  Support selected GLCs to conduct Integrated Outreaches  Equip GLCs that have had training on Long Acting methods of Family Planning with commodities and supplies  Conduct follow-up Mentorship of all those trained on LAM FP to ensure quality of services.

2.4 HIV/AIDS

Introduction HIV/AIDS services supported through UHMG AFFORD project focus on HIV prevention, care and treatment services. Implementation approaches involve both health facility and community/family centered interventions. Health facility interventions are delivered through the GLC, while community interventions are implemented through partnerships with CSO, through sub awards.

GLC lead interventions support HCT services, HIV care, positive prevention and opportunistic infections treatment among PHA. PMTCT services roll out through the GLC, based on option B+ have been added to UHMG’s facility based interventions, as part of expanded HIV control interventions in this program year.

Community HIV/AIDS interventions continue to target specific population groups to address their peculiar HIV prevention needs and vulnerabilities. Preventions services target the following groups; i. HIV prevention among couples: UHMG works with Humanitarian care Uganda (HCU) in 9 districts. The target population provides an good platform for leveraging resources for HIV prevention to include reproductive health services and also to incorporate maternal, and newborn care services. ii. HIV prevention among youth out of school and young couples. These interventions are implemented in the 3 districts of Oyam, Nwoya and Amuru. In addition, UHMG supports HIV prevention interventions

36 directed at Boda Boda operators, most of them being youth in self employment, in West Nile Region, Jinja and Mbale districts. iii. HIV prevention for Most at Risk populations (MARPS): MARPS supported are fisher folks (FF), truckers and commercial sex workers (CSW). a. Fisher Folk (FF): Through a sub granting mechanism, UHMG supports HIV prevention Interventions targeting FF and commercial sex workers(CSW) in 4 districts of Kalangala, Wakiso, Masaka and Mpigi. Sesse Community Development Association (SECODA), our subgrantee based in Kalangala also promotes family planning and safe drinking water especially to HIV positive clients. b. Truckers and CSW interventions: these interventions are mainly in Bwera Kasese because of cross border trade, through the National Youth organization for development (NAYODE) a sub grantee of UHMG, youth in Kasese districts are enabled to access HCT services, condoms and SMC, while commercial sex workers also receive FP methods of their choice and condoms.

c. Truckers and CSW interventions: West Nile districts have hot spots where truckers park for overnight stay. UHMG program staff works with the districts to provide HCT, condoms and RH services to truckers and their partners who are largely CSWs

HIV FY 2012-2013 WORK PLAN MATRIX TARGETS Q1 Outp Cum Activity Indicator Annual ut % Comments 1: Strengthen HCT Services in Private Clinics Distribute test kits to GLCs Number of test kits procures: 500,000 0 NA To start in Q2 accessed through JMS determine, statpak and unigold Support GLCs to provide HCT Number GLCs providing HCT 174 229 131% Some of the newly enroled service outlets do provide HCT and are being supported Support GLCs to conduct out Number of outreaches 60 0 NA To start in Q2 integrated reaches conducted by GLCs Integrated quarterly support Number of visits conducted 174 0 NA To start in Q2 supervision to GLCs Mentor GLC counselors GLC on Number of counselors 200 0 NA To start in Q2 HCT service provision mentored 2: Healthcare Waste management Distribute safety boxes to new Number of safety boxes 2400 0 NA To start in Q2 GLC enrolled for HTC services. distributed 3: Sexual and Other Risk Prevention-Truckers Reach truckers with IPC Number of truckers reached 3,000 979 33% Activity is with HIV prevention services ongoing. 400 and STI management truckers are

37 new contacts HCT outreaches (subset of HCT) Number tested and received 9000 3000 33% Activity is results through moonlight ongoing HCT camps at park yards Reach CSWs with IPC Number of CSWs reached 2000 601 30% Activity is with HIV prevention, FP and ongoing STI management Social market condoms Number of packets of 60,000 7,980 13% Activity is condoms sold ongoing 4: Sexual and Other Behavioral Risk Prevention – Fisher Folk

Reach fisher folk with IPC Number of FF reached with 20,900 3,920 18.8% Q1 messages on HIV prevention contribution & STI management.

Conduct HCT outreaches for Number tested and received 5,000 723 14.5% Q1 Fisher folk results contribution Reach CSWs with IPC Number of CSWs reached 1000 187 19% Q1 with individual and/or small contribution group messages on prevention, FP and referral for STI management

Promote condoms Number of condoms sold 50,000 8,008 16% Q1 contribution 5: Sexual and Other Behavioral Risk Prevention – Married couples and discordant couples

Conduct IPC activities on HIV Number of individual and/or 150,000 35,94 24% Q1 prevention small groups prevention 1 contribution messages Conduct CHCT outreaches Number of individuals tested 45,000 4,388 9.8% Ongoing as couples tested Integrate FP in HIV prevention Number of new FP acceptors 5,000 1739 35% Q1 among couples contribution 6: Sexual and Other Behavioral Risk Prevention – Youth

Conduct IPC activities on HIV Number of youth reached 50,000 7,806 16% Q1 prevention among youth contribution Carry out HCT outreach targeting Number of youth tested 5,000 414 8% Ongoing youths. 7: Sexual and Other Behavioral Risk Prevention – Boda Boda Cyclists (motorcycle taxi riders) as a subset of youth Carry out Interpersonal Number of bodaboda 6,000 Data Communication activities among reached unavailable in bodaboda cyclists time for report Conduct HCT outreaches for Number tested and received 3,000 Data bodaboda results unavailable in time for report Condom sales Number of condoms sold 300,000 34,37 11% 2

38 8: HIV Care & Positive prevention Services Provide PHAs with HIV care Number of PHA reached with 19,000 1,412 7% services at least 1 clinical care service Provide PHAs with positive Number of PHAs supported 19,000 1,412 7% Positive prevention services with PP services prevention services were integrated with care services 9: PMTCT

Train HWs on PMTCT from 50 Number HWs trained on 74 42 57% Activity on GLCs to provide ANC PMTCT going Provide HWs with on-job Number of HWs provided 74 To start in Q2 mentorship with on-job mentorship Reproduce and disseminate data Number of data collection 200 NA NA Job aids collection tools for HWs and tools reproduced and provided in mother mentors disseminated partnership with MOH Reproduce and disseminate job Number of MOH policy and 200 NA NA Job aids aides and relevant PMTCT guidelines and Job aides provided in policies and guidelines disseminated to 50 GLCs partnership with MOH Train mother mentors on PMTCT Number of mother mentors 50 To start in Q2 from 50 GLCs trained 10: HIV campaigns Design and conduct Campaign designed and 1 1 100% Multichannel PMTCT/EMTCT campaign implemented campaign developed Design and conduct Condom Campaign designed and 1 1 100% Done in Promotion BCC campaign implemented partnership with UNFPA 11: Support VMMC services Demand generation & referral by Number of men mobilized for 81,100 2,149 2.6% Ongoing sub-grantees to GLC & other HF MMC supported by 4 sub- grantees

Quarterly Activity Details

Support GLC to deliver Quality HIV Prevention and Care Services

HIV Care and positive prevention services are supported at GLC in partnership with community services linkage facilitators. Opportunistic infection management, FP services and use of condoms for secondary infection services are supported at GLC. Referrals for TB and ART eligibility assessment and enrollment are also done. A total of 1.412 unique individuals were provided with clinical care and prevention-with-positives services.

Support HIV Prevention Activities Targeting MARPS

39 Truckers and CSW; UHMG supports HIV control services targeting truckers and commercial sex workers in Kasese district’s hot spots of Mpondwe and Hima town council. Services to the target population (truckers) are delivered through the trained Pack Yard Volunteers (PYV) using IPC approach and at the 2 Condom HIV Information Centres (CHIC) located in each town of the 2 town council’s hot spots. Through CHIC centres condoms are sold to the truckers, HCT services are provided in partnership with GLC and HIV prevention and risk reduction materials are provided to the clients. PYV and CHIC centres support services linkages with health facilities through referrals and follow up of clients. This quarter, NAYODE collaborated with Kagando and Bwera hospitals to conduct HCT in Hima and Mpondwe town councils.

Highlights of quarterly accomplishments are summarized below. i. Truckers reached with HIV prevention services by PYVs and at CHIC centres – 1,000 of which 400 were new contacts. ii. Number of CSW reached for HIV prevention through IPC by PYV and at CHIC centres - 600. iii. Number of clients referred for STI, FP and SMC services at GLC – 166 iv. Number of condom packs sold through CHIC centres and outposts supported by PYV – 7,980.

Key lessons learnt v. Through peer educators - the PYV, CSWs, big number of beneficiaries were reached with information and some of these peer educators are self motivated and doing a good job of mobilizing others for services. vi. Working with peer educators, local leaders and collaborating with existing institutions like churches and health centres help to generate a lot of support and quick results. vii. Through linkages with health centres like Kagando, Bwera hospital, Hima clinic, Hima HCIII and Afiya kamili clinic, HCT were provided well and able to reach our target

Fisher folks and CSW; HIV prevention programs are supported through a sub grantee- Sesse Community Development Association (SECODA) in 5 districts (Kalangala, Masaka, Mpigi and Wakiso). Services are provided in 21 landing sites located in 6 sub counties. A team of trained peer educators who work as linkage facilitators and are also fishermen lead on the IPC and referral for services at various health facilities. The peer educators move from house to house, one on one session and in some instances call meetings with fishermen. Community drama is also used in some landing sites to relay messages through enter-education approach. They emphasize linkages between health centers and service delivery. A summary of key outputs from this target population are listed below.  Number of FF reached through IPC on HIV prevention, appropriate and consistent use of condoms – 3,920  Number of CSW reached through IPC on HIV prevention, appropriate and consistent use of condoms – 187  Number of condoms distributed through social marketing targeting FF and CSW – 8,008  Number of clients supported to access HIV care and positive prevention services at GLC – 178. SSECODA participated in the provision of care and treatment through the ART clinic in conjunction with Mugoye Health Centre II.  Number of clients referred for STI management and FP services – 104

40 Key lessons learnt from HIV intervention services targeting CSW and FF are summarized below. i. There is noticeable increase in consistent use of condoms which is a sign of behavior change among the fishermen ii. Constant and regular interaction will be very beneficial in getting results for HIV prevention iii. Linkages between prevention care and treatment is proven to be very beneficial since many people are coming out to access care and positive prevention services, thus leading more productive lives.

District 15-24 >25 years Totals M F M F Wakiso 1694 1863 1858 2133 7548 Kabale 1896 2076 2088 2350 8410 Lira 1687 1843 1942 2114 7586 Kanungu 1391 1544 1564 1742 6241 Kabarol 126 171 162 205 664 e Kamuli 293 342 352 413 1400 Mbale 386 443 465 528 1822 Kyenjojo 231 301 282 388 1202 Mukono 217 261 267 323 1068 Total 7921 8844 8980 10196 35941

HIV Prevention among Couples; UHMG works with Humanitarian Care Uganda (HCU) to scale up HIV prevention in 9 districts (Kabale, Kanungu, Wakiso, Lira, Mbale, Kamuli, Mukono, Kyenjojo and Kabarole). Through fighting HIV/AIDS in the family (FAITH) project HCU supports married couples to be faithful to their partners through valuing and promoting mutual faithfulness and fidelity. Using “Families that Prosper” curriculum designed by UHMG, HCU trained HERO couples as master trainers to scale up training of other couples on how to support and promote behaviors that promote HIV prevention among couples. This year,

41 supported interventions are being leveraged on maternal and child health (MCH) programs to promote health of mothers and children through increased uptake of family planning and other MCH services. HCU provides couple education and health promotion programs through couple clubs, each club is coordinated by a hero couple. At the moment there are 34 couple clubs in the 9 districts.

Highlights of HIV prevention achievements made among couples are listed below.  Number of couples counseled on fidelity and mutual faithfulness in the 9 districts – 35,941. Details of individual district contribution are summarized in the table above.  Number of couples mobilized and referred for HCT testing at GLC – 1,351. HCU in partnership with 11 GLC in 9 districts provided HCT services to the couples in the different couple groups.  Number of couples mobilized and referred for MCH and modern FP services in the 9 districts in partnership with GLC – 1,739.  Number of children referred for health services – 2,615  Number of male clients referred for safe male circumcision at GLC – 1,255

Key Lessons Learnt i. Integrating FP in HIV prevention services targeting couples enables couples to embrace FP services easily. ii. Couple HCT has enabled discordant couples to learn more about their status and how to prevent infection among the uninfected partners, it also reduces stigma within the couple clubs.

iii. Youth HIV Prevention Services; HIV control services among youth out of school and young couples are supported in 3 districts of Amuru, Nwoya and Oyam, in partnership with Health Alert Uganda (HAU). Key activities supported through this partnership include HIV prevention targeting Youth out of school and young couples. Implementation approach is through use of trained peer educators operating through youth clubs. Promoted services include, abstinence, promotion of consistent and appropriate condom use, HCT including partner testing, referral for safe male circumcision SMC), management of STI and family planning. For health facility based services, HAU works with 2 GLC, based in Gulu town (Fitzman & St Mauritz). The peer educators work as services linkage facilitators mobilizing youth club members to access services at the GLC and other health facilities.

Key achievements documented this quarter are presented below:  Number of condoms (pieces) distributed to youth – 18,384  Number of young couples and youth referred and accessed FP services – 1,270  Number of young men referred and offered SMC at GLC and other HF – 410  Number of youth referred and provided HCT services -410 (F-196, M-218)  Number of young positive provided with positive prevention counseling and care services – 256.

42 Condom Distribution in Amuru & HCT Services at an outreach in Oyam Districts

Lessons learnt  Early initiation on treatment optimizes health outcomes for PLWHA. In addition, assessing the immediate needs of PLWHA and identifying appropriate referrals for psychosocial and support services is essential to the adequate treatment of HIV infection.  Structural-level condom distribution interventions are efficacious in increasing condom availability and use, and reducing incident STIs and unintended pregnancy among youth.  The use of the expert peers to integrate child mothers in the project design as a key population will go a long way in promoting behavioral change among this particular group.  Partnership with health facilities increases services awareness and utilization among youth

Mobilization and Demand Generation

Support to National EMTCT Campaign; Working with MOH and USG Partners, UHMG supported the review of Elimination of Mother to Child (EMTCT) Communication Strategy. Further to this, UHMG in partnership with other stakeholders led the development EMTCT communication strategy to support roll out of PMTCT option B+ services delivery. Key outputs: i. A multichannel campaign with messages tailored for key audiences, based on the PMTCT four prongs. The 4 prongs are; a. Primary prevention of HIV in women and men of reproductive age, b. Provision of modern Family Planning services to meet the unmet need across all women of reproductive age. c. Prevention of mother to child transmission among HIV positive pregnant women, based on option B+ d. HIV care and treatment targeting HIV positive women and their immediate families.

43 ii. Key audiences were targeted with EMTCT messages specific to their profiles in society and roles in PMTCT. Key audiences that messages were developed include; a. Population in their reproductive age b. Pregnant women with unknown HIV status and their partners c. HIV positive women and their partners d. Leaders both at national, district and local levels e. Health workers and other service providers

Commemoration of World AIDS Day UHMG participated in World AIDS Day national awareness activities. Our involvement included providing HCT services at the commemoration venue in Kampala. UHMG programs director was hosted by NTV during prime news time (9.00 pm, December 1st 2012) to talk about the new focus of HIV prevention and care strategies; - HIV Prevention among youth, EMTCT national scale up with option B plus and combination prevention were highlighted as part of the ”Going to Zero” campaign. Going to zero entails zero HIV transmission, zero HIV death among PHA and zero stigmatization of people living with HIV/AIDS. Finally, UHMG participated in the national day commemoration which took place in Kalisizo, Rakai district. UHMG produced EMTCT fact sheets for dissemination to leaders for use in population mobilisation for services uptake.

Service delivery outputs –

Service & Indicator Annual Target Q1 Cum% HCT- Tested and Received results 338,145 37,991 11 Couples (A&B) – IPC 150,000 35,941 24 CSWs – IPC 3,000 788 26 Truckers – IPC 3,850 979 25 Fisher folk – IPC 20,900 3,920 19 Care & Positive Prevention 19,000 1,412 7 Condom sales 300,000 34,372 11 Youth - IPC 50,000 7,806 16

Plans for next quarter Activity highlights for the next quarter are presented below  HCT services through GLC static sites and outreaches  PMTCT services scale up using option B+ in the private health sector  HIV prevention among truckers, Fisher folks and CSW working with sub grantees  HIV prevention among youth in Mid North and Kasese, working with sub grantees  HIV prevention in 9 districts among couples, working with sub grantees  Carry EMTCT multichannel campaign n partnership with MoH and other stakeholders.

44 3. CROSS CUTTING ACTIVITIES AND SERVICES

3.1 MARKETING & STRATEGIC INFORMATION (MSI) – BRAND ACTIVITIES

Brand Activities: Performance Monitoring Table *NOTE: All Quarterly targets are based on 4-Qtr Year and include DFID FP products

Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Targets Progress, Comments puts Cotramox Esther Target of 7,900,000 1,975,000 tablets 9,600 5,257,066 0.48% Vs Qtr target Atuuse sold tablets There were supplier delays & Cotramox currently out of stock, expected in January. Networking 2 5 There’s a prospective w/decision makers in order from MJAP major institutions and (7000 pkts) NGOs; increase number from 6 to 8

Detailing in health and 2880 provider Targeting Re-assessed pharmacy providers; calls 5,760 detailing team which posters to improve provider calls will work with brand visibility distributors. Regional orientation 2 4 Scheduled as soon as meetings stock consignment is cleared. Brand Activities/Targets/ Q1 Target Q1 Actual Q2 Target Progress, Comments Outputs Restors +Zinkid 2,000,004 sachet 500,000 sachets 270,650 1,062,686 Restors 54 % Vs Qtr sachets sold sachets target (Esther Atuuse) Zinkid 38 % Vs Qtr Zinkid target 2,500,000 tablets 961,000 5,705,666 NMS and JMS (major tablets sold tablets buyers) requested for Co-pack concepts. Bids submitted to 10,000,000 tablets NMS Discussions with supplier ongoing for supply of Co- pack.

45 Visibility and presence 1,518 outlets 426 outlets Combination Racks through 4,556 ethical covered have been distributed outlets – pharmacies, in the central region drug shops (50% of to 318 ethical outlets total national (152 outlets had coverage) stocks of both Restors & Zinkid). Low uptake of Restors is related to pricing. 108 ethical outlets in the districts of Kasese, Kamwenge and Kyenjojo were merchandised (a total of 66 out of the 108 stock both Restors & Zinkid) Media Use radio, TV and Media Insights indicate, end billboards for Campaign is users are increasingly above the line up and demanding for the campaign running combination. Partnerships to To engage Exhibited, presented strengthen 2 partners in and sold at WADOPA distribution partnerships more Assembly Wakiso District Drug established community Presented at UPMA shop Operators demand meeting Association (WADOPA) generation Both associations are Uganda Private activities. purchasing the Midwives Association combination (UPMA) Detailing 2880 provider Currently re-assessing calls detailing team to drive demand. CMEs Booked for next quarter. Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Targets Progress, Comments puts

Condom "O" Open 4,000 additional promotion ‘O’ outlets Jeanne Marie (supermarkets, Nakato dukas/kiosks, hotels, lodges)

Sales volume of 375,000 389,376 610,624 103 % Vs Qtr target 1,500,000 pieces O has shown a steady sales curve this quarter.

46 1 mass media Scheduled campaign (DJ endorsements, TV and radio spots)

POS placement of Sourcing for . 10,000 posters and suppliers. 5000 metal plates

12 regional concert sponsorships Weekly supervision 3 1 4 Tullow Oil-purchased visits to monitor 4,320 pcs for their activities. staff members for Pursue corporate World AIDS day social responsibility celebrations. collaboration. Pending orders from: Total petrol station and Ministry of Internal Affairs.

Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Targets Progress, Comments puts PROTECTOR Achieve sales volume 5,562,500 4,460,400 10,372,906 80 % Vs Qtr target promotion of 22,249,960 condoms. Coordinate activities NAYODE,KOYID,H 3 0 3 with MARPS program, EALTH ALERT- Boda Boda campaign GULU,ASED- and Boda Boda U,HCU associations

Conduct mass media Ongoing through the (TV and radio) 12 regional 5,000 posters and distributors. 1,000 metal plates at To be enforced POS, 20,000 t-shirts through recruitment and caps for trade and of regional consumer promotions merchandising teams. Distribution through existing networks and retail outlets (dukas, pharmacies and drug shops Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Targets Progress, Comments puts AQUASAFE 5,400,000 tablets sold 1,350,000 551,520 3,048,480 41 % Vs Qtr target promotion There was a stock out of Aquasafe due to a proposed change in packaging from 80

47 tablets per dispenser to 100 tablets in the month of October. This affected the overall sales volume for quarter 1. Jeanne Marie Promotions at schools Scheduled for January Nakato Partners approached-Picfare ,Bata& Asiatic Sports Outlets in the process of selection for stocking-Mega Standard Supermarket, Shoprite & Kenjoy Increase community 50 0 100 Merchandising teams distribution points to in the process of 180 667 0 1333 recruitment

Partnerships with NGOs

1 plantation 1 1 2 Kakira Sugar Limited- activations & orientated head Workplaces trainings teachers and welfare officers on the use of Aquasafe. Sales order of 60,000pcs was achieved during this training.

PR during World Scheduled for March Water Day, World and September Water Week and Day respectively. of the African Child.

Mass media using TV(Bukedde & Booked to start with radio spots, talk shows NTV) a Go back to school and billboards. Radio(CBS, promo Capital, Sanyu) Suburb signs Trainings & Community 2 2 2 In collaboration with demonstrations orientations. School of Public for Aquasafe Health conducted a household training on water treatment using Aquasafe in Kisaasi slum-30 participants Kinawataka health fair conducted Aquasafe demonstration and training to over 1000 people that came for health services. Brand Activities/Targets/Out Q1 Target Q 1 Actual Q2 Targets Progress, Comments

48 puts Injectaplan Target 4,500,000 1,125,000 533,520 2,466,480 47 % Vs Qtr target (Lemi Paul) Participate in Participated in 1 WADOPA exhibition conferences/exhibitio with ns for visibility attendance of about 300. Coordinate with Worked Mayuge, Kyenjojo, programs community together in 5 Kalangala, Arch interventions to both interventions & apartments and promote Injectaplan trainings. Eureka’s place and sales of Injectaplan through GLCs Increase access to 4 major UPMA, WADOPA, Injectaplan through partnerships RHU and HCU collaboration with established. NGOs and professional associations.

CSR Initiatives to Mengo hospital with facilitate trainings and Barclays Bank. bulk purchases. Brand Activities/Targets/Out Q1 Target Q 1 Actual Q2 Targets Progress, Comments puts Pilplanplus Target 2,549,995 637,500 433,470 1,266,526 68 % Vs Qtr target (Lemi Paul) cycles.

Participate in 1 conducted WADOPA exhibition conferences/exhibitio ns for visibility Coordinate with 5 conducted. Mayuge, Kyenjojo, programs community Kalangala, Arch interventions to both apartments and promote Pilplanplus Eureka’s place and sales through GLCs Mass media (TV, Radio Running. Heritage route media radio) and billboard. TVC ad in final campaign launched. production.

Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Targets Progress, Comments puts Moonbeads Target 5,950 1,487 280 3,686 19 % Vs Qtr target (Lemi Paul) JMS shall be Distribute 200 per purchasing in the quarter though JMS next quarter

49 Coordinate with 5 conducted Mayuge, Kyenjojo, programs to make Kalangala, Arch sales to GLCs and apartments and community Eureka’s place interventions Increase access 2 Trainers of Moonbeams through FBOs Trainers recommendations on committed. going with Monday weekly reviews in Rubaga and Nsambya hospital Increase access to 2 confirmed. WADOPA and RHU Moonbeads through collaboration with NGOs and professional associations. Brand Activities/Targets/Out Q1 Target Q1 Actual Q2 Target Progress, Comments puts

NewFem Target of 40,000 10,000 7,540 19,126 75 % Vs Qtr target (Lemi Paul) cycles

Participate in Exhibited in one WADOPA exhibition conferences/exhibitio ns for visibility Coordinate with Oriented Kyenjojo, Arch programs community trainees during apartments and interventions to both 3 trainings Eureka’s place promote Newfem and sales of Newfem through GLCs Increase access to Working with 3 UPMA, WADOPA and Injectaplan through HCU collaboration with NGOs and professional associations. Health provider 1 ongoing. Case hospital shall recommendations continue training through weekly mothers using our Family Planning products as samples trainings Brand Activities/Targets/Out Q1 Target Q 1 Actual Q2 Targets Progress, Comments puts

Softsure Target 72,000 cycles 18,000 9,540 38,460 53 % Vs Qtr target (Lemi Paul) Participate in Exhibited in one WADOPA exhibition conferences/exhibitio ns for visibility

50 Coordinate with 5 conducted. Mayuge, Kyenjojo, programs community Kalangala, Arch interventions to both apartments and promote Softsure and Eureka’s place sales of Softsure through GLCs

Increase access to 4 done UPMA, WADOPA, Softsure through HCU and Mama collaboration with Tendo Foundation NGOs and professional associations.

Health provider Case hospital shall recommendations continue training through weekly mothers using our Family Planning products as samples trainings

CSR Mengo hospital with Barclays Bank.

Child Health

Restors + Zinkid The combination is slowly gaining acceptability among users after the media campaign was launched at the beginning of the quarter. Market insights show that some users are requesting for the combination by brand names. The combination has been heavily promoted through a “half love” media campaign supported by trade merchandizing, sales and distribution initiatives. To support the media campaign, efforts have put into increasing visibility of the combination in ethical outlets through the distribution of Restors/Zinkid racks. Over 300 outlets covered so far. This has encouraged outlet owners to have the combination on the racks. Partnerships with ethical outlet associations (e.g. Wakiso Drug shop Operators Association - WADOPA, and Uganda Private Midwives Association - UPMA) and with other implementers interested in the promotion of Zinc in Uganda (e.g. CHAI, MOH, and SHOPS project) have been created. With the Associations, product trainings have been conducted whereas with the implementers, plans are underway to work with UHMG in both below and above the line promotions of the combination.

Bulk buyers like NMS and JMS are putting a hold onto their purchases in preference of a Co-pack to encourage combination use among users. UHMG is currently pursuing the option of having a Co-pack in stock to be able to compete in the market for bulk business.

51 Product presentation at the UPMA meeting Question and Answer session with the UPMA members

AQUASAFE Aquasafe is steadily gaining top of mind awareness as a household brand. This will be enforced through the ‘Back to School’ promotion scheduled for January that will back up the ongoing school activations. We finalized mechanics for a “Go back to school promotion” during the quarter. This will be a joint promotion with School related favorite brands like Picfare (for stationery and textiles), Bata for footware and school bags. Other activities included community orientations with the School of Public Health in Mukono. Plantation activation were also conducted with Kakira Sugar works that has over 1000 employees, 8 primary schools and a secondary school. Subsequently the Kakira Sugars Works administration placed an order of 15 cartons for its community. We will continue to pursue bulk purchases through partner institutions like Malaria Consortium, BRAC, GOAL and Techno Serve, Inter-Aid Uganda.

HIV/AIDS

Cotramox Institutions, especially the USAID Implementation Partners continue to support product sales through bulk purchases. In this quarter, Cotramox was out of stock due to delays from the manufacturer. For institutional relationships, networking meetings will continue in the next quarter for bulk stock uplift. As well as detailing to continue encouraging trade uptake. NDA is reinforcing a regulation to restrict bulk packaging from commercial outlets in favor of strips. Bulk packs at the trade had disadvantaged Cotramox because they are priced much

52 lower than Cotramox, which is packaged in strips. The enforcement if consistent gives Cotramox a fair position in a huge market of people who purchase off the counter.

O’ Condom During the quarter, O registered a steady sales curve registering institutional sales from the private sector like Tullow Oil, which purchased over 4000 PCs for its employees on World Aids day. O will leverage on the newly launched general condom campaign. The media campaign has been extended to encourage usage during the festive season and another burst is planned between January- February during AFCON (African Cup of Nations) football season, which attracts heavy TV viewership.

PROTECTOR 2012/13 Focus: Engage opinion leaders to advocate for condom usage amongst targeted communities. We are in the process of sourcing for relevant celebrities to endorse Protector and in discussions with the Olympic Gold medalist. To stimulate demand especially during the festive season, Protector is being fronted in the general below the line condom promotions nationwide supported by both USAID and UNFPA.

Family Planning

Pilplanplus

2012/13 Focus: Build the affinity of the brand leveraging on the heritage of Pilplan. Having closed the previous FY at 133% sales, the current performance of 51% suggests that distributors over-stocked the pill and require support to move stock down the pipeline. There have been efforts to drive demand through partnering with associations like Uganda Private Midwives Association (UPMA) and Wakiso Drug Owners Operators Association (WADOPA) who have purchased to distribute to their end mile members. A major threat to Pilplanplus is the increasing in-flow of free Microgynon in commercial outlets with similar branding strip to Pilplanplus. A brand support mass media campaign, “Heritage Route”, was launched to drive demand. (Appealing local models were used). Campaign will be supported by intensive distribution to ensure availability in recommended retail outlets.

INJECTAPLAN 2012/13 Focus: Implement an integrated FP Smart Choices campaign with GLC’s as major outlets. Smart Choices launched with Injectaplan promoted with a model user. Fairs were also conducted in communities with referrals to GLC’s. Major sales were registered through Reproductive Health Uganda (RHU) and UPMA who have purchased for their clinics. Barclays bank also supported the brand by purchasing in a CSR initiative in Mengo Hospital, the Bank purchased 400 vials of Injectaplan contributing 100 CYPs. Other marketing and sales channels were through partners in SDS districts, GLCs, and through community outreaches in Kyenjojo, Mayuge, Kalangala and Kinawataka slum. These outreaches were co-sponsored by the private sector partners including DFCU bank and Oil Palm/Bidco. Injectaplan uptake started slowing down from last year’s when it was linked to HIV susceptibility, free depo –provera which now claims 15% of the market share (Independent.

53 Retail Audit by Research World Int) and further affected by changing user patterns tending towards Long term methods preference like IUDs and Implants.

MOONBEADS To reach more people the strategy was to recruit Trainers of Trainers (TOT’s) in FBO’s who would carry on continuous orientations. So far 2 big hospitals -Nsambya and Rubaga are covered and weekly reviews are being conducted to assess sales. This will be replicated in other regions in the next quarter.

SOFTSURE The focus for this quarter was to create consistent demand through GLC’s, hospital new mothers clubs and ANC influencers. Trainings are currently on going at Mengo and Case Hospitals by the midwives who demonstrate by sampling Softsure to new mothers. We also aimed at making Softsure available in key chain outlets, Ecopharm pharmacies have well distributed locations and are now stocking soft Sure. Substantial sales are also registered through professional associations like WADOPA, (Wakiso Drug shop Owners and Operators Association with over 700 members. UPMA (Uganda Private Midwives Association), partner NGO’s like Humanitarian care under their FP program and RHU. Through a CSR partnership with Barclays bank 200 cycles of Softsure were also purchased and donated to Mengo hospital.

During the Breastfeeding Week we worked with Mama Tendo foundation, a re-known community mentor to conduct trainings and promote Softsure in Mengo Hospital, Paragon Hospital, Kanyanya Health centre, Hope Clinic Lukuuli, Mothers nutritional seminar, YWCA, Mama Tendo seminar, New Vision printing and publishing house and teenage mother centre Kyengera.

NEWFEM As a COC targeting the urban middle class, focus was to ensure presence in key premium outlets. We have established a distribution partnership with Ecopharm chain of premium pharmacies. Sales have also been registered through Humanitarian Care Uganda, GLCs, Wakiso Drug Shop Owners and Operators Association (WADOPA) and Uganda Private Midwives Association. There is more potential with other large hospital maternity wings who have agreed to give samples to mothers during FP trainings and stock at their pharmacy.

LTAM MSI mobilized communities and generated demand through health fairs. Three (3) were conducted in Kalangala, Kinawataka, and Mayuge. Over 150 IUDs and Implants were inserted. Services were delivered by

54 Good Life Clinic partners. For follow on treatment patients were referred to Good life clinics and other health facilities within these communities.

Support to Good Life Clinics

Activity Annual Targets Q1 Targets Q1 Achieved Q2 Targets Progress, Comments

Branding Brand 300 clinics with the 100 clinics 11 clinics 189 clinics Procurement in process Good Life brand signage branded branded of contracting branding firm Distribution 300 clinics fully stocked 100 clinics 68 clinics fully 132 clinics Streamlining SMS and sales of all with all UHMG products fully stocked stocked with platform to aid in stock UHMG with all UHMG all UHMG status tracking products products products Distribution of 300 clinics receiving IEC 100 clinics 20 clinics 180 clinics Scanad is printing all FP IEC job aids materials of all UHMG receiving IEC received IEC translated consumer and products, translated in the materials materials brochures promotional major 7 languages materials

3.2 MARKETING & STRATEGIC INFORMATION (MSI) - COMMUNICATION

UHMG behavior change media campaigns continued to reach the majority of Ugandans during FY13 Quarter one (source: IPSOS/ SYNOVATE).

55 Communication Performance Monitoring Table:

Campaign Mass Media Interactive Media/Interpersonal Activations

Elimination of Mother Strategy: EMTCT Communication plan Creative briefs for 3 EMTCT key To Child Transmission developed and shared with EMTCT audiences developed. Campaign stakeholders Developed creative briefs and shared with EMTCT Core team 5 different DJ mentions/messages Ritah Mwagale/ Advocacy:50 Fact sheets on developed and aired on 10 Radio Daudi/ distributed among community, stations as part of World AIDS Lea Religious and political leaders Day EMTCT advocacy campaign during the World AIDS Day,120 Editorial: UHMG featured in front fact sheets produced and page story on 30th November on distributed during the National its efforts on EMTCT.UHMG EMTCT Stakeholder’s meeting. Participated in TV interview with NTV as World AIDS Day advocacy.

Campaign Mass Media Interactive Media/Interpersonal Activations

Condom Promotion UNFPA Condom promotion Interpersonal activities started in 8 UNFPA UNFPA campaign campaign launched on 15 Radio focus districts of Kanungu, Oyam, Kotido, stations countrywide. Kaabong, Katakwi, Moroto, Yumbe and Ritah Mwagale TV campaign scheduled in December. Mubende districts. Behavioral study on condom use  TV script has been developed and and non-use peer reviewed approved by MoH.

SCIPHA No funds allocated to mass SMS chat room now operational. media activities Communications work plan developed. (Ritah Mwagale) Posters of key SCIPHA achievements developed for CSF Close-out ceremony Over 40 Community dialogues conducted in 19 districts. Documented using photography Ka-SCIPHA mama’s club and Four tent model in Fort Portal done.

Smart choices Aired radio spots, DJ mentions on 1 training manual developed for the Good Life 10 radio stations promoters.

Sarah Mutesi/Daudi 54 Radio talk shows on 5 radio 135 GLCs promoters identified. stations (Radio one, Radio Buddu, Liberty FM, Akaboozi).

56 28 billboards & 63 roadsters erected. 9156 spots aired & 5000 DJ IEC (produce end user materials) mentions on 7 radio stations 500 posters, 40 birth plan cards, Saving Mothers Radio talk shows aired. 250 Community fact sheet 8 billboards & 16 roadsters produced, 250 flipcharts placed in strategic places in 4 produced. Sarah Mutesi districts Participated in Safe motherhood day in both 20 radio announcements aired. Kabarole & Kyenjojo and facilitated 40 health workers matched to show support Distributed IEC materials to 150 health workers.

Power of Day One 6 Radio talk shows on Voice of No activities undertaken as funds Malaria Teso. were unavailable.

Lea No further media running done under Power of Day One due to lack of funding. Conducted School art competitions in 34 schools representing 23 sub health districts in 15 districts of the intervention. A total of over AMFM 35,000 children reached with messages on Implemented testing and treating for malaria. successfully Road show activations carried out in 34sub - districts representing 23 districts of the An estimated intervention. A total of over 30,000 people 11,051,952 people 1,180 radio spots aired on 14 Radio stations in were reached with messages on the use of were reached with the central and Westnile RDTs and ACTs messages on Malaria 34 Advocacy meetings were held with religious prevention, Diagnosis leaders from more than three religious using RDTs and denominations representing districts of the treatment using ACTs intervention. via all 4 channels of A total of 287 religious leaders representing 23 Radio, School sub districts from 17 districts were reached competitions, Road with messages on malaria prevention, shows and Religious treatment and early diagnosis. leaders’ meetings

Get Off the sexual No Mass media Designed factsheets, posters and DVDs on Network CHCT. Designed and pre-tested messages for SMS Marrietah platform. Spear Got approval for police posters and completed photo shoot. Final production is on-going. Robot calls, poster models and SMS platform for prisons pending approval and

57 authorization.

3.3 MSI - Research

Introduction RME track implementation of UHMG program activities, services documentation and operational studies to inform UHMG programming that address national and program needs. Planned activities this quarter include; i. PEPFAR Annual reporting, ii. Orientation of district bio-statisticians on UHMG activities and plan for integration private sector services data into in district HMIS iii. Distribution of HMIS tools and provision of technical support to the GLCs especially the new ones on HMIS iv. Collection and compilation of monthly data from the GLCs. v. Orientation of sub grantees on data management and reporting requirements

Key achievements i. Uploaded program year work plan into UHMG database to facilitate its close monitoring ii. On job mentoring of the GLCs in HMIS and support supervision of the sub grantees iii. MEEPP annual reporting and quarterly reporting to USAID was compiled and submitted iv. Distribution of HMIS tools and provision of technical support to the GLCs is an ongoing activity v. On job mentoring of the GLCs in HMIS and support supervision of the sub grantees. This exercise was conducted Wakiso, Kampala and Mukono districts. vi. Re development of M & E database; The re-development of the UHMG database to capture data generated through the current HMIS was completed and appropriate checks to minimise inconsistencies instituted. What remains is to work with the district to ensure data is collected and reported. vii. Health Behaviour and Communication Survey was completed with participation of M&E team. The results from this survey are being awaited to inform programming. viii. Capacity Building in data management. During the quarter, the M & E Manager, together with 2 M & E officers attended a five days customized training in spatial data analysis using ArcGIS software. Using the skills obtained from the training, the M & E unit has been able to carry out cleaning of the Geo Coordinates captured during the mapping/facility assessment exercise. Currently UHMG has a single user licence. It is planned to build capacity of other UHMG staff and upgrade from single user licence to a server based one so that more people can have access and use it. ix. Capacity building in PMTCT services monitoring and documentation. The M & E Manager attended a five day Option B+ PMTCT M & E training organised by MoH.

Planned Activities for Quarter 2

58 i. Orientation of Bio-statisticians on UHMG private health sector (GLC) activities and plan for their integration in district HMIS ii. Collection and compilation of monthly data from the GLCs. iii. Orientation of sub grantees on data management and reporting requirements iv. On job mentoring of the GLCs in HMIS and support supervision of the sub grantees v. Support the districts to use the DHIS II system to report data from the GLCs to MOH. Most of the GLC are already populated in the system).

Activity Matrix

Commen Activity Indicator Annual Q1 % ts Number of quarterly reports 5.1 Collection of Data from GLCs received from GLCs 3 1 33% Ongoing 5.2 planning meeting with district Bio-statisticians 1 1 For Q2 Number of support 5.3 Conduct monitoring activities supervisory visits 1 1 33% Ongoing Number of GLC staff trained 5.4 Training of GLCs staff in HMIS in HMIS 120 120 For Q2 5.5 Reproduction of data Number of data management management tools tools produced NA NA Ongoing 5.6 Designing of online reporting Online reporting for GLC in Complete system for GLCs place 1 1 100% d 5.7 Quarterly Review meetings Staff, Number of review meetings Sub- grantees held 3 For Q2 5.8 Quarterly feedback to districts Number of Reports sent to and GLCs districts, GLCs 3 For Q2 Trained 5.9 Capacity building of M & E staff Number of M & E staff trained 4 4 100% on Arc GIS 5.10 AFFORD II end of Project AFFORD II end of project evaluation evaluation 1 For Q3

3.4 MSI Cross-Cutting Functions- Corporate & External Relations

Activity Description Outputs Progress, Comments Corporate social responsibility Private Sector Health fairs conducted with the support of Pharmaceutical Collaborations organizations like Quality chemicals, Ghittoes, Baylor, and Super Medic. Implemented with support from DFCU, Barclays, AAR, Bidco and others. Website Upgrade Appealing & Website upgraded, now more user friendly and relevant to functional website promote the organizations agenda. and increased awareness of the GL

59 Knowledge Management Improved Created a UHMG Photo and video database BCC team documentation of Acquired a professional camera UHMG programs. Had more knowledge management clinics on writing success stories, taking photographs, online filing of information Production of PR promotional Strong Good Life Published several items with GL messages. Calendars, diaries materials (Mariettah) brand. and others. Good Life (GL)umbrella brand Strong GL brand. Strategy developed and reviewed by the BOD. revamp Event management Extended services to Health fairs conducted in Mayuge, Kalangala, Kinawataka slum communities and others. Media relations Co-ordinated press coverage for Mayuge Health fair and got coverage from NTV, New Vision and Daily monitor for World’s Aids day. Co-ordinated press coverage for Kinawataka Health fair and got news coverage from WBS,UBC TVs, CBS Radio, UBC Radio, Capital FM and New Vision Co-ordinated press coverage for Kalangala Health fair and got coverage from NTV. Co-ordinated press coverage for AMFM school Gala and got coverage from WBS TV –Eseza omuto, Bukede TV and Bukede News paper. Co-ordinated press coverage for World AIDS Day with NTV and featured as part of day’s story as well as featured in the Daily monitor.

3.5 HUMAN RESOURCES & ADMINISTRATION (HRA)

Human Resource Management Recruitment staff

No. POSITION STAFF NAME START DATE 1. Finance & Investment Assistant Brenda Namubiru 1st October 2012 2. Malaria Officer Beatrice Kakiiza 1st October 2012 3. Finance & Investment Intern Roland Sanya 10th October 2012 4. Communications Intern Diana Ankunda 15th October 2012 5. Senior Internal Auditor John Bikala Wanzala 1st November 2012 6. Assistant Director HIV/AIDS Prevention & Thomson Ngabirano (Dr.) 1st November 2012 Care Services 7. Monitoring & Evaluation Manager Josephine Watuulo 1st November 2012 8. Finance & Administration Intern Emirinah Nabachwa 1st November 2012 9. Special Projects Intern Hudah Muleme 23rd November 2012 10. Director Community Linkages & Abel Asiimwe 3rd December2012 Community Generation 11. Regional Community Mobilization & Engagement Andrew Yawe Kigongo 3rd December2012 Officer (Central Region)

60 12. Warehouse Assistant Stephen Wango 3rd December2012 13. Senior Technical Officer – Private Sector Samuel Moses Okello (Dr.) 17th December 2012

Exited staff

No. POSITION STAFF NAME END DATE 1. Monitoring & Evaluation Officer Innocent Atukunda 30th November 2012 2. Warehouse Supervisor Henry Ssenfuma 17th December 2012

Annual performance-based salary increment: Staff received their salary increments based on their performance during the Financial Year 2012/2013 in October 2012. 3% increment of the Gross salary which was accrued per month was given to staff.

End-of-year event: The end-of-year all-staff appreciation event took place 20th December 2012 at KPalm Resort.

Holiday break: The UHMG offices were closed from 24th December 2012 to 6th January 2013, staff were advised to take additional days beyond the approved holidays as their annual leave.

Delivering on our Capacity building plan: Part of UHMG’s capacity building plan is to nurture a corporate mindset that is driven by Self-determination and performance management (accountability); an institutional culture: efficiency, effectiveness, and transparency; Communication: effective internal and external communication

In order to achieve the above, UHMG/AFFORD undertook number of activities this quarter, these included:

Staff team building retreat: The annual team building event was held from 3rd to 6th October 2012 at Protea Hotel in Mbale. IFE Consultants facilitated this exciting event where awareness some of the topics discussed were value-analysis and addition, team work and success, leadership, innovation, cultural diversity, and self- awareness. An innovation team was formed as a post-retreat initiative to support Senior Management in strategic thinking, and following through on actions agreed upon.

All-staff meeting: The all-staff meeting was held on 30th November 2012 (see pictures below). As part of staff welfare, a number of UHMG service providers were contacted to talk to staff about the services they provide. They comprised Jubilee Insurance Company Limited for Medical Insurance, AIG (Uganda) Limited for Group Personal Accident Insurance, and Insurance Company of East Africa (ICEA) for Assets & Vehicle Insurance. A real estate company, Sema Properties, also shared their property management services to encourage staff acquire land, and/or residential houses.

61 During this meeting, staff were also reminded about the importance of documentation as UHMG prepares for the AFFORD II project close-out. As a recap of the documentation training held on 28th November 2012, and facilitated by Kim Ogilvy, focused on improving skills in folder and file management, the importance of compiling success stories for future reference, and access of shared documents on the file server.

HR Capacity Assessments: KPMG completed the assessments of senior and middle-level management through interviews and on-line questionnaires. One-to-one feedback sessions with KPMG will be scheduled in January 2013 to update staff on the findings regarding their fitness for the current jobs, competences, and supervisor- supervisee work relationships/dynamics. Subsequent to these, mentorship plans, redeployments, and clear skill gaps critical to UHMG success will be bridged.

Skill development in financial compliance & procurement: As part of UHMG capacity building for sustainability, AFFORD/JHU facilitated a Procurement and Financial Management orientation training/workshop on 12th December 2012. Emphasis was placed on compliance and ethics issues related to contracting vendors and sub- grantees, as well as an awareness of the USAID rules and regulations. Pictured below are some of the participants that attended this training.

62 The workshop covered the following topics; i) Agreements Vs Contracts, ii) Sub-recipient Vs Vendors, iii)Sub Award types, iv) Reporting & Invoicing requirements, v)Procurement, vi)Independent Contractors, vii)USAID Guidelines for Sub Awards & Adherence, viii) UHMG Specific areas that need support, ix)International Travel, and x) Special Conditions between JHU/CCP and UHMG.

63 Governance

BOD meetings: The Board of Directors (BOD) continued to provide further guidance to Management on UHMG’s strategic direction. The Board Chairman held monthly briefing meetings with the Managing Director during the quarter. Quarterly meetings for the Board Committees’ were held between 2 nd and 16th November 2012. The Board of Directors’ meeting was held on 16th November 2012. Currently the board is focusing on organizational risk management and properly instituted corporate governance standards.

During the Board meeting a review of the current Board operations manual was discussed with the select committee, Risk management and IT policy were approved, and plans for UHMG restructuring discussed. The Board is also keenly tracking PF profitability and revenue generations as per the business plan.

Fleet Availability

The availability of the fleet this quarter decreased by 5% because motor vehicles Reg. No.s UAK 303Z and UAJ 032Y were not operational due to repairs arising from accidents. Insurance Company of East Africa (ICEA) is currently is handling compensation details.

Maintenance and Repairs

Reg. No. Km Start Km End Distance Fuel used Actual Target VarianceService and Status Remarks Oct Nov covered Usage % Repairs cost

UAA 912X 62115 62930 815 100 8 12 -47% 498,904 Coils Average UAA 667Y 100350 101975 1625 160 10 12 -16% NIL OK GOOD

64 UAJ 034Y 101535 105383 3848 334.54 12 12 0% 215,940 OK GOOD UAJ 032Y 89006 91307 2301 217.78 11 12 -8% 930,864 In-garage under repair UAP 632G 76805 79957 3152 279.29 11 12 -8% 862,580 Ok GOOD UAK 303Z 128722 131821 3099 328.22 9 10 -10% 6,364,90 OK GOOD UAJ 214Z 203335 208429 5094 499.54 10 10 0% 403,088 Ok GOOD UAR 141G 14056 23693 9637 1043.4 9 10 -10% 766,500 Ok GOOD UAR 186G 13975 23152 9177 933.59 10 10 0% 1,055,500 Ok GOOD UAB 178Z 200743 207213 6470 880.06 7 7 0% 774,198 Ok GOOD UAN 166F 187149 191007 3858 661 6 8 -25% 397,896 Ok Average UAJ 030Y 108301 110929 2628 291.3 9 8 13% NIL Clutch GOOD warned UAJ 396Y 133938 139226 5288 647 8 8 0% 985,064 Ok GOOD UAA 262Z 240803 243549 2746 523.4 5 6 -16% 860,810 OK Average UAN 430N 21337 23205 1868 317.13 6 6 0% NIL Ok GOOD UAA 935N 21025 24044 3019 616.08 5 6 -16% 370,000 Ok GOOD UAA 942N 15706 15784 78 70 1 6 -83% 370,000 Ok Average UDM 901R 18060 19091 1031 43 24 30 -20% 266,300 Ok GOOD

Two vehicles, UAJ 396Y and UAJ 030Y were also rebranded with an enlarged USAID logo in line with USAID branding guidelines. The rest of the vehicles will be rebranded in the next quarter.

Legal Management

Tax Returns: The process of filing all tax returns for the year 2006 to 2012 at the company registry was accomplished. As we await their feedback, we will submit tax returns for 2006 to 2012 to the NGO Board and the Uganda Revenue Authority.

Income Returns: The process of filing income returns for the period 1st July 2011 to 30 th June 2012, and the provisional tax for the period 1st July 2012 to 30th June 2013 was started. All returns will be submitted before the deadline on 31st December 2012.

Procurement Management

Annual Procurement Plans: Only the Human Resource & Administration and Marketing and Strategic Information directorates have so far submitted procurement plans. The consolidated UHMG procurement plan awaits the submission of other directorates’ plans.

Procurement of vehicles for new projects- HCT Kampala project: The acquisition of one vehicle (Jeep Cherokee) for the new Project –HCT Kampala is in progress. An advance payment of 30% was paid to Spear Motors. A request for approval for tax exemption was forwarded to USAID. The registration for the vehicle requires approval from USAID. Quotations for trucks and buses were solicited and submitted

65 for review. Once the revised specifications are submitted, the vans/bus will be procured during the next quarter.

Procurement of two Double Cabin pick-up trucks: The procurement process of the two pick-up trucks continued to progress. JHU/CCP effected the advance payment of 40% to Toyota (U) Limited. UHMG also received their tax exemption from USAID and for duty-free registration with URA. The vehicles are currently under registration as UHMG awaits JHU to complete the remaining 60% payment to the supplier.

Procurement of Furniture and Equipment for the new projects: Procurement of furniture and computers was completed for staff placed under the KGLIS, NUHITES and KAP Projects.

Construction of the Warehouse extension: we received funds through the DFID/USAID partnership to expand warehousing space. De-Zyn Forum Limited the selected Architectural firm finalized the drawings and Bills of Quantities for the proposed warehouse extension and submitted the documents to KCCA for approval. The Architects are in the process of identifying a contractor. Construction of the warehouse is expected to start in February after the contractor is selected.

ICT Management

ICT Policy: UHMG Board of Directors approved the ICT policy this quarter; absence of a comprehensive ICT policy is one of the major risks that had earlier been identified by auditors and the USAID/FMO team that conducted a pre-award assessment. The policy manual is has now circulated to all UHMG staff and will be a procedural guide for all ICT implementations, projects and resource use.

Procurement of equipment: We received two new server hardware machines and two overhead projectors for the UHMG boardrooms on the 11th December 2012. These items were part of the equipment where UHMG sought concurrence for procurement. These two projectors will help in the facilitation of trainings, meetings and workshops that take place in the UHMG boardrooms. The servers are to be used for the setup of a Human Resource and Payroll Management System, a document collaboration platform and a Fixed Asset Management application.

Monitoring cost effectiveness: telephone use: With the support of MFI Office Solutions Ltd (technical firm support for the UHMG office intercom) a new phone- usage policy was setup. All outgoing phone calls were reduced to a 3-minute limit duration. This has assisted in reducing telephone bills by around 41% since June 2012.

66 PLANS FOR THE NEXT QUARTER

Governance  Actualize Board Manual and Memarts (Memorandum and Articles of Association)  Hold the 2nd quarter board of directors and board committee meetings in Feb/Mar 2013

Human Resource Management Challenges  Work with KPMG to finalize the HR Capacity Assessment exercise  With KPMG’s support, initiate the performance objective-setting exercise for all staff for the FY 2012/2013, including filing and use of KRAs/KPIs for all staff  Recruit and/or redeploy staff for the new projects  Plan exit strategy and transition staff of closing projects (AFFORD - Jun/Sep 2013, STRIDES - Apr 2013).  Work towards UHMG’s re-structure model based on available and assured funding  Carry out the change management and resilience sessions

ICT Management  Finalize the installation of the payroll and Human Resource Management System  Procure and deploy an asset management module to help improve on asset tracking, utilization, performance, and compliance issues that arise from their usage  Integrate Server Virtualization Technologies to the UHMG network infrastructure so as to optimize the use of ICT resources and lower the ICT budget expenditure  Continue to orient staff on better file and document management with the new file server  Carry out quarterly equipment and ICT infrastructure maintenance and service  Prepare an ICT Operations Manual that will act as a guiding tool on the running of ICT projects and related process.  Install overhead projection systems in both board rooms

Procurement Management  Continue to emphasize compliance to procurement policies in order to realize value for money  Finalize the directorate and consolidated procurement plans for 2012-2013 that will guide the procurement, administration, and transport departments in planning for requests in advance  Finalize the procurement of vehicles for the new projects  Finalize the procurement of a contractor for the warehouse extension

Administration Management  Complete reviews of all draft policies that need board approval

67  Procure a walk-through metal detector to strengthen security checks.  Continue with the all-staff meetings bi-monthly.  Finalize country-wide hotel survey in Central region.  Continue with the all-staff and departmental meetings as per 2013 schedule

Transport/Fleet Management  Complete the re- branding with enlarged the USAID logo on the remaining vehicles  Introduce the fleet replacement/disposal plan in our vehicle policy  Dispose the two motor vehicles (UAP 705P and UAP 099Q) as per board approval  Organize an in-house training for all drivers in basic fleet control and customer care  Continue to improve the control measures in place for fuel consumption and vehicle maintenance to realize value for money  Submit valuation report to the Finance & Planning Board Committee, and actualize the asset  Organize an in-house training for all drivers in basic fleet control and customer care

Legal Management  Follow up on tax returns filed for the year 2006-2012 with the Company Registry, NGO Board, and URA

Finance and Investment During the quarter below are some of the highlights under financial management:  End of year Audit: The main focus for the quarter was on the 2011-2012 audit exercise, the exercise started in mid November and now been concluded with the exit meeting on 19 th Dec 2012. The exercise involved the General purpose Audit and the A-133 Audit which addresses USAID Compliance issues. The Audit exercise has been conducted by Ernst & Young. The field work has been completed and a draft report received from Ernst & Young, the final report shall be discussed and approved by the board in February 2013.  Internal Controls and Compliance: Emphasis on compliance was made through a number of ventures including sharing of the Finance manual on email, during staff meetings and the training which was conducted by JHU-CCP.  8 Financial Reports were submitted to different donors including CCP-AFFORD, Star South West- EGPAF, Strides-MSH, Access Medicines-MSH, Stop Malaria-PMI, SCHIPHA-CSF-JCRC, Reproductive Health-UNFPA project, and Spear Project-World Vision.  The Product Facility FM: (i) Systems strengthening continued at the Product facility where by debtor’s management has greatly improved through receiver of old debts by 70% and setting limits for all customers. (ii) Stock management continued with surprise stock counts conducted and end of year stock count conducted. All the closing stock figures were captured in the Tally system and the personnel in the warehouse were changed to mitigate further stock risks.

68  Grant management and the Funding Grid: UHMG currently runs 10 projects and this is being well- handled, this strongly demonstrates UHMG’s road to sustainability. Payroll software is being procured to assist in managing the Hr time allocation capturing.  Sub-Grantee management: Three assessment exercises were conducted during the quarter for ICOBI, NOYODE and Humanitarian Care Uganda in order to determine UHMG’s working relationship with the sub-grantees. Sub-awards have been issued to the sub-grantees and UHMG has made plans to train the sub-grantees during January 2013 and also make regular mentorships and field visits.  Warehouse Extension: The process has successfully been going on, the bills of quantity were received and an advert for the contractor has run. We hope to start construction mid January 2013. Approval of funds from AFFORD-CCP has been submitted awaiting concurrence from USAID. To note is that the available funds shall cover up to 40% of the construction and thus additional funds shall be recovered from a mortgage facility expected form the Bank as may be approved by the BOD.  Risk Management: Management has continued to press for awareness of UHMG’s risks in various areas, the Internal auditor is leading on this issue and has started sharing with the risk committee of staff on some of the audit areas that will enable UHMG mitigate its risks moving forward.  Business Plan analysis: UHMG reviewed the business plan in comparison with the annual performance as highlighted n the table below:

 Budget for the Year 2012-2013: UHMG finalized the budget or the year 2012-2013 and this was approved by the Board of Directors. The budget analysis is as shown below:

UHMG Revenue projections per source for the year 2012-2013

With the budget revenue analysis, it is indicated that UHMG other sources of revenue shall contribute to its operational costs by about 50% compared to last year’s 25%, leaving AFFORD with only 50% compared to last year’s 75%. This is a great achievement and management is aggressively working towards achieving 100% by June 2013 noting that AFFORD Project shall be winding up.

END OF REPORT

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