• Abstract and Figures
• Public Full-text

Quarterly Progress Report – FY2012 Quarter 3 (April – June 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 April to June, 2012, or the third quarter of fiscal year 2012 (FY12) 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 2012 (Year 2) 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 - Qtr 3

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

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  Managers hold staff accountable for performance to KRAs and KPIs

 HR Audit being conducted by AFFORD KPMG to re-calibrate staff KPIs and strengthen staff performance appraisal practices

 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 sector’ management practice strategic decisions based on profitability as well as risk-reduction Stock-counts conducted routinely; variances reduced and stewardship of capital assets,  including product stocks  Debt recovery improved for enhanced cash flow

 New products assessed for profitability, and adopted accordingly

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

All strategies generated by  All key strategies developed by Senior Management and operational managers are vetted through staff through a consultative process, and vetted by the MD and the BOD; organizational approval processes AFFORD KPMG reviews and assists as needed

 All strategies and their implementation assessed by management and Quarterly Performance Reports operational staff for effectiveness and cost-efficiency (programmatic and financial) submitted to BOD and Sponsors  Deliverables produced and quarterly targets achieved, and assessed by BOD and sponsors against UHMG Business Plan and sponsor-supported Annual Workplan

 BOD, MD and Senior Managers take corrective action within next quarter in the event targets are not being met

The product facility operates as a  PF Profitability analysis conducted quarterly; profitability improved over profit center & The programs unit FY2011 (see Financial Systems below). operates as a cost-recoverable consultancy business  Program Consultancy expands technical strategies and actively seeks new funding for programs (see Business Development below)

5 A Quality Management Hire internal auditor  Internal auditor hired; external A-133-Type audits conducted annually system for enhanced organizational  Recommendations of internal and external audits systematically pursued responsiveness High level of compliance with with BOD and MD support and AFFORD/KPMG assistance, specifically in conceptualized, internal systems and external the areas of stock management; human resources; financial implemented and sustained regulations according to compliance management; procurement; and IT practices by UHMG staff and Board and audit reports  Sr. Mgmt consistently enforce compliance requirements; Sr. Mgmt Orient staff on use of mandated identifies and takes remedial actions on audit findings within next protocols and standards; Orient & quarter coach staff on compliance  Staff oriented and coached on compliance principles and practices, with Staff monitored for compliance AFFORD/KPMG assistance every quarter  Internal auditor with Dir. Finance and HR conduct quarterly compliance audit review; AFFORD/KPMG conduct quarterly progress reviews

Adapt MOH guidelines and  Staff applying MOH quality assessment protocols in the field (e.g., with protocols for service quality Good Life Clinics) assessment  The PF has been accepted into the process of ISO Certification, and the Products certified by international body (ISO) ISO process has begun

Quality Management: Improve internal processes that  Marketing and Strategic Information (MSI) meets with Product facility Improved internal inhibit or facilitate objective (PF) to facilitate distribution communication and performance coordination  MSI meets with Programs Division on budgeting to facilitate local implementation

 MSI meets regularly with finance to facilitate procurement

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

 The Board of Directors is advancing its vision of UHMG sustainability through unified, rather than project-driven approaches to management, including unified technical strategies, a unified Management Structure (merger of special projects with Programs), and application of unified financial and administrative systems across projects.

2. DATA UTILIZATION Create a comprehensive Both strategic business units utilize  Sr. Mgmt use monitoring and evaluation data in all quarterly reviews monitoring and evaluation research data and monitoring tools 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 PilplanPlus sales study; initiation of a Retail audit; specifically: product distribution, initiation of Synovate Media Reach reporting; a study of birthing and sales, availability, program delivery practices for Saving Mothers Giving Life project; formative implementation, media campaign research for the Smart Choices Family Planning campaign; preparation monitoring, community activities for the joint Communication Survey conducted in collaboration with and activities at GLCs JHU/HCP and other USAID Implementing Partners (IPs). These studies are discussed in more detail in the Research section of the present report

6 Work-plan Implemented  Technical staff develop program plans and submit to Research Advisor for feedback  Technical staff use program data and research findings to inform programmatic decisions. 3. INNOVATIVE STRATEGIES Ensure mutually beneficial All Program Division activities link to  Product & program linkages inform strategic decisions and outputs and effective linkages and relevant health products through synergy occurs between joint implementation plans and UHMG’s business units reports

Ensure that all UHMG All strategies based on recent data  Refined HIV/AIDS programs in place and judged cutting edge by programs are considered and information obtained from stakeholders: e.g. HIV Strategies for PMTCT, MARPS and Sexual Network strategic and high quality by clients and their communities campaign scale-up. donors, clients and staff Increased involvement of clients and Retargeted RH/FP programs operational linking to products and services, communities in UHMG programs  e.g., DFID “Smart Choices” Family Planning strategy

 Retargeted malaria programs operational linking to products and services, e.g., roll-out of “Power of Day One” Malaria test-and-treat campaign

 Retargeted MCH programs operational linking to products and services and integrating HIV services, products and practices, e.g., Saving Mothers Giving Life (SMGL); Integrated MNCH/FP ‘1000 Days’ Approach

Ensure that UHMG Marketing strategies developed,  Brand Officers and communication officers create strategies with limited marketing strategies are documented and implemented external support, e.g., MNCH/FP ‘1000 Days’ Approach evidence-based and achieve stated targets Increased market demand for Marketing and Brand Mgrs can routinely identify linkages between services and products and targets  achieved products and programs; evidenced in joint MSI-PF meetings and in quarterly reports Establish routine Operational database of key  MSI & PF routinely use and update database of suppliers and customers communication with customers, used by customers and suppliers product and program managers Marketing events taking place per Work-plan (relationship marketing) and  strengthen related Brand managers develop functional management systems communication strategy with  Sales increase slower than anticipated due to debt collection and customers implementation of a ‘closed’ distribution system Ensure that all Product 3-month stock supplies on hand and  No stock-outs or shortages in RTP or UHMG products Facility operations are stock expiry at 0%. considered sustainable and dependable by donors, Spot check reports on compliance of SOPs followed by Product Facility staff to manage stocks and to clients and UHMG staff procedures and systems; quarterly  stock procurement plans in place develop procurement plan

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 quarterly bound stocks  Negative findings addressed w/in the quarter 4. BUSINESS DEVELOPMENT Increase and diversify Substantially increase number of  UHMG has NICRA, resource mobilization strategy, investment plan, sources of revenue for both sources and amount of resources resource mobilization team and product list in place (Indirect Costs have business units generated by both the program and been analysed in preparation for UHMG NICRA application, with product facility business units. AFFORD/KPMG assistance)

 UHMG awarded at least 3 non-AFFORD contracts totalling minimum $2m/year (bids submitted) UHMG business practices improved,  Working with the BOD on the UHMG Business Plan (Business Plan through BOD support and the orientations conducted for BOD and UHMG staff; implementation of assistance of AFFORD (KPMG & Business Plan through BOD Committee Meetings) Friends Consult) 7  Strengthening Stock Mgt through KPMG assistance  Conducted HR Audits of PF through KPMG assistance  Strengthening Procurement and IT Policies and Procedures  ISO Process initiated  Use of Return To Project (RTP) funds to offset mortgage proposal developed and approved by USAID. 5. FINANCIAL MANAGEMENT Effectively manage and Timely financial reports for all  Finance unit delivers financial reports by due date for all programs report on staff time and sources of funding finances across diversified Burn rate across all grants increased to 80% of targets funding sources Improved (accelerated) burn rate 

 Finance & HR teams develop staff LOE certification procedures Rare non-compliance with donor financial requirements  Financial control procedures monitored, and compliance enforced

Improve working capital Improved debtor’s ratio  Aging debt reduced between January and May by 44%, with management by the Product AFFORD/KPMG assistance Facility Improved stock management with no or minimal variances  Variances between records and stock on hand reduced significantly for Improved working capital RTP and UHMG products by end-June management position  25% of PF operating costs covered by revenues generated through PF net margins (excluding Marketing Costs)

Strengthen financial External audits verify that UHMG is  Finance Team produces documented response to each financial audit accountability and following international financial finding and recommendation; actions taken in FY12 on all audit items compliance

8 1. PRODUCT FACILITY STRATEGIC BUSINESS UNIT

Quarter 3 of FY-12 ended with many activities undertaken, all contributing to the improved operations of the Product Facility (PF). Capacity-building assistance was offered by AFFORD for improved stock management practices, a human resources audit, and a comprehensive approach to improved debt collection. UHMG had to withhold products from some major debtors until back-debts were recovered, resulting in a temporary decline in sales achievements for this quarter. A Market Retail Audit survey was also conducted with findings revealing significant distribution reach for UHMG brands in major territories, with gap analyses conducted for the current distribution system.

Sales report

Table of overall sales achievement of the quarter Product Category USAID Brands UHMG Brands Commercial Brands Total (Ug. Shs) Quarter 1 358,497,920 875,792,833 284,267,614 1,518,558,367 Quarter 2 398,323,300 621,564,428 397,337,730 1,417,225,458 317,474,2 258,636,3 229,479,2 805,589,7 Quarter 3 00 50 25 75 523,332,7 757,425,8 1,051,200,0 2,331,958,59 Targets 29 70 00 9 - Q3 Variance -205,858,529 -498,789,520 -821,720,775 1,526,368,824 % Achievement 61% 34% 22% 35%

Quarter 3 overall performances in contrast with quarter 2 reflect a general 44% decline. The general decline in the quarter resulted from the need to recover outstanding customer balances and reduce the PF debt burden.

Performance trends for USAID brands

Quarter 3 reflects a decline due to reduced sales activity. A number of wholesaler customers who had outstanding balances could not be served due to our preemptive credit control exercises.

Individual Product performance

9 USAID Q Target % % brands (Units) Qtr2 Achieved (+/-) Qtr 3 Achieved Var (+/-) - 3,385,844. 614,156.0 5,051,000. 1,051,00 Protector 4000000 00 84.6 0 00 126% 0 - Injectapla 476,750.0 223,250.0 256,950.0 n 700000 0 68.1 0 0 37% 443,050 PilplanPlu 403,661.0 303,160.0 s 400000 0 101 3,661.00 0 76% 96,840

Protector: The sales scored at 126% of the target. The demand was high at the distributor’s points namely Zee pharmacy, Super medic and Blue star pharmacy.

Injectaplan: The sales scored at 37%. This sales trend is declining. The major buyers were distributors, mainly Zee, Super medic and Blue star pharmacy in Northern Uganda.

PilplanPlus: The sales of Pilplan scored at 76%. This is a 25% decline compared to the previous quarter. Major buyers were distributors namely Zee, Super medic and Blue star pharmacy. It is anticipated that much of the stock was in the trade.

Quarter 3 sales performance reflects a declining trend in UHMG brands as shown below.

UHMG Brands Quarterly Target Total % Achieved Var (+/-) Zinkid 2500000 1529840 61% -970160 RestORS 500000 121950 24% -378050 Aquasafe 1350000 367200 27% -982800 Condom “O” 375000 78048 21% -296952 NewFem 13333 1780 13% -11553 SoftSure 18000 1800 10% -16200 Moon Beads 900 23 3% -877 10 Cotramox 1975000 28920 1% -1946080

Individual product performances for UHMG products:

Zinkid: The quarterly sales for Zinkid were 61% of the set target. The key customers for Zinkid are usually institutions. The main customers were Astra Pharma who bought 725,760 tablets; this went to an NGO. Other major buyers were JMS, Super medic, and Zee pharmaceuticals.

RestORS: Restores scored a 24% achievement. This low achievement was attributed to unfavorable prices competition. The recent sales promotion carried out by the MSI team showed that retailers were willing to stock but were unable to find it stocked at the wholesalers.

Aquasafe: Sales registered at 27% of the quarterly target. This too is largely an institutional product. Main customers were Humanitarian care Uganda and Blue star Pharma in Lira.

Condom O: The quarter sales recoded were at 21% of the quarterly target. There was a stock out period for more than a month in the quarter. The fresh stock received awaits NDA post shipment testing to make it available for quarter 4 sales activity.

NewFem: This Product scored 13% of the target due to inadequate demand creation. This was a drop from last quarter’s performance of 88%. A number of wholesalers know that NewFem is Microgynon and prefer to buy the cheaper brand Pilplan plus.

SoftSure: This product registered 10% achievement against the quarterly target. The low sales are attributed to lack of awareness among potential users. Main customers were pharmacies who bought few dispensers. Smart choice campaign and the drive to push the sales into the retail outlets by use of small scale delivery means will improve uptake of these special brands in the market.

Moon Beads: This product has scored at 3% against the set target. This was because there was a stock out and new stocks are still waiting branding. The stock is available for sales from second week of July.

11 Cotramox: Sales scored 1% of the target. This is also largely an institutional product and few packets were bought during the quarter mainly through pharmacies. Bulk orders from key institutions are expected in the next quarter given the trends of buyer behavior registered. Unfavorable tablet cost comparison with pack of 1000 renders Cotramox low opportunity for purchase by the institutions. NDA has however, outlawed the 1000 packs for the private market and we are not able to proceed with product development plan to launch Cotramox 1000 tablets in jars.

Commercial Sales

Month Target (Ug. Shs) Actual % Apr 350,400,000 65,565,865 19% May 350,400,000 98,402,870 28% Jun 350,400,000 65,510,490 19% 1,051,200,000 229,479,225

Availability of viable commercial products is a key success factor in sales. A 38% achievement in sales is low and the main reason for this low sale is limited commercially viable products. Many times suppliers of these brands are unable to maintain consistent supply and offer UHMG favorable prices. These include Bendex, Examination gloves, and IV fluids, Anti Malarial to mention but few. Delays in overseas shipments can also lead to delayed sales. An example was the Mosquito Net Consignment that was expected by end of December last year but only arrived in March 2012. A lot of sales especially in the back-to-school period were missed out. Sizeable orders from reputable NGOS’s like World Vision were cancelled due to insufficient or unavailable stocks.

Debt collections

With stepped up activity of debt collections, much effort was give to the exercise and the followings are the results of collections of both old and current sales debts

 RTP Collections – 251,423,700/-

 PF Collections – 885,786,674/-

 PD. Cheques – 58, 560,550/-

12 UHMG implemented a credit control committee to oversee and manage credit controls systems. UHMG established a ceiling above which no credit sales can pass in favour of a customer with pending debts. UHMG also commissioned an independent debt collector who started fieldwork in June and the scope of work includes forensic audit of the accounts record.

ACTIVITY PERFORMANCE MONITORING TABLE

Activity 1: PF strategies and business development

Activity Description Targets/Outputs Q3 comments

New products launched: Restors+Zinkid . New products launched  COMPRAL from Adcock Ingram, combination kit, Sprinkles, Nutributter Aminosof syrup DIPI, and Aminofer syrup from Medinomic,; Dazel Kit from Ajanta; Nutributter market survey completed and price quotation requested Increase in the profitability of the product facility . Increased profitability of the  Gross profitability has been product facility maintained at 23% of gross turnover Operational database of potential suppliers . Prospect suppliers negotiations  Database in place. New suppliers in indicating status of negotiations documented and tracked in active negotiation are Akacia of south operational database Africa, Athena and Medicamen of India and to sign agreement before September Increase in the product range of commercial brands . Increased product range of  MEDINOMICS AND Adcock Ingram with detailers fully paid for by manufacturers commercial brands with will be meeting retainer costs and detailers fully paid for by staff remunerated by 3% sales manufacturers commission on sales closed. Staff recruitment is ongoing. Four (4) new Memoranda of Understandings signed  4 new MOUs with suppliers  1 – Adcock Ingram contract received. between UHMG and the suppliers of pharmaceutical brands Carry out market surveys to reveal gaps, potentials  Market surveys conducted  Nutributter survey completed. and opportunities of entry with a brand (November) Extended market trend survey planned for July – September period. Limit local purchase to only confirmed orders from  Local purchases are still done, though the customers on confirmed orders or clearly projected sales turnover. Prospect suppliers trips conducted Supplier search to achieve sources of highly  Supplier searches carried out through reputable and quality products, with the Director of contacts and online. Visit will be the facility taking visits to suppliers inside and taken in July. outside of Uganda (December) Collect information on logistics and customer  Logistics and customer  This survey if for July – September demand forecast from both the public and private demand forecast information period, next quarter. sector target customers (December-March) collected Update the current marketing tools used to  Current marketing tools  Commission selling, riding on socially promote the product facility to reflect the new updated with new products marketed brands are the common products that have been introduced (October- strategies being used March) Create a link on the UHMG web site for orders and  Link on UHMG website  Websites has not been reviewed, enquiries (Jan-Mar?) established redesigned. A knowledge manager is coming on board to help UHMG achieve this activities Activity Manager: Philip Okello Apira  Linkages within UHMG:

13  Marketing and Strategic Information for the website link;  Marketing and Strategic Information will help in creating awareness of the products;  Programs and Services will help in identification of the product gaps in their areas of interventions and as well forming a channel through which products can be accessed by consumers.

Activity 2: Strengthening Product Facility operations

Activity Description Targets/Outputs Q3 comments

Legal consultation on restructuring strategies for PF . Legal assessment conducted  The activity has become obsolete as a commercial division of UHMG after the directive to maintain the 2- strands Establishment of increased HRA and Procurement . Establishment of increased  This plan has become obsolete as we functions within PF HRA and Procurement diversify procurement to admin functions directorate except for inventories. Cost analysis conducted of MSI (Brands) and . Cost analysis conducted  Cost of MSI activities been projected Programs & Services contributions to PF Sales in profit and loss calculation of quarterly finance reports PF attains increased operational autonomy  PF attains increased autonomy  This development has been reversed due to the new strategy of business unit integration PF Systems and Standard Operating Procedures  Clear operational status  With ISO intervention, KPMG system (SOPs) established and in use established reviews, SOP is being revised to keep alive importance updates within our operations processes. Activity Manager: Philip Okello Apira Linkages within UHMG:  HR/Admin  Finance

Activity 3: Strengthening management and financial systems

Activity Description Targets/Outputs Q3 Financial management  Tally software designed to  Finance manager recruited, in place. Hire and install a professional and skilful finance meet the reporting needs of  Tally usage reviewed, rights and manager to manage the finances of the division the product facility security control given according to Design tally to meet the needs of the product  Staff trained in Tally software needs and activity processes facility  Financial reporting regularly  Tally training done for specific staff, Conduct more training of Tally financial software disseminated coaching and troubleshooting have been a continuous activities Develop cost drivers and cost absorption strategies to show growth in capacity  ISO Certification training ongoing, with evaluation completed. Deploy a sales daily debt collector  Quarterly financial report prepared Sound financial management and reporting (both and presented for discussions cash and inventory) regularly disseminated  Sustainability test in progress Good relationships with customers and suppliers  Accurate and timely  Ongoing perceived resulting from accurate and timely statements for customers and statements suppliers Capacity of warehouse staff  Warehouse staff trained and  No further training was conducted A team of professional, proactive members of staff oriented to the new challenges  Sales target in force and being developed reviewed for performances tracking Warehouse staff trained and oriented to the new challenges Sales force empowered to make a difference in 14 their activities and contribute to achieving overall sales objectives Warehouse Management  Staff trained on stock and  Planned coaching and mentorship for  Train warehouse staff to improve their skills in stock warehouse management the warehouse staff but which has and warehouse management only delayed. Will be undertaken.  Regularly review SOM for further revision and follow up of implementation  Purchase land and construct another 600 sqm warehouse and no longer rent  Consult on business portfolio management  Consult TransAid for training and installation of necessary systems for effective logistics management ISO Certification Process reviews completed, entering into stage 3  ISO certification attained – implementation reviews/audits Finalize TOR and contract the consulting firm Start to process of ISO Certification in the year: Training, Reporting, Auditing, Certification and Follow up Working Capital management Debt management system in place,  Debt management procedures Credit control committee in place Debt management procedures in place in place External debt collector assigned to collect Debt recovery up to 80% within the sales period  Daily banking of cash and cash difficult debts and carry out debtors legal status equivalent analysis Credit ceiling by aging analysis and control Cash banking takes place daily  Monthly stock counts and Daily banking of cash and cash equivalent Dollar account active, but no payment in dollars variance management received in the quarter Selling and invoicing in US Dollars Building Dollar bank balance for overseas supplies payment Renegotiate supplies payment terms Monthly stock counts and variance management Other activities . Performance management Director in charge Staff skills will be reviewed by KPMG Identify personnel to be in charge of management system in place Draft Balance Scorecard in place, will be reports implemented in October Review the skills and attitudes of staff at the product facility to identify gaps and subsequent gap filling Institute a performance management system as in line with the private sector approaches to managing performances Put in place a staff structure for the Product Facility based on positions, not individuals Activity Manager: Philip Okello Apira Linkages:  IT skills from UHMG HR/Admin;  Systems audit by internal auditors/external auditors

Activity 4: Sales and distribution

Activity Description Targets/Outputs Statusquo remains. Major restructuring to be Re-organize the current sales structure to include  Reorganization of current sales done with the help of KPMG HR reviews the position of a key account manager who will structure completed focus on relationship selling among Institutions like NGO’s, Corporate among others. We have redesigned our job requirements to In view of the increasing product range, there is  Review of sales skills mix; gaps demand that a person with a medical need to review the current sales skills mix to identified and training 15 identify gaps. Gap filling could be solved by training, conducted background be recruited for marketing hiring/hiring, or re-deployment. pharmaceutical products. Going forward, we shall implement this with next recruitment. Regional pharmacies are in operations with the Operationalize the regional wholesale pharmacies  Increase in distribution reach right staff in Arua and Mbale to increase distribution reach in Arua and Mbale Implementation of closed distribution system Identify credible wholesalers/distributors that are . Identify credible being piloted, will be reviewed after September financially sound and have the ability to sell large wholesalers/distributors this year. volumes of products. A good regional presence and of UHMG face has Strengthen channel relationship by explicit  Channel relationships with been maintained. More meetings are planned performance recognition, awards, and networking distributors strengthened through regional trips activities with the distributors during the year  12 “Good Distribution” certificates awarded to distributors during the year Retail audit done. Results show more reach in Market survey for outlet audits and gaps  Market survey for outlet audits the west and lack of reach in many locations to identification in market share and reach for conducted below 60% commercial division Vehicles have not yet been purchased. Vehicles purchased for regional field staff, per  Vehicles purchased by AFFORD UHMG budget, facilitating field work II Product Facility targets  Sales value achieved in the  Three quarter period showed 37.7% year – 10 Billion Uganda achievement of annual target Shillings.  Retail audit shows about 60% of . Percentage of revenue from outlets carrying UHMG brands commercially marketed products Number of new  Achievement is U3.77b out of U10b commercial product suppliers target engaged by UHMG (AFFORD II)  Market survey not done for . Percentage of target retail commercial distribution due to lack of outlets carrying UHMG finance products from 50% to 70% . Mean self efficacy score based on perception of easiness to obtain and use UHMG- promoted products  Percentage of target population who find at least 3 UHMG promoted products easy to obtain  70% of targeted outlets stocking products distributed by Commercial Division  Annual Sales target of 10.0 Billion UGX achieved Activity Manager: Paul Kagumire Linkages:  Link with brand and research teams for better synergies in demand creation and market intelligence  Human Resource department for staff recruitment and motivation  Link with programs department for uptake of products  Link with public relations activities for relationship building and networking  Link with finance team for financing activities

Activity 5: Supply chain management

Activity Description Targets/Outputs Q3 comments Experienced stock out for O, due to delay in Absence of stock outs due to negligence . Absence of stock outs due to negligence payment of advance and not negligence in procurement 16 Relationship with suppliers is good Good relationships with suppliers resulting from . Refer to activity sheet #3 sharing with them the procurement plan in advance and making prompt payment All agreements are complete and signed by Agreements with key suppliers in place . Agreements with key suppliers in place both parties Procurement of: Procurements are in process Prepare a dynamic procurement plan for all products . Procurement of RestORS O Condom was received. It is undergoing Procurements made . Procurement of Zinkid post shipment testing Procurement of Condom O Post shipment testing of Protector . SoftSure: The supplier experienced some . Procurement of Aquasafe delays. The consignment will be delivered . Procurement of Commercial in July Products Aquasafe in under production with the manufacturer

Done, ongoing Monitor the performance of the procurement plan . Weekly monitor the on a weekly basis by updating it with actual performance of the consumption figures and goods received procurement plan This is an activity for quarter four Prepare the contraceptive procurement tables for . Contraceptive procurement donated products for submission to USAID tables prepared and submitted to USAID Done for products Procure packaging materials and instruction inserts . Protector packaging material . Injectaplan packaging material . Aquasafe packaging material The contract is done end of quarter 4 Contract the pharmaceutical company to do . Secondary packaging of secondary packaging Condoms . Secondary packaging of Pills . Secondary packaging of Injectables . Secondary packaging of Water purification tablets Activity Manager: Rachel Apio (with R. Kitonsa for secondary packaging) Linkages:  Accurate consumption data from the finance team  Accurate stock status reports from the warehouse team  Coordinate with UHMG MSI directorate

Key Highlights of the Achievements of the Quarter

Business Development Activities

We entered into an arrangement where we achieve appointment as sole distributor of Adcock Ingram brands in Uganda. Adcock is a relatively experienced pharmaceutical manufacturer and has a global presence with Africa base in South Africa. Recently, they set up their regional office in Nairobi to service the eastern Africa emerging market. This appointment is coming out of a well conducted negotiation that caused a movement of the multinational out of their ad hoc arrangement of supplying the market through 3 local technical representatives to a single LTR, namely UHMG.

17 We coordinated the manufacturing site inspection for GMP visits/renewal with NDA, for FDC India and Nutriset France. Nutriset had been approved and FDC India is yet to be inspected, hopefully in August 2012.

We also introduced new products from Medinomics’, India; Aminofer Syrup, Amino Soft Syrup and Dipi (DHA) ant-malaria.

We completed the brand specific market survey for Nutributter and are now developing the marketing plan to launch the product in the market.

In addition, we have been in high gear negotiation with Mission Pharma, and Akaacia Medical (Pty) South Africa for surgical and medical products.

We received most of the suppliers visiting the market, which has exposed us to a number of fronts: Naari AG, Triokaa pharmaceuticals of India, mission Pharma and Nutriset.

New Products Registration

Reviewed and submitted to NDA, the Malact product dossier files with Reference K 104, (Artemether 20mg + Lumefantrine 120mg) from Medreich India, the manufacturers of Cotramox. The expected approval date for the dossier evaluation is December 2012.

We also submitted the product file of Fasile One (Levonorgestrel 1.5mg), under K053, an emergency contraceptive pill from our new partners, NAARI a Multinational pharmaceutical company, with its head offices in Switzerland and manufacturing facilities in India under a re-known manufacturing plants of Jagsonpal Pharmaceuticals, India.

Work With Ministry Of Health (MOH)

UHMG has been appointed a committee member to the diarrhea pneumonia coordination committee (DPCC) to work with strategic partners to come up with a DPC policy and advise on availability and implementation of prevent protect and treat strategy for the diseases management in the country. This committee will be chaired by MOH but speared headed by CHAI country team. Together with technical working group – medicine procurement and supplies, UHMG as a member, has been highly appreciated for the social marketing strategies implemented and labeled as a strategic partner in the healthcare interventions. Also, as a member of reproductive health task force, we completed the reproductive health commodity alternative distribution strategy development where UHMG is a major and a member of a tripartite –MOH-NMS-UHMG distribution system in the RH Commodities distribution strategies.

Distribution and value chain

18 We have been implementing the closed distribution system with 14 distributors countrywide including two which are our own branch sales units. Our experience is that the system has offered us less market access and control of pricing down the chain. A number of interventions will be undertaken and this system will be up for evaluation and possible restructuring by September after we shall have piloted it for a t least 6 months. Also, we are advancing internal discussion to finding the most suitable balance between closing and opening partially, social and commercial distribution to provide for best brand specific distribution system for satisfactory results.

Regional pharmacies

We received approval and offer of operating license and both Arua and Mbale pharmacies are operating well though with a number of challenges akin to their status as new business settings. Progressive sales have been achieved through the regional outlets but which are still below our projections.

Supply chain and logistical activities

Protector Packaging: there has been a steady supply of protector condoms from KPI. This is attributed to the learning curve dropping significantly and having spare parts on hand. The technicians at KPI have increasingly gained hands on experience in operating the machine.

For Injectaplan, PilplanPlus Aquasafe SoftSure Zinkid and RestORS, we achieve zero stock out during the period. Secondary packing went on well achieving the set packaging targets but which built into stock pile up due to the down surge in sales mention above. For all the products mentioned above, we have stock of more than three monthly consumption rates and except for Aquasafe and SoftSure for which their replenishment are on the way to be delivered in July and early august respectively. O went out of stock but by close of the June, an air freighted consignment was arranged and delivered pending NDA post shipment testing. The stock-out of the brand however contributed negatively to the low achievement registered in the quarter. Apart from these, Moonbeads were out of stock for over 1 month after we overshot our target in the previous quarters coupled with delays in delivering our order and production of packaging materials for secondary packaging to be accomplished. A consignment of 5,000 Cycle beads arrived and is ready for sales in July.

Third Party Logistics

In this quarter, we received additional stock from NMS. We also had IUDs, Implants and condoms directly handled by UHMG on behalf of UNFPA. There were 200,000 female condoms delivered to UHMG after NMS had handled the NDA verification and clearing charges. The invoice of our services for the the period ending June to be presented for payment to MOH amounted to $275,512.48.

19 UHMG started receiving direct RH Commodities supplies from manufacturers on behalf of UNFPA/MOH for the private sector distribution under the alternative distributorship arrangement. In the months of May and June alone, UHMG, on behalf of the ministry of Health, received: Implanon, (Etenorgetsrel 68mg), Jadelle Implants (Levenorgestrel 75mg Implants), IUD’s 380 (Copper T 380 intra Uterine device).

Actions Planned for Next Quarter

 Open up distribution system in Kampala and central region. This will be to allow UHMG command the supply chain in the greater 60 – 70% of our market while continue piloting the closed distribution system in the greater territories outside the central region

 Apply for Malact special importation permit to provide for

 Distribution of promotional materials such as, fliers and posters in a number of outlets around Kampala and active brand sampling to prospective outlets and prescribers are expected to increase the visibility of the products and thus increase the sales.

 Follow up and developing the distributor for our OTC range, i.e. House of Vitamins.

 Forward and advance the consultations meetings with nutritionists’ at the Ministry of Health to include sprinkles in the National Micro Nutrient Guidelines for Uganda.

 Continue product detailing amongst doctors, pharmacists and supermarkets to create demand.

 Give OsteoPro particular emphasis because its sales are the lowest and showing a negative trend.

 An additional sales person has been recruited to cover a wider reach of potential customers and do more detailing.

 Follow up closely those existing customers for specific commercial brands and recruit new customers through the above planned activities

 Director and sales and distribution manager to make field customer visits to interface and pick intelligence from customers to use for further building strategies

Supply Chain Planned Activities

 Prepare contraceptive procurement tables for USAID donated products

 Streamline the management to third party logistics

 Procure packaging materials for Aquasafe

20  Prepare the procurement plan for UHMG brands and commercial products

21 2. PROGRAMS CONSULTANCY STRATEGIC BUSINESS UNIT

OVERVIEW

The programs and services supported by UHMG continue to be the main channel of delivery of health promotion behaviour for disease prevention and provision of high quality services to the target beneficiaries, in key intervention sectors. Focus remains on diseases and conditions that make the largest contribution to the burden of disease in Uganda.

Malaria: Malaria control services supported focus on malaria prevention and effective case management, through the private sector. In Quarter 3, UHMG continued to strengthen malaria services delivery in the private health sector through GLCs and drug shops. Focus was on improved diagnosis and case management of malaria, prevention and management of malaria in pregnancy, and increasing demand for malaria services. While the main thrust of malaria control effort was in the 11 focus districts of Eastern and Northern Uganda where malaria is highly endemic, UHMG also extended delivery of malaria quality services in the rest of the GLCs in all the 44 AFFORD priority districts. This was done through integration of malaria activities into other programs services; maternal/newborn and child health (MNCH) mainly due to malaria being one of the big challenges in this target group, as well as HIV/AIDS program activities. This was done as a way to scale up achievements done in the initial 6 focus districts of program year 2012-2011.

Maternal and Newborn/Child Health: MNCH interventions aim at making a contribution to the national goal of reducing maternal mortality from 435 to 131 per 100,000 live births by 2015, child mortality by 2/3 by 2015 and increasing the CPR from 26% to 30%. The strategic objectives to be addressed through this program sector component include; Increase the availability, accessibility and utilization of quality skilled care for maternal and child health services in the Good Life clinics; Improve appropriate and timely health care seeking behaviour for maternal and child health services at community level and Increase knowledge, access and correct utilisation of appropriate maternal, child and reproductive health products

Family Planning: Scale up of Family planning services is being done with additional support from DFID, under the Accelerating the Rise in Contraceptive (ARC) to cover additional 45 districts, to reach a total of 90 districts and 560 FP service delivery outlets. Short term methods which UHMG has been supporting are being scaled up, in addition to introduction of long acting methods in the choice of methods for the GLC.

HIV/AIDS: services scale is being scaled up to include combination prevention, expanding care services to include ART roll out in selected districts and biomedical prevention to include SMC, condom use scale up and PMTC pilot in selected GLC.

22 2.1 MALARIA

Planned activities highlights  Promote subsidized RDTs to the GLCs and drug shops  Orient 100 health workers on RDT use  Conduct integrated support visits to GLCs and drug shops  Support malaria services data documentation and reporting through HMIS system.  Create demand for malaria services in the private health sector through radio talk shows  Participate in the world malaria day national celebrations

Activities Implementation Progress

Activity Annual Quarterly outputs Comments Targets Q 1 Q 2 Q3 Q4 Improved Malaria case management through the GLC and GLS Conduct field visits to 50 drug 131 Completed in quarter 1 identify drug shops and shops 5 learning centers identified Clinics in each of the 5 15 36 private clinics 95 drug shops additional PMI districts clinics were identified Printing and 250 400 Completed in Q1 dissemination of job aides for the GLCs and GLSs Develop and print job 250 1,130 250 Adapted the MoH existing aides for VHTs materials: 500 VHT participants manuals 100 VHT Facilitators manuals 30 VHT Training of trainers guides 500 VHT Job aides Train master trainers 15 23 Completed in Q2 and exceed the on support supervision target by 8 because we decided to and case management more trainers to provide effective support. Subsidizing high quality Not 12,37 On going, supported through and affordable RDTs for applicab 5 subsidizing RDT the GLCs and GLS le Improved prevention and treatment for Malaria in Pregnancy (MiP) in private health sector Facilitate training of 250 Completed in Q2. Integrated private health providers 250 286 training in MiP and Case at learning centers on Management was done for phase 2 MiP and case PMI districts. 23 management Conducting community dialogue meetings Conduct Training of 20 20 Completed in Q2 Trainers (MFP,DHE, HE, HI) & GLCs for community dialogue meetings (fees and MOH travel) Number of community 2,388 1,230 Completed in Q2. Completed in meetings conducted only 5 districts. Subsequent programming was integrated in model village activities. Number of people that 49,700 24,25 0 Completed in Q2. Completed in participated in the 2 only 5 districts. Subsequent community dialogue programming was integrated in meetings model village activities. Formation of Drug Shop Associations Establishment of district Planned for Q 4 based secretariat to coordinate drug shop operators Malaria Communication Conduct Radio talk 30 30 Q3 output; Focused on 11 PMI shows districts Conduct Radio spots 400 1040 Q3 output; Focused on 11 PMI districts Monitoring of the 1 0 To be done in Q4 by NMCP communications campaign Reprint and distribute 2000 400 500 250 Reprinted the MoH Clinical national guidelines and guidelines and distribution is policies for Malaria planned in the coming quarter. Management in GLCs Participate in activities 1 1 Participated in national World to commemorate World Malaria Day Commemoration that Malaria day (WMD) was held in Dokolo District.

Service Delivery Outputs

Key outputs from the GC during Q3 are summarized below.

24 Monthly results in malaria in pregnancy and case management services Service area April May June Total Malaria (suspected OPD 19,277 5,045 20,651 44,973 attendances) Malaria in pregnancy 809 252 1,305 2,366 First dose(IPT1) 1,929 339 2,013 4,281 Second dose(IPT2) 1,183 186 1,304 2,673 Malaria microscopy 36,681 11,376 36,864 84,921 Malaria RDTs 5,739 2,730 9,253 17,722

As shown in the table diagnosis of malaria is higher than that for malaria suspected cases in the GLCs. This is attributed to the fact that sometimes clients are referred to the GLCs for only malaria tests and services got elsewhere such as the public health sector or drug shops. Some GLCs have also reported that some clients demand for malaria tests without consultation, probably as a way to evade the costs of consultation fees, but more so due BCC demand generation (power of day 1 campaigns) mobilization for suspected malaria lab confirmation before treatment.

As part of quality improvement, integrated support supervision was done in the GLCs and drug shops. Health workers from outlets visited were mentored in various aspects of service delivery; especially record keeping and data entry into the HMIs for GLCs and UHMG data collection tool for drug shops. Subsidized UHMG promoted products distribution, including those for malaria such as RDTs, ACTs, LLINs and gloves was also done. Job aides, data collection tools for drug shops and HMIS forms for GLCs were also distributed during these support visits.

Promotion of RDT subsidy

RDTs subsidy sales for Quarter 3 Month GLC Drug Shop Total 3,4 1, 4,4 April 00 000 00 7 1, 2,1 May 50 350 00 5,8 5,8 June 75 0 75 10,025 Total 2,350 12,375 12,3 Grand total of RDTs sold 75

25 UHMG also oriented 102 health workers from GLCs on RDT use as an integral part of workshops held for health care waste management, couple HCT and comprehensive HIV care and ART. Job aides were also distributed to these health workers oriented.

World Malaria Day

On April 25, 2012, UHMG joined the rest of the world to commemorate the world malaria day under the theme “Sustain Gains, Save Lives: Invest in Malaria”. The national event was held in Dokolo which is one of the PMI focus districts for UHMG’s malaria supported activities.

UHMG facilitated the Ministry of Health film van and two health educators to mobilize the community and educate them on the dangers of Malaria, reaching 162 people with services out of the 200 targeted. Messages about the Power of day one were highlighted. This helped mobilize the community for malaria case management in Agwatta HC III, and also mobilized them to attend the commemorations of the World Malaria Week on Wednesday 25th April 2012. Over 150 people attended the event. The District Health Officials were facilitated to conduct week long radio talk shows on Malaria Prevention, Treatment and Case management.

Increasing demand for malaria services through the private health sector

As part of the power of day one, UHMG continue to conduct radio talk shows on four radio stations– Continental FM, Radio Apac, Voice of Teso and Etop FM. In total 30 radio talk shows and 1040 radio spots were aired to enhance malaria prevention and prompt and effective case management, based on confirmed malaria cases through laboratory testing.

In addition, 68 Taxis were branded with Power of Day One adverts and they drive through various parts of the Eastern Region, 7 billboards translated into Luo and Atesot erected and placed along various highways, 40 Road stars placed, 66 health workers oriented on the Power of Day campaign (DHOs, DHEs, Master trainers, Midwives, Malaria Focal persons, Village Health team members). UHMG also oriented Radio Talk show Hosts on the Power of Day One campaign to improve their radio talk show facilitation skills ahead of talk show roll out. 26 Malaria Case Management – Progressive Performance; the table below summarizes annual achievements so far for the three quarters.

Oct. to Jun 2012 Malaria Case Management Services %ag Annual Quarter Q1 Q2 Q3 Cumm e Target Suspected Malaria 210,31 Cases 132,308 18,752 59,253 3 70% 300,000 Suspected Malaria Cases tested RDT/ 268,18 Microscope 122,505 48,789 96,892 6 99% 270000 Cases Positive 50,237 22,204 42,408 Positivity Rate 41 45.5 43.8

Challenges and Lessons Learnt

Data collection in drug shops is still a new concept, thus the need for intensive mentorships and partnerships with the district, to increase district ownership and enhance adherence to reporting requirements. One of the key lessons is that provision of subsidized products increases uptake of RDTs and malaria testing which ensures more rational use of malaria medicines.

Plans for next quarter

The main focus in Q4 will be to strengthen malaria service delivery in the private health sector and improve data collection from the drug shops in the 11 PMI focus districts. This will be aided by orientation of drug shop operators on how to use to data collection tool developed by UHMG for drug shops. Support for malaria control services will be provided nationally using the GLC and model village approach, taking advantage of national scale up for prompt malaria diagnosis and treatment campaign – the Power of Day 1.

2.2 MATERNAL, NEWBORN AND CHILD HEALTH (MNCH)

Support is directed both at the community and facility levels. At the facility level, the department supported 50 Good life clinics through building the capacity of private health practitioners to provide quality ANC, delivery, post natal care, child care including care of the new born, growth monitoring, integrated management of childhood illnesses (malnutrition, diarrhea, Acute respiratory tract infections and malaria, de worming, immunization and micronutrient supplements). Selected GLCs were supplied with basic MNCH equipment as well as facilitation to conduct integrated community outreaches for hard to reach areas.

27 In addition, UHMG supported interventions for community engagement through the model village approach in the districts of Mukono, Mbale, Lira and Serere. Good Life Promoters (GLPs) were engaged in sensitizing households on how to adopt risk reduction behaviors needed to reduce maternal and child morbidity and mortality in the communities. 40 Good Life promoters and 20 mother mentors were trained to mobilize for integrated MNCH interventions in the two new model villages in Kabarole and Kyenjojo.

Activity 1: Capacity building of Good Life clinics to provide quality and integrated MNCH services

Quarterly Outputs Comments Annual Activity Description Targets Q1 Q2 Q3 Q3 Targ Output et Train on Goal oriented 50 42 Completed antenatal care, safe deliveries, emergency obstetric care, data management Family planning training 200 0 0 200 199 CME sessions focusing on on short and medium short term and medium term Hormonal term family planning were contraceptives through conducted for 199 health CME sessions workers from 50 GLCs Child health training on 200 188 Completed nutrition, growth monitoring, assessment and management of malnutrition(IMCI) Procure and distribute 50 50 50 Completed. Replenishment data collection tools to 50 GLCs is ongoing integrated with Good life clinics to include support supervision ANC, maternity, FP and OPD registers Distribute basic MNCH 50 - 50 50 These include BP machines, equipment and supplies to GLCs Stethoscopes, Fetoscopes, 50 Good life clinics Aprons, Surgical gloves, and bulb syringes.

28 Procure and distribute 200 188 Completed MNCH job aids and IEC GLCs materials to 200 Good Life Clinics Conduct quarterly 50 GLCs 50 50 50 50 50 support supervision visits support supervision and were done for 50 GLCs. This was integrated with CME session was biannual Continuous for each of the 50 GLCs. Medical Education Specifically this was on Short sessions with the 50 Good term and medium term family Life clinics planning methods.

Activity 2: Integrated Community Outreaches Activity Description Annua Quarterly Outputs Comments l Target s Q1 Q2 Q3 Q3 Targ Outp et ut Conduct integrated 200 25 20 18 18 GLCs in Western Region community outreaches were supported to conduct with 50 GLCs each one day integrated quarter: 4 integrated outreaches for hard to reach community outreaches areas. were conducted by each of the participating Good Life clinics.

Activity 3: Community Sensitization on MNCH Interventions through model village concept

Annu Comments Quarterly Outputs al Activity Description Q1 Q2 Q3 Q3 Targe target out ts put Training of Community 100 40 40 60 60 Good Life Promoters Resource Persons on MNCH (including 20 mother interventions to conduct mentors) have been home visits in model villages. identified and are being Quarterly review meetings will trained in Kyenjojo and be held to assess the progress Kabarole in the 3rd Qtr. This is of their activities. in addition to the 40 already trained in Serere and Lira.

29 Run a Maternal and child 120 Strategy developed and health oriented radio talk 120 piloted in SMGL districts of shows involving Health Kabarole and Kyenjojo. Roll workers from GLCs. out nationally will be done in Q4. Procure and distribute Job 200 96 60 60 96 CRPs received job aids, the Aids for VHT/Community 60 newly identified GLPs will resource persons received the job aids during their training Conduct school visits within 20 6 7 0 We intend to conduct these the model villages school visits in Q4

Service Delivery Outcomes

Oct-June 2012 MCH Services Progress Performance Indicator Annual Quarterly service Remarks target outcomes Q1 Q2 Q3 cum % achievement MATERNAL HEALTH Number of mothers attending 40,000 6,16 4,21 7375 17,751 44% the first ANC visit at the GLC 2 4 Number of mothers attending 13,000 2,90 1,92 3601 8,427 65% the 4th ANC visit at the GLC 4 2 Number of mothers who 11200 4,54 3,04 5660 13,245 118% received IPT 1 at the GLC 5 0 Number of mothers who 6800 3,44 2,15 3729 9,327 137% received IPT 2 at the GLC 5 3 Pregnant women counselled, 11200 2,59 1,90 5518 10,022 89% tested and received HIV 7 7 results at GLC Number of mothers delivering 8000 2,62 1,74 3406 7,776 97% at GLC by skilled HW 6 4 Babies born with low birth 376 122 81 161 364 97% weight(<2.5 kgs) CHILD HEALTH Total OPD attendance of 100000 2072 2206 6018 10298 103% children under 5 years 7 8 5 0 Children under 5 years treated 2674 44.4% of <5 OPD for malaria 4 attendance Children under 5 years treated 4362 7.2% of <5 OPD for diarrhea

30 Support supervision Family planning CMEs

Support supervision was integrated with other activities conducted by the MNCH department. CME sessions were conducted for 199 health workers in 50 GLCs with a focus on short term and long term family planning methods. Key positive findings included provision of an integrated package of services at all GLCs, presence of a qualified staff to provide MNCH services at all facilities and possession of basic equipment for assessing the clients. Some of the challenges identified were inadequate staffing at the GLCs, inadequate skills on waste management, and inadequate utilization of data by the facilities. These were discussed with the GLC staff to find solutions.

Distribution of Basic MNCH Equipment to the GLCs

An assortment of basic equipment was distributed to 50 GLCs. These included Blood Pressure machines, stethoscopes, fetoscopes, bulb syringes, aprons and gloves. This was a timely intervention since most of the GLCs had one set of equipment that was being shared across all the departments/stations within the clinic.

Conducting integrated community outreaches

A total of 18 GLCs were facilitated to conduct 18 integrated community outreaches for hard to reach communities in their catchments. These were St. Mary’s maternity Bukomansimbi, St. Aloysius Ngobya maternity and Munathamat HC III in Lwengo, St. Josephs HC III in Mbarara, Kakoma HC III in Isingiro, Ibanda Mission HC III and Rwenkobwa HC III in Ibanda, St. Mary’s Kyeibuza HC III in Kiruhura, Nyabugando HC III and Kitabu HC III in Kasese, Agetereine Nursing Home, Yerya HC III, Papa’s Medical centre, OTA medical centre, Iruhura HC III, and Nkuruba HC III in Kabarole, Villa Maria and Midas Touch in Kyenjojo. The support was in form of provision of free/ subsidized commodities for the outreaches, IEC materials, data collection tools, transport and lunch for health workers as well as physical presence of the UHMG staff for mentoring at the outreaches. The services offered at these outreaches included Antenatal care, post natal care, immunization, treatment for common illnesses for children below 5 years, Family planning provision, HIV counseling and testing, and Health Education. A total of 2750 clients received services at these outreaches.

Community sensitization activities

The 96 trained Good Life Promoters (Community resource persons) in the 5 model villages of Kasawo in Mukono district, Bungokho and Nakaloke in Mbale district, Adekokwok in Lira district, and Pingire in Serere district were facilitated to conduct home visits and interpersonal communication activities to promote positive health behavior in an integrated way. They also refer the community members who need services to the GLCs. In addition, two new model villages were formed in the districts of Kabarole and Kyenjojo in the sub counties of Kasenda and Nyantungo respectively.

31 The community interventions in these model villages are coordinated by Iruhura HC III in Kabarole and Midas Touch Medical Centre in Kyenjojo. The respective District Health Teams were sensitized on model village activities and involved in the selection of the sub counties for model village activities. The health workers from the 8 GLCs in the two districts were oriented on integrated MNCH activities in the context of the model village concept. The two coordinating GLCs ( Iruhura and Midas Touch) were then actively involved in identification of 30 Good Life promoters (including 10 mother mentors) from each of the model villages who were trained and facilitated to conduct community sensitization and mobilization for integrated maternal and child health services.

Saving Mothers Giving Life campaign

UHMG led in designing a communication campaign emphasizing the need for pregnant mothers, their partners and the community to prepare for delivery at a health facility in the districts of Kyenjojo, Kamwenge, Kibale and Kabarole. To kick start the campaign, a communication strategy was developed with guidance from MOH, 5 concepts were developed, 2 pre-tests conducted and 3 partner meetings held. To support the mass media, 60 Good Life Promoters (including 20 mother mentors) have been identified and trained in the districts of Kyenjojo and Kabarole. IEC materials (posters, fact sheets, stickers and job aides) will also be produced.

Lessons learnt and best practices

1. Integration of activities with the various departments in UHMG creates a platform for leveraging on the limited resources and time, and allows for efficient delivery of comprehensive health services and products to the target population. 2. Partnerships with the district health office, and other implementing partners in the districts improves program outcomes

Planned Activities for 4 th Quarter (July-September 2012

Capacity building of Good Life clinics to provide quality and integrated MNCH services a. MN &CH activities: 1. Conduct support supervision of 50 GLCs and follow up of IMCI trainees 2. Support GLCs to conduct 157 integrated community outreaches for hard to reach areas 3. Support selected GLCs to conduct follow up of malnourished children in their homes for nutritional education and support. 4. Support supervision and mentoring health worker in MN & CH services delivery.

b. Community Sensitization on MNCH Interventions through model village concept 1. Scaling up model villages to reach 50 GLCs. This will involve all the sectors (HIV, Malaria, MNCH, RH) working through the model village framework.

32 2. Launching mothers Clubs in Kabarole, Kyenjojo, Kibale and Kamwenge and facilitating monthly mothers’ clubs activities in the four districts. 3. Scale up Saving Mothers Giving Life (SMGL) Campaign in Kyenjojo, Kabarole, Kibale and Kamwenge 4. Conduct a mini evaluation of the model village activities as a baseline for future evaluation of the UHMG model village activities.

Administrator Nyakatare HC III receiving equipment from the MNCH manager donated by UHMG to the Good Life Clinic

2.3 FAMILY PLANNING Activity highlights Family planning activities implemented by UHMG/AFFORD received additional support from DFID to scale up operations in additional 45 districts to reach a total of 90. Supported service delivery outlets were to be expanded from an initial 200 to 560. The scale up in family planning service utilization is supported through an integrated approach:  Family planning commodities security is supported through product facility operation, UHMG specialized department for health products warehousing and distribution, through a private sector supply chain system, as an alternate to public and private not for profit approaches.  Building the capacity of service providers to provide affordable quality services.  Mobilization of communities for FP services awareness, dispel myths and barriers, and raise demand for more services utilization

Key Activities Result 2: To increase access and affordability to quality family planning services and products  Improve quality of service provision at the private clinics.  Provision of infection prevention logistics, buckets, disinfectants, injection boxes etc  Distribution of IUD Kits, Equipment and supplies and logistics to the private clinics  Conduct monthly/quarterly supervisory visits to all network providers to assess provider skills and competency Result 3: To increase knowledge, awareness, demand and utilization of modern FP methods, including long term methods.  Recruitment and training of CORPs  Facilitate CORPs to carry out community health education on RH/FP  Design and implement Smart Choices family planning campaign.

33 Activity Progress Tracking Matrix

Target Results Cum. % Activity Q1 Q2 Q3 Result 2: Increase availability, affordability of FP services and products Mapping 560 328 328 Comments59% These of outlets outlets that are include capable clinics of and drug stocking shops reproduc tive health products Mapping 240 - - 138 138 58% 240 of mapped facilities but 138 capable enrolled of awaiting providing to join long term GLC methods Training 240 - - 41 41 41 of service trained providers central in long 13 term western methods 11, eastern 12 MOU 240 92 92 38% This signed excludes MOU with 200 GLC at DFID start (baseline) Distributi 240 - - 41 41 17% FP on of FP commodi commodi ties from

34 ties, MoH within were the distribute region, d (depo working 577,pills with 1320). other partners Distributi 240 Implants on of 1628 long (MoH acting FP stocks), commodi 84 IUCD ties insertion kits for 41 health facilities distribute d (IUCDs were not yet available) . Strengthe 240 - - 41 17% 41 n sterilizers infection , control in Infection clinics preventio and n hospitals commodi ties and supplies procured fro 41 health facilities Support 240 12 12 5% Support Quality supervisi Improve on) by ment MoH and activities UHMG) and mentorin g of staff 35 in long term methods service provision. In addition CME were conducte d in 50 clinics on short term methods. Result 3: Increase knowledge, health behaviors leading to demand and sustained utilization of FP services KAP study for modern 1 1 1 100 For Baseline for SMART choices FP methods % FP campaign and message development Design and pre-test 1 1 1 100 For Baseline for SMART choices campaign concepts and % campaign message materials development Identify , train and 720 36 were identified, training to facilitate community follow. 3 volunteers per facility resource persons will be enrolled and supported.

Progress

Result 2: Increase availability, affordability of FP services and products  Mapping of service outlets to increase the number of health offering short and long term family planning services. 42 additional districts were mapped, 240 facilities assessed, and 138 selected for services delivery. 92 MOU were signed. Details are provided in the table below. Clinic who are already working with other partners (Profam, Blue star) were not mapped.  Training of service providers in long term methods. 41 health workers were trained. Service providers who participated in this training were given start up commodities. These included; 6,600 condoms, 138 cycles of pills, 75 injectables. In addition participants participated in practicum placements in different hospitals in Kampala where 53 IUCD and 125 implants were inserted.  Distribution of family planning commodities. During the quarter, free MoH and UHMG brand commodities were distributed in GLC, to enable initiation of service delivery, while waiting stocks to arrive. Details of this activity are provided in the table below.

Contraceptive methods Amounts sold/free distribution IUD 0

36 Implants (implanon) 1628 Injectable 577 2 ml syringes 577 Pills (microgynon) 1320

 Strengthen infection control in clinics and hospitals. 12 GLC were supported with infection control kits; sterilizers, gloves, safety boxes and west bins.  Building the capacity for long term family planning services delivery. Insertion kits were procured for the 41 health facilities (81 set – 2 per facility). Other items distributed to the 12 facilities listed above in central region include; chloro-hexidine (disinfectant), stainless foot step bin, outpatient registers, FP registers, Antenatal registers (only to facilities providing ANC), bio-hazard safety boxes, sterile and non sterile gloves.2 boxes files and 2 buckets (green and blue).  Support supervision was conducted by 2 MOH officials and an RH trainer to ensure competency and proficiency in Family planning service provision in terms of counseling and actual insertion (12 clinics supported)  Distribution of MoH job aids and policy guidelines. MOH protocols/Job aids were given out to GLCs clinics. These include; MEC Wheels, Checklists, infection control protocol and complication Management plan.

Result 3: Demand creation activities to increase services utilization.  Knowledge, attitude and practices study was carried out to set a baseline and identify issues to address in the Family planning campaign communication strategy.  Smart choices family planning campaign concept development, pretesting and message approval were completed.  Selection of good life promoters to support demand generation activities were identified. Training will be carried out in the next quarter.

FP services utilization

Services utilization data from G164 GLC called during the quarter is presented in the table below. This data is mainly from original (AFFORD II GLCs). Data from new service outlets will be incorporated in the next quarter reporting. Service provision (from HMIS reports March –June 2012)

Contraceptives New users revisits Oral lofemenal 673 492 Oral Microglynon 1,629 1299 Oral ovrette or another POP 696 752 Oral others 564 517 Female condoms 1458 868 Male condoms 6826 4826 IUCDs 1,410 352 Injectable 4,154 3731 natural 437 134 Other methods 704 142 Total family planning users 15,020 10,175

Surgical Methods Utilization Pattern during the quarter

37 Female sterilization (tubal ligation) 54 Male sterilization 8 Implant new users 664 Implant revisits 155 Implant removals 136

Participation in World Population Day cerebrations, Hoima District

UHMG participated in a world population day celebrations in Hoima where the organization show-cased FP products/services and conducted static activity at God Grace medical centre in Kigorobya trading centre, Hoima. The static activity lasted 2 days, and the following was achievement were realized: implants 12; IUCD 4; depo 15; and implant removal 2.

Above, the Prime Minister (PM) Rt Honorable Amama Mbabazi inspecting UHMG exhibition during World Population Day cerebration in Hoima. UHMG staff was detailing family planning choices. The PM received a Genext T-shirt.

Challenges and Lesson learned

 Demand creation activities, especially below line activities for clinics need scale up, to support the multimedia communication campaign for increased services utilization.  Services data management need more support to ensure timely data management and reporting, in line with HMIS reporting requirements.

Planned activities for Q4

The main activities for the quarter include;  Building the capacity of GLC to deliver modern FP services, with emphasis on long term methods  Increase access to FP commodities to GLC  Increase demand and utilisation of FP services in GLC  Document best practices for scale up

38 2.4 HIV/AIDS

This quarter, UHMG continued to strengthen HIV prevention, care and treatment services through the GLCs and support for communities, through sub-grantees. This quarter focus was on integration to leverage on available limited resources, linking targeted beneficiaries to the recommended continuum of care in collaborations with other implementing partners in the districts.

Planned Activities

 Support sub-grantees to implement HIV prevention among MARPs, young people and couples  Develop the sub-grantee management manual  Pilot PMTCT services delivery in the private sector through selected sites.  Expand HIV care and treatment services in the private sector to include ART services in selected sites.  Conduct integrated support supervision in GLCs; Use SMS media for quality of care support improvement  Scale up the get of the sexual network campaign and condom promotion for MARPS, in partnership with DBTAs.

Progress of planned activities

A summary of to the FY 2012 HIV intervention services progress, main targets and outputs are summarized in the table below.

HIV/AIDS 2012 Activity Tracking Matrix Key activities Targ Outputs Cumulative ets Q1 Q2 Q3 Q No %a 4 ge 1. Strengthen HCT Services in private Clinics – the Good Life Clinics (GLC) Scale up HCT in GLC 184 174 174 174 95 % Train HW in couple HCT 100 52 48 100 100 % Support Post test clubs 5 5 5 5 100 % Support GLCs to conduct HCT 20 0 19 19 95 outreaches % Support HCT services quality through 174 174 174 174 100 quarterly supervision in GLCs % Support printing of HCT services data 174 0 174 174 100 tools & reporting % People tested 132, 328 195 34,2 86,5 66 000 00 56 19 75 % 39 2.Support infection control, medical waste management (MWM) and disposal Train HW in infection control and 100 n/a 82 82 80 MWM % Support GLC for safe medical waste 184 174 174 174 95 disposal % Procure and distribute safety boxes 2785 696 693 693 60 and waste bins % Conduct regular support supervision in 174 174 174 174 100 GLCs % 3. Scale up HIV prevention services for MARPS IPC for behavior change among 3,50 0 607 726 1333 38 truckers 0 % IPC for behavior change among fisher 19,0 349 213 849 1412 74 folks 00 9 4 1 4 % IPC for behavior change CSW 1000 89 299 446 834 83 % Condoms sales targeting MARPS 650, 45,0 508 175 2258 35 000 00 0 763 43 % Integrated MMC, STI/FP services for 100 100 100 100 MARPS % % % % 4. Scale up HIV prevention among couples Formation of additional couple clubs 4 0 4 4 100 % Train married couples in couple 48 0 48 48 100 counseling % Train couples in positive prevention 56 0 56 56 100 % Carry out IPC BCC for fidelity among 150, 48,2 22,5 206 9139 61 individuals who are couples 000 78 07 08 3 % Support couple HCT services for 19,8 402 514 3,74 1291 65 married couples 00 4 4 8 6 % Integration FP,MMC wrap around 1500 262 632 265 1159 77 activities % 5.HIV Prevention among Youth Promote Youth services through GLC 10 0 10 100 clubs % Train Youth peer educators for BCC 80 79 20 99 99 % Prevention of HIV through IPC BCC 50,0 178 243 734 1156 23 00 0 6 5 1 % Condom sales among youth 100, 150 219 157 5263 53 000 00 00 37 7 % Integrated youth services – MMC, STI 15,0 532 559 1091 7% & HCT 00 40 6. Scale up HIV Care & Positive Prevention Services PHA receive a least 1 services in care 12,5 181 211 248 6417 51 package 00 4 8 5 % HIV Care quality assessment in GLC 184 174 174 174 100 % Support quality care services in GLC 50 0 50 50 50 100 % Support PHA for PwP services 1050 659 303 118 4873 46 Package. 0 2 2 % 7. Scale up PMTCT Services Train HW on PMTCT services 100 0 0 0 0% Pre accreditation of GLC for PMTCT & 50 0 0 32 64 ART services % Provide PMTCT services to HIV+ PW in 700 0 0 0 0% 50 GLC Support mothers clubs linked to GLC 50 0 0 0 0% for PMTCT Train mothers mentors in mothers 100 0 0 0 0% clubs Design & conduct multimedia PMTCT 1 0 0 0 0% campaign 8. Demand for MMC generation, with DBTA Referral for MMC 1000 76 332 740 1148 115 % Develop and market MMC disposable kit 9. Scale up prevention services with DBTA Scale up get off sexual network 4 3 3 0 N/A among DBTA’s Promote condom use among DBTA 4 3 3 0 N/A programs

Strengthen HCT Services in Private Clinics

UHMG continued to support GLCs to provide HCT through the health facilities and outreaches conducted in the community. Data collection tools, technical support supervision and HCT kits and laboratory consumables were provided to help support GLCs provide HCT services.

Oct-June 2012 HCT Services Progressive Performance Annual Performa Category Target Q 1 Q 2 Q 3 Cum nce 137,40 91,33 Total counseled 0 33,981 20,941 36,416 8 66.5

41 134,70 89,48 Total tested 0 33,100 20,511 35,869 0 66.4 Received 132,00 82,16 results 0 32,800 15,143 34,219 2 62.2 HIV Positive 2,316 1,298 2,276 Positivity Rate 7.1 8.6 6.7 Tested as couples 19800 4,024 1,270 3,748 9,042 45.7

Specifically, UHMG procured and distributed HIV test kits and the consumables to the 174 GLCs. This include; 1,110 Determine, 329 Unigold, 1,430 Vacutainers, 2253 Vacutainers needles, 319 boxes of gloves and 1571 rolls of Cotton wool.

To increase access to HCT services, outreaches were done during the quarter by the GLCs targeting MARPs at their work places and the general population. In total, 1086 people were counselled and tested for HIV through outreaches conducted by 10 GLCs. Those who tested positive received starter pack of cotrimoxazole and aqua safe, family planning and condom supplies for one month, depending on their needs. They were also referred for further treatment, care and support to the nearby health facilities. Peer educators who helped mobilize for the activities followed up and tracked all referred clients for actual service delivery at referral sites. The newly diagnosed PHAs were also encouraged to join Post Test Clubs for psychosocial support.

Healthcare Waste Management

UHMG continued to support GLCs in health care waste management, through distribution of safety boxes for disposal of used/contaminated needles and syringes. In total, 696 safety boxes were distributed to 174 GLCs.

Sexual and Other Behavioural Risk Prevention – Truckers

UHMG targets truckers and CSWs along the hotspots on high in West Nile (Arua, Nebbi, and Koboko districts) and Kasese district through sub-grants to ASDE-U and NAYODE respectively. Interventions for truckers follow the CHIC center model with outreaches, moonlight HCT camps and visits by park yard volunteers (PYV) at various hot spots where large number of truckers station, to rest from their long journeys or await border point clearances. Achievements for this quarter are summarized below:

 252 truckers, 193 CSWs and 500 members from the surrounding communities were reached by 40 park yard volunteers from Hima and Mpondwe in Kasese district. In West Nile, 474 truckers, 253 CSWs and 1,369 members from the surrounding communities reached. IPC focused on integrated

42 HIV prevention with emphasis on consistent condom use, partner reduction, safe male circumcision, family planning for females, and reduction in alcohol consumption.

 IEC/BCC materials 4000 brochures and 1000 posters) targeting trucker drivers were designed printed and translated into Kishwali and the local language, to educate and inform the target population on the dangers and risk of having multiple sexual partners. Brochures were printed and disseminated to the truckers and the surrounding communities for message dissemination, information sharing on HIV prevention and behavior change in Kasese. 12 SMS messages were sent to 500 truckers registered in five languages in West Nile with emphasis on safe sex practices.

 Advocacy meeting one was held with 100 hundred local leaders from Kasese district and as a result of one the meetings, Hima and Mpondwe town councils provided the project with buildings for youth centres and promised space for CHICs in future. This was resolved that as the project progress the local council authority will be preparing for permanent homes for the youth and CHIC centres.

 Equipment items were procured for Youth Centres. These include: 2 TVs, 2 DVDs, 20 benches, 2 chairs 2 TV stands and 2 lockable shelves. In addition, 30 Health workers were oriented on youth friendly services.

 Through social marketing, 2,400 free condoms from the district were distributed, and 84,000 condoms were sold by peer educators.

Sexual and Other Behavioral Risk Prevention – Fisher Folk

UHMG HIV prevention interventions for fisher folk and CSWs on landing sites in Kalangala, Wakiso, Mukono and Masaka, were delivered through a sub grant to SSECODA to scale up operations of safe sailing boat project through us of peer educators and partnerships with the beach management units, district offices and other implementing partners such as AMREF. Quarter 3 achievements are summarized below

 Peer educators conducted routine interpersonal communication among 8491 fisher folk to address Gender based violence and alcoholism prevention messages among other risk factors in HIV transmission. Condom promotion and social marketing was done. 165 CSWs were also reached as an integral part of these activities on hotspots and bars on the landing sites.

 In partnership with Kalangala Home based voluntary and testing and Kalangala Forum for People Living with HIV/AIDS (KAFOPHANO) HCT outreaches were conducted reaching 753 fishermen with HCT services. Those who tested positive were linked for CD4 testing with psychosocial support provided by KAFOPHANO.

 Through these wellness outreaches, 231 fisher folk with symptoms suggestive of STIs were referred for care and treatment. These referrals includes; from Katabi sub-county to Entebe Grade B hospital; Mugoye and Bujumba sub- county to Kalangala Health Centre IV. Through partnership with AMREF, fisher folk were mobilized for SMC during

43 SMC camps on the landing sites. These were part of the wellness outreaches in which HCT, STI diagnosis and family planning counseling was provided.

 Through social marketing, peer educators promoted and distributed 39,000 condoms, 38 moon beads and 53 dispensers of aquasafe. Condom demonstration and education was done as part of these activities.

Sexual and Other Prevention-married and Discordant Couples

UHMG implemented HIV prevention among couples through a sub-grant to Humanitarian Care Uganda (HCU). Services were expanded to include new 5 districts (Kamuli, Mukono, Mbale, Kyenjojo and Kabrole). This is in addition to 1st phase districts of Kanungu, Lira, Kabale and Wakiso where services continue to be expended to include addition sub counties and clubs. The overall goal of HCU Faith project is to strengthen the capacity of communities to respond to the HIV/AIDS epidemic, promoting behaviour change towards faithfulness and the support of married couples to popularize and sustain their commitment to fidelity. In total, 20608 individuals were reached in the 9 districts with HIV prevention packages. Achievements of the quarter are summarized below:

 Advocacy with community leaders was conducted with religious and civic leaders in Mbale, Mukono, Kamuli, Kyenjojo and Kabalore as key influencers to the community for mobilization and also to bring about their buy in into the project.

 72 couples from the 5 new districts were trained on promotion of faithfulness and reduction of gender based violence. The training guide developed by UHMG (Families that Prosper) guided the training. The trainees were supported to form four fidelity clubs

 To address the issue of counselling discordant couples, 72 couples were trained in the 5 new districts. In addition, the same couples were trained on sexual and reproductive health, demand generation and advocacy for MN&CH services, including for family planning

 Through interpersonal communication activities supported by Hero couples, 20608 couples were reached with BCC messages to promote fidelity, increase couple communication and create demand for HIV/AIDS prevention and MCH/FP services.

 801 couples were provided with couple HCT services through outreaches conducted by GLCs. Of those tested 734 couples were concordant negative, 30 couples discordant while 37 were concordant positive. Referrals were made for all positives to health facilities for CD4 tests and chronic HIV care after initiation on cotrimoxazole and counseling on positive prevention.

 280 men were mobilized through fidelity clubs for safe male circumcision and referred to health facilities and GLC for SMC.

44  During the quarter, visibility of FAITH project activities, as a USAID UHMG funded project. 1440 T shirts and 900 umbrellas were procured, branded and distributed to Hero couples. In addition 34 signposts branded as USAID funded project implemented by UHMG were distributed in all 9 districts project sites.

Sexual and Other Behavioral Risk Prevention –Youth

UHMG supports youth programs through boda boda peer educators and youth clubs. Youth clubs are operated through a sub-grant to Health Alert in Amuru, Nwoya and Oyam, while boda boda cyclists are based in the districts of Arua, Nebbi, Moyo, Koboko, Jinja and Mbale with technical support. UHMG’s program focuses on promoting utilization of youth friendly reproductive health services, uptake of safe male circumcision, correct and consistent condom use, early detection and treatment of STIs, family planning and prevention teenage pregnancies.

Boda boda cyclists: UHMG continued implementing HIV prevention activities targeting Boda Boda cyclists and their clients at their work places to enable them develop health seeking behaviors, reduce on the risks of HIV infections, behavioral and adopt positive living for those who are Positive. The 99 trained Boda Boda Peer educators are reaching their peers with HIV prevention messages and activities in the districts of Arua, Nebbi, Koboko , Moyo, Jinja and Mbale. Besides reaching their peers, the Peer educators are also reaching their clients, the people they interact with during their work and the surrounding communities with HIV prevention activities and messages. The following are the key achievements for the quarter:

 Two hundred and ninety (290) boda cyclists in the districts of Moyo, Koboko and Arua were reached with integrated HIV prevention communication and services. Nebbi data had quality issues (Not unique individuals reported) which need to be addressed with the peer educators.

 HIV Counseling Testing (HCT) outreaches targeting Boda Boda cyclists and their clients were done during this quarter reaching 380 Boda Boda, and 504 community members. Mobilization for the outreach was done by the local leaders and the testing was done by selected Good Life Clinics in the respective districts and in close collaboration with the district officials. Moon light HCT was done in places like disco halls, bars, among other venues frequented by CSWs and their clients. Some outreaches were held at boda boda stages to cater for the mobile and busy nature of boda boda cyclists.

 Free condoms from the district Health offices in the districts of operations were distributed to boda boda cyclists by peer educators.

 Apart from the GLCs being supported by UHMG to provide serves to the Boda Boda Cyclists, other service providers were identified and mapped to provide other wrap around service to the cyclists

45 during this quarter. Referrals for STI/STD treatment, SMC, Family Planning and treatment, care and support was provided to the Boda Boda cyclists to help reduce on their risks of HIV infections and provide counselling on positive Living for those who tested HIV positive, respectively.

 Review meetings were done with the Boda Boda peer educators in the districts of Arua, Nebbi, Moyo, Koboko, Jinja and Mbale to provide technical support to the peers. The meetings aimed at discussing work progress, sharing experiences, challenges and possible solutions to guide the implementation of the project.

 Stakeholders meetings: Three meetings with the district leaders and other stakeholders were successfully held in the districts of Nebbi, Koboko and Moyo. These meetings were aimed at sensitizing the district leadership on the HIV situation in the sub region, the drivers of this HIV epidemic and goal of the ‘’Get Ready to Roll project” targeting the Boda Boda cyclists and the surrounding communities. The meeting discussed and agreed on various ways of district involvement in the project. Project work plan was shared with the district leaders.

Youth clubs: The following were the key achievements under the youth program.  156 young un-married people were referred for the service at various health facilities in the target districts, 144 were circumcised with the support from HA-U.

10 peer support clubs, with each club having 25 members were formed and 05 other groups strengthened in Oyam to enhance peer to peer interactions and sharing of experiences and lessons learnt.

 IPC awareness creations were conducted and reached 7,345 (4,840males and 2,505females) Among the key messages passed to community includes; benefits of early diagnosis, STIs & HIV prevention, consistent and correct use of condom, family planning services, benefits of medical male circumcision, modes of HIV prevention and transmission, and life skills.

 06 sessions of HCT out reaches were conducted reaching 354 (212m& 142f) young people and 07 young people who tested positive were referred for care and treatment.

 A total 151 (62M&89F) young people were referred for STIs assessment and treatement.

25 (15males & 10females) health workers were trained in delivery of youth friendly health services, pediatric counseling and risk reduction counselling, and communication skills

46 Quarterly Support supervision to Sub-grantees

Support supervision was provided to the five (5) sub grantees implementing sexual and risk reduction activities among truckers, CSW, Fisher folks, young people out of school and couples by UHMG to ensure they are implementing their activities as planned. Technical support was provided to these sub grantees to ensure that they were on track and to see the progress of work.

Positive Prevention

This quarter UHMG supported peer educators in close collaboration with health workers form the GLCs to provide positive prevention (PP) services to PHAs in the communities served by the GLCs. . Service provision was guided by the MOH minimum requirement of emphasizing partner disclosure and testing, safe sex, safe pregnancy, family planning, adherence to cotrimoxazole, treatment of STIs and linkage to support groups for psychosocial support.

1437 PHAs were reached with PP services. Of these 34.4% were male while 65.6% were females. During support visits, peer educators and health workers were mentored on how to use the profiling tool developed by HCP. This tool was used to enable peer educators and HWs understand the need of their clients at the time of encounters. As a result, counseling focuses on the most relevant and urgent needs of the clients.

HIV Care

UHMG continued to provide HIV clinical care services to PHAs through the GLCs. In total, 2,485 PHAs were reached. All those who tested positive at HCT were provided with a starter pack as highlighted in the HCT section above, and referred to nearby health facilities for CD4 testing. Tracking has been done through peer educators in 30 GLCs. This quarter, UHMG will pilot using SMS for tracking referred clients by providing airtime to 50 selected GLCs.

To contribute to the MOH efforts of scaling up ART through the private sector, UHMG partnered with MOH to build the capacity of 45 HWs from the 14 GLCs selected by MOH as ART sites to provide comprehensive HIV care and ART services.

HIV care services provided are summarized below.

Number of PHAs who received clinical care at GLCs segregated by sex HIV Care Annual Q1 Output Q2 Output Q3 Q4 Total Category target Output Output M F M F M F M F M F At least 1 Care 12,500 776 1038 103 1086 9 15 Service 2 5 32 47 4 Total 12,500 1814 2118 2485 6417 (51%)

PMTCT Services

In a bid to join national efforts towards virtual elimination of vertical transmission of pediatric HIV, UHMG partnered with MOH to assess GLCs that qualify to provide PMTCT services. Of the GLCs assessed, 32 GLCs were considered ready to start PMTCT service provision as they met most of the criteria for PMTCT site. This will start following PMTCT/EID and IMAI trainings for two HWs per GLC selected.

Lessons learnt

1. Over achievement was as a result of; engaging more peer educators and holding regular meetings to find challenges.

2. Need to carry out a lot of sensitization and mobilization to inform the public about the existence of the programs we are following.

3. Constant and regular interaction will be very beneficial in getting results for HIV prevention

4. Proper and consistence usage of condoms was demonstrated by fishermen from different landing sites.

5. Mapping HIV/AIDS organizations in the project area has been beneficial to SSECODA and HIV/AIDS organizations for strengthening referral networks.

Planned Activities

Key activities for Q4 include;  Scale up of MAPRS service for truckers, Fish folks and CSW working through subgrantees  Expand care and treatment to include ART.  Build the capacity for PMTC services in the private sesctor  Scale up condom prevention among MARPS and get of sexual network, working with DBTA.  Continue HCT services through GLC.

2.5 SYSTEMS STRENGTHENING, MONITORING & EVALUATION

Planned activities  Distribution of HMIS tools and provision of technical support to the GLCs  Completion of training of HMIS for Kampala district and those which missed the training  Mentoring of staff from the drug shops being supported in data management and distribution of data management and reporting tools  Development of joint work plan with districts where the GLCs are located to provide technical support to the entire private health sector and collect data  Re-designing of the UHMG database to capture data generated through the monthly HMIS reporting forms and generation of appropriate reports

48  Collection and compilation of data for the Quarterly review and reporting to UMEMS and bi- annual to MEEPP  UHMG database update  development

MEEPP Bi-Annual Reporting and UMEMS quarterly reporting

Bi-annual MEEPP reporting opened the activities for this quarter. Detailed data on activities being implemented by UHMG through the sub grantees and GLCs were reported on through the MEEPP online reporting system. Performance on most areas was below target. This was partly because of the delay in awarding contracts to the sub grantees. The performance in HCT and clinical care was lower than expected because data was collected for 5 months (October 20122 to February 2012) instead of the 6 months of the reporting period. This was because data had to be collected early enough to facilitate reporting. The reporting rate was also lower because many service outlets were using the HMIS reporting forms for the first time and were not used to it.

Training of GLC staff in HMIS

The training of facility staff from the old GLCs was completed with the training of 23 staff from Kampala facilities. This brought the number of staff trained in HMIS to 190. Some clinics did not send at least one staff for training. These will be mentored from their work places to ensure they appreciate the use of HMIS tools and follow the instructions for proper record keeping and reporting.

Distribution is of the tools is a continuous process during support supervision.

Printing and distribution of data collection tools

In an effort to improve data management in the GLCs, the M & E unit printed and distributed both data management and reporting tools. CLCs have ale requested the printing of tools to cover new service outlets and to ensure continuous supply for at least 6 months. The training, printing, and distribution of the HMIS tools have been appreciated by MOH as it is addressing one of MOH priority areas of getting data from the private service providers.

Type and Quantity of HMIS tools printed during the Quarter

Name of tool HMIS Number Quantity Printed HIV Counseling (HCT) Register HMIS 055b 206 Health Unit Outpatient Monthly Report HMIS 105 206 HCT Client Card HMIS 055A 1,854 Pre-Art Register HMIS 080 50 Art Register HMIS 081 50

49 Health unit Database 206 Health Unit Manual 206 Health Unit inpatient reporting form HMIS 108 50

Monthly Reporting/Data collection

Data for three months (March to May 2012) were collected during the last month of the reporting period. This is because monthly reporting has just started and the M & E unit not yet put a system in place to ensure that every month reports are collected. The table blow summarizes the returns as received from the field.

Statu Expecte Reporting Region s d Received Rate (%) Comments Old 79 66 84 85 Data collected for only May. The service Central New 13 11 providers are not yet trained in HMIS Old 42 40 95 73 Data collected for only May. The service East New 11 8 providers are not yet trained in HMIS Old 28 24 86 Training of new ones in provision LT FP North New 0 0 methods not been done Old 43 32 74 0 Some districts were not reached. The 4 service outlets in Ntungamo were not ready West New 10 0 to report(Kisoro, Masindi and Hoima) Overall 226 181 80

Data collected is reflected in the different program areas of the quarterly report. The data are validated by performing consistency checks on different sections of the HMIS data forms.

Challenges in the HMIS

 Some of the trained service providers in HMIG have moved on. Other service providers have taken it as an excuse for not compiling the reports.

 Some staff fill they are obliged to compile only the section for HIV counseling and testing, some sections are left unattended to and yet during the training, they were told that all sections referring to services provided by the service outlet must be filled.

 Some clinics have indicated they are not ready to fill the Monthly HMIS forms because it requires a lot of time.

50  There are some inconstancies in some areas of the HMIS forms. For example between the malaria cases seen and malaria cases tested. Clients seen and quantities dispensed. These are being investigated.

 Collecting monthly data from 90 districts is a big challenge. It is costly and requires a lot of time.

Routine Monitoring of field activities

During the quarter, the M & E staff provided technical support to a number of sub grantees implementing the different UHMG projects. Field visits were carried out in the HCU implementation sites in Mukono, Kamuli, Mbale, and Lira districts. The couple trainers tend to appreciate their roles speak a common language which is not the same among the peer educators. The use of the couple trainer’s manual tends to provide clear guidance in addition to the training they get. Mentoring of the SSECODA recruited M & E officer was carried out and the major areas of weaknesses affecting their data were highlighted. The GLCs were supported and those which never participated in the HMIS training were given the HMIS tools and mentored. Supported supervision and mentoring in data management were carried out for the trained drug shop operators. However, during data collection, the drug shop operators had not utilized them. There is therefore need for continued mentorship in data management so that the drug shop operators can appreciate the need to record data on service delivery and compile appropriate report.

Re-designing of the UHMG database

The process of re-designing the UHMG database to capture data generated through the monthly HMIS reporting forms and generation of appropriate reports started during the quarter. The data entry module was finalized and used to capture the data collected. Other modules one to generate use reports and the other to track work plan activity implementation are being developed. Based on this database, the M & E unit was able to generate service data on all services being supported at the GLCs. For details refer to the different program intervention areas.

Development of joint work plan with districts

This activity was put on hold until UHMG has signed MOUs with most districts. It has been pushed to year three work plan.

Planned activities

 Distribution of HMIS tools and provision of technical support to the GLCs especially the new ones  Training of the service providers from the new GLCs in HMIS  Training of HMIS new service outlets brought on board to provide long term FP methods and other services

51  Finalize the M & E data base and generate appropriate report  Collection and compilation of monthly data from the GLCs.  Compile data for annual review and reporting  UHMG database update( Routine activity)  Development of annual work plan  Support different department during work plan development  Installation of ArcGIS 10.1 and training three people  Upload of the AFFORD work plan in the UHMG database to facilitate it close monitoring

3. CROSS CUTTING ACTIVITIES AND SERVICES

3.1 MARKETING & STRATEGIC INFORMATION (MSI) – BRAND ACTIVITIES

Activity Performance Monitoring Table

Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved

Cotramox Annual target 4,900,870 2,999,130 22,620 62% Vs Annual Esther 7,900,000 Variance 2,976,510 Atuuse Quarterly target 1,975,000 Networking 6 institutions A networking Started on JCRC remained a w/decision makers workshop the process major supporter. in major institutions with of building and NGOs; increase institutions contacts. number from 4 to 8 offering services to PHLAs Detailing in health 459 640 1106 Detailing is currently and pharmacy pharmacies & pharmacy pharmacy/ on going countrywide. providers; posters 120 drug shop provider calls drug shop Feedback is that to improve brand calls made & 960 Health provider distributors requested visibility providers calls calls & 1702 for more support to Health deliver to areas social provider marketing areas that calls are not economically viable. Regional CMEs and 9 product 2 Not Stock uplift from the orientation orientation conducted, 52 meetings meetings In a Northern trade is still slow. the Eastern Uganda Region – 556 CME is Providers. scheduled. Distribution 6 Institutions Maintain Will continue to be in through 8 bought contacts. touch to prompt more institutions and RHU,IRCU leads. NGOS, pharmacies and health centres ICOBI,STAR SW,JCRU Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved Restors Advocate with MOH Attending Follow ups Popular Paed to +Zinkid targeting DHOs, MOH & CHAI endorse & feature on promotion & DHEs, POLs and meetings for media messages. uptake in VHTs on benefits of linkages. Participation in CHAI combination combination use meetings will use (UHMG brand) continue. Esther Atuuse Detailing to health 499 health 36 Health Media campaign has providers on providers provider, 26 been booked. combination use. 240 outlets GLCs Develop materials Concepts for Producing display for detailing and new campaign In progress. racks for the POS placement. route combination. Use radio, TV and developed & billboards for approved by Message demand creation to NDA. Developme run all year. nt in final stages.

Participate in health conferences for On plan. brand visibility Achieve annual sales of 2,000,000 sachets for Restors Restors: 1,040,580 12,648 Restors sales at 23.6% 459,420 Vs annual Budget.

53 Achieve sales Zinkid: 2,668,000 82,091 49.1% Vs Annual volume of 4,831,900 10,000,000 tablets for Zinkid Improve brand Media Mass media campaign awareness of the production in booked from Mid July. combination final stages. Increase availability, accessibility and visibility of RESTORS/ZINKID through 387 (75%) of pharmacies and 1,583 (60%) of drug shops in UHMG database Trainings & CMEs and trainings 6 facility based 7 conducted CMEs for of 1,000 HCPs in CMEs 855 Restors/Zinki public & private conducted in providers d sectors on central region; reached so Esther diarrhoea 147 attended far. Atuuse management and Product combination use. orientation meeting for drug association meetings in Eastern region; 556 providers were trained. Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved

Condom "O" Open 4,000 1121 Demand surpassed promotion additional ‘O’ forecast supply .Stock Jeanne outlets orders have been Marie (supermarkets, placed & to be Nakato dukas/kiosks, forwarded for hotels, lodges) approval.

54 Barbra A few outlets are still ,Joshua stocked.

Sales volume of 609,792 535,312 14,588 41.7% Vs Annual 1,500,000 pieces

1 mass media Radio – 7 TV ads 328 spots & mentions campaign (DJ stations running On on NBS & NTV endorsements, TV running + TV NBS and NTV and radio spots) (NTV) POS placement of Designs done, 10,000 posters and production & 5000 metal plates merchandising to proceed after outlet stocking. 12 regional concert 2 1 Participated in sponsorships NewVision Western Uganda events & O was heavily promoted. 8 ‘O’ theme nights 23 On hold , Theme nites in leading night awaiting scheduled to run clubs/bars per promotional concurrently with region campaign seasonal promo. Weekly supervision Trade visits done in visits to monitor Gulu, Mukono, activities. Mbarara, Bushenyi, Pursue corporate Mbale, Masaka, social responsibility Kasese, Kampala. collaboration. Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved PROTECTOR Achieve sales 5,247,780 2,999,180 51.6% Vs Annual promotion volume of 16,000,000 condoms.

55 Coordinate 1 done Done with STAR-SW activities with Job aide for Boda- MARPS program, Boda is being Boda Boda developed. campaign and Boda Boda associations Conduct mass Radio Promoted at CBS media (TV and interview Procured and radio) carried out on distribution on -going. Step and NBS stations Merchandizin Permanent 5,000 ABS boards at g on- going merchandizing POS, 20,000 t-shirts and materials were and caps for trade procured & well distribution of and consumer the materials received in outlets promotions in retail across the country. outlets . Distribution On-going MITs carried out in through existing Central region over networks and retail 15 trading centres in outlets (dukas, the month of July pharmacies and drug shops Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved AQUASAFE 5,400,000 tablets 1,860,640 1,769,680 208,160 34.5% Vs Annual promotion sold

Jeanne Promotions at 50 50 53 School workshop was Marie schools hosted for the Nakato Northern regions. 53 head teachers were oriented Increase 88 40 schools oriented, community and a major distribution points distributor in Soroti is to 180 supplying community outlets.

56 Partnerships with 1 - SNV Achieved a NGOs Partnership with SNV in west Nile in regards to Sanitation in 13 schools and surrounding communities - 1 KPI Oriented the communities around Kikajjo behind Aga Khan university with KPI. 1 plantation 2 Workplace activations orientation at KPI. & Over 200 staff attended. Workplaces trainings Plantation habitat training on plan with BIDCO & AAR Day of the African African child 2 Child. day – CSR Pictorial of the CSR Involvement in partnership partnership between Schools Rugby to with Vision Vision group and sample Aquasafe group UHMG Mass media using Mass media is 7 stations 830 spots booked for radio spots, talk running till and outdoor May-July in Central, shows and end of July in western, Northern, billboards. central and Eastern. other regions 84 Billboards& Sub- urban signs installed. Trainings & Community 5 Conducted in Eastern, demonstrati orientations. Central & Northern ons for Uganda. Aquasafe Jeanne Marie Nakato Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved

57 Injectaplan 2,800,000 vials sold 817,550 991,223 174,470 35.5% Vs. Annual promotion (650,000 CYP) Juliet Rumanyika Mass media (radio 37 Radio 3449 spots booked on talk shows) for Side talk shows Open Gate FM, Rupiny effects have been FM, Radio West, CBS, management conducted Super FM, Voice of w/providers on 7 radio Lango and Liberty FM. stations Radio talk shows by Sr. Gyns are also on ogoing. 5,000 providers 14 Health Trainings booked in trained on Providers various hospitals. counselling clients trained Detailing to 1,250 1,703 providers (gyn., Health midwives, nurses, providers drug shops, detailed to pharmacies) POS material: 5,000 100 health Materials procured posters, 10,000 providers brochures, fliers, ABS provider brochures, and 70 boards- 8,000 consumer Distributed. brochures. Participate in On plan. Plan for the Full conferences/exhibit Woman health camp ions for visibility in Q4. Coordinate with On-going GLCs promotion MNCH community starting in Q4 interventions to both promote Injectaplan and sales of Injectaplan through GLC ‘s. Increase access to Participating in Obs& Injectaplan through Gyn Association collaboration with events. NGOs and professional associations.

58 CMEs Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved Pilplanplus Achieve sales target 1,454,430 72,785 214,170 104.3% Vs. Annual promotion of 1,600,000 cycles

Detailing of 5,000 928 & 1572 providers outlets Exhibit at health 5 2 MUPSA – Mulago conferences school of Medicine and UPMPA – at hotel Africana. Mass media (TV, Communication radio) and billboard messages to be produced POS, promotional Materials and IEC materials, were 10,000 provider produced, brochures,8,000 pre-tested consumer leaflets. & 8,000 POS forwarded posters,1,000 t- to NDA for shirts approval. 1,000 lab coats,1,500 pens Collaborate with HCP, RHU, FHI, MSH, MOH, ENGAGE, UNAM- Uganda Nurses and midwives assoc, UPMA to increase access. Trainings & Conduct CMEs. 10 conducted 9 conducted Jinja RRH, Mbale RRH, CMEs for with 954 with 367 Tororo RRH, Arua Pilplanplus providers health RRH, Kuluva Hospital, Juliet providers Lacor Hospital, Teso Rumanyika safe motherhood, Louise MMC, Mengo

59 Hospital. Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved Moonbeads Achieve sales of 1800 1,254 23 31% Vs. Annual. Promotion 3,600 Sales anticipated to be increased this quarter. Humanitarian Care had a pending order for 576 pieces. Distribute 200 per 50 Had stock out, 5000 quarter though JMS additional pieces have been packaged.

Orient 320 HCPs Tororo RRH, Arua HCPs/Trainings and oriented RRH, Kuluva Hospital, CMEs 2 CMEs Teso safe motherhood, Louise Juliet MMC, Mengo Rumanyika Hospital. Coordinate with On plan. MNCH program in community interventions Increase access 1 Lacor Hospital through FBOs and conducted, training schools with 47 health providers Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved

NewFem Sales target of 8820 15,590 900 30% Vs. Annual promotion 40,000 cycles Detailing to 1,704 health providers in providers selective detailed to distribution points

60 Activations at On plan Initial contacts have corporate been made and workplaces using activities planned with direct marketing Mama Tendo. Mass media (radio, 3 Radio 655 spots booked on TV, billboards. stations + 1 radio, TV in 78 TV spots. central running Exhibitions 5 2 executed MUPSA – Mulago school of Medicine and UPMPA – at hotel Africana.

Exclusive—middle Conducted sales drive class—outlets for central region stocking NewFem. Brand Activities/Targets/ Q1 & Q2 Q3 Targets Actual Progress, Comments Outputs Achieved Softsure 72,000 cycles 46,680 6320 1,820 64% promotion (4,800 CYPs) Juliet Activations at ANC, Booked Planned for Q4 Rumanyika maternity homes and hospitals Target of 10 Booked Mulago. hospital maternity Louise Memorial centers promoting Softsure Nakasero Hospital Mengo Hospital Detailing to HCPs 26 providers Countrywide detailing (gyn., midwives, reached on-going. nurses, pharmacy dispensers) at private sector clinics Radio and TV 6 Media on- going till en adverts d of July

61 Participate at FP 2 executed MUPSA – Mulago exhibitions for school of Medicine visibility and UPMPA – at hotel Africana. Link Mothers clubs to ANCs with hospital-based activations Collaborate with MCP program for VHTS and community interventions Access through MSU, RHU, ´NGAGE, FHI, MSH, HCP Partner with fast- moving goods company targeting same audience (young mothers, breastfeeding mothers) Trainings & Conduct CMEs 9 Jinja RRH, Mbale RRH, CMEs for among HCPs conducted, Tororo RRH, Arua Softsure 367 RRH, Kuluva Hospital, providers Lacor Hospital, Teso reached. safe motherhood, Louise MMC, Mengo Hospital.

Progress of planned activities

CHILD HEALTH

Restors + Zinkid Restors is still challenged with a low uptake compared to its competitors, whereas Zinkid is at about 50% of annual target. The Zinkid target set was doubled anticipating a bid award from NMS which we lost. The gap has to be closed by end user and provider demand. Support campaign concepts have

62 been developed and approved by NDA. Production of mass media messages in final stages and media has been booked from Mid July. A merchandizing drive to display combination at outlets is on plan and orders for display racks have been placed. Strategically attending CHAI meetings with MOH for advocacy linkages.

Aquasafe Sales were higher in quarter 2 than 3. The re-purchase rate is quite slow and a carton can last a school for a term. Activities to enroll more schools continued. Another school workshop was conducted in Northern Uganda and 53 head teachers were in attendance. We received subsequent invitations to orient several schools and they procured Aquasafe. Old schools were also revisited to motivate new champions and to follow up stocks. This exercise will continue.

Advocacy partnerships were also initiated with the Hon. State Minister of Water & Environment who has picked interest and has school sanitation programs. The Hon. Minister of Education was also met and she committed to further discussions.

Other partnerships included, SNV, a Northern Uganda NGO with activities in over 40 schools. They invited orientations which were conducted. Also purchased products for donations.

HIV/AIDS

Cotramox Current buyers are still stocked, more networks to be created to widen base. A networking workshop which is aimed at interacting with institutional decision makers is scheduled next quarter. Good Life Clinics are also targeted for the uptake of Cotramox.

‘O’ Condom Demand surpassed supply and more stocks have been ordered. Distribution and merchandizing to start in the 2nd week of July. A promo to safe guard earned share & sustain gained sales was developed and pre-tested. Scheduled to run during the festive season.

PROTECTOR Stock supplies stabilized and a sales drive to stock outlets was conducted and it is on-going. A media campaign to support is on plan. Protector was heavily promoted during the CBS event promotion (Ekitobeero).

FAMILY PLANNING

Pilplanplus The market has been very receptive of PilplanPlus although providers approached acknowledged they needed more information to address change in combination and brand name. Provider brochures

63 were procured and are being distributed to Gyn and maternal medics. A brand campaign – “Heritage Route” has been developed and pre-tested. Awaiting NDA approval to launch mass media.

INJECTAPLAN Insights from Market impact teams reveal buyer behavior has shifted from bulk stocking to retail and they are indicators that traders need to be incentivized with a higher margin if they are to stock. A trade promotion is proposed to sell at a discounted price to uplift stock.

Family Planning radio talk shows kicked off and gyns are promoting Injectaplan and addressing side effect management. Spot Media placement is also heavy countrywide. Also talking to major referrals directly and direct orders have been placed in response. A trainer of trainers program is also on plan with senior medical workers in health facilities.

MOONBEADS New stocks have been packaged to supply pending orders and to meet increasing demand. With the new packaging a price increment is anticipated and key customers will be oriented on the new pricing. Focus in the next quarter is going to be on following up bulk buyers with the supporting them to educate their audiences and prompting more referrals.

SOFTSURE 3,449 radio spots running in Central, Western, Eastern and Northern Uganda. Discussions with maternity medic workers have been positive with most of them committing to recommend Softsure to the mothers. An advocate team amongst health providers will be oriented to educate mothers on our behalf. Mengo hospital which is highly targeted to kick start these activities receives about 200 mothers a week on immunization and ANC days. Daily deliveries recorded range from 25-50. Corporate activations are also planned in the next quarter to educate working mothers.

NEWFEM Media is running. Urban outlets have been stocked and merchandised. Corporate activations are planned. Below the line, Newfem will be promoted with Genext University activations and corporate activations.

3.2 MARKETING & STRATEGIC INFORMATION (MSI) - COMMUNICATION

Activity Performance Monitoring Table

64 Campaign Mass Media Interactive Media/Interpersonal Activations

Small families- Advocacy Campaign in full gear 60 GENEXT advocates trained in GeNext Phase 2 adverts have been developed Advocacy and Community mobilisation in Luo, Luganda, Runyakitara and skills Lea Atesot and are being pre-tested. An Advocacy Toolkit consisting of 6 Bwanika/Daudi English pre-tested and running documents to provide advocates with guidance during community activations Radio has been booked for July-Aug was developed. on 10 stations both upcountry and in Kampala. Advocates will conduct 3 community dialogues each week reaching at least 90 people in next 8 weeks. A total of 1440 community dialogues to be conducted. 43200 people expected to be reached with the message on Smaller families. Other activations to be carried out through community gatherings and events. Interacting and receiving feedback from 33176 GENEXT subscribers on the SMS platform. HCT- Sexual Campaign has stopped in urban STAR-SW scale up Network areas. 20 Billboards erected Campaign Scale Campaign has been scaled up in rural up and condom areas by STAR-SW in 13 districts of 10,000 posters printed and promotion Western Uganda distributed Began 17 months Radio Interpersonal communication Campaign on 15 Radio Daudi/Mariettah ongoing. Reached 1,826 stations in western people with HIV risk Uganda. reduction messages and summary is below; 2340 Radio spots aired STAR EC scale up 3660 Radio adverts aired. STAR EC has rolled out Star EC Scale up campaign in East and Central Star EC running Radio advertisements Uganda and Condom Promotion is on going through community activations and interpersonal

65 communication. Work with SPEAR on scale up has began

ANC Media campaign running on 13 Radio 1000 posters pinned up stations all over the Western part of (Lea the country. Bwanika/Daudi) 10,128 DJ mentions

9708 Radio spots aired 94 Radio talk shows conducted PMCT PMTCT Communication Strategy developed Creative briefs developed and forwarded to agency. Concepts developed Power of Day One Media booked for May-July 68 Taxis have been branded with Power (Lea/Daudi) 30 Radio talkshows aired on 4 Radio of Day One adverts. stations 7 billboards on various highways 1040 Radio spots aired 40 Road stars Interpersonal communication stalled for lack of Malaria Program Officer Get Ready To roll Follow up for peer educators job Boda-Boda aided drafted awaiting approval Campaign

(Mariettah) MNCH/FP Smart choices campaign Smart choices campaign (Sarah Mutesi) DJ mentions airing in Hoima ahead of Formulation of model villages in the World Population Day. districts of Kyenjojo & Kabarole (SMGL) Radio announcements for 3 days in Integrated messages in Community Mpigi on FP service provision. sensitization and home visits in Lira, Serere, Mbale and Mukono

SMGL Campaign Communication strategy developed and 2 concept pre-tests done 3 Partner and 1 district meeting held.

66 Radio scripts developed Job Aides developed Campaign sign off by MOH done. Ran 7 Radio takshows Documentation of SCIPHA Aired 378 Radio spots activities in Midwest, North SCIPHA Run 378 DJ mentions and East

Run SMS chartroom and (Ritah Mwagale) developed an implementation plan.

3.3 MSI - Research

Retail Audit: The retail audit survey which is meant to Provide information to UHMG about the sales, stock and distribution of its brands and its competitor brands on a quarterly basis; Track end consumer price paid for by consumers for UHMG/AFFORD brands; Track the reach of each of its brands in terms of availability in number of outlets by outlet classification... Health outlets (pharmacies, drug shops, clinics) General Merchandise outlets (dukas, supermarkets, grocery stores) and estimate relative market share of its brands census was commissioned within the quarter. Results of the retail audit;

The retail audit census yielded a total of 570 Registered Pharmacies, 2,403 registered clinics and 6,038 drug registered drug shops countrywide.

A sample size of 1100 health outlets was derived from the total sample of 9011. The table below shows retail sales for May.

Table of product overall performance by region by percentages – for May

Products Ka Mi Nor C No No So So Tot D C Ph % per mp d th e rth rth ut ut al – ru li ar produc ala W East n Ce W h h n=1 g n ma t est ern ntr est W Eas 100 S i cy (all t er al er est ter h c regions n r n er n o ) a n p l Protector 50 49 51 56 62 74 93 48 652 60 54 49 59%

Pilplan Plus 50 58 45 61 35 45 96 46 642 57 62 40 58%

Injectaplan 45 55 21 56 02 0 90 39 536 44 59 41 49%

67 Zinkid 35 51 38 08 30 34 36 32 342 24 43 44 31%

Restors 12 27 10 27 11 03 86 14 314 29 26 19 29%

Condom O 20 05 09 08 0 0 09 02 86 4 11 36 8%

Aquasafe 04 05 24 04 05 09 13 05 83 08 07 09 8%

Softsure 11 03 04 05 01 0 08 02 56 03 08 19 5%

Cotramox 01 02 0 01 0 0 11 0 26 02 03 04 2%

Newfem 03 02 01 02 0 0 06 01 26 01 04 10 2%

Moonbeads 03 02 0 02 0 0 0 01 14 01 02 04 1%

Formative research to examine the knowledge, attitudes and behaviours of commercial sex workers and fisher folk: This study is planned to help UHMG better understand the attitudes and behaviours of these unique populations. Information from these studies will be used to fine-tune the organization’s interventions. These KAPs will primarily use qualitative methods, including focus groups with fisher folk and sex workers. Target groups have been identified, Tools have been developed and refined, and fieldwork is scheduled to be conducted next quarter.

Pre-test for GeNext phase II (mobilized by youth) campaign materials: The pre-tests, mainly qualitative in nature, were conducted to get stakeholders’ understanding the materials before final production for dissemination. Pre-testing included determining if the poster is convincing to the target audiences, to find out if the audience understands the translated poster, to establish if the audience relates to the campaign poster, to establish if the posters are offensive or confusing, to establish if the poster is attractive to the audience and to understand if the wording in the poster is appropriate.

Concept tests for Saving Mothers Giving Life materials: The overall objective of the concept tests was to select the concepts that best communicate the new campaign. To establish whether the audience relate to the proposed concepts, To establish whether there is anything that is offensive/ confusing in the concepts and establish if the concepts are attractive to the audience and select the one that would be most effective. Finalizing focus group reports inform production of campaign messages.

USAID_IP joint BCC survey

68 The study is jointly conducted by implementing partners to evaluate the reach and affects of behaviour change communication efforts by a number of implementing partners. Progress to date: . Survey protocol developed and submitted to IRB for approval . Tools developed and being refined and submitted to IRB for approval . Districts for the survey selected . Sample size determined . Training manuals developed

Next quarter activities . MARPS qualitative research . Joint USAID BCC-IP’s survey . Pre-tests of various communication materials . Rapid assessment of brands interventions . Coordinate data collection of the retail audit and share findings with the brands and distribution teams.

3.4 MSI Cross-Cutting Functions - Corporate & External Relations

69 Activity Description Outputs Progress, Comments Build Strategic Partnerships Organize Uganda Rugby Union - In advanced discussions to penetrate professional & strategic of promoting O in events. Local communities meetings with SNV - Community NGO in N.Uganda, working potential donors together to advance Aquasafe in schools. Evelyn/Team and partner organisations to Barclays Bank - Proposal to purchase FP advance the goals products for hospital donations & joint of UHMG activations under consideration. IAA - Discussing implementation of joint health fairs. AAR – Discussing BIDCO plantations Kalangala health camps. Newvision & Day of the African Child - Participated in joint CSR at Kireka Special needs home, Aquasafe received publicity. Newvision has also received a proposal to purchase Aquasafe for their CSR. CBS Station - Associated with their prime event (Ekitobeero) to promote Protector & Aquasafe. Pepsi - Receptive in working with UHMG & we expect a briefing on CSR areas of interest. Centenary Bank - Proposal to purchase Aquasafe submitted. Waiting for a response. Mengo Hospital - Invited continuous FP education. Website Upgrade Information Compiling content, resource technical people dissemination identified. Evelyn/Team Publishing of the Annual Update Copies to be published and disseminated by report stakeholders of 20/7. UHMG’s annual Evelyn/Team progress Good Life (GL) umbrella Develop & Strategy approved by BOD, implementation has brand revamp implement GL started with conducting of a Baseline mini study strategy to guide messaging. Evelyn/BCC team Preparation of the AGM- Evaluation Organisation Committee was formed and preps Event set for 10th August Institutional have started. performance Evelyn/Lea/Joyce Kaija Health Marketing Steer meetings to Abstract submissions received from key 70 UHMG and Vision Group partnership - Kireka school for the disabled (orientation of Aquasafe and donations were given by both UHMG and Vision group staff to support the school children on the Day of the African Child)

Protector Condom, Condom ‘O’ & Aquasafe Exhibition during CBS event (Ekitobeero) in Nakivubo

MNCH & FP CME & Detailing Activities

71 Jinja Regional Referral Hospital Diarrhea management using Orientation on Moonbeads at Lacor Restors & Zinkid Hospital (Gulu)

UHMG Products orientation at Lira Regional Referral Hospital

Detailing at Teso safe Diarrhea Management CME using Motherhood in Soroti at Lira Regional Referral Hospital

3.5 HUMAN RESOURCES & ADMINISTRATION (HRA)

Human Resource Management

Recruitment

S/N POSITION STAFF NAME START DATE 1. SCIPHA Project Support Coordinator James Okweny 1st May 2012 2. Finance Manager – Product Facility Moses Kafeero 2nd May 2012 3. STRIDES Project Coordinator Anne Kyomugisha 2nd May 2012 4. STRIDES Project Assistant Hadijah Kibirige 2nd May 2012 6. Project Manager – Reproductive Health Dr. Margaret Elang 2nd May 2012 7. Driver – Head Office Joseph Kasozi 26th June 0212 8. Driver – Product Facility John Moses Mubbale 27th June 2012

Exited staff

S/N POSITION STAFF NAME END DATE 1. Transport Officer Paddy Kabega 26th April 2012 2. Malaria Program Officer Anne Kusiima Otedor 30th April 2012 3. Driver – Product Facility Godfrey Tusiime 10th May 2012 4. Reproductive Health Manager Sylvia Margaret Namulema (RIP) 13th June 2012 5. Deputy Project Manager - SCIPHA James M. Mukankusi 21st June 2012 72 Closure of the SCIPHA I Project: The SCIPHA I Project ended on 30th June 2012. We held a close-out meeting with the SCIPHA staff to appreciate their efforts towards completing this project, and prepare them for the exit process.

Human Resource Audit: Separate meetings were held with the Human Resource Board Committee, as well as with AFFORD and KPMG to review the Terms of Reference for the Human Resource Audit expected to commence in July 2012. This exercise is meant to assess and improve current staff capacity against existing job descriptions and key result areas, and to also assess if the JDs & KRAs are well-aligned to the organization’s goals and objectives

Insurance Coverage for all staff: As per policy and statutory regulations, the medical insurance cover was renewed with Jubilee Insurance Uganda Limited for the period 1st May 2012 to 30th April 2013, and Group Personal Accident renewed with Chartis Insurance Company Uganda Limited for the period 13th June 2012 to 12th June 2013.

Staff demise: We lost one our staff (the Reproductive Health Manager) on 13th June 2012 at International Hospital Kampala due to illness. She was buried on 15 th June in Mbirizi along Masaka-Mbarara road. “MAY SYLVIA MARGARET NAMULEMA’s SOUL REST IN ETERNAL PEACE”.

Meetings/Workshops held: Four (4) all-staff meetings during this quarter on 30th April, 11th May, 22nd June, and 29th June 2012 to discuss staff and welfare issues, and emphasize policy and compliance requirements. Staff were reminded on 19th June about unallowable costs with the US Government funds.

A staff satisfaction survey was conducted in May 2012, and results shared on the employees’ feedback to their working conditions and welfare, health and safety standards, job security, staff credibility, supervisor/supervisee relationship, departmental co-operation, timely communication, employee recognition, job loads, competence, performance standards and feedback, job advancement and professional growth, training opportunities, salary structure and fringe benefits, and current policies and procedures in place. Only 37 out of 91 staff participated in this exercise.

During the 29th June meeting, Kellie Klein (the International Finance and Operations Manager with Johns Hopkins University School of Public Health) had a refresher training with staff on accountability, compliance issues, budgeting and planning, performance evaluations, conflict of interest, and unallowable costs among others. We also shared our policies with her for review to ensure compliance with USG donor regulations.

The Human Resource & Administration Manager attended a Workshop at International Rescue Committee on 21st June 2012, where better payroll management and staff performance management were discussed with HR professionals in the INGO (International Non-Government Organizations) HR Network.

The Managing Director attended the Strategic Leadership training in June 2012 in Baltimore, USA.

Performance Monitoring: Staff appraisals continued during the quarter. New staff that successfully completed their probation were confirmed in employment. Staff were also reminded about the importance of time management, and weekly reports on staff time and attendance were shared.

Staff Birthdays: We continued to recognize staff birthdays which has motivated staff to belong and feel attached to the UHMG family.

73 Governance

Board of Directors and Board Committee meetings: In order to provide further guidance to management on UHMG’s strategic direction, the Board Committees’ quarterly meetings were held between April 16 th and 20th 2012 and the Board of Directors’ meeting on May 5, 2012. We also held a Board of Directors and Founder Members’ retreat during the quarter at Lake Victoria Serena Resort from May 4th to 6th, 2012. The retreat was aimed at addressing the structural and regulatory changes and adjustments required for growing organizations.

The Technical Board Committee held a Strategic Retreat on June 8 th and 9th 2012 at Country Lake Resort Garuga to discuss the revised strategies on Good Life Clinics, Resource Mobilization, and Communication. The Business Development and Finance & Planning Board Committees held a joint meeting on 16th June 2012, at the UHMG offices to further discuss UHMG’s strategy for sustainability beyond 2013. The meeting was attended by both Board Committee members and staff across the directorates (Product Facility, Marketing and Strategic Information, Finance & Investment, and Human Resource & Administration). The Human Resource, Finance & Planning, and Audit & Risk Board committees held a joint meeting on May 1st 2012 to review the current pay and fringe benefits of employees. They deferred the fringe benefits adjustments to the next financial year in October 2012.

Administration Management

Office security: We continued to remind staff about their safety, both at and after working hours. Security Group was contracted to provide security for the regional pharmacies in Arua and Mbale. Requisitions were made to procure additional security gadgets.

Hotel Survey: The survey to review the corporate agreements with country-wide hotels, and identification of new facilities that started in March 2012 continued. In the quarter, the following districts in the Western and Mid-western regions were covered: Mpigi, Masaka, Mbarara, Kibaale, Hoima, Buliisa, Masindi, Kigumba, Nakasongola and Luwero were covered. South- western and West Nile Regions will be done in the first month of the next quarter.

Asset Management

Proper management of our new office premises was ensured. Minor repairs were done on electricity, office doors and plumbing. We also received and engraved USAID assets from the closed UMEMS project.

Procurement Management

Annual Procurement Contracts: Excel Forwarders & Transporters Ltd was selected as the providers for vehicle hire services for the period ending 30th September 2013. Africa General, Motors Ltd, Kalumba and Sons, Toyota Uganda Ltd, Cooper Motors, Victoria Motors, Motor Centre were recommended to the Procurement Committee as the service providers for vehicle servicing and maintenance. Service contracts will be endorsed in the next quarter if agreed upon.

Annual Procurement Planning: KPMG reviewed our procurement plans, and recommended two versions i.e. Directorate Procurement plans and a Consolidated Procurement plan. During the month of May

74 2012, KPMG trained staff on how to prepare procurement plans, and their importance. The Consolidated Procurement Plan will be completed in July 2012.

Vehicle disposal: Concurrence was received from USAID to dispose off UAK 309Z, the Toyota pick-up that was badly damaged in an accident in February 2012, and eventually recommended as a write-off by the suppliers and insurers.

ICT (Information, Communication, and Technology) Management

New file server and domain controller: In April 2012, UHMG procured a new file server to replace the old one. The UHMG.ORG domain was installed afresh on this new server. The server was configured as a Domain Controller and as a File Server. In addition, the new server was set up with the new Windows 2008 Server which was an upgrade of the Windows 2003 Server software that was on the old server. All user accounts and domain policies were also reconfigured in line with the upgrade to facilitate more efficient network and systems management.

Preparation of HRMIS User Specifications: From the month of April through May, UHMG together with a consultancy firm (Data Care Ltd) prepared the User Specifications for a Human Resource Management Information System (HRMIS). This system is to help UHMG’s Human Resource Directorate and UHMG as a whole to streamline systems and administration processes in areas such as recruitment of staff, employee data management, and systems linkages with other directorates. A corresponding Terms of Reference document is currently being prepared to facilitate the procurement of the above mentioned system in the next quarter.

Local Area Network improvement: During the quarter, the UHMG Local Area Network was upgraded, and the Product Facility was connected to the same Local Subnet as the Head Office to facilitate faster data transfers across the network, and timely data back-ups.

Upgrade of all Accounting Software: The Tally.ERP9 Software that is used by the UHMG Accounts Team was upgraded in June 2012 from Tally ERP9 release 2.1 to release 3.4. This was done to enhance on the packages that the new Tally.ERP9 release offers and to provide fixes for software bugs in the previous release.

Simcard Registration of office phone lines: The compulsory simcard registration required by Uganda Communications Commission was effected in May 2012 when all office phone lines assigned to staff on our CUG (Closed User Group) were registered with Airtel Uganda Limited. This was as a result of a government directive to all Telecom operators in Uganda.

Transport Management

Additional Vehicles: Two vehicles (UAR 141G and UAR 186G) were received on 4th June 2012 to support our field activities. Thanks to USAID and AFFORD for their support in the tax exemption registration

75 process. The two Toyota Double Cabin Pick-ups below are to be branded during the next quarter after canopies have been procured. The procurement process for the branding and canopies is already underway.

Back view Front view Vehicle Policy and travel: Improvements were made to the Vehicle Policy and fuel management guidelines shared with “driving” staff. A drivers’ meeting was also held on 6 th June to improve vehicle management and operations. Monthly travel plans for the three (3) months were shared with all staff in advance to improve coordination of field activities.

Legal Management

Mediation and arbitration meetings: Held meeting with URA officials, our Board of Directors, and our tax consultants (Deloitte and Touché) on 14th June 2012 to defend our request to grant UHMG a tax exemption status.

Contract and document reviews: A number of contracts were reviewed and finalized during the quarter; Debt Collector (John Bosco Tugume Bosco), Investigative Auditor (Masiko Kabumba), Daewon Suppliers from India, Excel forwarders and transporters, and addendum for D-mark, KPI and HCU, MSU-4 way agreement, Spear implementing project, teaming agreements with World Vision, CDFU and DSW, HCU-addendum, agreements with the Good Life Clinics), and PHI (to strengthen capacity to GLCs). Completed a third party intermediary questionnaire required by US Foreign Corrupt Practices Act and Local Anti bribery law and submitted it to AFFORD.

Research and Opinions: Research was made and opinions written on the status of the pharmacists at registration level with NDA (National Drug Authority); remission of statutory payments of temporary staff with NSSF; relevance of having a third agency (Saatchi & Saatchi) for PR; as well as tax exemption and corporation tax regarding UHMG’s status. 76 Reviewed the legal component of the Jul-Dec 2011 Internal Audit Report, and shared responses with Kisaka and Company on the re-employment of casual laborers, Good Life Clinics (GLCs) contracts, Reputational risks with our partners, Integrity and ethical issues on publishing condoms without set age limits, and the terms of our Memoranda of Understanding (MOUs).

Reviewed UHMG’s Income Tax Returns for the period 2006 – 2011 and filed them with URA.

CONSTRAINTS AND CHALLENGES IN OPERATIONS

Human Resource Management  Uncompetitive salary scale within the current market to attract new and motivate current employees.  Non-communication of staff absence.

Administration Management  Storage of materials and products  Eating space continues to be a challenge as a canteen is not yet in place.

Procurement Management  Un-planned activities causing procurement emergencies  Delays in supplier payments that discouraged them from engaging in further business prospects

ICT Management  The delay in the supply of the new File Server by an extra month resulted delayed installation and user migration onto the new system. This has also resulted in delays in upgrades of client operating systems.

Transport Management  The exit of the Transport Officer and one driver constrained the available human resources.  Emergency travel requests continued despite the request for earlier planning.

PLANS FOR THE NEXT QUARTER

Complete and submit the Work Plan, Budgets, and Procurement Plans for the next financial year (FY8:Oct2012-Sep2013) by August 2012.

Governance  Finalize Board Manual and Memarts (Memorandum and Articles of Association)  Hold the 4th quarter board of directors and board committee meetings in July 2012  Hold the Annual General Meeting in August 2012

77 Human Resource Management and Development  Work with KPMG to commence the Human Resource Audit process  Finalize recruitment of the Malaria Program Officer, Brand Officer, and Maternal & Child Health Officer. Interviews were completed  Orient staff on the Level of Effort reporting tool  Hold annual staff team building event  Recognize outstanding employees

Administration Management  Finalize country-wide hotel survey in Northwestern, Western and Southwestern Uganda and share report with staff  Hold Staff and Departmental meetings as per 2012 schedule  Disseminate the revised office policy and procedures to all staff after board endorsement  Improve administration management systems and operations with KPMG support and guidance

Property Management  Carry out physical verification of assets and prepare a comprehensive report on all project assets  Finalize process of obtaining a tenant for the second floor

Procurement Management  Finalize the directorate and consolidated procurement plans for 2011-2012 and the 2012-2013  Disseminate the revised procurement policy and guidelines to all staff after KPMG’s revisions and board endorsement  Procure two (2) additional vehicles for our field operations  Finalize the procurement process for the construction of the warehouse extension

ICT Management  Upgrade of all user desktop computer operating systems to Windows 7  Procure Wireless Access Point, Microsoft Windows Server 2008 Enterprise, Microsoft Windows Server Operating Client Access License, Microsoft Windows Rights Management Client Access License, Adobe Creative 5.5 Master Suite Software, Resource Centre WorkStation, and Stata (5 licenses)  Install the Human Resource Management Information system, and work with Data Care on the staff orientation process and after-sales support  Upgrade of Internet link from WiMAX to Fibre optics  Orient staff on better file and document management with the new file server  Finalize the identification process for an off-site data back-up provider  Carry out quarterly equipment maintenance and service  Procure two overhead ceiling mounted projectors  Disseminate the revised ICT policy to all staff after KPMG’s revisions and board endorsement

Transport Management  Procure canopies for the new vehicles, brand the new and re-brand some old vehicles  Improve the control measures in place for fuel consumption and vehicle maintenance to realize value for money  Disseminate the revised vehicle policy to all staff after board endorsement

78  Carry out the defensive driving refresher course for all “driving” staff  Dispose-off three vehicles, i.e. two Nissan pick-ups (UAP 705P and UAP 099Q) and one Toyota pick-up (UAK 309Z) that was involved in an accident, following receipt of USAID’s concurrence

Legal Management  Compile matrix on pending legal issues  Complete the endorsement of UHMG’s contracts with the Good Life Clinics country-wide.

END OF REPORT

79

Load more

  0

Copy Link