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Usaid/Uganda Private Health Support Program (June 2013-June 2018)

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Usaid/Uganda Private Health Support Program (June 2013-June 2018) USAID/UGANDA PRIVATE HEALTH SUPPORT PROGRAM (JUNE 2013-JUNE 2018) FINAL REPORT Contract No.: AID-617-C-13-00005 C Mothers and infants awaiting treatment at St Francis Health Care Services in Njeru (January 2018) September 2018 This report is made possible by the support of the American People through the United States Agency for International Development (USAID). The contents of this report are the sole responsibility of Cardno Emerging Markets USA, Ltd. and do not necessarily reflect the views of USAID or the United States Government. USAID/UGANDA PRIVATE HEALTH SUPPORT PROGRAM (JUNE 2013-JUNE 2018) FINAL REPORT Submitted by: Cardno Emerging Markets USA, Ltd. Submitted to: USAID/Uganda Contract No.: AID-617-C-13-00005 DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. USAID/Uganda Private Health Support Program Table of Contents ACRONYMS ............................................................................................................................................................. III EXECUTIVE SUMMARY ........................................................................................................................................... 1 CONTEXTUAL OVERVIEW ..................................................................................................................................... 4 PROGRAM OBJECTIVES ............................................................................................................................................ 5 PROGRAM IMPLEMENTATION AND RESULTS ................................................................................................ 7 OBJECTIVE 1: EXPANDED AVAILABILITY OF HEALTH SERVICES BY PRIVATE SECTOR PROVIDERS. ...................... 7 1.1. Expanded Access and Availability of Health Services .......................................................................... 7 1.2. Expanded OVC service delivery ............................................................................................................ 18 1.3. Increased Access to Capital and Business Services .......................................................................... 24 OBJECTIVE 2: INCREASED AFFORDABILITY OF PRIVATE HEALTH SERVICES AND PRODUCTS .......................... 35 2.1. Financing strategies for services delivery ............................................................................................. 35 2.2. Reduced financial barriers to accessing health services .................................................................... 38 2.3. Supported Establishment of Effective Price Regulation Policies ...................................................... 40 OBJECTIVE 3: IMPROVED QUALITY OF PRIVATE HEALTH SECTOR FACILITIES AND SERVICES ............................. 44 3.1. Strengthened Technical Skills of Service Providers ............................................................................ 44 3.2. Established Voluntary Accreditation Program ...................................................................................... 47 3.3. Strengthened Professional Councils ..................................................................................................... 47 3.4. Improved HMIS ......................................................................................................................................... 48 3.5. Fostered Policy-Enabling Environment for the Private Health Sector .............................................. 48 3.6. Supported Building a More Cohesive and Capable Private Sector .................................................. 49 3.7. Strengthened Medical Bureaus and faith-based health networks ..................................................... 50 GRANTS UNDER CONTRACT .................................................................................................................................... 52 MONITORING, EVALUATION, AND LEARNING .......................................................................................................... 53 SUSTAINABILITY ....................................................................................................................................................... 53 PROGRAM MANAGEMENT ....................................................................................................................................... 54 CONSTRAINTS AND CHALLENGES .................................................................................................................. 55 LESSONS LEARNED .............................................................................................................................................. 57 THE WAY FORWARD ............................................................................................................................................. 58 APPENDICES ........................................................................................................................................................... 60 APPENDIX 1: PERFORMANCE INDICATORS DATA TABLE (PMP) ............................................................................ 60 APPENDIX 2: MAP OF PHS PROGRAM INTERVENTIONS AND DISTRICTS SUPPORTED.......................................... 66 APPENDIX 3: LIST OF IMPLEMENTING PARTNERS ................................................................................................... 67 APPENDIX 4: DISAGGREGATED DCA LOAN DATA .................................................................................................. 74 APPENDIX 5: LIST OF REPORTS AND DOCUMENTS DEVELOPED UNDER THE PHS PROGRAM............................. 76 APPENDIX 6: DETAILED ANNUAL OVC DATA ........................................................................................................ 78 APPENDIX 7: PRIVATE SECTOR STRATEGY ............................................................................................................ 80 APPENDIX 8: SELECTED PHS PROGRAM SUCCESS STORIES ............................................................................... 83 Final Report Page ii USAID/Uganda Private Health Support Program Acronyms A2F Access to Finance AGYW Adolescent Girls and Young Women ANC Antenatal Care ART Anti-Retroviral Therapy ARV Antiretroviral BDS Business Development Services Cardno Cardno Emerging Markets USA, Ltd. CBO Community-Based Organization CDCS Country Development Cooperation Strategy CDOs Community Development Officers CLA Collaborating, Learning and Adapting CPD Continuing Professional Development CWD Children with Disabilities DCA Development Credit Authority DHIS 2 District Health Information System 2 EID Early Infant Diagnosis EMHS Essential Medicines and Health Supplies List FBO Faith-Based Organization FP Family Planning GOU Government of Uganda HaaB Health as a Business HCB Healthcare Business HIPS USAID/Uganda Health Initiatives for the Private Sector Project HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome HMIS Health Management Information System HMO Health Management Organization HSS Health Systems Strengthening HTC HIV Testing and Counseling IDI Infectious Diseases Institute IHA Insight Health Advisors IPT Isoniazid Preventive Therapy IPTp Intermittent Preventive Treatment of Malaria in Pregnancy IRCU Inter-Religious Council of Uganda IUD Intra-Uterine Device KCCA Kampala City Council Authority MGLSD Ministry of Gender, Labor and Social Development MNCH Maternal, Newborn and Child Health Final Report Page iii USAID/Uganda Private Health Support Program MOH Ministry of Health NDA National Drug Authority NHIS National Health Insurance Scheme NTLP National Tuberculosis and Leprosy Program OVC Orphans and Vulnerable Children OVC MIS Orphans and Vulnerable Children Management Information System PEPFAR President’s Emergency Plan for AIDS Relief PFP Private for Profit PHP Private Healthcare Provider PHS USAID/Uganda Private Health Support Program PITC Provider-Initiated Testing and Counselling PLHIV People Living with HIV PMTCT Prevention of Mother-to-Child Transmission PNFP Private Not-For Profit PPPH Public-Private Partnerships for Health PSA Private Health Sector Assessment QI Quality Improvement SACCOs Savings and Credit Co-operatives SMC Safe Male Circumcision SQIS Self-Regulatory Quality Improvement System STI Sexually Transmitted Infection TB Tuberculosis TT Tetanus Toxoid UHC Universal Health Coverage UHF Uganda Healthcare Federation UMA Uganda Manufacturers Association USAID United States Agency for International Development USG United States Government VHTs Village Health Teams VMMC Voluntary Medical Male Circumcision VSLA Village Savings and Loan Association WAOS Web-based HIV/AIDS Ordering and Reporting System Final Report Page iv USAID/Uganda Private Health Support Program Executive Summary USAID/Uganda Private Health Support Program (the PHS Program) was a USAID-funded 5-year, $37.4 million flagship program in the private health sector in Uganda. Its goal was to improve the credibility and cohesiveness of the private sector and expand the capacity of service providers. The Program provided technical expertise, enhanced quality standards, improved access to capital, supported accreditation, and empowered professional associations and advocacy groups to provide leadership in the private sector. The Program sought to achieve this through three main intermediate results: 1) Expanded availability of health services by private providers; 2) Increased
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