Health Sector Ministerial Policy Statement

THE REPUBLIC OF UGANDA

THE REPUBLIC OF UGANDA HEALTH SECTOR MINISTERIAL POLICY STATEMENT MINISTERIAL POLICY STATEMENT FINANCIAL YEAR 2020/2021 MINISTRY OF HEALTH PLOT 6, LOURDEL ROAD, NAKASERO P.O.BOX 7272, KAMPALA www.health.go.ug BY DR. JANE RUTH ACENG, THE HON. MINISTER OF HEALTH

FINANCIAL YEAR 2020/2021 THE REPUBLIC OF UGANDA

HEALTH SECTOR

MINISTERIAL POLICY STATEMENT

BY DR. JANE RUTH ACENG THE HON. MINISTER OF HEALTH,

FINANCIAL YEAR 2020/2021

FINANCIAL YEAR 2020/2021 THE REPUBLIC OF UGANDA

HEALTH SECTOR

MINISTERIAL POLICY STATEMENT

BY DR. JANE RUTH ACENG THE HON. MINISTER OF HEALTH,

FINANCIAL YEAR 2020/2021

FINANCIAL YEAR 2020/2021 Health Ministerial Policy Statement for FY 2020/21

PB 1 Ministerial Policy Statement FY 2020/21

Abbreviations and Acronyms

ABC Abstinence, Be faithful and use Condoms ACP AIDS Control Programme ACT Artemisinin Combination Therapies ADB African Development Bank AFP Acute Flaccid Paralysis AHSPR Annual Health Sector Performance Report AI Avian Influenza AIDS Acquired Immuno-Deficiency Syndrome AIM AIDS Integrated Management AMREF African Medical Research Foundation ANC Ante Natal Care ARC Alliance for Rabies Control ARCC African Regional Certification Commission ART Anti Retroviral Therapy ARVs Antiretroviral Drugs AT Area Team AWP Annual Work Plan AZT Azidothymidine BCC Behavioural Change and Communication BEmOC Basic Emergency Obstetric Care BFP Budget Framework Paper BOP Best Operational Practices CAP Consolidated Appeal Process CB-DOTS Community Based TB Directly Observed Treatment CBDS Community Based Disease Surveillance CBGPM Community Based Growth Promotion Monitoring CCM Country Coordination Mechanism CDC Centre for Disease Control CDD Control of Diarrheal Diseases CDP Child Days Plus CFR Case Fatality Rate CHC Community Health Clubs (for Environmental Health) CL Credit Line CLTS Community Led Total Sanitation

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Abbreviations and Acronyms Abbreviations and Acronyms

ABC Abstinence, Be faithful and use Condoms CMD Community Medicine Distributor ACP AIDS Control Programme CME Continuing Medical Education ACT Artemisinin Combination Therapies COCTU Coordinating Officer for the Control of Trypanosomiasis in Uganda ADB African Development Bank CORPS Community Owned Resource Persons AFP Acute Flaccid Paralysis CPD Continuing Professional Development AHSPR Annual Health Sector Performance Report CQ Chloroquine AI Avian Influenza CSO Civil Society Organization AIDS Acquired Immuno-Deficiency Syndrome CYP Couple Years of Protection AIM AIDS Integrated Management DANIDA Danish International Development Assistance AMREF African Medical Research Foundation DBFP District Budget Framework Paper ANC Ante Natal Care DCCAs District Cold Chain Assistants ARC Alliance for Rabies Control DDT Dichlorodiphenyltrichloroethane ARCC African Regional Certification Commission DfID Department for International Development (UK) ART Anti Retroviral Therapy DGHS Director General of Health Services (of the Ministry of Health) ARVs Antiretroviral Drugs DHO District Health Officer AT Area Team DHT District Health Team AWP Annual Work Plan DISP District Infrastructure Support Programme AZT Azidothymidine DLT District League Table BCC Behavioural Change and Communication DOTS Directly Observed Treatment, short course (for TB) BEmOC Basic Emergency Obstetric Care DPOs Disabled Persons Organisation BFP Budget Framework Paper DPs Development Partners BOP Best Operational Practices DPT Diphtheria, Pertussis (whooping cough) and Tetanus vaccine CAP Consolidated Appeal Process DTLS District TB/Leprosy Supervisor CB-DOTS Community Based TB Directly Observed Treatment DTS Dried Tube Specimen CBDS Community Based Disease Surveillance DVS District Vaccine Stores CBGPM Community Based Growth Promotion Monitoring EAC East African Community CCM Country Coordination Mechanism EAIDANet East African Integrated Disease Surveillance Network CDC Centre for Disease Control ECN Enrolled Comprehensive Nurses CDD Control of Diarrheal Diseases ECSA East Central and Southern Africa CDP Child Days Plus EDP Epidemic and Disease Prevention, Preparedness and Response CFR Case Fatality Rate EGPAF Elizabeth Glaser Pediatric Foundation CHC Community Health Clubs (for Environmental Health) EHD Environmental Health Division CL Credit Line EHMIS Environmental Health Management Information System CLTS Community Led Total Sanitation EHP Environmental Health Programme

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Abbreviations and Acronyms

EMHS Essential Medicines and Health Supplies EMLU Essential Medicines List of Uganda EmOC Emergency Obstetric Care ENT Ear, Nose and Throat EPI Expanded Programme on Immunization EQC External Quality Control ERT Energy for Rural Transformation ESD Health Sub-District FDS Fiscal Decentralization Strategy FP Family Planning FY Financial Year GAIN Global Alliance for Improvement of Nutrition GAM Global Acute Malnutrition GAVI Global Alliance for vaccines and Immunisation GBV Gender Based Violence GDF Global Drug Fund GFATM Global Fund for HIV/AIDS, TB & Malaria GH General Hospital GoU Government of Uganda GPS Global Positioning System HAB Household Assessment Book HAF Human Resources for Health Action Framework HBMF Home Based Management of Fever HC Health Centre HCT HIV/AIDS Counseling and Testing HDP Health Development Partners HDPG Health Development Partners’ Group HIV Human Immuno-Deficiency Virus HMBC Health Manpower Resource Centre HMIS Health Management Information System HP&E Health Promotion and Education HPA Hospital Performance Assessment HPAC Health Policy Advisory Committee HPSI Health Promoting School Initiatives

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Abbreviations and Acronyms Abbreviations and Acronyms

EMHS Essential Medicines and Health Supplies HPV Human Papilloma Virus EMLU Essential Medicines List of Uganda HR Human Resource EmOC Emergency Obstetric Care HRH Human Resources for Health ENT Ear, Nose and Throat HRHIS Human Resource Information System EPI Expanded Programme on Immunization HSD Health Sub-Districts EQC External Quality Control HSS Health Systems Strengthening ERT Energy for Rural Transformation HSSP Health Sector Strategic Plan ESD Health Sub-District HSV 2 Herpes Simplex Virus type 2 FDS Fiscal Decentralization Strategy IANPHI International Association of Public Health Institution FP Family Planning ICCDE International Certification Commission for Dracunculiasis Eradication FY Financial Year ICN International Council of Nursing GAIN Global Alliance for Improvement of Nutrition ICT Information Communication Technology GAM Global Acute Malnutrition ICU Intensive Care Unit GAVI Global Alliance for vaccines and Immunisation IDA International Development Agency GBV Gender Based Violence IDB Islamic Development Bank GDF Global Drug Fund IDPs Internally Displaced Persons GFATM Global Fund for HIV/AIDS, TB & Malaria IDSR Integrated Disease Surveillance and Response GH General Hospital IEC Information Education and Communication GoU Government of Uganda ILO International Labour Organisation GPS Global Positioning System IMCI Integrated Management of Childhood Illness HAB Household Assessment Book IMR Infant Mortality Rate HAF Human Resources for Health Action Framework IMSCC Inter-Ministerial Standing Coordinating Committee (education and health) HBMF Home Based Management of Fever IMT International Monitoring Team HC Health Centre IPF Indicative Planning Figure HCT HIV/AIDS Counseling and Testing IPT Intermittent Preventive Treatment HDP Health Development Partners IRS Indoor Residual Spraying HDPG Health Development Partners’ Group ISH Integrated Sanitation and Hygiene HIV Human Immuno-Deficiency Virus ISS Integrated Support Supervision HMBC Health Manpower Resource Centre IST In-service training HMIS Health Management Information System IT Information Technology HP&E Health Promotion and Education ITNs Insecticide Treated Nets HPA Hospital Performance Assessment IVM Integrated Vector Management HPAC Health Policy Advisory Committee IYCF Infant and Young Child Feeding HPSI Health Promoting School Initiatives JAF Joint Assessment Framework

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Abbreviations and Acronyms

JCRC Joint Clinical Research Centre JICA Japan International Cooperation Agencies JMC Joint Monitoring Committee JMS Joint Medical Stores JRM Joint Review Missions KCC Kampala City Council KIU Kampala International University LC Local Council LGDP Local Government Development Project LGMSDP Local Government Management and Service Delivery Programme LLITNs Long Lasting Insecticide Treated Nets LRA Lords Resistance Army LTIA Long Term Institutional Arrangements MAAF Ministry of Agriculture, Animal Industry and Fisheries MCP Malaria Control Programme MDA Mass Drug Administration MDGs Millennium Development Goals MDR Multi-drug Resistant MIS Medicines Information System MMR Maternal Mortality Rate MNT Maternal Neonatal Tetanus MNTE Maternal Neonatal Tetanus Elimination MOES Ministry of Education and Sports MOFPED Ministry of Finance, Planning and Economic Development MOH Ministry of Health MOPS Ministry of Public Service MOU Memorandum of Understanding MPM Medicines and Pharmaceuticals Management MPS Ministerial Policy Statement MTC Medicines and Therapeutics Committee MTEF Medium Term Expenditure Framework NACME National Committee on Medical Equipment NCC National Certification Committee NCD Non Communicable Diseases

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Abbreviations and Acronyms Abbreviations and Acronyms

JCRC Joint Clinical Research Centre NCRL National Chemotherapeutics Research Laboratory JICA Japan International Cooperation Agencies NDA National Drug Authority JMC Joint Monitoring Committee NDP National Development Plan JMS Joint Medical Stores NDQCL National Drug Quality Control Laboratory JRM Joint Review Missions NEMA National Environmental Management Authority KCC Kampala City Council NGOs Non-Governmental Organisations KIU Kampala International University NHA National Health Assembly LC Local Council NHIS National Health Insurance Scheme LGDP Local Government Development Project NHP National Health Policy LGMSDP Local Government Management and Service Delivery Programme NHS National Health System LLITNs Long Lasting Insecticide Treated Nets NMCP National Malaria Control Strategic Plan LRA Lords Resistance Army NMS National Medical Stores LTIA Long Term Institutional Arrangements NPA/AI National Plan of Action for Avian Influenza MAAF Ministry of Agriculture, Animal Industry and Fisheries NRH National Referral Hospital MCP Malaria Control Programme NRTL National Reference TB and District Laboratories MDA Mass Drug Administration NTDs Neglected Tropical Diseases MDGs Millennium Development Goals NTF National Task Force MDR Multi-drug Resistant NTLP National Tuberculosis and Leprosy Control Program MIS Medicines Information System NW & SC National Water and Sewerage Cooperation MMR Maternal Mortality Rate OH &S Occupational Health and Safety MNT Maternal Neonatal Tetanus OOB Output-Oriented Budgeting MNTE Maternal Neonatal Tetanus Elimination OPD Outpatients Department MOES Ministry of Education and Sports ORS Oral Rehydration Salt MOFPED Ministry of Finance, Planning and Economic Development ORT Oral Rehydration Therapy MOH Ministry of Health PAD Patent –Ductus-Arterosus MOPS Ministry of Public Service PAF Poverty Action Fund MOU Memorandum of Understanding PC Partnership Committee MPM Medicines and Pharmaceuticals Management PCV Pneumococcal Conjugate Vaccine MPS Ministerial Policy Statement PEAP Poverty Eradication Action Plan MTC Medicines and Therapeutics Committee PEP Post Exposure Prophylaxis MTEF Medium Term Expenditure Framework PEPFAR President’s Emergency Plan for AIDS Relief (USA) NACME National Committee on Medical Equipment PHAST Participatory Hygiene and Sanitation Transformation NCC National Certification Committee PHC Primary Health Care NCD Non Communicable Diseases PHP Private Health Practitioners

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Abbreviations and Acronyms

PMI Presidential Malaria Initiative PMTCT Prevention of Mother to Child Transmission PNFP Private Not for Profit PPM Public Private Mix PPPH Public Private Partnership in Health PPS Private Patient Services PRDP Peace and Recovery Development Plan PSI Population Services International PWD Persons with Disabilities QAD Quality Assurance Department QMS Quality Management Systems REACH Regional East African Community Health RED Reach Every District (strategy) RIA Regulatory Impact Assessment ROM Result-Oriented Management RRH Regional Referral Hospital RUM Rational Use of Medicines SARs Severe Acute Respiratory Syndrome SER Socio Economic Rehabilitation SGBV Sexual Gender Based violence SH School Health SHSSPP Support to the Health Sector Strategic Plan Project SIDA Swedish International Development Agency SOC Integrated Sustainable Outreach Services SOPs Standard Operating Procedures SP Sulfadoxine/Pyrimethamine SRH Sexual and Reproductive Health and Rights STI Sexually Transmitted Infection SURE Securing Ugandan’s Rights to Essential Medicines SWAP Sector-Wide Approach TASO The AIDS Support Organization TB Tuberculosis TCMP Traditional and Complementary Medicine Practice/Practitioners THETA Traditional Healers and Medical Practitioners Together Against HIV/AIDS

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Abbreviations and Acronyms Abbreviations and Acronyms

PMI Presidential Malaria Initiative TRM Technical Review Meeting PMTCT Prevention of Mother to Child Transmission TTIs Transfusion Transmissible Infections PNFP Private Not for Profit UBOS Uganda Bureau of Statistics PPM Public Private Mix UBTS Uganda Blood Transfusion Services PPPH Public Private Partnership in Health UCG Uganda Clinical Guidelines PPS Private Patient Services UDHS Uganda Demographic and Health Survey PRDP Peace and Recovery Development Plan UGFATM Uganda Global Fund for AIDS, TB and Malaria PSI Population Services International UMCA Uganda Medicines Control Authority PWD Persons with Disabilities UMR Under 5 Mortality Rate QAD Quality Assurance Department UNBS Uganda National Bureau of Standards QMS Quality Management Systems UNCRL Uganda National Chemotherapeutics Research Laboratory REACH Regional East African Community Health UNEPI Uganda Expanded Programme on Immunisation RED Reach Every District (strategy) UNF Uganda National Formulary RIA Regulatory Impact Assessment UNFPA United Nations Fund for Population Activities ROM Result-Oriented Management UNHRO Uganda National Health Research Organisations RRH Regional Referral Hospital UNICEF United Nations Children’s Fund RUM Rational Use of Medicines UPE Universal Primary Education SARs Severe Acute Respiratory Syndrome URA Uganda Revenue Authority SER Socio Economic Rehabilitation URCI Urban Rabies Control Initiative SGBV Sexual Gender Based violence USAID United States Agency for International Development SH School Health USD US Dollar SHSSPP Support to the Health Sector Strategic Plan Project USE Universal Secondary Education SIDA Swedish International Development Agency Ushs Uganda Shillings SOC Integrated Sustainable Outreach Services UVRI Uganda Virus Research Institute SOPs Standard Operating Procedures VBDC Vector Borne Diseases Control SP Sulfadoxine/Pyrimethamine VHF Virus Haemorrhagic Fever SRH Sexual and Reproductive Health and Rights VHT Village Health Teams STI Sexually Transmitted Infection VPH Veterinary Public Health SURE Securing Ugandan’s Rights to Essential Medicines WFP World Food Programme SWAP Sector-Wide Approach WHO World Health Organisation TASO The AIDS Support Organization WISN Workload Indicator Staffing TB Tuberculosis YCF Young Childhood Feeding TCMP Traditional and Complementary Medicine Practice/Practitioners YSP Yellow Star Program THETA Traditional Healers and Medical Practitioners Together Against HIV/AIDS ZTLSs Zonal TB/Leprosy Supervisors

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Executive Summary

The goal of the sector is to accelerate movement towards Universal Health Coverage with essential health and related services needed for promotion of a healthy and productive life. The Mission of the sector is premised on facilitating the attainment of a good standard of health by all people of Uganda in order to promote a healthy and productive life.

The Health Sector Ministerial Policy Statement (MPS) for FY 2020/21) has been developed through a consultative process involving the Central Government Ministries Health Sector Development Partners and the Sector Budget Working Group. The Ministry has aligned the sector outcomes for FY 2020/21 to the National Development Plan III and the Health Sector Development Plan II, based on programme-based budgeting approach and the medium-term expenditure framework.

In line with the third National Development Plan (NDP III) the budget strategy for FY 2020/21 focuses on increasing average household incomes and improving quality of life of Ugandans through sustainable industrialisation and inclusive growth, regional equity, employment and sustainable wealth creation for all. The health sector seeks to accomplish objective four (4) of the NDP III that emphasizes the role of the health sector towards increasing productivity, inclusiveness and wellbeing of population for wealth creation.

The achievements of Ministry of Health during the FY 2018/19 were in accordance with the sector priorities and aligned to the HSDP and within the realm of the National Development Plan II. The sector continues to implement policies that are aligned to H.E the President’s 23 Strategic Guidelines and Directives that will deliver a minimum development package for every Ugandan so as to attain the middle income status.

SECTOR PRIORITIES FOR FY 2020/21 The key sector priorities for FY 2020/21 include the following: a) Prevention and control of Communicable Diseases with focus on high burden diseases (HIV/AIDS, TB, Malaria, Neglected Tropical Diseases) and epidemic prone diseases through community-based surveillance approaches. b) Prevention and control of Non-Communicable Diseases and injuries through promotion of physical exercise, healthy eating (e.g. address trans-fats) and regular health checks and advocacy for reduction the consumption of alcohol and tobacco products to reduce the increasing burden of NCDs, develop and implement hospital protocols to scale up triage and response to emergencies arising from high cases of Road traffic accidents and screening and management of NCDs. c) Improvement of Reproductive, Maternal, Neonatal, Child and Adolescent Health services. Specifically, by functionalising theatres at HC IVs and equipping (fridges, power back up & laboratory reagents) HC IVs to provide blood transfusion services to reduce maternal and neonatal deaths and other medical emergencies; implementation of the revised Male Involvement Strategy to increase male participation in family planning and utilization of other RMNCAH services and improve maternal and perinatal death reviews. d) Improving the emergency medical services and referral system by improving the functionality of high dependency units / ICUs in referral hospitals and hospitals along the highway, training in pre-hospital and Hospital Emergency care and improving communication on referral and ambulance systems. e) Expand community-level health promotion, education and prevention services in all programs to reduce exposure to communicable and non-communicable conditions risks with targeted interventions in districts with low coverages. This will include fast-tracking amendment and implementation of the Public Health Act, evidence generation for the CHEW Policy and building capacity of governance structures at community level (CDOs, Parish Chiefs) to adopt the multi-sectoral approach to health. f) Support health systems improvement in health information management and use, research and technology (Digitalising of the hospital and medical records). g) Strengthen Public-Private Partnerships in areas of reporting and financial access. h) Establishment of the National Health Insurance Scheme and improve the allocative and technical efficiency in the provision of financial resources in the health sector with focus on prevention vs curative.

CRITICAL UNFUNDED PRIORITIES IN THE SECTOR FOR FY 2020/21 The following have been identified as high impact interventions in the health sector that require immediate funding in FY 2020/21: a) Installation of blood fridges in 89 HCIV at UShs 2.2 billion. Install blood fridges to store blood in 89 Health Centre (HC IVs), thus increasing the number of services provided at this level. It is estimated that currently 8,400 mothers are being referred to regional referral hospitals because the HC IVs lack the capacity to perform obstetric care due to the lack of blood supplies. Installation of these blood fridges will allow these patients to receive on- site care, reduce unnecessary referrals, saving time and effort of specialised medical staff at the regional hospitals, and reduce transportation costs. The blood fridges are estimated to cost a total of UShs 2.2 billion.

10 11 Ministerial Policy Statement FY 2020/21 Ministerial Policy Statement FY 2020/21

Executive Summary Executive Summary

The goal of the sector is to accelerate movement towards Universal Health Coverage with essential health and related services b) Wage for Anaesthetic Officers and Anaesthetic Assistants at UShs 3.8 bn needed for promotion of a healthy and productive life. The Mission of the sector is premised on facilitating the attainment of a To fully provide surgical care at HC IVs, additional 89 Anaesthetic Officers and 124 Anaesthetic Assistants are required. Ministry good standard of health by all people of Uganda in order to promote a healthy and productive life. of Public Service is in the process of revising the staffing structures for HCIVs in anticipation of the funding for these positions. The wage requirement for these positions is estimated to cost UShs 3.8 bn annually. It is worth noting that MOH has already The Health Sector Ministerial Policy Statement (MPS) for FY 2020/21) has been developed through a consultative process trained these professional staff under URMCHIP/ WB project and bonded them to recruitment in the public service. involving the Central Government Ministries Health Sector Development Partners and the Sector Budget Working Group. The Ministry has aligned the sector outcomes for FY 2020/21 to the National Development Plan III and the Health Sector Development c) Recruitment of Medical Specialists at RRH at UShs 100m Plan II, based on programme-based budgeting approach and the medium-term expenditure framework. The Regional Referral Hospitals (RRHs) currently have the wage for Medical Specialists. However, due to delays in recruitment and hiring, in FY 2019/20 MOH contracted 11 medical specialists and posted them to RRHs. There is need to regularize this action In line with the third National Development Plan (NDP III) the budget strategy for FY 2020/21 focuses on increasing average and also recruit to fill the remaining vacant positions in the referral hospitals. The shs. 100 million will facilitate HSC to undertake household incomes and improving quality of life of Ugandans through sustainable industrialisation and inclusive growth, regional the recruitment exercise. equity, employment and sustainable wealth creation for all. The health sector seeks to accomplish objective four (4) of the NDP III that emphasizes the role of the health sector towards increasing productivity, inclusiveness and wellbeing of population for wealth d) Phasing in of PEPFAR Staff to Government Ownership at UShs 860 million creation. PEPFAR has been supporting health workers in both public and private not for profit (PNFPs) facilities. Some of the health workers in the public facilities have been absorbed where wage was available. However, 55 staff have not been absorbed in the The achievements of Ministry of Health during the FY 2018/19 were in accordance with the sector priorities and aligned to the Local Government structure because of inadequate wage funding. To prevent disruption of services, UShs 860 million is needed to HSDP and within the realm of the National Development Plan II. The sector continues to implement policies that are aligned to absorb these workers. MOH will also engage the Medical Bureaus and other respective facilities to develop a strategy to maintain H.E the President’s 23 Strategic Guidelines and Directives that will deliver a minimum development package for every Ugandan the services of health workers who are currently deployed to the PNFPs. so as to attain the middle income status. e) Digitalisation of RRHs at UShs 3 bn SECTOR PRIORITIES FOR FY 2020/21 The existing information management system interventions have been able to cover Mulago National Referral Hospital, The key sector priorities for FY 2020/21 include the following: Kamwempe, Uganda Cancer Institute (UCI) and Uganda Heart Institute (UHI). The plan is to link the other RRHs to the main a) Prevention and control of Communicable Diseases with focus on high burden diseases (HIV/AIDS, TB, Malaria, Neglected server system at Mulago. To accomplish this, an estimated total of UShs 8bn is needed. The integration is planned to be completed Tropical Diseases) and epidemic prone diseases through community-based surveillance approaches. in a phased manner and only UShs 3 bn is needed in FY 2020/21 to connect five RRHs. b) Prevention and control of Non-Communicable Diseases and injuries through promotion of physical exercise, healthy eating (e.g. address trans-fats) and regular health checks and advocacy for reduction the consumption of alcohol and tobacco products to f) Continuation of mTrack operations at Ushs 0.9bn reduce the increasing burden of NCDs, develop and implement hospital protocols to scale up triage and response to emergencies Until a more unified system is established, funding is needed to support investment in mTrack to ensure continuity of the weekly arising from high cases of Road traffic accidents and screening and management of NCDs. reports and timely surveillance. c) Improvement of Reproductive, Maternal, Neonatal, Child and Adolescent Health services. Specifically, by functionalising theatres at HC IVs and equipping (fridges, power back up & laboratory reagents) HC IVs to provide blood transfusion services to g) Integrated Support Supervision at UShs I bn reduce maternal and neonatal deaths and other medical emergencies; implementation of the revised Male Involvement Strategy to To implement the new Supportive Supervision Strategy, MOH will provide orientation and training of Health Unit Management increase male participation in family planning and utilization of other RMNCAH services and improve maternal and perinatal Committees (HUMCs) through their sub-counties. The estimated funds needed to develop and disseminate supervision guidelines, death reviews. training staff, and on-site supervision is UShs 1 Bn. d) Improving the emergency medical services and referral system by improving the functionality of high dependency units / ICUs in referral hospitals and hospitals along the highway, training in pre-hospital and Hospital Emergency care and improving h) TB Commodities require at UShs I5 bn communication on referral and ambulance systems. Development partners extensively support HIV/AIDS programs and services in Uganda. However, TB commodities remain e) Expand community-level health promotion, education and prevention services in all programs to reduce exposure to critically underfunded by the Government of Uganda, resulting in low treatment success and retention rates and increased drug communicable and non-communicable conditions risks with targeted interventions in districts with low coverages. This will resistance. The funding needed to address the gap in TB commodities is estimated to be UShs 15 Bn. include fast-tracking amendment and implementation of the Public Health Act, evidence generation for the CHEW Policy and building capacity of governance structures at community level (CDOs, Parish Chiefs) to adopt the multi-sectoral approach to i) Mama Kits require at UShs I3 bn health. Ensuring the availability of Mama Kits will contribute to reduce maternal and peri-natal mortality. f) Support health systems improvement in health information management and use, research and technology (Digitalising of the hospital and medical records). j) Counterpart funding of Ushs 6bn for the expansion of Busolwe General Hospital. The Spanish debt swap has earmarked funds g) Strengthen Public-Private Partnerships in areas of reporting and financial access. for Busolwe General Hospital and the designs are soon being completed. However, Government committed to provide to provide h) Establishment of the National Health Insurance Scheme and improve the allocative and technical efficiency in the provision of Ushs 6bn in FY 2020/21 which has not been done. The Spanish will not release their funds until the Government fulfils its financial resources in the health sector with focus on prevention vs curative. obligation.

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Vote:014 Ministry of Health

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

II. Strategic Objective 1. To provide inclusive and quality health care services through policy formulation and providing strategic direction, planning and coordination of health care provision in Uganda; 2. To address the key determinants of health through strengthening of intersectoral collaborations and partnerships; 3. To enhance the health sector competitiveness in the region and globally; and 4. To increase financial risk protection of households against impoverishment due to health expenditures. III. Major Achievements in 2019/20 1. Measles Rubella mass vaccination campaign covering 128 districts conducted (vaccinated 19,476,110 over and above the targeted 18,100,000 2. The Annual Health Sector Performance Report 2018/19 was compiled and disseminated in the Joint Review Mission where the Aide-Memoir was developed. 3. Disseminated the Health Sector Quality Improvement Framework and Strategic plan 2015/16 to 25 districts and the National Infection Prevention and Control Guidelines in 20 Districts 4. Completed up to 98% civil works at Mulago Super Specialized Hospital. 5. Completed the rehabilitation of Kawolo Hospital. 6. Civil works at Kayunga and Yumbe Hospital have progressed up to 88% with Kayunga at 94% and Yumbe at 81%. 7. Civil works at The Regional Hospital for Paediatric surgery have progressed up to 90% 8. The Ministry offered scholarships for 555 students in RMNCAH priority courses from certificate to Masters of Medicine degrees. 169 students who completed their studies in June 2019 are undergoing deployment. 9. 70 hospitals have been oriented on Result Based Financing including Regional Referral and General Hospital. 52 districts have been added to the 79 under phase I and II to raise the total number of districts on RBF to 131 districts 10. A national quantification of blood, reagents and related supplies was produced 11. Standard Operating Procedures to operationalise the Essential Medicines and Health Supplies (EMHS)Management Manual developed 12. Procured 230,550 doses of penta, 71,970 doses of IPV, 1,110,420 doses of Measles & Rubella (MR) and 995,500 doses of Rota_liq. Preparatory meetings,mobilization and sensitization for MR polio campaign held. 13. Produced and Launched the Presidential Initiative to healthy Eating and Healthy Lifestyle (National day of Physical Exercise), Integrated Management of Acute Malnutrition (IMAM) Guidelines and Maternal Infant and Young Child Nutrition (MIYCAN) guidelines at final draft. 14. Carried out a number of support supervision activities across the country in addition to the Area Team Supervision in Local Governments, National, Regional Referrals and Lower Health Facilities. 15. 491 solar systems in 157 Heath facilities in Ntoroko, Bundibugyo,Kiryandongo, Masindi, Mbale, Sironko,Bulambuli, Bukwo, Mayuge, Amuria & Katakwi Districts were maintained; and80% were kept in good functional condition. 16. Maintenance of Philips brand Ultrasound scanners (49) and x-ray machines (42) was carried out in 10RRH, 23GH, 28HCIV & Mulago NRH by M/s Dash-S Technologies Inc. average of 66% of the x-ray machines and 78% of the Ultrasound scanners were fully functional. 17. 124 Pieces of medical equipment were maintained by Biomedical Engineers and Technicians from Wabigalo workshop, serviced equipment (suction machines,oxygen therapy apparatus, patienttrolleys) in 9 KCCA Ambulances.

IV. Medium Term Plans • Continue to invest in prevention and control of Non-Communicable and Communicable Diseases with focus on high burden diseases (HIV/AIDS, TB, Malaria, Neglected Tropical Disease) and epidemic prone diseases. Emphasis on expansion of community-level health promotion, education and prevention services to reduce exposure to communicable and non- communicable conditions risks. • Improving the functionality of health facilities at all levels (HR, medicines supply and management including blood, medical equipment, health infrastructure, quality assurance, performance management, financing, policy and regulation). • Improving the emergency and referral system.

12 13 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To provide the highest possible level of health services to all people in Uganda through delivery of promotive, preventive, curative, palliative and rehabilitative health services at all levels. 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 8.663 14.617 4.699 14.617 14.617 14.617 14.617 14.617 1. To provide inclusive and quality health care services through policy formulation and providing strategic direction, planning Recurrent and coordination of health care provision in Uganda; 2. To address the key determinants of health through strengthening of inter- Non Wage 61.049 67.269 28.978 67.332 80.799 96.959 116.350 139.621 sectoral collaborations and partnerships; 3. To enhance the health sector competitiveness in the region and globally; and 4. To GoU 80.178 68.208 18.846 49.708 49.708 49.708 49.708 49.708 increase financial risk protection of households against impoverishment due to health expenditures. Devt. III. Major Achievements in 2019/20 Ext. Fin. 433.017 1,059.367 123.910 1,119.793 813.780 8.944 4.648 0.000 149.890 150.094 52.523 131.658 145.124 161.284 180.676 203.946 1. Measles Rubella mass vaccination campaign covering 128 districts conducted (vaccinated 19,476,110 over and above the GoU Total targeted 18,100,000 Total GoU+Ext Fin (MTEF) 582.907 1,209.461 176.433 1,251.450 958.904 170.228 185.324 203.946 2. The Annual Health Sector Performance Report 2018/19 was compiled and disseminated in the Joint Review Mission where the Aide-Memoir was developed. Arrears 0.164 0.229 0.177 3.230 0.000 0.000 0.000 0.000 3. Disseminated the Health Sector Quality Improvement Framework and Strategic plan 2015/16 to 25 districts and the National 583.071 1,209.690 176.610 1,254.680 958.904 170.228 185.324 203.946 Infection Prevention and Control Guidelines in 20 Districts Total Budget 4. Completed up to 98% civil works at Mulago Super Specialized Hospital. A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A 5. Completed the rehabilitation of Kawolo Hospital. 6. Civil works at Kayunga and Yumbe Hospital have progressed up to 88% with Kayunga at 94% and Yumbe at 81%. Grand Total 583.071 1,209.690 176.610 1,254.680 958.904 170.228 185.324 203.946 7. Civil works at The Regional Hospital for Paediatric surgery have progressed up to 90% Total Vote Budget 582.907 1,209.461 176.433 1,251.450 958.904 170.228 185.324 203.946 8. The Ministry offered scholarships for 555 students in RMNCAH priority courses from certificate to Masters of Medicine Excluding Arrears degrees. 169 students who completed their studies in June 2019 are undergoing deployment. 9. 70 hospitals have been oriented on Result Based Financing including Regional Referral and General Hospital. 52 districts have been added to the 79 under phase I and II to raise the total number of districts on RBF to 131 districts VI. Budget By Economic Clasification 10. A national quantification of blood, reagents and related supplies was produced Table V6.1 2019/20 and 2020/21 Budget Allocations by Item 11. Standard Operating Procedures to operationalise the Essential Medicines and Health Supplies (EMHS)Management Manual developed 12. Procured 230,550 doses of penta, 71,970 doses of IPV, 1,110,420 doses of Measles & Rubella (MR) and 995,500 doses of 2019/20 Approved Budget 2020/21 Draft Estimates Rota_liq. Preparatory meetings,mobilization and sensitization for MR polio campaign held. Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total 13. Produced and Launched the Presidential Initiative to healthy Eating and Healthy Lifestyle (National day of Physical Output Class : Outputs Provided 66.747 821.120 0.000 887.868 70.215 789.572 859.788 Exercise), Integrated Management of Acute Malnutrition (IMAM) Guidelines and Maternal Infant and Young Child Nutrition (MIYCAN) guidelines at final draft. 211 Wages and Salaries 19.053 11.768 0.000 30.821 19.804 18.343 38.147 14. Carried out a number of support supervision activities across the country in addition to the Area Team Supervision in Local Governments, National, Regional Referrals and Lower Health Facilities. 212 Social Contributions 8.698 0.958 0.000 9.656 8.939 1.056 9.995 15. 491 solar systems in 157 Heath facilities in Ntoroko, Bundibugyo,Kiryandongo, Masindi, Mbale, Sironko,Bulambuli, 213 Other Employee Costs 2.570 0.000 0.000 2.570 2.350 0.000 2.350 Bukwo, Mayuge, Amuria & Katakwi Districts were maintained; and80% were kept in good functional condition. 16. Maintenance of Philips brand Ultrasound scanners (49) and x-ray machines (42) was carried out in 10RRH, 23GH, 28HCIV 221 General Expenses 4.728 17.887 0.000 22.615 5.813 22.781 28.594 & Mulago NRH by M/s Dash-S Technologies Inc. average of 66% of the x-ray machines and 78% of the Ultrasound scanners 222 Communications 0.261 0.118 0.000 0.379 0.337 0.800 1.137 were fully functional. 17. 124 Pieces of medical equipment were maintained by Biomedical Engineers and Technicians from Wabigalo workshop, 223 Utility and Property Expenses 1.305 0.000 0.000 1.305 1.402 0.000 1.402 serviced equipment (suction machines,oxygen therapy apparatus, patienttrolleys) in 9 KCCA Ambulances. 224 Supplies and Services 17.211 553.578 0.000 570.790 16.005 563.222 579.227

IV. Medium Term Plans 225 Professional Services 0.807 11.127 0.000 11.934 0.878 33.848 34.726 227 Travel and Transport 9.012 222.353 0.000 231.365 10.733 145.560 156.293 • Continue to invest in prevention and control of Non-Communicable and Communicable Diseases with focus on high burden diseases (HIV/AIDS, TB, Malaria, Neglected Tropical Disease) and epidemic prone diseases. Emphasis on expansion of 228 Maintenance 2.895 0.023 0.000 2.918 3.640 0.134 3.774 community-level health promotion, education and prevention services to reduce exposure to communicable and non- communicable conditions risks. 273 Employer social benefits 0.007 0.000 0.000 0.007 0.190 0.000 0.190 • Improving the functionality of health facilities at all levels (HR, medicines supply and management including blood, medical 282 Miscellaneous Other Expenses 0.200 3.308 0.000 3.508 0.124 3.827 3.951 equipment, health infrastructure, quality assurance, performance management, financing, policy and regulation). • Improving the emergency and referral system.

12 13 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Output Class : Outputs Funded 42.024 48.670 0.000 90.694 40.025 129.133 169.157

262 To international organisations 1.960 0.000 0.000 1.960 2.960 0.000 2.960

263 To other general government units 29.565 48.670 0.000 78.235 26.566 106.201 132.767

264 To Resident Non-government units 10.499 0.000 0.000 10.499 10.499 0.000 10.499

291 Tax Refunds 0.000 0.000 0.000 0.000 0.000 22.932 22.932

Output Class : Capital Purchases 41.323 189.576 0.000 230.899 21.418 201.088 222.506

281 Property expenses other than interest 0.000 0.956 0.000 0.956 0.000 0.000 0.000

312 FIXED ASSETS 41.323 188.620 0.000 229.943 21.418 201.088 222.506

Output Class : Arrears 0.229 0.000 0.000 0.229 3.230 0.000 3.230

321 DOMESTIC 0.229 0.000 0.000 0.229 3.230 0.000 3.230

Grand Total : 150.323 1,059.367 0.000 1,209.690 134.888 1,119.793 1,254.680

Total excluding Arrears 150.094 1,059.367 0.000 1,209.461 131.658 1,119.793 1,251.450

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 01 Health Governance and Regulation 0.650 0.691 0.322 0.747 0.500 0.500 8.000 2.000

03 Quality Assurance 0.650 0.691 0.322 0.000 0.000 0.000 0.000 0.000

20 Standards, Accreditation and Patient 0.000 0.000 0.000 0.747 0.500 0.500 8.000 2.000 Protection 02 Health infrastructure and 70.834 273.730 49.983 412.847 254.326 19.531 31.500 27.000 equipment 1027 Institutional Support to MoH 10.829 14.228 1.158 0.000 0.000 0.000 0.000 0.000

1185 Italian Support to HSSP and PRDP 0.100 0.000 0.000 0.000 0.000 0.000 0.000 0.000

1187 Support to Mulago Hospital 17.533 21.360 7.946 0.000 0.000 0.000 0.000 0.000 Rehabilitation 1243 Rehabilitation and Construction of 0.050 23.126 8.011 13.130 0.000 0.000 0.000 0.000 General Hospitals 1315 Construction of Specialised Neonatal 14.967 5.100 0.050 0.000 0.000 0.000 0.000 0.000 and Maternal Unit in Mulago Hospital 1344 Renovation and Equipping of Kayunga 6.296 75.157 8.680 32.710 0.000 0.000 0.000 0.000 and Yumbe General Hospitals 1393 Construction and Equipping of the 0.025 0.050 0.020 0.000 0.000 0.000 0.000 0.000 International Specialized Hospital of Uganda 1394 Regional Hospital for Paediatric 11.896 1.085 0.264 0.000 0.000 0.000 0.000 0.000 Surgery 1440 Uganda Reproductive Maternal and 8.388 119.961 23.845 332.620 79.326 9.531 11.500 7.000 Child Health Services Improvement Project 1519 Strengthening Capacity of Regional 0.750 3.000 0.000 1.000 0.000 0.000 0.000 0.000 Referral Hospitals

14 15 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Output Class : Outputs Funded 42.024 48.670 0.000 90.694 40.025 129.133 169.157 1539 Italian Support to Health Sector 0.000 10.663 0.010 13.298 150.000 0.000 0.000 0.000 Development Plan- Karamoja Infrastructure 262 To international organisations 1.960 0.000 0.000 1.960 2.960 0.000 2.960 Development Project Phase II 1566 Retooling of Ministry of Health 0.000 0.000 0.000 20.088 25.000 10.000 20.000 20.000 263 To other general government units 29.565 48.670 0.000 78.235 26.566 106.201 132.767 03 Health Research 1.040 0.788 0.394 0.788 0.700 0.750 9.000 5.000 264 To Resident Non-government units 10.499 0.000 0.000 10.499 10.499 0.000 10.499 04 Research Institutions 0.800 0.548 0.274 0.548 0.400 0.460 6.500 4.000 291 Tax Refunds 0.000 0.000 0.000 0.000 0.000 22.932 22.932 05 JCRC 0.240 0.240 0.120 0.240 0.300 0.290 2.500 1.000 Output Class : Capital Purchases 41.323 189.576 0.000 230.899 21.418 201.088 222.506 05 Pharmaceutical and other Supplies 432.149 830.376 84.571 756.815 616.162 47.122 32.856 32.708 281 Property expenses other than interest 0.000 0.956 0.000 0.956 0.000 0.000 0.000 0220 Global Fund for AIDS, TB and Malaria 416.735 760.303 70.490 708.605 556.000 12.000 11.000 10.000 312 FIXED ASSETS 41.323 188.620 0.000 229.943 21.418 201.088 222.506 1436 GAVI Vaccines and Health Sector 15.148 69.712 13.989 47.829 53.162 27.122 11.856 12.708 Output Class : Arrears 0.229 0.000 0.000 0.229 3.230 0.000 3.230 Development Plan Support 321 DOMESTIC 0.229 0.000 0.000 0.229 3.230 0.000 3.230 18 Pharmaceuticals & Natural Medicine 0.266 0.360 0.092 0.381 7.000 8.000 10.000 10.000

Grand Total : 150.323 1,059.367 0.000 1,209.690 134.888 1,119.793 1,254.680 06 Public Health Services 14.824 33.655 11.316 12.045 25.000 35.000 40.000 50.000

Total excluding Arrears 150.094 1,059.367 0.000 1,209.461 131.658 1,119.793 1,251.450 06 Community Health 1.657 1.843 0.470 0.556 1.000 0.900 1.200 1.000

08 Communicable Diseases Prevention & 5.356 4.936 1.361 5.641 5.000 10.000 11.000 23.000 VII. Budget By Programme And Subprogramme Control 13 Health Education, Promotion & 1.027 0.344 0.136 0.932 0.500 1.500 2.000 3.000 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Communication 14 Reproductive and Child Health 0.521 0.563 0.159 0.736 0.800 3.000 3.000 4.500 FY 2019/20 Medium Term Projections Billion Uganda shillings 1413 East Africa Public Health Laboratory 4.455 19.453 7.162 0.050 0.000 0.000 0.000 0.000 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Network project Phase II Outturn Budget End Dec Proposed 1441 Uganda Sanitation Fund Project II 1.808 4.375 1.132 0.450 0.000 0.000 0.000 0.000 Budget 21 Environmental Health 0.000 0.854 0.363 1.038 0.900 0.900 1.000 1.000 01 Health Governance and Regulation 0.650 0.691 0.322 0.747 0.500 0.500 8.000 2.000 22 Non-Communicable Diseases 0.000 0.188 0.118 0.584 0.300 1.000 1.500 1.000 03 Quality Assurance 0.650 0.691 0.322 0.000 0.000 0.000 0.000 0.000 23 National Health Laboratory & Diagnostic 0.000 0.513 0.194 0.896 8.000 8.000 10.000 7.000 20 Standards, Accreditation and Patient 0.000 0.000 0.000 0.747 0.500 0.500 8.000 2.000 Services Protection 24 Integrated Epidemiology, Surveillance & 0.000 0.586 0.221 1.163 8.500 9.700 10.300 9.500 02 Health infrastructure and 70.834 273.730 49.983 412.847 254.326 19.531 31.500 27.000 Public Health Emergencies equipment 08 Clinical Health Services 43.456 47.790 23.149 45.955 20.000 25.000 20.000 30.000 1027 Institutional Support to MoH 10.829 14.228 1.158 0.000 0.000 0.000 0.000 0.000 09 shared National Services (Interns 36.353 40.321 20.659 36.421 15.000 19.000 14.000 20.000 1185 Italian Support to HSSP and PRDP 0.100 0.000 0.000 0.000 0.000 0.000 0.000 0.000 allowances, transfers to international organisations and transfers to districts) 1187 Support to Mulago Hospital 17.533 21.360 7.946 0.000 0.000 0.000 0.000 0.000 11 Nursing & Midwifery Services 0.532 0.631 0.122 0.598 0.200 0.500 0.500 1.000 Rehabilitation 1243 Rehabilitation and Construction of 0.050 23.126 8.011 13.130 0.000 0.000 0.000 0.000 15 Clinical Services 2.312 2.167 0.820 4.249 2.000 2.500 2.000 3.000 General Hospitals 1315 Construction of Specialised Neonatal 14.967 5.100 0.050 0.000 0.000 0.000 0.000 0.000 16 Emergency Medical Services 0.833 0.941 0.318 0.915 0.800 1.000 1.000 1.000 and Maternal Unit in Mulago Hospital 17 Health Infrastructure 3.427 3.729 1.230 3.773 2.000 2.000 2.500 5.000 1344 Renovation and Equipping of Kayunga 6.296 75.157 8.680 32.710 0.000 0.000 0.000 0.000 and Yumbe General Hospitals 49 Policy, Planning and Support 20.117 22.660 6.876 25.483 42.216 42.326 43.968 57.238 1393 Construction and Equipping of the 0.025 0.050 0.020 0.000 0.000 0.000 0.000 0.000 Services International Specialized Hospital of Uganda 01 Headquarters 12.394 15.394 4.436 6.824 17.723 17.818 16.741 18.489 1394 Regional Hospital for Paediatric 11.896 1.085 0.264 0.000 0.000 0.000 0.000 0.000 Surgery 02 Health Sector Strategy and Policy 2.084 2.185 0.538 1.891 5.000 5.000 6.000 9.000 1440 Uganda Reproductive Maternal and 8.388 119.961 23.845 332.620 79.326 9.531 11.500 7.000 Child Health Services Improvement Project 10 Internal Audit Department 0.322 0.433 0.118 0.463 0.800 0.800 1.000 5.000 1519 Strengthening Capacity of Regional 0.750 3.000 0.000 1.000 0.000 0.000 0.000 0.000 12 Human Resource Management 1.102 4.449 1.714 14.913 17.693 17.709 18.727 20.749 Referral Hospitals Department

14 15 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

1500 Institutional Capacity Building in the 4.215 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Health Sector-Phase II 19 Health Sector Partners & Multi-Sectoral 0.000 0.200 0.070 1.394 1.000 1.000 1.500 4.000 Coordination Total for the Vote 583.071 1,209.690 176.610 1,254.680 958.904 170.228 185.324 203.946

Total Excluding Arrears 582.907 1,209.461 176.433 1,251.450 958.904 170.228 185.324 203.946

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 01 Health Governance and Regulation Programme Objective To Improve quality of health care and patient safety : Responsible Officer: Permanent Secretary, Ministry of Health Programme Outcome: Conduct regular health sector performance review, monitoring and evaluation. Sector Outcomes contributed to by the Programme Outcome 1. Improved level of sector collaboration and partnership Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• Proportion of health facilities attaining Star 3(>75) status under the health facility quality 10% 2018 35% 40% 50% of care assessement program; SubProgramme: 20 Standards, Accreditation and Patient Protection Output: 01 Sector performance monitored and evaluated Number of Quarterly Performance review meetings held 2 2 2

Output: 03 Support supervision provided to Local Governments and referral hospitals Number of support supervision visits to Regional Referral Hospitals (RRHs), General Hospitals Health 2 2 2 Center IVs and Local Government conducted Output: 04 Standards and guidelines developed Number of Standards and Guidelines developed 3 3 3

Programme : 02 Health infrastructure and equipment Programme Objective To improve the quality and accessibility of health infrastructure and equipment : Responsible Officer: Permanent Secretary, Ministry of Health Programme Outcome: Development and management of health sector infrastructure and equipment. Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23

16 17 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Total Excluding Arrears 582.907 1,209.461 176.433 1,251.450 958.904 170.228 185.324 203.946

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 02 Health infrastructure and equipment Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21 Programme Objective To improve the quality and accessibility of health infrastructure and equipment : Vote:014 Ministry of Health ResponsibleVote: Officer:014 PermanentMinistry Secretary, of Health Ministry of Health ProgrammeMinistry of HealthOutcome: Development and management of health sector infrastructure andMinisterial equipment. Policy Statement FY 2020/21 Sector Outcomes contributed to by the Programme Outcome Ministry of Health Ministerial Policy Statement FY 2020/21 1.Vote: Improved quality014 of lifeMinistry at all levels of Health 1500 Institutional Capacity Building in the 4.215 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Baseline Base year Target Projection Projection Health Sector-Phase II Performance Targets 19 Health Sector Partners & Multi-Sectoral 0.000 0.200 0.070 1.394 1.000 1.000 1.500 4.000 Vote:014 Ministry of Health Coordination Outcome Indicators 2020/21 2021/22 2022/23 Total for the Vote 583.071 1,209.690 176.610 1,254.680 958.904 170.228 185.324 203.946 Baseline Base year Target Projection Projection

Total Excluding Arrears 582.907 1,209.461 176.433 1,251.450 958.904 170.228 185.324 203.946 • Proportion of the functional health centre IVs(offering ceaserian and blood transfusion 50% 2018 80% 90% 95% section) VIII. Programme Performance and Medium Term Plans • Proportion of subcounties with functional HC IIIs; 55% 2018 90% 95% 99% Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) • Proportion of functional imaging and radiography equipment in hospitals; 80% 2016 90% 95% 99%

Programme : 01 Health Governance and Regulation SubProgramme: 1344 Renovation and Equipping of Kayunga and Yumbe General Hospitals Output: 01 Monitoring, Supervision and Evaluation of Health Systems Programme Objective To Improve quality of health care and patient safety : Number of support and monitoring visits conducted 4

Responsible Officer: Permanent Secretary, Ministry of Health Output: 77 Purchase of Specialised Machinery & Equipment Programme Outcome: Conduct regular health sector performance review, monitoring and evaluation. Percentage of equipment procured and installed 100%

Sector Outcomes contributed to by the Programme Outcome Number of Hospitals equipped 2 1. Improved level of sector collaboration and partnership Output: 80 Hospital Construction/rehabilitation Performance Targets Number of hospitals renovated 2 Outcome Indicators 2020/21 2021/22 2022/23 Percentage of completion of construction/rehabilitation 100% Baseline Base year Target Projection Projection Number of support and monitoring visits conducted 4 • Proportion of health facilities attaining Star 3(>75) status under the health facility quality 10% 2018 35% 40% 50% of care assessement program; SubProgramme: 1519 Strengthening Capacity of Regional Referral Hospitals SubProgramme: 20 Standards, Accreditation and Patient Protection Output: 77 Purchase of Specialised Machinery & Equipment Output: 01 Sector performance monitored and evaluated Percentage of equipment procured and installed 100% 100% 100%

Number of Quarterly Performance review meetings held 2 2 2 Number of Hospitals equipped 14 14 14

Output: 03 Support supervision provided to Local Governments and referral hospitals SubProgramme: 1539 Italian Support to Health Sector Development Plan- Karamoja Infrastructure Development Project Phase II Number of support supervision visits to Regional Referral Hospitals (RRHs), General Hospitals Health 2 2 2 Center IVs and Local Government conducted Output: 01 Monitoring, Supervision and Evaluation of Health Systems Output: 04 Standards and guidelines developed Number of support and monitoring visits conducted 4 4 4

Number of Standards and Guidelines developed 3 3 3 Output: 77 Purchase of Specialised Machinery & Equipment Programme : 02 Health infrastructure and equipment Percentage of equipment procured and installed 100% 0% 0% Programme Objective To improve the quality and accessibility of health infrastructure and equipment Output: 80 Hospital Construction/rehabilitation : Percentage of completion of construction/rehabilitation 10% 50% 100% Responsible Officer: Permanent Secretary, Ministry of Health SubProgramme: 1566 Retooling of Ministry of Health Programme Outcome: Development and management of health sector infrastructure and equipment. Output: 01 Monitoring, Supervision and Evaluation of Health Systems Sector Outcomes contributed to by the Programme Outcome Number of support and monitoring visits conducted 2 2 2 1. Improved quality of life at all levels Output: 77 Purchase of Specialised Machinery & Equipment Performance Targets Percentage of equipment procured and installed 100% 100% 100% Outcome Indicators 2020/21 2021/22 2022/23 Output: 80 Hospital Construction/rehabilitation Percentage of completion of construction/rehabilitation 100% 100% 100%

Programme : 03 Health Research

16 17 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Programme Objective To improve research for enhanced innovations , inventions and applications : Responsible Officer: Permanent Secretary, Ministry of Health Programme Outcome: Undertake basic, epidemiological, applied, interventional and operational research; Chemotherapeutic research; Coordinate research activities Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• Proportion of reseach informed policy and guidelines 100% 2018 100% 100% 100%

SubProgramme: 04 Research Institutions Output: 52 Support to Uganda National Health Research Organisation(UNHRO) No. of conservation gardens established 6 10 14

No. of research information dissemination seminars 4 5 6

No. of therapies and formulations evaluated.TBD 8 10 12

SubProgramme: 05 JCRC Output: 51 Specialised Medical Research in HIV/AIDS and Clinical Care (JCRC) No. of researches in HIV/AIDS conducted 1 1 1

Programme : 05 Pharmaceutical and other Supplies Programme Objective To improve the quality and accessible medicines, equipment and other health supplies : Responsible Officer: Permanent Secretary, Ministry of health Programme Outcome: Development of policy and guidelines for Medicines , equipment and other health supplies Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

18 19 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Programme Objective To improve research for enhanced innovations , inventions and applications • Proportion of health facilities without drug stock out for 41 tracer medicines in previous 3 85% 2018 90% 93% 97% : months Responsible Officer: Permanent Secretary, Ministry of Health SubProgramme: 0220 Global Fund for AIDS, TB and Malaria Programme Outcome: Undertake basic, epidemiological, applied, interventional and operational research; Chemotherapeutic Output: 01 Preventive and curative Medical Supplies (including immuninisation) research; Coordinate research activities No. and percentage of districts/reporting units reporting no stock-out of first-line anti-TB drugs during the 98% 98% 99% Sector Outcomes contributed to by the Programme Outcome reporting period. Number of people tested and counseled for HIV and who received results 8,000,000 8,500,000 9,000,000 1. Enhanced competitiveness in the health sector Performance Targets Number of hospitals(GH, RRH, NRH) submitting reports on activities of inpatient pharmacies 72 72 72 Outcome Indicators 2020/21 2021/22 2022/23 Output: 03 Monitoring and Evaluation Capacity Improvement Baseline Base year Target Projection Projection Number of stakeholder meetings held 10 10 10 • Proportion of reseach informed policy and guidelines 100% 2018 100% 100% 100% SubProgramme: 1436 GAVI Vaccines and Health Sector Development Plan Support

SubProgramme: 04 Research Institutions Output: 02 Strengthening Capacity of Health Facility Managers Output: 52 Support to Uganda National Health Research Organisation(UNHRO) Number of Health facilities supported to conduct outreaches 3,549 3,549 3,800 No. of conservation gardens established 6 10 14 Output: 03 Monitoring and Evaluation Capacity Improvement

No. of research information dissemination seminars 4 5 6 Number of districts with integrated and updated micro plans 135 135 135

No. of therapies and formulations evaluated.TBD 8 10 12 Number of stakeholder meetings held 1 1 1

SubProgramme: 05 JCRC Number of oversight visits to health regions led by MOH Top Management 1 1 1 Output: 51 Specialised Medical Research in HIV/AIDS and Clinical Care (JCRC) Programme : 06 Public Health Services No. of researches in HIV/AIDS conducted 1 1 1 Programme Objective To Undertake Policy Development, Coordination, Planning, Implementation oversight, Monitoring and : Evaluation of Communicable Disease Control Programs in Uganda. Programme : 05 Pharmaceutical and other Supplies Programme Objective To improve the quality and accessible medicines, equipment and other health supplies : Responsible Officer: Permanent Secretary, Ministry of health Programme Outcome: Development of policy and guidelines for Medicines , equipment and other health supplies Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

18 19 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Responsible Officer: Permanent Secretary Ministry of Health Programme Outcome: Quality and accessible public health services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• DPT3 Coverage 95% 2018 98% 98% 99%

• Couple Years of protection 4500000 2018 4,800,000 4,900,000 5,000,000

• Proportion of epidemics/disease outbreaks contained 100% 2018 100% 100% 100%

SubProgramme: 06 Community Health Output: 01 Community Health Services (control of communicable and non communicable diseases) No. of districts monitoring reports on communicable and non-communicable diseases 127 127 127

SubProgramme: 08 Communicable Diseases Prevention & Control Output: 02 National Endemic and Epidemic Disease Control No. of coordination meetings held 6 8 10

No. of quarterly Technical support supervision conducted 2 2 3

Output: 03 Technical Support, Monitoring and Evaluation No. of districts supervised quarterly on EPI, RH, CH, Nutrition, Comprehensive HIV/AIDS e.t.c) 77 80 85

Output: 04 Immunisation % of children under 1 year reached with the third dose of Pneumococcal Conjugate Vaccine (PCV3) at the 95% 95% 95% national level % of children under one year immunized against measles 95% 95% 95%

% of children under one year reached with 3rd dose of penta valent vaccine at national level 96% 95% 95%

Output: 05 Coordination of Clinical and Public Health emergencies including the Nodding Disease No of bi-quarterly support supervision visits reports 2 3 2

No. of meetings and conferences held(nationally and internationally) 2 2 2

No. of Policies and guidelines developed and disseminated 1 2

Output: 07 Indoor Residual Spraying (IRS) services No. of districts provided with IRS services 10 12 15

SubProgramme: 1413 East Africa Public Health Laboratory Network project Phase II Output: 01 Community Health Services (control of communicable and non communicable diseases) No. of districts monitoring reports on communicable and non-communicable diseases 4

20 21 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Responsible Officer: Permanent Secretary Ministry of Health SubProgramme: 21 Environmental Health Programme Outcome: Quality and accessible public health services Output: 01 Community Health Services (control of communicable and non communicable diseases) Sector Outcomes contributed to by the Programme Outcome No. of districts monitoring reports on communicable and non-communicable diseases 134 138 138

1. Improved quality of life at all levels Percentage of health workers and service providers trained in the "new"districts 50% 50% 50%

Performance Targets Percentage of villages declared Open Defecation Free (ODF) in the 38 districts 60% 60% 60% Outcome Indicators 2020/21 2021/22 2022/23 Output: 03 Technical Support, Monitoring and Evaluation Baseline Base year Target Projection Projection No. of districts supervised quarterly on EPI, RH, CH, Nutrition, Comprehensive HIV/AIDS e.t.c) 20 20 20 • DPT3 Coverage 95% 2018 98% 98% 99% SubProgramme: 22 Non-Communicable Diseases • Couple Years of protection 4500000 2018 4,800,000 4,900,000 5,000,000 Output: 01 Community Health Services (control of communicable and non communicable diseases) • Proportion of epidemics/disease outbreaks contained 100% 2018 100% 100% 100% No. of districts monitoring reports on communicable and non-communicable diseases 10 10 10

SubProgramme: 06 Community Health Percentage of health workers and service providers trained in the "new"districts 75% 78% 82%

Output: 01 Community Health Services (control of communicable and non communicable diseases) SubProgramme: 23 National Health Laboratory & Diagnostic Services No. of districts monitoring reports on communicable and non-communicable diseases 127 127 127 Output: 02 National Endemic and Epidemic Disease Control SubProgramme: 08 Communicable Diseases Prevention & Control No. of coordination meetings held 10 10 10

Output: 02 National Endemic and Epidemic Disease Control No. of quarterly Technical support supervision conducted 4 4 4 No. of coordination meetings held 6 8 10 No. of weekly surveillance reports released 12 12 12 No. of quarterly Technical support supervision conducted 2 2 3 SubProgramme: 24 Integrated Epidemiology, Surveillance & Public Health Emergencies Output: 03 Technical Support, Monitoring and Evaluation Output: 02 National Endemic and Epidemic Disease Control 77 80 85 No. of districts supervised quarterly on EPI, RH, CH, Nutrition, Comprehensive HIV/AIDS e.t.c) No. of coordination meetings held 12 12 12

Output: 04 Immunisation No. of quarterly Technical support supervision conducted 4 4 4 % of children under 1 year reached with the third dose of Pneumococcal Conjugate Vaccine (PCV3) at the 95% 95% 95% national level No. of weekly surveillance reports released 52 52 52 % of children under one year immunized against measles 95% 95% 95% Output: 05 Coordination of Clinical and Public Health emergencies including the Nodding Disease % of children under one year reached with 3rd dose of penta valent vaccine at national level 96% 95% 95% No of bi-quarterly support supervision visits reports 2 2 2

Output: 05 Coordination of Clinical and Public Health emergencies including the Nodding Disease No. of meetings and conferences held(nationally and internationally) 1 2 2

No of bi-quarterly support supervision visits reports 2 3 2 No. of Policies and guidelines developed and disseminated 1 2 2

No. of meetings and conferences held(nationally and internationally) 2 2 2 Programme : 08 Clinical Health Services No. of Policies and guidelines developed and disseminated 1 2 Programme Objective Develop and coordinate standards guidelines and policies on infrastructure, medicines and health supplies, : and integrated curative services. Output: 07 Indoor Residual Spraying (IRS) services Provide support supervision referral hospitals and the districts. No. of districts provided with IRS services 10 12 15 Coordination of medical board, interns and tertiary health issues. Responsible Officer: Permanent Secretary Ministry of Health SubProgramme: 1413 East Africa Public Health Laboratory Network project Phase II Programme Outcome: Quality and accessible clinical health services Output: 01 Community Health Services (control of communicable and non communicable diseases) Sector Outcomes contributed to by the Programme Outcome No. of districts monitoring reports on communicable and non-communicable diseases 4 1. Improved quality of life at all levels

20 21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• Institutional/Facility based Infant Mortality rate 52 2018 43 42 41

• Institutional/Facility based perinatal mortality rate 18 2016 15 14 14

• Institutional/Facility based Maternity Mortality rate 102 208 80 75 70

SubProgramme: 15 Clinical Services Output: 01 Technical support, monitoring and evaluation Technical support, monitoring and evaluation of service providers and facilities 4 4 4

Output: 05 Coordination of Clinical and Public Health Emergencies including the Nodding Syndrome No of bi-quarterly support supervision visits reports 2

SubProgramme: 16 Emergency Medical Services Output: 04 National Ambulance Services Proportion of calls and inter-facility referrals received and responded to 60% 70% 90%

No. of Policies and guidelines developed and disseminated 4 6 10

No. of emergency care providers trained 500 700 900

SubProgramme: 17 Health Infrastructure Output: 01 Technical support, monitoring and evaluation Technical support, monitoring and evaluation of service providers and facilities 4 4 4

Programme : 49 Policy, Planning and Support Services Programme Objective To improve the Health policy, strategic direction, planning and coordination : Responsible Officer: Permanent Secretary, Ministry of Health Programme Outcome: Policy development ,financial management, auditing, human resource development, planning, budgeting, administrative and nursing services. Sector Outcomes contributed to by the Programme Outcome 1. Improved level of sector collaboration and partnership Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

22 23 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Performance Targets • Proportion of national and HLG with comprehensive annual health plans and budgets 100% 2018 100% 100% 100%

Outcome Indicators 2020/21 2021/22 2022/23 • proportion of quarterly sector performance reports analysed and actioned 100% 2018 100% 100% 100%

Baseline Base year Target Projection Projection • Timeliness and completeness of monthly HMIS reporting 100% 2018 100% 100% 100% • Institutional/Facility based Infant Mortality rate 52 2018 43 42 41 SubProgramme: 10 Internal Audit Department • Institutional/Facility based perinatal mortality rate 18 2016 15 14 14 Output: 01 Policy, consultation, planning and monitoring services • Institutional/Facility based Maternity Mortality rate 102 208 80 75 70 Number of quarterly comprehensive internal audit report produced 4 4 4

SubProgramme: 15 Clinical Services Number of quarterly supervision visits 2 2 2

Output: 01 Technical support, monitoring and evaluation SubProgramme: 19 Health Sector Partners & Multi-Sectoral Coordination Technical support, monitoring and evaluation of service providers and facilities 4 4 4 Output: 01 Policy, consultation, planning and monitoring services Output: 05 Coordination of Clinical and Public Health Emergencies including the Nodding Syndrome Comprehensive annual sector workplan and budget submitted 1 1 1

No of bi-quarterly support supervision visits reports 2 Quarterly budget performance reports produced 4 4 4

SubProgramme: 16 Emergency Medical Services Number of quarterly project performance reports compiled 4 4 4

Output: 04 National Ambulance Services Number of quarterly supervision visits 8 8 8 Proportion of calls and inter-facility referrals received and responded to 60% 70% 90%

No. of Policies and guidelines developed and disseminated 4 6 10 IX. Major Capital Investments And Changes In Resource Allocation

No. of emergency care providers trained 500 700 900 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

SubProgramme: 17 Health Infrastructure FY 2019/20 FY 2020/21 Output: 01 Technical support, monitoring and evaluation Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Technical support, monitoring and evaluation of service providers and facilities 4 4 4 Vote 014 Ministry of Health

Programme : 49 Policy, Planning and Support Services Program : 08 02 Health infrastructure and equipment

Programme Objective To improve the Health policy, strategic direction, planning and coordination Development Project : 1243 Rehabilitation and Construction of General Hospitals : Responsible Officer: Permanent Secretary, Ministry of Health Output: 08 02 80 Hospital Construction/rehabilitation Completion of rehabilitation works on Busolwe and Kawolo Civil works completed at Kawolo and 85% 40% of Works completed at Busolwe including Programme Outcome: Policy development ,financial management, auditing, human resource development, planning, budgeting, Hospitals level of equipment including; fully equipped refurbishment of OPD, wards, external works, administrative and nursing services. physiotherapy department, Casuality and lagoon, staff houses. Trauma equipment, Mortuary equipment, Sector Outcomes contributed to by the Programme Outcome Operating theatre equipment, Laboratory fully Civil works at Gombe Hospital completed equipped. including fencing, staff housing and wards 1. Improved level of sector collaboration and partnership Designs for Busolwe Hospital in progress Performance Targets Total Output Cost(Ushs Thousand) 23,025,885 7,978,548 12,840,000 Outcome Indicators 2020/21 2021/22 2022/23 Gou Dev’t: 0 0 9,000,000 Baseline Base year Target Projection Projection Ext Fin: 23,025,885 7,978,548 3,840,000

A.I.A: 0 0 0

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

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

22 23 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Medical equipment and hospital furniture supplied, installed Obtained No Objections from the Funding Kayunga and Yumbe Hospitals fully equipped and commissioned Agencies and submitted the draft contracts to the Solicitor General for clearance. The clearance had not been obtained by the end of the quarter. Total Output Cost(Ushs Thousand) 25,327,072 0 20,650,000

Gou Dev’t: 1,160,580 0 0

Ext Fin: 24,166,492 0 20,650,000

A.I.A: 0 0 0

Output: 08 02 80 Hospital Construction/rehabilitation

100% rehabilitation works for Kayunga and Yumbe General Hospital construction works 100% completed and completed and handed over. Overall construction works progressed to 88% handed over for Kayunga and Yumbe General Hospitals with Kayunga General Hospital at 94% and Yumbe General Hospital at 81% Total Output Cost(Ushs Thousand) 47,137,820 6,949,500 9,925,000

Gou Dev’t: 5,444,420 1,657,550 1,380,000

Ext Fin: 41,693,400 5,291,950 8,545,000

A.I.A: 0 0 0

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

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

Three vehicles purchased for support supervision of RBF 24 Motor Vehicles procured ;20 for Project Management and District Supervision and 4 for EVD support & 20 motor cycles Birth and Death Registration supervision Total Output Cost(Ushs Thousand) 570,000 0 2,192,957

Gou Dev’t: 0 0 0

Ext Fin: 570,000 0 2,192,957

A.I.A: 0 0 0

Output: 08 02 77 Purchase of Specialised Machinery & Equipment

RMNCAH equipment procured and distributed including beds, Equipping of Health Centres: The essential Critical RMNCAH equipment & EVD Equipment obstetric & neonatal equipment, surgical instruments equipment package at Health Centre III and under CERC procured and distributed Health Centre IV has been updated. Prioritisation of equipment to be procured is ongoing and a market survey for the cost of equipment is being conducted by the procurement department. Two interventions are planned under the provision of medical equipment; (i) Equipment retooling for operational HC III based on the received and analysed inventories of existing equipment. (ii) Equipping the 81 health units to be upgraded under the project

Total Output Cost(Ushs Thousand) 10,000,000 3,775,483 34,141,062

Gou Dev’t: 0 0 0

Ext Fin: 10,000,000 3,775,483 34,141,062

24 25 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Medical equipment and hospital furniture supplied, installed Obtained No Objections from the Funding Kayunga and Yumbe Hospitals fully equipped A.I.A: 0 0 0 and commissioned Agencies and submitted the draft contracts to the Solicitor General for clearance. The Output: 08 02 78 Purchase of Office and Residential Furniture and Fittings clearance had not been obtained by the end of the quarter. Medical furniture to selected facilities procured Total Output Cost(Ushs Thousand) 25,327,072 0 20,650,000 and distributed Total Output Cost(Ushs Thousand) 0 0 1,855,425 Gou Dev’t: 1,160,580 0 0 Gou Dev’t: 0 0 0 Ext Fin: 24,166,492 0 20,650,000 Ext Fin: 0 0 1,855,425 A.I.A: 0 0 0 A.I.A: 0 0 0 Output: 08 02 80 Hospital Construction/rehabilitation Output: 08 02 80 Hospital Construction/rehabilitation 100% rehabilitation works for Kayunga and Yumbe General Hospital construction works 100% completed and completed and handed over. Overall construction works progressed to 88% handed over Maternity Units constructed in 82 selected Health for Kayunga and Yumbe General Hospitals facilities with Kayunga General Hospital at 94% and Yumbe General Hospital at 81% Total Output Cost(Ushs Thousand) 0 0 110,142,550 Total Output Cost(Ushs Thousand) 47,137,820 6,949,500 9,925,000 Gou Dev’t: 0 0 0 Gou Dev’t: 5,444,420 1,657,550 1,380,000 Ext Fin: 0 0 110,142,550 Ext Fin: 41,693,400 5,291,950 8,545,000 A.I.A: 0 0 0 A.I.A: 0 0 0 Development Project : 1519 Strengthening Capacity of Regional Referral Hospitals Development Project : 1440 Uganda Reproductive Maternal and Child Health Services Improvement Project Output: 08 02 77 Purchase of Specialised Machinery & Equipment Output: 08 02 75 Purchase of Motor Vehicles and Other Transport Equipment Specialised equipment procured for Regional Referral Started preparatory activities for undertaking a Radiology, theatre, Intensive Care Unit, Accident Three vehicles purchased for support supervision of RBF 24 Motor Vehicles procured ;20 for Project including ultrasound, x-ray, operating tables feasibility study and tender documents for and Emergency, Maternity and Neonatal Intensive Management and District Supervision and 4 for procurement of the contractor and supplier. care Unit equipment purchased for all 14 Regional EVD support & 20 motor cycles Birth and Death Referral Hospitals Registration supervision Total Output Cost(Ushs Thousand) 3,000,000 0 1,000,000 Total Output Cost(Ushs Thousand) 570,000 0 2,192,957 Gou Dev’t: 3,000,000 0 1,000,000 Gou Dev’t: 0 0 0 Ext Fin: 0 0 0 Ext Fin: 570,000 0 2,192,957 A.I.A: 0 0 0 A.I.A: 0 0 0 Development Project : 1539 Italian Support to Health Sector Development Plan- Karamoja Infrastructure Development Project Phase II Output: 08 02 77 Purchase of Specialised Machinery & Equipment Output: 08 02 75 Purchase of Motor Vehicles and Other Transport Equipment RMNCAH equipment procured and distributed including beds, Equipping of Health Centres: The essential Critical RMNCAH equipment & EVD Equipment obstetric & neonatal equipment, surgical instruments equipment package at Health Centre III and under CERC procured and distributed 8 motor vehicles procured for each of the 8 Districts in the Funding to be accessed after Phase I is Vehicles ( 4WD vehicles and motorcycles) for 8 Health Centre IV has been updated. Karamoja region completed Districts in Karamoja Region procured Prioritisation of equipment to be procured is 8 motor cycles procured for each of the 8 districts in the ongoing and a market survey for the cost of Karamoja region equipment is being conducted by the procurement department. Total Output Cost(Ushs Thousand) 2,480,000 0 3,360,000 Two interventions are planned under the provision of medical equipment; Gou Dev’t: 0 0 0 (i) Equipment retooling for operational HC III based on the received and analysed inventories Ext Fin: 2,480,000 0 3,360,000 of existing equipment. (ii) Equipping the 81 health units to be A.I.A: 0 0 0 upgraded under the project Output: 08 02 80 Hospital Construction/rehabilitation

20% completion of construction works undertaken at selected Funding to be accessed after Phase I is 10% completion of civil works at selected sites in Total Output Cost(Ushs Thousand) 10,000,000 3,775,483 34,141,062 Health facilities in Karamoja region including facility completed Karamoja region upgrades, rehabilitation and construction of New facilities Gou Dev’t: 0 0 0 Total Output Cost(Ushs Thousand) 7,885,205 0 9,081,987 Ext Fin: 10,000,000 3,775,483 34,141,062

24 25 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Gou Dev’t: 0 0 0

Ext Fin: 7,885,205 0 9,081,987

A.I.A: 0 0 0

Development Project : 1566 Retooling of Ministry of Health

Output: 08 02 72 Government Buildings and Administrative Infrastructure

MOH Headquarters toilets and lighting renovated and corridors tiled. Wabigalo Offices for HID renovated. Perimeter wall at Wabigalo constructed. Elevator at MOH Headquarters renovated MOH archives constructed at Wabigalo. TB offices renovated. Rehabilitationof MoH parking yard undertaken. Total Output Cost(Ushs Thousand) 0 0 1,177,000

Gou Dev’t: 0 0 1,177,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

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

Integrated Health Management Information System spread to all the Regional Refferal Hospitals

Computer, anti virus software and Laptops purchased for MoH Headquarter staff Total Output Cost(Ushs Thousand) 0 0 6,336,000

Gou Dev’t: 0 0 6,336,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 02 80 Hospital Construction/rehabilitation

Final certificates and retention for Specialised Maternal and Neonatal Hospital cleared Total Output Cost(Ushs Thousand) 0 0 2,000,000

Gou Dev’t: 0 0 2,000,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Program : 08 05 Pharmaceutical and other Supplies

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

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

Purchase of motor vehicles Film Vans for HIV grant and Motor vehicles for LLIN Total Output Cost(Ushs Thousand) 0 0 1,102,000

Gou Dev’t: 0 0 0

Ext Fin: 0 0 1,102,000

26 27 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Gou Dev’t: 0 0 0 A.I.A: 0 0 0

Ext Fin: 7,885,205 0 9,081,987 Development Project : 1436 GAVI Vaccines and Health Sector Development Plan Support

A.I.A: 0 0 0 Output: 08 05 77 Purchase of Specialised Machinery & Equipment

Development Project : 1566 Retooling of Ministry of Health 1 standby generator, 10 generators, 2 cold rooms, 122 fire 5,213 Vaccine Carriers 18 SDD refrigerators procured extinguishers, 5000 PQS compliant vaccine carriers & 1155 Output: 08 02 72 Government Buildings and Administrative Infrastructure PQS compliant cold boxes, 2500 CCEOP equipment & 1,155 cold boxes 365 freeze free vaccine carriers procured assorted spare parts procured MOH Headquarters toilets and lighting renovated 635 cold chain equipment under CCEOP and corridors tiled. Wabigalo Offices for HID renovated. Total Output Cost(Ushs Thousand) 13,362,610 0 6,148,521 Perimeter wall at Wabigalo constructed. Elevator at MOH Headquarters renovated Gou Dev’t: 0 0 0 MOH archives constructed at Wabigalo. TB offices renovated. Ext Fin: 13,362,610 0 6,148,521 Rehabilitationof MoH parking yard undertaken. Total Output Cost(Ushs Thousand) 0 0 1,177,000 A.I.A: 0 0 0

Gou Dev’t: 0 0 1,177,000 X. Vote Challenges and Plans To Improve Performance Ext Fin: 0 0 0

A.I.A: 0 0 0 Vote Challenges

Output: 08 02 76 Purchase of Office and ICT Equipment, including Software 1. Huge disease burden owing to mainly malaria, new-born conditions and growing number of NCDs. 2. Inadequate staffing at all levels a significant number of posts are not filled and current staffing norms not commensurate with Integrated Health Management Information System spread to all the Regional Refferal the services provided and workload. Hospitals 3. Inadequate funds for the maintenance of medical equipment nationwide. 4. Management of various disease outbreaks and public health emergencies is not equitably funded. Computer, anti virus software and Laptops 5. The current influx of refugees into the country and internally displaced persons puts pressure on existing resources and is a risk purchased for MoH Headquarter staff of importation of vaccine preventable diseases. Total Output Cost(Ushs Thousand) 0 0 6,336,000 6. Poor governance and management practices at health facilities. Gou Dev’t: 0 0 6,336,000 7. Stocks outs of key commodities at facility level owing to inadequate budget allocation for EMHS. 8. Domestic arrears totalling up to Shillings. 42 billion not provided for in the budget. Ext Fin: 0 0 0

A.I.A: 0 0 0 Plans to improve Vote Performance Output: 08 02 80 Hospital Construction/rehabilitation • Investment in health promotion and disease prevention interventions since 75% of the diseases are preventable. Final certificates and retention for Specialised • The staffing norms will be revised to take into consideration the growing population and range of services provided. Maternal and Neonatal Hospital cleared • Prioritize equipping and accreditation of HC IVs to provide blood transfusion for improving Emergency Obstetric and Newborn Total Output Cost(Ushs Thousand) 0 0 2,000,000 Care. Gou Dev’t: 0 0 2,000,000 • Increased focus on retooling and maintenance of medical equipment including training and recruitment of Biomedical Engineers. • Advocacy for financing of the Refugee Health and Nutrition Plan from contingency funds at district and national level for Ext Fin: 0 0 0 epidemic response. • Strengthen supervision and mentorship of the Local Governments and health facilities. A.I.A: 0 0 0 • Continue to improve infrastructure including staff accommodation. Program : 08 05 Pharmaceutical and other Supplies • Emphasize data use at subnational level and point of collection through training and mentorship and in with collaboration with the Division of Health Information. Development Project : 0220 Global Fund for AIDS, TB and Malaria • Improve coordination of donors and ensuring alignment to country strategies to the Paris Declaration principles for more aid effectiveness. Output: 08 05 75 Purchase of Motor Vehicles and Other Transport Equipment

Purchase of motor vehicles Film Vans for HIV grant and Motor vehicles for LLIN XI Off Budget Support Total Output Cost(Ushs Thousand) 0 0 1,102,000 Table 11.1 Off-Budget Support by Sub-Programme Gou Dev’t: 0 0 0

Ext Fin: 0 0 1,102,000

26 27 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0806 Public Health Services 9.34 6.46 Recurrent Budget Estimates 14 Reproductive and Child Health 9.34 6.46 427-United Nations Population Fund 9.34 6.46

Programme 0808 Clinical Health Services 0.38 0.78 Recurrent Budget Estimates 16 Emergency Medical Services 0.38 0.78 526-Korea S. (Rep) 0.38 0.78

Total for Vote 9.72 7.24

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Reduce HIV/AIDS prevalence Issue of Concern : The increasing HIV/AIDs prevalence Planned Interventions : The HIV Care and treatment program has been scaled up. The number of centers providing ART services currently is 1,830. The ministry will continue to spread awareness on HIV/AIDs prevention, control and treatment. Budget Allocation (Billion) : 7.000 Performance Indicators: Number of individuals tested. Number of HIV-tested individuals treated. Number of condoms procured. Number of condoms distributed. Issue Type: Gender

Objective : To make Health Services accessible to all Issue of Concern : Difficulty in accessing Health services in some part of the country Planned Interventions : Health infrastructure designs reviewed to make structural considerations for: pregnant mothers, mothers with disabilities Special consideration to be made for populations in hard to reach areas Budget Allocation (Billion) : 3.000 Performance Indicators: Proportion of the functional health centre IVs(offering ceaserian and blood transfusion section) Proportion of subcounties with functional HC IIIs Proportion of functional imaging and radiography equipment in hospitals

Issue Type: Enviroment

Objective : Control of epidemic diseases and other infections Issue of Concern : High disease burden, of which, 70% is preventable through proper hygiene and sanitation

28 29 Ministry of Health Ministerial Policy Statement FY 2020/21 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:014 Ministry of Health

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Planned Interventions : Fuctionalization of the National Sanitation Working Group. Budget Estimates Programme 0806 Public Health Services 9.34 6.46 Promotion of environmentally friendly energy sources e.g. solar & water harvesting in Health Facilities Recurrent Budget Estimates

14 Reproductive and Child Health 9.34 6.46 Budget Allocation (Billion) : 2.500 427-United Nations Population Fund 9.34 6.46 Performance Indicators: Number of Villages declared Open Defecation free. Programme 0808 Clinical Health Services 0.38 0.78 Number of Hand washing facilities at rural latrines Recurrent Budget Estimates XIII. Personnel Information 16 Emergency Medical Services 0.38 0.78 526-Korea S. (Rep) 0.38 0.78 Table 13.1 Staff Establishment Analysis

Total for Vote 9.72 7.24 Title Salary Scale Number Of Approved Positions Number Of Filled Positions XII. Vote Cross Cutting Policy And Other Budgetary Issues Assistant U1E 1 0 Commisioner/Informationand Table 12.1: Cross- Cutting Policy Issues Knowledge Management Issue Type: HIV/AIDS Assistant Commissioner U1E 7 0 Assistant Commissioner (HP&E) U1E 1 0 Objective : Reduce HIV/AIDS prevalence Assistant Commissioner Clinical U1E 1 0 Issue of Concern : The increasing HIV/AIDs prevalence Pathology and Laboratory Services Planned Interventions : The HIV Care and treatment program has been scaled up. The number of centers providing ART Assistant Commissioner Human U1E 1 0 services currently is 1,830. Resource Development The ministry will continue to spread awareness on HIV/AIDs prevention, control and treatment. Director U1SE 2 0 Budget Allocation (Billion) : 7.000 Commissioner U1SE 5 0 Performance Indicators: Number of individuals tested. Director Strategy, Policy and U1SE 1 0 Number of HIV-tested individuals treated. Development Number of condoms procured. Number of condoms distributed. Senior Planner - Human Resources U3 1 0 for Health Issue Type: Gender Gender and Equity Officer U4 1 0 Objective : To make Health Services accessible to all Driver U8 5 0 Issue of Concern : Difficulty in accessing Health services in some part of the country Office Attendant U8 5 0 Planned Interventions : Health infrastructure designs reviewed to make structural considerations for: pregnant mothers, mothers with disabilities Table 13.2 Staff Recruitment Plan Special consideration to be made for populations in hard to reach areas Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Budget Allocation (Billion) : 3.000 Scale Approved Filled Posts Posts Cleared for Per Month Salary Performance Indicators: Proportion of the functional health centre IVs(offering ceaserian and blood transfusion section) Posts Filling (UGX) (UGX) Proportion of subcounties with functional HC IIIs FY2020/21 Proportion of functional imaging and radiography equipment in hospitals Director U1SE 2 0 2 2 5,786,504 69,438,048 Assistant U1E 1 0 1 1 2,328,850 27,946,199 Issue Type: Enviroment Commisioner/Informationand Knowledge Management Objective : Control of epidemic diseases and other infections Assistant Commissioner U1E 7 0 7 7 16,301,950 195,623,400 Assistant Commissioner (HP&E) U1E 1 0 1 1 2,328,850 27,946,200 Issue of Concern : High disease burden, of which, 70% is preventable through proper hygiene and sanitation Assistant Commissioner Clinical U1E 1 0 1 1 1,728,007 20,736,080 Pathology and Laboratory Services

28 29 Ministry of Health Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health

Assistant Commissioner Human U1E 1 0 1 1 1,690,780 20,289,360 Resource Development Commissioner U1SE 5 0 5 5 13,140,375 157,684,500 Director Strategy, Policy and U1SE 1 0 1 1 2,369,300 28,431,605 Development Driver U8 5 0 5 5 1,049,295 12,591,540 Gender and Equity Officer U4 1 0 1 1 940,366 11,284,391 Office Attendant U8 5 0 5 5 1,141,580 13,698,960 Senior Planner - Human Resources U3 1 0 1 1 990,589 11,887,064 for Health Total 31 0 31 31 49,796,446 597,557,347

30 31 Ministry of Health Ministerial Policy Statement FY 2020/21 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:014 Ministry of Health Vote:114 Uganda Cancer Institute

Assistant Commissioner Human U1E 1 0 1 1 1,690,780 20,289,360 Resource Development V1: Vote Overview Commissioner U1SE 5 0 5 5 13,140,375 157,684,500 I. Vote Mission Statement Director Strategy, Policy and U1SE 1 0 1 1 2,369,300 28,431,605 Development Provision of state of the art cancer prevention and care by advancing knowledge, fostering the use of research as a resource in Driver U8 5 0 5 5 1,049,295 12,591,540 training and professional development Gender and Equity Officer U4 1 0 1 1 940,366 11,284,391 II. Strategic Objective Office Attendant U8 5 0 5 5 1,141,580 13,698,960 Senior Planner - Human Resources U3 1 0 1 1 990,589 11,887,064 To offer super specialized services in areas of cancer treatment, research and prevention through conducting research into all for Health aspects of common cancers in Uganda, provision of optimal evidence based clinical care, and provision of training for health Total 31 0 31 31 49,796,446 597,557,347 care professionals using endemic cancers as model disease training. III. Major Achievements in 2019/20 CANCER RESEARCH SERVICES 2 REC monitoring reviews were carried out and 7 REC meetings were held 11 Collaborative research studies (2 MUJHU, 7 Fred Hutch and 2 Cambridge) were initiated at the UCI 15 UCI staff supported UCI staff to present at International Conferences and Research fora 15 student initiated research proposals were supported. 27 research proposals were reviewed by UCI Research Ethic Committee 2 clinical trials (Mirasol trial, Rituximab trial) were initiated at the UCI

CANCER CARE SERVICES 151,958 prescriptions were dispensed to patients 761 minor and 138 major surgical procedures were carried out at UCI 263,599 assorted clinical laboratory investigations (CBCs, chemistries, Blood transfusion, platelets transfusions, HIV tests, Urine analysis, Bone marrow processing, Peripheral films, B/S for malaria, cytology, Micro biology) were conducted at UCI 151,958 prescriptions were dispensed to patients 4,642 inpatient days of comprehensive oncology clinical care were provided at UCI satellite clinics 6,720 outpatient days of comprehensive oncology clinical care were provided at UCI satellite clinics 21,640 inpatient days of comprehensive oncology clinical care provided at UCI 26,415 outpatient days of comprehensive oncology clinical care were provided at UCI 2,474 (Females: 1,424. Males:1,050) new patient cases received and attended to at UCI 37,845 chemo for infusion was reconstituted at the UCI pharmacy

CANCER OUTREACH SERVICES 7 Short distance cancer awareness and screening in communities conducted 129 Cancer awareness and screening clinics were conducted at UCI 6 Long distance outreaches were conducted Conducted three cancer survivor-ship sessions with groups of cancer survivors. Conducted two TV and 6 radio talk shows. (UBC TV and three (3) Radio talk shows on Top Radio, Q FM in Lira, Radio North in Alebtong and UBC radio)

RADIOTHERAPY SERVICES 819 patients were planned for radiation therapy using CT-simulator, convention simulator and computer planning 17,031 treatment sessions were conducted on cobalt 60 machine 128 radiation therapy education sessions were provided to patients

UCI PROJECT Funds were front-loaded in Q2 and interim certificates were paid. All civil works associated with installation of the cobalt machine were finalized, pending commissioning of the cobalt-60 machine

30 31 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute

External works (boundary wall, parking yard etc) were executed. Electrical works (electrical fittings finalised in the bunkers, procurement of the main electrical panel/generator and transformer in the final stages.) Mechanical works 95% done, wall angles were fixed. External wall finishes done. Internal wall finishes 85% done. Electrical works; all wiring done, fixing of fittings commenced. Mechanical works 100% done.

ADB SUPPORT TO UCI 93 trainees have completed long-term training programs. These include eighteen (18) fellows in different programs including Paediatric Haematology and Oncology, Adult medical Oncology and Haematology, surgical oncology, gynaecologic Oncology and 1 in interventional radiology, 25 MMEDs (Radiology, surgery, internal medicine, pathology, anaesthesia and paediatrics), 1 Radio pharmaceutics, 17 other masters, and 31 other programs. Cast levels 1-2 of the multipurpose building. Completed block walling for level 1, Completed mechanical and electrical first fix for level, 90% excavations done. Cast levels 1-4 of block A of the multipurpose building. Foundation works of Block B done. Advance procurement of all capital electrical and mechanical equipment done to 60%. External works are at 25% progress. Construction works are currently at 20% instead of 41%

INSTITUTIONAL SUPPORT TO UCI Contract for procurement of a mammography machine was sent to Solicitor General for clearance. Contract for procurement of the rest of the assorted medical equipment was awarded to MIS histo Clear Diagnostic Supplies Ltd, MIS Abacus Pharmac Africa Ltd, later forwarded to Solicitor General for clearance since it is above the UGX 200m threshold.

IV. Medium Term Plans Construction and equipping the Northern Uganda oncology and diagnostic center Completion and commissioning the radiotherapy bunkers and completion of the auxiliary building. Construction and equipping the center of excellence Procurement of a mammography for breast cancer patients. Construction and equipping of the regional cancer centers.

32 33 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute Vote:114 Uganda Cancer Institute

External works (boundary wall, parking yard etc) were executed. Electrical works (electrical fittings finalised in the bunkers, procurement of the main electrical panel/generator and transformer in the final stages.) V. Summary of Past Performance and Medium Term Budget Allocations Mechanical works 95% done, wall angles were fixed. External wall finishes done. Internal wall finishes 85% done. Electrical works; all wiring done, fixing of fittings commenced. Table 5.1: Overview of Vote Expenditures (UShs Billion) Mechanical works 100% done. 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 ADB SUPPORT TO UCI Outturn Budget by End Dec 93 trainees have completed long-term training programs. These include eighteen (18) fellows in different programs including Wage 4.739 5.116 2.837 6.296 6.296 6.296 6.296 6.296 Paediatric Haematology and Oncology, Adult medical Oncology and Haematology, surgical oncology, gynaecologic Oncology Recurrent and 1 in interventional radiology, 25 MMEDs (Radiology, surgery, internal medicine, pathology, anaesthesia and paediatrics), 1 Non Wage 10.218 14.925 7.147 14.811 17.773 21.327 25.593 30.711 Radio pharmaceutics, 17 other masters, and 31 other programs. GoU 11.929 13.929 8.663 13.929 13.929 13.929 13.929 13.929 Cast levels 1-2 of the multipurpose building. Completed block walling for level 1, Completed mechanical and electrical first fix Devt. for level, 90% excavations done. Cast levels 1-4 of block A of the multipurpose building. Foundation works of Block B done. Ext. Fin. 20.470 57.288 9.922 70.812 0.000 0.000 0.000 0.000 Advance procurement of all capital electrical and mechanical equipment done to 60%. External works are at 25% progress. Construction works are currently at 20% instead of 41% GoU Total 26.886 33.970 18.647 35.036 37.998 41.552 45.818 50.936 Total GoU+Ext Fin (MTEF) 47.356 91.258 28.569 105.848 37.998 41.552 45.818 50.936 INSTITUTIONAL SUPPORT TO UCI Arrears 0.020 0.000 0.000 0.005 0.000 0.000 0.000 0.000 Contract for procurement of a mammography machine was sent to Solicitor General for clearance. Contract for procurement of the rest of the assorted medical equipment was awarded to MIS histo Clear Diagnostic Supplies Ltd, Total Budget 47.376 91.258 28.569 105.853 37.998 41.552 45.818 50.936 MIS Abacus Pharmac Africa Ltd, later forwarded to Solicitor General for clearance since it is above the UGX 200m threshold. A.I.A Total 1.432 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 48.808 91.258 28.569 105.853 37.998 41.552 45.818 50.936 IV. Medium Term Plans Total Vote Budget 48.788 91.258 28.569 105.848 37.998 41.552 45.818 50.936 Excluding Arrears Construction and equipping the Northern Uganda oncology and diagnostic center Completion and commissioning the radiotherapy bunkers and completion of the auxiliary building. Construction and equipping the center of excellence VI. Budget By Economic Clasification Procurement of a mammography for breast cancer patients. Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Construction and equipping of the regional cancer centers. 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 21.238 6.000 0.000 27.238 22.891 0.000 22.891

211 Wages and Salaries 7.273 0.000 0.000 7.273 8.927 0.000 8.927

212 Social Contributions 0.097 0.000 0.000 0.097 0.241 0.000 0.241

213 Other Employee Costs 0.318 0.000 0.000 0.318 0.173 0.000 0.173

221 General Expenses 1.507 6.000 0.000 7.507 1.434 0.000 1.434

222 Communications 0.151 0.000 0.000 0.151 0.145 0.000 0.145

223 Utility and Property Expenses 0.714 0.000 0.000 0.714 0.682 0.000 0.682

224 Supplies and Services 9.313 0.000 0.000 9.313 9.225 0.000 9.225

225 Professional Services 0.102 0.000 0.000 0.102 0.544 0.000 0.544

227 Travel and Transport 0.876 0.000 0.000 0.876 0.680 0.000 0.680

228 Maintenance 0.887 0.000 0.000 0.887 0.840 0.000 0.840

Output Class : Capital Purchases 12.732 51.288 0.000 64.020 12.144 70.812 82.956

281 Property expenses other than interest 0.150 0.000 0.000 0.150 0.300 0.000 0.300

32 33 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute

312 FIXED ASSETS 12.582 51.288 0.000 63.870 11.844 70.812 82.656

Output Class : Arrears 0.000 0.000 0.000 0.000 0.005 0.000 0.005

321 DOMESTIC 0.000 0.000 0.000 0.000 0.005 0.000 0.005

Grand Total : 33.970 57.288 0.000 91.258 35.041 70.812 105.853

Total excluding Arrears 33.970 57.288 0.000 91.258 35.036 70.812 105.848

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 57 Cancer Services 48.808 91.258 28.569 105.853 37.998 41.552 45.818 50.936

01 Management/support services 6.157 7.566 3.972 8.755 9.609 9.582 11.541 14.063

02 Medical Services 9.713 11.804 5.656 11.686 13.786 13.786 17.277 17.277

03 Internal Audit 0.025 0.065 0.030 0.065 0.065 0.065 0.065 0.700

04 Radiotherapy 0.513 0.605 0.326 0.605 0.608 4.190 3.004 4.966

1120 Uganda Cancer Institute Project 8.809 10.609 7.745 10.509 10.609 10.509 10.509 0.000

1345 ADB Support to UCI 22.459 59.277 10.781 72.801 1.989 1.989 1.989 0.000

1476 Institutional Support to Uganda Cancer 1.131 1.131 0.052 0.000 0.000 0.000 0.000 0.000 Institute 1527 Establishment of an Oncology Centre in 0.000 0.200 0.006 0.300 0.200 0.300 0.300 13.929 Northern Uganda 1570 Retooling of Uganda Cancer Institute 0.000 0.000 0.000 1.131 1.131 1.131 1.131 0.000

Total for the Vote 48.808 91.258 28.569 105.853 37.998 41.552 45.818 50.936

Total Excluding Arrears 48.788 91.258 28.569 105.848 37.998 41.552 45.818 50.936

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 57 Cancer Services Programme Objective To manage cancer and any cancer related diseases through research, care and training in the specialty of : oncology Responsible Officer: Dr Jackson Orem

Programme Outcome: Improved cancer services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets

34 35 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute Vote:114 Uganda Cancer Institute

312 FIXED ASSETS 12.582 51.288 0.000 63.870 11.844 70.812 82.656 Outcome Indicators 2020/21 2021/22 2022/23 Output Class : Arrears 0.000 0.000 0.000 0.000 0.005 0.000 0.005 Baseline Base year Target Projection Projection

321 DOMESTIC 0.000 0.000 0.000 0.000 0.005 0.000 0.005 • % reduction in cancer incidence 0.02% 2015 0.02% 0.03% 0.05% Grand Total : 33.970 57.288 0.000 91.258 35.041 70.812 105.853 • % change in disease presentation (from stage III & IV to II & I) 4.9% 2015 3% 3% 5% Total excluding Arrears 33.970 57.288 0.000 91.258 35.036 70.812 105.848 • % of patients under effective treatment 45% 2015 60% 65% 70%

VII. Budget By Programme And Subprogramme SubProgramme: 02 Medical Services

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Output: 01 Cancer Research Number of cancer research studies initiated and co 24 24 24 Billion Uganda shillings FY 2019/20 Medium Term Projections Number of peer reviewed publications and presentat 25 25 25 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Number of training workshops conducted by UCI 4 4 4 Budget 57 Cancer Services 48.808 91.258 28.569 105.853 37.998 41.552 45.818 50.936 Output: 02 Cancer Care Services 01 Management/support services 6.157 7.566 3.972 8.755 9.609 9.582 11.541 14.063 Number of inpatient stays 40,000 40,000 40,000

02 Medical Services 9.713 11.804 5.656 11.686 13.786 13.786 17.277 17.277 No.of investigations undertaken 900,000 900,000 900,000 03 Internal Audit 0.025 0.065 0.030 0.065 0.065 0.065 0.065 0.700 Number of outpatient visits 60,000 60,000 60,000 04 Radiotherapy 0.513 0.605 0.326 0.605 0.608 4.190 3.004 4.966 Number of new cancer patients registered 5,000 5,000 5,000 1120 Uganda Cancer Institute Project 8.809 10.609 7.745 10.509 10.609 10.509 10.509 0.000 Output: 03 Cancer Outreach Service 1345 ADB Support to UCI 22.459 59.277 10.781 72.801 1.989 1.989 1.989 0.000 Number of outreach visits conducted 32 32 32 1476 Institutional Support to Uganda Cancer 1.131 1.131 0.052 0.000 0.000 0.000 0.000 0.000 Institute Number of clients examined 61,600 61,600 61,600 1527 Establishment of an Oncology Centre in 0.000 0.200 0.006 0.300 0.200 0.300 0.300 13.929 Northern Uganda Number of clients screened 61,600 61,600 61,600 1570 Retooling of Uganda Cancer Institute 0.000 0.000 0.000 1.131 1.131 1.131 1.131 0.000 Total for the Vote 48.808 91.258 28.569 105.853 37.998 41.552 45.818 50.936 IX. Major Capital Investments And Changes In Resource Allocation 48.788 91.258 28.569 105.848 37.998 41.552 45.818 50.936 Total Excluding Arrears Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

VIII. Programme Performance and Medium Term Plans FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) end Dec Outputs Programme : 57 Cancer Services Vote 114 Uganda Cancer Institute Programme Objective To manage cancer and any cancer related diseases through research, care and training in the specialty of Program : 08 57 Cancer Services : oncology Development Project : 1120 Uganda Cancer Institute Project Responsible Officer: Dr Jackson Orem Output: 08 57 72 Government Buildings and Administrative Infrastructure

Programme Outcome: Improved cancer services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets

34 35 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute

Complete 100% civil works construction of the Radiotherapy Funds were front-loaded in Q2 and interim 85% civil works of the auxiliary building Bunkers and installation of the LINAC machine (8.2Bn) certificates were paid. All civil works completed Complete 85% civil works construction of the service support associated with installation of the cobalt Interim certificates for construction of building for the radiotherapy bunkers and nuclear medicine. machine were finalized, pending radiotherapy bunkers and the auxiliary building Expansion of the pediatric wing initiated (2Bn) commissioning of the cobalt-60 machine paid Complete payment for fencing the land for the Regional External works (boundary wall, parking yard Cancer Center in Mbarara (200m) etc) were executed. Electrical works (electrical Protective fence for CCCP building erected fittings finalised in the bunkers, procurement of CCCP building furnished (25m) the main electrical panel/generator and The Cancer Registry in Mayuge refurbished UCI UMEME meters separated from Mulago NRH meters transformer in the final stages.) (81m) Mechanical works 95% done Wall angles fixed.

Funds were front-loaded in Q2 and interim certificates were paid. External wall finishes done. Internal wall finishes 85% done Electrical works; all wiring done, fixing of fittings commenced. Mechanical works 100% done. Drainage pipes fixed.

Payment for fencing the land for the Regional Cancer Center in Mbarara was made

Contract for erecting the protective fence was awarded. Payment for separating UMEME meters was made

Total Output Cost(Ushs Thousand) 10,309,000 7,745,499 8,545,235

Gou Dev’t: 10,309,000 7,745,499 8,545,235

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 57 77 Purchase of Specialised Machinery & Equipment

Final payment for mammography completed.

Total Output Cost(Ushs Thousand) 0 0 850,000

Gou Dev’t: 0 0 850,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Development Project : 1345 ADB Support to UCI

Output: 08 57 72 Government Buildings and Administrative Infrastructure

Complete construction of the Multipurpose building for the Cast levels 1-2 of the building Completed block Multipurpose building for the center of excellence East Africa Center of Excellence in Oncology. Handover of walling for level 1 Completed mechanical and completed the Building by June 2020 electrical first fix for level 1. 90% excavations done. cast levels 1-4 of block A of the building. Foundation works of Block B done. Advance procurement of all capital electrical and mechanical equipment done to 60%. External works are at 25% progress. Construction works are currently at 20% instead of 41%

36 37 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute Vote:114 Uganda Cancer Institute

Complete 100% civil works construction of the Radiotherapy Funds were front-loaded in Q2 and interim 85% civil works of the auxiliary building Total Output Cost(Ushs Thousand) 40,690,577 3,104,910 71,646,287 Bunkers and installation of the LINAC machine (8.2Bn) certificates were paid. All civil works completed Complete 85% civil works construction of the service support associated with installation of the cobalt Interim certificates for construction of Gou Dev’t: 652,365 158,832 834,265 building for the radiotherapy bunkers and nuclear medicine. machine were finalized, pending radiotherapy bunkers and the auxiliary building Expansion of the pediatric wing initiated (2Bn) commissioning of the cobalt-60 machine paid Ext Fin: 40,038,212 2,946,078 70,812,023 Complete payment for fencing the land for the Regional External works (boundary wall, parking yard Cancer Center in Mbarara (200m) etc) were executed. Electrical works (electrical A.I.A: 0 0 0 Protective fence for CCCP building erected fittings finalised in the bunkers, procurement of CCCP building furnished (25m) the main electrical panel/generator and The Cancer Registry in Mayuge refurbished Development Project : 1570 Retooling of Uganda Cancer Institute UCI UMEME meters separated from Mulago NRH meters transformer in the final stages.) (81m) Mechanical works 95% done Output: 08 57 77 Purchase of Specialised Machinery & Equipment Wall angles fixed. 40 color coded bins, 20 basic monitors, 8 Funds were front-loaded in Q2 and interim weighing scales, 30 oxygen concetrators, 30 drip certificates were paid. External wall finishes stands, 5 patient stretchers, 15 stethoscopes, 5 done. Internal wall finishes 85% done patient exterminators, 2 laparotomy sets, 5 oxygen Electrical works; all wiring done, fixing of cylinders, 20 plastic contain, 20 infusion pumps fittings commenced. procured (294m) Mechanical works 100% done. Assorted medical equipment procured Drainage pipes fixed. Automatic injector (100m), Mould room equipment for radiotherapy (150m), Slide stainer Payment for fencing the land for the Regional (42m),Tissue cassette printer (65m), temperature Cancer Center in Mbarara was made monitoring system for pharmacy (100m)

Contract for erecting the protective fence was Total Output Cost(Ushs Thousand) 0 0 751,000 awarded. Payment for separating UMEME meters was Gou Dev’t: 0 0 751,000 made Ext Fin: 0 0 0

A.I.A: 0 0 0 Total Output Cost(Ushs Thousand) 10,309,000 7,745,499 8,545,235

Gou Dev’t: 10,309,000 7,745,499 8,545,235 X. Vote Challenges and Plans To Improve Performance Ext Fin: 0 0 0 Vote Challenges A.I.A: 0 0 0 Staffing Output: 08 57 77 Purchase of Specialised Machinery & Equipment The UCI currently operates under the previous staffing structure of a Department under Mulago Hospital. With the assent to the Final payment for mammography completed. UCI Act, the mandate of the UCI was expanded to coordinate the management of cancer and cancer related diseases in the country. The UCI ought to be restructured in order to expand the staffing capacity so as to undertake the wider mandate of the Institute. Total Output Cost(Ushs Thousand) 0 0 850,000 Inadequate infrastructure Gou Dev’t: 0 0 850,000 The current infrastructure cannot accommodate the large patient numbers, both the inpatients and the patient hostels. At the OPD, Ext Fin: 0 0 0 the men and women share wards. This in effect compromises the quality of care.

A.I.A: 0 0 0 Financing for regional centers. There are over 32,000 new patient cases annually as per the Kampala Cancer Registry. Only 20% (5000) make it to the UCI. There Development Project : 1345 ADB Support to UCI is need to construct regional centers in order to bring services closer to the people whilst de-congesting the main UCI campus. Output: 08 57 72 Government Buildings and Administrative Infrastructure Inadequate funding for drugs Complete construction of the Multipurpose building for the Cast levels 1-2 of the building Completed block Multipurpose building for the center of excellence With the increasing cost of cancer drugs, the current budget (8.8Bn) is insufficient to cater to the high patient numbers at the UCI. East Africa Center of Excellence in Oncology. Handover of walling for level 1 Completed mechanical and completed The current budget is grossly subsidized by donations, without which would adversely render the current budget inadequate. the Building by June 2020 electrical first fix for level 1. 90% excavations done. cast levels 1-4 of block A of the building. Foundation works of Block B done. Advance Plans to improve Vote Performance procurement of all capital electrical and mechanical equipment done to 60%. External works are at 25% progress. Fast-track the establishment of the regional cancer centers in order to bring services closer to the people whilst curbing the severe Construction works are currently at 20% problem of congestion at UCI instead of 41% Approve the restructuring process to bring more cancer specialists on board

36 37 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0857 Cancer Services 0.00 18.36 Recurrent Budget Estimates 02 Medical Services 0.00 18.36 400-MULTI-LATERAL DEVELOPMENT PARTNERS 0.00 18.36

Total for Vote 0.00 18.36

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Non description of HIV/AIDS patients Issue of Concern : Non discrimination of persons living with HIV Planned Interventions : Draft UCI HR Structure and manual developed Budget Allocation (Billion) : 0.020 Performance Indicators: Draft UCI HR Structure and manual Issue Type: Gender

Objective : Non discrimination of cancer patients by gender

Issue of Concern : Gender responsiveness Planned Interventions : Gender mainstreaming guidelines disseminated Budget Allocation (Billion) : 0.020 Performance Indicators: Gender mainstreaming guidelines Issue Type: Enviroment

Objective : Disposal of bio and cytotoxic waste according to standards

Issue of Concern : Safe disposal of waste Planned Interventions : Timely disposal of radioactive materials and cytotoxic waste Budget Allocation (Billion) : 0.050 Performance Indicators: Number of dispatches of cytotoxic waste

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

38 39 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21 Uganda Cancer Institute Ministerial Policy Statement FY 2020/21

Vote:114 Uganda Cancer Institute Vote:114 Uganda Cancer Institute

XI Off Budget Support Title Salary Scale Number Of Approved Positions Number Of Filled Positions MEDICAL OFFICER SPECIAL U2-SC 8 6 Table 11.1 Off-Budget Support by Sub-Programme GRADE Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Principal Clinical Officer U3 SC 1 0 Budget Estimates Principal Nursing Officer U3 SC 4 2 Programme 0857 Cancer Services 0.00 18.36 Recurrent Budget Estimates Senior physiotherapist U3 SC 1 0 02 Medical Services 0.00 18.36 Sen. Cancer Registrar U3 Up 1 0 400-MULTI-LATERAL DEVELOPMENT PARTNERS 0.00 18.36 PRINCIPAL RADIOGRAPHER U3SC 2 1 Total for Vote 0.00 18.36 Senior Clinical Officer U4 SC 1 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues Health Educator U4SC 4 2 Table 12.1: Cross- Cutting Policy Issues MEDICAL OFFICER U4SC 20 13 SENIOR RADIOGRAPHER U4SC 2 1 Issue Type: HIV/AIDS LABORATORY TECHNICIAN U5-SC 4 3 Objective : Non description of HIV/AIDS patients DISPENSER U5SC 4 3 Issue of Concern : Non discrimination of persons living with HIV PHYSIOTHERAPIST U5SC 2 1 Planned Interventions : Draft UCI HR Structure and manual developed RADIOGRAPHER U5SC 3 2 Budget Allocation (Billion) : 0.020 NURSING ASSISTANT U8 Up 4 2 Performance Indicators: Draft UCI HR Structure and manual Table 13.2 Staff Recruitment Plan Issue Type: Gender Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Objective : Non discrimination of cancer patients by gender Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Issue of Concern : Gender responsiveness FY2020/21 DISPENSER U5SC 4 3 1 1 1,200,000 14,400,000 Planned Interventions : Gender mainstreaming guidelines disseminated Health Educator U4SC 4 2 2 2 4,400,000 52,800,000 Budget Allocation (Billion) : 0.020 LABORATORY TECHNICIAN U5-SC 4 3 1 1 924,091 11,089,092 Performance Indicators: Gender mainstreaming guidelines MEDICAL OFFICER U4SC 20 13 7 2 6,000,000 72,000,000 Issue Type: Enviroment MEDICAL OFFICER SPECIAL U2-SC 8 6 2 2 4,927,222 59,126,664 GRADE NURSING ASSISTANT U8 Up 4 2 2 2 599,718 7,196,616 Objective : Disposal of bio and cytotoxic waste according to standards PHYSIOTHERAPIST U5SC 2 1 1 1 1,200,000 14,400,000 Issue of Concern : Safe disposal of waste Principal Clinical Officer U3 SC 1 0 1 1 1,204,288 14,451,456 Principal Nursing Officer U3 SC 4 2 2 2 2,920,480 35,045,760 Planned Interventions : Timely disposal of radioactive materials and cytotoxic waste PRINCIPAL RADIOGRAPHER U3SC 2 1 1 1 1,885,742 22,628,904 Budget Allocation (Billion) : 0.050 RADIOGRAPHER U5SC 3 2 1 1 1,200,000 14,400,000 Performance Indicators: Number of dispatches of cytotoxic waste Sen. Cancer Registrar U3 Up 1 0 1 1 979,805 11,757,660 Senior Clinical Officer U4 SC 1 0 1 1 1,276,442 15,317,304 XIII. Personnel Information Senior physiotherapist U3 SC 1 0 1 1 1,204,288 14,451,456 Table 13.1 Staff Establishment Analysis SENIOR RADIOGRAPHER U4SC 2 1 1 1 2,200,000 26,400,000 Total 61 36 25 20 32,122,076 385,464,912

38 39 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute

V1: Vote Overview I. Vote Mission Statement To provide preventive, promotive and clinical cardiovascular services and conduct research and training in cardiovascular science

II. Strategic Objective To enhance prevention and promotion of cardiovascular care

III. Major Achievements in 2019/20 Heart care: • 255 out of 400 planned cardiac interventions performed (44 open heart surgeries, 24 closed heart surgeries and 187 catheterization procedures). • 10,434 out of 12,500 planned outpatient attendances. • 5,783 out of 8,000 planned ECHOs and 4,506 out of 7,000 planned ECGs, 54,373 out of 75,000 planned laboratory tests done. • 719 out of 900 planned general ward admissions and 327 out of 350 planned ICU/CCU admissions.

Heart Research: • 7 out of 5 planned research papers on RHD, heart failure, cardiac surgery and cardiac intensive care published in international peer reviewed journals. • Ongoing disease registries for Arrhythmia, Acute Myocardial Infarction, Paediatric Cardiology and hypertension. • UHI Research Ethics Committee approval process ongoing.

Heart Outreaches: • 6 support supervision visits to Moroto, Hoima, Kiwoko, Lira, Fort Portal and Arua Regional Referral Hospitals out of the 7 planned visits. • Participated in 3 out of 5 planned health camps; World Heart Day, National Physical Activity Day, and Judiciary camp. • Enhanced awareness of heart diseases through media talk shows on UBC, NTV and NBS.

Uganda Heart Institute Project: • Renovation works of the 12-bed ICU ongoing. • 1 anaesthesia machine procured.

Heart Institute Support Services: • UHI Board facilitated. • UHI management and staff meetings facilitated. • Service providers contracted for cleaning, sanitation, maintenance services. • UHI utilities paid. • UHI staff salaries and pension paid. • Staff Professional Fee paid. IV. Medium Term Plans • Increase number of cardiac interventions to reduce referrals abroad. • Improve infrastructure by constructing and equipping the UHI home. • Set up regional cardiac clinics to improve access to heart care for all. • Carry out basic and clinical research in heart disease and its management. • Promote awareness and prevention of heart disease.

40 41 Uganda Heart Institute Ministerial Policy Statement FY 2020/21 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute Vote:115 Uganda Heart Institute

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To provide preventive, promotive and clinical cardiovascular services and conduct research and training in cardiovascular science 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 3.768 4.599 2.002 4.599 4.599 4.599 4.599 4.599 To enhance prevention and promotion of cardiovascular care Recurrent Non Wage 4.628 15.458 6.138 15.738 18.885 22.662 27.195 32.634 III. Major Achievements in 2019/20 GoU 4.284 4.650 1.705 4.650 4.650 4.650 4.650 4.650 Devt. Heart care: 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • 255 out of 400 planned cardiac interventions performed (44 open heart surgeries, 24 closed heart surgeries and 187 Ext. Fin. catheterization procedures). GoU Total 12.680 24.707 9.845 24.987 28.134 31.911 36.444 41.883 • 10,434 out of 12,500 planned outpatient attendances. • 5,783 out of 8,000 planned ECHOs and 4,506 out of 7,000 planned ECGs, 54,373 out of 75,000 planned laboratory tests done. Total GoU+Ext Fin (MTEF) 12.680 24.707 9.845 24.987 28.134 31.911 36.444 41.883 • 719 out of 900 planned general ward admissions and 327 out of 350 planned ICU/CCU admissions. Arrears 0.076 0.000 0.000 0.063 0.000 0.000 0.000 0.000 Heart Research: Total Budget 12.756 24.707 9.845 25.050 28.134 31.911 36.444 41.883 • 7 out of 5 planned research papers on RHD, heart failure, cardiac surgery and cardiac intensive care published in international peer reviewed journals. A.I.A Total 4.831 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • Ongoing disease registries for Arrhythmia, Acute Myocardial Infarction, Paediatric Cardiology and hypertension. 17.587 24.707 9.845 25.050 28.134 31.911 36.444 41.883 • UHI Research Ethics Committee approval process ongoing. Grand Total Total Vote Budget 17.510 24.707 9.845 24.987 28.134 31.911 36.444 41.883 Heart Outreaches: Excluding Arrears • 6 support supervision visits to Moroto, Hoima, Kiwoko, Lira, Fort Portal and Arua Regional Referral Hospitals out of the 7 planned visits. VI. Budget By Economic Clasification • Participated in 3 out of 5 planned health camps; World Heart Day, National Physical Activity Day, and Judiciary camp. • Enhanced awareness of heart diseases through media talk shows on UBC, NTV and NBS. Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

Uganda Heart Institute Project: 2019/20 Approved Budget 2020/21 Draft Estimates • Renovation works of the 12-bed ICU ongoing. • 1 anaesthesia machine procured. Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 20.057 0.000 0.000 20.057 20.337 0.000 20.337 Heart Institute Support Services: • UHI Board facilitated. 211 Wages and Salaries 6.207 0.000 0.000 6.207 6.421 0.000 6.421 • UHI management and staff meetings facilitated. 212 Social Contributions 0.182 0.000 0.000 0.182 0.282 0.000 0.282 • Service providers contracted for cleaning, sanitation, maintenance services. • UHI utilities paid. 213 Other Employee Costs 0.123 0.000 0.000 0.123 0.437 0.000 0.437 • UHI staff salaries and pension paid. • Staff Professional Fee paid. 221 General Expenses 1.784 0.000 0.000 1.784 1.451 0.000 1.451 222 Communications 0.195 0.000 0.000 0.195 0.190 0.000 0.190 IV. Medium Term Plans 223 Utility and Property Expenses 0.377 0.000 0.000 0.377 0.367 0.000 0.367 • Increase number of cardiac interventions to reduce referrals abroad. • Improve infrastructure by constructing and equipping the UHI home. 224 Supplies and Services 5.828 0.000 0.000 5.828 5.828 0.000 5.828 • Set up regional cardiac clinics to improve access to heart care for all. 225 Professional Services 0.000 0.000 0.000 • Carry out basic and clinical research in heart disease and its management. 3.288 3.288 3.283 3.283 • Promote awareness and prevention of heart disease. 226 Insurances and Licenses 0.365 0.000 0.000 0.365 0.257 0.000 0.257

227 Travel and Transport 0.843 0.000 0.000 0.843 0.970 0.000 0.970

228 Maintenance 0.865 0.000 0.000 0.865 0.850 0.000 0.850

Output Class : Capital Purchases 4.650 0.000 0.000 4.650 4.650 0.000 4.650

40 41 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute

281 Property expenses other than interest 0.150 0.000 0.000 0.150 0.150 0.000 0.150

312 FIXED ASSETS 4.500 0.000 0.000 4.500 4.500 0.000 4.500

Output Class : Arrears 0.000 0.000 0.000 0.000 0.063 0.000 0.063

321 DOMESTIC 0.000 0.000 0.000 0.000 0.063 0.000 0.063

Grand Total : 24.707 0.000 0.000 24.707 25.050 0.000 25.050

Total excluding Arrears 24.707 0.000 0.000 24.707 24.987 0.000 24.987

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 58 Heart Services 17.550 24.707 9.845 25.050 28.134 31.911 36.444 41.883

01 Management 5.899 9.707 3.875 9.948 11.670 12.569 13.829 18.070

02 Medical Services 7.351 10.331 4.255 10.435 11.790 14.657 17.925 19.113

03 Internal Audit 0.016 0.020 0.010 0.017 0.025 0.035 0.040 0.050

1121 Uganda Heart Institute Project 4.284 4.500 1.705 0.000 0.000 0.000 0.000 0.000

1526 Uganda Heart Institute Infrastructure 0.000 0.150 0.000 0.150 0.150 0.150 0.150 0.150 Development Project 1568 Retooling of Uganda Heart Institute 0.000 0.000 0.000 4.500 4.500 4.500 4.500 4.500

Total for the Vote 17.550 24.707 9.845 25.050 28.134 31.911 36.444 41.883

Total Excluding Arrears 17.474 24.707 9.845 24.987 28.134 31.911 36.444 41.883

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 58 Heart Services Programme Objective 1. To enhance health promotion and prevention of cardiovascular disease : 2. To increase institutional effectiveness and efficiency in delivery of cardiovascular services

3. To provide quality, equitable and accessible cardiovascular services to both local and international clients.

4. To carry out clinical and operational research in cardiovascular disease and its management. Responsible Officer: Dr. Omagino O.O. John Programme Outcome: Quality and accessible Heart Services Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector

42 43 Uganda Heart Institute Ministerial Policy Statement FY 2020/21 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute Vote:115 Uganda Heart Institute

281 Property expenses other than interest 0.150 0.000 0.000 0.150 0.150 0.000 0.150 Performance Targets 312 FIXED ASSETS 4.500 0.000 0.000 4.500 4.500 0.000 4.500 Outcome Indicators 2020/21 2021/22 2022/23 Output Class : Arrears 0.000 0.000 0.000 0.000 0.063 0.000 0.063 Baseline Base year Target Projection Projection

321 DOMESTIC 0.000 0.000 0.000 0.000 0.063 0.000 0.063 • Proportion of patients in need of cardiac surgery operated 60% 2019 70% 80% 90% Grand Total : 24.707 0.000 0.000 24.707 25.050 0.000 25.050 • Annual(%) decrease in number of referrals for heart conditions abroad 38% 2019 30% 28% 25% Total excluding Arrears 24.707 0.000 0.000 24.707 24.987 0.000 24.987 SubProgramme: 02 Medical Services VII. Budget By Programme And Subprogramme Output: 01 Heart Research No. of Proposals on Heart Disease 10 15 20 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme No. of Publications on Heart Disease 10 15 20 Billion Uganda shillings FY 2019/20 Medium Term Projections Output: 02 Heart Care Services FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed No. of heart operations 150 200 300 Budget 58 Heart Services 17.550 24.707 9.845 25.050 28.134 31.911 36.444 41.883 No. of Outpatients 25,000 30,000 30,000 01 Management 5.899 9.707 3.875 9.948 11.670 12.569 13.829 18.070 No. of Thoracic and Closed Heart Operations 650 800 1,000

02 Medical Services 7.351 10.331 4.255 10.435 11.790 14.657 17.925 19.113 % Reduction in Referrals abroad 30% 28% 25% 03 Internal Audit 0.016 0.020 0.010 0.017 0.025 0.035 0.040 0.050

1121 Uganda Heart Institute Project 4.284 4.500 1.705 0.000 0.000 0.000 0.000 0.000 IX. Major Capital Investments And Changes In Resource Allocation

1526 Uganda Heart Institute Infrastructure 0.000 0.150 0.000 0.150 0.150 0.150 0.150 0.150 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Development Project 1568 Retooling of Uganda Heart Institute 0.000 0.000 0.000 4.500 4.500 4.500 4.500 4.500 FY 2019/20 FY 2020/21 Total for the Vote 17.550 24.707 9.845 25.050 28.134 31.911 36.444 41.883 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Total Excluding Arrears 17.474 24.707 9.845 24.987 28.134 31.911 36.444 41.883 Vote 115 Uganda Heart Institute

Program : 08 58 Heart Services VIII. Programme Performance and Medium Term Plans Development Project : 1568 Retooling of Uganda Heart Institute Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Output: 08 58 76 Purchase of Office and ICT Equipment, including Software Programme : 58 Heart Services - Access control system, CCTV camera system, Programme Objective 1. To enhance health promotion and prevention of cardiovascular disease automatic fire extinguisher system, refrigerator, 2 television sets and decoder procured. : - 28 computers, firewall system, 3 laptops, 4 2. To increase institutional effectiveness and efficiency in delivery of cardiovascular services printers, 1 heavy duty photocopier and other assorted office and ICT items 3. To provide quality, equitable and accessible cardiovascular services to both local and international Total Output Cost(Ushs Thousand) 0 0 662,170 clients. Gou Dev’t: 0 0 662,170

4. To carry out clinical and operational research in cardiovascular disease and its management. Ext Fin: 0 0 0 Responsible Officer: Dr. Omagino O.O. John A.I.A: 0 0 0 Programme Outcome: Quality and accessible Heart Services Output: 08 58 77 Purchase of Specialised Machinery & Equipment Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector

42 43 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute

- 1 slave patient monitor, 1 inline patient monitor, 1 portable echo machine, surgical operating instruments, ultrasound scan machine, syringe pumps, fluid warmer, bedside monitors, gas steriliser, coagulation analyser and assorted medical items. Total Output Cost(Ushs Thousand) 0 0 3,307,830

Gou Dev’t: 0 0 3,307,830

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

• Inadequate space to fully utilise UHI capacity. In the short term, UHI requires funding worth USD 4 Million for remodeling of ward 2C. While in the long run, funds worth USD 70 Million are required for constructing and equipping a state-of-the-art facility for UHI. • Limited funding for specialized sundries and human resource development. UHI requires the additional UGX 5.0 billion pledged by Parliament on 14th February 2018 to be able to perform 200 more cardiac interventions, conduct more research and train more staff in the areas of cardiac surgery, anaesthesia, critical care, perfusion and cardiology. - There is need for 100% release of funds for domestic arrears worth UGX 878,000,000.

Plans to improve Vote Performance

• Improve UHI funding mechanisms by identifying alternative sources of funding, enhancing research in heart care and improving access to quality heart care to generate more revenue. • Recruit and train more super specialised staff to fill the skills gap. • Timely procurement of super specialized supplies and sundries. • Acquire more space for UHI services. • Promote awareness and prevention of heart disease. XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

N/A

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Promote prevention by putting mechanisms in place to control its transmission to both staff and patients. Issue of Concern : Accidental injuries (needle or instrument pricks) and direct contact with infected persons. Planned Interventions : 1. Staff should wear uniforms and protective gears while attending to patients. 2. Conduct routine staff screening to establish the status of those injured at work. Budget Allocation (Billion) : 0.040 Performance Indicators: 1. Availability of uniforms and protective gears. 2. Routine screening of staff and patients.

44 45 Uganda Heart Institute Ministerial Policy Statement FY 2020/21 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute Vote:115 Uganda Heart Institute

- 1 slave patient monitor, 1 inline patient monitor, Issue Type: Gender 1 portable echo machine, surgical operating instruments, ultrasound scan machine, syringe pumps, fluid warmer, bedside monitors, gas Objective : Promote access to quality heart care to all regardless of gender. steriliser, coagulation analyser and assorted medical items. Issue of Concern : Inability to access heart services at UHI. Total Output Cost(Ushs Thousand) 0 0 3,307,830 Planned Interventions : Provide equal and accessible heart services to all. Gou Dev’t: 0 0 3,307,830 Budget Allocation (Billion) : 0.258 Ext Fin: 0 0 0 Performance Indicators: Number of support supervision visits to regional referral hospitals. A.I.A: 0 0 0 Issue Type: Enviroment

X. Vote Challenges and Plans To Improve Performance Objective : Promote a clean and hygienic environment for heart patients and other stakeholders. Issue of Concern : Infectious environment Vote Challenges Planned Interventions : 1. Segregate medical waste, recyclable and non-recyclable waste. • Inadequate space to fully utilise UHI capacity. In the short term, UHI requires funding worth USD 4 Million for remodeling of 2. Procure appropriate disposal collection bags for each of the categories. ward 2C. While in the long run, funds worth USD 70 Million are required for constructing and equipping a state-of-the-art facility for UHI. Budget Allocation (Billion) : 0.129 • Limited funding for specialized sundries and human resource development. UHI requires the additional UGX 5.0 billion pledged Performance Indicators: Cleaning and sanitation service providers contracted. by Parliament on 14th February 2018 to be able to perform 200 more cardiac interventions, conduct more research and train more staff in the areas of cardiac surgery, anaesthesia, critical care, perfusion and cardiology. XIII. Personnel Information - There is need for 100% release of funds for domestic arrears worth UGX 878,000,000. Table 13.1 Staff Establishment Analysis Plans to improve Vote Performance Title Salary Scale Number Of Approved Positions Number Of Filled Positions • Improve UHI funding mechanisms by identifying alternative sources of funding, enhancing research in heart care and improving access to quality heart care to generate more revenue. Consultant (Cardiac Surgery) U1SE 4 2 • Recruit and train more super specialised staff to fill the skills gap. MOSG (Cardiac Surgery) U2 3 1 • Timely procurement of super specialized supplies and sundries. • Acquire more space for UHI services. MOSG - Critical Care U2 3 2 • Promote awareness and prevention of heart disease. Principal Catheterisation Laboratory U3 1 0 XI Off Budget Support Technologist Senior Internal Auditor U3 1 0 Table 11.1 Off-Budget Support by Sub-Programme Biomedical Engineer U4 1 0 N/A Senior Cardio Respiratory U4 1 0 Physiotherapist XII. Vote Cross Cutting Policy And Other Budgetary Issues Stenographer U5 1 0 Table 12.1: Cross- Cutting Policy Issues Medical Records Assistant U7 2 1 Issue Type: HIV/AIDS Theatre Attendant U8 2 1

Objective : Promote prevention by putting mechanisms in place to control its transmission to both Table 13.2 Staff Recruitment Plan staff and patients. Issue of Concern : Accidental injuries (needle or instrument pricks) and direct contact with infected persons. Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Planned Interventions : 1. Staff should wear uniforms and protective gears while attending to patients. Posts Filling (UGX) (UGX) 2. Conduct routine staff screening to establish the status of those injured at work. FY2020/21 Budget Allocation (Billion) : 0.040 Biomedical Engineer U4 1 0 1 1 2,200,000 26,400,000 Performance Indicators: 1. Availability of uniforms and protective gears. Consultant (Cardiac Surgery) U1SE 4 2 2 2 8,400,000 100,800,000 2. Routine screening of staff and patients. Medical Records Assistant U7 2 1 1 1 268,143 3,217,716

44 45 Uganda Heart Institute Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute

MOSG - Critical Care U2 3 2 1 1 3,750,000 45,000,000 MOSG (Cardiac Surgery) U2 3 1 2 2 7,500,000 90,000,000 Principal Catheterisation U3 1 0 1 1 3,200,000 38,400,000 Laboratory Technologist Senior Cardio Respiratory U4 1 0 1 1 2,200,000 26,400,000 Physiotherapist Senior Internal Auditor U3 1 0 1 1 979,805 11,757,660 Stenographer U5 1 0 1 1 447,080 5,364,960 Theatre Attendant U8 2 1 1 1 209,859 2,518,308 Total 19 7 12 12 29,154,887 349,858,644

46 47 Uganda Heart Institute Ministerial Policy Statement FY 2020/21 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:115 Uganda Heart Institute Vote:116 National Medical Stores

MOSG - Critical Care U2 3 2 1 1 3,750,000 45,000,000 V1: Vote Overview MOSG (Cardiac Surgery) U2 3 1 2 2 7,500,000 90,000,000 Principal Catheterisation U3 1 0 1 1 3,200,000 38,400,000 I. Vote Mission Statement Laboratory Technologist To effectively and efficiently supply Essential Medicines and Medical Supplies to Public Health Facilities in Uganda. Senior Cardio Respiratory U4 1 0 1 1 2,200,000 26,400,000 Physiotherapist Senior Internal Auditor U3 1 0 1 1 979,805 11,757,660 II. Strategic Objective Stenographer U5 1 0 1 1 447,080 5,364,960 a. Procure, warehouse and distribute Essential medicines and health supplies to all public health facilities b. Maximise value Theatre Attendant U8 2 1 1 1 209,859 2,518,308 offering to our customers. c. Strengthen management efficiency and effectiveness for improved service delivery. d. Enhance Total 19 7 12 12 29,154,887 349,858,644 innovations for efficient service delivery. e. Broaden and sustain the resource base of corporation. f. Enhance organisational capacity for sustainable operations and growth of National Medical Stores. g. Strengthen partnerships and collaborations for improved stakeholder engagement. III. Major Achievements in 2019/20 The Corporation received shs. 265.37 bn and spent shs 259.018 billion in Quarter 1 and Quarter 2 of the FY 2019/20, representing a 97.6% overall performance. The release and expenditure was in accordance to levels of care i.e. Health center II (8.24 bn); Health center III(23.91bn); Health center IV(9.43bn); General hospitals(14.26bn); Regional Referrals (13.43bn);National Referral hospitals(12.06bn.);ACTS, ARVS and Anti-TB drugs(97.09bn); Specialized units(UBTS,UHI) (21.96bn); Emergency and donated items(1.61bn); Reproductive health items(10.30bn); Immunization supplies including Hepatitis B Vaccine(13.37bn); Laboratory items(9.65bn); shs 5.61bn and 18.10 bn for corporate support services. The expenditure on Essential Medicines and Health Supplies was 99.9% of the released funds and 79% for other Corporate support services. Specifically: • Shs 10.3 bn was spent on reproductive health items (family planning) and safe delivery kits (MAMA KITS) to all women during child birth spread across the entire Country including the hard to reach and hard to stay in places like Kaabong, Abim, Ntoroko, Zombo and the Islands of Kalangala, Buvuma and Namayingo. • Shs. 87.3 bn was spent on ARVs that were equitably distributed to all government treatment centres spread across the entire Country ranging from Health Centre IIs, IIIs, IVs up to the National Referral hospitals. These were accessible to all categories of the population including women, men, girls, boys, persons with disabilities, the poor, orphans, prisoners and ethnic minorities like the Batwa and Bamba in Bwindi and Ntoroko. • Shs. 3.32 bn was spent on anti-malarial medicines and supplies equitably delivered to all public health facilities spread across the entire Country including the hard to reach, hard to stay in places and the rural residents. • Shs 13.37 bn was spent on vaccines and Immunisation supplies meant for children below 5 years (against the published list of killer diseases); girls above 10 years (for prevention of cervical cancer) and women of child bearing ages (for prevention against transmission of Tetanus to the unborn babies). These are equitably distributed to all public health facilities spread across the entire country including the urban areas, rural areas, hard to reach and hard to stay in places. • The essential medicine supplies included medicines for treatment of non-communicable diseases like Diabetes, hypertension, etc. that mainly affect the elderly across the country including the poor rural communities who access medical care from Health Centre IIs, IIIs and IVs. • Essential medicines and health supplies for the mental health were equitably delivered to all public health facilities spread across the entire country up to Health Centre IIs. These were available to all age groups including the disabled persons. Medicines for Epilepsy, a neglected ailment, were equitably availed at levels of health care across the Country to cater for stigmatized patients. • Medicines for management of nodding disease syndrome were delivered to all public health facilities in Lango and Acholi sub- regions.

IV. Medium Term Plans The Corporation will continue to: • Procure, store and equitably distribute embossed essential medicines and health supplies to all public health facilities, in accordance with the levels of health care taking into consideration the age, sex and location including the hard to reach and hard to stay in places like Kaabong, Abim, Ntoroko, Zombo and the Islands of Kalangala, Buvuma and Namayingo. These supplies will be accessible to all categories of the population visiting the public health facilities including women, men, girls, boys, persons with disabilities, the poor, orphans, prisoners, street children, the internally displaced persons and ethnic

46 47 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores

minorities like the Batwa and Bamba in Bwindi and Ntoroko. The essential medicine supplies will include medicines for treatment of non-communicable diseases like Diabetes, hypertension, etc. that mainly affect the elderly across the country including the poor rural communities who access medical care from Health Centre IIs, IIIs and IVs. This will also include medical uniforms (for both male and female health workers) and stationery procured, stored and distributed to all public health facilities spread across the entire Country. The stationery is used for health information management to inform budgeting and resource allocation. • Strengthen management efficiency and effectiveness of improved service delivery and enhance innovations for efficient service delivery. • Enhance organizational capacity for sustainable operations and growth making it the preferred warehouse for Development Partners to have their items stored and distributed. • Strengthen partnerships and collaboration for improved stakeholder engagement. • Enhance efforts to prepare and review procurement plans with health facilities as a key factor in getting procurement plans right and ensuring all needs are taken care of including special categories within the population especially the youth, women, men, disabled and elderly. • Special attention will be paid to the marginalized groups like the mentally challenged and disabled. There will be prominent consideration for people infected with HIV/AIDS to support the implementation of Test and treat policy which will reduce transmission of disease and lead to its eventual elimination. • Medicines for management of nodding disease syndrome will be delivered to all public health facilities in the affected regions like the Lango and Acholi sub-regions.

The Corporation anticipates to start the implementation of the new Enterprise Resource Planning system, financed by USAID on 1st July 2020.

The new ultra-modern warehouse constructed with funding from the Global Fund and Government of Uganda worth shs. 69.9 billion is expected to be completed by December 2020 hence increasing the warehousing capacity of the Corporation.

The medium term expenditure framework for FY 2021/22 is Shs 473.01 billion. This will be implemented in accordance to the levels of care, using FY 2020/21 as the baseline, represented below: 1. Health center II (10.27 bn); 2. Health center III (27.93 bn); 3. Health center IV (11.76 bn); 4. General hospitals(17.9bn); 5. Regional Referrals (16.77 bn); 6. National Referral hospitals (15.06 bn.); 7. ACTS, ARVS and Anti-TB drugs (151.52 bn); 8. Specialized units (UBTS, UHI) (31.38 bn); 9. Emergency and donated items (2.3 bn); 10. Reproductive health items (14.7 bn); 11. Immunization supplies including Hepatitis B Vaccines (26.68 bn); 12. Laboratory items (10.12 bn); 13. Shs 75.05 bn for other Corporate support services including wage and Shs.10.08 bn for retooling.

48 49 National Medical Stores Ministerial Policy Statement FY 2020/21 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores Vote:116 National Medical Stores

minorities like the Batwa and Bamba in Bwindi and Ntoroko. The essential medicine supplies will include medicines for treatment of non-communicable diseases like Diabetes, hypertension, V. Summary of Past Performance and Medium Term Budget Allocations etc. that mainly affect the elderly across the country including the poor rural communities who access medical care from Health Centre IIs, IIIs and IVs. Table 5.1: Overview of Vote Expenditures (UShs Billion) This will also include medical uniforms (for both male and female health workers) and stationery procured, stored and distributed to all public health facilities spread across the entire Country. The stationery is used for health information 2019/20 MTEF Budget Projections management to inform budgeting and resource allocation. 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 • Strengthen management efficiency and effectiveness of improved service delivery and enhance innovations for efficient service Outturn Budget by End Dec delivery. Wage 9.913 11.987 5.610 11.987 11.987 11.987 11.987 11.987 • Enhance organizational capacity for sustainable operations and growth making it the preferred warehouse for Development Recurrent Partners to have their items stored and distributed. Non Wage 286.789 384.185 253.407 384.185 461.022 553.226 663.872 796.646 • Strengthen partnerships and collaboration for improved stakeholder engagement. GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • Enhance efforts to prepare and review procurement plans with health facilities as a key factor in getting procurement plans Devt. right and ensuring all needs are taken care of including special categories within the population especially the youth, women, Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 men, disabled and elderly. • Special attention will be paid to the marginalized groups like the mentally challenged and disabled. There will be prominent GoU Total 296.702 396.172 259.018 396.172 473.009 565.214 675.859 808.633 consideration for people infected with HIV/AIDS to support the implementation of Test and treat policy which will reduce transmission of disease and lead to its eventual elimination. Total GoU+Ext Fin (MTEF) 296.702 396.172 259.018 396.172 473.009 565.214 675.859 808.633 • Medicines for management of nodding disease syndrome will be delivered to all public health facilities in the affected regions Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 like the Lango and Acholi sub-regions. Total Budget 296.702 396.172 259.018 396.172 473.009 565.214 675.859 808.633 The Corporation anticipates to start the implementation of the new Enterprise Resource Planning system, financed by USAID on 1st July 2020. A.I.A Total 5.412 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 The new ultra-modern warehouse constructed with funding from the Global Fund and Government of Uganda worth shs. 69.9 billion is expected to be completed by December 2020 hence increasing the warehousing capacity of the Corporation. Total Vote Budget 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Excluding Arrears The medium term expenditure framework for FY 2021/22 is Shs 473.01 billion. This will be implemented in accordance to the levels of care, using FY 2020/21 as the baseline, represented below: VI. Budget By Economic Clasification 1. Health center II (10.27 bn); 2. Health center III (27.93 bn); Table V6.1 2019/20 and 2020/21 Budget Allocations by Item 3. Health center IV (11.76 bn); 4. General hospitals(17.9bn); 2019/20 Approved Budget 2020/21 Draft Estimates 5. Regional Referrals (16.77 bn); 6. National Referral hospitals (15.06 bn.); Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total 7. ACTS, ARVS and Anti-TB drugs (151.52 bn); Output Class : Outputs Provided 396.172 0.000 0.000 396.172 396.172 0.000 396.172 8. Specialized units (UBTS, UHI) (31.38 bn); 211 Wages and Salaries 23.003 0.000 0.000 23.003 24.340 0.000 24.340 9. Emergency and donated items (2.3 bn); 10. Reproductive health items (14.7 bn); 212 Social Contributions 1.631 0.000 0.000 1.631 1.631 0.000 1.631 11. Immunization supplies including Hepatitis B Vaccines (26.68 bn); 12. Laboratory items (10.12 bn); 221 General Expenses 10.719 0.000 0.000 10.719 13.162 0.000 13.162 13. Shs 75.05 bn for other Corporate support services including wage and Shs.10.08 bn for retooling. 223 Utility and Property Expenses 1.530 0.000 0.000 1.530 1.369 0.000 1.369

224 Supplies and Services 336.407 0.000 0.000 336.407 336.407 0.000 336.407

225 Professional Services 5.576 0.000 0.000 5.576 4.874 0.000 4.874

227 Travel and Transport 13.861 0.000 0.000 13.861 11.745 0.000 11.745

228 Maintenance 3.446 0.000 0.000 3.446 2.644 0.000 2.644

Grand Total : 396.172 0.000 0.000 396.172 396.172 0.000 396.172

Total excluding Arrears 396.172 0.000 0.000 396.172 396.172 0.000 396.172

VII. Budget By Programme And Subprogramme

48 49 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 59 Pharmaceutical and Medical 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Supplies 01 Pharmaceuticals and Other Health 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Supplies Total for the Vote 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633

Total Excluding Arrears 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 59 Pharmaceutical and Medical Supplies Programme Objective To provide supplies of medicines and other pharmaceutical supplies to the Ugandan Population : Responsible Officer: Mr. Moses Kamabare Programme Outcome: Quality and accessible medicines, equipment and other health supplies Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

50 51 National Medical Stores Ministerial Policy Statement FY 2020/21 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores Vote:116 National Medical Stores

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme • Proportion of medicines and supplies procured and distributed against the consolidated 396.172 1920 100% 100% 100% procurement plan Billion Uganda shillings FY 2019/20 Medium Term Projections SubProgramme: 01 Pharmaceuticals and Other Health Supplies FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Output: 06 Supply of EMHS to HC 11 ( Basic Kit) Outturn Budget End Dec Proposed Budget Value of EMHS basic kits supplied to HC II 10.27 10.78 11.32 59 Pharmaceutical and Medical 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Output: 07 Supply of EMHS to HC 111 ( Basic Kit) Supplies 01 Pharmaceuticals and Other Health 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Value of EMHS basic kits supplied to HC III 27.93 29.33 30.8 Supplies Total for the Vote 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Output: 08 Supply of EMHS to HC 1V Value ( shs Billions) of EMHS supplied to HC IV 11.76 12.35 12.97 Total Excluding Arrears 302.114 396.172 259.018 396.172 473.009 565.214 675.859 808.633 Output: 09 Supply of EMHS to General Hospitals VIII. Programme Performance and Medium Term Plans Value ( shs Billions) of EMHS procured and supplied to General Hospitals 17.9 18.8 19.74

Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Output: 10 Supply of EMHS to Regional Referral Hospitals Programme : 59 Pharmaceutical and Medical Supplies Value ( shs Billions) of EMHS supplied to Regional Referral Hospitals 16.77 17.61 18.49

Programme Objective To provide supplies of medicines and other pharmaceutical supplies to the Ugandan Population Output: 11 Supply of EMHS to National Referral Hospitals : Value ( shs Billions) of EMHS supplied to National Referral Hospitals 15.06 15.81 16.6 Responsible Officer: Mr. Moses Kamabare Programme Outcome: Quality and accessible medicines, equipment and other health supplies Output: 13 Supply of EMHS to Specialised Units Sector Outcomes contributed to by the Programme Outcome Value ( shs Billions) of specialised medicines supplied to specialized units 31.38 32.95 34.6 1. Improved quality of life at all levels Output: 14 Supply of Emergency and Donated Medicines Performance Targets Value ( shs Billions) spent on emergencies, donations and related costs 2.3 2.42 2.54 Outcome Indicators 2020/21 2021/22 2022/23 Output: 15 Supply of Reproductive Health Items Baseline Base year Target Projection Projection Value( Shs billions) of Reproductive health commodities distributed to health Facilities 14.72 15.46 16.23

Output: 16 Immunisation Supplies Value of vaccines supplied to health facilities 26.68 28.01 29.41

Output: 17 Supply of Lab Commodities to accredited Facilities Value of Labaratory procured and supplied against plan 10.12 10.63 11.16

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

Fluctuating foreign exchange rate which affects the prices at which Medicines and Health Supplies are procured.

There has been no substantial and proportionate increase in the past for funding for Medicines and Health Supplies despite

50 51 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores

increase in population for Regional referral Hospital. The increase in the number and cases of Non-communicable Diseases infections especially among the elderly has not been matched with an increase in funding.

Limited storage space for Essential Medicines and Health Supplies (EMHSs) which affects the volume of stock that can be received and stored at the warehouse at any one time.

Access challenges to some of the Islands like Kalangala, Buvuma and Namayingo and other hard to reach areas like Kisoro and Buduma especially during the rainy seasons which causes delays in delivery of the essential medicines and health supplies.

Plans to improve Vote Performance

The Corporation will follow guidance on contracting in the local current and continuously monitor the effects of the exchange rate in order to engage relevant stakeholders in case of adverse effects on the available cash flows.

The Corporation will continue to engage the Government and relevant authorities/stakeholders through the Ministry of Health to increase funds allocation to priority areas that are either unfunded or under-funded.

The Corporation anticipates to complete the construction of a 30,000 pallets ultra-modern warehouse within FY 2019/20 which will increase the storage capacity substantially, providing sufficient storage for the Essential Medicines and Health Supplies.

Continued collaboration with other Government sectors to prioritise providing access to the Islands and other hard to reach areas in the country.

Other initiatives for continuous improvement: The corporation will continue to drive participatory planning with all key stakeholder in the Health sector during the development of the procurement plans for Essential Medicines and Health Supplies. This promotes ownership of the budget output and understanding of the funding gaps which eventually inform funds allocation.

The implementation of the all-inclusive and seamless Enterprise Resource Planning (ERP) effective Ist July 2020 will improve vote performance at all stages i.e. from planning to budget execution while supporting the self-ordering process by the public health facilities. XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

N/A

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To avail ARVS equitably to treatment centres spread throughout the country, to all communities in the urban and rural centres including the hard to reach hard to stay in places like Abim, Amudat, Bundibugyo, Kaabong, Ntoroko, Kisoro, Napak, Omoro, Yumbe, Zombo and the islands of Buvuma, Kalangala Namayingo. Shs 140.3 billion has been allocated to avert the HIV/AIDS scourge through the test and treat policy which is intended to buttress efforts towards HIV/AIDS prevalence. Issue of Concern : Adequate and affordable ARVs to accredited facilities

52 53 National Medical Stores Ministerial Policy Statement FY 2020/21 National Medical Stores Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores Vote:116 National Medical Stores

increase in population for Regional referral Hospital. The increase in the number and cases of Non-communicable Diseases Planned Interventions : Avail ARVS to treatment centres spread across the country including the more vulnerable areas infections especially among the elderly has not been matched with an increase in funding. like the islands of Buvuma, Kalangala Namayingo, and the hard to reach districts like Abim,Amudat ,Bundibugyo, Kaabong , Ntoroko,Napak,Omoro,Yumbe and Zombo . Limited storage space for Essential Medicines and Health Supplies (EMHSs) which affects the volume of stock that can be 140.300 received and stored at the warehouse at any one time. Budget Allocation (Billion) : Performance Indicators: Procure, Store and Distrute ARVs worth shs 140.3 billion. Access challenges to some of the Islands like Kalangala, Buvuma and Namayingo and other hard to reach areas like Kisoro and Buduma especially during the rainy seasons which causes delays in delivery of the essential medicines and health supplies. Issue Type: Gender

Objective : Medicines for children, women, men, youth, elderly, disabled and ethnic minorities in the rural and urban communities accessing medical care from Health Centre IIs, IIIs and IVs through to the National Referral Hospitals. Mama Kits and other reproductive health supplies of Shs 14.72 bn Plans to improve Vote Performance equitably supplied to all public health facilities across the country including the islands of Buvuma, Kalangala Namayingo, and hard to reach regions like Karamoja,West Nile and mountainous The Corporation will follow guidance on contracting in the local current and continuously monitor the effects of the exchange rate regions. in order to engage relevant stakeholders in case of adverse effects on the available cash flows. Issue of Concern : Gender The Corporation will continue to engage the Government and relevant authorities/stakeholders through the Ministry of Health to Planned Interventions : To avail Health supplies to children, women, youth, elderly,disabled. Items like MAMA KITS, increase funds allocation to priority areas that are either unfunded or under-funded. family planning supplies and other reproductive health items equitably supplied to public health facilities spread throughout the Country. The Corporation anticipates to complete the construction of a 30,000 pallets ultra-modern warehouse within FY 2019/20 which will increase the storage capacity substantially, providing sufficient storage for the Essential Medicines and Health Supplies. Budget Allocation (Billion) : 14.720 Continued collaboration with other Government sectors to prioritise providing access to the Islands and other hard to reach areas in Performance Indicators: Procure, store and distribute essential medicines and health supplies including MAMA KITS and the country. other reproductive health items to those in need worth shs. 14.72 billion. Issue Type: Enviroment Other initiatives for continuous improvement: The corporation will continue to drive participatory planning with all key stakeholder in the Health sector during the development Objective : Retrieve all expired and non-viable medicines for safe incineration from all public health facilities of the procurement plans for Essential Medicines and Health Supplies. This promotes ownership of the budget output and as part of the professional and safe services offered to the public. understanding of the funding gaps which eventually inform funds allocation. Support some public health facilities in the construction of facilities for safe medical waste disposal. The implementation of the all-inclusive and seamless Enterprise Resource Planning (ERP) effective Ist July 2020 will improve vote Maintain proper hygiene and sanitary conditions especially for female staff by providing sanitary performance at all stages i.e. from planning to budget execution while supporting the self-ordering process by the public health items. facilities. An amount of shs 354 million has been earmarked for these initiatives. XI Off Budget Support Issue of Concern : Environment Table 11.1 Off-Budget Support by Sub-Programme Planned Interventions : Professional services rendered to all health facilities spread across the country N/A Budget Allocation (Billion) : 0.354 XII. Vote Cross Cutting Policy And Other Budgetary Issues Performance Indicators: Safe incineration of expired drugs as part of the professional services rendered worth shs 0.354 billion. Table 12.1: Cross- Cutting Policy Issues XIII. Personnel Information Issue Type: HIV/AIDS Table 13.1 Staff Establishment Analysis Objective : To avail ARVS equitably to treatment centres spread throughout the country, to all communities in the urban and rural centres including the hard to reach hard to stay in places like Abim, Amudat, Title Salary Scale Number Of Approved Positions Number Of Filled Positions Bundibugyo, Kaabong, Ntoroko, Kisoro, Napak, Omoro, Yumbe, Zombo and the islands of PICKER PACKER-1 GRADE 10 76 68 Buvuma, Kalangala Namayingo. Shs 140.3 billion has been allocated to avert the HIV/AIDS scourge through the test and treat policy which is intended to buttress efforts towards HIV/AIDS DRIVER-1 GRADE 11 52 30 prevalence. TURN MAN-1 GRADE 12 66 26 Issue of Concern : Adequate and affordable ARVs to accredited facilities HEAD OF STORES AND GRADE 2 2 1 OPERATIONS

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ACCOUNTANT REVENUE GRADE 4 2 1 CUSTOMER CARE OFFICER GRADE 4 2 1 CUSTOMER CARE GRADE 4 10 9 REPRESENTATIVE DATABASE ADMINISTRATOR GRADE 4 2 1 HUMAN RESOURCE GRADE 4 2 1 MANAGEMENT OFFICER PROGRAMME DEVELOPER GRADE 5 11 1 CUSTOMER CARE ASSISTANT- GRADE 6 10 9 1 ICT ASSISTSNT (SYSTEMS GRADE 6 2 1 SUPPORT PERSONAL ASSISTANT GRADE 6 5 4 PUBLIC RELATIONS GRADE 6 2 1 ASSISTANT COLD CHAIN TECHNICIAN GRADE 8 5 2

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT REVENUE GRADE 4 2 1 1 1 7,561,641 90,739,694 COLD CHAIN TECHNICIAN GRADE 8 5 2 3 3 6,267,204 75,206,443 CUSTOMER CARE GRADE 6 10 9 1 1 2,895,122 34,741,469 ASSISTANT-1 CUSTOMER CARE OFFICER GRADE 4 2 1 1 1 7,561,641 90,739,694 CUSTOMER CARE GRADE 4 10 9 1 1 6,861,641 82,339,694 REPRESENTATIVE DATABASE ADMINISTRATOR GRADE 4 2 1 1 1 7,561,641 90,739,694 DRIVER-1 GRADE 11 52 30 22 22 36,719,207 440,630,480 HEAD OF STORES AND GRADE 2 2 1 1 1 17,774,604 213,295,250 OPERATIONS HUMAN RESOURCE GRADE 4 2 1 1 1 7,561,641 90,739,694 MANAGEMENT OFFICER ICT ASSISTSNT (SYSTEMS GRADE 6 2 1 1 1 2,704,114 32,449,365 SUPPORT PERSONAL ASSISTANT GRADE 6 5 4 1 1 2,704,114 32,449,365 PICKER PACKER-1 GRADE 10 76 68 8 8 13,335,840 160,030,080 PROGRAMME DEVELOPER GRADE 5 11 1 10 10 55,473,737 665,684,838 PUBLIC RELATIONS GRADE 6 2 1 1 1 2,895,122 34,741,469 ASSISTANT TURN MAN-1 GRADE 12 66 26 40 40 52,093,146 625,117,752 Total 249 156 93 93 229,970,415 2,759,644,980

54 55 National Medical Stores Ministerial Policy Statement FY 2020/21 Health Service Commission Ministerial Policy Statement FY 2020/21

Vote:116 National Medical Stores Vote:134 Health Service Commission

ACCOUNTANT REVENUE GRADE 4 2 1 V1: Vote Overview CUSTOMER CARE OFFICER GRADE 4 2 1 I. Vote Mission Statement CUSTOMER CARE GRADE 4 10 9 The Mission of the Health Service Commission is: REPRESENTATIVE DATABASE ADMINISTRATOR GRADE 4 2 1 To build a fundamentally strong and competent human resource base for efficient and effective health services delivery. HUMAN RESOURCE GRADE 4 2 1 MANAGEMENT OFFICER II. Strategic Objective PROGRAMME DEVELOPER GRADE 5 11 1 The strategic objectives of the Commission are to: 1) Provide timely advice to H.E. the President and Government on matters CUSTOMER CARE ASSISTANT- GRADE 6 10 9 relating to the state of the Health service as mandated by the law. 2) Recruit in efficient and effective manner health workers to 1 meet Uganda citizens' health needs in accordance with the goals of the Health Sector Policy and Development Plan 2015/16- ICT ASSISTSNT (SYSTEMS GRADE 6 2 1 2019/20. 3) Carry out advocacy and make recommendations to improve the terms and conditions of service of the health SUPPORT workforce. 4) Enhance the institutional capacity of the Health Service Commission to deliver on its mandate. PERSONAL ASSISTANT GRADE 6 5 4 III. Major Achievements in 2019/20 PUBLIC RELATIONS GRADE 6 2 1 ASSISTANT i. 230 Health Workers of all categories for Ministry of Health Headquarters, Butabika National Mental Referral Hospital and Regional Referral Hospitals recruited. This includes critical cadres like Midwives (to enhance maternal and child health), Nurses COLD CHAIN TECHNICIAN GRADE 8 5 2 (enhance critical nursing care), Medical Officers (enhance access to health care), Dental Surgeons, Allied Health Professionals, Administrative and Scientific staff , Medical Specialists in Obs &Gyn (enhance maternal health care), Medical Specialists in Table 13.2 Staff Recruitment Plan Peadiatrics (enhance child health care services), Medical Specialists in Ophthalmology, Medical Specialists in E.N.T, Medical Specialists in Internal Medicine (enhance care on upcoming health concerns such as old age related illnesses). Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual ii. 187 Health Workers for Entebbe Regional Referral Hospital validated. Scale Approved Filled Posts Posts Cleared for Per Month Salary iii. Adverts for Ministry of Health headquarters, Regional Referral Hospitals, UVRI and Mulago National Referral Hospital Posts Filling (UGX) (UGX) were run. FY2020/21 iv. Recruitment planning workshop held. ACCOUNTANT REVENUE GRADE 4 2 1 1 1 7,561,641 90,739,694 v. Workshop to review recruitment guidelines to DSCs held. COLD CHAIN TECHNICIAN GRADE 8 5 2 3 3 6,267,204 75,206,443 vi. 354 Human Resource for Health Cases of re-designations of nursing cadre, confirmation, corrigenda, study leave, interdictions, abscondments, retirement on medical grounds decisions made. These were mainly in the Ministry of Health CUSTOMER CARE GRADE 6 10 9 1 1 2,895,122 34,741,469 ASSISTANT-1 Headquarters, Mulago National Referral Hospital, Uganda Blood Transfusion Services, Uganda Cancer Institute, Uganda Virus Research Institute, Kampala Capital City Authority and Regional Referral Hospitals which are geographically located across the CUSTOMER CARE OFFICER GRADE 4 2 1 1 1 7,561,641 90,739,694 country. CUSTOMER CARE GRADE 4 10 9 1 1 6,861,641 82,339,694 vii. Support supervision to 24 (Katakwi, Bukedea, Kaberamaido, Soroti, Rubanda, Kisoro, Ruliga, Kabale, Lamwo, Kitgum, REPRESENTATIVE Amuru, Gulu, Adjumani, Moyo, Obongi, Yumbe, Rakai, Kyotera, Butambala, Mpigi, Namayingo, Mayuge, Bugiri and Jinja DATABASE ADMINISTRATOR GRADE 4 2 1 1 1 7,561,641 90,739,694 Districts/Districts Service Commissions, 6 RRHs (Soroti, Kabale, Gulu, Arua, China Uganda Frienship and Jinja Hospitals DRIVER-1 GRADE 11 52 30 22 22 36,719,207 440,630,480 carried out. HEAD OF STORES AND GRADE 2 2 1 1 1 17,774,604 213,295,250 viii. Technical support to three (3) Districts/DSCs of Sheema, Lyantonde and Sironko provided. OPERATIONS ix. Two (2) Extra ordinary meetings and Five (5) Ordinary meeting held. HUMAN RESOURCE GRADE 4 2 1 1 1 7,561,641 90,739,694 x. Administrative support services provided. MANAGEMENT OFFICER xi. Q1 performance report produced and submitted. ICT ASSISTSNT (SYSTEMS GRADE 6 2 1 1 1 2,704,114 32,449,365 xii. BFP FY 2020-2021 produced and submitted. SUPPORT xiii. Registry shelves, 5 filing cabinets, 2 Office desks and 2 Office chairs procured. PERSONAL ASSISTANT GRADE 6 5 4 1 1 2,704,114 32,449,365 IV. Medium Term Plans PICKER PACKER-1 GRADE 10 76 68 8 8 13,335,840 160,030,080 PROGRAMME DEVELOPER GRADE 5 11 1 10 10 55,473,737 665,684,838 i. Recruit 1,100 health workers of all categories for Ministry of Health (MoH) Headquarters, Mulago National Referral Hospital, Butabika National Referral Mental (BNRMH) Hospital, Kampala Capital City Authority (KCCA), Regional Referral Hospitals PUBLIC RELATIONS GRADE 6 2 1 1 1 2,895,122 34,741,469 ASSISTANT (RRHs), Specialized Health Institutions, namely: Uganda Cancer Institute (UCI), Uganda Blood Transfusion Services (UBTS) and Uganda Prisons Health Services. This includes critical cadres like Midwives (to enhance maternal and child health), Nurses TURN MAN-1 GRADE 12 66 26 40 40 52,093,146 625,117,752 (enhance critical nursing care), Medical Officers (enhance access to health care), Dental Surgeons, Allied Health Professionals, Total 249 156 93 93 229,970,415 2,759,644,980 Administrative and Scientific staff , Medical Specialists in Obs &Gyn (enhance maternal health care), Medical Specialists in Peadiatrics (enhance child health care services), Medical Specialists in Ophthalmology, Medical Specialists in E.N.T, Medical Specialists in Internal Medicine (enhance care on upcoming health concerns such as old age related illnesses). ii. Process 1,000 Human Resource for Health decisions on confirmation, corrigenda, redesignation, study leave, interdictions,

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abscondments and retirements. The Human Resource for Health decision are made irrespective of the gender. iii. Carry out Support Supervision to 84 Districts, 18 Regional Referral Hospitals and National Health Institutions and Kampala Capital City Authority (KCCA) Health Units. The Regional referral Hospitals are geographically distributed across the country. iv. Provide Technical Support to DSCs, Central Government Health Institutions and Departments under the jurisdiction of HSC on Human Resource for Health (HRH) issues on demand driven basis. v. Carry out Performance career enhancement training for Members and staff of the Health Service Commission in accordance with the training plan. vi. Carry out Monitoring and tracking implementation of the HSC decisions, deployment, reporting and retention of health workers. vii. The HSC HIV/AIDS workplace policy implemented irrespective of the gender. viii. Implement additional modules of the e-recruitment system. ix. Disseminate the recruitment guidelines to the DSCs. x. Provide administrative support services.

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abscondments and retirements. The Human Resource for Health decision are made irrespective of the gender. iii. Carry out Support Supervision to 84 Districts, 18 Regional Referral Hospitals and National Health Institutions and Kampala V. Summary of Past Performance and Medium Term Budget Allocations Capital City Authority (KCCA) Health Units. The Regional referral Hospitals are geographically distributed across the country. iv. Provide Technical Support to DSCs, Central Government Health Institutions and Departments under the jurisdiction of HSC Table 5.1: Overview of Vote Expenditures (UShs Billion) on Human Resource for Health (HRH) issues on demand driven basis. v. Carry out Performance career enhancement training for Members and staff of the Health Service Commission in accordance 2019/20 MTEF Budget Projections with the training plan. 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 vi. Carry out Monitoring and tracking implementation of the HSC decisions, deployment, reporting and retention of health Outturn Budget by End Dec workers. Wage 2.228 2.325 1.126 2.325 2.325 2.325 2.325 2.325 vii. The HSC HIV/AIDS workplace policy implemented irrespective of the gender. Recurrent viii. Implement additional modules of the e-recruitment system. Non Wage 3.770 4.462 1.809 4.705 5.646 6.775 8.130 9.755 ix. Disseminate the recruitment guidelines to the DSCs. GoU 0.263 0.080 0.018 0.080 0.080 0.080 0.080 0.080 x. Provide administrative support services. Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 6.261 6.867 2.953 7.110 8.051 9.180 10.535 12.161 Total GoU+Ext Fin (MTEF) 6.261 6.867 2.953 7.110 8.051 9.180 10.535 12.161 Arrears 0.000 0.000 0.000 0.041 0.000 0.000 0.000 0.000 Total Budget 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161 Total Vote Budget 6.261 6.867 2.953 7.110 8.051 9.180 10.535 12.161 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 6.787 0.000 0.000 6.787 7.030 0.000 7.030

211 Wages and Salaries 2.985 0.000 0.000 2.985 2.923 0.000 2.923

212 Social Contributions 0.198 0.000 0.000 0.198 0.312 0.000 0.312

213 Other Employee Costs 0.782 0.000 0.000 0.782 0.911 0.000 0.911

221 General Expenses 1.213 0.000 0.000 1.213 1.254 0.000 1.254

222 Communications 0.039 0.000 0.000 0.039 0.036 0.000 0.036

223 Utility and Property Expenses 0.777 0.000 0.000 0.777 0.777 0.000 0.777

224 Supplies and Services 0.000 0.000 0.000 0.000 0.039 0.000 0.039

225 Professional Services 0.045 0.000 0.000 0.045 0.045 0.000 0.045

227 Travel and Transport 0.553 0.000 0.000 0.553 0.554 0.000 0.554

228 Maintenance 0.195 0.000 0.000 0.195 0.179 0.000 0.179

Output Class : Capital Purchases 0.080 0.000 0.000 0.080 0.080 0.000 0.080

312 FIXED ASSETS 0.080 0.000 0.000 0.080 0.080 0.000 0.080

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Output Class : Arrears 0.000 0.000 0.000 0.000 0.041 0.000 0.041

321 DOMESTIC 0.000 0.000 0.000 0.000 0.041 0.000 0.041

Grand Total : 6.867 0.000 0.000 6.867 7.151 0.000 7.151

Total excluding Arrears 6.867 0.000 0.000 6.867 7.110 0.000 7.110

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 52 Human Resource Management for 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161 Health 01 Finance and Administration 4.828 5.153 2.228 5.427 6.070 6.879 7.850 8.710

02 Human Resource Management 1.148 1.336 0.584 1.296 1.565 1.840 2.171 2.567

03 Internal Audit 0.022 0.031 0.014 0.036 0.035 0.040 0.046 0.358

0365 Health Service Commision 0.263 0.080 0.018 0.000 0.000 0.000 0.000 0.000

04 Recruitment and selection systems 0.000 0.267 0.108 0.312 0.300 0.340 0.389 0.446

1635 Retooling of Health Service 0.000 0.000 0.000 0.080 0.080 0.080 0.080 0.080 Commission Total for the Vote 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161

Total Excluding Arrears 6.261 6.867 2.953 7.110 8.051 9.180 10.535 12.161

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 52 Human Resource Management for Health Programme Objective 1. Provide timely advice to H.E. the President and Government on matters relating to the state of the : Health Service as mandated by the law. 2. Recruit in an efficient and effective manner health workers to meet Uganda citizen health needs in accordance with the goals of the Health Sector Policy and Development Plan. 3. Carry out advocacy and make recommendations to improve the terms and conditions of service of the health workforce. 4. Enhance the institutional capacity of the Health Service Commission to deliver on its mandate. Responsible Officer: MARY THEOPISTA WENENE Programme Outcome: Improved status of human resources for health in the health service Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23

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Output Class : Arrears 0.000 0.000 0.000 0.000 0.041 0.000 0.041 Baseline Base year Target Projection Projection

321 DOMESTIC 0.000 0.000 0.000 0.000 0.041 0.000 0.041 • Proportion of qualified health workers recruited against the annual recruitment plan at 80% 201516 100% 100% 100% national level Grand Total : 6.867 0.000 0.000 6.867 7.151 0.000 7.151 SubProgramme: 02 Human Resource Management Total excluding Arrears 6.867 0.000 0.000 6.867 7.110 0.000 7.110 Output: 05 Technical Support and Support Supervision VII. Budget By Programme And Subprogramme No. of Districts /DSCs provided with Technical Support and Support Supervision 84 90 95

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Output: 06 Health Workers Recruitment and Human Resource for Health Management Services No. of Health Workers recruited in Central Government Health Institutions 1,100 1,200 1,200 Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 IX. Major Capital Investments And Changes In Resource Allocation Outturn Budget End Dec Proposed Budget Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) 52 Human Resource Management for 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161 Health N/A 01 Finance and Administration 4.828 5.153 2.228 5.427 6.070 6.879 7.850 8.710

02 Human Resource Management 1.148 1.336 0.584 1.296 1.565 1.840 2.171 2.567 X. Vote Challenges and Plans To Improve Performance

03 Internal Audit 0.022 0.031 0.014 0.036 0.035 0.040 0.046 0.358 Vote Challenges 0365 Health Service Commision 0.263 0.080 0.018 0.000 0.000 0.000 0.000 0.000 The following challenges were experienced during the period under review: 04 Recruitment and selection systems 0.000 0.267 0.108 0.312 0.300 0.340 0.389 0.446 Internal Challenges to the HSC i. Limited alignment of human resource planning, budgeting and recruitment to the planning and budgeting cycle. 1635 Retooling of Health Service 0.000 0.000 0.000 0.080 0.080 0.080 0.080 0.080 ii. Inadequate Office space for the Members and Staff of the Commission. Commission iii. Inadequate transport for the Members and Staff of the Commission. Total for the Vote 6.261 6.867 2.953 7.151 8.051 9.180 10.535 12.161 iv. Inadequate resources to fully operationalise the 3rd Department of the HSC. Total Excluding Arrears 6.261 6.867 2.953 7.110 8.051 9.180 10.535 12.161 v. Inadequate resources to fully operationalise the e-recruitment system. vi. Lack of resources to develop the land in Butabika. Challenges External to the HSC VIII. Programme Performance and Medium Term Plans i. Limited alignment of the recruitment process to the budgeting process. ii. Difficulty in attracting critical cadre like in Anaesthesia, Pathology, Orthopaedics, Radiology, Ophthalmology, ENT and Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Internal Medicine this affects the availability and quality of services.. iii. Difficulty in attracting DHOs and ADHOs in the Districts. Less than two thirds of the Districts have substantively appointed Programme : 52 Human Resource Management for Health DHOs and ADHOs. iv. Large numbers of applicants for some cadres for example nursing and laboratory cadre that increase the cost of recruitment Programme Objective 1. Provide timely advice to H.E. the President and Government on matters relating to the state of the since the Commission had to conduct written exams. : Health Service as mandated by the law. v. Delay in the review of the structures for health workers both at Local and Central Government to take into account the changing 2. Recruit in an efficient and effective manner health workers to meet Uganda citizen health needs in nature of service, health professionals and increasing population. accordance with the goals of the Health Sector Policy and Development Plan. vi. Difficulty in retaining Medical Officers and Consultants in Regional Health Facilities. 3. Carry out advocacy and make recommendations to improve the terms and conditions of service of the vii. Increasing number of DSCs to provide technical support health workforce. 4. Enhance the institutional capacity of the Health Service Commission to deliver on its mandate. Responsible Officer: MARY THEOPISTA WENENE Plans to improve Vote Performance Programme Outcome: Improved status of human resources for health in the health service i. Provision of additional resources to enable the Commission achieve its mandate. Sector Outcomes contributed to by the Programme Outcome ii. Recommendations for the Review terms and conditions of service for health workers to enhance attraction and retention. iii. Fully operationalize all the modules of the e-recruitment system for handling HRH activities. 1. Improved quality of life at all levels iv. Enhance the retooling budget of the Commission to enable construction of offices in Butabika and purchase of transport for its Performance Targets Members and staff v. Expedite and implement reviewed structures of health facilities in Local Governments and Regional Referral Hospitals. Outcome Indicators 2020/21 2021/22 2022/23

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XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

N/A

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : Support to HIV/AIDS affected and infected staff irrespective of gender Issue of Concern : HIV/AIDS at work place Planned Interventions : Support ot HIV/AIDS affected and infected staff irrespective of gender and provide key communication campaigns and messages to Members and staff Budget Allocation (Billion) : 0.005 Performance Indicators: Number of staff supported Number of health talks conducted Issue Type: Gender

Objective : Fairness in recruitment of health workers irrespective of Gender. Issue of Concern : Gender and equity Planned Interventions : Fairness and Order of merit in recruitment process Budget Allocation (Billion) : 0.005 Performance Indicators: Number of health workers recruited on merit Issue Type: Enviroment

Objective : Safe and healthy work environment Issue of Concern : Healthy work Environment Planned Interventions : Awareness on safe and healthy work environment. Provision of disposable bins and shredder for waste management Budget Allocation (Billion) : 0.005 Performance Indicators: Number of waste disposal points/bins

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions ASST.COMM/HRM EXAMS U1 1 1 ASSISTANT COMMISSION U1 E 2 0 HUMAN RESOURCE MANAGEMENT SECRETARY U1S 1 1

60 61 Health Service Commission Ministerial Policy Statement FY 2020/21 Health Service Commission Ministerial Policy Statement FY 2020/21

Vote:134 Health Service Commission Vote:134 Health Service Commission

XI Off Budget Support Commissioner Human Resource U1SE 1 1 Advisory Services Table 11.1 Off-Budget Support by Sub-Programme Commissioner Recruitment and U1SE 1 0 selection systems N/A UNDER SECRETARY U1SE 1 1 XII. Vote Cross Cutting Policy And Other Budgetary Issues Principal Assistant Secretary U2 1 1 Table 12.1: Cross- Cutting Policy Issues PRINCIPAL HUMAN RESOURCE U2 8 6 OFFICER Issue Type: HIV/AIDS SENIOR ACCOUNTANT U3 1 1 Objective : Support to HIV/AIDS affected and infected staff irrespective of gender SENIOR ASSISTANT U3 1 1 SECRETARY Issue of Concern : HIV/AIDS at work place SENIOR ECONOMIST U3 1 1 Planned Interventions : Support ot HIV/AIDS affected and infected staff irrespective of gender and provide key communication campaigns and messages to Members and staff SENIOR HUMAN RESOURCE U3 9 3 OFFICER Budget Allocation (Billion) : 0.005 SENIOR PERSONAL U3 3 2 Performance Indicators: Number of staff supported SECRETARY Number of health talks conducted Senior Procurement Officer U3 1 0 Issue Type: Gender Senior Records Officer U3 1 0 Objective : Fairness in recruitment of health workers irrespective of Gender. Senior Systems Administrator U3 1 0 Issue of Concern : Gender and equity ACCOUNTANT U4 1 0 Planned Interventions : Fairness and Order of merit in recruitment process AUDITOR U4 1 1 Budget Allocation (Billion) : 0.005 INVENTORY MANAGEMENT U4 1 0 OFFICER Performance Indicators: Number of health workers recruited on merit PERSONAL SECRETARY U4 4 1 Issue Type: Enviroment PROCUREMENT OFFICER U4 1 1 Objective : Safe and healthy work environment Records Officer U4 1 0 Issue of Concern : Healthy work Environment SEN. ASST. REC. OFF. U4 1 0 Planned Interventions : Awareness on safe and healthy work environment. ASST. RECORDS OFFICER U5 2 0 Provision of disposable bins and shredder for waste management Budget Allocation (Billion) : 0.005 SEN. ACCTS ASST. U5 1 0 Performance Indicators: Number of waste disposal points/bins SENIOR OFFICE SUPERVISOR U5 1 0 ACCOUNTS ASSISTANT U7 1 1 XIII. Personnel Information RECEPTIONIST U7 2 2 Table 13.1 Staff Establishment Analysis RECORDS ASSISTANT U7 1 1 Title Salary Scale Number Of Approved Positions Number Of Filled Positions DRIVER U8 18 8 ASST.COMM/HRM EXAMS U1 1 1 OFFICE ATTENDANT U8 6 6 ASSISTANT COMMISSION U1 E 2 0 PRINCIPAL PERSONAL US 1 1 HUMAN RESOURCE SECRETARY MANAGEMENT Table 13.2 Staff Recruitment Plan SECRETARY U1S 1 1

60 61 Health Service Commission Ministerial Policy Statement FY 2020/21

Vote:134 Health Service Commission

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT U4 1 0 1 1 846,042 10,152,504 ASSISTANT COMMISSION U1 E 2 0 2 2 3,381,560 40,578,720 HUMAN RESOURCE MANAGEMENT Commissioner Recruitment and U1SE 1 0 1 1 1,859,451 22,313,412 selection systems INVENTORY MANAGEMENT U4 1 0 1 1 846,042 10,152,504 OFFICER PERSONAL SECRETARY U4 4 1 3 3 1,804,023 21,648,276 PRINCIPAL HUMAN U2 2 0 2 2 2,425,240 29,102,880 RESOURCE OFFICER SEN. ACCTS ASST. U5 1 0 1 1 555,564 6,666,768 SEN. ASST. REC. OFF. U4 1 0 1 1 798,535 9,582,420 SENIOR HUMAN RESOURCE U3 3 0 3 3 2,738,313 32,859,756 OFFICER SENIOR PERSONAL U3 3 2 1 1 943,990 11,327,880 SECRETARY Senior Systems Administrator U3 1 0 1 1 1,242,821 14,913,852 Total 20 3 17 17 17,441,581 209,298,972

62 63 Health Service Commission Ministerial Policy Statement FY 2020/21 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:134 Health Service Commission Vote:151 Uganda Blood Transfusion Service (UBTS)

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual V1: Vote Overview Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) I. Vote Mission Statement FY2020/21 To provide sufficient and efficacious blood and blood products through voluntary blood donations and blood processing for ACCOUNTANT U4 1 0 1 1 846,042 10,152,504 appropriate use in health care service delivery. ASSISTANT COMMISSION U1 E 2 0 2 2 3,381,560 40,578,720 HUMAN RESOURCE MANAGEMENT II. Strategic Objective Commissioner Recruitment and U1SE 1 0 1 1 1,859,451 22,313,412 selection systems To make available safe and adequate quantities of blood to all hospitals for the management of patients in need in all health care facilities INVENTORY MANAGEMENT U4 1 0 1 1 846,042 10,152,504 OFFICER III. Major Achievements in 2019/20 PERSONAL SECRETARY U4 4 1 3 3 1,804,023 21,648,276 PRINCIPAL HUMAN U2 2 0 2 2 2,425,240 29,102,880 Collected and tested 152,757 units of blood against TTIs; -Mobilized 400,000 potential blood donors; -Counseled 152,757 RESOURCE OFFICER donors on post donation activities; Supervised 6 regional blood banks; Documented Q1&Q2 medical supplies and reagents from SEN. ACCTS ASST. U5 1 0 1 1 555,564 6,666,768 National Medical Stores; Issued 123,008 units of blood to 419 Health Facilities country wide; Disseminated UBTS M&E SEN. ASST. REC. OFF. U4 1 0 1 1 798,535 9,582,420 Framework and tools to 320 participants in Kitovu, Mbarara, Arua and Gulu; Conducted assessment training covering 250 participants on M&E in 3 Regional Blood Banks of Arua, Gulu and Mbale; Assessed 15 Health Facilities for Accreditation; SENIOR HUMAN RESOURCE U3 3 0 3 3 2,738,313 32,859,756 Construction is at 55% (level covering roof trusses 100%, reinforced concrete retaining wall 100%, electrical fix 100%, OFFICER mechanical fix 100%, cement sand line plaster 100% and cement-sand rendering 100%); -Up graded and maintained cold rooms SENIOR PERSONAL U3 3 2 1 1 943,990 11,327,880 in Mbarara SECRETARY Senior Systems Administrator U3 1 0 1 1 1,242,821 14,913,852 IV. Medium Term Plans Total 20 3 17 17 17,441,581 209,298,972 Review and formulate UBTS Policy; Develop and implement UBTS strategic plan; Strengthen UBTS capacity for blood collection, processing, supply and management; Infrastructure development; and strengthen Blood Safety Information System;

62 63 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS)

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 3.829 3.838 1.920 3.923 3.923 3.923 3.923 3.923 Recurrent Non Wage 12.436 12.234 5.613 11.976 14.371 17.245 20.695 24.833 GoU 2.870 1.870 1.364 1.870 1.870 1.870 1.870 1.870 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Total GoU+Ext Fin (MTEF) 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Arrears 0.000 0.000 0.000 0.055 0.000 0.000 0.000 0.000 Total Budget 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 A.I.A Total 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 Total Vote Budget 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 16.072 0.000 0.000 16.072 15.899 0.000 15.899

211 Wages and Salaries 4.819 0.000 0.000 4.819 4.957 0.000 4.957

212 Social Contributions 0.337 0.000 0.000 0.337 0.339 0.000 0.339

213 Other Employee Costs 0.339 0.000 0.000 0.339 0.074 0.000 0.074

221 General Expenses 2.729 0.000 0.000 2.729 2.675 0.000 2.675

222 Communications 0.012 0.000 0.000 0.012 0.012 0.000 0.012

223 Utility and Property Expenses 0.380 0.000 0.000 0.380 0.450 0.000 0.450

224 Supplies and Services 0.325 0.000 0.000 0.325 0.476 0.000 0.476

225 Professional Services 0.080 0.000 0.000 0.080 0.080 0.000 0.080

227 Travel and Transport 4.431 0.000 0.000 4.431 4.758 0.000 4.758

228 Maintenance 2.020 0.000 0.000 2.020 1.479 0.000 1.479

282 Miscellaneous Other Expenses 0.600 0.000 0.000 0.600 0.600 0.000 0.600

Output Class : Capital Purchases 1.870 0.000 0.000 1.870 1.870 0.000 1.870

64 65 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS) Vote:151 Uganda Blood Transfusion Service (UBTS)

312 FIXED ASSETS 1.870 0.000 0.000 1.870 1.870 0.000 1.870 V. Summary of Past Performance and Medium Term Budget Allocations Output Class : Arrears 0.000 0.000 0.000 0.000 0.055 0.000 0.055 Table 5.1: Overview of Vote Expenditures (UShs Billion) 321 DOMESTIC 0.000 0.000 0.000 0.000 0.055 0.000 0.055

2019/20 MTEF Budget Projections Grand Total : 17.942 0.000 0.000 17.942 17.824 0.000 17.824 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Total excluding Arrears 17.942 0.000 0.000 17.942 17.769 0.000 17.769 Outturn Budget by End Dec Wage 3.829 3.838 1.920 3.923 3.923 3.923 3.923 3.923 Recurrent VII. Budget By Programme And Subprogramme Non Wage 12.436 12.234 5.613 11.976 14.371 17.245 20.695 24.833 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme GoU 2.870 1.870 1.364 1.870 1.870 1.870 1.870 1.870 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Billion Uganda shillings FY 2019/20 Medium Term Projections GoU Total 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Total GoU+Ext Fin (MTEF) 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Budget 53 Safe Blood Provision 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 Arrears 0.000 0.000 0.000 0.055 0.000 0.000 0.000 0.000 01 Administration 4.597 4.638 2.140 4.519 5.023 5.423 6.123 6.523 Total Budget 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 02 Regional Blood Banks 11.628 11.394 5.373 11.396 13.201 15.655 18.365 22.053 A.I.A Total 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0242 Uganda Blood Transfusion Service 2.870 1.870 1.364 0.000 0.000 0.000 0.000 0.000 Grand Total 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 03 Internal Audit 0.040 0.040 0.020 0.040 0.070 0.090 0.130 0.180 Total Vote Budget 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Excluding Arrears 1672 Retooling of Uganda Blood Transfusion 0.000 0.000 0.000 1.870 1.870 1.870 1.870 1.870 services VI. Budget By Economic Clasification Total for the Vote 19.135 17.942 8.898 17.824 20.164 23.038 26.487 30.626 19.135 17.942 8.898 17.769 20.164 23.038 26.487 30.626 Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total Excluding Arrears

2019/20 Approved Budget 2020/21 Draft Estimates VIII. Programme Performance and Medium Term Plans Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Output Class : Outputs Provided 16.072 0.000 0.000 16.072 15.899 0.000 15.899 Programme : 53 Safe Blood Provision 211 Wages and Salaries 4.819 0.000 0.000 4.819 4.957 0.000 4.957 Programme Objective 1. To expand the Blood transfusion infrastructure to operate adequately within a decentralised health care 212 Social Contributions 0.337 0.000 0.000 0.337 0.339 0.000 0.339 : delivery system. 213 Other Employee Costs 0.339 0.000 0.000 0.339 0.074 0.000 0.074 2. To increase the annual blood collection necessary to meet the blood requirements for all patients in the hospitals throughout the whole country. 221 General Expenses 2.729 0.000 0.000 2.729 2.675 0.000 2.675 3. To operate an active nationwide Quality Assurance Program that ensures Blood Safety- improve 222 Communications 0.012 0.000 0.000 0.012 0.012 0.000 0.012 quality systems. 4. To promote appropriate clinical use of blood. 223 Utility and Property Expenses 0.380 0.000 0.000 0.380 0.450 0.000 0.450 5. To strengthen the organisational capacity of UBTS to enable efficient and effective service delivery

224 Supplies and Services 0.325 0.000 0.000 0.325 0.476 0.000 0.476 Responsible Officer: Dr. Dorothy Kyeyune Byabazaire 225 Professional Services 0.080 0.000 0.000 0.080 0.080 0.000 0.080 Programme Outcome: Quality and accessible Safe Blood 227 Travel and Transport 4.431 0.000 0.000 4.431 4.758 0.000 4.758 Sector Outcomes contributed to by the Programme Outcome 228 Maintenance 2.020 0.000 0.000 2.020 1.479 0.000 1.479 1. Improved quality of life at all levels 282 Miscellaneous Other Expenses 0.600 0.000 0.000 0.600 0.600 0.000 0.600 Performance Targets Output Class : Capital Purchases 1.870 0.000 0.000 1.870 1.870 0.000 1.870

64 65 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS)

Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• proportion of health centres without blood stockouts 75% 2017 85% 90% 90%

SubProgramme: 01 Administration Output: 01 Adminstrative Support Services No. of blood banks and collection centres supervised quarterly 14 14 16

SubProgramme: 02 Regional Blood Banks Output: 02 Collection of Blood No. of Units of blood Collected 300,000 360,000 420,000

Units of blood distributed to health facilities 285,000 342,000 399,000

No. of supervision visits done in the region 4 4 4

Output: 03 Monitoring & Evaluation of Blood Operations No. of routine monitoring activities done in Regions 4 4 4

Output: 04 Laboratory Services No of Units of blood tested for TTI’s 300,000 360,000 420,000

No. of units of blood distributed to Health Facilities 285,000 342,000 399,000

No. of field team support supervision done in health care facilities 4 4 4

No. of trainings(to imrove heamovigilance in health facilities) 4 4 4

SubProgramme: 03 Internal Audit Output: 03 Monitoring & Evaluation of Blood Operations No. of routine monitoring activities done in Regions 4 4 4

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 151 Uganda Blood Transfusion Service (UBTS)

Program : 08 53 Safe Blood Provision

Development Project : 1672 Retooling of Uganda Blood Transfusion services

Output: 08 53 72 Government Buildings and Administrative Infrastructure

The on going Re modelling and Expansion of cold rooms and stores at Nakasero Project liability defects amount paid. Total Output Cost(Ushs Thousand) 0 0 720,000

66 67 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS) Vote:151 Uganda Blood Transfusion Service (UBTS)

Outcome Indicators 2020/21 2021/22 2022/23 Gou Dev’t: 0 0 720,000 Baseline Base year Target Projection Projection Ext Fin: 0 0 0

• proportion of health centres without blood stockouts 75% 2017 85% 90% 90% A.I.A: 0 0 0

SubProgramme: 01 Administration X. Vote Challenges and Plans To Improve Performance Output: 01 Adminstrative Support Services Vote Challenges No. of blood banks and collection centres supervised quarterly 14 14 16 Inadequate medical supplies and reagents; Limited/ small pool of blood donors; Aged fleet of blood collection vehicles; Inadequate SubProgramme: 02 Regional Blood Banks staff for blood collection; Inappropriate blood usage and accountability; Inadequate infrastructure for blood transfusion in refugee Output: 02 Collection of Blood hosting districts No. of Units of blood Collected 300,000 360,000 420,000 Plans to improve Vote Performance

Units of blood distributed to health facilities 285,000 342,000 399,000 Enhance UBTS capacity for medical supplies and reagents; Enhance UBTS capacity for blood collection and processing; Establish blood repositories at district level; Strengthen data collection, processing and reporting; and Capacity building. No. of supervision visits done in the region 4 4 4

Output: 03 Monitoring & Evaluation of Blood Operations XI Off Budget Support No. of routine monitoring activities done in Regions 4 4 4 Table 11.1 Off-Budget Support by Sub-Programme

Output: 04 Laboratory Services N/A No of Units of blood tested for TTI’s 300,000 360,000 420,000 XII. Vote Cross Cutting Policy And Other Budgetary Issues No. of units of blood distributed to Health Facilities 285,000 342,000 399,000 Table 12.1: Cross- Cutting Policy Issues No. of field team support supervision done in health care facilities 4 4 4 Issue Type: HIV/AIDS No. of trainings(to imrove heamovigilance in health facilities) 4 4 4 Objective : To increase staff awareness on HIV/AIDS ; SubProgramme: 03 Internal Audit Output: 03 Monitoring & Evaluation of Blood Operations Issue of Concern : Low awareness of HIV/AIDS among staff No. of routine monitoring activities done in Regions 4 4 4 Planned Interventions : Conduct sensitization meetings on HIV/AIDS to staff; Internal assessment of HIV/AIDS among staff; Provide some support to the affected staff Budget Allocation (Billion) : 0.120 IX. Major Capital Investments And Changes In Resource Allocation Performance Indicators: Number of staff sensitized; Number of staff being receiving support Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Issue Type: Gender FY 2019/20 FY 2020/21 Objective : To enhance UBTS capacity in gender responsive budgeting Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Issue of Concern : Low capacity in gender responsive budgeting Vote 151 Uganda Blood Transfusion Service (UBTS) Planned Interventions : Train key staff in gender responsive budgeting Program : 08 53 Safe Blood Provision Budget Allocation (Billion) : 0.100 Development Project : 1672 Retooling of Uganda Blood Transfusion services Performance Indicators: Number of key staff trained in gender responsive budgeting Output: 08 53 72 Government Buildings and Administrative Infrastructure Issue Type: Enviroment The on going Re modelling and Expansion of cold rooms and stores at Nakasero Project liability Objective : Effective waste management defects amount paid. Total Output Cost(Ushs Thousand) 0 0 720,000 Issue of Concern : Poor waste management

66 67 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS)

Planned Interventions : Train staff in good practices of waste management Budget Allocation (Billion) : 0.100 Performance Indicators: Number of staff trained in good practice of waste management

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions PRINCIPAL MEDICAL OFFICER U2 6 5 SENIOR PRINCIPAL U2 1 0 LABORATORY TECHNOLOGIST PRINCIPAL NURSING OFFICER U3 1 0 Blood Donor Recruiter U4 18 9 Personal Secretary U4 2 0 Senior Lab Technologist U4 16 12 Senior Lab. Technician U4 16 12 Senior Nursing Officer U4 23 16 Systems Administrator U4 7 1 Ass.Procurement U5 1 0 Engineering Assistant U5 1 0 Nursing Officer U5 37 18 Receptionist U6 6 0 Accounts Assistant U7 10 3 Accounts Assistant U7 3 0 Donor Clerk U7 37 25 Askari U8 23 16 Driver U8 50 35

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Accounts Assistant U7 10 3 7 7 3,655,792 43,869,504 Askari U8 23 16 7 7 2,099,013 25,188,156 Ass.Procurement U5 1 0 1 1 639,507 7,674,084 Blood Donor Recruiter U4 18 9 9 9 19,800,000 237,600,000 Donor Clerk U7 37 25 12 12 6,076,104 72,913,248 Driver U8 50 35 15 15 4,497,885 53,974,620

68 69 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21 Uganda Blood Transfusion Service (UBTS) Ministerial Policy Statement FY 2020/21

Vote:151 Uganda Blood Transfusion Service (UBTS) Vote:151 Uganda Blood Transfusion Service (UBTS)

Planned Interventions : Train staff in good practices of waste management Engineering Assistant U5 1 0 1 1 1,200,000 14,400,000 Nursing Officer U5 37 18 19 18 21,600,000 259,200,000 Budget Allocation (Billion) : 0.100 Personal Secretary U4 2 0 2 2 1,202,682 14,432,184 Performance Indicators: Number of staff trained in good practice of waste management PRINCIPAL MEDICAL U2 6 5 1 1 3,750,000 45,000,000 OFFICER XIII. Personnel Information PRINCIPAL NURSING OFFICER U3 1 0 1 1 3,300,000 39,600,000

Table 13.1 Staff Establishment Analysis Receptionist U6 6 0 6 6 2,321,832 27,861,984 Senior Lab Technologist U4 16 12 4 4 5,286,696 63,440,352 Title Salary Scale Number Of Approved Positions Number Of Filled Positions Senior Lab. Technician U4 16 12 4 4 5,286,696 63,440,352 PRINCIPAL MEDICAL OFFICER U2 6 5 Senior Nursing Officer U4 23 16 7 7 21,000,000 252,000,000 SENIOR PRINCIPAL U2 1 0 1 1 3,750,000 45,000,000 SENIOR PRINCIPAL U2 1 0 LABORATORY LABORATORY TECHNOLOGIST TECHNOLOGIST PRINCIPAL NURSING OFFICER U3 1 0 Systems Administrator U4 7 1 6 6 15,000,000 180,000,000 Blood Donor Recruiter U4 18 9 Total 255 152 103 102 120,466,207 1,445,594,484 Personal Secretary U4 2 0 Senior Lab Technologist U4 16 12 Senior Lab. Technician U4 16 12 Senior Nursing Officer U4 23 16 Systems Administrator U4 7 1 Ass.Procurement U5 1 0 Engineering Assistant U5 1 0 Nursing Officer U5 37 18 Receptionist U6 6 0 Accounts Assistant U7 10 3 Accounts Assistant U7 3 0 Donor Clerk U7 37 25 Askari U8 23 16 Driver U8 50 35

Table 13.2 Staff Recruitment Plan

68 69 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex

V1: Vote Overview I. Vote Mission Statement To be a center of excellence in providing super-specialized healthcare in Africa.

II. Strategic Objective - To increase the range and quality of super-specialised health care services thereby reducing referrals abroad. - To provide super-specialised training to health workers. - To conduct operational research in order to promote evidence based practice. III. Major Achievements in 2019/20 By the end of December 2019 (mid year), Mulago National Referral hospital had registered the following achievements:

- The bill to establish Mulago National Specialized hospital is before the First Parliamentary Counsel - Maintenance, servicing and repair of medical equipment;Medical beds, autoclaves, CT Scan and transport equipment serviced,Five operating theaters maintained on framework contract - The hospital procured a service provider for detailed design and architectural works for the houses to be constructed - 380,739 specialized outpatient attendances - 96,983 admissions - 558,142 patient days - 9,937 surgical interventions - 21,870 emergencies - 6 days, average length of stay - 32,450 images - 1,007,541 laboratory investigations - 2,583 immunizations

IV. Medium Term Plans The hospital will contribute to the NDP III objective of human capital development through provision of equitable specialized health care services. Thus the following medium term plans have endorsed to achieve the above objective: 1. Promote staff retention through motivation schemes like accommodation, allowances, medical expenses etc 2. Procure equipment and furniture 3. Establish Mulago specialized hospital as a corporate body 4. Remodel and rehabilitate upper Mulago and make it functional 5. Raise more revenue 6.Digitizing all hospital operations 7.Improving quality management systems through implementation of ISO guidelines

70 71 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex Vote:161 Mulago Hospital Complex

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To be a center of excellence in providing super-specialized healthcare in Africa. 2019/20 MTEF Budget Projections II. Strategic Objective 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec - To increase the range and quality of super-specialised health care services thereby reducing referrals abroad. - To provide Wage 28.357 29.206 11.879 29.206 29.206 29.206 29.206 29.206 super-specialised training to health workers. - To conduct operational research in order to promote evidence based practice. Recurrent Non Wage 24.222 28.930 12.981 27.749 33.298 39.958 47.950 57.540 III. Major Achievements in 2019/20 GoU 6.020 11.020 3.107 6.020 6.020 6.020 6.020 6.020 Devt. By the end of December 2019 (mid year), Mulago National Referral hospital had registered the following achievements: Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 - The bill to establish Mulago National Specialized hospital is before the First Parliamentary Counsel GoU Total 58.599 69.156 27.967 62.974 68.524 75.184 83.175 92.765 - Maintenance, servicing and repair of medical equipment;Medical beds, autoclaves, CT Scan and transport equipment serviced,Five operating theaters maintained on framework contract Total GoU+Ext Fin (MTEF) 58.599 69.156 27.967 62.974 68.524 75.184 83.175 92.765 - The hospital procured a service provider for detailed design and architectural works for the houses to be constructed 2.047 2.479 2.479 1.748 0.000 0.000 0.000 0.000 - 380,739 specialized outpatient attendances Arrears - 96,983 admissions Total Budget 60.646 71.635 30.446 64.722 68.524 75.184 83.175 92.765 - 558,142 patient days - 9,937 surgical interventions A.I.A Total 3.801 0.000 0.000 0.000 0.000 0.000 0.000 0.000 - 21,870 emergencies 64.447 71.635 30.446 64.722 68.524 75.184 83.175 92.765 - 6 days, average length of stay Grand Total - 32,450 images Total Vote Budget 62.400 69.156 27.967 62.974 68.524 75.184 83.175 92.765 - 1,007,541 laboratory investigations Excluding Arrears - 2,583 immunizations VI. Budget By Economic Clasification IV. Medium Term Plans Table V6.1 2019/20 and 2020/21 Budget Allocations by Item The hospital will contribute to the NDP III objective of human capital development through provision of equitable specialized health care services. Thus the following medium term plans have endorsed to achieve the above objective: 2019/20 Approved Budget 2020/21 Draft Estimates 1. Promote staff retention through motivation schemes like accommodation, allowances, medical expenses etc Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total 2. Procure equipment and furniture 3. Establish Mulago specialized hospital as a corporate body Output Class : Outputs Provided 56.538 0.000 0.000 56.538 55.356 0.000 55.356 4. Remodel and rehabilitate upper Mulago and make it functional 211 Wages and Salaries 31.302 0.000 0.000 31.302 31.052 0.000 31.052 5. Raise more revenue 6.Digitizing all hospital operations 212 Social Contributions 4.010 0.000 0.000 4.010 4.442 0.000 4.442 7.Improving quality management systems through implementation of ISO guidelines 213 Other Employee Costs 4.061 0.000 0.000 4.061 2.447 0.000 2.447

221 General Expenses 2.760 0.000 0.000 2.760 2.760 0.000 2.760

222 Communications 0.160 0.000 0.000 0.160 0.160 0.000 0.160

223 Utility and Property Expenses 6.861 0.000 0.000 6.861 7.311 0.000 7.311

224 Supplies and Services 2.179 0.000 0.000 2.179 2.699 0.000 2.699

225 Professional Services 1.015 0.000 0.000 1.015 0.915 0.000 0.915

227 Travel and Transport 0.649 0.000 0.000 0.649 0.559 0.000 0.559

228 Maintenance 3.541 0.000 0.000 3.541 3.011 0.000 3.011

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

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

70 71 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex

Output Class : Capital Purchases 11.020 0.000 0.000 11.020 6.020 0.000 6.020

312 FIXED ASSETS 11.020 0.000 0.000 11.020 6.020 0.000 6.020

Output Class : Arrears 2.479 0.000 0.000 2.479 1.748 0.000 1.748

321 DOMESTIC 2.479 0.000 0.000 2.479 1.748 0.000 1.748

Grand Total : 71.635 0.000 0.000 71.635 64.722 0.000 64.722

Total excluding Arrears 69.156 0.000 0.000 69.156 62.974 0.000 62.974

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 54 National Referral Hospital Services 64.447 71.635 30.446 64.722 68.524 75.184 83.175 92.765

01 Management 22.423 22.847 11.643 20.934 24.777 24.494 24.153 33.743

02 Medical Services 35.864 37.579 15.637 37.579 37.579 44.522 52.854 52.854

0392 Mulago Hospital Complex 6.020 11.020 3.107 0.000 0.000 0.000 0.000 0.000

04 Internal Audit Department 0.140 0.189 0.060 0.189 0.149 0.149 0.149 0.149

1637 Retooling of Mulago National Referral 0.000 0.000 0.000 6.020 6.020 6.020 6.020 6.020 Hospital Total for the Vote 64.447 71.635 30.446 64.722 68.524 75.184 83.175 92.765

Total Excluding Arrears 62.400 69.156 27.967 62.974 68.524 75.184 83.175 92.765

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 54 National Referral Hospital Services Programme Objective To provide Super-specialized healthcare Services, training of health workers and conduct research : Responsible Officer: Dr. B.B Byarugaba Programme Outcome: Quality and accessible National Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector 2. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

72 73 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex Vote:161 Mulago Hospital Complex

Output Class : Capital Purchases 11.020 0.000 0.000 11.020 6.020 0.000 6.020 • % increase of super-specialised cases managed. 5% 2019 6% 5% 3%

312 FIXED ASSETS 11.020 0.000 0.000 11.020 6.020 0.000 6.020 • % increase in diagnostic investigations carried out 2000000 2019 2.5% 2.2% 2.2% Output Class : Arrears 2.479 0.000 0.000 2.479 1.748 0.000 1.748 • Average length of Stay 4 2019 4 4 4 321 DOMESTIC 2.479 0.000 0.000 2.479 1.748 0.000 1.748 SubProgramme: 02 Medical Services Grand Total : 71.635 0.000 0.000 71.635 64.722 0.000 64.722 Output: 01 Inpatient Services - National Referral Hospital Total excluding Arrears 69.156 0.000 0.000 69.156 62.974 0.000 62.974 No. of specialized in-patients (Admissions) 280,000 285,000 290,000

VII. Budget By Programme And Subprogramme Referral In 850,000 900,000 950,000

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Average length of stay (ALOS)-days 5 5 5 Bed occupancy rate(BOR) 90% 90% 90% Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Output: 02 Outpatient Services - National Referral Hospital Outturn Budget End Dec Proposed 860,000 900,000 1,000,000 Budget No of specialised outpatient clinic attendances 54 National Referral Hospital Services 64.447 71.635 30.446 64.722 68.524 75.184 83.175 92.765 Output: 04 Diagnostic Services 01 Management 22.423 22.847 11.643 20.934 24.777 24.494 24.153 33.743 No of MRI and city Scans conducted 72,000 74,000 76,000 02 Medical Services 35.864 37.579 15.637 37.579 37.579 44.522 52.854 52.854 No. of laboratory investigations done 2,300,000 2,500,000 2,800,000 0392 Mulago Hospital Complex 6.020 11.020 3.107 0.000 0.000 0.000 0.000 0.000 Output: 07 Immunisation Services 04 Internal Audit Department 0.140 0.189 0.060 0.189 0.149 0.149 0.149 0.149 Comprehensive annual sector workplan and budget su Yes Yes Yes 1637 Retooling of Mulago National Referral 0.000 0.000 0.000 6.020 6.020 6.020 6.020 6.020 Hospital SubProgramme: 04 Internal Audit Department Total for the Vote 64.447 71.635 30.446 64.722 68.524 75.184 83.175 92.765 Output: 08 Audit Services Total Excluding Arrears 62.400 69.156 27.967 62.974 68.524 75.184 83.175 92.765 Number of quarterly comprehensive internal audit r 4 4 4

VIII. Programme Performance and Medium Term Plans SubProgramme: 1637 Retooling of Mulago National Referral Hospital Output: 80 Hospital Construction/rehabilitation Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) No. of hospitals benefiting from the construction of new facilities 1 1 1 Programme : 54 National Referral Hospital Services No. of hospitals benefiting from the renovation of existing facilities 1 1 1 Programme Objective To provide Super-specialized healthcare Services, training of health workers and conduct research : Output: 82 Staff houses construction and rehabilitation Responsible Officer: Dr. B.B Byarugaba No. of staff houses constructed 150 150 150 Quality and accessible National Referral Hospital Services Programme Outcome: No. of staff houses rehabilitated 150 150 150 Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector IX. Major Capital Investments And Changes In Resource Allocation

2. Improved quality of life at all levels Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

72 73 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 161 Mulago Hospital Complex

Program : 08 54 National Referral Hospital Services

Development Project : 1637 Retooling of Mulago National Referral Hospital

Output: 08 54 77 Purchase of Specialised Machinery & Equipment

Assorted medical equipment; Microlaryngoscopy set- adult, Microlaryngoscopy set- pediatric,Esophagoscopy set- pedaitric, Bronchoscopy set- adults, Flexible fiberscope pediatric,Flexible fiberscope pediatric, Hybrid tympanometer, and many others Total Output Cost(Ushs Thousand) 0 0 2,800,000

Gou Dev’t: 0 0 2,800,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 54 80 Hospital Construction/rehabilitation

Re organisation of , re-modeling and refurbishment of existing structures, wards and units to suit their specified use, extension of piped oxygen and suction to be connected Total Output Cost(Ushs Thousand) 0 0 1,500,000

Gou Dev’t: 0 0 1,500,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 54 82 Staff houses construction and rehabilitation

Refurbished roofs ( removal of asbestos) Renovation and Rehabilitation of dilapidated staff houses to improve the welfare of staff Total Output Cost(Ushs Thousand) 0 0 1,720,000

Gou Dev’t: 0 0 1,720,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Limited existing budget to operationalize Lower Mulago (Mulago National Specialized Hospital) 2. Poor infrastructure to efficiently accommodate national referral services at Upper Mulago 3. Human resource challenges in terms of numbers, cadre mix and scope of specialization due to inadequate wage 4. Limited supply of specialized medicines 5. Housing deficits for staff and interns with only 24.2% being accommodated

74 75 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex Vote:161 Mulago Hospital Complex

FY 2019/20 FY 2020/21

Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Plans to improve Vote Performance end Dec Outputs Vote 161 Mulago Hospital Complex 1. Improvement of infrastructure at upper Mulago 2. Procurement of medical machinery and equipment to functionalize upper Mulago( Mulago national referral hospital) Program : 08 54 National Referral Hospital Services 3.Construction of 5 level parking yard under PPP Development Project : 1637 Retooling of Mulago National Referral Hospital 4.Establishment of a solar plant on rooftops under PPP Output: 08 54 77 Purchase of Specialised Machinery & Equipment XI Off Budget Support Assorted medical equipment; Microlaryngoscopy set- adult, Microlaryngoscopy set- Table 11.1 Off-Budget Support by Sub-Programme pediatric,Esophagoscopy set- pedaitric, Bronchoscopy set- adults, Flexible fiberscope N/A pediatric,Flexible fiberscope pediatric, Hybrid tympanometer, and many others XII. Vote Cross Cutting Policy And Other Budgetary Issues Total Output Cost(Ushs Thousand) 0 0 2,800,000 Table 12.1: Cross- Cutting Policy Issues Gou Dev’t: 0 0 2,800,000

Ext Fin: 0 0 0 Issue Type: HIV/AIDS

A.I.A: 0 0 0 Objective : HIV awareness, testing, care and treatment Output: 08 54 80 Hospital Construction/rehabilitation Issue of Concern : Improved access to HIV Prevention, care and treatment Re organisation of , re-modeling and refurbishment of existing structures, wards and Planned Interventions : i) Conducting an adolescent clinic to create awareness units to suit their specified use, extension of piped ii) HIV prevention promotional messages in the hospital oxygen and suction to be connected iii) Provision of HIV care and treatment services Total Output Cost(Ushs Thousand) 0 0 1,500,000

Gou Dev’t: 0 0 1,500,000 Budget Allocation (Billion) : 0.120

Ext Fin: 0 0 0 Performance Indicators: i) Conducting an adolescent clinic to create awareness ii) HIV prevention promotional messages in the hospital A.I.A: 0 0 0 iii) Provision of HIV care and treatment services

Output: 08 54 82 Staff houses construction and rehabilitation Issue Type: Gender Refurbished roofs ( removal of asbestos) Renovation and Rehabilitation of dilapidated staff houses to improve the welfare of staff Objective : Provision of equitable health care services Total Output Cost(Ushs Thousand) 0 0 1,720,000 Issue of Concern : Gender sensitivity in health care delivery Gou Dev’t: 0 0 1,720,000 Planned Interventions : Isolated wards ( male and female) Differentiated areas of convenience for men and women Ext Fin: 0 0 0 Equal opportunities for staff A.I.A: 0 0 0 Budget Allocation (Billion) : 0.800 X. Vote Challenges and Plans To Improve Performance Performance Indicators: Gender sensitivity number of male and female patients Vote Challenges Issue Type: Enviroment 1. Limited existing budget to operationalize Lower Mulago (Mulago National Specialized Hospital) 2. Poor infrastructure to efficiently accommodate national referral services at Upper Mulago Objective : Cleanliness, sanitation and proper disposal of medical waste 3. Human resource challenges in terms of numbers, cadre mix and scope of specialization due to inadequate wage Issue of Concern : Healing environment and waste management 4. Limited supply of specialized medicines 5. Housing deficits for staff and interns with only 24.2% being accommodated

74 75 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex

Planned Interventions : Proper waste disposal Renovation of wards to improve ventilation Promote use of walk ways to protect the green belt

Budget Allocation (Billion) : 0.566 Performance Indicators: Improved healing environment

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions CONSULTANT U1 107 42 SENIOR CONSULTANT U1 56 24 MEDICAL OFFICER SPECIAL U2 177 52 GRADE SENIOR LABARATORY U4(Med-2) 4 1 TECHNICIAN SENIOR ANAESTHETIC U4(Med-2) 5 3 OFFICER SENIOR LABARATORY U4(Med-2) 9 6 TECHNOLOGIST SENIOR NURSING OFFICER U4(Med-2) 1550 47 Medical Records Officer U4L 20 0 Inventory Management Officer U4U 2 0 MEDICAL OFFICER U4U 102 56 NURSING OFFICER U5 180 140 ANAESTHETIC OFFICER U5(SC) 43 17 RECORDS ASSISTANT U6L 122 54 VEHICLE ATTENDANT U8 2 1 Senior Consultant (Surgery) US1E 24 4

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ANAESTHETIC OFFICER U5(SC) 43 17 26 7 8,400,000 100,800,000 CONSULTANT U1 107 42 65 6 18,393,780 220,725,360 Inventory Management Officer U4U 2 0 2 2 2,392,878 28,714,536 MEDICAL OFFICER U4U 102 56 46 14 184,800,000 2,217,600,000 MEDICAL OFFICER SPECIAL U2 177 52 125 16 38,880,144 466,561,728 GRADE Medical Records Officer U4L 20 0 20 5 3,006,705 36,080,460

76 77 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21 Mulago Hospital Complex Ministerial Policy Statement FY 2020/21

Vote:161 Mulago Hospital Complex Vote:161 Mulago Hospital Complex

Planned Interventions : Proper waste disposal NURSING OFFICER U5 180 140 40 40 23,090,280 277,083,360 Renovation of wards to improve ventilation RECORDS ASSISTANT U6L 122 54 68 21 8,909,313 106,911,756 Promote use of walk ways to protect the green belt SENIOR LABARATORY U4(Med-2) 4 1 3 3 6,600,000 79,200,000 TECHNICIAN Budget Allocation (Billion) : 0.566 SENIOR ANAESTHETIC U4(Med-2) 5 3 2 2 4,400,000 52,800,000 OFFICER Performance Indicators: Improved healing environment SENIOR CONSULTANT U1 56 24 32 8 31,177,064 374,124,768 XIII. Personnel Information Senior Consultant (Surgery) US1E 24 4 20 20 90,000,000 1,080,000,000 SENIOR LABARATORY U4(Med-2) 9 6 3 3 6,600,000 79,200,000 Table 13.1 Staff Establishment Analysis TECHNOLOGIST SENIOR NURSING OFFICER U4(Med-2) 1550 47 1503 31 68,200,000 818,400,000 Title Salary Scale Number Of Approved Positions Number Of Filled Positions VEHICLE ATTENDANT U8 2 1 1 1 277,660 3,331,920 CONSULTANT U1 107 42 Total 2403 447 1956 179 495,127,824 5,941,533,888 SENIOR CONSULTANT U1 56 24 MEDICAL OFFICER SPECIAL U2 177 52 GRADE SENIOR LABARATORY U4(Med-2) 4 1 TECHNICIAN SENIOR ANAESTHETIC U4(Med-2) 5 3 OFFICER SENIOR LABARATORY U4(Med-2) 9 6 TECHNOLOGIST SENIOR NURSING OFFICER U4(Med-2) 1550 47 Medical Records Officer U4L 20 0 Inventory Management Officer U4U 2 0 MEDICAL OFFICER U4U 102 56 NURSING OFFICER U5 180 140 ANAESTHETIC OFFICER U5(SC) 43 17 RECORDS ASSISTANT U6L 122 54 VEHICLE ATTENDANT U8 2 1 Senior Consultant (Surgery) US1E 24 4

Table 13.2 Staff Recruitment Plan

76 77 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital

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

II. Strategic Objective To offer Specialized and general Mental Health Services

III. Major Achievements in 2019/20 1. Planned to attend to 29,392 patients in the Mental Health Clinic and 17,244 were attended to 2. Planned to attend to 4,929 patients in the Child Mental Clinic and 3,683 were attended to 3. Planned to attend to 881 patients in the Alcohol Drug Unit and 493 were attended to 4. Planned to attend to 44,000 patients in the general OPD and 21,876 were attended to 5. Planned to have 60 outreach clinics conducted in areas of Nkokonjeru, Nansana, Kitetika, Kawempe, Katalemwa and Kitebi and 30 were conducted 6. Planned to resettle 900 patients and 481 were resettled 7. Planned to conduct 30,800 laboratory investigations and16,790 were conducted 8. All patients were provided with meals, uniforms and beddings 9. Hospital infrastructure, grounds, vehicles, machinery and equipment were maintained

IV. Medium Term Plans The Hospital`s medium term plans for enhancing provision of mental and general health care including provision of mental health training to male, female and disabled students, provision of technical supervision, research and advocacy on mental health issues regarding male, female and marginalized groups. Operationalization of the expanded Female Admission Ward that is to completed in the Financial Year 2019/20, renovation on the Male Admission Ward and Kirinya Wards to address the increasing number of patients especially the youth. With the acquisition of an MRI machine the most vulnerable, elderly and mental patients will be in position to receive this service free of charge. Availability of a standby ambulance for expectant mothers since Butabika Hospital does not offer maternity services.

78 79 Butabika Hospital Ministerial Policy Statement FY 2020/21 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital Vote:162 Butabika Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To offer super specialized and general mental health services; conduct mental health training, mental health related research and provide support to mental health care services in the country 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 5.110 5.700 2.600 5.700 5.700 5.700 5.700 5.700 To offer Specialized and general Mental Health Services Recurrent Non Wage 5.780 7.572 3.154 7.530 9.036 10.844 13.012 15.615 III. Major Achievements in 2019/20 GoU 1.807 8.308 0.206 8.308 8.308 8.308 8.308 8.308 Devt. 1. Planned to attend to 29,392 patients in the Mental Health Clinic and 17,244 were attended to 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 2. Planned to attend to 4,929 patients in the Child Mental Clinic and 3,683 were attended to Ext. Fin. 3. Planned to attend to 881 patients in the Alcohol Drug Unit and 493 were attended to GoU Total 12.697 21.580 5.961 21.538 23.044 24.852 27.020 29.623 4. Planned to attend to 44,000 patients in the general OPD and 21,876 were attended to 5. Planned to have 60 outreach clinics conducted in areas of Nkokonjeru, Nansana, Kitetika, Kawempe, Katalemwa and Kitebi Total GoU+Ext Fin (MTEF) 12.697 21.580 5.961 21.538 23.044 24.852 27.020 29.623 and 30 were conducted 0.000 0.000 0.000 0.008 0.000 0.000 0.000 0.000 6. Planned to resettle 900 patients and 481 were resettled Arrears 7. Planned to conduct 30,800 laboratory investigations and16,790 were conducted Total Budget 12.697 21.580 5.961 21.547 23.044 24.852 27.020 29.623 8. All patients were provided with meals, uniforms and beddings 9. Hospital infrastructure, grounds, vehicles, machinery and equipment were maintained A.I.A Total 1.205 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 13.902 21.580 5.961 21.547 23.044 24.852 27.020 29.623 IV. Medium Term Plans Total Vote Budget 13.902 21.580 5.961 21.538 23.044 24.852 27.020 29.623 The Hospital`s medium term plans for enhancing provision of mental and general health care including provision of mental Excluding Arrears health training to male, female and disabled students, provision of technical supervision, research and advocacy on mental health issues regarding male, female and marginalized groups. Operationalization of the expanded Female Admission Ward that is to VI. Budget By Economic Clasification completed in the Financial Year 2019/20, renovation on the Male Admission Ward and Kirinya Wards to address the increasing number of patients especially the youth. With the acquisition of an MRI machine the most vulnerable, elderly and mental Table V6.1 2019/20 and 2020/21 Budget Allocations by Item patients will be in position to receive this service free of charge. Availability of a standby ambulance for expectant mothers since Butabika Hospital does not offer maternity services. 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 13.272 0.000 0.000 13.272 13.430 0.000 13.430

211 Wages and Salaries 6.450 0.000 0.000 6.450 6.550 0.000 6.550

212 Social Contributions 0.373 0.000 0.000 0.373 0.433 0.000 0.433

213 Other Employee Costs 0.527 0.000 0.000 0.527 0.425 0.000 0.425

221 General Expenses 2.352 0.000 0.000 2.352 2.352 0.000 2.352

222 Communications 0.022 0.000 0.000 0.022 0.022 0.000 0.022

223 Utility and Property Expenses 0.629 0.000 0.000 0.629 0.629 0.000 0.629

224 Supplies and Services 1.205 0.000 0.000 1.205 1.462 0.000 1.462

225 Professional Services 0.000 0.000 0.000 0.000 0.200 0.000 0.200

227 Travel and Transport 0.283 0.000 0.000 0.283 0.283 0.000 0.283

228 Maintenance 1.433 0.000 0.000 1.433 1.076 0.000 1.076

Output Class : Capital Purchases 8.308 0.000 0.000 8.308 8.108 0.000 8.108

281 Property expenses other than interest 0.030 0.000 0.000 0.030 0.090 0.000 0.090

78 79 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital

312 FIXED ASSETS 8.278 0.000 0.000 8.278 5.048 0.000 5.048

314 INVENTORIES (STOCKS AND STORES) 0.000 0.000 0.000 0.000 2.970 0.000 2.970

Output Class : Arrears 0.000 0.000 0.000 0.000 0.008 0.000 0.008

321 DOMESTIC 0.000 0.000 0.000 0.000 0.008 0.000 0.008

Grand Total : 21.580 0.000 0.000 21.580 21.547 0.000 21.547

Total excluding Arrears 21.580 0.000 0.000 21.580 21.538 0.000 21.538

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 55 Provision of Specialised Mental 13.902 21.580 5.961 21.547 23.044 24.852 27.020 29.623 Health Services 01 Management 12.036 13.239 5.749 13.206 14.703 16.510 18.679 21.282

02 Internal Audit Section 0.027 0.033 0.006 0.033 0.033 0.033 0.033 0.033

0911 Butabika and health centre 1.300 4.300 0.009 0.000 0.000 0.000 0.000 0.000 remodelling/construction 1474 Institutional Support to Butabika 0.540 4.008 0.197 0.000 0.000 0.000 0.000 0.000 National Referral Hospital 1572 Retooling of Butabika National Referral 0.000 0.000 0.000 8.308 8.308 8.308 8.308 8.308 Hospital Total for the Vote 13.902 21.580 5.961 21.547 23.044 24.852 27.020 29.623

Total Excluding Arrears 13.902 21.580 5.961 21.538 23.044 24.852 27.020 29.623

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 55 Provision of Specialised Mental Health Services Programme Objective To provide super specialised and general mental health services, conduct mental health training, mental : health related research and to provide support to mental health care services in the country Responsible Officer: Dr. Juliet Nakku Programme Outcome: Quality and accessible Specialised mental health services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

80 81 Butabika Hospital Ministerial Policy Statement FY 2020/21 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital Vote:162 Butabika Hospital

312 FIXED ASSETS 8.278 0.000 0.000 8.278 5.048 0.000 5.048 • % increase of referred mental health cases managed; bed occupancy rate 14% 20172018 15% 16% 16%

314 INVENTORIES (STOCKS AND STORES) 0.000 0.000 0.000 0.000 2.970 0.000 2.970 SubProgramme: 01 Management Output Class : Arrears 0.000 0.000 0.000 0.000 0.008 0.000 0.008 Output: 02 Mental Health inpatient Services Provided 321 DOMESTIC 0.000 0.000 0.000 0.000 0.008 0.000 0.008 No. of investigations conducted 38,000 40,000 42,000 Grand Total : 21.580 0.000 0.000 21.580 21.547 0.000 21.547 No. of male and female admitted 9,350 10,753 11,000 Total excluding Arrears 21.580 0.000 0.000 21.580 21.538 0.000 21.538 Referral cases in 510 515 520

VII. Budget By Programme And Subprogramme Output: 04 Specialised Outpatient and PHC Services Provided 17,000 19,550 22,482 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme No. of out-patients in specialized clinics No. of male and female attended to in the adolesce 4,929 5,668 6,518 Billion Uganda shillings FY 2019/20 Medium Term Projections No. of male and female attended to in the mental h 29,392 33,800 38,870 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed 44,000 50,600 58,190 Budget No. of patients attended to in the general outpati 55 Provision of Specialised Mental 13.902 21.580 5.961 21.547 23.044 24.852 27.020 29.623 Output: 05 Community Mental Health Services and Technical Supervision Health Services 01 Management 12.036 13.239 5.749 13.206 14.703 16.510 18.679 21.282 No. of male and female patients seen in the outreach clinics 3,519 4,046 4,653

02 Internal Audit Section 0.027 0.033 0.006 0.033 0.033 0.033 0.033 0.033 No. of Technical support supervision visits conducted 24 24 24

0911 Butabika and health centre 1.300 4.300 0.009 0.000 0.000 0.000 0.000 0.000 No. of outreach clinics conducted 60 60 60 remodelling/construction 1474 Institutional Support to Butabika 0.540 4.008 0.197 0.000 0.000 0.000 0.000 0.000 No. of visits to regional referral hospitals 24 24 24 National Referral Hospital 1572 Retooling of Butabika National Referral 0.000 0.000 0.000 8.308 8.308 8.308 8.308 8.308 Hospital IX. Major Capital Investments And Changes In Resource Allocation Total for the Vote 13.902 21.580 5.961 21.547 23.044 24.852 27.020 29.623 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Total Excluding Arrears 13.902 21.580 5.961 21.538 23.044 24.852 27.020 29.623 FY 2019/20 FY 2020/21 VIII. Programme Performance and Medium Term Plans Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Vote 162 Butabika Hospital

Programme : 55 Provision of Specialised Mental Health Services Program : 08 55 Provision of Specialised Mental Health Services Programme Objective To provide super specialised and general mental health services, conduct mental health training, mental Development Project : 1572 Retooling of Butabika National Referral Hospital : health related research and to provide support to mental health care services in the country Output: 08 55 77 Purchase of Specialised Machinery & Equipment Responsible Officer: Dr. Juliet Nakku Assorted medical equipment including chemistry Programme Outcome: Quality and accessible Specialised mental health services analyzer, EEG machines, hematology analyzer, ultrasound machine , 2 heavy duty washing Sector Outcomes contributed to by the Programme Outcome machines and incinerator procured 1. Improved quality of life at all levels Total Output Cost(Ushs Thousand) 0 0 1,876,000 Gou Dev’t: 0 0 1,876,000 Performance Targets Ext Fin: 0 0 0 Outcome Indicators 2020/21 2021/22 2022/23 A.I.A: 0 0 0 Baseline Base year Target Projection Projection Output: 08 55 78 Purchase of Office and Residential Furniture and Fittings

80 81 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital

Procurement of assorted furniture including Hospital beds Total Output Cost(Ushs Thousand) 0 0 500,000

Gou Dev’t: 0 0 500,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 55 80 Hospital Construction/rehabilitation

Extension of perimeter wall, renovation of Male admission ward and Kirinya wards A, B and C, installation of 5 cooking stoves and extension of walkway at OPD Total Output Cost(Ushs Thousand) 0 0 5,325,000

Gou Dev’t: 0 0 5,325,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Insufficient funds on several items 2. Inadequate human resource 3. Bed occupancy has remained above 150% 4. Increasing prices of goods and services 5. High rate of destruction of infrastructure and consumables leading to high maintenance costs due to the nature of patients

Plans to improve Vote Performance

1. Introduction of new Appropriation in Aid(A.I.A) services to improve on revenue 2. Improving on the procurement process 3. Declaring vacant posts to Ministry of Public Service 4. Expansion of the Female Admission Ward to address the increasing number of patients

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0855 Provision of Specialised Mental Health Services 0.00 0.00 Recurrent Budget Estimates 01 Management 0.00 0.00 451-Global Alliance for Vaccines Immunisation 0.00 0.00

Total for Vote 0.00 0.00

XII. Vote Cross Cutting Policy And Other Budgetary Issues

82 83 Butabika Hospital Ministerial Policy Statement FY 2020/21 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital Vote:162 Butabika Hospital

Procurement of assorted furniture including Table 12.1: Cross- Cutting Policy Issues Hospital beds Total Output Cost(Ushs Thousand) 0 0 500,000 Issue Type: HIV/AIDS Gou Dev’t: 0 0 500,000 Objective : Increase uptake of comprehensive HIV treatment packages Ext Fin: 0 0 0 Issue of Concern : HIV positive mental health patients are marginalized A.I.A: 0 0 0 Planned Interventions : Provide treatment for all mental health patients with associated HIV infection Output: 08 55 80 Hospital Construction/rehabilitation Budget Allocation (Billion) : 0.500 Extension of perimeter wall, renovation of Male admission ward and Kirinya wards A, B and C, Performance Indicators: Number of HIV positive mentally ill patients treated installation of 5 cooking stoves and extension of walkway at OPD Issue Type: Gender Total Output Cost(Ushs Thousand) 0 0 5,325,000 Objective : To create equity and fairness in accessing health services amongst various gender and also equal Gou Dev’t: 0 0 5,325,000 opportunities for all gender in the Hospital services Ext Fin: 0 0 0 Issue of Concern : Stigmatization against mentally ill female, children and disabled patients leading to reduced access to care A.I.A: 0 0 0 Planned Interventions : Increase access to mental health care for female, children and disabled mentally ill patients X. Vote Challenges and Plans To Improve Performance Budget Allocation (Billion) : 0.200 Performance Indicators: 1. Number of female and disabled patients seen Vote Challenges 2. Number of children seen 1. Insufficient funds on several items Issue Type: Enviroment 2. Inadequate human resource 3. Bed occupancy has remained above 150% Objective : Preservation and improvement of the environment through application of deliberate environmental 4. Increasing prices of goods and services friendly practices 5. High rate of destruction of infrastructure and consumables leading to high maintenance costs due to the nature of patients Issue of Concern : Encroachment and degradation of the Hospital land and areas surrounding Butabika Hospital Planned Interventions : 1. Increase tree planting Plans to improve Vote Performance 2. Eviction of encroachers, promote environmentally health practice Budget Allocation (Billion) : 0.100 1. Introduction of new Appropriation in Aid(A.I.A) services to improve on revenue 2. Improving on the procurement process Performance Indicators: 1. Court order instructing the encroachers to leave the Hospital land 3. Declaring vacant posts to Ministry of Public Service 2. Tree planting 4. Expansion of the Female Admission Ward to address the increasing number of patients 3. Standard practices in environmental protection practices XIII. Personnel Information XI Off Budget Support Table 13.1 Staff Establishment Analysis Table 11.1 Off-Budget Support by Sub-Programme Title Salary Scale Number Of Approved Positions Number Of Filled Positions Billion Uganda Shillings 2019/20 Approved 2020/21 Draft SEN. CONSULTANT (PSYCH) U1 SE 5 3 Budget Estimates Programme 0855 Provision of Specialised Mental Health Services 0.00 0.00 Consultant Psychiatry U1SE 5 2 Recurrent Budget Estimates MEDICAL OFFICER SPECIAL U2 9 5 01 Management 0.00 0.00 GR.(PSYCH) 451-Global Alliance for Vaccines Immunisation 0.00 0.00 Principal Medical Social Worker U2 1 0

Total for Vote 0.00 0.00 SEN PRINCIPAL NURSING U2(Med-2) 1 0 OFFICER XII. Vote Cross Cutting Policy And Other Budgetary Issues Princ.Psychiatric Clinical Officer U3 3 2

82 83 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital

Principal Clinical Officer U3 1 0 Principal Occupational Therapist U3 1 0 Senior Counselor U3 1 0 Clinical Psychologist U4 4 2 Senior Nursing Officers U4 12 11 Senior Public Health Dental Officer U4 1 0 MEDICAL RECORDS OFFICER U4L 1 0 Dispenser U5(SC) 3 1 Nursing Officer (Nursing) U5(SC) 4 1 Nursing Officer (Psychiatry) U5(SC) 65 61 Psychiatric Clinical Officer U5(SC) 7 5 Enrolled Psychiatric Nurse U7 90 77 Store Assistant U7 1 0 Artisan U8 6 4 Laboratory Attendant U8 1 0 Semistress U8 2 1 MENTAL ATTENDANT U8(Med) 65 55 Askari U8L 42 36 KITCHEN ATTENDANT U8L 24 18 Driver U8U 9 5

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Artisan U8 6 4 2 2 0 0 Askari U8L 42 36 6 6 1,282,992 15,395,904 Clinical Psychologist U4 4 2 2 2 2,179,066 26,148,792 Consultant Psychiatry U1SE 5 2 3 2 8,400,000 100,800,000 Dispenser U5(SC) 3 1 2 2 2,400,000 28,800,000 Driver U8U 9 5 4 4 948,276 11,379,312 Enrolled Psychiatric Nurse U7 90 77 13 13 5,371,054 64,452,648 KITCHEN ATTENDANT U8L 24 18 6 6 1,282,992 15,395,904 Laboratory Attendant U8 1 0 1 1 209,859 2,518,308 MEDICAL OFFICER SPECIAL U2 9 5 4 3 0 0 GR.(PSYCH) MEDICAL RECORDS OFFICER U4L 1 0 1 1 601,341 7,216,092 MENTAL ATTENDANT U8(Med) 65 55 10 10 3,138,320 37,659,840

84 85 Butabika Hospital Ministerial Policy Statement FY 2020/21 Butabika Hospital Ministerial Policy Statement FY 2020/21

Vote:162 Butabika Hospital Vote:162 Butabika Hospital

Principal Clinical Officer U3 1 0 Nursing Officer (Nursing) U5(SC) 4 1 3 3 3,600,000 43,200,000 Nursing Officer (Psychiatry) U5(SC) 65 61 4 4 4,800,000 57,600,000 Principal Occupational Therapist U3 1 0 Princ.Psychiatric Clinical Officer U3 3 2 1 1 0 0 Senior Counselor U3 1 0 Principal Clinical Officer U3 1 0 1 1 1,345,765 16,149,180 Clinical Psychologist U4 4 2 Principal Medical Social Worker U2 1 0 1 1 0 0 Senior Nursing Officers U4 12 11 Principal Occupational Therapist U3 1 0 1 1 1,345,765 16,149,180 Psychiatric Clinical Officer U5(SC) 7 5 2 2 2,400,000 28,800,000 Senior Public Health Dental Officer U4 1 0 Semistress U8 2 1 1 1 0 0 MEDICAL RECORDS OFFICER U4L 1 0 SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 Dispenser U5(SC) 3 1 OFFICER SEN. CONSULTANT (PSYCH) U1 SE 5 3 2 2 0 0 Nursing Officer (Nursing) U5(SC) 4 1 Senior Nursing Officers U4 12 11 1 1 0 0 Nursing Officer (Psychiatry) U5(SC) 65 61 Senior Counselor U3 1 0 1 1 902,612 10,831,344 Psychiatric Clinical Officer U5(SC) 7 5 Senior Public Health Dental U4 1 0 1 1 1,131,967 13,583,604 Officer Enrolled Psychiatric Nurse U7 90 77 Store Assistant U7 1 0 1 1 316,393 3,796,716 Store Assistant U7 1 0 Total 364 289 75 73 45,156,402 541,876,824 Artisan U8 6 4 Laboratory Attendant U8 1 0 Semistress U8 2 1 MENTAL ATTENDANT U8(Med) 65 55 Askari U8L 42 36 KITCHEN ATTENDANT U8L 24 18 Driver U8U 9 5

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Artisan U8 6 4 2 2 0 0 Askari U8L 42 36 6 6 1,282,992 15,395,904 Clinical Psychologist U4 4 2 2 2 2,179,066 26,148,792 Consultant Psychiatry U1SE 5 2 3 2 8,400,000 100,800,000 Dispenser U5(SC) 3 1 2 2 2,400,000 28,800,000 Driver U8U 9 5 4 4 948,276 11,379,312 Enrolled Psychiatric Nurse U7 90 77 13 13 5,371,054 64,452,648 KITCHEN ATTENDANT U8L 24 18 6 6 1,282,992 15,395,904 Laboratory Attendant U8 1 0 1 1 209,859 2,518,308 MEDICAL OFFICER SPECIAL U2 9 5 4 3 0 0 GR.(PSYCH) MEDICAL RECORDS OFFICER U4L 1 0 1 1 601,341 7,216,092 MENTAL ATTENDANT U8(Med) 65 55 10 10 3,138,320 37,659,840

84 85 Arua Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:163 Arua Referral Hospital

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

II. Strategic Objective - To enhance quality, safety and scope of health care services to clients - To improve managerial efficiency in resource allocation, utilization and accountability - To build capacity of service providers in the lower facilities for better quality health care - To strengthen the referral systems and partnerships for efficient health care services - To strengthen health research and training - To enhance promotive, preventive and rehabilitative health services in order to reduce the burden of disease in the region III. Major Achievements in 2019/20 The following outputs were achieved midyear by Arua Regional Referral Hospital (July - December 2019);- - Inpatient Services: 13,330 Admissions, 3.8 Days Average Length of Stay, 98.9% Bed Occupancy Rate, 2106 Major Surgical Procedures done and 3764 Deliveries.

- Outpatient Services: 63,338 Specialised Outpatient Attendance and 9,647 General OPD Attendance.

- Medicines and supplies procured: Cumulatively 0.36640054329 billion worth of medicines and supplies was procured and there were no incidents of expiry of medicines and supplies.

- Diagnostic Services: 61,109 Laboratory Tests done, 3,665 Ultra Sound Scans done but no X-ray Examinations done and 27 Postmortems done.

- Management and support services: 2 Hospital Management board meetings held, 20 Department Meetings held, 2 Senior Staff Meetings held, 2 Rounds of Specialist Outreach Programme coordinated. Payment of staff salaries by 28th of every month.Payroll Managed, Wage Bill and Recruitment Plans developed, Pension and Gratuity Managed, Performance of staff managed, Wellness of staff managed, Rewards and Sanctions managed. Quarterly financial/activity and other reports were submitted timely. Patient information managed; 3 monthly Reports and one quarterly report generated and submitted. Records and Information Management Systems managed.

- Under Rehabilitation and institutional support the following were achieved;- Staff house construction: Slab Cast for Floor 1 and walls erected for Floor 2 slab. Site Meetings held, Site Supervision, Payment of Interim Certificate for works accomplished done. Institutional Support: Placing bid Advert and Solicitation of Supplier for Generator, Evaluation of Bids, Award of Contracts, Generator delivered and installed and works on the generator housing started, interim certificate paid. IV. Medium Term Plans In the midterm, and in line with the National Development Plan III Objective 3: To improve population health, safety and management (Page 161) and elaborated in page 163. The hospital will seek to fulfill this objective by providing general and specialized outpatient services, admissions, provide clean environment for staff and patients, and continue paying utilities which are essential in the functioning of the hospital. The hospital will also continue with supervision of the lower health facilities within its area of operating to ensure minimum standards of care are maintained on the ground. The hospital will also continue with the construction of staff house, continue with maintenance of medical equipment in the region fencing entire hospital land, purchase office furniture and equipment, construct an Administration block, construct a new mortuary and install intercom.

86 87 Arua Referral Hospital Ministerial Policy Statement FY 2020/21 Arua Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:163 Arua Referral Hospital Vote:163 Arua Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) Increasing access of the people within West Nile region to quality specialized health care services in a client centered manner, with professionalism, integrity, and accountability in order to increase their productivity. 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 4.315 5.049 2.193 5.049 5.049 5.049 5.049 5.049 - To enhance quality, safety and scope of health care services to clients - To improve managerial efficiency in resource Recurrent allocation, utilization and accountability - To build capacity of service providers in the lower facilities for better quality health Non Wage 3.355 3.110 1.415 5.026 5.026 5.026 5.026 5.026 care - To strengthen the referral systems and partnerships for efficient health care services - To strengthen health research and GoU 1.059 1.060 0.415 0.800 2.200 2.700 1.818 1.818 training - To enhance promotive, preventive and rehabilitative health services in order to reduce the burden of disease in the Devt. region Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 III. Major Achievements in 2019/20 GoU Total 8.729 9.220 4.022 10.875 12.275 12.775 11.893 11.893 The following outputs were achieved midyear by Arua Regional Referral Hospital (July - December 2019);- Total GoU+Ext Fin (MTEF) 8.729 9.220 4.022 10.875 12.275 12.775 11.893 11.893 - Inpatient Services: 13,330 Admissions, 3.8 Days Average Length of Stay, 98.9% Bed Occupancy Rate, 2106 Major Surgical Procedures done and 3764 Deliveries. Arrears 0.000 0.000 0.000 0.035 0.000 0.000 0.000 0.000 8.729 9.220 4.022 10.911 12.275 12.775 11.893 11.893 - Outpatient Services: 63,338 Specialised Outpatient Attendance and 9,647 General OPD Attendance. Total Budget A.I.A Total 0.065 0.000 0.000 0.000 0.000 0.000 0.000 0.000 - Medicines and supplies procured: Cumulatively 0.36640054329 billion worth of medicines and supplies was procured and there were no incidents of expiry of medicines and supplies. Grand Total 8.794 9.220 4.022 10.911 12.275 12.775 11.893 11.893 Total Vote Budget 8.794 9.220 4.022 10.875 12.275 12.775 11.893 11.893 - Diagnostic Services: 61,109 Laboratory Tests done, 3,665 Ultra Sound Scans done but no X-ray Examinations done and 27 Excluding Arrears Postmortems done.

- Management and support services: 2 Hospital Management board meetings held, 20 Department Meetings held, 2 Senior Staff VI. Budget By Economic Clasification Meetings held, 2 Rounds of Specialist Outreach Programme coordinated. Payment of staff salaries by 28th of every Table V6.1 2019/20 and 2020/21 Budget Allocations by Item month.Payroll Managed, Wage Bill and Recruitment Plans developed, Pension and Gratuity Managed, Performance of staff managed, Wellness of staff managed, Rewards and Sanctions managed. Quarterly financial/activity and other reports were submitted timely. Patient information managed; 3 monthly Reports and one quarterly report generated and submitted. Records 2019/20 Approved Budget 2020/21 Draft Estimates and Information Management Systems managed. Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 8.160 0.000 0.000 8.160 10.075 0.000 10.075 - Under Rehabilitation and institutional support the following were achieved;- Staff house construction: Slab Cast for Floor 1 and walls erected for Floor 2 slab. Site Meetings held, Site Supervision, Payment 211 Wages and Salaries 5.184 0.000 0.000 5.184 5.184 0.000 5.184 of Interim Certificate for works accomplished done. Institutional Support: Placing bid Advert and Solicitation of Supplier for Generator, Evaluation of Bids, Award of Contracts, 212 Social Contributions 0.637 0.000 0.000 0.637 0.806 0.000 0.806 Generator delivered and installed and works on the generator housing started, interim certificate paid. 213 Other Employee Costs 0.739 0.000 0.000 0.739 2.486 0.000 2.486

IV. Medium Term Plans 221 General Expenses 0.372 0.000 0.000 0.372 0.372 0.000 0.372 In the midterm, and in line with the National Development Plan III Objective 3: To improve population health, safety and 222 Communications 0.024 0.000 0.000 0.024 0.024 0.000 0.024 management (Page 161) and elaborated in page 163. The hospital will seek to fulfill this objective by providing general and specialized outpatient services, admissions, provide clean environment for staff and patients, and continue paying utilities which 223 Utility and Property Expenses 0.429 0.000 0.000 0.429 0.428 0.000 0.428 are essential in the functioning of the hospital. The hospital will also continue with supervision of the lower health facilities 224 Supplies and Services 0.165 0.000 0.000 0.165 0.165 0.000 0.165 within its area of operating to ensure minimum standards of care are maintained on the ground. The hospital will also continue with the construction of staff house, continue with maintenance of medical equipment in the region fencing entire hospital land, 227 Travel and Transport 0.338 0.000 0.000 0.338 0.338 0.000 0.338 purchase office furniture and equipment, construct an Administration block, construct a new mortuary and install intercom. 228 Maintenance 0.271 0.000 0.000 0.271 0.271 0.000 0.271

Output Class : Capital Purchases 1.060 0.000 0.000 1.060 0.800 0.000 0.800

312 FIXED ASSETS 1.060 0.000 0.000 1.060 0.800 0.000 0.800

Output Class : Arrears 0.000 0.000 0.000 0.000 0.035 0.000 0.035

86 87 Arua Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:163 Arua Referral Hospital

321 DOMESTIC 0.000 0.000 0.000 0.000 0.035 0.000 0.035

Grand Total : 9.220 0.000 0.000 9.220 10.911 0.000 10.911

Total excluding Arrears 9.220 0.000 0.000 9.220 10.875 0.000 10.875

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 8.794 9.220 4.022 10.911 12.275 12.775 11.893 11.893

01 Arua Referral Hospital Services 7.487 7.911 3.439 9.862 9.827 9.827 9.827 9.827

02 Arua Referral Hospital Internal Audit 0.016 0.016 0.013 0.016 0.016 0.016 0.016 0.016

03 Arua Regional Maintenance 0.232 0.232 0.155 0.232 0.232 0.232 0.232 0.232

1004 Arua Rehabilitation Referral Hospital 0.937 0.860 0.215 0.600 2.000 2.500 1.591 1.000

1469 Institutional Support to Arua Regional 0.122 0.200 0.200 0.000 0.000 0.000 0.000 0.000 Referral Hospital 1581 Retooling of Arua Rehabilitation 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.818 Referral Hospital Total for the Vote 8.794 9.220 4.022 10.911 12.275 12.775 11.893 11.893

Total Excluding Arrears 8.794 9.220 4.022 10.875 12.275 12.775 11.893 11.893

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To improve the health of the catchment population through provision of specialized curative, preventive, : promotive and rehabilitative health services. Responsible Officer: DR. NYEKO J. FILBERT Programme Outcome: Inclusive and quality healthcare services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• % increase of specialised clinic outpatients attendances 2% 2019 0.5% 1% 1.5%

• % increase of diagnostic investigations carried 1% 2019 0.5% 1% 1.5%

• Bed occupancy rate 104% 2019 85% 85% 85%

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Vote:163 Arua Referral Hospital Vote:163 Arua Referral Hospital

321 DOMESTIC 0.000 0.000 0.000 0.000 0.035 0.000 0.035 SubProgramme: 01 Arua Referral Hospital Services Grand Total : 9.220 0.000 0.000 9.220 10.911 0.000 10.911 Output: 01 Inpatient services Total excluding Arrears 9.220 0.000 0.000 9.220 10.875 0.000 10.875 No. of in patients (Admissions) 26,000 26,500 27,000

Average Length of Stay (ALOS) - days 4 4 4 VII. Budget By Programme And Subprogramme Bed Occupancy Rate (BOR) 85 85 85 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Number of Major Operations (including Ceasarian se 6,000 6,500 7,000 Billion Uganda shillings FY 2019/20 Medium Term Projections Referral cases in 5,250 5,500 5,750 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Output: 02 Outpatient services Budget Total general outpatients attendance 10,000 9,500 9,000 56 Regional Referral Hospital Services 8.794 9.220 4.022 10.911 12.275 12.775 11.893 11.893

01 Arua Referral Hospital Services 7.487 7.911 3.439 9.862 9.827 9.827 9.827 9.827 Number of Specialised Clinic Attendances 150,750 151,500 152,250

02 Arua Referral Hospital Internal Audit 0.016 0.016 0.013 0.016 0.016 0.016 0.016 0.016 Referral cases in 5,250 5,500 5,750

03 Arua Regional Maintenance 0.232 0.232 0.155 0.232 0.232 0.232 0.232 0.232 Output: 03 Medicines and health supplies procured and dispensed 1004 Arua Rehabilitation Referral Hospital 0.937 0.860 0.215 0.600 2.000 2.500 1.591 1.000 Value of medicines received/dispensed (Ush bn) 1.23 1.25 1.3 1469 Institutional Support to Arua Regional 0.122 0.200 0.200 0.000 0.000 0.000 0.000 0.000 Referral Hospital Output: 04 Diagnostic services 1581 Retooling of Arua Rehabilitation 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.818 No. of laboratory tests carried out 122,400 124,800 127,200 Referral Hospital Total for the Vote 8.794 9.220 4.022 10.911 12.275 12.775 11.893 11.893 No. of patient xrays (imaging) taken 4,000 4,000 4,000

Total Excluding Arrears 8.794 9.220 4.022 10.875 12.275 12.775 11.893 11.893 Number of Ultra Sound Scans 8,000 8,200 8,500

Output: 05 Hospital Management and support services VIII. Programme Performance and Medium Term Plans Assets register updated on a quarterly basis 4 4 4 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Timely payment of salaries and pensions by the 2 12 12 12 Programme : 56 Regional Referral Hospital Services Timely submission of quarterly financial/activity 4 4 4 Programme Objective To improve the health of the catchment population through provision of specialized curative, preventive, : promotive and rehabilitative health services. Output: 06 Prevention and rehabilitation services Responsible Officer: DR. NYEKO J. FILBERT No. of antenatal cases (All attendances) 16,000 16,000 16,000

Programme Outcome: Inclusive and quality healthcare services No. of children immunised (All immunizations) 45,000 45,000 45,000 Sector Outcomes contributed to by the Programme Outcome No. of family planning users attended to (New and Old) 4,000 4,000 4,000 1. Improved quality of life at all levels Number of ANC Visits (All visits) 16,000 16,000 16,000 Performance Targets Percentage of HIV positive pregnant women not on H 0% 0% 0% Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection Output: 07 Immunisation services Number of Childhood Vaccinations given (All contac 45,000 45,000 45,000 • % increase of specialised clinic outpatients attendances 2% 2019 0.5% 1% 1.5% SubProgramme: 03 Arua Regional Maintenance • % increase of diagnostic investigations carried 1% 2019 0.5% 1% 1.5% Output: 05 Hospital Management and support services • Bed occupancy rate 104% 2019 85% 85% 85% Assets register updated on a quarterly basis 4 4 4

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Vote:163 Arua Referral Hospital

Timely payment of salaries and pensions by the 2 12 12 12

Timely submission of quarterly financial/activity 4 4 4

SubProgramme: 1004 Arua Rehabilitation Referral Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 6 9 5

Cerificates of progress/ Completion 2 4 4

SubProgramme: 1581 Retooling of Arua Rehabilitation Referral Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 1 1 1

Cerificates of progress/ Completion 4 4 4

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 .2 .2

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 163 Arua Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Arua Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

Slab for Floor 1,2,3 & 4 for the Storeyed Staff House Cast by Slab Cast for Floor 1 and walls erected for Phase II of 7-Storey Staff house Construction end of the Financial Year. Floor 2 slab. Site Meetings held, Site Works: Slab Cast for Floor 3 & 4 and walls Supervision, Payment of Interim Certificate for erected for Floor 2 and 3. works accomplished. Total Output Cost(Ushs Thousand) 860,000 215,000 600,000

Gou Dev’t: 860,000 215,000 600,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

- Limited staff accommodation, - Inadequate budget inclusive of medicines and supplies, - Limited medical equipment to match hospital mandate, - High community expectations: - Difficulty in projecting hospital service catchment population due to refugee influx from Sudan and Congo boarder.

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Vote:163 Arua Referral Hospital Vote:163 Arua Referral Hospital

Timely payment of salaries and pensions by the 2 12 12 12 - Inadequate staffing, - Manual data collection affecting accuracy and quick generation of reports. Timely submission of quarterly financial/activity 4 4 4 - Unstable power supply from the provider (WENRECO) affects the limited budget for fuel and smooth running of activities in the hospital. SubProgramme: 1004 Arua Rehabilitation Referral Hospital Output: 81 Staff houses construction and rehabilitation Plans to improve Vote Performance No. of staff houses constructed/rehabilitated 6 9 5 - Increased supervision internally and in the region, - Monitoring of staff attendance to duty within the hospital, Cerificates of progress/ Completion 2 4 4 - Supervision of works, - Improvement of resource accountability, SubProgramme: 1581 Retooling of Arua Rehabilitation Referral Hospital - Improvement of the working environment and occupational safety, Output: 81 Staff houses construction and rehabilitation - Adherence to procurement regulations, - Ensuring functionality of all committee established within the hospital. No. of staff houses constructed/rehabilitated 1 1 1 XI Off Budget Support Cerificates of progress/ Completion 4 4 4 Table 11.1 Off-Budget Support by Sub-Programme Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 .2 .2 Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 2.95 IX. Major Capital Investments And Changes In Resource Allocation Recurrent Budget Estimates Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) 01 Arua Referral Hospital Services 0.00 2.95 426-UNICEF 0.00 0.91 FY 2019/20 FY 2020/21 451-Global Alliance for Vaccines Immunisation 0.00 0.28 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs 550-United States of America 0.00 0.86 Vote 163 Arua Referral Hospital World Bank- URMCHIP 0.00 0.90

Program : 08 56 Regional Referral Hospital Services Total for Vote 0.00 2.95 Development Project : 1004 Arua Rehabilitation Referral Hospital XII. Vote Cross Cutting Policy And Other Budgetary Issues Output: 08 56 81 Staff houses construction and rehabilitation Table 12.1: Cross- Cutting Policy Issues Slab for Floor 1,2,3 & 4 for the Storeyed Staff House Cast by Slab Cast for Floor 1 and walls erected for Phase II of 7-Storey Staff house Construction end of the Financial Year. Floor 2 slab. Site Meetings held, Site Works: Slab Cast for Floor 3 & 4 and walls Supervision, Payment of Interim Certificate for erected for Floor 2 and 3. Issue Type: HIV/AIDS works accomplished. Total Output Cost(Ushs Thousand) 860,000 215,000 600,000 Objective : To Provide comprehensive HIV/AIDs services.

Gou Dev’t: 860,000 215,000 600,000 Issue of Concern : There is still high prevalence of HIV in the community. Low adherence to HAART.

Ext Fin: 0 0 0 Planned Interventions : Proper patient care for opportunistic infections, early diagnosis, HIV counseling and testing, Antiretroviral treatment, eMTCT, post-exposure prophylaxis. Health education of HIV/AID both in A.I.A: 0 0 0 the hospital and community. Budget Allocation (Billion) : 0.040 X. Vote Challenges and Plans To Improve Performance Performance Indicators: 1) Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% of HIV+ put in care and 90% Viral suppression. Vote Challenges 2) 100% of HIV+ Mothers enrolled in Care and % of HIV+ clients enrolled on ART. - Limited staff accommodation, 3) No. of clients done HCT. - Inadequate budget inclusive of medicines and supplies, Issue Type: Gender - Limited medical equipment to match hospital mandate, - High community expectations: Objective : To have equal access to health services despite gender, age and social economic status. - Difficulty in projecting hospital service catchment population due to refugee influx from Sudan and Congo boarder.

90 91 Arua Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:163 Arua Referral Hospital

Issue of Concern : Incidents of maternal and neonatal mortality, Undocumented domestic violence cases, Low attendance to family planning, and low male involvement in family planning. Planned Interventions : Improved patient care and access, early diagnosis, Cancer screening and treatment, management of victims of sexual violence and other forms of violence against women, immunization of children and girls. Having a vibrant adolescent friendly services. Budget Allocation (Billion) : 0.050 Performance Indicators: No of Children Immunised, No. of Family Planning Contacts and male involvement in family planning, Number of Adolescent Attending ANC, Number GBV cases treated. Issue Type: Enviroment

Objective : To have a clean and safe working hospital environment. Issue of Concern : Facility bases infections and Safe working environment. Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, occupational health and safety activities, tree planting on the compound, sewerage management and good waste disposal. Budget Allocation (Billion) : 0.200 Performance Indicators: 12 Support Supervision to unit/wards, Number of Monthly Meetings, Regular cleaning of compounds, timely payment for utilities. XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant (Obs. & Gyn) U1SE 1 0 Senior Consultant MEDICAL U1SE 1 0 Medical Officer Special Grade U2(Med-1) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 (Opthamology) Medical Officer Special Grade U2(Med-1) 1 0 (Public Health) Medical Officer Special Grade U2(Med-1) 1 0 (Surgeon) Medical Officer Special U2U 1 0 GradeOrthopaedic Surgeon Senior Dispensor U4 1 0 Medical Officers U4(Med-1) 10 5 Pharmacist U4(Med-1) 1 0 MEDICAL RECORDS OFFICER U4L 1 0 Anaesthetic Officer U5(SC) 2 1 Clinical Officer U5(SC) 3 2

92 93 Arua Referral Hospital Ministerial Policy Statement FY 2020/21 Arua Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:163 Arua Referral Hospital Vote:163 Arua Referral Hospital

Issue of Concern : Incidents of maternal and neonatal mortality, Undocumented domestic violence cases, Low Dispenser U5(SC) 6 2 attendance to family planning, and low male involvement in family planning. Occupational Therapist U5(SC) 1 0 Planned Interventions : Improved patient care and access, early diagnosis, Cancer screening and treatment, management of victims of sexual violence and other forms of violence against women, immunization of children PHYSIOTHERAPIST U5(SC) 2 0 and girls. Having a vibrant adolescent friendly services. Enrolled Midwives U7 20 11 Budget Allocation (Billion) : 0.050 Performance Indicators: No of Children Immunised, No. of Family Planning Contacts and male involvement in family Table 13.2 Staff Recruitment Plan planning, Number of Adolescent Attending ANC, Number GBV cases treated. Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Issue Type: Enviroment Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Objective : To have a clean and safe working hospital environment. FY2020/21 Issue of Concern : Facility bases infections and Safe working environment. Anaesthetic Officer U5(SC) 2 1 1 1 1,200,000 14,400,000 Clinical Officer U5(SC) 3 2 1 1 1,200,000 14,400,000 Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, occupational health and safety activities, tree planting on the compound, sewerage management Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 and good waste disposal. Dispenser U5(SC) 6 2 4 4 4,800,000 57,600,000 Budget Allocation (Billion) : 0.200 Enrolled Midwives U7 20 11 9 9 5,018,697 60,224,364 Performance Indicators: 12 Support Supervision to unit/wards, Number of Monthly Meetings, Regular cleaning of Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (ENT) compounds, timely payment for utilities. Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 XIII. Personnel Information (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Opthamology) Table 13.1 Staff Establishment Analysis Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Public Health) Title Salary Scale Number Of Approved Positions Number Of Filled Positions Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Consultant (Obs. & Gyn) U1SE 1 0 (Surgeon) Medical Officer Special U2U 1 0 1 1 3,750,000 45,000,000 Senior Consultant MEDICAL U1SE 1 0 GradeOrthopaedic Surgeon Medical Officer Special Grade U2(Med-1) 1 0 Medical Officers U4(Med-1) 10 5 5 5 15,000,000 180,000,000 (ENT) MEDICAL RECORDS OFFICER U4L 1 0 1 1 601,341 7,216,092 Medical Officer Special Grade U2(Med-1) 1 0 Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 (Medicine) Pharmacist U4(Med-1) 1 0 1 1 3,000,000 36,000,000 Medical Officer Special Grade U2(Med-1) 1 0 PHYSIOTHERAPIST U5(SC) 2 0 2 1 1,200,000 14,400,000 (Opthamology) Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Medical Officer Special Grade U2(Med-1) 1 0 Senior Dispensor U4 1 0 1 1 1,322,163 15,865,956 (Public Health) Total 55 21 34 33 65,742,201 788,906,412 Medical Officer Special Grade U2(Med-1) 1 0 (Surgeon) Medical Officer Special U2U 1 0 GradeOrthopaedic Surgeon Senior Dispensor U4 1 0 Medical Officers U4(Med-1) 10 5 Pharmacist U4(Med-1) 1 0 MEDICAL RECORDS OFFICER U4L 1 0 Anaesthetic Officer U5(SC) 2 1 Clinical Officer U5(SC) 3 2

92 93 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:164 Fort Portal Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide accessible and quality health care to all people in Rwenzori region through delivery of promotive, preventive, curative, palliative and rehabilitative health care.

II. Strategic Objective a. To enhance health education and promotion at community level. b. To reduce maternal and Child mortality and morbidity c. To reduce morbidity, mortality and transmission of communicable diseases d. To reduce morbidity and mortality attributable to communicable diseases e. To enhance hospital capacity for effective service delivery III. Major Achievements in 2019/20 By end of Q2, under capital development, procurement of 250 patient mattresses was procured, contract for installation of 10 security solar lights awarded and bids for the perimeter wall evaluated. Two dental chairs and an ultrasound machine contracts awarded.

Inpatients cumulative achievement by end of Q2 was as follows; Admissions were 13,705 out of the targeted 30,000 (39.5%). Deliveries were targeted at 7,000 and achieved 4,224, Bed occupancy rate was 73% out of the targeted 85%, Average length of stay target was 4 days and achievement was 4.05 days, 3,724 major operations were achieved out of the target 3,000. More major operations were done due to the various surgical camps that were held during period under review. The target for blood transfusion was 3,500 achievements was 1,189. The hospital received 2,546 as referrals in while only 72 were referred out during the reporting period.

Outpatient target for general OPD was 130,000 and achievement was 86,788 Contacts. Out of the planned 120,000 contacts for Outpatient Specialized contacts, the achievement was 63,151. There was Over performance in General OPD contacts due to improved quality of services, community mobilization through radio talks and referrals from lower facilities.

Diagnostics achieved were Lab Examinations 74,483 compared to 262,500 that were targeted. This was due to recurrent stock outs of reagents. Out of the targeted 21,000 radiological investigations 8,225 was achieved due to the breakdown of the X-ray machine. The hospital introduced a new service of ECG and 137 examinations were done.

Under Prevention and rehabilitation, 433 family planning contacts were achieved out of the target of 3,000, The targeted 32,000 vaccinations achievement was 10,934 vaccinations and 2,228 ANC contacts achieved out of targeted 10,000.

Under support services, asset registers were updated, medical equipment captured in NOMAD, and assorted medical equipment were serviced and maintained. Health workers were trained on medical equipment use and routine maintenance.

IV. Medium Term Plans • Development of a 30-year master plan to guide the development of the hospital infrastructure • Improve hospital security, staff accommodation, rehabilitate existing infrastructure, reduce on costs of utilities by use rain water harvesting and solar power. • Reduce staff gaps by timely identification declaration and recruitment of staff within the allocated wage bill. • Strengthen and improve on data management, utilization and dissemination through digitalization • Continue lobbying and fast tracking of hospital infrastructure development to meet the client service demands including Laboratory, accident and Emergency. • Continue buying additional assorted and specialized medical equipment as a way of improving patient outcomes, boost diagnostic capability and enhance and generally improve the health of the population in the region

94 95 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:164 Fort Portal Referral Hospital Vote:164 Fort Portal Referral Hospital

Under support services, asset registers were updated, medical equipment captured in NOMAD, and assorted medical equipment 211 Wages and Salaries 5.964 0.000 0.000 5.964 5.956 0.000 5.956 were serviced and maintained. Health workers were trained on medical equipment use and routine maintenance. 212 Social Contributions 0.435 0.000 0.000 0.435 0.467 0.000 0.467

213 Other Employee Costs 0.822 0.000 0.000 0.822 0.580 0.000 0.580 IV. Medium Term Plans 221 General Expenses 0.237 0.000 0.000 0.237 0.288 0.000 0.288 • Development of a 30-year master plan to guide the development of the hospital infrastructure • Improve hospital security, staff accommodation, rehabilitate existing infrastructure, reduce on costs of utilities by use rain 222 Communications 0.037 0.000 0.000 0.037 0.033 0.000 0.033 water harvesting and solar power. • Reduce staff gaps by timely identification declaration and recruitment of staff within the allocated wage bill. 223 Utility and Property Expenses 0.682 0.000 0.000 0.682 0.635 0.000 0.635 • Strengthen and improve on data management, utilization and dissemination through digitalization 224 Supplies and Services 0.213 0.000 0.000 0.213 0.306 0.000 0.306 • Continue lobbying and fast tracking of hospital infrastructure development to meet the client service demands including Laboratory, accident and Emergency. 227 Travel and Transport 0.213 0.000 0.000 0.213 0.199 0.000 0.199 • Continue buying additional assorted and specialized medical equipment as a way of improving patient outcomes, boost 228 Maintenance 0.271 0.000 0.000 0.271 0.201 0.000 0.201 diagnostic capability and enhance and generally improve the health of the population in the region Output Class : Capital Purchases 1.060 0.000 0.000 1.060 0.780 0.000 0.780

312 FIXED ASSETS 1.060 0.000 0.000 1.060 0.780 0.000 0.780

Output Class : Arrears 0.151 0.000 0.000 0.151 0.127 0.000 0.127

94 95 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:164 Fort Portal Referral Hospital

321 DOMESTIC 0.151 0.000 0.000 0.151 0.127 0.000 0.127

Grand Total : 10.086 0.000 0.000 10.086 9.572 0.000 9.572

Total excluding Arrears 9.935 0.000 0.000 9.935 9.445 0.000 9.445

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Fort Portal Referral Hospital Services 6.845 8.816 4.053 8.582 8.455 8.455 8.455 8.455

02 Fort Portal Referral Hospital Internal 0.016 0.016 0.003 0.016 0.016 0.016 0.016 0.016 Audit 03 Fort Portal Regional Maintenance 0.189 0.194 0.073 0.194 0.194 0.194 0.194 0.194

1004 Fort Portal Rehabilitation Referral 0.900 0.790 0.000 0.580 0.520 0.000 0.000 0.000 Hospital 1470 Institutional Support to Fort Portal 0.160 0.270 0.000 0.000 0.000 0.000 0.000 0.000 Regional Referral Hospital 1576 Retooling of Fort Portal Regional 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Referral Hospital Total for the Vote 8.110 10.086 4.129 9.572 9.385 8.865 8.892 8.892

Total Excluding Arrears 7.933 9.935 3.978 9.445 9.385 8.865 8.892 8.892

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To provide general and specialized services which are inclusive to the catchment population in Rwenzori : Region Responsible Officer: Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• % increase of specialized clinic outpatients attendances 5% 2019 10% 15% 20%

• % increase of diagnostic investigations carried 10% 2019 12.5% 15% 17%

• Bed occupancy rate 74% 2019 80% 85% 85%

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Vote:164 Fort Portal Referral Hospital Vote:164 Fort Portal Referral Hospital

321 DOMESTIC 0.151 0.000 0.000 0.151 0.127 0.000 0.127 SubProgramme: 01 Fort Portal Referral Hospital Services Grand Total : 10.086 0.000 0.000 10.086 9.572 0.000 9.572 Output: 01 Inpatient services Total excluding Arrears 9.935 0.000 0.000 9.935 9.445 0.000 9.445 No. of in-patients (Admissions) 30,000 30,000 30,000

Average Length of Stay (ALOS) - days 4 4 4 VII. Budget By Programme And Subprogramme Bed Occupancy Rate (BOR) 80% 85% 85% Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Number of Major Operations (including Ceasarian section) 4,000 4,000 4,000 Billion Uganda shillings FY 2019/20 Medium Term Projections Referral cases in 7,000 7,600 8,000 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Output: 02 Outpatient services Budget Total general outpatients attendance 100,000 110,000 120,000 56 Regional Referral Hospital Services 8.110 10.086 4.129 9.572 9.385 8.865 8.892 8.892

01 Fort Portal Referral Hospital Services 6.845 8.816 4.053 8.582 8.455 8.455 8.455 8.455 No. of specialised clinic attendances 130,000 135,000 140,000

02 Fort Portal Referral Hospital Internal 0.016 0.016 0.003 0.016 0.016 0.016 0.016 0.016 Output: 03 Medicines and health supplies procured and dispensed Audit 03 Fort Portal Regional Maintenance 0.189 0.194 0.073 0.194 0.194 0.194 0.194 0.194 Value of medical equipment procured(Ush Bn) 1.4 1.5 1.6

1004 Fort Portal Rehabilitation Referral 0.900 0.790 0.000 0.580 0.520 0.000 0.000 0.000 Output: 04 Diagnostic services Hospital No. of laboratory tests carried out 150,000 175,000 200,000 1470 Institutional Support to Fort Portal 0.160 0.270 0.000 0.000 0.000 0.000 0.000 0.000 Regional Referral Hospital No. of patient xrays (imaging) taken 10,000 12,000 15,000 1576 Retooling of Fort Portal Regional 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Referral Hospital Number of Ultra Sound Scans 15,000 17,000 20,000 Total for the Vote 8.110 10.086 4.129 9.572 9.385 8.865 8.892 8.892 Output: 05 Hospital Management and support services Total Excluding Arrears 7.933 9.935 3.978 9.445 9.385 8.865 8.892 8.892 Assets register updated on a quarterly basis 4 4 4

VIII. Programme Performance and Medium Term Plans Timely payment of salaries and pensions by the 2 12 12 12

Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Timely submission of quarterly financial/activity 4 4 4

Programme : 56 Regional Referral Hospital Services Output: 06 Prevention and rehabilitation services Programme Objective To provide general and specialized services which are inclusive to the catchment population in Rwenzori No. of antenatal cases (All attendances) 10,000 12,000 13,000 : Region No. of children immunised (All immunizations) 32,000 33,000 35,000 Responsible Officer: Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services No. of family planning users attended to (New and Old) 2,000 2,500 3,000 Sector Outcomes contributed to by the Programme Outcome Number of ANC Visits (All visits) 10,000 12,000 13,000

1. Improved quality of life at all levels Percentage of HIV positive pregnant women not on H 0% 0% 0%

Performance Targets Output: 07 Immunisation Services Outcome Indicators 2020/21 2021/22 2022/23 Number of Childhood Vaccinations given (All contac 35,000 35,000 36,000 Baseline Base year Target Projection Projection SubProgramme: 02 Fort Portal Referral Hospital Internal Audit • % increase of specialized clinic outpatients attendances 5% 2019 10% 15% 20% Output: 05 Hospital Management and support services • % increase of diagnostic investigations carried 10% 2019 12.5% 15% 17% Assets register updated on a quarterly basis 4 4 4

• Bed occupancy rate 74% 2019 80% 85% 85% Timely payment of salaries and pensions by the 2 12 12 12

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Vote:164 Fort Portal Referral Hospital

Timely submission of quarterly financial/activity 4 4 4

SubProgramme: 03 Fort Portal Regional Maintenance Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 12 12 12

Timely submission of quarterly financial/activity 4 4 4

SubProgramme: 1576 Retooling of Fort Portal Regional Referral Hospital Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 .35

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 164 Fort Portal Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Fort Portal Rehabilitation Referral Hospital

Output: 08 56 80 Hospital Construction/rehabilitation

Phase one of perimeter wall fence worth 500 Million Designs and BOQs completed. 1.6km of perimeter wall constructed constructed. Solicitation for the contractor on going. Ten solar security lights wort 40 Million installed Quotations received Evaluation on going. Total Output Cost(Ushs Thousand) 540,000 0 580,000

Gou Dev’t: 540,000 0 580,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Understaffing: The issue of low staffing especially among the critical specialist cadres limits the hospital capacity to deliver o some of the planned activities 2. Disease Outbreaks: The hospital being situated in the Viral Hemorrhagic Fevers corridor, there is usually threats of disease outbreaks. The emergence of new disease conditions in and around the region especially near the border with the Congo exposes us the risk of diseases like ebola and CCF 3. Master Plan: The hospital has no master plan to guide a systemic development of the hospital infrastructure. 4. Inadequate infrastructure: The hospital lacks an accident and emergence unit, the Labs are scattered in various buildings and some diagnostic equipment is underutilized due to lack of space for installation. The wards are congested with floor cases that compromise infection prevention and control. 5. High Numbers of refugees in the region: The presence of refugees in the region with their unique health needs, hence

98 99 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:164 Fort Portal Referral Hospital Vote:164 Fort Portal Referral Hospital

Timely submission of quarterly financial/activity 4 4 4 straining the already constrained service delivery. 6. We want to continue constructing the perimeter wall around the hospital premises that is intended to further protect the hospital SubProgramme: 03 Fort Portal Regional Maintenance property and improve client confidence and satisfaction that will improve access to health 7. Development of a year master plan to guide the development of the hospital infrastructure Output: 05 Hospital Management and support services 8. Embarking on construction of various hospital structures, namely Accident and emergency unit. Assets register updated on a quarterly basis 4 4 4 9. Expansion and construction of a central one-stop state of the art laboratory. 10. Continue buying additional assorted and specialized medical equipment as a way of improving patient outcomes, boost Timely payment of salaries and pensions by the 2 12 12 12 diagnostic capability and enhance and generally improve the health of the population in the region

Timely submission of quarterly financial/activity 4 4 4 Plans to improve Vote Performance SubProgramme: 1576 Retooling of Fort Portal Regional Referral Hospital Output: 85 Purchase of Medical Equipment Lobby with partners for joint collaboration in shared resource mobilization and usage. Financial discipline through strong internal controls. Practice rational drug use and continue lobbying for additional funding from Government. Value of medical equipment procured (Ush Bn) .2 .35 Monitor staff productivity through Staff performance managing, training and mentorship. Lobby for filling of vacant positions on the establishment. IX. Major Capital Investments And Changes In Resource Allocation Strengthening support supervision both internally and in lower facilities in the region by functionalizing operations in HCIVs. This Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) will de-congest the referral hospital. FY 2019/20 FY 2020/21 Focus will also be geared to supporting community interventions including specialist outreaches, surgical camps and media Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned engagements for social mobilization and sensitization on disease prevention especially to the most remote, vulnerable and neediest. end Dec Outputs Vote 164 Fort Portal Referral Hospital Develop infrastructure Master plan to guide constructions in the entity. Program : 08 56 Regional Referral Hospital Services Priories construction Accident and emergency, laboratory and wards depending on availability of funds. Development Project : 1004 Fort Portal Rehabilitation Referral Hospital

Output: 08 56 80 Hospital Construction/rehabilitation Develop strategies to address the refugee and host populations. Lobby with partners for joint collaboration in shared resource mobilization and usage towards refugee populations. Phase one of perimeter wall fence worth 500 Million Designs and BOQs completed. 1.6km of perimeter wall constructed constructed. Solicitation for the contractor on going. Ten solar security lights wort 40 Million installed Quotations received Evaluation on going. XI Off Budget Support Total Output Cost(Ushs Thousand) 540,000 0 580,000 Table 11.1 Off-Budget Support by Sub-Programme Gou Dev’t: 540,000 0 580,000 Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Ext Fin: 0 0 0 Budget Estimates A.I.A: 0 0 0 Programme 0856 Regional Referral Hospital Services 0.00 1.60 Recurrent Budget Estimates X. Vote Challenges and Plans To Improve Performance 01 Fort Portal Referral Hospital Services 0.00 1.60 410-International Development Association (IDA) 0.00 1.05 Vote Challenges 451-Global Alliance for Vaccines Immunisation 0.00 0.55 1. Understaffing: The issue of low staffing especially among the critical specialist cadres limits the hospital capacity to deliver o some of the planned activities Total for Vote 0.00 1.60 2. Disease Outbreaks: The hospital being situated in the Viral Hemorrhagic Fevers corridor, there is usually threats of disease outbreaks. The emergence of new disease conditions in and around the region especially near the border with the Congo exposes us XII. Vote Cross Cutting Policy And Other Budgetary Issues the risk of diseases like ebola and CCF Table 12.1: Cross- Cutting Policy Issues 3. Master Plan: The hospital has no master plan to guide a systemic development of the hospital infrastructure. 4. Inadequate infrastructure: The hospital lacks an accident and emergence unit, the Labs are scattered in various buildings and some diagnostic equipment is underutilized due to lack of space for installation. The wards are congested with floor cases that compromise infection prevention and control. 5. High Numbers of refugees in the region: The presence of refugees in the region with their unique health needs, hence

98 99 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

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Issue Type: HIV/AIDS

Objective : Reduction in New HIV Infections 95% Viral load suppression among ART clinic clients Issue of Concern : High HIV population prevalence rates above the National Rates Planned Interventions : • Implement EMTCT policies and Guidelines • Ppregnant HIV+ mothers enrolled into the PMTCT program • Exposed HIV exposed Infants enrolled in EMTCT program • 3000 Safe Male Medical circumcisions • Implement MARPS programe.

Budget Allocation (Billion) : 0.030 Performance Indicators: • EMTCT policies and Guidelines Implemented • All pregnant HIV+ mothers enrolled into the PMTCT program • All Exposed HIV exposed Infants enrolled in EMTCT program • 3000 Safe Male Medical circumcisions done • MARPS programe implemented.

Issue Type: Gender

Objective : • Designating a gender Focal Person to co-ordinate Gender Issues • To develop an Instructional Gender mainstreaming policy and Guidelines • To Have a sexual Harassment policy and focal person for Sexual Harassment • To document and analyse all GBDV cases • Teenage and elderly corner at the triage • 1/3 of slots on hospital committees reserved for females • Designating wards by gender • Patient data analysed in the context of Gender

Issue of Concern : Unequal access of services based on gender. High HIV prevalence among teenage girls Planned Interventions : Develop institutional gender mainstreaming policy Designate a gender focal person Track all cases of GBV segregated by sex and age Establish adolescent friendly health services Budget Allocation (Billion) : 0.030 Performance Indicators: Gender focal person assigned Gender mainstreaming policy developed and disseminated

Age, sex segregated hospital data GBV cases mapped and handled Adolescent health friendly services

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Issue Type: HIV/AIDS Issue Type: Enviroment

Objective : Reduction in New HIV Infections Objective : • Safely dispose all clinical medical waste 95% Viral load suppression among ART clinic clients • Set up policies that involve patients in environmental issues Issue of Concern : High HIV population prevalence rates above the National Rates • Maintain a clean and safe environment • Develop work place safety policy and guidelines Planned Interventions : • Implement EMTCT policies and Guidelines • Environmental audit of premises, enhance “our safe home” through banning of polythene papers • Ppregnant HIV+ mothers enrolled into the PMTCT program in the hospital, • Exposed HIV exposed Infants enrolled in EMTCT program • 3000 Safe Male Medical circumcisions Issue of Concern : Increasing rates of Hospital Acquired Infections. • Implement MARPS programe. Planned Interventions : • Train Health workers in universal Infection Prevention control protocol. Budget Allocation (Billion) : 0.030 • Segregate waste from point of generation to point of final disposal according to WHO guideline • incineration of medical waste Performance Indicators: • EMTCT policies and Guidelines Implemented • Implementation of 5S-CQI- Kaizen • All pregnant HIV+ mothers enrolled into the PMTCT program • All Exposed HIV exposed Infants enrolled in EMTCT program Budget Allocation (Billion) : 0.050 • 3000 Safe Male Medical circumcisions done • MARPS programe implemented. Performance Indicators: • 100 Health workers in universal Infection Prevention control protocol. • 70% of Medical Waste Segregated from point of generation to point of final disposal Issue Type: Gender • 100% medical waste incinerated • 70% of hospital units Implementing 5S-CQI- Kaizen Objective : • Designating a gender Focal Person to co-ordinate Gender Issues • To develop an Instructional Gender mainstreaming policy and Guidelines XIII. Personnel Information • To Have a sexual Harassment policy and focal person for Sexual Harassment • To document and analyse all GBDV cases Table 13.1 Staff Establishment Analysis • Teenage and elderly corner at the triage • 1/3 of slots on hospital committees reserved for females Title Salary Scale Number Of Approved Positions Number Of Filled Positions • Designating wards by gender • Patient data analysed in the context of Gender Consultant (OBS & GYN) U1SE 1 0 PRINCIPAL HOSPITAL U2L 1 0 Issue of Concern : Unequal access of services based on gender. ADMINISTRATOR High HIV prevalence among teenage girls MOSG (Ophthalmology) U3 1 0 Planned Interventions : Develop institutional gender mainstreaming policy Designate a gender focal person MOSG (Medicine) U3 (SC) 1 0 Track all cases of GBV segregated by sex and age MOSG (Public Health) U3 (SC) 1 0 Establish adolescent friendly health services Budget Allocation (Billion) : 0.030 MOSG (Surgery) U3 (SC) 1 0 Performance Indicators: Gender focal person assigned Principal Occupational Therapist U3(Med-2) 1 0 Gender mainstreaming policy developed and disseminated ACCOUNTANT - FORT PORTAL U4 1 0 REG. REF HOSPITAL Age, sex segregated hospital data GBV cases mapped and handled HOSPITAL ADMINISTRATOR - U4 1 0 Adolescent health friendly services FORT PORTAL REG. REF HOSPITAL SENIOR NURSING OFFICER - U4 15 12 FORT PORTAL REG. REF HOSPITAL Assistant Procurment Officer U5 1 0 CLINICAL OFFICER - FORT U5 16 9 PORTAL REG. REF HOSPITAL Nursing Officer (Nursing) U5(SC) 40 37

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Radiographer U5(SC) 1 0 Nursing Officer(Midwife) U5U 20 16 SENIOR ASSISTANT U5U 2 1 ACCOUNTANT Theatre Assistant U6(Med) 7 5 ASSISTANT ACCOUNTANT U6U 2 1 Enrolled Midwife U7(Med) 20 18 Enrolled Nurse U7U 40 35 DRIVER - FORT PORTAL REG. U8 5 3 REF HOSPITAL Plumber U8U 2 1

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT - FORT U4 1 0 1 1 1,020,697 12,248,364 PORTAL REG. REF HOSPITAL ASSISTANT ACCOUNTANT U6U 2 1 1 1 436,677 5,240,124 Assistant Procurment Officer U5 1 0 1 1 591,555 7,098,660 CLINICAL OFFICER - FORT U5 16 9 7 5 4,686,800 56,241,600 PORTAL REG. REF HOSPITAL Consultant (OBS & GYN) U1SE 1 0 1 1 0 0 DRIVER - FORT PORTAL REG. U8 5 3 2 2 599,718 7,196,616 REF HOSPITAL Enrolled Midwife U7(Med) 20 18 2 2 1,226,316 14,715,792 Enrolled Nurse U7U 40 35 5 4 19,621,056 235,452,672 HOSPITAL ADMINISTRATOR - U4 1 0 1 1 943,010 11,316,120 FORT PORTAL REG. REF HOSPITAL MOSG (Medicine) U3 (SC) 1 0 1 1 2,463,611 29,563,332 MOSG (Ophthalmology) U3 1 0 1 1 0 0 MOSG (Public Health) U3 (SC) 1 0 1 1 2,463,611 29,563,332 MOSG (Surgery) U3 (SC) 1 0 1 1 2,463,611 29,563,332 Nursing Officer (Nursing) U5(SC) 40 37 3 3 3,600,000 43,200,000 Nursing Officer(Midwife) U5U 20 16 4 4 9,600,000 115,200,000 Plumber U8U 2 1 1 1 237,069 2,844,828 Principal Occupational Therapist U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PRINCIPAL HOSPITAL U2L 1 0 1 1 1,291,880 15,502,560 ADMINISTRATOR Radiographer U5(SC) 1 0 1 1 1,200,000 14,400,000 SENIOR ASSISTANT U5U 2 1 1 1 598,822 7,185,864 ACCOUNTANT

102 103 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21 Fort Portal Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:164 Fort Portal Referral Hospital Vote:164 Fort Portal Referral Hospital

Radiographer U5(SC) 1 0 SENIOR NURSING OFFICER - U4 15 12 3 3 3,966,489 47,597,868 FORT PORTAL REG. REF Nursing Officer(Midwife) U5U 20 16 HOSPITAL Theatre Assistant U6(Med) 7 5 2 1 850,000 10,200,000 SENIOR ASSISTANT U5U 2 1 ACCOUNTANT Total 180 138 42 38 60,960,922 731,531,064 Theatre Assistant U6(Med) 7 5 ASSISTANT ACCOUNTANT U6U 2 1 Enrolled Midwife U7(Med) 20 18 Enrolled Nurse U7U 40 35 DRIVER - FORT PORTAL REG. U8 5 3 REF HOSPITAL Plumber U8U 2 1

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT - FORT U4 1 0 1 1 1,020,697 12,248,364 PORTAL REG. REF HOSPITAL ASSISTANT ACCOUNTANT U6U 2 1 1 1 436,677 5,240,124 Assistant Procurment Officer U5 1 0 1 1 591,555 7,098,660 CLINICAL OFFICER - FORT U5 16 9 7 5 4,686,800 56,241,600 PORTAL REG. REF HOSPITAL Consultant (OBS & GYN) U1SE 1 0 1 1 0 0 DRIVER - FORT PORTAL REG. U8 5 3 2 2 599,718 7,196,616 REF HOSPITAL Enrolled Midwife U7(Med) 20 18 2 2 1,226,316 14,715,792 Enrolled Nurse U7U 40 35 5 4 19,621,056 235,452,672 HOSPITAL ADMINISTRATOR - U4 1 0 1 1 943,010 11,316,120 FORT PORTAL REG. REF HOSPITAL MOSG (Medicine) U3 (SC) 1 0 1 1 2,463,611 29,563,332 MOSG (Ophthalmology) U3 1 0 1 1 0 0 MOSG (Public Health) U3 (SC) 1 0 1 1 2,463,611 29,563,332 MOSG (Surgery) U3 (SC) 1 0 1 1 2,463,611 29,563,332 Nursing Officer (Nursing) U5(SC) 40 37 3 3 3,600,000 43,200,000 Nursing Officer(Midwife) U5U 20 16 4 4 9,600,000 115,200,000 Plumber U8U 2 1 1 1 237,069 2,844,828 Principal Occupational Therapist U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PRINCIPAL HOSPITAL U2L 1 0 1 1 1,291,880 15,502,560 ADMINISTRATOR Radiographer U5(SC) 1 0 1 1 1,200,000 14,400,000 SENIOR ASSISTANT U5U 2 1 1 1 598,822 7,185,864 ACCOUNTANT

102 103 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital

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

II. Strategic Objective - To improve maternal and child health in the catchment area - Contribute to scaling up of health sector strategic interventions in order to improve the health of the community - Prevention,management and control of communicable diseases - To improve effectiveness,efficiency and accountability of hospital operations - To support clinical departments by ensuring efficient, safe environmentally health system infrastructure for smooth deliver of health services - Prevention,management and control of non communicable diseases III. Major Achievements in 2019/20 As per 31st December 2019 total number of General OPD cases attended to were 42,217 out of the planned number of 167,471; Out of these 62% were women, 25% were children and 13% were men.Total number of patients admitted were 15,379 out of 26,610 planned and again women and children were the majority comprising 81.5% of the total admissions; Bed Occupancy was 76% and men were just less than one quarter out of 75.5% planned; Average length of stay was 3 days. It was noticed that 20% of women admitted ran away before recovering. Total number laboratory investigations were 119,123 out of the planned 180,000 and women comprised of 60% of the total investigations; total x-rays and U/S scans done were 4,423 and 4,390 respectively ; 6,516 out of 4,450 patients were attended to in Physiotherapy and occupational therapy clinics and these were mostly the elderly and disabled. 8445 women attended ANC clinics out of the expected 16,000 ; 28,198 women attended Family Planning services and there were no men who attended family planning; Medical equipment maintenance unit carried out 4 user trainings and maintained the equipment in the region. IV. Medium Term Plans In the medium term the hospital plans to complete the 54 units of staff accomodation, purchase and install solar lumps,construct a perimeter wall along the hospital, put up walkways, renovate some wards, purchase and install a 144,000 liter water tank.

104 105 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital Vote:165 Gulu Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) Gulu Regional Referral Hospital (GRRH) exists to provide specialized health care, preventive, promotive, curative and rehabilitative services to the population of eight districts of the Acholi sub-region; conduct training, research and support 2019/20 MTEF Budget Projections supervision to general hospitals and lower level health facilities in the region. 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec II. Strategic Objective Wage 4.482 5.109 2.140 5.109 5.109 5.109 5.109 5.109 Recurrent - To improve maternal and child health in the catchment area - Contribute to scaling up of health sector strategic interventions in Non Wage 2.362 2.833 1.194 4.544 4.544 4.544 4.544 4.544 order to improve the health of the community - Prevention,management and control of communicable diseases - To improve GoU 1.486 1.488 0.544 1.900 1.900 1.200 0.227 0.227 effectiveness,efficiency and accountability of hospital operations - To support clinical departments by ensuring efficient, safe Devt. environmentally health system infrastructure for smooth deliver of health services - Prevention,management and control of non 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 communicable diseases Ext. Fin. GoU Total 8.330 9.431 3.878 11.553 11.553 10.853 9.880 9.880 III. Major Achievements in 2019/20 Total GoU+Ext Fin (MTEF) 8.330 9.431 3.878 11.553 11.553 10.853 9.880 9.880 As per 31st December 2019 total number of General OPD cases attended to were 42,217 out of the planned number of 167,471; Out of these 62% were women, 25% were children and 13% were men.Total number of patients admitted were 15,379 out of Arrears 0.001 0.284 0.261 0.200 0.000 0.000 0.000 0.000 26,610 planned and again women and children were the majority comprising 81.5% of the total admissions; Bed Occupancy was 8.331 9.715 4.139 11.753 11.553 10.853 9.880 9.880 76% and men were just less than one quarter out of 75.5% planned; Average length of stay was 3 days. It was noticed that 20% Total Budget of women admitted ran away before recovering. Total number laboratory investigations were 119,123 out of the planned A.I.A Total 0.144 0.000 0.000 0.000 0.000 0.000 0.000 0.000 180,000 and women comprised of 60% of the total investigations; total x-rays and U/S scans done were 4,423 and 4,390 respectively ; 6,516 out of 4,450 patients were attended to in Physiotherapy and occupational therapy clinics and these were Grand Total 8.475 9.715 4.139 11.753 11.553 10.853 9.880 9.880 mostly the elderly and disabled. 8445 women attended ANC clinics out of the expected 16,000 ; 28,198 women attended Total Vote Budget 8.474 9.431 3.878 11.553 11.553 10.853 9.880 9.880 Family Planning services and there were no men who attended family planning; Medical equipment maintenance unit carried Excluding Arrears out 4 user trainings and maintained the equipment in the region. IV. Medium Term Plans VI. Budget By Economic Clasification In the medium term the hospital plans to complete the 54 units of staff accomodation, purchase and install solar lumps,construct Table V6.1 2019/20 and 2020/21 Budget Allocations by Item a perimeter wall along the hospital, put up walkways, renovate some wards, purchase and install a 144,000 liter water tank. 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.943 0.000 0.000 7.943 9.653 0.000 9.653

211 Wages and Salaries 5.395 0.000 0.000 5.395 5.426 0.000 5.426

212 Social Contributions 0.535 0.000 0.000 0.535 1.557 0.000 1.557

213 Other Employee Costs 0.623 0.000 0.000 0.623 1.308 0.000 1.308

221 General Expenses 0.144 0.000 0.000 0.144 0.196 0.000 0.196

222 Communications 0.026 0.000 0.000 0.026 0.069 0.000 0.069

223 Utility and Property Expenses 0.651 0.000 0.000 0.651 0.329 0.000 0.329

224 Supplies and Services 0.232 0.000 0.000 0.232 0.219 0.000 0.219

225 Professional Services 0.008 0.000 0.000 0.008 0.015 0.000 0.015

227 Travel and Transport 0.156 0.000 0.000 0.156 0.231 0.000 0.231

228 Maintenance 0.165 0.000 0.000 0.165 0.290 0.000 0.290

273 Employer social benefits 0.009 0.000 0.000 0.009 0.015 0.000 0.015

Output Class : Capital Purchases 1.488 0.000 0.000 1.488 1.900 0.000 1.900

104 105 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital

312 FIXED ASSETS 1.488 0.000 0.000 1.488 1.900 0.000 1.900

Output Class : Arrears 0.284 0.000 0.000 0.284 0.200 0.000 0.200

321 DOMESTIC 0.284 0.000 0.000 0.284 0.200 0.000 0.200

Grand Total : 9.715 0.000 0.000 9.715 11.753 0.000 11.753

Total excluding Arrears 9.431 0.000 0.000 9.431 11.553 0.000 11.553

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Gulu Referral Hospital Services 6.810 8.048 3.515 9.675 9.474 9.474 9.474 9.474

02 Gulu Referral Hospital Internal Audit 0.011 0.011 0.006 0.011 0.011 0.011 0.011 0.011

03 Gulu Regional Maintenance 0.168 0.168 0.074 0.168 0.168 0.168 0.168 0.168

1004 Gulu Rehabilitation Referral Hospital 1.238 1.488 0.544 1.700 1.700 1.000 0.227 0.227

1468 Institutional Support to Gulu Regional 0.248 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Referral Hospital 1585 Retooling of Gulu Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.000 0.000 Hospital Total for the Vote 8.475 9.715 4.139 11.753 11.553 10.853 9.880 9.880

Total Excluding Arrears 8.474 9.431 3.878 11.553 11.553 10.853 9.880 9.880

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To provide quality and sustainable general and specialized health services to all the population of Acholi : Sub-Region

Responsible Officer: Dr James ELIMA Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• % increase of specialised clinic outpatients attendances 124,925 2019 13% 14% 15%

106 107 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital Vote:165 Gulu Referral Hospital

312 FIXED ASSETS 1.488 0.000 0.000 1.488 1.900 0.000 1.900 • % increase of diagnostic investigations carried 127,830 2019 9% 10.4% 12%

Output Class : Arrears 0.284 0.000 0.000 0.284 0.200 0.000 0.200 • Bed occupancy rate 74.3% 2019 78% 79% 80% 321 DOMESTIC 0.284 0.000 0.000 0.284 0.200 0.000 0.200 SubProgramme: 01 Gulu Referral Hospital Services Grand Total : 9.715 0.000 0.000 9.715 11.753 0.000 11.753 Output: 01 Inpatient services Total excluding Arrears 9.431 0.000 0.000 9.431 11.553 0.000 11.553 No. of in-patients (Admissions) 27,100 27,500 2,780

VII. Budget By Programme And Subprogramme Average Length of Stay (ALOS) - days 3 3 3

77 78 79 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Bed Occupancy Rate (BOR) Number of Major Operations (including Ceasarian se 2,380 3,000 3,500 Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Output: 02 Outpatient services Outturn Budget End Dec Proposed No. of general outpatients attended to 168,500 169,000 169,500 Budget 56 Regional Referral Hospital Services 8.475 9.715 4.139 11.753 11.553 10.853 9.880 9.880 No. of specialised outpatients attended to 126,500 127,400 127,800

01 Gulu Referral Hospital Services 6.810 8.048 3.515 9.675 9.474 9.474 9.474 9.474 Referral cases in 82 85 90 02 Gulu Referral Hospital Internal Audit 0.011 0.011 0.006 0.011 0.011 0.011 0.011 0.011 Output: 03 Medicines and health supplies procured and dispensed 03 Gulu Regional Maintenance 0.168 0.168 0.074 0.168 0.168 0.168 0.168 0.168 Value of medicines received/dispensed (Ush bn) 1.5 1.6 1.7 1004 Gulu Rehabilitation Referral Hospital 1.238 1.488 0.544 1.700 1.700 1.000 0.227 0.227 Output: 04 Diagnostic services 1468 Institutional Support to Gulu Regional 0.248 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Referral Hospital No. of laboratory tests carried out 129,000 129,150 129,300 1585 Retooling of Gulu Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.000 0.000 Hospital No. of patient xrays (imaging) taken 2,500 2,600 2,700 Total for the Vote 8.475 9.715 4.139 11.753 11.553 10.853 9.880 9.880 Number of Ultra Sound Scans 4,500 4,600 4,700 Total Excluding Arrears 8.474 9.431 3.878 11.553 11.553 10.853 9.880 9.880 Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4 VIII. Programme Performance and Medium Term Plans Timely payment of salaries and pensions by the 2 Yes Yes Yes Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Timely submission of quarterly financial/activity Yes Yes Yes Programme : 56 Regional Referral Hospital Services Output: 06 Prevention and rehabilitation services Programme Objective To provide quality and sustainable general and specialized health services to all the population of Acholi : Sub-Region No. of antenatal cases (All attendances) 9,950 10,000 1,050

No. of children immunised (All immunizations) 42,800 42,900 43,000 Responsible Officer: Dr James ELIMA Programme Outcome: Quality and accessible Regional Referral Hospital Services No. of family planning users attended to (New and Old) 3,900 4,000 4,050 Sector Outcomes contributed to by the Programme Outcome Number of ANC Visits (All visits) 6,060 7,000 7,040

1. Improved quality of life at all levels Percentage of HIV positive pregnant women not on H 0% 0% 0%

Performance Targets SubProgramme: 1004 Gulu Rehabilitation Referral Hospital Outcome Indicators 2020/21 2021/22 2022/23 Output: 80 Hospital Construction/rehabilitation Baseline Base year Target Projection Projection No. of hospitals benefiting from the renovation of existing facilities 1 1 1 • % increase of specialised clinic outpatients attendances 124,925 2019 13% 14% 15% No. of reconstructed/rehabilitated general wards 2 2 2

106 107 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital

Cerificates of progress/ Completion 4 2 2

Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 54 54 54

Cerificates of progress/ Completion 4 4 2

SubProgramme: 1585 Retooling of Gulu Regional Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of existing facilities 1 1 1

No. of reconstructed/rehabilitated general wards 2 1 1

Cerificates of progress/ Completion 4 4 4

Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 54 54 54

Cerificates of progress/ Completion 4 4 4

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .11 1.01 1.01

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 165 Gulu Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Gulu Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

54 staff units constructed and site meetings held The contractor had to wait for the variations Construction of double storeyed building of 54 before proceeding units of staff houses continued Total Output Cost(Ushs Thousand) 1,048,000 395,200 1,250,000

Gou Dev’t: 1,048,000 395,200 1,250,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

The major challenges include: . Inadequate staffing especially with Senior Consultants, consultants and Medical Officer Special Grade 2. High attrition rate of health workers

108 109 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital Vote:165 Gulu Referral Hospital

Cerificates of progress/ Completion 4 2 2 3. Lack of accommodation for the health workers 4. Lack of cardinal diagnostic equipment CTC scan and MRI Output: 81 Staff houses construction and rehabilitation However with the capital investments so far the hospital has made major positive steps a) Purchase a linen washing machine No. of staff houses constructed/rehabilitated 54 54 54 b) Rehabilitated the sewerage system c) Procured a vehicle for the Hospital Director 4 4 2 Cerificates of progress/ Completion d)Continued construction of the 54 units of staff quarters in a storeyed building SubProgramme: 1585 Retooling of Gulu Regional Referral Hospital Output: 80 Hospital Construction/rehabilitation Plans to improve Vote Performance No. of hospitals benefiting from the renovation of existing facilities 1 1 1

No. of reconstructed/rehabilitated general wards 2 1 1 Strengthen support supervision with task allocation; improve on time management by introducing the clocking machine; regular meetings; build staff capacity through trainings (short and long term); improve staff welfare. Complete the construction of the 54 Cerificates of progress/ Completion 4 4 4 units of staff accomodation will also contribute to performance improvement.; encouraging staff to work and lobbying implementing partners to fill in gaps in service delivery. Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 54 54 54 XI Off Budget Support 4 4 4 Cerificates of progress/ Completion Table 11.1 Off-Budget Support by Sub-Programme Output: 85 Purchase of Medical Equipment Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Value of medical equipment procured (Ush Bn) .11 1.01 1.01 Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 0.28 IX. Major Capital Investments And Changes In Resource Allocation Recurrent Budget Estimates 01 Gulu Referral Hospital Services 0.00 0.28 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) 436-Global Fund for HIV, TB & Malaria 0.00 0.28

FY 2019/20 FY 2020/21 Total for Vote 0.00 0.28

Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned XII. Vote Cross Cutting Policy And Other Budgetary Issues end Dec Outputs Vote 165 Gulu Referral Hospital Table 12.1: Cross- Cutting Policy Issues

Program : 08 56 Regional Referral Hospital Services Issue Type: HIV/AIDS Development Project : 1004 Gulu Rehabilitation Referral Hospital Objective : To achieve the 95-95-95 UNAIDS target by 2021 Output: 08 56 81 Staff houses construction and rehabilitation Issue of Concern : Most of the people living with HIV do not know their HIV status 54 staff units constructed and site meetings held The contractor had to wait for the variations Construction of double storeyed building of 54 before proceeding units of staff houses continued Planned Interventions : Targeted provider initiated HIV testing and counselling both at facility and community level Total Output Cost(Ushs Thousand) 1,048,000 395,200 1,250,000 Linkage of all newly identified HIV positive to care Health education and psychological needs assessment and counselling. Phone reminders and Gou Dev’t: 1,048,000 395,200 1,250,000 physical follow up Ext Fin: 0 0 0 Budget Allocation (Billion) : 0.900 A.I.A: 0 0 0 Performance Indicators: Number of patients tested Number of contacts made X. Vote Challenges and Plans To Improve Performance 95-95-95 target achieved Vote Challenges Issue Type: Gender

The major challenges include: Objective : Ensure equal access to health services . Inadequate staffing especially with Senior Consultants, consultants and Medical Officer Special Grade 2. High attrition rate of health workers

108 109 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital

Issue of Concern : Long waiting time for the marginalized groups in accessing health services Planned Interventions : Availing additional manpower to handle such category of patients Budget Allocation (Billion) : 0.500 Performance Indicators: Number of disadvantaged patients treated

Issue Type: Enviroment

Objective : Promotion of hygiene through washing hands Issue of Concern : There is limited awareness among the patients and health workers Planned Interventions : Sensitize the patients and health workers on hand washing. Creating hand washing facilities in all departments Budget Allocation (Billion) : 0.800 Performance Indicators: Number of departments with hand washing facilities

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant (Anaesthesia) U1SE 1 0 Consultant (Medicine) U1SE 1 0 Consultant (Obs. & Gyn) U1SE 1 0 Consultant (Paediatrics) U1SE 1 0 Consultant (Surgery ) U1SE 1 0 Consultant Ophthalmology U1SE 1 0 Medical Officer Special Grade U2(Med-1) 1 0 (Paediatrics) Medical Officer Special Grade U2U 1 0 (Opthamology) Medical Officer Special Grade U2U 1 0 (Radiology) Medical Officer Special U2U 1 0 GradeOrthopaedic Surgeon PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 OFFICER MEDICAL OFFICERS U4(Med-1) 10 6 SENIOR ORTHOPAEDIC U4(Med-2) 3 1 OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 0 HOSPITAL ADMINISTRATOR U4L 1 0 HUMAN RESOURCE OFFICER U4L 1 0 LABORATORY TECHNOLOGIST U5 4 2

110 111 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital Vote:165 Gulu Referral Hospital

Issue of Concern : Long waiting time for the marginalized groups in accessing health services OPTHALAMIC CLINICAL U5 2 0 OFFICER Planned Interventions : Availing additional manpower to handle such category of patients ANAESTHETIC OFFICER U5(SC) 3 1 Budget Allocation (Billion) : 0.500 CLINICAL OFFICER U5(SC) 6 4 Performance Indicators: Number of disadvantaged patients treated NUTRITIONIST U5(SC) 1 0 Issue Type: Enviroment Occupational Therapist U5(SC) 1 0 ORTHOPAEDIC OFFICER U5(SC) 3 0 Objective : Promotion of hygiene through washing hands PHYSIOTHERAPIST U5(SC) 2 0 Issue of Concern : There is limited awareness among the patients and health workers Radiographer U5(SC) 2 0 Planned Interventions : Sensitize the patients and health workers on hand washing. Creating hand washing facilities in all departments POOL STENOGRAPHER U6L 2 0 Budget Allocation (Billion) : 0.800 ENGINEERINGTECHNICIAN U6U 1 0 Performance Indicators: Number of departments with hand washing facilities ENROLLED MIDWIFE U7(Med) 20 16 XIII. Personnel Information ENROLLED NURSE U7U 42 0 ASSISTANT ENGINEERING U8 1 0 Table 13.1 Staff Establishment Analysis OFFICER (ELECTRICAL) Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant (Radiology) US1E 1 0

Consultant (Anaesthesia) U1SE 1 0 Table 13.2 Staff Recruitment Plan Consultant (Medicine) U1SE 1 0 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Consultant (Obs. & Gyn) U1SE 1 0 Scale Approved Filled Posts Posts Cleared for Per Month Salary Consultant (Paediatrics) U1SE 1 0 Posts Filling (UGX) (UGX) FY2020/21 Consultant (Surgery ) U1SE 1 0 ANAESTHETIC OFFICER U5(SC) 3 1 2 2 2,400,000 28,800,000 Consultant Ophthalmology U1SE 1 0 ASSISTANT ENGINEERING U8 1 0 1 1 249,034 2,988,408 OFFICER (ELECTRICAL) Medical Officer Special Grade U2(Med-1) 1 0 CLINICAL OFFICER U5(SC) 6 4 2 2 2,400,000 28,800,000 (Paediatrics) Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Medical Officer Special Grade U2U 1 0 Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 (Opthamology) Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Medical Officer Special Grade U2U 1 0 (Radiology) Consultant (Paediatrics) U1SE 1 0 1 1 4,200,000 50,400,000 Medical Officer Special U2U 1 0 Consultant (Radiology) US1E 1 0 1 1 4,200,000 50,400,000 GradeOrthopaedic Surgeon Consultant (Surgery ) U1SE 1 0 1 1 4,200,000 50,400,000 PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 Consultant Ophthalmology U1SE 1 0 1 1 4,200,000 50,400,000 OFFICER ENGINEERINGTECHNICIAN U6U 1 0 1 1 436,677 5,240,124 MEDICAL OFFICERS U4(Med-1) 10 6 ENROLLED MIDWIFE U7(Med) 20 16 4 4 2,452,632 29,431,584 SENIOR ORTHOPAEDIC U4(Med-2) 3 1 ENROLLED NURSE U7U 42 0 42 12 58,863,168 706,358,016 OFFICER HOSPITAL ADMINISTRATOR U4L 1 0 1 1 601,341 7,216,092 SENIOR RADIOGRAPHER U4(Med-2) 2 0 HUMAN RESOURCE OFFICER U4L 1 0 1 1 601,341 7,216,092 HOSPITAL ADMINISTRATOR U4L 1 0 LABORATORY U5 4 2 2 2 1,138,080 13,656,960 TECHNOLOGIST HUMAN RESOURCE OFFICER U4L 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Opthamology) LABORATORY TECHNOLOGIST U5 4 2

110 111 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics) Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Radiology) Medical Officer Special U2U 1 0 1 1 3,750,000 45,000,000 GradeOrthopaedic Surgeon MEDICAL OFFICERS U4(Med-1) 10 6 4 4 12,000,000 144,000,000 NUTRITIONIST U5(SC) 1 0 1 1 1,200,000 14,400,000 Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 OPTHALAMIC CLINICAL U5 2 0 2 2 1,138,080 13,656,960 OFFICER ORTHOPAEDIC OFFICER U5(SC) 3 0 3 1 1,200,000 14,400,000 PHYSIOTHERAPIST U5(SC) 2 0 2 2 2,400,000 28,800,000 POOL STENOGRAPHER U6L 2 0 2 2 848,506 10,182,072 PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OFFICER Radiographer U5(SC) 2 0 2 2 2,400,000 28,800,000 SENIOR ORTHOPAEDIC U4(Med-2) 3 1 2 2 4,400,000 52,800,000 OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 0 2 2 4,400,000 52,800,000 Total 119 30 89 57 147,828,859 1,773,946,308

112 113 Gulu Referral Hospital Ministerial Policy Statement FY 2020/21 Hoima Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:165 Gulu Referral Hospital Vote:166 Hoima Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics) V1: Vote Overview Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 I. Vote Mission Statement (Radiology) Medical Officer Special U2U 1 0 1 1 3,750,000 45,000,000 To facilitate the attainment of a good standard of health, nutrition and wellbeing for all people of Bunyoro region in order to GradeOrthopaedic Surgeon promote a healthy and productive life. MEDICAL OFFICERS U4(Med-1) 10 6 4 4 12,000,000 144,000,000 NUTRITIONIST U5(SC) 1 0 1 1 1,200,000 14,400,000 II. Strategic Objective Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 To provide specialized health care services to Bunyoro Region including: a. Offering Comprehensive, curative, promotion and OPTHALAMIC CLINICAL U5 2 0 2 2 1,138,080 13,656,960 rehabilitative care b. Offering tertiary training and continuous professional development c. Undertaking and conducting OFFICER operational, professional and technical research in health d. Carry out disease surveillance in the region e. Evaluation and ORTHOPAEDIC OFFICER U5(SC) 3 0 3 1 1,200,000 14,400,000 monitoring of implementation of health programs PHYSIOTHERAPIST U5(SC) 2 0 2 2 2,400,000 28,800,000 III. Major Achievements in 2019/20 POOL STENOGRAPHER U6L 2 0 2 2 848,506 10,182,072 PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 Hoima Hospital achieved the following for FY 2019/20, as by end of December 2019: OFFICER Radiographer U5(SC) 2 0 2 2 2,400,000 28,800,000 (1) Financing: 80% of the funds released were utilized. The funds that were not used included funds for projects yet to be SENIOR ORTHOPAEDIC U4(Med-2) 3 1 2 2 4,400,000 52,800,000 completed and salaries for staff not yet recruited OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 0 2 2 4,400,000 52,800,000 (2) Inpatient services: No. of in-patients admissions (13508 out of the annual target of 30000), Average Length of Stay (ALOS) (3.6), Bed Occupancy Rate (86.4%), Number of Major Operations (including Caesarian sections) (2472 out of 6500 annual Total 119 30 89 57 147,828,859 1,773,946,308 target)

(3) Outpatient services: No. of general outpatients attended (57129 out of 180000 annual target), No. of specialized outpatients attended (28665 out of 60000 annual target), Referral cases in (3657 out of 4800 annual target)

(4) Diagnostic services: No. of laboratory tests (64340 out of 120000 annual target), No. of patient x-rays (1210 out of 8000 annual target), Number of Ultra Sound Scans (5324 out of 6000 annual target)

(5) Support services: Assets register updated on a quarterly basis (1), Timely payment of salaries and pensions (100%), Timely submission of quarterly financial reports (100%)

(6) Preventive services: No. of antenatal cases (All attendances) (5412 out of 16000 annual target), No. of children immunized (All immunizations) (17866 out of 32000 annual target), No. of family planning users attended to (New and Old) (2189 out of 5000 annual target)

(7) Capital Development: - Installed oxygen piping on Pediatrics ward, Neonatal Intensive Care unit, High Dependence unit, Accident and Emergency unit and Post natal ward. - Rehabilitated water system (inclusive of installation of underground water supply) - Installed solar electricity supply systems on Pediatrics ward, Maternity ward, Gynecology ward, Labor suite, Postnatal ward, Surgical ward, Medical ward and Private wing - Purchased and maintained assorted medical and office equipment as well as other infrastructure - Completed construction of the Sewage Lagoon (1) - Completed construction of the perimeter wall fence (1) IV. Medium Term Plans During the upcoming medium term, the following are the plans that will be undertaken:

(1) Refurbishments of wards & selected staff houses

(2) Construction and repairs of walkways

(3) Construction of selected patients toilets

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(4) Construction of mortuary

(5) Purchase of 2 Ambulances

(6) Purchase and installation incinerator

(7) Initiate construction of multi ward/lab/records complex

(8) Install electronic medical records system

(9) Procure assorted medical equipment, medical furniture and assorted office furniture

(10) Construction of Interns and staff accommodation facilities

(11) Development of Hospital Infrastructure (Master) plan and Strategic/Investment Plan

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(4) Construction of mortuary V. Summary of Past Performance and Medium Term Budget Allocations

(5) Purchase of 2 Ambulances Table 5.1: Overview of Vote Expenditures (UShs Billion)

(6) Purchase and installation incinerator 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 (7) Initiate construction of multi ward/lab/records complex Outturn Budget by End Dec Wage 4.956 6.198 2.672 6.198 6.198 6.198 6.198 6.198 (8) Install electronic medical records system Recurrent Non Wage 1.737 2.226 0.846 2.208 2.208 2.208 2.208 2.208 (9) Procure assorted medical equipment, medical furniture and assorted office furniture GoU 1.060 0.760 0.110 0.200 0.200 1.550 2.227 2.227 Devt. (10) Construction of Interns and staff accommodation facilities Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 (11) Development of Hospital Infrastructure (Master) plan and Strategic/Investment Plan GoU Total 7.753 9.185 3.628 8.606 8.606 9.956 10.633 10.633 Total GoU+Ext Fin (MTEF) 7.753 9.185 3.628 8.606 8.606 9.956 10.633 10.633 Arrears 0.164 0.110 0.110 0.055 0.000 0.000 0.000 0.000 Total Budget 7.917 9.294 3.738 8.661 8.606 9.956 10.633 10.633 A.I.A Total 0.120 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.037 9.294 3.738 8.661 8.606 9.956 10.633 10.633 Total Vote Budget 7.873 9.185 3.628 8.606 8.606 9.956 10.633 10.633 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 8.425 0.000 0.000 8.425 8.506 0.000 8.506

211 Wages and Salaries 6.372 0.000 0.000 6.372 6.398 0.000 6.398

212 Social Contributions 0.387 0.000 0.000 0.387 0.437 0.000 0.437

213 Other Employee Costs 0.470 0.000 0.000 0.470 0.409 0.000 0.409

221 General Expenses 0.198 0.000 0.000 0.198 0.222 0.000 0.222

222 Communications 0.014 0.000 0.000 0.014 0.024 0.000 0.024

223 Utility and Property Expenses 0.388 0.000 0.000 0.388 0.302 0.000 0.302

224 Supplies and Services 0.203 0.000 0.000 0.203 0.212 0.000 0.212

225 Professional Services 0.000 0.000 0.000 0.000 0.100 0.000 0.100

226 Insurances and Licenses 0.000 0.000 0.000 0.000 0.005 0.000 0.005

227 Travel and Transport 0.187 0.000 0.000 0.187 0.177 0.000 0.177

228 Maintenance 0.205 0.000 0.000 0.205 0.219 0.000 0.219

Output Class : Capital Purchases 0.760 0.000 0.000 0.760 0.100 0.000 0.100

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312 FIXED ASSETS 0.760 0.000 0.000 0.760 0.100 0.000 0.100

Output Class : Arrears 0.110 0.000 0.000 0.110 0.055 0.000 0.055

321 DOMESTIC 0.110 0.000 0.000 0.110 0.055 0.000 0.055

Grand Total : 9.294 0.000 0.000 9.294 8.661 0.000 8.661

Total excluding Arrears 9.185 0.000 0.000 9.185 8.606 0.000 8.606

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Hoima Referral Hospital Services 6.762 8.426 3.577 8.352 8.297 8.297 8.297 8.297

02 Hoima Referral Hospital Internal Audit 0.008 0.008 0.004 0.008 0.008 0.008 0.008 0.008

03 Hoima Regional Maintenance 0.098 0.101 0.047 0.101 0.101 0.101 0.101 0.101

1004 Hoima Rehabilitation Referral Hospital 1.069 0.660 0.095 0.000 0.000 1.350 2.000 2.000

1480 Institutional Support to Hoima Regional 0.100 0.100 0.015 0.000 0.000 0.000 0.000 0.000 Hospital 1584 Retooling of Hoima Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Hospital Total for the Vote 8.037 9.294 3.738 8.661 8.606 9.956 10.633 10.633

Total Excluding Arrears 7.873 9.185 3.628 8.606 8.606 9.956 10.633 10.633

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To provide specialized and general health services through care and treatment, disease prevention, : rehabilitation and health promotion services in Bunyoro Region Responsible Officer: Dr. Peter Mukobi Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• % increase of specialized clinic outpatient attendances 67065 2019 5% 5% 5%

116 117 Hoima Referral Hospital Ministerial Policy Statement FY 2020/21 Hoima Referral Hospital Ministerial Policy Statement FY 2020/21

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312 FIXED ASSETS 0.760 0.000 0.000 0.760 0.100 0.000 0.100 • % increase of diagnostic investigations carried out 117126 2019 5% 5% 5%

Output Class : Arrears 0.110 0.000 0.000 0.110 0.055 0.000 0.055 • Bed occupancy rate 85% 2019 85% 85% 85% 321 DOMESTIC 0.110 0.000 0.000 0.110 0.055 0.000 0.055 SubProgramme: 01 Hoima Referral Hospital Services Grand Total : 9.294 0.000 0.000 9.294 8.661 0.000 8.661 Output: 01 Inpatient services Total excluding Arrears 9.185 0.000 0.000 9.185 8.606 0.000 8.606 No. of in-patients (Admissions) 26,500 26,550 26,600

VII. Budget By Programme And Subprogramme Average Length of Stay (ALOS) - days 4 4 4

85% 85% 85% Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Bed Occupancy Rate (BOR) Number of Major Operations (including Ceasarian se 4,200 4,250 4,300 Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Output: 02 Outpatient services Outturn Budget End Dec Proposed No. of general outpatients attended to 120,000 121,000 122,000 Budget 56 Regional Referral Hospital Services 8.037 9.294 3.738 8.661 8.606 9.956 10.633 10.633 No. of specialised outpatients attended to 61,000 61,500 62,000

01 Hoima Referral Hospital Services 6.762 8.426 3.577 8.352 8.297 8.297 8.297 8.297 Referral cases in 4,500 4,550 4,600 02 Hoima Referral Hospital Internal Audit 0.008 0.008 0.004 0.008 0.008 0.008 0.008 0.008 Output: 03 Medicines and health supplies procured and dispensed 03 Hoima Regional Maintenance 0.098 0.101 0.047 0.101 0.101 0.101 0.101 0.101 Value of medicines received/dispensed (Ush bn) 1.2 1.3 1.4 1004 Hoima Rehabilitation Referral Hospital 1.069 0.660 0.095 0.000 0.000 1.350 2.000 2.000 Output: 04 Diagnostic services 1480 Institutional Support to Hoima Regional 0.100 0.100 0.015 0.000 0.000 0.000 0.000 0.000 Hospital No. of laboratory tests carried out 120,500 120,600 120,700 1584 Retooling of Hoima Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Hospital No. of patient xrays (imaging) taken 8,100 8,200 8,300 Total for the Vote 8.037 9.294 3.738 8.661 8.606 9.956 10.633 10.633 Number of Ultra Sound Scans 6,100 6,150 6,200 Total Excluding Arrears 7.873 9.185 3.628 8.606 8.606 9.956 10.633 10.633 Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4 VIII. Programme Performance and Medium Term Plans Timely payment of salaries and pensions by the 2 Yes Yes Yes Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Timely submission of quarterly financial/activity Yes yes Yes Programme : 56 Regional Referral Hospital Services Output: 06 Prevention and rehabilitation services Programme Objective To provide specialized and general health services through care and treatment, disease prevention, : rehabilitation and health promotion services in Bunyoro Region No. of antenatal cases (All attendances) 10,000 10,100 10,150 Responsible Officer: Dr. Peter Mukobi No. of children immunised (All immunizations) 32,500 33,000 33,500 Programme Outcome: Quality and accessible Regional Referral Hospital Services No. of family planning users attended to (New and Old) 3,200 3,300 3,400 Sector Outcomes contributed to by the Programme Outcome Number of ANC Visits (All visits) 10,000 10,100 10,150 1. Improved quality of life at all levels Percentage of HIV positive pregnant women not on H 0% 0% 0% Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Output: 07 Immunisation Services Baseline Base year Target Projection Projection Number of Childhood Vaccinations given (All contac 32,500 33,000 33,500

• % increase of specialized clinic outpatient attendances 67065 2019 5% 5% 5%

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SubProgramme: 02 Hoima Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 Yes Yes Yes

Timely submission of quarterly financial/activity Yes Yes Yes

SubProgramme: 03 Hoima Regional Maintenance Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 Yes Yes Yes

Timely submission of quarterly financial/activity Yes Yes Yes

SubProgramme: 1584 Retooling of Hoima Regional Referral Hospital Output: 05 Hospital Management and support services Timely payment of salaries and pensions by the 2 Yes Yes Yes

Timely submission of quarterly financial/activity Yes Yes Yes

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 .2 .2

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

The vote experiences several challenges that include among many the following:

(1) Low community responsiveness to disease prevention

(2) Lack of allocation for infrastructure development in FY 2020/21 (except for retooling)

(3) Lack of an intensive care unit thus relatively high case fatalities

(4) Absence of an Ambulance ever since funding was cut during last FY2019/20 hence difficulties in managing referral services

(5) Low capacity of Incinerator thus frequent breakdowns and accumulation of medical waste thus need for high volume incinerator

(6) Insufficient ward space thus frequent floor cases. Similarly, there is insufficient records management space as well several other services hence constraining service provision

(7) Difficulties in records capture, analyses and use as a result of cumbersome paper based medical records systems

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SubProgramme: 02 Hoima Referral Hospital Internal Audit (8) Insufficient Assorted medical Equipment, furniture and office furniture in all departments Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4 (9) Insufficient Interns and staff accommodation facilities thus low motivation and retention as a result of difficult working conditions Timely payment of salaries and pensions by the 2 Yes Yes Yes Plans to improve Vote Performance Timely submission of quarterly financial/activity Yes Yes Yes The following actions shall be undertaken in order to improve vote performance during the FY: SubProgramme: 03 Hoima Regional Maintenance Output: 05 Hospital Management and support services (1) Conduct community mobilization interventions in order to promote disease prevention Assets register updated on a quarterly basis 4 4 4 (2) Continue lobbying stakeholders for infrastructure development support such as procurement of incinerator, ward and office space expansion, assorted medical & office equipment as well as staff accommodation Timely payment of salaries and pensions by the 2 Yes Yes Yes (3) Lobby for improvements in emergency services (inclusive of ICU support and purchase of ambulances) Timely submission of quarterly financial/activity Yes Yes Yes (4) Step up monitoring and supervision to ensure quality service provision SubProgramme: 1584 Retooling of Hoima Regional Referral Hospital Output: 05 Hospital Management and support services (5) Continued support to Community Health Department to accelerate disease prevention interventions at community level Timely payment of salaries and pensions by the 2 Yes Yes Yes XI Off Budget Support

Timely submission of quarterly financial/activity Yes Yes Yes Table 11.1 Off-Budget Support by Sub-Programme Output: 85 Purchase of Medical Equipment Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Value of medical equipment procured (Ush Bn) .2 .2 .2 Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 2.24 IX. Major Capital Investments And Changes In Resource Allocation Recurrent Budget Estimates 01 Hoima Referral Hospital Services 0.00 2.24 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) 410-International Development Association (IDA) 0.00 0.90

N/A 426-UNICEF 0.00 0.44

451-Global Alliance for Vaccines Immunisation 0.00 0.28 X. Vote Challenges and Plans To Improve Performance 550-United States of America 0.00 0.62

Vote Challenges Total for Vote 0.00 2.24 The vote experiences several challenges that include among many the following: XII. Vote Cross Cutting Policy And Other Budgetary Issues (1) Low community responsiveness to disease prevention Table 12.1: Cross- Cutting Policy Issues

(2) Lack of allocation for infrastructure development in FY 2020/21 (except for retooling) Issue Type: HIV/AIDS (3) Lack of an intensive care unit thus relatively high case fatalities Objective : Hoima Hospital plans to contribute towards the reduction in the number of new HIV infections through the following objectives: (4) Absence of an Ambulance ever since funding was cut during last FY2019/20 hence difficulties in managing referral services (1) To Increase coverage and utilization of HIV/AIDS prevention, care and treatment services (5) Low capacity of Incinerator thus frequent breakdowns and accumulation of medical waste thus need for high volume incinerator (2) To ensure community adoption of safer sexual behavior and reduction of HIV/AIDS risk for all people men, women and the vulnerable inclusive (6) Insufficient ward space thus frequent floor cases. Similarly, there is insufficient records management space as well several other services hence constraining service provision Issue of Concern : There is a high level of HIV/AIDS related morbidity and mortality among men, women, children (7) Difficulties in records capture, analyses and use as a result of cumbersome paper based medical records systems and vulnerable populations in Bunyoro region

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Planned Interventions : (1) Screening for HIV at static & community outreaches

(2) Treatment and care for HIV positives

(3) Conduct Health Education and promotion for Abstinence, Being faithful and Condom Use

(4) Promote access for prevention of HIV services

Budget Allocation (Billion) : 0.700 Performance Indicators: (1) 90% identification of HIV positives

(2) 90% treatment of HIV positive people

(3) 90% viral suppression among HIV positives people

Issue Type: Gender

Objective : (1) To reduce gender inequalities among women men, girls, boys, & disabled persons at Hoima Hospital

(2) To increase knowledge & understanding of human rights among women, men, children & disabled persons at Hoima Hospital

(3) To strengthen women's capacities in decision making at the hospital Issue of Concern : Persistent inequalities among women, men, boys, girls and disabled persons associated with gender based violence in Bunyoro region Planned Interventions : (1) Promote gender development approaches in Planning, implementation and Monitoring of health interventions

(2) Ensure access, participation and Health benefits to all women, men, boys, girls and disabled persons

Budget Allocation (Billion) : 0.300 Performance Indicators: (1) 50% Proportion of women in decision-making at Hospital

(2) 100% disaggregation of hospital data by sex

(3) 50% reduction in Maternal Mortality Ratio

(4) 20% reduction in Incidence of gender based violence patients Issue Type: Enviroment

Objective : To establish and maintain an efficient mechanism for sustainable environment resources management at Hoima hospital

Issue of Concern : Environmental degradation through urbanization leading to increase in preventable diseases like malaria

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Planned Interventions : (1) Screening for HIV at static & community outreaches Planned Interventions : (1) Health education and promotion for environmental interventions in malaria and other diseases prevention (2) Treatment and care for HIV positives (2) Promote go-green initiatives in hospital environment e.g Plant trees etc. (3) Conduct Health Education and promotion for Abstinence, Being faithful and Condom Use Budget Allocation (Billion) : 0.300 (4) Promote access for prevention of HIV services Performance Indicators: (1) 30 trees planted per year Budget Allocation (Billion) : 0.700 (2) 1 incinerator maintained Performance Indicators: (1) 90% identification of HIV positives (3) 100% of units with environmental education sessions (2) 90% treatment of HIV positive people (4) 100% units with acceptable cleanliness (3) 90% viral suppression among HIV positives people XIII. Personnel Information Issue Type: Gender Table 13.1 Staff Establishment Analysis

Objective : (1) To reduce gender inequalities among women men, girls, boys, & disabled persons at Hoima Title Salary Scale Number Of Approved Positions Number Of Filled Positions Hospital Consultant ENT U1SE 1 0 (2) To increase knowledge & understanding of human rights among women, men, children & disabled persons at Hoima Hospital Consultant Medicine U1SE 1 0 Consultant Paediatrician U1SE 1 0 (3) To strengthen women's capacities in decision making at the hospital Consultant Radiology U1SE 1 0 Issue of Concern : Persistent inequalities among women, men, boys, girls and disabled persons associated with gender Consultnat (Public Health) U1SE 1 0 based violence in Bunyoro region Senior Consultant MEDICAL U1SE 1 0 Planned Interventions : (1) Promote gender development approaches in Planning, implementation and Monitoring of health interventions Medical Officer Special Grade U2(Med-1) 1 0 (Paediatrics) (2) Ensure access, participation and Health benefits to all women, men, boys, girls and disabled Medical Officer Special Grade U2(Med-1) 1 0 persons (Public Health) Medical Officer Special Grade U2U 1 0 Budget Allocation (Billion) : 0.300 (Radiology) Performance Indicators: (1) 50% Proportion of women in decision-making at Hospital Medical Officer Special Grade U2U 1 0 (Senior Dental Surgeon) (2) 100% disaggregation of hospital data by sex PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 OFFICER (3) 50% reduction in Maternal Mortality Ratio PRINCIPAL CLINICAL OFFICER U3(Med-2) 1 0 (4) 20% reduction in Incidence of gender based violence patients Principal Dispenser U3(Med-2) 1 0 Issue Type: Enviroment PRINCIPAL PHYSIOTHERAPIST U3(Med-2) 1 0 Objective : To establish and maintain an efficient mechanism for sustainable environment resources Senior Nursing Officer U4(Med-2) 14 0 management at Hoima hospital SENIOR PSYCHIATRIC U4(Med-2) 1 0 CLINICAL OFFICER Issue of Concern : Environmental degradation through urbanization leading to increase in preventable diseases like malaria HOSPITAL ADMINISTRATOR U4L 1 0 HUMAN RESOURCE OFFICER U4L 1 0 MEDICAL RECORDS OFFICER U4L 2 0

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Internal Auditor U4U 1 0 PROCUREMENT OFFICER U4U 1 0 NURSING OFF (NURSING) U5 SC 40 0 Occupational Therapist U5(SC) 1 0 PHYSIOTHERAPIST U5(SC) 1 0 Psychiatric Clinical Officer U5(SC) 1 0 ASSISTANT MEDICAL U5L 2 0 RECORDS OFFICER ASSISTANT RECORDS OFFICER U5L 2 0 ASSISTANT PROCUREMENT U5U 1 0 OFFICER Nursing Officer(Midwife) U5U 20 0 ASSISTANT ACCOUNTANT U6U 1 0 ENROLLED MIDWIFE U7(Med) 20 0 ENROLLED Psychiatry NURSE U7(Med) 2 0 Enrolled Nurse U7U 40 0 Senior Consultant (Obs. & Gyn) US1E 1 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ASSISTANT ACCOUNTANT U6U 1 0 1 1 436,677 5,240,124 ASSISTANT MEDICAL U5L 2 0 2 1 479,759 5,757,108 RECORDS OFFICER ASSISTANT PROCUREMENT U5U 1 0 1 1 598,822 7,185,864 OFFICER ASSISTANT RECORDS U5L 2 0 2 1 479,759 5,757,108 OFFICER Consultant ENT U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Medicine U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Paediatrician U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Radiology U1SE 1 0 1 1 4,200,000 50,400,000 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 ENROLLED MIDWIFE U7(Med) 20 0 20 2 1,226,316 14,715,792 Enrolled Nurse U7U 40 0 40 2 9,810,528 117,726,336 ENROLLED Psychiatry NURSE U7(Med) 2 0 2 2 1,226,316 14,715,792 HOSPITAL ADMINISTRATOR U4L 1 0 1 1 601,341 7,216,092 HUMAN RESOURCE OFFICER U4L 1 0 1 1 601,341 7,216,092 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics)

122 123 Hoima Referral Hospital Ministerial Policy Statement FY 2020/21 Hoima Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:166 Hoima Referral Hospital Vote:166 Hoima Referral Hospital

Internal Auditor U4U 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Radiology) PROCUREMENT OFFICER U4U 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Senior Dental Surgeon) NURSING OFF (NURSING) U5 SC 40 0 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Occupational Therapist U5(SC) 1 0 (Public Health) MEDICAL RECORDS OFFICER U4L 2 0 2 1 601,341 7,216,092 PHYSIOTHERAPIST U5(SC) 1 0 NURSING OFF (NURSING) U5 SC 40 0 40 1 898,337 10,780,044 Psychiatric Clinical Officer U5(SC) 1 0 Nursing Officer(Midwife) U5U 20 0 20 1 2,400,000 28,800,000 ASSISTANT MEDICAL U5L 2 0 Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 RECORDS OFFICER PHYSIOTHERAPIST U5(SC) 1 0 1 1 1,200,000 14,400,000 ASSISTANT RECORDS OFFICER U5L 2 0 PRINCIPAL ANAESTHETIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OFFICER ASSISTANT PROCUREMENT U5U 1 0 PRINCIPAL CLINICAL U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OFFICER OFFICER Nursing Officer(Midwife) U5U 20 0 Principal Dispenser U3(Med-2) 1 0 1 1 3,100,000 37,200,000 ASSISTANT ACCOUNTANT U6U 1 0 PRINCIPAL U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PHYSIOTHERAPIST ENROLLED MIDWIFE U7(Med) 20 0 PROCUREMENT OFFICER U4U 1 0 1 1 940,366 11,284,392 ENROLLED Psychiatry NURSE U7(Med) 2 0 Psychiatric Clinical Officer U5(SC) 1 0 1 1 1,200,000 14,400,000 Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Enrolled Nurse U7U 40 0 Senior Consultant (Obs. & Gyn) US1E 1 0 1 1 4,500,000 54,000,000 Senior Consultant (Obs. & Gyn) US1E 1 0 Senior Nursing Officer U4(Med-2) 14 0 14 2 4,400,000 52,800,000 SENIOR PSYCHIATRIC U4(Med-2) 1 0 1 1 2,200,000 26,400,000 Table 13.2 Staff Recruitment Plan CLINICAL OFFICER Total 166 0 166 37 84,840,162 1,018,081,944 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ASSISTANT ACCOUNTANT U6U 1 0 1 1 436,677 5,240,124 ASSISTANT MEDICAL U5L 2 0 2 1 479,759 5,757,108 RECORDS OFFICER ASSISTANT PROCUREMENT U5U 1 0 1 1 598,822 7,185,864 OFFICER ASSISTANT RECORDS U5L 2 0 2 1 479,759 5,757,108 OFFICER Consultant ENT U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Medicine U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Paediatrician U1SE 1 0 1 1 3,179,753 38,157,036 Consultant Radiology U1SE 1 0 1 1 4,200,000 50,400,000 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 ENROLLED MIDWIFE U7(Med) 20 0 20 2 1,226,316 14,715,792 Enrolled Nurse U7U 40 0 40 2 9,810,528 117,726,336 ENROLLED Psychiatry NURSE U7(Med) 2 0 2 2 1,226,316 14,715,792 HOSPITAL ADMINISTRATOR U4L 1 0 1 1 601,341 7,216,092 HUMAN RESOURCE OFFICER U4L 1 0 1 1 601,341 7,216,092 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics)

122 123 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide quality,accessible health services to the catchment area

II. Strategic Objective a. To improve the quality and safety of hospital care by offering comprehensive specialised and general curative, promotive preventive and rehabilitative health care services. b. To contribute to scaling up critical HSSIP interventions. c. To strengthen research activities. d. To strengthen training of health workers. e. To strengthen collaboration with other hospitals and offer a supporting role to health facilities in the catchment area. f. To improve effectiveness and efficiency of hospital services. g. To strengthen hospital partnerships. III. Major Achievements in 2019/20

IV. Medium Term Plans 1. Improve hospital security by installing cctv cameras, staff accommodation, rehabilitate existing infrastructure, reduce on costs of utilities by use rain water harvesting and solar power. 2. Reduce staff gaps by timely identification declaration and recruitment of staff within the allocated wage bill. 3. Strengthen and improve on data management, utilization and dissemination through digitization 4. Continue lobbying and fast tracking Phase Two hospital construction of the hospital to meet the client service demands especially and move to meet national demands of Jinja City with the entity serving as a Regional Center of Excellence 5. Continue developing and improving Specialized health care services, emergency and accident care, training and health research for improved livelihoods and lab-our productivity in the region. Side rooms made functional for charging to increase revenue,quality improvement efforts strengthened,environmental friendly waste disposal methods supported, complete second phase of the staff house block,construct the wall fence around the hospital,construction and equipping the emergency unit ,operational research activities given priority.

124 125 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital Vote:167 Jinja Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To provide quality,accessible health services to the catchment area 2019/20 MTEF Budget Projections II. Strategic Objective 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec a. To improve the quality and safety of hospital care by offering comprehensive specialised and general curative, promotive Wage 5.277 7.198 3.215 7.198 7.198 7.198 7.198 7.198 preventive and rehabilitative health care services. b. To contribute to scaling up critical HSSIP interventions. c. To strengthen Recurrent research activities. d. To strengthen training of health workers. e. To strengthen collaboration with other hospitals and offer a Non Wage 2.811 3.731 1.732 3.036 3.036 3.036 3.036 3.036 supporting role to health facilities in the catchment area. f. To improve effectiveness and efficiency of hospital services. g. To GoU 1.487 1.188 0.678 1.600 1.065 0.200 0.227 0.227 strengthen hospital partnerships. Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 III. Major Achievements in 2019/20 GoU Total 9.575 12.117 5.625 11.834 11.299 10.434 10.461 10.461 Total GoU+Ext Fin (MTEF) 9.575 12.117 5.625 11.834 11.299 10.434 10.461 10.461 IV. Medium Term Plans Arrears 0.727 0.183 0.127 0.068 0.000 0.000 0.000 0.000 1. Improve hospital security by installing cctv cameras, staff accommodation, rehabilitate existing infrastructure, reduce on costs Total Budget 10.302 12.299 5.752 11.902 11.299 10.434 10.461 10.461 of utilities by use rain water harvesting and solar power. 2. Reduce staff gaps by timely identification declaration and recruitment of staff within the allocated wage bill. A.I.A Total 0.210 0.000 0.000 0.000 0.000 0.000 0.000 0.000 3. Strengthen and improve on data management, utilization and dissemination through digitization 4. Continue lobbying and fast tracking Phase Two hospital construction of the hospital to meet the client service demands Grand Total 10.512 12.299 5.752 11.902 11.299 10.434 10.461 10.461 especially and move to meet national demands of Jinja City with the entity serving as a Regional Center of Excellence 5. Total Vote Budget 9.785 12.117 5.625 11.834 11.299 10.434 10.461 10.461 Continue developing and improving Specialized health care services, emergency and accident care, training and health research Excluding Arrears for improved livelihoods and lab-our productivity in the region. Side rooms made functional for charging to increase revenue,quality improvement efforts strengthened,environmental friendly waste disposal methods supported, complete second phase of the staff house block,construct the wall fence around the VI. Budget By Economic Clasification hospital,construction and equipping the emergency unit ,operational research activities given priority. Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 10.929 0.000 0.000 10.929 10.234 0.000 10.234

211 Wages and Salaries 7.259 0.000 0.000 7.259 7.278 0.000 7.278

212 Social Contributions 1.054 0.000 0.000 1.054 1.179 0.000 1.179

213 Other Employee Costs 1.119 0.000 0.000 1.119 0.294 0.000 0.294

221 General Expenses 0.153 0.000 0.000 0.153 0.116 0.000 0.116

222 Communications 0.021 0.000 0.000 0.021 0.017 0.000 0.017

223 Utility and Property Expenses 0.743 0.000 0.000 0.743 0.739 0.000 0.739

224 Supplies and Services 0.223 0.000 0.000 0.223 0.277 0.000 0.277

227 Travel and Transport 0.172 0.000 0.000 0.172 0.173 0.000 0.173

228 Maintenance 0.186 0.000 0.000 0.186 0.161 0.000 0.161

Output Class : Capital Purchases 1.188 0.000 0.000 1.188 1.600 0.000 1.600

281 Property expenses other than interest 0.100 0.000 0.000 0.100 0.110 0.000 0.110

312 FIXED ASSETS 1.088 0.000 0.000 1.088 1.490 0.000 1.490

124 125 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital

Output Class : Arrears 0.183 0.000 0.000 0.183 0.068 0.000 0.068

321 DOMESTIC 0.183 0.000 0.000 0.183 0.068 0.000 0.068

Grand Total : 12.299 0.000 0.000 12.299 11.902 0.000 11.902

Total excluding Arrears 12.117 0.000 0.000 12.117 11.834 0.000 11.834

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 10.512 12.299 5.752 11.902 11.299 10.434 10.461 10.461

01 Jinja Referral Hospital Services 8.844 10.955 5.057 10.153 10.085 10.085 10.085 10.085

02 Jinja Referral Hospital Internal Audit 0.010 0.021 0.017 0.014 0.012 0.012 0.012 0.012

03 Jinja Regional Maintenance 0.093 0.135 0.000 0.135 0.137 0.137 0.137 0.137

1004 Jinja Rehabilitation Referral Hospital 1.364 1.100 0.678 1.360 0.165 0.100 0.000 0.000

1481 Institutional Support to Jinja Regional 0.200 0.088 0.000 0.000 0.000 0.000 0.000 0.000 Hospital 1636 Retooling of Jinja Regional Referral 0.000 0.000 0.000 0.240 0.900 0.100 0.227 0.227 Hospital Total for the Vote 10.512 12.299 5.752 11.902 11.299 10.434 10.461 10.461

Total Excluding Arrears 9.785 12.117 5.625 11.834 11.299 10.434 10.461 10.461

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective a. To improve the quality and safety of hospital services . : b. To contribute to scaling up critical hssip interventions

c. To strengthen research activities. d. To strengthen training of health workers.

e. To strengthen collaboration with other hospitals and offer a supporting role to health facilities in the catchment area.

f. To improve effectiveness and efficiency of hospital services.

g. To strengthen hospital partnerships.

Responsible Officer: Dr. Nkuruziza Edward Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome

126 127 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital Vote:167 Jinja Referral Hospital

Output Class : Arrears 0.183 0.000 0.000 0.183 0.068 0.000 0.068 1. Improved quality of life at all levels

321 DOMESTIC 0.183 0.000 0.000 0.183 0.068 0.000 0.068 Performance Targets

Grand Total : 12.299 0.000 0.000 12.299 11.902 0.000 11.902 Outcome Indicators 2020/21 2021/22 2022/23

Total excluding Arrears 12.117 0.000 0.000 12.117 11.834 0.000 11.834 Baseline Base year Target Projection Projection

• % increase of specialised clinic outpatients attendances 34,000 2019 2% 1% 1% VII. Budget By Programme And Subprogramme • Bed occupancy rate 45000 2021 85% 85% 86% Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme SubProgramme: 01 Jinja Referral Hospital Services FY 2019/20 Medium Term Projections Billion Uganda shillings Output: 01 Inpatient services FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 No. of in-patients (Admissions) 40,000 42,000 45,000 Outturn Budget End Dec Proposed Budget Average Length of Stay (ALOS) - days 4.5 4 4 56 Regional Referral Hospital Services 10.512 12.299 5.752 11.902 11.299 10.434 10.461 10.461 Bed Occupancy Rate (BOR) 85% 85% 84% 01 Jinja Referral Hospital Services 8.844 10.955 5.057 10.153 10.085 10.085 10.085 10.085 6,000 6,500 7,000 02 Jinja Referral Hospital Internal Audit 0.010 0.021 0.017 0.014 0.012 0.012 0.012 0.012 Number of Major Operations (including Ceasarian se

03 Jinja Regional Maintenance 0.093 0.135 0.000 0.135 0.137 0.137 0.137 0.137 Output: 02 Outpatient services

1004 Jinja Rehabilitation Referral Hospital 1.364 1.100 0.678 1.360 0.165 0.100 0.000 0.000 No. of general outpatients attended to 150,000 150,000 155,000

1481 Institutional Support to Jinja Regional 0.200 0.088 0.000 0.000 0.000 0.000 0.000 0.000 No. of specialised outpatients attended to 130,000 143,000 145,000 Hospital 1636 Retooling of Jinja Regional Referral 0.000 0.000 0.000 0.240 0.900 0.100 0.227 0.227 Referral cases in 3,000 3,500 4,000 Hospital Total for the Vote 10.512 12.299 5.752 11.902 11.299 10.434 10.461 10.461 Output: 05 Hospital Management and support services

Total Excluding Arrears 9.785 12.117 5.625 11.834 11.299 10.434 10.461 10.461 Assets register updated on a quarterly basis 4 4 4 Timely payment of salaries and pensions by the 2 yes yes yes VIII. Programme Performance and Medium Term Plans Timely submission of quarterly financial/activity yes yes yes Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Output: 06 Prevention and rehabilitation services Programme : 56 Regional Referral Hospital Services No. of antenatal cases (All attendances) 11,000 11,500 11,900 Programme Objective a. To improve the quality and safety of hospital services . No. of children immunised (All immunizations) 14,000 15,000 16,000 : b. To contribute to scaling up critical hssip interventions No. of family planning users attended to (New and Old) 5,000 5,500 6,000 c. To strengthen research activities. d. To strengthen training of health workers. Number of ANC Visits (All visits) 13,000 14,000 16,000

e. To strengthen collaboration with other hospitals and offer a supporting role to health facilities in the Percentage of HIV positive pregnant women not on H 1% 1% 1% catchment area. Output: 07 Immunisation Services f. To improve effectiveness and efficiency of hospital services. Number of Childhood Vaccinations given (All contac 13,000 15,000 15,500

g. To strengthen hospital partnerships. SubProgramme: 02 Jinja Referral Hospital Internal Audit Output: 01 Inpatient services Responsible Officer: Dr. Nkuruziza Edward No. of in-patients (Admissions) 37,000 42,000 45,000 Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome Average Length of Stay (ALOS) - days 4 4 4

126 127 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital

Bed Occupancy Rate (BOR) 85% 85% 85%

Number of Major Operations (including Ceasarian se 6,500 7,000 7,200

SubProgramme: 03 Jinja Regional Maintenance Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

SubProgramme: 1004 Jinja Rehabilitation Referral Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 12 3 1

Cerificates of progress/ Completion 3 2 1

SubProgramme: 1636 Retooling of Jinja Regional Referral Hospital Output: 80 Hospital Construction/rehabilitation No. of reconstructed/rehabilitated general wards 10 12 16

Cerificates of progress/ Completion 3 2 3

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 167 Jinja Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Jinja Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

Completion of casting the slab of second floor and starting on Slab for the second floor caste ,started on 16 unit staff block constructed the brick works of the same floor walling for the third floor. Total Output Cost(Ushs Thousand) 1,100,000 644,895 1,360,000

Gou Dev’t: 1,100,000 644,895 1,360,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

Limited budget to meet recurrent expenditures such as,purchase of drugs ,reasonable budget to cater for allowances for specialists

128 129 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital Vote:167 Jinja Referral Hospital

Bed Occupancy Rate (BOR) 85% 85% 85% es,budget to operationalize the the community health department ,lack of space for emergency care at pediatrics unit,land encroachment ,additional funding to cater for salaries for the private wing specialists Number of Major Operations (including Ceasarian se 6,500 7,000 7,200 Plans to improve Vote Performance SubProgramme: 03 Jinja Regional Maintenance Output: 05 Hospital Management and support services Procurement of theater equipment's to improve on surgical outputs, training middle level managers for effectiveness and efficiency,support supervision to lower facilities will help them in early referrals ,improve and increase staff accommodation to Assets register updated on a quarterly basis 4 4 4 improve emergency care response Continue with the quality improvement activities,such as KAIZEN and 5S yes yes yes Timely payment of salaries and pensions by the 2 Continue with multi year staff house construction to get to 32 units Timely submission of quarterly financial/activity yes yes yes Procure equipment's and operationalise the intensive care unit Lobby to have the non wage budget increased to finance salaries,drugs ,buy equipment's for private services SubProgramme: 1004 Jinja Rehabilitation Referral Hospital XI Off Budget Support Output: 81 Staff houses construction and rehabilitation Table 11.1 Off-Budget Support by Sub-Programme No. of staff houses constructed/rehabilitated 12 3 1

Cerificates of progress/ Completion 3 2 1 Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates SubProgramme: 1636 Retooling of Jinja Regional Referral Hospital Programme 0856 Regional Referral Hospital Services 0.00 0.28 Output: 80 Hospital Construction/rehabilitation Recurrent Budget Estimates 01 Jinja Referral Hospital Services 0.00 0.28 No. of reconstructed/rehabilitated general wards 10 12 16 400-MULTI-LATERAL DEVELOPMENT PARTNERS 0.00 0.28 Cerificates of progress/ Completion 3 2 3 Total for Vote 0.00 0.28

IX. Major Capital Investments And Changes In Resource Allocation XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion)

FY 2019/20 FY 2020/21 Issue Type: HIV/AIDS Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Objective : Provide these services to every body regardless of gender,age,individual ability end Dec Outputs Issue of Concern : No proper signage showing clients where and time when these services are provided Vote 167 Jinja Referral Hospital Planned Interventions : provide signs indicating service delivery centers and the time Program : 08 56 Regional Referral Hospital Services Budget Allocation (Billion) : 0.001 Development Project : 1004 Jinja Rehabilitation Referral Hospital Performance Indicators: Posters and bill boards in palace Output: 08 56 81 Staff houses construction and rehabilitation Issue Type: Gender Completion of casting the slab of second floor and starting on Slab for the second floor caste ,started on 16 unit staff block constructed the brick works of the same floor walling for the third floor. Total Output Cost(Ushs Thousand) 1,100,000 644,895 1,360,000 Objective : Indiscriminately provide health services across the social divide

Gou Dev’t: 1,100,000 644,895 1,360,000 Issue of Concern : Some clients are not comfortable with particular sex to provide a service to them

Ext Fin: 0 0 0 Planned Interventions : Recruit more staff of both sex in those areas such as x-ray department,orient them of the challenge.

A.I.A: 0 0 0 Budget Allocation (Billion) : 0.020 Performance Indicators: staff of both sex posted to those units,oriented and serve the clients indiscriminately X. Vote Challenges and Plans To Improve Performance Issue Type: Enviroment Vote Challenges Objective : Use environmentally friendly medical waste disposal methods Limited budget to meet recurrent expenditures such as,purchase of drugs ,reasonable budget to cater for allowances for specialists Issue of Concern : No proper and safe medical waste disposal mechanism

128 129 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital

Planned Interventions : Repair the incinerator and make it functional Budget Allocation (Billion) : 0.002 Performance Indicators: Incinerator repaired and functional

XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant (Ophthalmology) U1SE 1 0 Senior Consultant Internal Medicine U1SE 1 0 Principal Laboratory Technologist U3SC 1 0 Inventory Management Officer U4U 1 0 LABARATORY U5(SC) 3 0 TECHNOLOGIST ASSISTANT ACCOUNTANT U6U 3 1 Askari U8L 10 8 Consultant Obstetrics/Gynaecology US1E 1 0 Senior Consultant (Surgery) US1E 1 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 LABARATORY U5(SC) 3 0 3 2 2,400,000 28,800,000 TECHNOLOGIST Askari U8L 10 8 2 2 427,664 5,131,968 ASSISTANT ACCOUNTANT U6U 3 1 2 2 873,354 10,480,248 Consultant (Ophthalmology) U1SE 1 0 1 1 2,628,075 31,536,900 Consultant Obstetrics/Gynaecology US1E 1 0 1 1 2,905,088 34,861,056 Inventory Management Officer U4U 1 0 1 1 1,196,439 14,357,268 Principal Laboratory Technologist U3SC 1 0 1 1 1,594,867 19,138,404 Senior Consultant (Surgery) US1E 1 0 1 1 4,500,000 54,000,000 Senior Consultant Internal U1SE 1 0 1 1 0 0 Medicine Total 22 9 13 12 16,525,487 198,305,844

130 131 Jinja Referral Hospital Ministerial Policy Statement FY 2020/21 Kabale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:167 Jinja Referral Hospital Vote:168 Kabale Referral Hospital

Planned Interventions : Repair the incinerator and make it functional V1: Vote Overview Budget Allocation (Billion) : 0.002 I. Vote Mission Statement Incinerator repaired and functional Performance Indicators: To provide accessible and quality health care to all people in Kabale region through delivery of promotive, preventive, curative, palliative and rehabilitative health care XIII. Personnel Information II. Strategic Objective Table 13.1 Staff Establishment Analysis 1. To contribute to the production of a healthy human capital through provision of equitable, safe and sustainable health services Title Salary Scale Number Of Approved Positions Number Of Filled Positions 2. To address key determinants of health through strengthening intersectoral collaboration and partnerships 3. To enhance health Consultant (Ophthalmology) U1SE 1 0 sector competitiveness 4. To increase financial risk protection of households against impoverishment due to health expenditures Senior Consultant Internal Medicine U1SE 1 0 III. Major Achievements in 2019/20 Principal Laboratory Technologist U3SC 1 0 Budget performance as at end Q2 1. Approved budget was 8.579bn. The budget released was 4.46bn (52.7%). Percentage of the budget spent is 42.3% and Inventory Management Officer U4U 1 0 percentage of the released spent is 80.3%. LABARATORY U5(SC) 3 0 TECHNOLOGIST Subprogram: 01 Kabale Referral Hospital Services Clinical achievements: ASSISTANT ACCOUNTANT U6U 3 1 1. As regards Inpatient services, 8304 patients were admitted against a target of 7475 with an Average Length of Stay of 4.2 days Askari U8L 10 8 against 5 days and a Bed Occupancy Rate of 52.2% against 80%. Major surgeries including caesarean cases were1498. The target was 825 for the last 6 months. Consultant Obstetrics/Gynaecology US1E 1 0 Senior Consultant (Surgery) US1E 1 0 2. General Outpatients attended to cumulatively were 55729 against a target 35058. 47057 patients were seen in the Specialized clinics whose target was 15308. Referral cases in were 700against a target of 400. Table 13.2 Staff Recruitment Plan 3. Under diagnostics, 45099 laboratory investigations were carried out against a target of 50058. Patient x-rays taken were 1543 against a target of 1558 and ultrasound scans were 3486 against a target of 3000 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) 4. About Hospital Management and Support Services, 2 Hospital Management Board meetings were held. 6 Top Management FY2020/21 meetings held as well as other committee, departmental and general staff meetings. Daily morning meetings were also held. LABARATORY U5(SC) 3 0 3 2 2,400,000 28,800,000 TECHNOLOGIST Subprogram: 03 Kabale Regional Maintenance Workshop Askari U8L 10 8 2 2 427,664 5,131,968 1. As regards the achievements in the Regional Maintenance Workshop, 576 Job Cards were raised. This was against a target of ASSISTANT ACCOUNTANT U6U 3 1 2 2 873,354 10,480,248 200 job cards. Equipment worked on were 690 against a target of 2760 in 63 Health Units visited in the catchment area. Consultant (Ophthalmology) U1SE 1 0 1 1 2,628,075 31,536,900 Project: 1004 Kabale Regional Hospital Rehabilitation Consultant Obstetrics/Gynaecology US1E 1 0 1 1 2,905,088 34,861,056 1. The Interns’ Hostel has been constructed up to the 3rd floor. Walling and casting of the steel reinforced columns. Inventory Management Officer U4U 1 0 1 1 1,196,439 14,357,268 2. Medical records department was renovated to completion. Principal Laboratory Technologist U3SC 1 0 1 1 1,594,867 19,138,404 3. The Adolescent clinic was fenced off as planned. 4. Contract for construction of a toilet for the nurses’ hostel was signed Senior Consultant (Surgery) US1E 1 0 1 1 4,500,000 54,000,000 5. Rehabilitation of the Surgical Ward was nearing completion at 80%. Senior Consultant Internal U1SE 1 0 1 1 0 0 Medicine Project: 1473 Institutional Support to Kabale Regional Referral Hospital Total 22 9 13 12 16,525,487 198,305,844 1. Furniture and fixtures were procured, distributed and installed in the respective areas and were in use. Items procured include lockable mounted shelves for resource center, filing cabinets in maternity ward, office chairs and tables for the Hospital Director’s office and the reception. Executive chair for Principal Human Resource Officer to mention but a few. 2. The LPO for Assorted Medical Equipment was ready. These include wheel chairs, operating table, digital clinical thermometers, incubators, blood pressure machines and others.

IV. Medium Term Plans 1. Continue with the construction of the Interns’ Hostel. Expected output for the Intern’ Hostel for 2020/2021 is complete steel

130 131 Kabale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:168 Kabale Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide accessible and quality health care to all people in Kabale region through delivery of promotive, preventive, curative, palliative and rehabilitative health care

II. Strategic Objective 1. To contribute to the production of a healthy human capital through provision of equitable, safe and sustainable health services 2. To address key determinants of health through strengthening intersectoral collaboration and partnerships 3. To enhance health sector competitiveness 4. To increase financial risk protection of households against impoverishment due to health expenditures III. Major Achievements in 2019/20 Budget performance as at end Q2 1. Approved budget was 8.579bn. The budget released was 4.46bn (52.7%). Percentage of the budget spent is 42.3% and percentage of the released spent is 80.3%.

Subprogram: 01 Kabale Referral Hospital Services Clinical achievements: 1. As regards Inpatient services, 8304 patients were admitted against a target of 7475 with an Average Length of Stay of 4.2 days against 5 days and a Bed Occupancy Rate of 52.2% against 80%. Major surgeries including caesarean cases were1498. The target was 825 for the last 6 months.

2. General Outpatients attended to cumulatively were 55729 against a target 35058. 47057 patients were seen in the Specialized clinics whose target was 15308. Referral cases in were 700against a target of 400.

3. Under diagnostics, 45099 laboratory investigations were carried out against a target of 50058. Patient x-rays taken were 1543 against a target of 1558 and ultrasound scans were 3486 against a target of 3000

4. About Hospital Management and Support Services, 2 Hospital Management Board meetings were held. 6 Top Management meetings held as well as other committee, departmental and general staff meetings. Daily morning meetings were also held.

Subprogram: 03 Kabale Regional Maintenance Workshop 1. As regards the achievements in the Regional Maintenance Workshop, 576 Job Cards were raised. This was against a target of 200 job cards. Equipment worked on were 690 against a target of 2760 in 63 Health Units visited in the catchment area.

Project: 1004 Kabale Regional Hospital Rehabilitation 1. The Interns’ Hostel has been constructed up to the 3rd floor. Walling and casting of the steel reinforced columns. 2. Medical records department was renovated to completion. 3. The Adolescent clinic was fenced off as planned. 4. Contract for construction of a toilet for the nurses’ hostel was signed 5. Rehabilitation of the Surgical Ward was nearing completion at 80%.

KabaleProject: Referral1473 Institutional Hospital Support to Kabale Regional Referral Hospital Ministerial Policy Statement FY 2020/21 1. Furniture and fixtures were procured, distributed and installed in the respective areas and were in use. Items procured include lockable mounted shelves for resource center, filing cabinets in maternity ward, office chairs and tables for the Hospital KabaleDirector Referral’s office Hospital and the reception. Executive chair for Principal Human Resource OfficerMinisterial to mention Policy but aStatement few. FY 2020/21 Vote:2. The LPO168 for AssortedKabale Medical EquipmentReferral was Hospital ready. These include wheel chairs, operating table, digital clinical thermometers, incubators, blood pressure machines and others. Vote:168 Kabale Referral Hospital IV. Medium Term Plans reinforced columns, roof the structure and start on finishes. 21. ProcureContinue medical with the equipment construction including of the Internsa ventilator,’ Hostel. examination Expected couches,output for paediatric the Intern beds,’ Hostel sterilizing for 2020/2021 drum, oral is complete scope and steel reinforcedothers. columns, roof the structure and start on finishes. 23. ProcureHold stakeholder medical equipment engagement including meetings a ventilator,to get information examination for compiling couches, paediatricthe Strategic beds, Plan. sterilizing drum, oral scope and others.5. Procure ICT and office equipment, which will include CCTV surveillance cameras to expand hospital security, desk top 3computers,. Hold stakeholder laptop and engagement accompanying meetings items to like get UPS.information for compiling the Strategic Plan. 56. ProcureProvide ICTtechnical and office Support equipment, Supervision which both will internally include andCCTV externally. surveillance This camerasis aimed toat expandensuring hospital that field security, work isdesk done top as computers,expected but laptop also toand follow accompanying up on services items delivery like UPS. in the other health facilities under the supervision of Kabale Regional 6Referral. Provide Hospital. technical Support Supervision both internally and externally. This is aimed at ensuring that field work is done as expected7. Carry onbut offering also to followhealth servicesup on services to the peopledelivery of in Kigezi the other and healthbeyond facilities (Regional under Maintenance the supervision Workshop of Kabale goes Regionalas far as Ankole ReferralRegion). Hospital. 78. CarryContinue on offeringworking health with our services Implementing to the people Partners of Kigezi in preferred and beyond select (Regional health areas. Maintenance Workshop goes as far as Ankole Region). 8. Continue working with our Implementing Partners in preferred select health areas.

132 133 Kabale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:168 Kabale Referral Hospital

KabaleProject: Referral1473 Institutional Hospital Support to Kabale Regional Referral Hospital Ministerial Policy Statement FY 2020/21 Kabale Referral Hospital Ministerial Policy Statement FY 2020/21 1. Furniture and fixtures were procured, distributed and installed in the respective areas and were in use. Items procured include lockable mounted shelves for resource center, filing cabinets in maternity ward, office chairs and tables for the Hospital KabaleDirector Referral’s office Hospital and the reception. Executive chair for Principal Human Resource OfficerMinisterial to mention Policy but aStatement few. FY 2020/21 Vote:2. The LPO168 for AssortedKabale Medical EquipmentReferral was Hospital ready. These include wheel chairs, operating table, digital clinical Vote:168 Kabale Referral Hospital thermometers, incubators, blood pressure machines and others. Vote:168 Kabale Referral Hospital IV. Medium Term Plans reinforced columns, roof the structure and start on finishes. 21. ProcureContinue medical with the equipment construction including of the Internsa ventilator,’ Hostel. examination Expected couches,output for paediatric the Intern beds,’ Hostel sterilizing for 2020/2021 drum, oral is complete scope and steel V. Summary of Past Performance and Medium Term Budget Allocations others. reinforced columns, roof the structure and start on finishes. Table 5.1: Overview of Vote Expenditures (UShs Billion) 23. ProcureHold stakeholder medical equipment engagement including meetings a ventilator,to get information examination for compiling couches, paediatricthe Strategic beds, Plan. sterilizing drum, oral scope and others.5. Procure ICT and office equipment, which will include CCTV surveillance cameras to expand hospital security, desk top 3computers,. Hold stakeholder laptop and engagement accompanying meetings items to like get UPS.information for compiling the Strategic Plan. 2019/20 MTEF Budget Projections 56. ProcureProvide ICTtechnical and office Support equipment, Supervision which both will internally include andCCTV externally. surveillance This camerasis aimed toat expandensuring hospital that field security, work isdesk done top as 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 computers,expected but laptop also toand follow accompanying up on services items delivery like UPS. in the other health facilities under the supervision of Kabale Regional Outturn Budget by End Dec Referral Hospital. 6. Provide technical Support Supervision both internally and externally. This is aimed at ensuring that field work is done as Wage 3.604 4.160 1.918 4.160 4.160 4.160 4.160 4.160 expected7. Carry onbut offering also to followhealth servicesup on services to the peopledelivery of in Kigezi the other and healthbeyond facilities (Regional under Maintenance the supervision Workshop of Kabale goes Regionalas far as Ankole Recurrent ReferralRegion). Hospital. Non Wage 2.046 2.831 1.230 2.591 2.591 2.591 2.591 2.591 78. CarryContinue on offeringworking health with our services Implementing to the people Partners of Kigezi in preferred and beyond select (Regional health areas. Maintenance Workshop goes as far as Ankole GoU 1.488 1.488 0.435 1.900 2.080 1.357 0.227 0.227 Region). Devt. 8. Continue working with our Implementing Partners in preferred select health areas. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 7.138 8.479 3.583 8.651 8.831 8.108 6.978 6.978 Total GoU+Ext Fin (MTEF) 7.138 8.479 3.583 8.651 8.831 8.108 6.978 6.978 Arrears 0.147 0.099 0.058 0.056 0.000 0.000 0.000 0.000 Total Budget 7.285 8.579 3.642 8.708 8.831 8.108 6.978 6.978 A.I.A Total 0.347 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 7.632 8.579 3.642 8.708 8.831 8.108 6.978 6.978 Total Vote Budget 7.485 8.479 3.583 8.651 8.831 8.108 6.978 6.978 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 6.991 0.000 0.000 6.991 6.771 0.000 6.771

211 Wages and Salaries 4.493 0.000 0.000 4.493 4.520 0.000 4.520

212 Social Contributions 0.416 0.000 0.000 0.416 0.449 0.000 0.449

213 Other Employee Costs 0.529 0.000 0.000 0.529 0.256 0.000 0.256

221 General Expenses 0.258 0.000 0.000 0.258 0.292 0.000 0.292

222 Communications 0.014 0.000 0.000 0.014 0.018 0.000 0.018

223 Utility and Property Expenses 0.493 0.000 0.000 0.493 0.423 0.000 0.423

224 Supplies and Services 0.205 0.000 0.000 0.205 0.217 0.000 0.217

225 Professional Services 0.003 0.000 0.000 0.003 0.023 0.000 0.023

227 Travel and Transport 0.226 0.000 0.000 0.226 0.243 0.000 0.243

228 Maintenance 0.353 0.000 0.000 0.353 0.330 0.000 0.330

Output Class : Capital Purchases 1.488 0.000 0.000 1.488 1.880 0.000 1.880

281 Property expenses other than interest 0.100 0.000 0.000 0.100 0.000 0.000 0.000

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312 FIXED ASSETS 1.388 0.000 0.000 1.388 1.880 0.000 1.880

Output Class : Arrears 0.099 0.000 0.000 0.099 0.056 0.000 0.056

321 DOMESTIC 0.099 0.000 0.000 0.099 0.056 0.000 0.056

Grand Total : 8.579 0.000 0.000 8.579 8.708 0.000 8.708

Total excluding Arrears 8.479 0.000 0.000 8.479 8.651 0.000 8.651

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Kabale Referral Hospital Services 5.816 6.811 3.095 6.486 6.429 6.429 6.429 6.429

02 Kabale Referral Hospital Internal Audit 0.011 0.011 0.005 0.011 0.011 0.011 0.011 0.011

03 Kabale Regional Maintenance Workshop 0.317 0.268 0.106 0.311 0.311 0.311 0.311 0.311

1004 Kabale Regional Hospital Rehabilitaion 1.165 1.337 0.412 1.700 1.880 1.157 0.000 0.000

1473 Institutional Support to Kabale Regional 0.323 0.151 0.023 0.000 0.000 0.000 0.000 0.000 Referral Hospital 1582 Retooling of Kabale Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Hospital Total for the Vote 7.632 8.579 3.642 8.708 8.831 8.108 6.978 6.978

Total Excluding Arrears 7.485 8.479 3.583 8.651 8.831 8.108 6.978 6.978

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective 1. To contribute to the production of a healthy human capital through provision of all-inclusive equitable, : safe and sustainable health services

2. To address key determinants of health through strengthening inter-sectoral collaboration, partnerships and participation of all.

3. To strengthen training and institutional research.

4. To improve effectiveness and efficiency of hospital services.

Responsible Officer: Accounting Officer, Dr. Sophie Namasopo Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels

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312 FIXED ASSETS 1.388 0.000 0.000 1.388 1.880 0.000 1.880 Performance Targets Output Class : Arrears 0.099 0.000 0.000 0.099 0.056 0.000 0.056 Outcome Indicators 2020/21 2021/22 2022/23 321 DOMESTIC 0.099 0.000 0.000 0.099 0.056 0.000 0.056 Baseline Base year Target Projection Projection

Grand Total : 8.579 0.000 0.000 8.579 8.708 0.000 8.708 • % increase of specialised clinic outpatients attendences 15% 2018 29% 36% 42% Total excluding Arrears 8.479 0.000 0.000 8.479 8.651 0.000 8.651 • % increase of diagnostic investigations carried out; 15.8% 2018 34% 41% 48%

VII. Budget By Programme And Subprogramme • Bed occupancy rate 80% 2018 75% 75% 80%

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme SubProgramme: 01 Kabale Referral Hospital Services Output: 01 Inpatient services Billion Uganda shillings FY 2019/20 Medium Term Projections No. of in-patients (Admissions) 16,608 16,890 16,895 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Average Length of Stay (ALOS) - days 4 4 4 Budget 56 Regional Referral Hospital Services 7.632 8.579 3.642 8.708 8.831 8.108 6.978 6.978 Bed Occupancy Rate (BOR) 75% 75% 80% 01 Kabale Referral Hospital Services 5.816 6.811 3.095 6.486 6.429 6.429 6.429 6.429 Number of Major Operations (including Ceasarian se 3,000 2,445 2,450

02 Kabale Referral Hospital Internal Audit 0.011 0.011 0.005 0.011 0.011 0.011 0.011 0.011 Output: 02 Outpatient services 03 Kabale Regional Maintenance Workshop 0.317 0.268 0.106 0.311 0.311 0.311 0.311 0.311 No. of general outpatients attended to 111,458 112,015 112,575 1004 Kabale Regional Hospital Rehabilitaion 1.165 1.337 0.412 1.700 1.880 1.157 0.000 0.000 No. of specialised outpatients attended to 40,072 42,076 44,180 1473 Institutional Support to Kabale Regional 0.323 0.151 0.023 0.000 0.000 0.000 0.000 0.000 Referral Hospital Referral cases in 1,000 1,005 1,010 1582 Retooling of Kabale Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Hospital Output: 04 Diagnostic services Total for the Vote 7.632 8.579 3.642 8.708 8.831 8.108 6.978 6.978 No. of laboratory tests carried out 103,111 108,267 113,680

Total Excluding Arrears 7.485 8.479 3.583 8.651 8.831 8.108 6.978 6.978 No. of patient xrays (imaging) taken 3,115 3,131 3,147

Number of Ultra Sound Scans 6,500 6,533 6,566 VIII. Programme Performance and Medium Term Plans Output: 05 Hospital Management and support services Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Assets register updated on a quarterly basis 1 1 1 Programme : 56 Regional Referral Hospital Services Timely payment of salaries and pensions by the 2 yes yes yes Programme Objective 1. To contribute to the production of a healthy human capital through provision of all-inclusive equitable, : safe and sustainable health services Timely submission of quarterly financial/activity yes yes yes

2. To address key determinants of health through strengthening inter-sectoral collaboration, partnerships Output: 06 Prevention and rehabilitation services and participation of all. No. of antenatal cases (All attendances) 6,000 6,435 6,437

3. To strengthen training and institutional research. No. of children immunised (All immunizations) 24,000 22,784 22,785

4. To improve effectiveness and efficiency of hospital services. No. of family planning users attended to (New and Old) 4,000 47,857 47,859

Responsible Officer: Accounting Officer, Dr. Sophie Namasopo Number of ANC Visits (All visits) 3,600 3,504 3,506 Programme Outcome: Quality and accessible Regional Referral Hospital Services Percentage of HIV positive pregnant women not on H 0% 0% 0% Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels

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Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 3,106 3,122 3,138

SubProgramme: 02 Kabale Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

SubProgramme: 03 Kabale Regional Maintenance Workshop Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

SubProgramme: 1004 Kabale Regional Hospital Rehabilitaion Output: 72 Government Buildings and Administrative Infrastructure Number of buildings constructed 1 1 1

SubProgramme: 1582 Retooling of Kabale Regional Referral Hospital Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

Output: 72 Government Buildings and Administrative Infrastructure Number of buildings constructed 1 1 1

Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .08 .2 .2

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 168 Kabale Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Kabale Regional Hospital Rehabilitaion

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Vote:168 Kabale Referral Hospital Vote:168 Kabale Referral Hospital

Output: 07 Immunisation Services Output: 08 56 72 Government Buildings and Administrative Infrastructure Number of Childhood Vaccinations given (All contac 3,106 3,122 3,138 Construction of the Interns’ hostel is a project that commenced Walling and construction of steel columns was Continue with construction of the Interns' hostel. in FY 2017/18. It will be implemented in two phases over a 5- still ongoing. Currently, the building has reached the third and year period, it consists of civil works for a 4-level building and last floor. SubProgramme: 02 Kabale Referral Hospital Internal Audit all associated electro-mechanical installations. Output: 05 Hospital Management and support services Total Output Cost(Ushs Thousand) 1,000,000 372,586 1,700,000

Assets register updated on a quarterly basis 4 4 4 Gou Dev’t: 1,000,000 372,586 1,700,000

Timely payment of salaries and pensions by the 2 yes yes yes Ext Fin: 0 0 0

Timely submission of quarterly financial/activity yes yes yes A.I.A: 0 0 0

SubProgramme: 03 Kabale Regional Maintenance Workshop X. Vote Challenges and Plans To Improve Performance Output: 05 Hospital Management and support services Vote Challenges Assets register updated on a quarterly basis 4 4 4 Despite the functioning of the Vote, it has had challenges and these include the following; Timely payment of salaries and pensions by the 2 yes yes yes 1. Inadequate budget especially for retooling and rehabilitation. 2. Unstable power, hence high expenditure on fuel but also overuse of the already worn out generator. yes yes yes Timely submission of quarterly financial/activity 3. Limited number of specialized medical workforce because of inadequate wage to recruit. 4. Limited staff accommodation. SubProgramme: 1004 Kabale Regional Hospital Rehabilitaion Output: 72 Government Buildings and Administrative Infrastructure Plans to improve Vote Performance Number of buildings constructed 1 1 1 In order to improve vote performance, the following shall be done; SubProgramme: 1582 Retooling of Kabale Regional Referral Hospital 1. Lobby for more funds from government and other funding agencies to enable the institution to work on its planned activities. Output: 05 Hospital Management and support services 2. Government should increase wage in order to enable the hospital recruit specialized work force. Assets register updated on a quarterly basis 4 4 4 XI Off Budget Support Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes Table 11.1 Off-Budget Support by Sub-Programme

Output: 72 Government Buildings and Administrative Infrastructure Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Number of buildings constructed 1 1 1 Programme 0856 Regional Referral Hospital Services 0.00 1.18 Output: 85 Purchase of Medical Equipment Recurrent Budget Estimates Value of medical equipment procured (Ush Bn) .08 .2 .2 01 Kabale Referral Hospital Services 0.00 1.18 410-International Development Association (IDA) 0.00 0.90

IX. Major Capital Investments And Changes In Resource Allocation 451-Global Alliance for Vaccines Immunisation 0.00 0.28 Total for Vote 0.00 1.18 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) XII. Vote Cross Cutting Policy And Other Budgetary Issues FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Table 12.1: Cross- Cutting Policy Issues end Dec Outputs Issue Type: HIV/AIDS Vote 168 Kabale Referral Hospital

Program : 08 56 Regional Referral Hospital Services Objective : To reduce incidences of occupational hazards resulting from working on People Living with HIV

Development Project : 1004 Kabale Regional Hospital Rehabilitaion

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Issue of Concern : Occupational accidents leading to staff contracting HIV/AIDS sharps (needle) pricks and other means of transmission.

Planned Interventions : 1. Proper sharps usage and disposal in availed of safety boxes 2. Display Standard Operating Procedures (SoPs) 3. Practice 5S (Sort, Set, Shine, Standardize and Sustain) in the work place 4. Avail emergency medicines for PEP and make it easy to access

Budget Allocation (Billion) : 0.002 Performance Indicators: 1. Availability of SoPs at workplace. 2. Availability of safety boxes. 3. OI journals running 4. Availability of an emergency medicine trolley

Issue Type: Gender

Objective : To provide equitable health services to all clients both within and outside Kigezi region.

Issue of Concern : lack of a leveled platform for addressing Gender Based Violence (GBV) in the general public and the vulnerable populations

Planned Interventions : • Sensitize health workers on detection and management of gender related concerns • Support and strengthen functionality of Gender Based Violence clinic. • Establish a data base for gender related concerns.

Budget Allocation (Billion) : 0.005 Performance Indicators: • Percentage of hospital staff trained on GBV (50%) • Number of gender based cases handled in the hospital (70%) • Percentage of GBV cases entered in the GBV register • Number of radio talk shows on GBV held per quarter (4)

Issue Type: Enviroment

Objective : To ensure creation of a better environment both within the hospital surrounding community and the entire public.

Issue of Concern : Despite the measures put in place to ensure proper disposable of waste, it is still a challenge to maintain the required waste disposal standards as set by the institution.

Planned Interventions : • Provide needed color coded waste bins for waste segregation and appropriate disposal. • Provide manpower for waste collection • Sensitize community on danger of non-bio degradable waste

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Issue of Concern : Occupational accidents leading to staff contracting HIV/AIDS sharps (needle) pricks and other Budget Allocation (Billion) : 0.004 means of transmission. Performance Indicators: • Percentage of hospital departments and units with color coded waste bins and bags (100%) • Number of personnel involved in collection and disposal waste Planned Interventions : 1. Proper sharps usage and disposal in availed of safety boxes XIII. Personnel Information 2. Display Standard Operating Procedures (SoPs) 3. Practice 5S (Sort, Set, Shine, Standardize and Sustain) in the work place Table 13.1 Staff Establishment Analysis 4. Avail emergency medicines for PEP and make it easy to access Title Salary Scale Number Of Approved Positions Number Of Filled Positions Budget Allocation (Billion) : 0.002 Consultant -ENT U1E 1 0 Performance Indicators: 1. Availability of SoPs at workplace. Consultant -Psychiatry U1E 1 0 2. Availability of safety boxes. 3. OI journals running Snr.Consultant (Surgery) U1E 1 0 4. Availability of an emergency medicine trolley Consultant (Anaesthesia) U1SE 1 0 Issue Type: Gender Consultant (Surgery ) U1SE 1 0 Consultant - Paediatrics U1SE 1 0 Objective : To provide equitable health services to all clients both within and outside Kigezi region. Consultant Ophthalmology U1SE 1 0 Consultnat (Public Health) U1SE 1 0 Issue of Concern : lack of a leveled platform for addressing Gender Based Violence (GBV) in the general public and the vulnerable populations Senior Consultant Obsetrics & U1SE 1 0 Gynaechology Medical Officer Special Grade U2(Med-1) 1 0 Planned Interventions : • Sensitize health workers on detection and management of gender related concerns (ENT) • Support and strengthen functionality of Gender Based Violence clinic. Medical Officer Special Grade U2(Med-1) 1 0 • Establish a data base for gender related concerns. (Opthamology) Medical Officer Special Grade U2(Med-1) 1 0 Budget Allocation (Billion) : 0.005 (Orthopaedic Surgeon) Performance Indicators: • Percentage of hospital staff trained on GBV (50%) Medical Officer Special Grade U2(Med-1) 1 0 • Number of gender based cases handled in the hospital (70%) (Public Health) • Percentage of GBV cases entered in the GBV register Medical Officer Special Grade U2(Med-1) 1 0 • Number of radio talk shows on GBV held per quarter (4) (Radiologist) Medical Officer Special Grade U2(Med-1) 1 0 Issue Type: Enviroment (Surgeon) SEN PRINCIPAL NURSING U2(Med-2) 1 0 Objective : To ensure creation of a better environment both within the hospital surrounding community and the OFFICER entire public. MOSG -Pathology U2SC 1 0 MOSG - Anaesthesia U2SE 1 0 Issue of Concern : Despite the measures put in place to ensure proper disposable of waste, it is still a challenge to Medical Officer Special Grade U2U 1 0 maintain the required waste disposal standards as set by the institution. (Psychiatry) Princ Physiotherapist U3 1 0 Principal Occupational Therapist U3(Med-2) 1 0 Planned Interventions : • Provide needed color coded waste bins for waste segregation and appropriate disposal. • Provide manpower for waste collection Principal Public Health Dental U3(Med-2) 1 0 • Sensitize community on danger of non-bio degradable waste Officer

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SENIOR.MEDICAL SOCIAL U3L 1 0 WORKER Inventory Mgt Officer U4 2 0 Princ. Anaesthetist U4 1 0 Princ.Psychiatric Clinical Officer U4 1 0 Senior Nrsing Officer U4 15 6 Snr.Lab Technologist U4 2 1 DENTAL SURGEON U4(Med-1) 1 0 SENIOR CLINICAL OFFICER U4(Med-2) 3 1 SENIOR OPTHALMIC CLINICAL U4(Med-2) 2 0 OFFICER Senior Radiographer U4(Med-2) 2 1 SENIOR.DISPENSER U4(Med-2) 2 0 Sen. Psych. Clinical Officer U4U 2 1 Asst. Inventory Mgt Officer U5 2 1 Nursing Officer (Midwifery) U5 10 8 Clinical Officer U5(SC) 11 9 LABARATORY U5(SC) 2 0 TECHNOLOGIST PSYCHIATRIC CLINICAL U5(SC) 4 2 OFFICER CLINICAL OFFICER Audiological U5(SC) 1 0 CLINICAL OFFICER Dermatology U5(SC) 1 0 Nursing Officer (Nursing) U5(SC) 25 22 Nutritionist U5(SC) 1 0 Occupational Therapist U5(SC) 1 0 OPTHALMIC CLINICAL U5(SC) 4 0 OFFICER Public Health Dental Officer U5(SC) 1 0 Radiographer U5(SC) 2 1 Enrolled Midwife U7(Med) 38 23 Enrolled Nurse U7U 78 67 Artisan Mechanic U8 1 0 Driver U8U 5 3 Consultant (Orthopaedic) US1E 1 0 Consultant (Radiology) US1E 1 0 Senior Consultant (Paediatrics) US1E 1 0

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Vote:168 Kabale Referral Hospital Vote:168 Kabale Referral Hospital

SENIOR.MEDICAL SOCIAL U3L 1 0 Senior consultant -Medicine US1E 1 0 WORKER Inventory Mgt Officer U4 2 0 Table 13.2 Staff Recruitment Plan

Princ. Anaesthetist U4 1 0 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Princ.Psychiatric Clinical Officer U4 1 0 Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Senior Nrsing Officer U4 15 6 FY2020/21 Snr.Lab Technologist U4 2 1 Clinical Officer U5(SC) 11 9 2 2 2,400,000 28,800,000 LABARATORY U5(SC) 2 0 2 2 2,400,000 28,800,000 DENTAL SURGEON U4(Med-1) 1 0 TECHNOLOGIST PSYCHIATRIC CLINICAL U5(SC) 4 2 2 2 2,400,000 28,800,000 SENIOR CLINICAL OFFICER U4(Med-2) 3 1 OFFICER SENIOR OPTHALMIC CLINICAL U4(Med-2) 2 0 Artisan Mechanic U8 1 0 1 1 277,660 3,331,920 OFFICER Asst. Inventory Mgt Officer U5 2 1 1 1 598,822 7,185,864 Senior Radiographer U4(Med-2) 2 1 CLINICAL OFFICER U5(SC) 1 0 1 1 1,200,000 14,400,000 Audiological SENIOR.DISPENSER U4(Med-2) 2 0 CLINICAL OFFICER U5(SC) 1 0 1 1 1,200,000 14,400,000 Sen. Psych. Clinical Officer U4U 2 1 Dermatology Consultant - Paediatrics U1SE 1 0 1 1 2,628,075 31,536,900 Asst. Inventory Mgt Officer U5 2 1 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Nursing Officer (Midwifery) U5 10 8 Consultant (Orthopaedic) US1E 1 0 1 1 4,200,000 50,400,000 Clinical Officer U5(SC) 11 9 Consultant (Radiology) US1E 1 0 1 1 4,200,000 50,400,000 Consultant (Surgery ) U1SE 1 0 1 1 4,200,000 50,400,000 LABARATORY U5(SC) 2 0 TECHNOLOGIST Consultant -ENT U1E 1 0 1 1 2,905,088 34,861,056 PSYCHIATRIC CLINICAL U5(SC) 4 2 Consultant Ophthalmology U1SE 1 0 1 1 4,200,000 50,400,000 OFFICER Consultant -Psychiatry U1E 1 0 1 1 2,905,088 34,861,056 CLINICAL OFFICER Audiological U5(SC) 1 0 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 CLINICAL OFFICER Dermatology U5(SC) 1 0 DENTAL SURGEON U4(Med-1) 1 0 1 1 3,000,000 36,000,000 Driver U8U 5 3 2 2 474,138 5,689,656 Nursing Officer (Nursing) U5(SC) 25 22 Enrolled Midwife U7(Med) 38 23 15 15 9,197,370 110,368,440 Nutritionist U5(SC) 1 0 Enrolled Nurse U7U 78 67 11 5 24,526,320 294,315,840 Occupational Therapist U5(SC) 1 0 Inventory Mgt Officer U4 2 0 2 1 798,534 9,582,408 OPTHALMIC CLINICAL U5(SC) 4 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Psychiatry) OFFICER Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Public Health Dental Officer U5(SC) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Radiographer U5(SC) 2 1 (Opthamology) Enrolled Midwife U7(Med) 38 23 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Orthopaedic Surgeon) Enrolled Nurse U7U 78 67 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Public Health) Artisan Mechanic U8 1 0 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Driver U8U 5 3 (Radiologist) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Consultant (Orthopaedic) US1E 1 0 (Surgeon) Consultant (Radiology) US1E 1 0 MOSG - Anaesthesia U2SE 1 0 1 1 1,992,454 23,909,448 MOSG -Pathology U2SC 1 0 1 1 2,311,543 27,738,516 Senior Consultant (Paediatrics) US1E 1 0 Nursing Officer (Midwifery) U5 10 8 2 2 1,822,176 21,866,112

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Vote:168 Kabale Referral Hospital

Nursing Officer (Nursing) U5(SC) 25 22 3 3 3,600,000 43,200,000 Nutritionist U5(SC) 1 0 1 1 1,200,000 14,400,000 Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 OPTHALMIC CLINICAL U5(SC) 4 0 4 4 4,800,000 57,600,000 OFFICER Princ Physiotherapist U3 1 0 1 1 1,361,843 16,342,116 Princ. Anaesthetist U4 1 0 1 1 1,348,763 16,185,156 Princ.Psychiatric Clinical Officer U4 1 0 1 1 1,320,503 15,846,036 Principal Occupational Therapist U3(Med-2) 1 0 1 1 3,100,000 37,200,000 Principal Public Health Dental U3(Med-2) 1 0 1 1 3,100,000 37,200,000 Officer Public Health Dental Officer U5(SC) 1 0 1 1 1,200,000 14,400,000 Radiographer U5(SC) 2 1 1 1 1,200,000 14,400,000 SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 OFFICER Sen. Psych. Clinical Officer U4U 2 1 1 1 2,200,000 26,400,000 SENIOR CLINICAL OFFICER U4(Med-2) 3 1 2 2 4,400,000 52,800,000 Senior Consultant (Paediatrics) US1E 1 0 1 1 4,500,000 54,000,000 Senior consultant -Medicine US1E 1 0 1 1 3,752,910 45,034,920 Senior Consultant Obsetrics & U1SE 1 0 1 1 4,500,000 54,000,000 Gynaechology Senior Nrsing Officer U4 15 6 9 9 11,888,046 142,656,552 SENIOR OPTHALMIC U4(Med-2) 2 0 2 2 4,400,000 52,800,000 CLINICAL OFFICER Senior Radiographer U4(Med-2) 2 1 1 1 2,200,000 26,400,000 SENIOR.DISPENSER U4(Med-2) 2 0 2 2 4,400,000 52,800,000 SENIOR.MEDICAL SOCIAL U3L 1 0 1 1 902,612 10,831,344 WORKER Snr.Consultant (Surgery) U1E 1 0 1 1 3,604,620 43,255,440 Snr.Lab Technologist U4 2 1 1 1 1,276,442 15,317,304 Total 247 146 101 94 189,443,007 2,273,316,084

142 143 Kabale Referral Hospital Ministerial Policy Statement FY 2020/21 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:168 Kabale Referral Hospital Vote:169 Masaka Referral Hospital

Nursing Officer (Nursing) U5(SC) 25 22 3 3 3,600,000 43,200,000 V1: Vote Overview Nutritionist U5(SC) 1 0 1 1 1,200,000 14,400,000 Occupational Therapist U5(SC) 1 0 1 1 1,200,000 14,400,000 I. Vote Mission Statement OPTHALMIC CLINICAL U5(SC) 4 0 4 4 4,800,000 57,600,000 Increasing access of people with in Masaka region to quality specialized Health care services in a client centerd manner, with OFFICER professionalism, integrity and accountability in order to increase their productivity. Princ Physiotherapist U3 1 0 1 1 1,361,843 16,342,116 Princ. Anaesthetist U4 1 0 1 1 1,348,763 16,185,156 II. Strategic Objective Princ.Psychiatric Clinical Officer U4 1 0 1 1 1,320,503 15,846,036 Provision of specialized and general health care services, through delivery of curative, preventive, rehabilitative and promotive Principal Occupational Therapist U3(Med-2) 1 0 1 1 3,100,000 37,200,000 health services, capacity building, training, research and support supervision to other health facilities in Masaka region. Principal Public Health Dental U3(Med-2) 1 0 1 1 3,100,000 37,200,000 Officer III. Major Achievements in 2019/20 Public Health Dental Officer U5(SC) 1 0 1 1 1,200,000 14,400,000 1) Inpatient Services: 18728 Admissions against a target of 18570, 3 Days Average Length of Stay, 75%Bed Occupancy Rate, Radiographer U5(SC) 2 1 1 1 1,200,000 14,400,000 2588 Major Surgical Procedures done including deliveries against a target of 2005. SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 OFFICER 2) Outpatient Services: 66750 Specialised Outpatient Attendance against a target of 51346 and 39606 General OPD Attendance Sen. Psych. Clinical Officer U4U 2 1 1 1 2,200,000 26,400,000 against a target of 62248. SENIOR CLINICAL OFFICER U4(Med-2) 3 1 2 2 4,400,000 52,800,000 3) Medicines and supplies procured: Cumulatively 0.64 billion worth of medicines and supplies was procured and there were no Senior Consultant (Paediatrics) US1E 1 0 1 1 4,500,000 54,000,000 incidents of expiry of medicines and supplies. Senior consultant -Medicine US1E 1 0 1 1 3,752,910 45,034,920 Senior Consultant Obsetrics & U1SE 1 0 1 1 4,500,000 54,000,000 4) Diagnostic Services: 91338 Laboratory Tests done against a target of 262570, 6152 Ultra Sound Scans done against a target of Gynaechology 7130, X-ray Examinations done were 2730 against a target of 5000. Senior Nrsing Officer U4 15 6 9 9 11,888,046 142,656,552 5) Management and support services: 4 Management meetings held, 24 Senior Staff Meetings held, 10 Rounds of Specialist SENIOR OPTHALMIC U4(Med-2) 2 0 2 2 4,400,000 52,800,000 CLINICAL OFFICER Outreach Programme conducted. Payment of staff salaries by 28th of every month. Payroll managed. Wage Bill and Recruitment Plans developed, Pension and Gratuity Managed, Performance of staff managed, Welfare of staff managed, Rewards and Senior Radiographer U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Sanctions managed. Quarterly financial/activity and other reports were submitted timely. Patient information managed; 6 SENIOR.DISPENSER U4(Med-2) 2 0 2 2 4,400,000 52,800,000 monthly Reports and 2 quarterly reports generated and submitted. Records and Information Management Systems managed. SENIOR.MEDICAL SOCIAL U3L 1 0 1 1 902,612 10,831,344 WORKER 6) Under Rehabilitation and institutional support the following were achieved;-Maternal and Child Health Complex constructed Snr.Consultant (Surgery) U1E 1 0 1 1 3,604,620 43,255,440 up to 91%, Incinerator installed, inverters procured an installed. 3 Site Meetings held, Site Supervision, Payment of Interim Snr.Lab Technologist U4 2 1 1 1 1,276,442 15,317,304 Certificate for works accomplished done. Total 247 146 101 94 189,443,007 2,273,316,084 IV. Medium Term Plans

• In the medium term, and in line with the National Development Plan objective 1 (Pgs. 190 & 193) which seeks to contribute to the production of a healthy human capital through provision of equitable, safe and sustainable Health services. The Hospital will continue to strengthen cooperate governance by regular consultation and scheduled meetings to involve the Hospital Management Board in major decisions.

• Resource allocation for capital development will majorly be for the ongoing projects. Service delivery will continue to be gender sensitive in terms of clinical care, use of hospital facilities and response to clients needs. Clients will receive services according to need, for example children and women will be given priority. Patients who require urgent attention will be attended to before the ones that can wait.

• Equity will also apply to issues relating to health care workers. Positions in the hospital will be open for competition regardless of gender, tribe and age if applicable.

• Infrastructure developments will include completion of the MCH complex and equipping it with equipment that will serve the mothers/ children as well as the disabled patients.

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Vote:169 Masaka Referral Hospital

• Resume the construction of the senior staff hostel.in order to ease the current accommodation challenges.

• Fencing the Hospital land, Construction of a medicine/medical supplies store. Construction of an emergency skills lab, Procurement of other equipment like X-ray, Accident/Emergency equipment as well as Construction of an Administration block.

144 145 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital Vote:169 Masaka Referral Hospital

• Resume the construction of the senior staff hostel.in order to ease the current accommodation challenges. V. Summary of Past Performance and Medium Term Budget Allocations • Fencing the Hospital land, Construction of a medicine/medical supplies store. Construction of an emergency skills lab, Procurement of other equipment like X-ray, Accident/Emergency equipment as well as Construction of an Administration block. Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 4.135 4.600 2.300 4.600 4.600 4.600 4.600 4.600 Recurrent Non Wage 1.787 2.526 1.244 2.433 2.433 2.433 2.433 2.433 GoU 2.058 2.058 0.991 3.497 3.500 3.200 3.627 3.627 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 7.980 9.184 4.535 10.530 10.533 10.233 10.660 10.660 Total GoU+Ext Fin (MTEF) 7.980 9.184 4.535 10.530 10.533 10.233 10.660 10.660 Arrears 0.006 0.314 0.000 0.931 0.000 0.000 0.000 0.000 Total Budget 7.986 9.499 4.535 11.461 10.533 10.233 10.660 10.660 A.I.A Total 0.317 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.303 9.499 4.535 11.461 10.533 10.233 10.660 10.660 Total Vote Budget 8.297 9.184 4.535 10.530 10.533 10.233 10.660 10.660 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.126 0.000 0.000 7.126 7.078 0.000 7.078

211 Wages and Salaries 4.793 0.000 0.000 4.793 4.811 0.000 4.811

212 Social Contributions 0.405 0.000 0.000 0.405 0.438 0.000 0.438

213 Other Employee Costs 0.441 0.000 0.000 0.441 0.322 0.000 0.322

221 General Expenses 0.294 0.000 0.000 0.294 0.276 0.000 0.276

222 Communications 0.008 0.000 0.000 0.008 0.009 0.000 0.009

223 Utility and Property Expenses 0.548 0.000 0.000 0.548 0.551 0.000 0.551

224 Supplies and Services 0.334 0.000 0.000 0.334 0.341 0.000 0.341

225 Professional Services 0.000 0.000 0.000 0.000 0.045 0.000 0.045

227 Travel and Transport 0.155 0.000 0.000 0.155 0.185 0.000 0.185

228 Maintenance 0.146 0.000 0.000 0.146 0.099 0.000 0.099

273 Employer social benefits 0.002 0.000 0.000 0.002 0.002 0.000 0.002

Output Class : Capital Purchases 2.058 0.000 0.000 2.058 3.452 0.000 3.452

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

312 FIXED ASSETS 2.028 0.000 0.000 2.028 3.452 0.000 3.452

Output Class : Arrears 0.314 0.000 0.000 0.314 0.931 0.000 0.931

321 DOMESTIC 0.314 0.000 0.000 0.314 0.931 0.000 0.931

Grand Total : 9.499 0.000 0.000 9.499 11.461 0.000 11.461

Total excluding Arrears 9.184 0.000 0.000 9.184 10.530 0.000 10.530

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Masaka Referral Hospital Services 6.230 7.428 3.534 7.951 7.020 7.020 7.020 7.020

02 Masaka Referral Hospital Internal Audit 0.006 0.013 0.010 0.013 0.013 0.013 0.013 0.013

1004 Masaka Rehabilitation Referral Hospital 2.058 2.058 0.991 3.297 3.300 3.200 3.627 3.627

1586 Retooling of Masaka Regional Referral 0.000 0.000 0.000 0.200 0.200 0.000 0.000 0.000 Hospital Total for the Vote 8.294 9.499 4.535 11.461 10.533 10.233 10.660 10.660

Total Excluding Arrears 8.288 9.184 4.535 10.530 10.533 10.233 10.660 10.660

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective : -To enhance quality, safety, and scope of health care services to all clients. - To build capacity of health care providers in the lower health facilities for better health care - To strengthen health care research and training. - To reduce morbidity, mortality, and transmission of communicable diseases. - To reduce maternal and child mortality and morbidity. - To enhance promotive, preventive and rehabilitative health services in order to reduce disease burden in the region.. - To improve managerial efficiency in resource allocation, utilisation and accountability

Responsible Officer: Dr Nathan Onyachi Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets

146 147 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital Vote:169 Masaka Referral Hospital

281 Property expenses other than interest 0.030 0.000 0.000 0.030 0.000 0.000 0.000 Outcome Indicators 2020/21 2021/22 2022/23 312 FIXED ASSETS 2.028 0.000 0.000 2.028 3.452 0.000 3.452 Baseline Base year Target Projection Projection

Output Class : Arrears 0.314 0.000 0.000 0.314 0.931 0.000 0.931 • % increase of specialised clinic outpatients attendances 166701 2018 12% 12% 12% 321 DOMESTIC 0.314 0.000 0.000 0.314 0.931 0.000 0.931 SubProgramme: 01 Masaka Referral Hospital Services Grand Total : 9.499 0.000 0.000 9.499 11.461 0.000 11.461 Output: 01 Inpatient services Total excluding Arrears 9.184 0.000 0.000 9.184 10.530 0.000 10.530 No. of in-patients (Admissions) 42,000 43,000 44,000

VII. Budget By Programme And Subprogramme Average Length of Stay (ALOS) - days 3 3 3

85 85 85 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Bed Occupancy Rate (BOR) Number of Major Operations (including Ceasarian se 43,000 44,000 45,000 Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Output: 02 Outpatient services Outturn Budget End Dec Proposed No. of general outpatients attended to 130,000 131,000 132,000 Budget 56 Regional Referral Hospital Services 8.294 9.499 4.535 11.461 10.533 10.233 10.660 10.660 No. of specialised outpatients attended to 120,000 130,000 135,000

01 Masaka Referral Hospital Services 6.230 7.428 3.534 7.951 7.020 7.020 7.020 7.020 Referral cases in 2,700 2,770 2,850 02 Masaka Referral Hospital Internal Audit 0.006 0.013 0.010 0.013 0.013 0.013 0.013 0.013 Output: 03 Medicines and health supplies procured and dispensed 1004 Masaka Rehabilitation Referral Hospital 2.058 2.058 0.991 3.297 3.300 3.200 3.627 3.627 Value of medicines received/dispensed (Ush bn) 1.5 2 2.5 1586 Retooling of Masaka Regional Referral 0.000 0.000 0.000 0.200 0.200 0.000 0.000 0.000 Hospital Output: 04 Diagnostic services Total for the Vote 8.294 9.499 4.535 11.461 10.533 10.233 10.660 10.660 No. of laboratory tests carried out 300,000 310,000 320,000 Total Excluding Arrears 8.288 9.184 4.535 10.530 10.533 10.233 10.660 10.660 No. of patient xrays (imaging) taken 11,000 12,000 13,000

Number of Ultra Sound Scans 16,000 17,000 18,000 VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4 Programme : 56 Regional Referral Hospital Services Timely payment of salaries and pensions by the 2 yes yes yes Programme Objective : -To enhance quality, safety, and scope of health care services to all clients. Timely submission of quarterly financial/activity yes yes yes - To build capacity of health care providers in the lower health facilities for better health care - To strengthen health care research and training. Output: 06 Prevention and rehabilitation services - To reduce morbidity, mortality, and transmission of communicable diseases. - To reduce maternal and child mortality and morbidity. No. of antenatal cases (All attendances) 17,000 18,000 19,000 - To enhance promotive, preventive and rehabilitative health services in order to reduce disease burden in No. of children immunised (All immunizations) 43,000 44,000 45,000 the region.. - To improve managerial efficiency in resource allocation, utilisation and accountability No. of family planning users attended to (New and Old) 6,000 6,500 6,600

Responsible Officer: Dr Nathan Onyachi Number of ANC Visits (All visits) 17,000 18,000 19,000 Programme Outcome: Quality and accessible Regional Referral Hospital Services Percentage of HIV positive pregnant women not on H 0% 0% 0%

Sector Outcomes contributed to by the Programme Outcome Output: 07 Immunisation Services 1. Improved quality of life at all levels Number of Childhood Vaccinations given (All contac 43,000 44,000 45,000 Performance Targets

146 147 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

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SubProgramme: 02 Masaka Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 3 3 3

Timely payment of salaries and pensions by the 2 12 12 12

Timely submission of quarterly financial/activity 4 4 4

SubProgramme: 1004 Masaka Rehabilitation Referral Hospital Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 1

Timely payment of salaries and pensions by the 2 Hospital projects supervised Timely submission of quarterly financial/activity Hospital Projects supervised SubProgramme: 1586 Retooling of Masaka Regional Referral Hospital Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 169 Masaka Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Masaka Rehabilitation Referral Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

Continue with the construction of the 40 unit Senior staff quarters by casting of first floor slab, doing block works on first floor, and putting first electrical and plumbing fixes. Total Output Cost(Ushs Thousand) 0 0 600,000

Gou Dev’t: 0 0 600,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 82 Maternity ward construction and rehabilitation

148 149 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital Vote:169 Masaka Referral Hospital

SubProgramme: 02 Masaka Referral Hospital Internal Audit Maternity and children ward complex completed External plastering, rails and shuttering. Complete the construction works on the Maternal Mechanical and Electical works as well as and Child Health Complex by compound Output: 05 Hospital Management and support services terrazzo works. Landscaping and Beautification around the complex, doing final fixes on mechanical and Assets register updated on a quarterly basis 3 3 3 electrical, 2 certificates issued, Supervision of works done, and handover of the b Timely payment of salaries and pensions by the 2 12 12 12 Total Output Cost(Ushs Thousand) 1,600,000 932,899 2,651,562

Timely submission of quarterly financial/activity 4 4 4 Gou Dev’t: 1,600,000 932,899 2,651,562 Ext Fin: 0 0 0 SubProgramme: 1004 Masaka Rehabilitation Referral Hospital A.I.A: 0 0 0 Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 1 X. Vote Challenges and Plans To Improve Performance Timely payment of salaries and pensions by the 2 Hospital projects Vote Challenges supervised Timely submission of quarterly financial/activity Hospital The budget for the hospital is not adequate considering the activities and the current workload. The staffing structure is not Projects commensurate to the work load. There is overcrowding in the wards and particularly in Maternity. The drugs which are supposed supervised to handle a full month cannot cover the patients, a good number of them go without drugs.The Xray machine and other diagnostic SubProgramme: 1586 Retooling of Masaka Regional Referral Hospital machines break down regularly. The Capital development budget cannot complete the 2 projects ie the MCH Complex and the Senior Staff Quarters in the stipulated time.. Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 Plans to improve Vote Performance

The Hospital is improving on the Private wing services with a view to collect more money which can be used to bridge the gaps on IX. Major Capital Investments And Changes In Resource Allocation the general side and to motivate health workers through payment of allowances.The Hospital leadership is in contact with the Minstry of Health and Ministry of Public Services regarding the improvement of the staff structure.We have also requested for Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) increment of the wage bill to enable us recruit more staff.The Hospital will do regular marternal and neonatal mortality audits. It will also do regular performance improvement projects and meetings. FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned XI Off Budget Support end Dec Outputs Table 11.1 Off-Budget Support by Sub-Programme Vote 169 Masaka Referral Hospital

Program : 08 56 Regional Referral Hospital Services Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Development Project : 1004 Masaka Rehabilitation Referral Hospital Programme 0856 Regional Referral Hospital Services 0.00 1.83 Output: 08 56 81 Staff houses construction and rehabilitation Recurrent Budget Estimates

Continue with the construction of the 40 unit 01 Masaka Referral Hospital Services 0.00 1.83 Senior staff quarters by casting of first floor slab, 451-Global Alliance for Vaccines Immunisation 0.00 0.28 doing block works on first floor, and putting first electrical and plumbing fixes. 526-Korea S. (Rep) 0.00 0.66 Total Output Cost(Ushs Thousand) 0 0 600,000 Result best financing 0.00 0.90 Gou Dev’t: 0 0 600,000 Total for Vote 0.00 1.83 Ext Fin: 0 0 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues A.I.A: 0 0 0

Output: 08 56 82 Maternity ward construction and rehabilitation Table 12.1: Cross- Cutting Policy Issues Issue Type: HIV/AIDS

Objective : To provide comprehensive HIV/AIDS services

148 149 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

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Issue of Concern : Increased cases of new HIV infections. Planned Interventions : Proper patient care for opportunistic infections, early diagnosis, HIV counseling and testing, Antiretroviral treatment, eMTCT, post-exposure prophylaxis. Health education of HIV/AID both in the hospital and community. Budget Allocation (Billion) : 0.350 Performance Indicators: 1) Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% of HIV+ put in care and 90% Viral suppression. 2) 100% of HIV+ Mothers enrolled in Care and % of HIV+ clients enrolled on ART. 3) No. of clients done HCT. Issue Type: Gender

Objective : To have equal access to Health services despite gender, age and social status. Issue of Concern : Incidents of maternal and neonatal mortality, Undocumented domestic violence cases, Low attendance to family planning, and low male involvement in family planning. Planned Interventions : Improved patient care and access, early diagnosis, Cancer screening and treatment, management of victims of sexual violence and other forms of violence against women, immunization of children and girls. Having a vibrant adolescent friendly services. Budget Allocation (Billion) : 0.160 Performance Indicators: No of Children Immunised, No. of Family Planning Contacts and male involvement in family planning, Number of Adolescent Attending ANC, Number GBV cases treated. Issue Type: Enviroment

Objective : To have a clean and safe working Hospital environment. Issue of Concern : Facility bases infections and Safe working environment. Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, occupational health and safety activities, tree planting on the compound, sewerage management and good waste disposal. Budget Allocation (Billion) : 0.395 Performance Indicators: Number of Support Supervision visits to unit/wards, Number of Monthly QI Meetings, Number of times compound is cleaned, timely payment for utilities. XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant (Anaesthesia) U1SE 1 0 Consultant (Obs. & Gyn) U1SE 1 0 Consultant (Paediatrics) U1SE 1 0 Consultant (Pathology) U1SE 1 0 Consultant (Surgery ) U1SE 1 0 Consultant Ophthalmology U1SE 1 0

150 151 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital Vote:169 Masaka Referral Hospital

Issue of Concern : Increased cases of new HIV infections. Consultant Psychiatry U1SE 1 0 Planned Interventions : Proper patient care for opportunistic infections, early diagnosis, HIV counseling and testing, Consultant Radiology U1SE 1 0 Antiretroviral treatment, eMTCT, post-exposure prophylaxis. Health education of HIV/AID both in the hospital and community. Consultnat (Public Health) U1SE 1 0 Budget Allocation (Billion) : 0.350 Senior Consultant MEDICAL U1SE 1 0 Performance Indicators: 1) Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% Medical Officer Special Grade U2(Med-1) 1 0 of (Medicine) HIV+ put in care and 90% Viral suppression. Medical Officer Special Grade U2(Med-1) 1 0 2) 100% of HIV+ Mothers enrolled in Care and % of HIV+ clients enrolled on ART. (Public Health) 3) No. of clients done HCT. Medical Officer Special Grade U2U 1 0 Issue Type: Gender (Opthamology) Principal Anaesthetic Officer U3(Med-2) 1 0 Objective : To have equal access to Health services despite gender, age and social status. PRINCIPAL NURSING OFFICER U3(Med-2) 1 0 Issue of Concern : Incidents of maternal and neonatal mortality, Undocumented domestic violence cases, Low attendance to family planning, and low male involvement in family planning. Principal Radiographer U3(Med-2) 1 0 Planned Interventions : Improved patient care and access, early diagnosis, Cancer screening and treatment, management of SENIOR.DISPENSER U4(Med-2) 2 1 victims of sexual violence and other forms of violence against women, immunization of children and girls. Having a vibrant adolescent friendly services. Anaesthetic Officer U5(SC) 2 0 Budget Allocation (Billion) : 0.160 PRINCIPAL STORES ASSISTANT U5U 1 0 Performance Indicators: No of Children Immunised, No. of Family Planning Contacts and male involvement in family KITCHEN ATTENDANT U8L 11 1 planning, Number of Adolescent Attending ANC, Number GBV cases treated. Senior Consultant (Paediatrics) US1E 1 0 Issue Type: Enviroment Table 13.2 Staff Recruitment Plan Objective : To have a clean and safe working Hospital environment. Issue of Concern : Facility bases infections and Safe working environment. Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, Posts Filling (UGX) (UGX) occupational health and safety activities, tree planting on the compound, sewerage management FY2020/21 and good waste disposal. Anaesthetic Officer U5(SC) 2 0 2 2 2,400,000 28,800,000 Budget Allocation (Billion) : 0.395 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Performance Indicators: Number of Support Supervision visits to unit/wards, Number of Monthly QI Meetings, Number of Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 times Consultant (Paediatrics) U1SE 1 0 1 1 4,200,000 50,400,000 compound is cleaned, timely payment for utilities. Consultant (Pathology) U1SE 1 0 1 1 4,200,000 50,400,000 XIII. Personnel Information Consultant (Surgery ) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant Ophthalmology U1SE 1 0 1 1 4,200,000 50,400,000 Table 13.1 Staff Establishment Analysis Consultant Psychiatry U1SE 1 0 1 1 4,200,000 50,400,000 Title Salary Scale Number Of Approved Positions Number Of Filled Positions Consultant Radiology U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Anaesthesia) U1SE 1 0 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 KITCHEN ATTENDANT U8L 11 1 10 10 2,138,320 25,659,840 Consultant (Obs. & Gyn) U1SE 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 Consultant (Paediatrics) U1SE 1 0 (Opthamology) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Consultant (Pathology) U1SE 1 0 (Medicine) Consultant (Surgery ) U1SE 1 0 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Public Health) Consultant Ophthalmology U1SE 1 0 Principal Anaesthetic Officer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PRINCIPAL NURSING OFFICER U3(Med-2) 1 0 1 1 3,100,000 37,200,000

150 151 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital

Principal Radiographer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PRINCIPAL STORES U5U 1 0 1 1 598,822 7,185,864 ASSISTANT Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant (Paediatrics) US1E 1 0 1 1 4,500,000 54,000,000 SENIOR.DISPENSER U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Total 33 2 31 31 74,687,142 896,245,704

152 153 Masaka Referral Hospital Ministerial Policy Statement FY 2020/21 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:169 Masaka Referral Hospital Vote:170 Mbale Referral Hospital

Principal Radiographer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 V1: Vote Overview PRINCIPAL STORES U5U 1 0 1 1 598,822 7,185,864 ASSISTANT I. Vote Mission Statement Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 To provide general and specialized, curative preventive, promotive, and rehabilitative services in the 16 Districts of Elgon Senior Consultant (Paediatrics) US1E 1 0 1 1 4,500,000 54,000,000 catchment area SENIOR.DISPENSER U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Total 33 2 31 31 74,687,142 896,245,704 II. Strategic Objective - To improve the quality of patient care as per the Ministry of Health and other conventional standards and guidelines - To increase access to specialized and diagnostic services - To contribute to regional and national human resources development in the health sector - To contribute to the development and implementation of the National Health Policy - To ensure efficient and effective resource utilization III. Major Achievements in 2019/20 Performance by end of quarter 2- Inpatient services - Admitted 28974, ALOS, 3, BOR 85%, and major operations 1253 cases operated. General OPD 38987, specialist OPD 7976patients seen, Referral cases in 1070. No. of laboratory tests carried out 83741 tests, No. of patient xrays (imaging) taken 1674 X-Rays done, Number of Ultra Sound Scans - 1489. Completed medicine stores, and registry. Started renovation of staff houses , maintained medical equipment in facilities within Mt Elgon region IV. Medium Term Plans We shall complete the construction of Surgical Complex shell structure up to roofing level. Complete Renovation of 60 Units of staff Houses. We shall on numbers and quality of medical equipment. Decrease the numbers of patients reffed to Regional Referral Hospital through capacity building of the lower Health facilities.

152 153 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 5.886 6.638 2.919 6.638 6.638 6.638 6.638 6.638 Recurrent Non Wage 3.588 4.310 1.708 4.461 4.461 4.461 4.461 4.461 GoU 1.058 3.058 0.262 0.750 2.700 4.760 7.127 7.127 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 10.532 14.007 4.889 11.849 13.799 15.859 18.226 18.226 Total GoU+Ext Fin (MTEF) 10.532 14.007 4.889 11.849 13.799 15.859 18.226 18.226 Arrears 0.006 0.542 0.542 0.141 0.000 0.000 0.000 0.000 Total Budget 10.538 14.548 5.431 11.990 13.799 15.859 18.226 18.226 A.I.A Total 0.126 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 10.664 14.548 5.431 11.990 13.799 15.859 18.226 18.226 Total Vote Budget 10.658 14.007 4.889 11.849 13.799 15.859 18.226 18.226 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 10.949 0.000 0.000 10.949 11.099 0.000 11.099

211 Wages and Salaries 7.025 0.000 0.000 7.025 7.027 0.000 7.027

212 Social Contributions 0.986 0.000 0.000 0.986 1.127 0.000 1.127

213 Other Employee Costs 0.923 0.000 0.000 0.923 0.952 0.000 0.952

221 General Expenses 0.319 0.000 0.000 0.319 0.314 0.000 0.314

222 Communications 0.025 0.000 0.000 0.025 0.029 0.000 0.029

223 Utility and Property Expenses 0.779 0.000 0.000 0.779 0.780 0.000 0.780

224 Supplies and Services 0.326 0.000 0.000 0.326 0.284 0.000 0.284

225 Professional Services 0.010 0.000 0.000 0.010 0.010 0.000 0.010

227 Travel and Transport 0.248 0.000 0.000 0.248 0.233 0.000 0.233

228 Maintenance 0.308 0.000 0.000 0.308 0.343 0.000 0.343

273 Employer social benefits 0.000 0.000 0.000 0.000 0.001 0.000 0.001

Output Class : Capital Purchases 3.058 0.000 0.000 3.058 0.750 0.000 0.750

154 155 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital Vote:170 Mbale Referral Hospital

312 FIXED ASSETS 3.058 0.000 0.000 3.058 0.750 0.000 0.750 V. Summary of Past Performance and Medium Term Budget Allocations Output Class : Arrears 0.542 0.000 0.000 0.542 0.141 0.000 0.141 Table 5.1: Overview of Vote Expenditures (UShs Billion) 321 DOMESTIC 0.542 0.000 0.000 0.542 0.141 0.000 0.141

2019/20 MTEF Budget Projections Grand Total : 14.548 0.000 0.000 14.548 11.990 0.000 11.990 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Total excluding Arrears 14.007 0.000 0.000 14.007 11.849 0.000 11.849 Outturn Budget by End Dec Wage 5.886 6.638 2.919 6.638 6.638 6.638 6.638 6.638 Recurrent VII. Budget By Programme And Subprogramme Non Wage 3.588 4.310 1.708 4.461 4.461 4.461 4.461 4.461 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme GoU 1.058 3.058 0.262 0.750 2.700 4.760 7.127 7.127 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Billion Uganda shillings FY 2019/20 Medium Term Projections GoU Total 10.532 14.007 4.889 11.849 13.799 15.859 18.226 18.226 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Total GoU+Ext Fin (MTEF) 10.532 14.007 4.889 11.849 13.799 15.859 18.226 18.226 Budget 56 Regional Referral Hospital Services 10.664 14.548 5.431 11.990 13.799 15.859 18.226 18.226 Arrears 0.006 0.542 0.542 0.141 0.000 0.000 0.000 0.000 01 Mbale Referral Hospital Services 9.230 11.114 5.126 10.863 10.723 10.723 10.723 10.723 Total Budget 10.538 14.548 5.431 11.990 13.799 15.859 18.226 18.226 02 Mbale Referral Hospital Internal Audit 0.015 0.015 0.000 0.015 0.015 0.015 0.015 0.015 A.I.A Total 0.126 0.000 0.000 0.000 0.000 0.000 0.000 0.000 03 Mbale Regional Maintenance 0.361 0.361 0.043 0.361 0.361 0.361 0.361 0.361 Grand Total 10.664 14.548 5.431 11.990 13.799 15.859 18.226 18.226 1004 Mbale Rehabilitation Referral Hospital 0.000 2.000 0.000 0.550 2.700 4.000 5.377 5.246 Total Vote Budget 10.658 14.007 4.889 11.849 13.799 15.859 18.226 18.226 Excluding Arrears 1478 Institutional Support to Mbale Regional 1.058 1.058 0.262 0.000 0.000 0.000 0.000 0.000 Hospital 1580 Retooling of Mbale Regional Referral 0.000 0.000 0.000 0.200 0.000 0.760 1.750 1.881 VI. Budget By Economic Clasification Hospital Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total for the Vote 10.664 14.548 5.431 11.990 13.799 15.859 18.226 18.226 Total Excluding Arrears 10.658 14.007 4.889 11.849 13.799 15.859 18.226 18.226 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total VIII. Programme Performance and Medium Term Plans Output Class : Outputs Provided 10.949 0.000 0.000 10.949 11.099 0.000 11.099 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) 211 Wages and Salaries 7.025 0.000 0.000 7.025 7.027 0.000 7.027

212 Social Contributions 0.986 0.000 0.000 0.986 1.127 0.000 1.127 Programme : 56 Regional Referral Hospital Services

213 Other Employee Costs 0.923 0.000 0.000 0.923 0.952 0.000 0.952 Programme Objective To enhance accessibility to quality health services in the region. : 221 General Expenses 0.319 0.000 0.000 0.319 0.314 0.000 0.314 Responsible Officer: Hospital Director, DR. EMMANUEL TUGAINEYO ITUUZA 222 Communications 0.025 0.000 0.000 0.025 0.029 0.000 0.029 Programme Outcome: Quality and accessible health services 223 Utility and Property Expenses 0.779 0.000 0.000 0.779 0.780 0.000 0.780 Sector Outcomes contributed to by the Programme Outcome 224 Supplies and Services 0.326 0.000 0.000 0.326 0.284 0.000 0.284 1. Improved quality of life at all levels 225 Professional Services 0.010 0.000 0.000 0.010 0.010 0.000 0.010 Performance Targets 227 Travel and Transport 0.248 0.000 0.000 0.248 0.233 0.000 0.233 Outcome Indicators 2020/21 2021/22 2022/23 228 Maintenance 0.308 0.000 0.000 0.308 0.343 0.000 0.343 Baseline Base year Target Projection Projection 273 Employer social benefits 0.000 0.000 0.000 0.000 0.001 0.000 0.001 • % increase of specialised clinic outpatients attendances 5% 2019 10% 10% 10% Output Class : Capital Purchases 3.058 0.000 0.000 3.058 0.750 0.000 0.750

154 155 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital

• % increase of diagnostic investigations carried 63000 2019 10% 15% 18%

• Bed occupancy rate 85% 2019 85% 85% 85%

SubProgramme: 01 Mbale Referral Hospital Services Output: 01 inpatients services No. of in-patients (Admissions) 52,000 52,000 52,000

Average Length of Stay (ALOS) - days 3 3 3

Bed Occupancy Rate (BOR) 85 85 85

Number of Major Operations (including Ceasarian se 16,000 16,000 16,000

Output: 02 Outpatient services No. of general outpatients attended to 88,000 88,000 88,000

No. of specialised outpatients attended to 22,000 88,000 22,000

Referral cases in 1,000 1,000 1,000

Output: 04 Diagnostic services No. of laboratory tests carried out 150,000 150,000 150,000

No. of patient xrays (imaging) taken 8,000 8,000 8,000

Number of Ultra Sound Scans 8,000 8,000 8,000

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 salaries salaries Salaries paid by paid by paid by 28th of 28th of 28th of every every every month month month Timely submission of quarterly financial/activity prepare and prepare and prepare and submit 4 submit 4 submit 4 quarterly quarterly quarterly reports reports reports Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 5,600 5,600 5,600

No. of children immunised (All immunizations) 14,000 14,000 1,400

No. of family planning users attended to (New and Old) 1,600 1,600 1,600

Number of ANC Visits (All visits) 48,800 48,800 48,800

Percentage of HIV positive pregnant women not on H 5% 5% 5%

Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 33,220 33,220 33,220

156 157 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital Vote:170 Mbale Referral Hospital

• % increase of diagnostic investigations carried 63000 2019 10% 15% 18% SubProgramme: 1004 Mbale Rehabilitation Referral Hospital

• Bed occupancy rate 85% 2019 85% 85% 85% Output: 83 OPD and other ward construction and rehabilitation No. of OPD wards constructed .55 2 4 SubProgramme: 01 Mbale Referral Hospital Services Output: 01 inpatients services No. of OPD wards rehabilitated 3 2 No. of in-patients (Admissions) 52,000 52,000 52,000 No. of other wards constructed 1 1 1

Average Length of Stay (ALOS) - days 3 3 3 Cerificates of progress/ Completion 1 1 1

Bed Occupancy Rate (BOR) 85 85 85 SubProgramme: 1580 Retooling of Mbale Regional Referral Hospital

Number of Major Operations (including Ceasarian se 16,000 16,000 16,000 Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .2 .75 2 Output: 02 Outpatient services No. of general outpatients attended to 88,000 88,000 88,000 IX. Major Capital Investments And Changes In Resource Allocation No. of specialised outpatients attended to 22,000 88,000 22,000 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Referral cases in 1,000 1,000 1,000 FY 2019/20 FY 2020/21 Output: 04 Diagnostic services Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned No. of laboratory tests carried out 150,000 150,000 150,000 end Dec Outputs No. of patient xrays (imaging) taken 8,000 8,000 8,000 Vote 170 Mbale Referral Hospital Program : 08 56 Regional Referral Hospital Services Number of Ultra Sound Scans 8,000 8,000 8,000 Development Project : 1004 Mbale Rehabilitation Referral Hospital Output: 05 Hospital Management and support services Output: 08 56 83 OPD and other ward construction and rehabilitation Assets register updated on a quarterly basis 4 4 4 2nd floor suspended slab done. flame for columns done. Adverts run, bids sold, and bid evaluation done Second (2nd) level of the surgical complex cast Timely payment of salaries and pensions by the 2 salaries salaries Salaries Casting for third floor slab done paid by paid by paid by Total Output Cost(Ushs Thousand) 2,000,000 0 550,000 28th of 28th of 28th of every every every Gou Dev’t: 2,000,000 0 550,000 month month month Timely submission of quarterly financial/activity prepare and prepare and prepare and Ext Fin: 0 0 0 submit 4 submit 4 submit 4 quarterly quarterly quarterly A.I.A: 0 0 0 reports reports reports Output: 06 Prevention and rehabilitation services X. Vote Challenges and Plans To Improve Performance No. of antenatal cases (All attendances) 5,600 5,600 5,600 Vote Challenges No. of children immunised (All immunizations) 14,000 14,000 1,400 In adequate supply of drugs and sundries for ever increasing number of patients. Lack of an Ambulance, High maintenance of very No. of family planning users attended to (New and Old) 1,600 1,600 1,600 old infrastructure, insufficient funds allocated for construction of the surgical complex Insufficient number of human resource personnel not commensurate with the workload. Insufficient number of specialists cadres. Number of ANC Visits (All visits) 48,800 48,800 48,800 Insufficient funds for Gratuity and Pensions. Percentage of HIV positive pregnant women not on H 5% 5% 5%

Output: 07 Immunisation Services Plans to improve Vote Performance Number of Childhood Vaccinations given (All contac 33,220 33,220 33,220 Increase integrated medical community Outreaches, and increase support supervision to the lower heath centers

XI Off Budget Support

156 157 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 1.18 Recurrent Budget Estimates 01 Mbale Referral Hospital Services 0.00 1.18 451-Global Alliance for Vaccines Immunisation 0.00 0.28

Result based financing 0.00 0.90

Total for Vote 0.00 1.18

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To encourage all clients who come to the hospital to be tested on HIV/Aids Issue of Concern : : Increased cases of new HIV infections Planned Interventions : Proper patient care for opportunistic infections, early diagnosis, HIV counseling and testing, Antiviral treatment, eMTCT, post-exposure prophylaxis. Health education of HIV/AID both in the hospital and community.

Budget Allocation (Billion) : 0.060 Performance Indicators: Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% of HIV+ put in care and 90% Viral suppression.100% of HIV+ Mothers enrolled in Care and % of HIV+ clients enrolled on ART. No. of clients done HCT.

Issue Type: Gender

Objective : To encourage male involvement in ANC and family planning clinics. This shall be done through radio talks, church leaders and political leaders Issue of Concern : To encourage male involvement in maternal child health services Planned Interventions : To use radio talks, political and church leaders Budget Allocation (Billion) : 0.050 Performance Indicators: Increased percentage in couple attendances Issue Type: Enviroment

Objective : To improve on waste management with in and around the hospital Issue of Concern : To have clean and safe working hospital Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, occupational health and safety activities, tree planting on the compound, sewerage management and good waste disposal.

Budget Allocation (Billion) : 0.050

158 159 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital Vote:170 Mbale Referral Hospital

Table 11.1 Off-Budget Support by Sub-Programme Performance Indicators: 12 Support Supervision to unit/wards, Number of Monthly Meetings, Regular cleaning of compounds, timely payment for utilities. Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 1.18 XIII. Personnel Information Recurrent Budget Estimates Table 13.1 Staff Establishment Analysis 01 Mbale Referral Hospital Services 0.00 1.18 451-Global Alliance for Vaccines Immunisation 0.00 0.28 Title Salary Scale Number Of Approved Positions Number Of Filled Positions

Result based financing 0.00 0.90 Consultant (Anaesthesia) U1SE 1 0

Total for Vote 0.00 1.18 Consultant (Medicine) U1SE 1 0 Consultant (Obs. & Gyn) U1SE 1 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues Medical Officer Special Grade U2(Med-1) 1 0 Table 12.1: Cross- Cutting Policy Issues (Medicine) Pharmacist U4(Med-1) 2 0 Issue Type: HIV/AIDS ACCOUNTANT U4U 1 0 Objective : To encourage all clients who come to the hospital to be tested on HIV/Aids Medical Officer U4U 26 18 Issue of Concern : : Increased cases of new HIV infections LABARATORY U5(SC) 2 0 Planned Interventions : Proper patient care for opportunistic infections, early diagnosis, HIV counseling and testing, TECHNOLOGIST Antiviral treatment, eMTCT, post-exposure prophylaxis. Health education of HIV/AID both in the Medical Records Assistant U7 7 3 hospital and community. Askari U8L 15 10 Budget Allocation (Billion) : 0.060 Dhobi U8L 10 5 Performance Indicators: Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% Office Attendant U8L 3 0 of HIV+ put in care and 90% Viral suppression.100% of HIV+ Mothers enrolled in Care and % of HIV+ clients enrolled on ART. No. of clients done HCT. Driver U8U 8 5 Plumber U8U 1 0 Issue Type: Gender Table 13.2 Staff Recruitment Plan Objective : To encourage male involvement in ANC and family planning clinics. This shall be done through radio talks, church leaders and political leaders Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Issue of Concern : To encourage male involvement in maternal child health services Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Planned Interventions : To use radio talks, political and church leaders FY2020/21 Budget Allocation (Billion) : 0.050 LABARATORY U5(SC) 2 0 2 2 2,400,000 28,800,000 TECHNOLOGIST Performance Indicators: Increased percentage in couple attendances ACCOUNTANT U4U 1 0 1 1 940,366 11,284,392 Issue Type: Enviroment Askari U8L 15 10 5 4 855,328 10,263,936 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Objective : To improve on waste management with in and around the hospital Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 Issue of Concern : To have clean and safe working hospital Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Dhobi U8L 10 5 5 5 1,069,160 12,829,920 Planned Interventions : Provision of safe and clean water, Provision of power in the hospital, 5S enforcement, occupational health and safety activities, tree planting on the compound, sewerage management Driver U8U 8 5 3 2 474,138 5,689,656 and good waste disposal. Medical Officer U4U 26 18 8 3 39,600,000 475,200,000 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Budget Allocation (Billion) : 0.050 (Medicine) Medical Records Assistant U7 7 3 4 4 1,843,472 22,121,664

158 159 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital

Office Attendant U8L 3 0 3 2 427,664 5,131,968 Pharmacist U4(Med-1) 2 0 2 1 3,000,000 36,000,000 Plumber U8U 1 0 1 1 237,069 2,844,828 Total 79 41 38 29 67,197,197 806,366,364

160 161 Mbale Referral Hospital Ministerial Policy Statement FY 2020/21 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:170 Mbale Referral Hospital Vote:171 Soroti Referral Hospital

Office Attendant U8L 3 0 3 2 427,664 5,131,968 V1: Vote Overview Pharmacist U4(Med-1) 2 0 2 1 3,000,000 36,000,000 Plumber U8U 1 0 1 1 237,069 2,844,828 I. Vote Mission Statement Total 79 41 38 29 67,197,197 806,366,364 To increase access to all people in the Teso sub -region to quality general and specialized health services.

II. Strategic Objective 1. To improve the quality and safety of hospital care 2. To contribute to scaling up critical Health Sector Development Plan (HSDP) interventions 3. To strengthen research activities 4. Strengthen training of health workers 5. To strengthen collaboration with other hospitals and provide the support supervision to lower level health facilities in the Teso Region 6. To improve effectiveness and efficiency of hospital services 7. To strengthen hospital partnerships III. Major Achievements in 2019/20 I. OUTPUT 01:INPATIENTS. 12,809 Inpatients of planned half year 12500. 2063 Deliveries of planned half year 2250. 1575 Major surgeries of planned half year 1750. 102.65 % BOR of planned 100% BOR. 4.35 ALOS of planned 5 ALOS. II. OUTPUT 02:OUTPATIENTS 24690 General outpatients of planned half year 42,500. 990 Surgical outpatients of planned half year 1,200. 346 Paediatrics outpatients of planned half year 1,500. 582 Gynae outpatients of planned half year 1,100. 4888 Eye outpatients of planned half year 4,700. 2929 ENT outpatients of planned half year 2,250. 423 Dental outpatients planned half year 1,250. 835 Orthopaedic outpatients of planned half year 1750. III. OUTPUT 03:MEDICINES AND HEALTH SUPPLIES PROCURED AND DISPERSED 0.474 worth of medicines procured planned half year 0.6 worth of medicines. IV. OUTPUT 4: DIAGNOSTICS. 69771 Lab Test performed of planned half year 125,000. 1887 Blood transfusion done of planned half year 1,500. 804 U/S scans done of planned half year 5,000. 345 Xray performed of planned half year 5,000. 320 police forms performed of planned half year 250 police forms. 13 Postmortem forms performed 25 postmortems. V. OUTPUT 5:HOSPITAL MANAGEMENT AND SUPPORT SERVICES Payment of salaries, pension, gratuity and allowance done. Staff appraisal performed. 2 Audit Reports completed and reported. Regional maintenance of health centers equipment in the 9 districts and regional hospital done. Indoor and outdoor waste management and cleaning done. VI. OUTPUT 6:PREVENTION AND REHABILITATION SERVICES. 1697 Physiotherapy cases handled of planned half year 1500. 2461 ANC services provided of planned half year 3000,. 1615 Family planning services provided of planned half year 10,500. 4542 mothers and child immunization performed of planned half year 14000. VII. OUTPUT 7:IMMUNIZATION Screening and vaccination of mothers and children done

160 161 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital

IV. Medium Term Plans 1. Construction of Surgical/Maternal complex 20 Billion. Soroti R.R.H has not yet benefited from expansion of wards, OPD, laboratory etc. 2. Improve on the pharmacy space through construction of new buildings. Severe crowding severely impacts negatively on the quality of care. 3. Acquisition of Land for expansion since hospital is going to serve as a teaching hospital hence a better environment is essential. 4. Expand the existing wards in order to improve on working environment and accommodate modern equipment. 5. Reduced Utility Bills by installation of solar lighting systems.

162 163 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital Vote:171 Soroti Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations IV. Medium Term Plans Table 5.1: Overview of Vote Expenditures (UShs Billion) 1. Construction of Surgical/Maternal complex 20 Billion. Soroti R.R.H has not yet benefited from expansion of wards, OPD, 2019/20 MTEF Budget Projections laboratory etc. 2. Improve on the pharmacy space through construction of new buildings. Severe crowding severely impacts negatively on the 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 quality of care. Outturn Budget by End Dec Wage 4.226 4.579 1.705 4.579 4.579 4.579 4.579 4.579 3. Acquisition of Land for expansion since hospital is going to serve as a teaching hospital hence a better environment is Recurrent essential. 2.338 2.719 1.085 2.245 2.245 2.245 2.245 2.245 4. Expand the existing wards in order to improve on working environment and accommodate modern equipment. Non Wage 5. Reduced Utility Bills by installation of solar lighting systems. GoU 1.488 1.138 0.095 0.200 0.200 1.550 2.227 2.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.051 8.435 2.885 7.024 7.024 8.374 9.051 9.051 Total GoU+Ext Fin (MTEF) 8.051 8.435 2.885 7.024 7.024 8.374 9.051 9.051 Arrears 0.052 0.000 0.000 0.318 0.000 0.000 0.000 0.000 Total Budget 8.104 8.435 2.885 7.342 7.024 8.374 9.051 9.051 A.I.A Total 0.054 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.157 8.435 2.885 7.342 7.024 8.374 9.051 9.051 Total Vote Budget 8.105 8.435 2.885 7.024 7.024 8.374 9.051 9.051 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.297 0.000 0.000 7.297 6.824 0.000 6.824

211 Wages and Salaries 4.671 0.000 0.000 4.671 4.698 0.000 4.698

212 Social Contributions 0.549 0.000 0.000 0.549 0.616 0.000 0.616

213 Other Employee Costs 0.745 0.000 0.000 0.745 0.210 0.000 0.210

221 General Expenses 0.163 0.000 0.000 0.163 0.192 0.000 0.192

222 Communications 0.011 0.000 0.000 0.011 0.014 0.000 0.014

223 Utility and Property Expenses 0.570 0.000 0.000 0.570 0.472 0.000 0.472

224 Supplies and Services 0.172 0.000 0.000 0.172 0.182 0.000 0.182

227 Travel and Transport 0.224 0.000 0.000 0.224 0.265 0.000 0.265

228 Maintenance 0.191 0.000 0.000 0.191 0.175 0.000 0.175

282 Miscellaneous Other Expenses 0.002 0.000 0.000 0.002 0.000 0.000 0.000

Output Class : Capital Purchases 1.138 0.000 0.000 1.138 0.200 0.000 0.200

312 FIXED ASSETS 1.138 0.000 0.000 1.138 0.200 0.000 0.200

162 163 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital

Output Class : Arrears 0.000 0.000 0.000 0.000 0.318 0.000 0.318

321 DOMESTIC 0.000 0.000 0.000 0.000 0.318 0.000 0.318

Grand Total : 8.435 0.000 0.000 8.435 7.342 0.000 7.342

Total excluding Arrears 8.435 0.000 0.000 8.435 7.024 0.000 7.024

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Soroti Referral Hospital Services 6.523 7.151 2.723 6.989 6.671 6.671 6.671 6.671

02 Soroti Referral Hospital Internal Audit 0.005 0.005 0.002 0.012 0.012 0.012 0.012 0.012

03 Soroti Regional Maintenance 0.141 0.141 0.065 0.141 0.141 0.141 0.141 0.141

1004 Soroti Rehabilitation Referral Hospital 0.738 0.708 0.076 0.000 0.000 0.000 0.000 0.000

1471 Institutional Support to Soroti Regional 0.750 0.430 0.018 0.000 0.000 0.000 0.000 0.000 Referral Hospital 1587 Retooling of Soroti Regional Referral 0.000 0.000 0.000 0.200 0.200 1.550 2.227 2.227 Hospital Total for the Vote 8.157 8.435 2.885 7.342 7.024 8.374 9.051 9.051

Total Excluding Arrears 8.105 8.435 2.885 7.024 7.024 8.374 9.051 9.051

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To provide specialized and general health care to all people in the Teso sub region. : To conduct training of health workers, research and support supervision to districts and lower level health facilities in the region.

To improve quality and safety of hospital services, to contribute to scaling up of critical HSDP interventions.

To strengthen hospital partnerships with other hospitals and agencies. Responsible Officer: Dr. Mwanga Michael Programme Outcome: quality and accessible regional health services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets

164 165 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital Vote:171 Soroti Referral Hospital

Output Class : Arrears 0.000 0.000 0.000 0.000 0.318 0.000 0.318 Outcome Indicators 2020/21 2021/22 2022/23 321 DOMESTIC 0.000 0.000 0.000 0.000 0.318 0.000 0.318 Baseline Base year Target Projection Projection

Grand Total : 8.435 0.000 0.000 8.435 7.342 0.000 7.342 • % increase of specialised clinic outpatients attendances 8000 2019 8% 10% 12% Total excluding Arrears 8.435 0.000 0.000 8.435 7.024 0.000 7.024 • % increase of diagnostic investigations carried 100000 2019 10% 15% 20%

VII. Budget By Programme And Subprogramme • Bed occupancy rate 84% 2019 93% 93% 93%

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme SubProgramme: 01 Soroti Referral Hospital Services Output: 01 Inpatient services Billion Uganda shillings FY 2019/20 Medium Term Projections No. of in-patients (Admissions) 30,000 32,000 34,000 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Average Length of Stay (ALOS) - days 5 5 5 Budget 56 Regional Referral Hospital Services 8.157 8.435 2.885 7.342 7.024 8.374 9.051 9.051 Bed Occupancy Rate (BOR) 98% 99% 100% 01 Soroti Referral Hospital Services 6.523 7.151 2.723 6.989 6.671 6.671 6.671 6.671 Number of Major Operations (including Ceasarian section) 3,500 3,700 3,900

02 Soroti Referral Hospital Internal Audit 0.005 0.005 0.002 0.012 0.012 0.012 0.012 0.012 Output: 02 Outpatient services 03 Soroti Regional Maintenance 0.141 0.141 0.065 0.141 0.141 0.141 0.141 0.141 Total general outpatients attendance 65,000 70,000 75,000 1004 Soroti Rehabilitation Referral Hospital 0.738 0.708 0.076 0.000 0.000 0.000 0.000 0.000 No. of specialised clinics attendances 18,000 20,000 22,000 1471 Institutional Support to Soroti Regional 0.750 0.430 0.018 0.000 0.000 0.000 0.000 0.000 Referral Hospital Referral cases in 600 800 1,000 1587 Retooling of Soroti Regional Referral 0.000 0.000 0.000 0.200 0.200 1.550 2.227 2.227 Hospital Output: 03 Medicines and health supplies procured and dispensed Total for the Vote 8.157 8.435 2.885 7.342 7.024 8.374 9.051 9.051 Value of medicines received/dispensed (Ush bn) 1.2 1.2 1.2

Total Excluding Arrears 8.105 8.435 2.885 7.024 7.024 8.374 9.051 9.051 Output: 04 Diagnostic services No. of laboratory tests carried out 160,000 165,000 170,000 VIII. Programme Performance and Medium Term Plans No. of patient xrays (imaging) taken 3,000 3,500 4,000 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) No. of Ultra Sound Scans 1,000 2,000 3,000 Programme : 56 Regional Referral Hospital Services Output: 05 Hospital Management and support services Programme Objective To provide specialized and general health care to all people in the Teso sub region. : Quarterly financial reports submitted timely By 28th day By 28th By 28th day of the First day of the of the first To conduct training of health workers, research and support supervision to districts and lower level health month First month month facilities in the region. proceeding proceeding proceeding the the Quarter the Quarter To improve quality and safety of hospital services, to contribute to scaling up of critical HSDP Quarter interventions. Output: 06 Prevention and rehabilitation services

To strengthen hospital partnerships with other hospitals and agencies. Percentage of HIV positive pregnant women not on HAART initiated on ARVs 0% 0% 0% Responsible Officer: Dr. Mwanga Michael Output: 07 Immunisation Services Programme Outcome: quality and accessible regional health services No. of Childhood immunized (All immunizations) 10,000 12,000 14,000 Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets

164 165 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital

Output: 19 Human Resource Management Services Timely payment of salaries and pensions by the 2 Payments Payments of Payments of of salary salary and salary and and pensions by pensions by pensions by 28th of the 28th of the 28th of the calender Calender calender Month Month Month SubProgramme: 02 Soroti Referral Hospital Internal Audit Output: 05 Hospital Management and support services Quarterly financial reports submitted timely Yes Yes Yes

SubProgramme: 03 Soroti Regional Maintenance Output: 05 Hospital Management and support services Quarterly financial reports submitted timely Yes Yes Yes

SubProgramme: 1004 Soroti Rehabilitation Referral Hospital Output: 83 OPD and other ward construction and rehabilitation No. of OPD wards rehabilitated 1 2 2

No. of other wards rehabilitated 1 1 2

SubProgramme: 1587 Retooling of Soroti Regional Referral Hospital Output: 83 OPD and other ward construction and rehabilitation No. of OPD wards rehabilitated 1 1

No. of other wards rehabilitated 1 1 2

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Lack of Adequate Work space. 2. Limited number of specialized medical workforce. 3. Limited funding for capital development in priority area such infrastructure development, better well equipped wards, Accident, trauma and emergency care including intensive care units. 4. Challenges in disposal of non medical waste generated because hospital lacks dumping trucks. 5. High cost of utilities e.g power, water

Plans to improve Vote Performance

1. Re-metering of staff quarters to reduce on utility budget. 2. Construction of surgical /maternal complex. 3. Lobbying for funds to improve on waste management through purchase of incinerator.

166 167 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital Vote:171 Soroti Referral Hospital

Output: 19 Human Resource Management Services 4. Use of power saving gadgets such as solar lighting. Timely payment of salaries and pensions by the 2 Payments Payments of Payments of of salary salary and salary and and pensions by pensions by XI Off Budget Support pensions by 28th of the 28th of the 28th of the calender Calender Table 11.1 Off-Budget Support by Sub-Programme calender Month Month Month Billion Uganda Shillings 2019/20 Approved 2020/21 Draft SubProgramme: 02 Soroti Referral Hospital Internal Audit Budget Estimates Output: 05 Hospital Management and support services Programme 0856 Regional Referral Hospital Services 0.00 1.41 Recurrent Budget Estimates Quarterly financial reports submitted timely Yes Yes Yes 01 Soroti Referral Hospital Services 0.00 1.41 SubProgramme: 03 Soroti Regional Maintenance 451-Global Alliance for Vaccines Immunisation 0.00 0.28

Output: 05 Hospital Management and support services RBF 0.00 1.14 Yes Yes Yes Quarterly financial reports submitted timely Total for Vote 0.00 1.41

SubProgramme: 1004 Soroti Rehabilitation Referral Hospital XII. Vote Cross Cutting Policy And Other Budgetary Issues Output: 83 OPD and other ward construction and rehabilitation Table 12.1: Cross- Cutting Policy Issues No. of OPD wards rehabilitated 1 2 2 Issue Type: HIV/AIDS No. of other wards rehabilitated 1 1 2 Objective : scaling up HIV treatment and access SubProgramme: 1587 Retooling of Soroti Regional Referral Hospital and reducing new HIV infection to 0% Output: 83 OPD and other ward construction and rehabilitation Issue of Concern : prevention of Mother to child transmission of HIV. No. of OPD wards rehabilitated 1 1 Reducing number of new infection to 0%. Provision of medicine and treatment for persons living with HIV. No. of other wards rehabilitated 1 1 2 Planned Interventions : Radio talk shows. Health Education ,counselling,treatment. Outreaches and follow up IX. Major Capital Investments And Changes In Resource Allocation Budget Allocation (Billion) : 0.005 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Performance Indicators: Number of patients enrolled on care. Number of newly born HIV free from HIV positive mothers. N/A Number of radio talk shows held Issue Type: Gender X. Vote Challenges and Plans To Improve Performance Objective : Improving the social status of people in society such as males and females,persons with Vote Challenges disability,the Elderly,Adolescent and infants among others through aligning plans and budgets to 1. Lack of Adequate Work space. meet the needs of the various categories. 2. Limited number of specialized medical workforce. Fair and just allocation of resources to meet the needs of females and males,persons with 3. Limited funding for capital development in priority area such infrastructure development, better well equipped wards, Accident, disabilities,the Elderly,adolescent and infantsthrough providing services that address maternal trauma and emergency care including intensive care units. services,adolescent friendly clinics,access to access ways for disabilities and drugs 4. Challenges in disposal of non medical waste generated because hospital lacks dumping trucks. Issue of Concern : Gender equal opportunity to work. 5. High cost of utilities e.g power, water Proper facility Access facility and friendly restrooms Planned Interventions : providing access ways for persons with disabilities. Immunization action for infants. Plans to improve Vote Performance health education and treatments. provision of medicines to elderly. 1. Re-metering of staff quarters to reduce on utility budget. antenatal clinics for pregnant mothers 2. Construction of surgical /maternal complex. 3. Lobbying for funds to improve on waste management through purchase of incinerator. Budget Allocation (Billion) : 0.005

166 167 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital

Performance Indicators: Number of infants immunized. Access facilities like ramps. Record Health education sessions conducted. Issue Type: Enviroment

Objective : Waste management Proper waste management and disposal with preventive methodology against occupational hazards Issue of Concern : Poor waste management because of lack of incinerator. Planned Interventions : Construct and install an incinerator. Provide skipper bin for collection of non medical waste. Budget Allocation (Billion) : 0.005 Performance Indicators: Functional Incinerator. waste bin availble XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Hospital Director U1S 1 0 Medical Officer Special Grade U2(Med-1) 1 0 (Paediatrics) Medical Officer Special Grade U2(Med-1) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 (Psychiatry) Medical Officer Special Grade U2(Med-1) 1 0 (Surgeon) SEN PRINCIPAL NURSING U2(Med-2) 1 0 OFFICER PRINCIPAL HOSPITAL U2L 1 0 ADMINISTRATOR PRINCIPAL HUMAN RESOURCE U2L 1 0 OFFICER Medical Officer Special Grade U2U 1 0 (Opthamology) Principal Nursing Officer U3(Med-2) 1 0 HOSPITAL ADMINISTRATOR U4L 1 0 Medical Officer U4U 5 3 Clinical Officer U5(SC) 3 3 ASSISTANT RECORDS OFFICER U5L 2 1 Stenographer Secretary U5L 1 0

168 169 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21 Soroti Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:171 Soroti Referral Hospital Vote:171 Soroti Referral Hospital

Performance Indicators: Number of infants immunized. Table 13.2 Staff Recruitment Plan Access facilities like ramps. Record Health education sessions conducted. Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Issue Type: Enviroment Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Objective : Waste management FY2020/21 Proper waste management and disposal with preventive methodology against occupational hazards ASSISTANT RECORDS U5L 2 1 1 1 479,759 5,757,108 OFFICER Issue of Concern : Poor waste management because of lack of incinerator. HOSPITAL ADMINISTRATOR U4L 1 0 1 1 601,341 7,216,092 Planned Interventions : Construct and install an incinerator. Hospital Director U1S 1 0 1 1 4,800,000 57,600,000 Provide skipper bin for collection of non medical waste. Medical Officer U4U 5 3 2 2 26,400,000 316,800,000 Budget Allocation (Billion) : 0.005 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics) Performance Indicators: Functional Incinerator. waste bin availble Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (ENT) XIII. Personnel Information Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Table 13.1 Staff Establishment Analysis (Psychiatry) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Title Salary Scale Number Of Approved Positions Number Of Filled Positions (Surgeon) Hospital Director U1S 1 0 PRINCIPAL HOSPITAL U2L 1 0 1 1 1,291,880 15,502,560 ADMINISTRATOR Medical Officer Special Grade U2(Med-1) 1 0 PRINCIPAL HUMAN U2L 1 0 1 1 1,291,880 15,502,560 (Paediatrics) RESOURCE OFFICER Medical Officer Special Grade U2(Med-1) 1 0 Principal Nursing Officer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 (ENT) SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 Medical Officer Special Grade U2(Med-1) 1 0 OFFICER (Medicine) Stenographer Secretary U5L 1 0 1 1 479,759 5,757,108 Medical Officer Special Grade U2(Med-1) 1 0 Total 19 4 15 15 60,694,619 728,335,428 (Psychiatry) Medical Officer Special Grade U2(Med-1) 1 0 (Surgeon) SEN PRINCIPAL NURSING U2(Med-2) 1 0 OFFICER PRINCIPAL HOSPITAL U2L 1 0 ADMINISTRATOR PRINCIPAL HUMAN RESOURCE U2L 1 0 OFFICER Medical Officer Special Grade U2U 1 0 (Opthamology) Principal Nursing Officer U3(Med-2) 1 0 HOSPITAL ADMINISTRATOR U4L 1 0 Medical Officer U4U 5 3 Clinical Officer U5(SC) 3 3 ASSISTANT RECORDS OFFICER U5L 2 1 Stenographer Secretary U5L 1 0

168 169 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide quality specialized Curative, Preventive, Promotional and Rehabilitative services to the population of Lango Sub- region in order to promote economic productivity

II. Strategic Objective 1. To provide holistic, cost effective and quality health services. 2. To attract, retain and develop human resources for delivery of quality health services. 3. To conduct training of health workers and students for better health. 4. To conduct operational and collaborative research 5. To strengthen community health and integrated multi-disciplinary support supervision to lower health units to enhance prevention and referral (for effective and efficient health ) 6. To strengthen leadership and governance for effective and efficient service delivery. III. Major Achievements in 2019/20 1. Inpatient services: 5388 admissions compared to the quarterly target of 4800; while 80.2 % Bed occupancy compared to the quarterly target of 85; Average Length of stay was 5.5 days compared to the target of 4 days; and 904 major operations were carried out compared to the quarterly target of 2481.

2. Outpatient services: 249 referrals in; 35,594 specialized outpatients compared to the quarterly target of 54,075; while 26,077 general outpatients were seen compared to the quarterly target of 7030 patients.

3. Medicines and related supplies: Drugs worth UGX 229,648,550 during the quarter but deliveries worth UGX 198,909,168.41 were made. To note is that a list of non-communicable diseases medicines such as insulin mixtard human, metformin and glibenclamide for diabetes and pyrimethamine 25mg+sulfadoxine for malaria in pregnant women, phenytoin sodium and phenobarbital for mental health, nifedipine retard and bendrofluazide for hypertension. This provided a major relief on the already strained budget.

4. Diagnostic services: 1323 X-rays conducted compared to the quarterly target of 1309; Ultrasound contacts were 1801 compared to the quarterly target of 1663; while Laboratory contacts were 49,817 compared to the quarterly target of 36, 689; Blood Transfusions done were 1166.

5. Management and support services achieved what had planned for example Inside Cleaning undertaken for three months at UGX 10,890,225; Compound Cleaning undertaken at UGX 16,311,414; Food Supplied to TB Unit at UGX 4,447,000; Maintenance and Repair of Motor Vehicles Of ambulance at UGX 5,122,000; Non-medical stationery procured at UGX 10,080,200; Guarding Services paid for at a cost of UGX 1,350,00/=; Uniforms and protective wear worth UGX 2,975,000/=; Submitted financial, and activity reports.

6. Prevention: 1386 ANC contacts realized compared to the quarterly target 3640; HIV/AIDS positive mothers enrolled on ART on quarterly basis were 22 tested and 22 (100) %; Family planning contacts were 421compared to the quarterly target of 59.

7. Immunization: 5,526 immunizations done compared to the target of 5,479 immunizations contacts

8. Human resource services: 298 staff paid in July, 282 in August, 280 in September; 93 pensioners were paid; several staff were facilitated to attend trainings /workshop and staff welfare (medical expenses, incapacity, death ) provided and taken care of.

9. Records management services: 3 DHIS reports were filled on a monthly basis and submitted, Stationery for all departments procured and distributed.

10. Internal audit services: Continued with value for money audit as well and verification of goods, works and services

11. Regional workshop: continued with both routine and preventive maintenance, user training, as well refresher courses for

170 171 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

V1: Vote Overview technicians, for The workshop was able to maintain 80% of medical equipment in the entire region in condition “A”; while 95 equipment were I. Vote Mission Statement serviced/repaired to full functional status A; Medical equipment spares/worth UGX 13,613,880/= were procured; 16 Health workers (anesthetists and theater assistants) were trained at a cost of UGX 2,448,000/=; One workshop performance report for To provide quality specialized Curative, Preventive, Promotional and Rehabilitative services to the population of Lango Sub- 1st quarter was presented at a regional workshop meeting. region in order to promote economic productivity 12.PROJECTS: Infrastructure development:

II. Strategic Objective i.Staff hostel: The staff hostel suffered a major set back by 2 months, but the contractor was able to continue with the Steel and form works for Columns, staircase to the 3rd floor. 1. To provide holistic, cost effective and quality health services. 2. To attract, retain and develop human resources for delivery of quality health services. 3. To conduct training of health workers and students for better health. 4. To conduct operational and ii. JICA Project: Site clearance and mobilization was done; renovations Contractor procured by JICA, Ground breaking collaborative research 5. To strengthen community health and integrated multi-disciplinary support supervision to lower health undertaken, Mobilization and final site clearance and Hoarding was done, Renovation of site offices, workers houses and stores units to enhance prevention and referral (for effective and efficient health ) 6. To strengthen leadership and governance for and Excavation and construction of OPD building. effective and efficient service delivery. Retooling III. Major Achievements in 2019/20 i.Procured 100 patient mattresses. ii. Procured 100 litre autoclave for theater 1. Inpatient services: 5388 admissions compared to the quarterly target of 4800; while 80.2 % Bed occupancy compared to the ii. Procured extra compound solar lights quarterly target of 85; Average Length of stay was 5.5 days compared to the target of 4 days; and 904 major operations were carried out compared to the quarterly target of 2481. IV. Medium Term Plans 2. Outpatient services: 249 referrals in; 35,594 specialized outpatients compared to the quarterly target of 54,075; while 26,077 general outpatients were seen compared to the quarterly target of 7030 patients. 1.Review the master plan that guides the operations of the entity in the medium term;

3. Medicines and related supplies: Drugs worth UGX 229,648,550 during the quarter but deliveries worth UGX 198,909,168.41 2.Lobby for specialists and Continue to attract, retain and develop health workers in order to fulfill the mandate of the entity; were made. To note is that a list of non-communicable diseases medicines such as insulin mixtard human, metformin and glibenclamide for diabetes and pyrimethamine 25mg+sulfadoxine for malaria in pregnant women, phenytoin sodium and 3.Liaise with stakeholders for the rehabilitation and renovation of wards specifically maternity and pediatric complex. phenobarbital for mental health, nifedipine retard and bendrofluazide for hypertension. This provided a major relief on the already strained budget. 4. Install electronic medical records system to secure and utilize data for improved service delivery.

7. Immunization: 5,526 immunizations done compared to the target of 5,479 immunizations contacts

9. Records management services: 3 DHIS reports were filled on a monthly basis and submitted, Stationery for all departments procured and distributed.

10. Internal audit services: Continued with value for money audit as well and verification of goods, works and services

11. Regional workshop: continued with both routine and preventive maintenance, user training, as well refresher courses for

170 171 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 4.442 5.199 2.114 5.199 5.199 5.199 5.199 5.199 Recurrent Non Wage 2.180 2.669 1.261 5.342 5.342 5.342 5.342 5.342 GoU 1.455 1.488 0.435 2.515 0.200 0.200 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.078 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Total GoU+Ext Fin (MTEF) 8.078 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Arrears 0.054 0.203 0.160 0.078 0.000 0.000 0.000 0.000 Total Budget 8.132 9.559 3.969 13.135 10.741 10.741 10.768 10.768 A.I.A Total 0.050 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.182 9.559 3.969 13.135 10.741 10.741 10.768 10.768 Total Vote Budget 8.128 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.868 0.000 0.000 7.868 10.541 0.000 10.541

211 Wages and Salaries 5.348 0.000 0.000 5.348 5.369 0.000 5.369

212 Social Contributions 0.587 0.000 0.000 0.587 0.646 0.000 0.646

213 Other Employee Costs 0.670 0.000 0.000 0.670 3.284 0.000 3.284

221 General Expenses 0.193 0.000 0.000 0.193 0.179 0.000 0.179

222 Communications 0.009 0.000 0.000 0.009 0.010 0.000 0.010

223 Utility and Property Expenses 0.588 0.000 0.000 0.588 0.605 0.000 0.605

224 Supplies and Services 0.157 0.000 0.000 0.157 0.152 0.000 0.152

225 Professional Services 0.012 0.000 0.000 0.012 0.004 0.000 0.004

226 Insurances and Licenses 0.006 0.000 0.000 0.006 0.006 0.000 0.006

227 Travel and Transport 0.191 0.000 0.000 0.191 0.176 0.000 0.176

228 Maintenance 0.107 0.000 0.000 0.107 0.111 0.000 0.111

Output Class : Capital Purchases 1.488 0.000 0.000 1.488 2.515 0.000 2.515

172 173 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

281 Property expenses other than interest 0.090 0.000 0.000 0.090 0.140 0.000 0.140 V. Summary of Past Performance and Medium Term Budget Allocations 312 FIXED ASSETS 1.398 0.000 0.000 1.398 2.375 0.000 2.375 Table 5.1: Overview of Vote Expenditures (UShs Billion) Output Class : Arrears 0.203 0.000 0.000 0.203 0.078 0.000 0.078

2019/20 MTEF Budget Projections 321 DOMESTIC 0.203 0.000 0.000 0.203 0.078 0.000 0.078 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Grand Total : 9.559 0.000 0.000 9.559 13.135 0.000 13.135 Outturn Budget by End Dec Wage 4.442 5.199 2.114 5.199 5.199 5.199 5.199 5.199 Total excluding Arrears 9.356 0.000 0.000 9.356 13.056 0.000 13.056 Recurrent 2.180 2.669 1.261 5.342 5.342 5.342 5.342 5.342 Non Wage VII. Budget By Programme And Subprogramme GoU 1.455 1.488 0.435 2.515 0.200 0.200 0.227 0.227 Devt. Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.078 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Billion Uganda shillings FY 2019/20 Medium Term Projections Total GoU+Ext Fin (MTEF) 8.078 9.356 3.809 13.056 10.741 10.741 10.768 10.768 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Arrears 0.054 0.203 0.160 0.078 0.000 0.000 0.000 0.000 Budget 56 Regional Referral Hospital Services 8.182 9.559 3.969 13.135 10.741 10.741 10.768 10.768 Total Budget 8.132 9.559 3.969 13.135 10.741 10.741 10.768 10.768 01 Lira Referral Hospital Services 6.584 7.923 3.467 10.472 10.394 10.403 10.403 10.403 A.I.A Total 0.050 0.000 0.000 0.000 0.000 0.000 0.000 0.000 02 Lira Referral Hospital Internal Audit 0.015 0.019 0.006 0.019 0.019 0.009 0.009 0.009 Grand Total 8.182 9.559 3.969 13.135 10.741 10.741 10.768 10.768 03 Lira Regional Maintenance 0.128 0.128 0.062 0.128 0.128 0.128 0.128 0.128 Total Vote Budget 8.128 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Excluding Arrears 1004 Lira Rehabilitation Referral Hospital 1.297 1.350 0.305 2.315 0.000 0.000 0.000 0.000 1477 Institutional Support to Lira Regional 0.158 0.138 0.130 0.000 0.000 0.000 0.000 0.000 VI. Budget By Economic Clasification Hospital 1583 Retooling of Lira Regional Hospital 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total for the Vote 8.182 9.559 3.969 13.135 10.741 10.741 10.768 10.768 2019/20 Approved Budget 2020/21 Draft Estimates Total Excluding Arrears 8.128 9.356 3.809 13.056 10.741 10.741 10.768 10.768 Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.868 0.000 0.000 7.868 10.541 0.000 10.541 VIII. Programme Performance and Medium Term Plans 211 Wages and Salaries 5.348 0.000 0.000 5.348 5.369 0.000 5.369 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) 212 Social Contributions 0.587 0.000 0.000 0.587 0.646 0.000 0.646 Programme : 56 Regional Referral Hospital Services 213 Other Employee Costs 0.670 0.000 0.000 0.670 3.284 0.000 3.284 Programme Objective Improvement in the total health of the people within Lango Sub Program in order to promote a productive 221 General Expenses 0.193 0.000 0.000 0.193 0.179 0.000 0.179 : population 222 Communications 0.009 0.000 0.000 0.009 0.010 0.000 0.010 Responsible Officer: Hospital Director 223 Utility and Property Expenses 0.588 0.000 0.000 0.588 0.605 0.000 0.605 Programme Outcome: Quality and accessible Regional Referral Hospital Services 224 Supplies and Services 0.157 0.000 0.000 0.157 0.152 0.000 0.152 Sector Outcomes contributed to by the Programme Outcome 225 Professional Services 0.012 0.000 0.000 0.012 0.004 0.000 0.004 1. Improved quality of life at all levels 226 Insurances and Licenses 0.006 0.000 0.000 0.006 0.006 0.000 0.006 Performance Targets 227 Travel and Transport 0.191 0.000 0.000 0.191 0.176 0.000 0.176 Outcome Indicators 2020/21 2021/22 2022/23 228 Maintenance 0.107 0.000 0.000 0.107 0.111 0.000 0.111 Baseline Base year Target Projection Projection Output Class : Capital Purchases 1.488 0.000 0.000 1.488 2.515 0.000 2.515

172 173 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

• Percentage (%) increase of specialised clinic outpatients attendances 2.28% 2018 3.1% 3.2% 3.3%

• Percentage (%) increase of diagnostic investigations carried 2.28% 2018 3.1% 3.2% 3.3%

• Percentage bed occupancy rate 85% 2018 85% 85% 85%

SubProgramme: 01 Lira Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 29,198 30,133 31,127

Average Length of Stay (ALOS) - days 4 4 4

Bed Occupancy Rate (BOR) 85% 85% 85%

Number of Major Operations (including Ceasarian section) 10,229 10,556 10,905

Output: 02 Outpatient services Total general outpatients attendance 28,990 29,918 30,905

No. of specilaized clinic attendances 223,005 230,141 237,736

Referral cases in 22,300 23,014 23,773

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 1.4 1.4 1.4

Output: 04 Diagnostic services No. of laboratory tests carried out 303,984 313,717 324,064

No. of patient xrays (imaging) taken 6,367 6,571 6,788

Number of Ultra Sound Scans 10,165 10,490 10,837

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 15,012 15,492 16,004

Output: 07 Immunisation Services No. of Childhood Immunized (All immunizations) 44,624 46,052 47,572

SubProgramme: 02 Lira Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

174 175 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

• Percentage (%) increase of specialised clinic outpatients attendances 2.28% 2018 3.1% 3.2% 3.3% SubProgramme: 03 Lira Regional Maintenance

• Percentage (%) increase of diagnostic investigations carried 2.28% 2018 3.1% 3.2% 3.3% Output: 05 Hospital Management and support services 4 4 4 • Percentage bed occupancy rate 85% 2018 85% 85% 85% Assets register updated on a quarterly basis Timely payment of salaries and pensions by the 2 yes yes yes SubProgramme: 01 Lira Referral Hospital Services Output: 01 Inpatient services Timely submission of quarterly financial/activity yes yes yes No. of in-patients (Admissions) 29,198 30,133 31,127 SubProgramme: 1004 Lira Rehabilitation Referral Hospital

Average Length of Stay (ALOS) - days 4 4 4 Output: 80 Hospital Construction/rehabilitation 1 Bed Occupancy Rate (BOR) 85% 85% 85% No. of hospitals benefiting from the renovation of existing facilities 1 Number of Major Operations (including Ceasarian section) 10,229 10,556 10,905 No. of reconstructed/rehabilitated general wards Cerificates of progress/ Completion 4 Output: 02 Outpatient services Total general outpatients attendance 28,990 29,918 30,905 Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 1 No. of specilaized clinic attendances 223,005 230,141 237,736 2 Referral cases in 22,300 23,014 23,773 Cerificates of progress/ Completion

Output: 03 Medicines and health supplies procured and dispensed SubProgramme: 1583 Retooling of Lira Regional Hospital Value of medicines received/dispensed (Ush bn) 1.4 1.4 1.4 Output: 80 Hospital Construction/rehabilitation No. of hospitals benefiting from the renovation of existing facilities 1 Output: 04 Diagnostic services Cerificates of progress/ Completion 4 No. of laboratory tests carried out 303,984 313,717 324,064

No. of patient xrays (imaging) taken 6,367 6,571 6,788 Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .07 .2 .2 Number of Ultra Sound Scans 10,165 10,490 10,837

Output: 05 Hospital Management and support services IX. Major Capital Investments And Changes In Resource Allocation Assets register updated on a quarterly basis 4 4 4 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Timely payment of salaries and pensions by the 2 yes yes yes FY 2019/20 FY 2020/21 Timely submission of quarterly financial/activity yes yes yes Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Output: 06 Prevention and rehabilitation services end Dec Outputs Vote 172 Lira Referral Hospital No. of antenatal cases (All attendances) 15,012 15,492 16,004 Program : 08 56 Regional Referral Hospital Services Output: 07 Immunisation Services Development Project : 1004 Lira Rehabilitation Referral Hospital No. of Childhood Immunized (All immunizations) 44,624 46,052 47,572 Output: 08 56 80 Hospital Construction/rehabilitation SubProgramme: 02 Lira Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 yes yes yes

Timely submission of quarterly financial/activity yes yes yes

174 175 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

2km Perimeter fence/ wall constructed Site clearance and mobilization; Excavation of Construction of walkway between Labor ward the trench; cast it with blinding concrete, and and existing Obstetric unit by JICA co- Construction of the wall supervised construction of plinth wall and finishes, funded. walling,,, construction of piers Construction of MCH waiting area (18M * 12 M) by JICA-Counter funded. Construction of a fence and gate house on the new OPD/ Causality by JICA- Co funded. functionality of the new building by JICA co funded. JICA projects monitored and supervised Medical waste incinerator relocated away from the staff house /OPD area. Perimeter fence completed Total Output Cost(Ushs Thousand) 400,000 149,679 1,245,000

Gou Dev’t: 400,000 149,679 1,245,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

Output: 08 56 81 Staff houses construction and rehabilitation

1. Internal finishes (fix tiles) completed 1. Internal finishes (fix tiles) completed 2. Retention fees paid Mechanical works (water supply, storage, Staff house construction monitored and 2. Mechanical works (water supply, storage, distribution) distribution) completed 3. Electrical works supervised. completed (power connection, extension, distribution) Staff house external finishes completed, and roads completed 4. External works -landscaping paved. 3. Electrical works (power connection, extension, distribution) completed 5. Supervision done. completed Casting 3rd floor slab, columns and stair case. 4. External works -landscaping completed Undertaking the plastering , Electrical and mechanical works. 5. Supervision done Total Output Cost(Ushs Thousand) 950,000 154,972 940,000

Gou Dev’t: 950,000 154,972 940,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Limited specialized services due to Lack of specialists, coupled with delays in recruitment and failure to retain the recruited staff leads to poor service delivery and subsequently poor health outcome

2. Increased demand and use of hospital services against allocated resources leading to stock outs, pressure on utilities.

3. Old and Dilapidated infrastructure associated with high costs of maintenance. Additionally there is limited space leading to overcrowding and compromising service delivery.

Plans to improve Vote Performance

1. The entity shall continue to lobby for specialists to enable functionality of the special clinics and further move towards fulfilling the mandate of the referral hospital that is offer specialist services for improved health;

2. Adherence to staff attraction procedures (fairness to all potential candidates ) and innovate retention as well as staff

176 177 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

2km Perimeter fence/ wall constructed Site clearance and mobilization; Excavation of Construction of walkway between Labor ward development strategies shall greatly motivate stakeholders; the trench; cast it with blinding concrete, and and existing Obstetric unit by JICA co- Construction of the wall supervised construction of plinth wall and finishes, funded. walling,,, construction of piers Construction of MCH waiting area (18M * 12 M) 3. Adhere to work plans and budgets for effective service delivery; by JICA-Counter funded. Construction of a fence and gate house on the new 4. The entity shall continue to adhere to the PFMA 2015 and other regulatory instruments- PPDA, in implementations of OPD/ Causality by JICA- Co funded. programme outputs and projects functionality of the new building by JICA co funded. JICA projects monitored and supervised 5. Capital expenses to be phased and construction to be undertaken within the resource envelope available Medical waste incinerator relocated away from the staff house /OPD area. 6. Enhance Partnership with stakeholders in areas of comparative advantage Perimeter fence completed Total Output Cost(Ushs Thousand) 400,000 149,679 1,245,000 7. Strengthen Value for money audits. Gou Dev’t: 400,000 149,679 1,245,000

Ext Fin: 0 0 0 XI Off Budget Support

A.I.A: 0 0 0 Table 11.1 Off-Budget Support by Sub-Programme Output: 08 56 81 Staff houses construction and rehabilitation Billion Uganda Shillings 2019/20 Approved 2020/21 Draft 1. Internal finishes (fix tiles) completed 1. Internal finishes (fix tiles) completed 2. Retention fees paid Budget Estimates Mechanical works (water supply, storage, Staff house construction monitored and 2. Mechanical works (water supply, storage, distribution) distribution) completed 3. Electrical works supervised. Programme 0856 Regional Referral Hospital Services 0.11 1.28 completed (power connection, extension, distribution) Staff house external finishes completed, and roads Recurrent Budget Estimates completed 4. External works -landscaping paved. 3. Electrical works (power connection, extension, distribution) completed 5. Supervision done. 01 Lira Referral Hospital Services 0.11 1.28 completed Casting 3rd floor slab, columns and stair case. 410-International Development Association (IDA) 0.00 0.90 4. External works -landscaping completed Undertaking the plastering , Electrical and mechanical works. 445-World Health Organisation (WHO) 0.11 0.10 5. Supervision done 451-Global Alliance for Vaccines Immunisation 0.00 0.28 Total Output Cost(Ushs Thousand) 950,000 154,972 940,000 Total for Vote 0.11 1.28 Gou Dev’t: 950,000 154,972 940,000

Ext Fin: 0 0 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues

A.I.A: 0 0 0 Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS X. Vote Challenges and Plans To Improve Performance Objective : Increase male/partner involvement in HIV care Vote Challenges Issue of Concern : Low male/ partner involvement 1. Limited specialized services due to Lack of specialists, coupled with delays in recruitment and failure to retain the recruited staff leads to poor service delivery and subsequently poor health outcome Planned Interventions : a. Introduce couple testing 2. Increased demand and use of hospital services against allocated resources leading to stock outs, pressure on utilities. b. Introduce male friendly treatment services 3. Old and Dilapidated infrastructure associated with high costs of maintenance. Additionally there is limited space leading to overcrowding and compromising service delivery. Budget Allocation (Billion) : 0.150 Performance Indicators: a. No of couples tested, counselled and given results

Plans to improve Vote Performance b. Number of male/ partners who test positive and start treatment

1. The entity shall continue to lobby for specialists to enable functionality of the special clinics and further move towards fulfilling c. Males circumcised; the mandate of the referral hospital that is offer specialist services for improved health;

2. Adherence to staff attraction procedures (fairness to all potential candidates ) and innovate retention as well as staff Objective : To offer special services to Most At Risk Populations (MARPS)

176 177 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

Issue of Concern : MARPS don't easily access care and they are reservoir for HIV infection Planned Interventions : Strengthen special clinic for MARPS

Conduct community outreaches to reach out to them

Monitor Viral Load among MARPS attending the HIV clinic

Give Information, Educate and communicate through available channels Budget Allocation (Billion) : 0.200 Performance Indicators: Number of MARPS tested for HIV

Number of MARPS in care

Number of MARPS with undetectable viral load

Number of HIV/AIDS targeted IEC messages Issue Type: Gender

Objective : To improve the management of clients i.e. survivors and victims with conditions of special concern to the community (Gender based violence)

Issue of Concern : Widespread GBV and poor management of survivors and victims

Planned Interventions : Equip the entity with PEP KITS, HIV, and Pregnancy, STIs;

Documentation and preservation of information of clients with conditions of special concern to the community Budget Allocation (Billion) : 0.160 Performance Indicators: a) Value of PEP Kits, HIV, pregnancy and STIs KITs;

b) Number of examination reports by Police;

c) GBV registers (preservation of evidence and examination). Objective : There is need to extend Services for vulnerable groups e.g. older persons, mothers, adolescents, youth, and persons with disabilities Issue of Concern : Limited healthcare services to address needs of marginalized groups(older persons,PWDs, mothers, destitute

Planned Interventions : a) Procure medicines and supplies for treatment of degenerative diseases;

b) Conduct health camps for elderly, PWDs;

c) Procure assistance devices;

d) Strengthen special;

e) Provide special meals to MDR TB with special meals

Budget Allocation (Billion) : 0.300

178 179 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

Issue of Concern : MARPS don't easily access care and they are reservoir for HIV infection Performance Indicators: a) Value of medicines and supplies for the treatment of disease for vulnerable groups including the elderly and PWDS Planned Interventions : Strengthen special clinic for MARPS b) Number of health camps Conduct community outreaches to reach out to them c) Number of assistance devices; Monitor Viral Load among MARPS attending the HIV clinic d) Number of special clinics Give Information, Educate and communicate through available channels Objective : There is need to improve security and access of the physical health infrastructure by special groups Budget Allocation (Billion) : 0.200 of people and other users Performance Indicators: Number of MARPS tested for HIV Issue of Concern : Insecurity and inaccessibility of the physical health infrastructure by special groups of people and other users Number of MARPS in care Planned Interventions : 081720210668-To improve security and access of the physical health infrastructure by special groups of people and other users Number of MARPS with undetectable viral load Budget Allocation (Billion) : 0.487 Number of HIV/AIDS targeted IEC messages Performance Indicators: a. % perimeter wall Issue Type: Gender b. % sheltered walkway Objective : To improve the management of clients i.e. survivors and victims with conditions of special concern to the community (Gender based violence) c.Number of entrances for the new and renovated units expanded.

Issue of Concern : Widespread GBV and poor management of survivors and victims d.Number of Appliances, bedding, Aides

Planned Interventions : Equip the entity with PEP KITS, HIV, and Pregnancy, STIs; Issue Type: Enviroment Documentation and preservation of information of clients with conditions of special concern to the community Objective : There is need to improve on the environmental hygiene through provision of cleaning materials, outsourcing cleaning services and waste management; prevent and control hospital acquired Budget Allocation (Billion) : 0.160 infections Educate, and communicate environmental related concerns to the clients Performance Indicators: a) Value of PEP Kits, HIV, pregnancy and STIs KITs; Issue of Concern : unsafe hospital environment b) Number of examination reports by Police; Planned Interventions : outsource service providers c) GBV registers (preservation of evidence and examination). Supervise outsourced providers Objective : There is need to extend Services for vulnerable groups e.g. older persons, mothers, adolescents, youth, and persons with disabilities Budget Allocation (Billion) : 0.140 Issue of Concern : Limited healthcare services to address needs of marginalized groups(older persons,PWDs, Performance Indicators: frequency of evacuation mothers, destitute number of infection control meetings a) Procure medicines and supplies for treatment of degenerative diseases; Planned Interventions : XIII. Personnel Information b) Conduct health camps for elderly, PWDs; Table 13.1 Staff Establishment Analysis c) Procure assistance devices; Title Salary Scale Number Of Approved Positions Number Of Filled Positions d) Strengthen special; Consultant (Medicine) U1SE 1 0 e) Provide special meals to MDR TB with special meals Consultant Psychiatry U1SE 1 0 Senior Consultant SURGEON U1SE 1 0 Budget Allocation (Billion) : 0.300 Medical Officer Special Grade( U2(Med-1) 1 0 Obsetrics & Gynaechology)

178 179 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 (Medicine) Medical Officer Special Grade U2U 1 0 (Opthamology) Medical Officer Special Grade U2U 1 0 (Psychiatry) Principal Dispenser U3(Med-2) 1 0 Principal Orthopaedic Technician U3(Med-2) 1 0 Principal Radiographer U3(Med-2) 1 0 SENIOR ANAESTHETIC U4(Med-2) 3 2 OFFICER SENIOR OPTHALMIC CLINICAL U4(Med-2) 3 2 OFFICER SENIOR ORTHOPAEDIC U4(Med-2) 3 2 OFFICER SENIOR ORTHOPAEDIC U4(Med-2) 2 1 TECHNICIAN SENIOR PHYSIOTHERAPIST U4(Med-2) 2 1 SENIOR PUBLIC.HEALTH U4(Med-2) 2 0 DENTAL OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 1 CLINICAL OFFICER U5(SC) 16 5 OCCUPATIONAL THERAPIST U5(SC) 1 0 OPTHALMIC CLINICAL U5(SC) 1 0 OFFICER ORTHOPAEDIC OFFICER U5(SC) 3 2 ORTHOPAEDIC TECHNICIAN U5(SC) 3 2 PHYSIOTHERAPIST U5(SC) 1 0 PSYCHIATRIC CLINICAL U5(SC) 4 0 OFFICER THEATRE ASSISTANT U6(Med) 5 2 ENROLLED MIDWIFE U7(Med) 20 19 CARPENTER U8 1 0 ASKARI U8L 20 15 DRIVER U8U 8 5 PLUMBER U8U 2 0

Table 13.2 Staff Recruitment Plan

180 181 Lira Referral Hospital Ministerial Policy Statement FY 2020/21 Lira Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:172 Lira Referral Hospital Vote:172 Lira Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual (ENT) Scale Approved Filled Posts Posts Cleared for Per Month Salary Medical Officer Special Grade U2(Med-1) 1 0 Posts Filling (UGX) (UGX) (Medicine) FY2020/21 ASKARI U8L 20 15 5 5 1,069,160 12,829,920 Medical Officer Special Grade U2U 1 0 (Opthamology) CARPENTER U8 1 0 1 1 283,488 3,401,856 Medical Officer Special Grade U2U 1 0 CLINICAL OFFICER U5(SC) 16 5 11 11 13,200,000 158,400,000 (Psychiatry) Consultant (Medicine) U1SE 1 0 1 1 6,035,667 72,428,004 Principal Dispenser U3(Med-2) 1 0 Consultant Psychiatry U1SE 1 0 1 1 6,035,667 72,428,004 Principal Orthopaedic Technician U3(Med-2) 1 0 DRIVER U8U 8 5 3 3 711,207 8,534,484 ENROLLED MIDWIFE U7(Med) 20 19 1 1 613,158 7,357,896 Principal Radiographer U3(Med-2) 1 0 Medical Officer Special Grade U2U 1 0 1 1 4,500,962 54,011,544 SENIOR ANAESTHETIC U4(Med-2) 3 2 (Opthamology) OFFICER Medical Officer Special Grade U2U 1 0 1 1 4,500,962 54,011,544 (Psychiatry) SENIOR OPTHALMIC CLINICAL U4(Med-2) 3 2 Medical Officer Special Grade( U2(Med-1) 1 0 1 1 4,500,962 54,011,544 OFFICER Obsetrics & Gynaechology) SENIOR ORTHOPAEDIC U4(Med-2) 3 2 Medical Officer Special Grade U2(Med-1) 1 0 1 1 4,500,962 54,011,544 OFFICER (ENT) SENIOR ORTHOPAEDIC U4(Med-2) 2 1 Medical Officer Special Grade U2(Med-1) 1 0 1 1 4,500,962 54,011,544 TECHNICIAN (Medicine) OCCUPATIONAL THERAPIST U5(SC) 1 0 1 1 1,200,000 14,400,000 SENIOR PHYSIOTHERAPIST U4(Med-2) 2 1 OPTHALMIC CLINICAL U5(SC) 1 0 1 1 1,200,000 14,400,000 SENIOR PUBLIC.HEALTH U4(Med-2) 2 0 OFFICER DENTAL OFFICER ORTHOPAEDIC OFFICER U5(SC) 3 2 1 1 1,200,000 14,400,000 SENIOR RADIOGRAPHER U4(Med-2) 2 1 ORTHOPAEDIC TECHNICIAN U5(SC) 3 2 1 1 1,200,000 14,400,000 CLINICAL OFFICER U5(SC) 16 5 PHYSIOTHERAPIST U5(SC) 1 0 1 1 1,200,000 14,400,000 PLUMBER U8U 2 0 2 2 474,138 5,689,656 OCCUPATIONAL THERAPIST U5(SC) 1 0 Principal Dispenser U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OPTHALMIC CLINICAL U5(SC) 1 0 Principal Orthopaedic Technician U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OFFICER Principal Radiographer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 ORTHOPAEDIC OFFICER U5(SC) 3 2 PSYCHIATRIC CLINICAL U5(SC) 4 0 4 4 4,800,000 57,600,000 ORTHOPAEDIC TECHNICIAN U5(SC) 3 2 OFFICER SENIOR ANAESTHETIC U4(Med-2) 3 2 1 1 2,200,000 26,400,000 PHYSIOTHERAPIST U5(SC) 1 0 OFFICER Senior Consultant SURGEON U1SE 1 0 1 1 7,307,602 87,691,224 PSYCHIATRIC CLINICAL U5(SC) 4 0 OFFICER SENIOR OPTHALMIC U4(Med-2) 3 2 1 1 2,200,000 26,400,000 CLINICAL OFFICER THEATRE ASSISTANT U6(Med) 5 2 SENIOR ORTHOPAEDIC U4(Med-2) 3 2 1 1 2,200,000 26,400,000 ENROLLED MIDWIFE U7(Med) 20 19 OFFICER SENIOR ORTHOPAEDIC U4(Med-2) 2 1 1 1 2,200,000 26,400,000 CARPENTER U8 1 0 TECHNICIAN SENIOR PHYSIOTHERAPIST U4(Med-2) 2 1 1 1 2,200,000 26,400,000 ASKARI U8L 20 15 SENIOR PUBLIC.HEALTH U4(Med-2) 2 0 2 2 4,400,000 52,800,000 DRIVER U8U 8 5 DENTAL OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 1 1 1 2,200,000 26,400,000 PLUMBER U8U 2 0 THEATRE ASSISTANT U6(Med) 5 2 3 3 2,550,000 30,600,000 Table 13.2 Staff Recruitment Plan Total 113 59 54 54 98,484,897 1,181,818,764

180 181 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:173 Mbarara Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide inclusive, accessible equitable and participatory comprehensive specialized Health services, Conduct Tertiary Health Training, Research and Contribute to the health Sector Strategic objectives.

II. Strategic Objective 1. To offer comprehensive inclusive, accessible and participatory specialised curative, promotive, preventive and rehabilitative health care services. 2. To provide outreach specialist and technical support supervision services for prevention and control of Non-Communicable and Communicable Diseases with focus on high burden diseases like diabetes, Hypertension and HIV/AIDS, TB and Malaria. 3. To build capacity, offer tertiary training and continuing Professional Development to health workers for improved service delivery and HCIV functionality. 4. To strengthen operational health, technical and professional research. 5. To strengthen the referral systems for efficient and effective for improvement of quality, safety and scope of health care services. 6. To improve managerial efficiency and partnerships in resource mobilization, allocation, utilization and accountability. III. Major Achievements in 2019/20 The following outputs were achieved midyear by Mbarara Regional Referral Hospital (July - December 2019) In patient services:

1. 17,901 admissions achieved against Mid year target of 30,000 2. 4. 2 Days average length of stay against Mid year target of 4 Days. 3. 85.5 % Bed occupancy rate against Mid year target of 85% 4. 4,669 Total surgical operations done of which 3,555 were major& 3,127 were minor against mid year target of 4,500.

Out patients Services:

1. 13,304 General outpatients against target of 20,000 Midyear Target; 2. 43,524 Special clinics attendance against Midyear target of 64,000. 3. A total of 4,842 deliveries done against 6,000 target mid-year. (2,733 Normal deliveries & 2,071 Caesarean sections)

General out patient’s including special clinics attendances were below the target due to renovation works in OPD and also the Christmas festive season.

Diagnostics:

1) 90,812 Lab examination tests were done out of 46,500 Mid year target 2) 2,495 X-rays examinations were achieved out of 2750; 3) 3,679 Ultra sound imaging examinations done out of 4,000 4) 186 ECG (Electrocardiogram)tests done against 138 5) 143 ECHO(Echocardiography) done out of 140 6) 579 CT Scan Investigations out of 800 7) 101 Endoscopy tests out of 140 8) 91 Dialysis sessions carried out of 50. 9) 3,158 Blood transfusions done out of 3,000.

Prevention Services:

8,762 antenatal attendances received out of 1,500; 1940 EMTCT(Elimination of mother to Child Transmission of HIV) achieved out of 200 planned; Postnatal attendances 1,835; 4,553 HCT(HIV Counselling and Testing) achieved; 1,752 Family Planning contacts registered out of 1,200 planned mid year.

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V1: Vote Overview Immunization Services: I. Vote Mission Statement 14,242 Immunizations out of 7,750. Due to the removal of the voucher system many mothers attend free ANC services in the hospital, To provide inclusive, accessible equitable and participatory comprehensive specialized Health services, Conduct Tertiary Health Over 50% deliver in the hospital and encouraged to have their babies immunized hence high performance against target. Training, Research and Contribute to the health Sector Strategic objectives. Management Services: II. Strategic Objective 1) One Hospital Management Board meeting was held as per plan. 2 Hospital Board Sub Committee meetings held. 2 contracts 1. To offer comprehensive inclusive, accessible and participatory specialised curative, promotive, preventive and rehabilitative committee meetings held; 3 Medicines and Therapeutic Committee; 8 Senior management and 24 departmental meetings. health care services. 2. To provide outreach specialist and technical support supervision services for prevention and control of Non-Communicable and Communicable Diseases with focus on high burden diseases like diabetes, Hypertension and 2) Utility payments (Yaka for power) and water were cleared; 4,914 Meals provided to 670 malnourished children, destitute HIV/AIDS, TB and Malaria. 3. To build capacity, offer tertiary training and continuing Professional Development to health patients (Covering children in Oncology; Nutrition; Psychiatric; TB wards & abandoned patients in the wards. Buried (85 adults workers for improved service delivery and HCIV functionality. 4. To strengthen operational health, technical and professional and 255 Children unclaimed bodies. (FSB MSB and aborted babies). research. 5. To strengthen the referral systems for efficient and effective for improvement of quality, safety and scope of health care services. 6. To improve managerial efficiency and partnerships in resource mobilization, allocation, utilization and 3) Hospital well cleaned supervised by the administrators and Infection Control and Prevention committee; Old items ( vehicles accountability. and obsolete medical equipment) were disposed off. .

III. Major Achievements in 2019/20 4) Final accounts were prepared & audited; Domestic arrears submitted for verification by Earnest and Young as advised by Finance; Value for money audit exit meeting held with the Internal Audit team and a report produced. The following outputs were achieved midyear by Mbarara Regional Referral Hospital (July - December 2019) In patient services: 5) Quarter one performance report compiled and submitted to Ministry of Finance. and Ministry of Health. 1. 17,901 admissions achieved against Mid year target of 30,000 Human Resource: 2. 4. 2 Days average length of stay against Mid year target of 4 Days. 3. 85.5 % Bed occupancy rate against Mid year target of 85% 1) All staff paid Salaries for the two quarters amounting to Ugx 1,194,355,003 However, a balance of Ugx 93,191,977 remained 4. 4,669 Total surgical operations done of which 3,555 were major& 3,127 were minor against mid year target of 4,500. due to some unfilled positions. Out patients Services: 2) Monthly data capture was done including entry of newly transferred; staff. Recruitment for FY 2019/20 being followed up and staff formally under PEPFAR were regularized 1. 13,304 General outpatients against target of 20,000 Midyear Target; 2. 43,524 Special clinics attendance against Midyear target of 64,000. 3) Domestic arrears for pensioners were submitted to Earnest and Young for Audit and onward transmission to Ministry of 3. A total of 4,842 deliveries done against 6,000 target mid-year. Finance for payment. (2,733 Normal deliveries & 2,071 Caesarean sections) 4) Hospital restructuring with support from Ministries of Public service, and partners (Intra-Health) with a draft sent to Ministry General out patient’s including special clinics attendances were below the target due to renovation works in OPD and also the of Health. Christmas festive season. Records Services: Diagnostics: 1) 26 Weekly surveillance reports produced and submitted through MTRAC; 6 HMIS monthly reports produced and submitted 1) 90,812 Lab examination tests were done out of 46,500 Mid year target to DHIS2, 2 Quarterly Health Management Information System( HMIS) reports produced and submitted to DHIS2, 2) 2,495 X-rays examinations were achieved out of 2750; 3) 3,679 Ultra sound imaging examinations done out of 4,000 2) 2 In-house trainings conducted specifically on data capture and reporting, On job mentorships by the records team, 6 Data 4) 186 ECG (Electrocardiogram)tests done against 138 cleaning activities conducted, 2 Quarterly data review meetings done; Data capture tools received from partners and distributed 5) 143 ECHO(Echocardiography) done out of 140 to wards, 6) 579 CT Scan Investigations out of 800 . 7) 101 Endoscopy tests out of 140 8) 91 Dialysis sessions carried out of 50. Internal Audit: 9) 3,158 Blood transfusions done out of 3,000. 1) Annual and quarterly work plans produced.; Exit meeting with the Auditor General was done and responses made; Prevention Services: 2) Hospital Stores were inspected; management guided on internal controls; Deliveries of purchased witnessed and verified. 8,762 antenatal attendances received out of 1,500; 1940 EMTCT(Elimination of mother to Child Transmission of HIV) achieved out of 200 planned; Postnatal attendances 1,835; 4,553 HCT(HIV Counselling and Testing) achieved; 1,752 Family 3) The FY 2018/19 internal audit report was produced, circulated and corrective actions taken. Planning contacts registered out of 1,200 planned mid year. 4) Auditor Generals reports and responses submitted to PAC Management was advised on risk mitigation and performance

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improvement.

Capital development: (Hospital Construction and Rehabilitation).

1. Residential Buildings (Staff House construction):

The process of starting the Multi Year 56 Unit storeyed staff house construction(One Bed room, sitting room and kitchen self- contained) has been initiated. A consultant procured to develop structural drawings, BoQs and bidding process started. Clearances from the various authorities (NEMA, Mbarara Municipal Council, Ministry of Works and other relevant agencies done; Documentations already done, contracts committee reviewed, Documents submitted to the Solicitor General for legal advice and works planned to commence in 4th quarter.

2. Non Residential (Perimeter wall construction)

Perimeter wall construction ongoing; works estimated at 80%, works on gates started. Fittings being made for solar power and CCTV camera; Site meeting are ongoing and monthly updates given. Down payments made, Certificate amounting to Ugx 520 Million received and payment of Ugx 266 Million made. Works expected to be finished by 4th Quarter.

3. Laboratory Construction by East African Public Health Lab(EAPHLAB/World Bank.)

Construction works for the Laboratory are estimated at 80%; and ongoing works include window & ceiling finishings; fitting door & window frames; Electrical and plumbing works near completion; Site meetings and progress updates given monthly. Works delayed due to variations made & completion expected by June, 2020.

4) OPD Renovation works.

Renovation works at the Out patient’s department completed with the walls and the roof newly painted and broken parts replaced; Works being finalised in the toilets and walk ways. Burglar proofing done and electrical fittings replaced and Payments made for certificate issued by the contractor.

5) Medical Ward:

Works completed on the Male side involving(painting, terrazzo floor works); Works still on going in the female side involving terrazzo floor, painting & plumbing. Monthly progress updates being made to management; Works expected for completion and ward occupied by March 2020

Institutional support (Retooling):

1. Purchase of Motor Vehicles and Other Transport; Ambulance procured, delivered and already in use with all payments made to Toyota.

2. Purchase of Medical Equipment: This involves assorted medical equipment and major maintenance obligations;for emergency and Specialised clinics; Equipment including 4 ventilators for ICU, 10 Beds for ICU and a central ICU monitor already delivered. Installed and in use in the ICU unit were procured. 2 washing machines and a Drier for hospital ward and theatre linen delivered and installed as per specifications and already in use.

3) ENT equipment as per specifications also delivered installed and already in use.and Specifications and clearances are further being made by the contracts committee for more specified procurements of medical equipment as an ongoing process.

Medical Equipment workshop

1) Conducted Equipment Inventory within the hospital and in the lower health Units. A computer received from JICA to support NOMAD. All inventory uploaded and updates on going.

2) Planned to refurbish the workshop & Staff identified for recruitment submitted to Health Service commission; Required tools identified, Electrical and Plumbing materials procured, installations done; Attended the Regional Medical Equipment Quarterly

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improvement. review meeting in Mbale and Soroti.

Capital development: (Hospital Construction and Rehabilitation). 3) Carried out routine repairs and equipment maintenance in the hospital; ICU equipment installed and theatre in emergency functionalsed; User training activities on going with 4 CMEs done on Pulse Oxy-Meter and Table Autoclave use and 1. Residential Buildings (Staff House construction): maintenance & biomedical students and interns supported

The process of starting the Multi Year 56 Unit storeyed staff house construction(One Bed room, sitting room and kitchen self- contained) has been initiated. A consultant procured to develop structural drawings, BoQs and bidding process started. IV. Medium Term Plans Clearances from the various authorities (NEMA, Mbarara Municipal Council, Ministry of Works and other relevant agencies done; Documentations already done, contracts committee reviewed, Documents submitted to the Solicitor General for legal 1. Improve hospital security, staff accommodation, rehabilitate existing infrastructure, reduce on costs of utilities by use rain advice and works planned to commence in 4th quarter. water harvesting and solar power.

2. Non Residential (Perimeter wall construction) 2. Reduce staff gaps by timely identification declaration and recruitment of staff within the allocated wage bill.

Perimeter wall construction ongoing; works estimated at 80%, works on gates started. Fittings being made for solar power and 3. Strengthen and improve on data management, utilization and dissemination through digitalization CCTV camera; Site meeting are ongoing and monthly updates given. Down payments made, Certificate amounting to Ugx 520 Million received and payment of Ugx 266 Million made. Works expected to be finished by 4th Quarter. 4. Continue lobbying and fast tracking Phase Two hospital construction of the hospital to meet the client service demands especially and move to meet national demands of Mbarara Capital City with the entity serving as a Regional Centre of 3. Laboratory Construction by East African Public Health Lab(EAPHLAB/World Bank.) Excellence

Construction works for the Laboratory are estimated at 80%; and ongoing works include window & ceiling finishings; fitting 5. Continue developing and improving Specialized health care services, emergency and accident care, training and health door & window frames; Electrical and plumbing works near completion; Site meetings and progress updates given monthly. research for improved livelihoods and labour productivity in the region. Works delayed due to variations made & completion expected by June, 2020.

4) OPD Renovation works.

5) Medical Ward:

Institutional support (Retooling):

1. Purchase of Motor Vehicles and Other Transport; Ambulance procured, delivered and already in use with all payments made to Toyota.

Medical Equipment workshop

1) Conducted Equipment Inventory within the hospital and in the lower health Units. A computer received from JICA to support NOMAD. All inventory uploaded and updates on going.

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V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 4.753 5.427 2.504 5.427 5.427 5.427 5.427 5.427 Recurrent Non Wage 1.984 3.664 1.492 4.877 4.877 4.877 4.877 4.877 GoU 1.921 1.678 0.472 0.800 1.800 2.050 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.658 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Total GoU+Ext Fin (MTEF) 8.658 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Arrears 0.162 1.122 0.653 0.210 0.000 0.000 0.000 0.000 Total Budget 8.820 11.891 5.122 11.314 12.104 12.354 10.531 10.531 A.I.A Total 0.404 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 9.223 11.891 5.122 11.314 12.104 12.354 10.531 10.531 Total Vote Budget 9.062 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 9.092 0.000 0.000 9.092 10.304 0.000 10.304

211 Wages and Salaries 5.917 0.000 0.000 5.917 5.917 0.000 5.917

212 Social Contributions 0.477 0.000 0.000 0.477 1.887 0.000 1.887

213 Other Employee Costs 0.718 0.000 0.000 0.718 0.519 0.000 0.519

221 General Expenses 0.232 0.000 0.000 0.232 0.232 0.000 0.232

222 Communications 0.016 0.000 0.000 0.016 0.016 0.000 0.016

223 Utility and Property Expenses 0.757 0.000 0.000 0.757 0.757 0.000 0.757

224 Supplies and Services 0.522 0.000 0.000 0.522 0.522 0.000 0.522

225 Professional Services 0.003 0.000 0.000 0.003 0.003 0.000 0.003

227 Travel and Transport 0.213 0.000 0.000 0.213 0.213 0.000 0.213

228 Maintenance 0.231 0.000 0.000 0.231 0.231 0.000 0.231

273 Employer social benefits 0.005 0.000 0.000 0.005 0.005 0.000 0.005

Output Class : Capital Purchases 1.678 0.000 0.000 1.678 0.800 0.000 0.800

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312 FIXED ASSETS 1.678 0.000 0.000 1.678 0.800 0.000 0.800 V. Summary of Past Performance and Medium Term Budget Allocations Output Class : Arrears 1.122 0.000 0.000 1.122 0.210 0.000 0.210 Table 5.1: Overview of Vote Expenditures (UShs Billion) 321 DOMESTIC 1.122 0.000 0.000 1.122 0.210 0.000 0.210

2019/20 MTEF Budget Projections Grand Total : 11.891 0.000 0.000 11.891 11.314 0.000 11.314 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Total excluding Arrears 10.770 0.000 0.000 10.770 11.104 0.000 11.104 Outturn Budget by End Dec Wage 4.753 5.427 2.504 5.427 5.427 5.427 5.427 5.427 Recurrent VII. Budget By Programme And Subprogramme Non Wage 1.984 3.664 1.492 4.877 4.877 4.877 4.877 4.877 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme GoU 1.921 1.678 0.472 0.800 1.800 2.050 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Billion Uganda shillings FY 2019/20 Medium Term Projections GoU Total 8.658 10.770 4.469 11.104 12.104 12.354 10.531 10.531 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Total GoU+Ext Fin (MTEF) 8.658 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Budget 56 Regional Referral Hospital Services 9.223 11.891 5.122 11.314 12.104 12.354 10.531 10.531 Arrears 0.162 1.122 0.653 0.210 0.000 0.000 0.000 0.000 01 Mbarara Referral Hospital Services 7.284 10.137 4.618 10.438 10.228 10.228 10.228 10.228 Total Budget 8.820 11.891 5.122 11.314 12.104 12.354 10.531 10.531 02 Mbarara Referral Hospital Internal Audit 0.016 0.016 0.005 0.016 0.016 0.016 0.016 0.016 A.I.A Total 0.404 0.000 0.000 0.000 0.000 0.000 0.000 0.000 03 Mbarara Regional Maintenance Workshop 0.000 0.060 0.027 0.060 0.060 0.060 0.060 0.060 Grand Total 9.223 11.891 5.122 11.314 12.104 12.354 10.531 10.531 1004 Mbarara Rehabilitation Referral 1.534 1.278 0.359 0.600 1.600 1.850 0.000 0.000 Total Vote Budget 9.062 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Hospital Excluding Arrears 1479 Institutional Support to Mbarara 0.389 0.400 0.113 0.000 0.000 0.000 0.000 0.000 Regional Hospital VI. Budget By Economic Clasification 1578 Retooling of Mbarara Regional Referral 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Hospital Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total for the Vote 9.223 11.891 5.122 11.314 12.104 12.354 10.531 10.531

2019/20 Approved Budget 2020/21 Draft Estimates Total Excluding Arrears 9.062 10.770 4.469 11.104 12.104 12.354 10.531 10.531 Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 9.092 0.000 0.000 9.092 10.304 0.000 10.304 VIII. Programme Performance and Medium Term Plans

211 Wages and Salaries 5.917 0.000 0.000 5.917 5.917 0.000 5.917 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

212 Social Contributions 0.477 0.000 0.000 0.477 1.887 0.000 1.887 Programme : 56 Regional Referral Hospital Services 213 Other Employee Costs 0.718 0.000 0.000 0.718 0.519 0.000 0.519 Programme Objective Quality inclusive, participatory, accessible and equitable specialised Regional Referral Hospital Services 221 General Expenses 0.232 0.000 0.000 0.232 0.232 0.000 0.232 : Responsible Officer: Dr. Barigye Celestine Hospital Director 222 Communications 0.016 0.000 0.000 0.016 0.016 0.000 0.016 Programme Outcome: Quality and accessible Regional Referral Hospital Services 223 Utility and Property Expenses 0.757 0.000 0.000 0.757 0.757 0.000 0.757 Sector Outcomes contributed to by the Programme Outcome 224 Supplies and Services 0.522 0.000 0.000 0.522 0.522 0.000 0.522 1. Improved quality of life at all levels 225 Professional Services 0.003 0.000 0.000 0.003 0.003 0.000 0.003 Performance Targets 227 Travel and Transport 0.213 0.000 0.000 0.213 0.213 0.000 0.213 Outcome Indicators 2020/21 2021/22 2022/23 228 Maintenance 0.231 0.000 0.000 0.231 0.231 0.000 0.231 Baseline Base year Target Projection Projection 273 Employer social benefits 0.005 0.000 0.000 0.005 0.005 0.000 0.005 • % increase of specialised clinic outpatients attendences 25 2018 40% 70% 80% Output Class : Capital Purchases 1.678 0.000 0.000 1.678 0.800 0.000 0.800

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• % increase of diagnostic investigations carried 55% 2018 75% 85% 90%

• Bed occupancy rate 85% 2017 85% 85% 85%

SubProgramme: 01 Mbarara Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 30,000 32,000 35,000

Average Length of Stay (ALOS) - days 4 4 4

Bed Occupancy Rate (BOR) 85% 85% 85%

Output: 02 Outpatient services No. of general outpatients attended to 40,000 42,000 45,000

No. of specialised outpatients attended to 128,000 130,000 132,000

Referral cases in 4,600 4,650 4,800

Output: 04 Diagnostic services No. of laboratory tests carried out 93,000 94,000 95,000

No. of patient xrays (imaging) taken 5,500 5,600 5,800

Number of Ultra Sound Scans 8,000 8,200 8,500

Output: 05 Hospital Management and support services Quarterly financial reports submitted timely 4 4 4

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 3,000 3,250 3,500

No. of children immunised (All immunizations) 15,500 16,000 16,500

No. of family planning users attended to (New and Old) 2,500 2,600 2,800

Number of ANC Visits (All visits) 3,000 3,200 3,500

Percentage of HIV positive pregnant women not on H 0% 0% 0%

Output: 07 Immunisation Services Number of Childhood Vaccinations given (All contac 15,500 15,600 15,800

SubProgramme: 02 Mbarara Referral Hospital Internal Audit Output: 05 Hospital Management and support services Quarterly financial reports submitted timely 4 4 4

SubProgramme: 03 Mbarara Regional Maintenance Workshop Output: 05 Hospital Management and support services Quarterly financial reports submitted timely yes yes yes

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• % increase of diagnostic investigations carried 55% 2018 75% 85% 90% SubProgramme: 1004 Mbarara Rehabilitation Referral Hospital

• Bed occupancy rate 85% 2017 85% 85% 85% Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 1 1 1 SubProgramme: 01 Mbarara Referral Hospital Services Output: 01 Inpatient services SubProgramme: 1578 Retooling of Mbarara Regional Referral Hospital No. of in-patients (Admissions) 30,000 32,000 35,000 Output: 85 Purchase of Medical Equipment .2 .2 .2 Average Length of Stay (ALOS) - days 4 4 4 Value of medical equipment procured (Ush Bn)

Bed Occupancy Rate (BOR) 85% 85% 85% IX. Major Capital Investments And Changes In Resource Allocation Output: 02 Outpatient services Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) No. of general outpatients attended to 40,000 42,000 45,000 FY 2019/20 FY 2020/21 No. of specialised outpatients attended to 128,000 130,000 132,000 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Referral cases in 4,600 4,650 4,800 end Dec Outputs Vote 173 Mbarara Referral Hospital Output: 04 Diagnostic services Program : 08 56 Regional Referral Hospital Services No. of laboratory tests carried out 93,000 94,000 95,000 Development Project : 1004 Mbarara Rehabilitation Referral Hospital No. of patient xrays (imaging) taken 5,500 5,600 5,800 Output: 08 56 81 Staff houses construction and rehabilitation Number of Ultra Sound Scans 8,000 8,200 8,500 Start up construction of Phase One 4 storied 56 Unit staff 1) The process of starting the Multi Year 56 56 unit storried(One bed room, sitting and kitchen house. Unit storeyed staff house (One Bed room, self contained) junior staff house constructed Output: 05 Hospital Management and support services sitting room and kitchen self-contained) construction was initiated. This involves 4 4 4 Quarterly financial reports submitted timely procuring a consultant to develop structural drawings, BoQs that will kick start the bidding Output: 06 Prevention and rehabilitation services process. This will also include starting the bidding the process, seeking clearances from No. of antenatal cases (All attendances) 3,000 3,250 3,500 the various authorities (NEMA, Mbarara Municipal Council, Ministry of Works and No. of children immunised (All immunizations) 15,500 16,000 16,500 other relevant agencies. 2) Various consultations with MOH No. of family planning users attended to (New and Old) 2,500 2,600 2,800 infrastructure division already done for designs and technical advice. 3) Documentations already done and the Number of ANC Visits (All visits) 3,000 3,200 3,500 contracts committee reviewed; Documents submitted to the Solicitor General for legal Percentage of HIV positive pregnant women not on H 0% 0% 0% advice and clearance. 4) Adverts expected by February for Output: 07 Immunisation Services consultancy and bidders for works and award of contract planned to commence in 4th quarter. Number of Childhood Vaccinations given (All contac 15,500 15,600 15,800 5) Site hand over and ground breaking planned by end of April and works to fully commence before end of the quarter. SubProgramme: 02 Mbarara Referral Hospital Internal Audit Output: 05 Hospital Management and support services Total Output Cost(Ushs Thousand) 600,000 0 600,000 Quarterly financial reports submitted timely 4 4 4 Gou Dev’t: 600,000 0 600,000 Ext Fin: 0 0 0 SubProgramme: 03 Mbarara Regional Maintenance Workshop Output: 05 Hospital Management and support services A.I.A: 0 0 0 Quarterly financial reports submitted timely yes yes yes X. Vote Challenges and Plans To Improve Performance

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Vote Challenges

1) The hospital has many specialised services Eg. (Renal Dialysis, CT Scan, Neuro Surgery, Cancer treatment and Electro, Encephalogram(EEG) and the medical supplies for these services are not in the NMS list. This calls for adjustments and considerations on budgetary allocations for medicines and supplies.

2) Poor medical equipment functionality due to wear, tear, long usage and inadequate maintenance since the hospital does not yet have a fully functional Regional Medical Equipment maintenance workshop. Specialised equipment keeps breaking down (Eg X- ray, CT scan, BP machines, autoclaves associated with high parts/ maintenance costs.

3) Inadequate and limited staff accommodation associated with high rents costs, difficulty in staff attraction and retention. This affects duty coverage and emergency response especially at night.

4) Lack of a functional Incinerator for proper waste management/disposal. The hospital basically stores the waste but has no facility for final disposal or incineration especially for the infectious waste.

5) Old and dilapidated structures with limited working space causing overcrowding. There is limited land for expansion and no attendants shade. Need for fast tracking second phase of hospital construction.

6) Heavy Work load/inadequate staff due to the restricted structure: The Current establishment structure is 377 out stripped by increased work load leading to fatigue and inefficiencies. Need to fasten restructuring as already started.

7) Utility bills especially the YAKA system for hospital services continues to create domestic arrears

Plans to improve Vote Performance

1) The hospital will be committed to work within the provisions of the approved budget and service delivery targets with emphasis to quality improvement (Improved Stock management, proper accountability for medicines and reduction of stock outs, as a contribution to achieve the health sector objectives.

2) Management will strengthen support supervision to the lower health facilities in the region to build their capacity to deliver improved services. The units will also be supported to operationalise the theatres, improve referrals and management of Emergencies. This will reduce un necessary referrals and stream lines the referral system. Training, mentorship, placements and surgical camps will be supported to address the common Non Communicable diseases in the region.

3) Monitoring and Evaluation using Standard check lists for both internal and external technical supervision will be enforced in the region and avenues for information sharing established for improved service delivery.

4) Service contracts with duty schedules, task allocations and schedules of duties for improved performance management among the staff. Staff welfare will be improved by provision of teas, working tools and timely payments of emoluments; Improve duty coverage using biometric analysis and duty attendance registers; lobby with partners to fill service delivery gaps and ensure timely and regular supply of medicines and other sundries.

5) The regional Medical Equipment maintenance activities including user trainings will be strengthened for equipment functionality, with improved clean and safe working environment to ensure user/patients/workers’ rights and safety.

6) Internal resource controls especially for finances, medicines and other resources will be enforced coupled with proper leadership and governance to ensure accountability and value for money. The medicines and therapeutic committee in place will be strengthened for effective and efficient management of medicines.

7) Management structures, committees and bodies functionalized for efficiency and effectiveness in service delivery. Strict and close Supervision of works by appointing contract managers, frequent site meetings, strict verification of items procured by user units to ensure quality and value for money working through project management committees (Appointed Project managers)

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Vote Challenges 8) Stake holders’ involvement including the local communities, Partners for integrated service delivery will be enforced. Regular planning, review, feedback and updates meetings conducted including client’s engagement for sensitization, mobilization and 1) The hospital has many specialised services Eg. (Renal Dialysis, CT Scan, Neuro Surgery, Cancer treatment and Electro, feedback through the media. Encephalogram(EEG) and the medical supplies for these services are not in the NMS list. This calls for adjustments and considerations on budgetary allocations for medicines and supplies. XI Off Budget Support

2) Poor medical equipment functionality due to wear, tear, long usage and inadequate maintenance since the hospital does not yet Table 11.1 Off-Budget Support by Sub-Programme have a fully functional Regional Medical Equipment maintenance workshop. Specialised equipment keeps breaking down (Eg X- ray, CT scan, BP machines, autoclaves associated with high parts/ maintenance costs. Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates 3) Inadequate and limited staff accommodation associated with high rents costs, difficulty in staff attraction and retention. This Programme 0856 Regional Referral Hospital Services 0.00 2.05 affects duty coverage and emergency response especially at night. Recurrent Budget Estimates 4) Lack of a functional Incinerator for proper waste management/disposal. The hospital basically stores the waste but has no 01 Mbarara Referral Hospital Services 0.00 2.05 facility for final disposal or incineration especially for the infectious waste. 436-Global Fund for HIV, TB & Malaria 0.00 1.77

5) Old and dilapidated structures with limited working space causing overcrowding. There is limited land for expansion and no 451-Global Alliance for Vaccines Immunisation 0.00 0.28 attendants shade. Need for fast tracking second phase of hospital construction. Total for Vote 0.00 2.05

6) Heavy Work load/inadequate staff due to the restricted structure: The Current establishment structure is 377 out stripped by XII. Vote Cross Cutting Policy And Other Budgetary Issues increased work load leading to fatigue and inefficiencies. Need to fasten restructuring as already started. Table 12.1: Cross- Cutting Policy Issues 7) Utility bills especially the YAKA system for hospital services continues to create domestic arrears Issue Type: HIV/AIDS

Objective : 1) To reduce incidence of HIV infections by implementing the 90,90,90 policy of Test Treat and Plans to improve Vote Performance Suppress Issue of Concern : Increased HIV incidence among MARPS (Commercial Sex workers, Working class, Long distance 1) The hospital will be committed to work within the provisions of the approved budget and service delivery targets with emphasis drivers, adolescents) to quality improvement (Improved Stock management, proper accountability for medicines and reduction of stock outs, as a contribution to achieve the health sector objectives. Planned Interventions : Conduct HIV health education, Safe male circumcision,condom distribution HIV/AIDS/TB counselling/testing; Treat STDs and STIs 2) Management will strengthen support supervision to the lower health facilities in the region to build their capacity to deliver Positives initiated on ART; improved services. The units will also be supported to operationalise the theatres, improve referrals and management of Exposed clients provided PEP, Emergencies. This will reduce un necessary referrals and stream lines the referral system. Training, mentorship, placements and Condoms distributed. moonlight outreaches done, surgical camps will be supported to address the common Non Communicable diseases in the region.

3) Monitoring and Evaluation using Standard check lists for both internal and external technical supervision will be enforced in the Budget Allocation (Billion) : 8,000,000.000 region and avenues for information sharing established for improved service delivery. Performance Indicators: Numbers of: 4) Service contracts with duty schedules, task allocations and schedules of duties for improved performance management among Health education sessions held, the staff. Staff welfare will be improved by provision of teas, working tools and timely payments of emoluments; Improve duty People counselled & tested. coverage using biometric analysis and duty attendance registers; lobby with partners to fill service delivery gaps and ensure timely Males circumcised, and regular supply of medicines and other sundries. Positives initiated on ART; Exposed clients provided PEP, 5) The regional Medical Equipment maintenance activities including user trainings will be strengthened for equipment Condoms distributed. functionality, with improved clean and safe working environment to ensure user/patients/workers’ rights and safety. Moonlight outreaches done, Couples tested 6) Internal resource controls especially for finances, medicines and other resources will be enforced coupled with proper leadership and governance to ensure accountability and value for money. The medicines and therapeutic committee in place will be Objective : To give HAART to all eligible clients strengthened for effective and efficient management of medicines. ((95,95,95 policy)

7) Management structures, committees and bodies functionalized for efficiency and effectiveness in service delivery. Strict and Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 95% of close Supervision of works by appointing contract managers, frequent site meetings, strict verification of items procured by user Issue of Concern : the positives put into care and 95% Viral suppression. units to ensure quality and value for money working through project management committees (Appointed Project managers)

190 191 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:173 Mbarara Referral Hospital

Planned Interventions : • Targeted testing • Viral Load monitoring. • Supplies • Provision of Pr-ePEP prophylaxis . • Client follow up for Lost to follow patients.

Budget Allocation (Billion) : 10,000,000.000 Performance Indicators: • Number of clients on full HAART, • Number of clients counselled, • Compliance levels of those client treatment. • Number of clients followed up•

Issue Type: Gender

Objective : To have equal access to health services despite gender, age, sex and sexual orientation and social economic status or otherwise. Issue of Concern : Access to maternal child health services Planned Interventions : Provision of free maternal child health services, automatic waiver for services under the paying wing for all mothers and children who can’t afford; Document and follow up Gender based violence cases in the hospital.

Budget Allocation (Billion) : 4,000,000.000 Performance Indicators: Number of deliveries conducted in the facility and children below five treated; Number of clients with disabilities treated. Waivers provided in the private wing; Number of gender based violence cases reported and handled in the hospital.

Objective : To educate the community about the dangers of late service seeking behaviour Issue of Concern : Delayed health seeking behaviour resulting into complications, high morbidity and mortality especially maternal and neonatal morbidity Planned Interventions : Health education at hospital, Community outreaches, special clinics adolescents and paediatrics, old, disabled and incapacitated Involvement of special groups Improve supervision, referral system, emergency & ambulatory services. Budget Allocation (Billion) : 8,000,000.000 Performance Indicators: Number of mothers seeking early ANC in 1st to 4th Visits; mothers delivering in hospital, Reduction in maternal perinatal death, Number of cases referred by CHWs &peers.

Issue Type: Enviroment

Objective : To have a clean and safe working hospital environment Issue of Concern : Hospitable and Safe environment resulting into accidents, insecurity and infection Planned Interventions : Safe clean water; constant power; cleaning supervision, Qi 5S. Signages; compound beatification, tree cover; Provision of protective wear & uniforms; Supervision; Disposal of obsolete items and equipment

192 193 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:173 Mbarara Referral Hospital Vote:173 Mbarara Referral Hospital

Planned Interventions : • Targeted testing Budget Allocation (Billion) : 6,000,000.000 • Viral Load monitoring. • Supplies Performance Indicators: Clean &safe working environment; Availability of water, power Proper waste management, staff • Provision of Pr-ePEP prophylaxis . protected. 5S implemented. • Client follow up for Lost to follow patients. Objective : To ensure proper hospital waste disposal and management Issue of Concern : Hospital environmental pollution and public safety. Budget Allocation (Billion) : 10,000,000.000 Planned Interventions : Proper waste segregation, transportation &disposal, functional sewage system, disposal of expired Performance Indicators: • Number of clients on full HAART, items, incineration of dangerous wastes. Use of power and water monitored. • Number of clients counselled, • Compliance levels of those client treatment. Budget Allocation (Billion) : 2,000,000.000 • Number of clients followed up• Performance Indicators: Clean, safe and welcoming hospital environment, Reduced accumulation of expired items, dangerous wastes disposed, Issue Type: Gender XIII. Personnel Information Objective : To have equal access to health services despite gender, age, sex and sexual orientation and social economic status or otherwise. Table 13.1 Staff Establishment Analysis Issue of Concern : Access to maternal child health services Title Salary Scale Number Of Approved Positions Number Of Filled Positions Planned Interventions : Provision of free maternal child health services, automatic waiver for services under the paying Consultant (Anaesthesia) U1SE 1 0 wing for all mothers and children who can’t afford; Document and follow up Gender based violence cases in the hospital. Consultant (Medicine) U1SE 1 0 Consultant (Obs. & Gyn) U1SE 1 0

Budget Allocation (Billion) : 4,000,000.000 Senior Consultant MEDICAL U1SE 1 0 Performance Indicators: Number of deliveries conducted in the facility and children below five treated; Number of clients Medical Officer Special Grade U2(Med-1) 1 0 with disabilities treated. (Medicine) Waivers provided in the private wing; Number of gender based violence cases reported and Medical Officer Special Grade U2(Med-1) 1 0 handled in the hospital. (Surgeon) SEN PRINCIPAL NURSING U2(Med-2) 1 0 Objective : To educate the community about the dangers of late service seeking behaviour OFFICER Issue of Concern : Delayed health seeking behaviour resulting into complications, high morbidity and mortality Principal Anaesthetic Officer U3(Med-2) 1 0 especially maternal and neonatal morbidity PRINCIPAL PSYCHIATRIC U3(Med-2) 1 0 Planned Interventions : Health education at hospital, CLINICAL OFFICER Community outreaches, SENIOR ORTHOPAEDIC U4(Med-2) 1 0 special clinics adolescents and paediatrics, old, disabled and incapacitated OFFICER Involvement of special groups Improve supervision, referral system, emergency & ambulatory services. SENIOR RADIOGRAPHER U4(Med-2) 2 1 Budget Allocation (Billion) : 8,000,000.000 ORTHOPAEDIC TECHNICIAN U5(SC) 1 0 Performance Indicators: Number of mothers seeking early ANC in 1st to 4th Visits; mothers delivering in hospital, ENROLLED MIDWIFE U7(Med) 52 47 Reduction in maternal perinatal death, Number of cases referred by CHWs &peers. Consultant (Orthopaedic) US1E 1 0 Senior Consultant (Surgery) US1E 1 0 Issue Type: Enviroment Table 13.2 Staff Recruitment Plan Objective : To have a clean and safe working hospital environment Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Issue of Concern : Hospitable and Safe environment resulting into accidents, insecurity and infection Scale Approved Filled Posts Posts Cleared for Per Month Salary Planned Interventions : Safe clean water; constant power; cleaning supervision, Qi 5S. Signages; compound beatification, Posts Filling (UGX) (UGX) tree cover; Provision of protective wear & uniforms; Supervision; Disposal of obsolete items and FY2020/21 equipment Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000

192 193 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:173 Mbarara Referral Hospital

Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Orthopaedic) US1E 1 0 1 1 4,200,000 50,400,000 ENROLLED MIDWIFE U7(Med) 52 47 5 5 3,065,790 36,789,480 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Surgeon) ORTHOPAEDIC TECHNICIAN U5(SC) 1 0 1 1 1,200,000 14,400,000 Principal Anaesthetic Officer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PRINCIPAL PSYCHIATRIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 CLINICAL OFFICER SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 OFFICER Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant (Surgery) US1E 1 0 1 1 4,500,000 54,000,000 SENIOR ORTHOPAEDIC U4(Med-2) 1 0 1 1 2,200,000 26,400,000 OFFICER SENIOR RADIOGRAPHER U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Total 67 48 19 19 51,665,790 619,989,480

194 195 Mbarara Referral Hospital Ministerial Policy Statement FY 2020/21 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:173 Mbarara Referral Hospital Vote:174 Mubende Referral Hospital

Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 V1: Vote Overview Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Orthopaedic) US1E 1 0 1 1 4,200,000 50,400,000 I. Vote Mission Statement ENROLLED MIDWIFE U7(Med) 52 47 5 5 3,065,790 36,789,480 To be a center of excellence in providing both specialized and general curative, preventive, health promotion and rehabilitative Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 services to all the people in our catchment region and neighboring areas based on equity and equality without segregation or (Medicine) disadvantaging anybody. Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Surgeon) II. Strategic Objective ORTHOPAEDIC TECHNICIAN U5(SC) 1 0 1 1 1,200,000 14,400,000 a. To improve the quality and productivity of the people by enhancing good health through increasing awareness and uptake of Principal Anaesthetic Officer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 disease prevention interventions. b. To reduce Maternal and Neo Natal Mortality. c. To contribute to the body of knowledge in PRINCIPAL PSYCHIATRIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 health care through training, research and disseminating best practices. d. To combat HIV/AIDS, TB, Malaria and other CLINICAL OFFICER infectious diseases. e. To strengthen collaboration with other stake holders. f. To build a formidable and highly motivated and SEN PRINCIPAL NURSING U2(Med-2) 1 0 1 1 3,500,000 42,000,000 committed health care work force. OFFICER Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 III. Major Achievements in 2019/20 Senior Consultant (Surgery) US1E 1 0 1 1 4,500,000 54,000,000 • Inpatient services: 87% bed occupancy rate (10,426 admissions, 4 days average length of stay, 1,105 cesarean section SENIOR ORTHOPAEDIC U4(Med-2) 1 0 1 1 2,200,000 26,400,000 deliveries and 1,590 major surgeries) OFFICER • Outpatient services: 19.7% increment in specialists clinic outpatient attendances in comparison with half year last year (49,109 SENIOR RADIOGRAPHER U4(Med-2) 2 1 1 1 2,200,000 26,400,000 attendances and 2,086 referrals in) Total 67 48 19 19 51,665,790 619,989,480 • Diagnostic services: 53% decline in diagnostic investigations in comparison to half year last year (including 16,850 lab tests, 0 ultra sound scan investigations and 807 x-ray investigations) • Hospital management and support services: Q4 performance report and annual performance report prepared, Q1 one performance report prepared, two board meetings held, 3 top management meetings held, two senior staff meetings, maintained buildings/compounds, provided and paid for utilities, special meals provided to the needy and laundry services rendered. Serviced vehicles six times, repaired 4 vehicles and purchased two tires for ambulance. • Prevention and rehabilitation services: 4,934 antenatal attendances, 1,068 people received family planning, 96.5% of mothers who tested HIV+ initiated on ART, 12,449 clients tested for HIV, 561 new clients initiated on HIV treatment and a total of 6,222 clients active on treatment cumulatively. • Immunization services: 16,962 immunizations conducted • Hospital Construction/rehabilitation: Walk way completed. Solar power installation completed while the drilling of the well has been completed, submersible pump sunk, water quality testing ongoing and plumbing. Site protection and power connection also ongoing. • Hospital Construction/rehabilitation: The project for construction of the seven units complex has stalled at roofing level due to poor funding with only some of the trusses fixed

IV. Medium Term Plans • In the medium term the entity will continue to strengthen cooperate governance by regular consultation and scheduled meetings to involve the Hospital Management Board in major decisions. • The specialists support supervision visits to the lower level health facilities on quarterly basis will continue and be strengthened to ensure better performance at the lower level facilities and enable the Regional Referral Hospital concentrate on its core function as a referral. • Quality improvement projects will continue to be done by all departments/units for better service delivery. • Partnership with implementing partners is being explored to computerize data on all the units of the entity for better planning and performance. • Resource allocation for capital development will majorly be for the ongoing project. Service delivery will continue to be gender sensitive in terms of clinical care, use of hospital facilities and response to client’s needs. • Clients will receive services according to need, for example children and women will be given priority. • Patients who require urgent attention will be attended to before the ones that can wait. Equity will also apply to issues relating to health care workers. Positions in the hospital will be open for competition regardless of gender, tribe and age if applicable. Infrastructure developments will always take into consideration disabled clients and staff.

194 195 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 4.375 5.434 2.326 5.434 5.434 5.434 5.434 5.434 Recurrent Non Wage 1.145 1.774 0.596 3.078 3.078 3.078 3.078 3.078 GoU 1.052 1.060 0.934 2.750 2.000 0.700 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 6.573 8.269 3.856 11.262 10.512 9.212 8.739 8.739 Total GoU+Ext Fin (MTEF) 6.573 8.269 3.856 11.262 10.512 9.212 8.739 8.739 Arrears 0.263 0.004 0.002 0.000 0.000 0.000 0.000 0.000 Total Budget 6.836 8.273 3.858 11.262 10.512 9.212 8.739 8.739 A.I.A Total 0.085 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 6.921 8.273 3.858 11.262 10.512 9.212 8.739 8.739 Total Vote Budget 6.658 8.269 3.856 11.262 10.512 9.212 8.739 8.739 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.209 0.000 0.000 7.209 8.512 0.000 8.512

211 Wages and Salaries 5.583 0.000 0.000 5.583 5.614 0.000 5.614

212 Social Contributions 0.175 0.000 0.000 0.175 0.210 0.000 0.210

213 Other Employee Costs 0.413 0.000 0.000 0.413 1.682 0.000 1.682

221 General Expenses 0.158 0.000 0.000 0.158 0.158 0.000 0.158

222 Communications 0.041 0.000 0.000 0.041 0.032 0.000 0.032

223 Utility and Property Expenses 0.353 0.000 0.000 0.353 0.324 0.000 0.324

224 Supplies and Services 0.160 0.000 0.000 0.160 0.170 0.000 0.170

227 Travel and Transport 0.151 0.000 0.000 0.151 0.164 0.000 0.164

228 Maintenance 0.170 0.000 0.000 0.170 0.154 0.000 0.154

273 Employer social benefits 0.004 0.000 0.000 0.004 0.004 0.000 0.004

Output Class : Capital Purchases 1.060 0.000 0.000 1.060 2.750 0.000 2.750

312 FIXED ASSETS 1.060 0.000 0.000 1.060 2.750 0.000 2.750

196 197 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital Vote:174 Mubende Referral Hospital

Output Class : Arrears 0.004 0.000 0.000 0.004 0.000 0.000 0.000 V. Summary of Past Performance and Medium Term Budget Allocations 321 DOMESTIC 0.004 0.000 0.000 0.004 0.000 0.000 0.000 Table 5.1: Overview of Vote Expenditures (UShs Billion) Grand Total : 8.273 0.000 0.000 8.273 11.262 0.000 11.262

2019/20 MTEF Budget Projections Total excluding Arrears 8.269 0.000 0.000 8.269 11.262 0.000 11.262 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec VII. Budget By Programme And Subprogramme Wage 4.375 5.434 2.326 5.434 5.434 5.434 5.434 5.434 Recurrent Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Non Wage 1.145 1.774 0.596 3.078 3.078 3.078 3.078 3.078 GoU 1.052 1.060 0.934 2.750 2.000 0.700 0.227 0.227 Billion Uganda shillings FY 2019/20 Medium Term Projections Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed GoU Total 6.573 8.269 3.856 11.262 10.512 9.212 8.739 8.739 Budget 56 Regional Referral Hospital Services 6.921 8.273 3.858 11.262 10.512 9.212 8.739 8.739 Total GoU+Ext Fin (MTEF) 6.573 8.269 3.856 11.262 10.512 9.212 8.739 8.739 01 Mubende Referral Hospital Services 5.523 7.121 2.893 8.420 8.420 8.420 8.420 8.420 Arrears 0.263 0.004 0.002 0.000 0.000 0.000 0.000 0.000 02 Mubende Referral Hospital Internal Audit 0.010 0.010 0.005 0.010 0.010 0.010 0.010 0.010 Total Budget 6.836 8.273 3.858 11.262 10.512 9.212 8.739 8.739 03 Mubende Regional Maintenance 0.082 0.082 0.026 0.082 0.082 0.082 0.082 0.082 A.I.A Total 0.085 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1004 Mubende Rehabilitation Referal 1.154 0.890 0.887 2.550 1.800 0.500 0.150 0.150 Grand Total 6.921 8.273 3.858 11.262 10.512 9.212 8.739 8.739 Hospital 6.658 8.269 3.856 11.262 10.512 9.212 8.739 8.739 1482 Institutional Support to Mubende 0.152 0.170 0.047 0.000 0.000 0.000 0.000 0.000 Total Vote Budget Regional Hospital Excluding Arrears 1579 Retooling of Mubende Regional 0.000 0.000 0.000 0.200 0.200 0.200 0.077 0.077 Referral Hospital VI. Budget By Economic Clasification Total for the Vote 6.921 8.273 3.858 11.262 10.512 9.212 8.739 8.739

Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total Excluding Arrears 6.658 8.269 3.856 11.262 10.512 9.212 8.739 8.739

2019/20 Approved Budget 2020/21 Draft Estimates VIII. Programme Performance and Medium Term Plans Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 7.209 0.000 0.000 7.209 8.512 0.000 8.512 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

211 Wages and Salaries 5.583 0.000 0.000 5.583 5.614 0.000 5.614 Programme : 56 Regional Referral Hospital Services 212 Social Contributions 0.175 0.000 0.000 0.175 0.210 0.000 0.210 Programme Objective To provide specialized and general health care services, preventive, rehabilitative and health promotion 213 Other Employee Costs 0.413 0.000 0.000 0.413 1.682 0.000 1.682 : services through provision of mental health care, orthopedic/physiotherapy services to all the people including the elderly, children and the destitute. 221 General Expenses 0.158 0.000 0.000 0.158 0.158 0.000 0.158 Responsible Officer: Dr. Andema Alex 222 Communications 0.041 0.000 0.000 0.041 0.032 0.000 0.032 Programme Outcome: Quality and accessible Regional Referral Hospital Services 223 Utility and Property Expenses 0.353 0.000 0.000 0.353 0.324 0.000 0.324 Sector Outcomes contributed to by the Programme Outcome 224 Supplies and Services 0.160 0.000 0.000 0.160 0.170 0.000 0.170 1. Improved quality of life at all levels 227 Travel and Transport 0.151 0.000 0.000 0.151 0.164 0.000 0.164 Performance Targets 228 Maintenance 0.170 0.000 0.000 0.170 0.154 0.000 0.154 Outcome Indicators 2020/21 2021/22 2022/23 273 Employer social benefits 0.004 0.000 0.000 0.004 0.004 0.000 0.004 Baseline Base year Target Projection Projection Output Class : Capital Purchases 1.060 0.000 0.000 1.060 2.750 0.000 2.750 • Bed Occupancy Rate (BOR) 69% 20172018 75% 80% 80% 312 FIXED ASSETS 1.060 0.000 0.000 1.060 2.750 0.000 2.750

196 197 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital

• Percentage increase of diagnostic investigations carried out. 8% 20172018 10% 15% 15%

• Percentage increase of specialised clinic outpatients attendances 5% 20172018 8% 10% 10%

SubProgramme: 01 Mubende Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 18,000 19,000 20,000

Average Length of Stay (ALOS) - days 4 4 4

Bed Occupancy Rate (BOR) 75 80 80

Number of Major Operations (including Ceasarian se 4,800 5,000 5,250

Output: 02 Outpatient services Total general outpatients attendances 25,000 27,500 30,250

Number of specialised clinic attendences 95,000 104,500 114,950

Referral cases in 3,620 3,982 4,380

Output: 04 Diagnostic services No. of laboratory tests carried out 95,000 109,250 120,175

No. of patient xrays (imaging) taken 4,200 4,830 5,550

Number of Ultra Sound Scans 4,500 5,175 5,950

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 28 Yes Yes Yes

Quarterly financial reports submitted timely Yes Yes Yes

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 13,860 15,246 16,770

No. of family planning users attended to (New and Old) 2,900 3,200 3,520

Percentage of HIV positive pregnant women not on H 1% 1% 1%

Output: 07 Immunisation Services Number of Children immunized (All immunizations) 38,800 42,700 46,900

SubProgramme: 02 Mubende Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 28 Yes Yes Yes

Quarterly financial reports submitted timely Yes Yes Yes

198 199 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital Vote:174 Mubende Referral Hospital

• Percentage increase of diagnostic investigations carried out. 8% 20172018 10% 15% 15% SubProgramme: 03 Mubende Regional Maintenance

• Percentage increase of specialised clinic outpatients attendances 5% 20172018 8% 10% 10% Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4 SubProgramme: 01 Mubende Referral Hospital Services Output: 01 Inpatient services Timely payment of salaries and pensions by the 28 Yes Yes Yes No. of in-patients (Admissions) 18,000 19,000 20,000 Quarterly financial reports submitted timely Yes Yes Yes

Average Length of Stay (ALOS) - days 4 4 4 SubProgramme: 1004 Mubende Rehabilitation Referal Hospital

Bed Occupancy Rate (BOR) 75 80 80 Output: 80 Hospital Construction/rehabilitation 1 Number of Major Operations (including Ceasarian se 4,800 5,000 5,250 Number of wards/ buildings constructed/ Rehabilitated

Output: 02 Outpatient services IX. Major Capital Investments And Changes In Resource Allocation Total general outpatients attendances 25,000 27,500 30,250 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Number of specialised clinic attendences 95,000 104,500 114,950 FY 2019/20 FY 2020/21 Referral cases in 3,620 3,982 4,380 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Output: 04 Diagnostic services end Dec Outputs No. of laboratory tests carried out 95,000 109,250 120,175 Vote 174 Mubende Referral Hospital Program : 08 56 Regional Referral Hospital Services No. of patient xrays (imaging) taken 4,200 4,830 5,550 Development Project : 1004 Mubende Rehabilitation Referal Hospital Number of Ultra Sound Scans 4,500 5,175 5,950 Output: 08 56 83 OPD and other ward construction and rehabilitation Output: 05 Hospital Management and support services Complete roofing of the seven units complex, Assets register updated on a quarterly basis 4 4 4 plastering, metal works, plumbing, electrical internal fittings. Timely payment of salaries and pensions by the 28 Yes Yes Yes Total Output Cost(Ushs Thousand) 0 0 2,500,000

Quarterly financial reports submitted timely Yes Yes Yes Gou Dev’t: 0 0 2,500,000 Ext Fin: 0 0 0 Output: 06 Prevention and rehabilitation services A.I.A: 0 0 0 No. of antenatal cases (All attendances) 13,860 15,246 16,770

No. of family planning users attended to (New and Old) 2,900 3,200 3,520 X. Vote Challenges and Plans To Improve Performance Percentage of HIV positive pregnant women not on H 1% 1% 1% Vote Challenges Output: 07 Immunisation Services • The hospital continues to have vacant positions on the staff establishment especially at the specialists’ level leading to failure to Number of Children immunized (All immunizations) 38,800 42,700 46,900 provide some of the critical services like orthopedic surgery yet we are on a high way and receive many road traffic accidents. • Lack of staff accommodation makes a timely response to call and emergency duty difficult as staff are scattered far from the SubProgramme: 02 Mubende Referral Hospital Internal Audit facility. • Inadequate funding for both non-wage recurrent and capital development budgets has led to stalling of a project for the Output: 05 Hospital Management and support services construction of the seven units complex and failure to meet some of the basic requirements like minor renovations and Assets register updated on a quarterly basis 4 4 4 maintenance of buildings and sewerage services, food, lighting and many others leading to accumulation of domestic arrears. • Power blackout that normally happens for half of the time in a week continues to affect operations of the hospital putting a lot of Timely payment of salaries and pensions by the 28 Yes Yes Yes pressure on the budget for fuel to run generators and sometimes leaving the entity in total blackout. • Inadequate blood supply to the hospital contributes to over 60% of the referrals to Mulago, especially for pregnant mothers. Quarterly financial reports submitted timely Yes Yes Yes • Installation of new equipment and addition of new buildings continues to increase the operational costs for non-wage recurrent costs especially for utilities that have more than doubled and cleaning services that continue to be poor due to inadequate funding.

198 199 • The hospital continues to have vacant positions on the staff establishment especially at the specialists’ level leading to failure to provide some of the critical services like orthopedic surgery yet we are on a high way and receive many road traffic accidents. • Lack of staff accommodation makes a timely response to call and emergency duty difficult as staff are scattered far from the facility. • Inadequate funding for both non-wage recurrent and capital development budgets has led to stalling of a project for the constructionMubende Referral of the seven Hospital units complex and failure to meet some of the basic requirements Ministeriallike minor renovationsPolicy Statement and FY 2020/21 maintenance of buildings and sewerage services, food, lighting and many others leading to accumulation of domestic arrears. • Power blackout that normally happens for half of the time in a week continues to affect operations of the hospital putting a lot of pressureVote: on the budget for fuelMubende to run generators Referral and sometimesHospital leaving the entity in total blackout. • Inadequate blood174 supply to the hospital contributes to over 60% of the referrals to Mulago, especially for pregnant mothers. • Installation of new equipment and addition of new buildings continues to increase the operational costs for non-wage recurrent costs especially for utilities that have more than doubled and cleaning services that continue to be poor due to inadequate funding.

Plans to improve Vote Performance

• To address vote challenges, the entity in the medium term continues to allocate the bigger percentage of capital development funds towards the completion of the stalled seven units’ complex, but this is not sufficient enough to have a major impact towards completion of the same. • To address the challenge of vacant staffing positions the entity continues to seek clearance to recruit and fill critical staff positions using available wage. • There are also plans to partner with the Royal College of Pathologists London (UK) to put a blood bank in the hospital but the only stumbling block is resources to put up a building to house the blood bank which is the responsibility of the hospital as envisaged by the partnership. • Implementation of quality improvement projects and furthering cooperation with implementing partners is trying to bridge the existing service gaps. • The entity has shared the challenge of under funding and being the least funded among the referral hospitals with the Ministry of Health and Ministry of Finance seeking improved allocations to meet the basic needs of service delivery. • Investment has also been done in alternative water source to reduce the money spent on water and allocate it for other services.

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.18 1.24 Recurrent Budget Estimates 01 Mubende Referral Hospital Services 0.18 1.24 410-International Development Association (IDA) 0.00 0.90

Mildmay Uganda 0.18 0.34

Total for Vote 0.18 1.24

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To counsel, test and treat all the people tested positive for HIV Issue of Concern : Testing and treatment of all the people tested positive Planned Interventions : 1. To treat all HIV+ pregnant mothers 2. Access to HIV/AIDS services by adolescence 3. To suppress the viral load in clients on treatment

Budget Allocation (Billion) : 0.200 Performance Indicators: 1. 100% of HIV+ pregnant mothers enrolled on treatment 2. Percentage of adolescence maintained in the HIV/AIDS clinic 3. To ensure that 95% and above of clients on treatment have suppression of the virus.

200 201 • The hospital continues to have vacant positions on the staff establishment especially at the specialists’ level leading to failure to provide some of the critical services like orthopedic surgery yet we are on a high way and receive many road traffic accidents. • Lack of staff accommodation makes a timely response to call and emergency duty difficult as staff are scattered far from the facility. • Inadequate funding for both non-wage recurrent and capital development budgets has led to stalling of a project for the constructionMubende Referral of the seven Hospital units complex and failure to meet some of the basic requirements Ministeriallike minor renovationsPolicy Statement and FY 2020/21 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21 maintenance of buildings and sewerage services, food, lighting and many others leading to accumulation of domestic arrears. • Power blackout that normally happens for half of the time in a week continues to affect operations of the hospital putting a lot of pressureVote: on the budget for fuelMubende to run generators Referral and sometimesHospital leaving the entity in total blackout. Vote: Mubende Referral Hospital • Inadequate blood174 supply to the hospital contributes to over 60% of the referrals to Mulago, especially for pregnant mothers. 174 • Installation of new equipment and addition of new buildings continues to increase the operational costs for non-wage recurrent costs especially for utilities that have more than doubled and cleaning services that continue to be poor due to inadequate funding.

Issue Type: Gender Plans to improve Vote Performance Objective : To attain equity and fairness in accessing health care services in regard to gender and equal • To address vote challenges, the entity in the medium term continues to allocate the bigger percentage of capital development opportunities in the hospital funds towards the completion of the stalled seven units’ complex, but this is not sufficient enough to have a major impact towards completion of the same. Issue of Concern : Lack of equity and fairness in accessing health care services in regard to gender and equal • To address the challenge of vacant staffing positions the entity continues to seek clearance to recruit and fill critical staff opportunities in the hospital positions using available wage. Planned Interventions : 1. Access to OPD services by children aged under five years. • There are also plans to partner with the Royal College of Pathologists London (UK) to put a blood bank in the hospital but the 2. Access to health care services by gender based violence victims only stumbling block is resources to put up a building to house the blood bank which is the responsibility of the hospital as 3. Access to adolescent friendly services envisaged by the partnership. • Implementation of quality improvement projects and furthering cooperation with implementing partners is trying to bridge the Budget Allocation (Billion) : 0.060 existing service gaps. • The entity has shared the challenge of under funding and being the least funded among the referral hospitals with the Ministry of Performance Indicators: 1. Number of children below the age of five served in OPD. Health and Ministry of Finance seeking improved allocations to meet the basic needs of service delivery. 2. Number of gender based violence victims served • Investment has also been done in alternative water source to reduce the money spent on water and allocate it for other services. 3. Number of adolescence attending the OPD adolescence clinic

XI Off Budget Support Issue Type: Enviroment

Table 11.1 Off-Budget Support by Sub-Programme Objective : To create a hygienic and healing environment in the hospital Issue of Concern : Poor hygiene and bad environment leading to hospital acquired infections Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Planned Interventions : 1. Reduction of sepsis cases Programme 0856 Regional Referral Hospital Services 0.18 1.24 2. Production and supply of alcohol for hand hygiene on all units Recurrent Budget Estimates 01 Mubende Referral Hospital Services 0.18 1.24 3. An active infection prevention and control committee 410-International Development Association (IDA) 0.00 0.90 Budget Allocation (Billion) : 0.140 Mildmay Uganda 0.18 0.34 Performance Indicators: 1. Number of sepsis cases reported in the hospital Total for Vote 0.18 1.24

XII. Vote Cross Cutting Policy And Other Budgetary Issues 2. Quantity of alcohol produced and supplied to units Table 12.1: Cross- Cutting Policy Issues 3. Monthly meetings of the infection control and prevention committee

Issue Type: HIV/AIDS XIII. Personnel Information Objective : To counsel, test and treat all the people tested positive for HIV Table 13.1 Staff Establishment Analysis Issue of Concern : Testing and treatment of all the people tested positive Title Salary Scale Number Of Approved Positions Number Of Filled Positions Planned Interventions : 1. To treat all HIV+ pregnant mothers 2. Access to HIV/AIDS services by adolescence Consultant (ENT) U1SE 1 0 3. To suppress the viral load in clients on treatment Consultant (Ophthamology) U1SE 1 0

Budget Allocation (Billion) : 0.200 Consultant (Orthopaedics) U1SE 1 0 Performance Indicators: 1. 100% of HIV+ pregnant mothers enrolled on treatment Consultant (Pathology) U1SE 1 0 2. Percentage of adolescence maintained in the HIV/AIDS clinic Consultant Anesthesia U1SE 1 0 3. To ensure that 95% and above of clients on treatment have suppression of the virus. Consultant Orthopaedic U1SE 1 0 Consultnat (Public Health) U1SE 1 0

200 201 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 (Opthamology) Medical Officer Special Grade U2(Med-1) 1 1 (Radiologist) Medical Officer Special Grade U2U 1 0 (Opthamology) Prnc Radiographer U3 1 0 Principal Occupational Therapist U3(Med-2) 1 0 Sen Orth Officer U4 1 0 Sen Psych Clinical Officer U4 1 0 SNO U4 15 6 Surgeon U4 1 0 Pharmacist U4(Med-1) 1 0 SENIOR LABARATORY U4(Med-2) 1 0 TECHNICIAN Senior Radiographer U4(Med-2) 4 2 Accountant U4U 1 0 Medical Officer U4U 10 8 NO U5 18 13 Stenographer/Secretary U5 1 0 OPTHALMIC CLINICAL U5(SC) 1 0 OFFICER Public Health Dental Officer U5(SC) 1 0 Stores Assistant U6U 1 0 Cleriical Officer U7 1 0 Accounts Assistant U7U 4 2 MENTAL ATTENDANT U8(Med) 3 0 Consultant (Radiology) US1E 1 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Accounts Assistant U7U 4 2 2 2 755,562 9,066,744 Medical Officer U4U 10 8 2 2 26,400,000 316,800,000 MENTAL ATTENDANT U8(Med) 3 0 3 3 941,496 11,297,952 NO U5 18 13 5 5 3,769,310 45,231,720 OPTHALMIC CLINICAL U5(SC) 1 0 1 1 1,200,000 14,400,000 OFFICER Pharmacist U4(Med-1) 1 0 1 1 3,000,000 36,000,000

202 203 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21 Mubende Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:174 Mubende Referral Hospital Vote:174 Mubende Referral Hospital

Medical Officer Special Grade U2(Med-1) 1 0 Principal Occupational Therapist U3(Med-2) 1 0 1 1 3,100,000 37,200,000 (Opthamology) Prnc Radiographer U3 1 0 1 1 1,315,765 15,789,180 Medical Officer Special Grade U2(Med-1) 1 1 Public Health Dental Officer U5(SC) 1 0 1 1 1,200,000 14,400,000 (Radiologist) Sen Orth Officer U4 1 0 1 1 1,131,967 13,583,604 Medical Officer Special Grade U2U 1 0 Sen Psych Clinical Officer U4 1 0 1 1 1,131,967 13,583,604 (Opthamology) SENIOR LABARATORY U4(Med-2) 1 0 1 1 2,200,000 26,400,000 Prnc Radiographer U3 1 0 TECHNICIAN Principal Occupational Therapist U3(Med-2) 1 0 Senior Radiographer U4(Med-2) 4 2 2 2 4,400,000 52,800,000 SNO U4 15 6 9 7 7,923,769 95,085,228 Sen Orth Officer U4 1 0 Stenographer/Secretary U5 1 0 1 1 753,862 9,046,344 Sen Psych Clinical Officer U4 1 0 Stores Assistant U6U 1 0 1 1 436,677 5,240,124 SNO U4 15 6 Surgeon U4 1 0 1 1 1,131,967 13,583,604 Surgeon U4 1 0 Total 65 31 34 32 60,792,342 729,508,104 Pharmacist U4(Med-1) 1 0 SENIOR LABARATORY U4(Med-2) 1 0 TECHNICIAN Senior Radiographer U4(Med-2) 4 2 Accountant U4U 1 0 Medical Officer U4U 10 8 NO U5 18 13 Stenographer/Secretary U5 1 0 OPTHALMIC CLINICAL U5(SC) 1 0 OFFICER Public Health Dental Officer U5(SC) 1 0 Stores Assistant U6U 1 0 Cleriical Officer U7 1 0 Accounts Assistant U7U 4 2 MENTAL ATTENDANT U8(Med) 3 0 Consultant (Radiology) US1E 1 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Accounts Assistant U7U 4 2 2 2 755,562 9,066,744 Medical Officer U4U 10 8 2 2 26,400,000 316,800,000 MENTAL ATTENDANT U8(Med) 3 0 3 3 941,496 11,297,952 NO U5 18 13 5 5 3,769,310 45,231,720 OPTHALMIC CLINICAL U5(SC) 1 0 1 1 1,200,000 14,400,000 OFFICER Pharmacist U4(Med-1) 1 0 1 1 3,000,000 36,000,000

202 203 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide quality,equitable,safe, sustainable, general and specialised services to the people of Karamoja region and beyond.

II. Strategic Objective To provide comprehensive, super specialized health service, contact tertiary health training, research and contributing to health policy and planning. III. Major Achievements in 2019/20 • 9,597 out of 10,000 Patient Admitted, 98% Bed Occupancy Rate, 6 Days average length of stay • 431 out of 1,000 Deliveries registered, 824 out of 1,000 Major surgeries done, 36,236 out of 80,000 General out Patients seen, 6,352 out of 8,000 Casualty Cases attended, 14,748 out of 25,000 Patients in Out Patient Special Clinic attended • 71,810 out of 125 Laboratory and Pathological cases done, 0 X-ray out of 4,000 examinations done, 2,183 out of 5,000 Ultra Sound scans done, 3,260 out of 800 Blood transfusions done • 1,150 out of 3,500 Family Planning contacts done, out of 8,000 Antenatal Attendances, • 6,553 out of 8,000 People immunised as static service including Vit A, De-worming and tetanus, • 2 Hospital Board meeting held, 18 Top Management meetings held, 18 Finance meetings held, 4 Quarterly Reports submitted, 2 Out Reach to lower health level units done, Civil works continued, 4 Site meetings conducted, Evaluation on Progress of works done, • Assorted medical equipment procured (Ugx 50M), Assorted furniture and fixtures procured (Ugx 33M) IV. Medium Term Plans • Completing construction of 30Units staff accommodation to improve on attraction and retention of staff. • Strengthen and fully functionalise the community health department and also provide necessary support to enable the department deliver quality services within the hospital and the region. • Strengthening the medical equipment regional workshop activities in the region through building capacity of the staff. • Engage regional Stake holders to support the hospital with unfunded priorities like feeding of patients, operationalization of the Neonatal Care unit in the region,

204 205 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To provide quality,equitable,safe, sustainable, general and specialised services to the people of Karamoja region and beyond. 2019/20 MTEF Budget Projections II. Strategic Objective 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec To provide comprehensive, super specialized health service, contact tertiary health training, research and contributing to health Wage 3.682 4.331 1.960 4.331 4.331 4.331 4.331 4.331 policy and planning. Recurrent Non Wage 1.049 1.507 0.698 1.413 1.413 1.413 1.413 1.413 III. Major Achievements in 2019/20 GoU 1.488 1.488 0.550 1.200 0.600 0.200 0.227 0.227 Devt. • 9,597 out of 10,000 Patient Admitted, 98% Bed Occupancy Rate, 6 Days average length of stay 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • 431 out of 1,000 Deliveries registered, 824 out of 1,000 Major surgeries done, 36,236 out of 80,000 General out Patients seen, Ext. Fin. 6,352 out of 8,000 Casualty Cases attended, 14,748 out of 25,000 Patients in Out Patient Special Clinic attended GoU Total 6.219 7.326 3.207 6.944 6.344 5.944 5.971 5.971 • 71,810 out of 125 Laboratory and Pathological cases done, 0 X-ray out of 4,000 examinations done, 2,183 out of 5,000 Ultra Sound scans done, 3,260 out of 800 Blood transfusions done Total GoU+Ext Fin (MTEF) 6.219 7.326 3.207 6.944 6.344 5.944 5.971 5.971 • 1,150 out of 3,500 Family Planning contacts done, out of 8,000 Antenatal Attendances, 0.000 0.000 0.000 0.003 0.000 0.000 0.000 0.000 • 6,553 out of 8,000 People immunised as static service including Vit A, De-worming and tetanus, Arrears • 2 Hospital Board meeting held, 18 Top Management meetings held, 18 Finance meetings held, 4 Quarterly Reports submitted, Total Budget 6.219 7.326 3.207 6.947 6.344 5.944 5.971 5.971 2 Out Reach to lower health level units done, Civil works continued, 4 Site meetings conducted, Evaluation on Progress of works done, A.I.A Total 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • Assorted medical equipment procured (Ugx 50M), Assorted furniture and fixtures procured (Ugx 33M) Grand Total 6.242 7.326 3.207 6.947 6.344 5.944 5.971 5.971 IV. Medium Term Plans Total Vote Budget 6.242 7.326 3.207 6.944 6.344 5.944 5.971 5.971 • Completing construction of 30Units staff accommodation to improve on attraction and retention of staff. Excluding Arrears • Strengthen and fully functionalise the community health department and also provide necessary support to enable the department deliver quality services within the hospital and the region. VI. Budget By Economic Clasification • Strengthening the medical equipment regional workshop activities in the region through building capacity of the staff. • Engage regional Stake holders to support the hospital with unfunded priorities like feeding of patients, operationalization of Table V6.1 2019/20 and 2020/21 Budget Allocations by Item the Neonatal Care unit in the region, 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 5.838 0.000 0.000 5.838 5.744 0.000 5.744

211 Wages and Salaries 4.398 0.000 0.000 4.398 4.398 0.000 4.398

212 Social Contributions 0.076 0.000 0.000 0.076 0.078 0.000 0.078

213 Other Employee Costs 0.119 0.000 0.000 0.119 0.019 0.000 0.019

221 General Expenses 0.157 0.000 0.000 0.157 0.160 0.000 0.160

222 Communications 0.025 0.000 0.000 0.025 0.025 0.000 0.025

223 Utility and Property Expenses 0.549 0.000 0.000 0.549 0.299 0.000 0.299

224 Supplies and Services 0.172 0.000 0.000 0.172 0.172 0.000 0.172

225 Professional Services 0.005 0.000 0.000 0.005 0.005 0.000 0.005

227 Travel and Transport 0.183 0.000 0.000 0.183 0.387 0.000 0.387

228 Maintenance 0.153 0.000 0.000 0.153 0.196 0.000 0.196

273 Employer social benefits 0.000 0.000 0.000 0.000 0.004 0.000 0.004

Output Class : Capital Purchases 1.488 0.000 0.000 1.488 1.200 0.000 1.200

204 205 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

312 FIXED ASSETS 1.488 0.000 0.000 1.488 1.200 0.000 1.200

Output Class : Arrears 0.000 0.000 0.000 0.000 0.003 0.000 0.003

321 DOMESTIC 0.000 0.000 0.000 0.000 0.003 0.000 0.003

Grand Total : 7.326 0.000 0.000 7.326 6.947 0.000 6.947

Total excluding Arrears 7.326 0.000 0.000 7.326 6.944 0.000 6.944

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

01 Moroto Referral Hosptial Services 4.622 5.706 2.601 5.615 5.612 5.612 5.612 5.612

02 Moroto Referral Hospital Internal Audit 0.007 0.007 0.004 0.007 0.007 0.007 0.007 0.007

03 Moroto Regional Maintenance 0.125 0.125 0.053 0.125 0.125 0.125 0.125 0.125

1004 Moroto Rehabilitation Referal Hospital 1.388 1.413 0.476 1.000 0.400 0.000 0.000 0.000

1472 Institutional Support to Moroto 0.100 0.075 0.073 0.000 0.000 0.000 0.000 0.000 Regional Referral Hospital 1577 Retooling of Moroto Rehabilitation 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Referral Hospital Total for the Vote 6.242 7.326 3.207 6.947 6.344 5.944 5.971 5.971

Total Excluding Arrears 6.242 7.326 3.207 6.944 6.344 5.944 5.971 5.971

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective • To expand and sustain the delivery of high quality safe services. : • To attract and retain critical human resources for health. • To strengthen the referral systems and collaborate for efficient health care services

Responsible Officer: Dr. Watmon Benedicto Programme Outcome: Quality and accessible regional health services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

206 207 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

312 FIXED ASSETS 1.488 0.000 0.000 1.488 1.200 0.000 1.200 • Percentage increase of speciliezed clinic out patient attendance 20% 2018 35% 45% 55%

Output Class : Arrears 0.000 0.000 0.000 0.000 0.003 0.000 0.003 • Bed Occupancy 85% 2018 85% 85% 85% 321 DOMESTIC 0.000 0.000 0.000 0.000 0.003 0.000 0.003 • Diagonostic services 10% 2018 40% 50% 60% Grand Total : 7.326 0.000 0.000 7.326 6.947 0.000 6.947 SubProgramme: 01 Moroto Referral Hosptial Services Total excluding Arrears 7.326 0.000 0.000 7.326 6.944 0.000 6.944 Output: 01 Inpatient services VII. Budget By Programme And Subprogramme No. of in-patients (Admissions) 15,000 18,000 20,000

4 4 4 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Average Length of Stay (ALOS) - days Bed Occupancy Rate (BOR) 85% 85% 85% Billion Uganda shillings FY 2019/20 Medium Term Projections Number of Major Operations (including Ceasarian section) 2,500 2,700 3,000 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget Output: 02 Outpatient services 56 Regional Referral Hospital Services 6.242 7.326 3.207 6.947 6.344 5.944 5.971 5.971 Total general outpatients attendance 80,000 85,000 90,000

01 Moroto Referral Hosptial Services 4.622 5.706 2.601 5.615 5.612 5.612 5.612 5.612 No. of specialised clinic attendances 30,000 35,000 40,000 02 Moroto Referral Hospital Internal Audit 0.007 0.007 0.004 0.007 0.007 0.007 0.007 0.007 Referral cases in 2,700 2,500 2,300 03 Moroto Regional Maintenance 0.125 0.125 0.053 0.125 0.125 0.125 0.125 0.125 Output: 04 Diagnostic services 1004 Moroto Rehabilitation Referal Hospital 1.388 1.413 0.476 1.000 0.400 0.000 0.000 0.000 No. of laboratory tests carried out 150,000 155,000 160,000 1472 Institutional Support to Moroto 0.100 0.075 0.073 0.000 0.000 0.000 0.000 0.000 Regional Referral Hospital No. of patient xrays (imaging) taken 4,000 4,200 4,500 1577 Retooling of Moroto Rehabilitation 0.000 0.000 0.000 0.200 0.200 0.200 0.227 0.227 Referral Hospital Number of Ultra Sound Scans 5,000 5,200 5,500 Total for the Vote 6.242 7.326 3.207 6.947 6.344 5.944 5.971 5.971 Output: 05 Hospital Management and support services Total Excluding Arrears 6.242 7.326 3.207 6.944 6.344 5.944 5.971 5.971 Assets register updated on a quarterly basis 4 4 4

VIII. Programme Performance and Medium Term Plans Timely payment of salaries and pensions by the 2 YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Quarterly financial reports submitted timely Output: 06 Prevention and rehabilitation services Programme : 56 Regional Referral Hospital Services No. of antenatal cases (All attendances) 3,000 3,200 3,500 Programme Objective • To expand and sustain the delivery of high quality safe services. : • To attract and retain critical human resources for health. No. of family planning users attended to (New and Old) 3,500 3,600 3,750 • To strengthen the referral systems and collaborate for efficient health care services Percentage of HIV positive pregnant women not on HAART initiated on ARVs 0% 0% 0% Responsible Officer: Dr. Watmon Benedicto Output: 07 Immunisation Services Programme Outcome: Quality and accessible regional health services No. of children immunised (All immunizations) 10,000 12,000 15,000 Sector Outcomes contributed to by the Programme Outcome SubProgramme: 02 Moroto Referral Hospital Internal Audit 1. Improved quality of life at all levels Output: 05 Hospital Management and support services Performance Targets Assets register updated on a quarterly basis 4 4 4 Outcome Indicators 2020/21 2021/22 2022/23 Timely payment of salaries and pensions by the 2 YES/NO YES/NO YES/NO Baseline Base year Target Projection Projection Quarterly financial reports submitted timely YES/NO YES/NO YES/NO

206 207 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

SubProgramme: 03 Moroto Regional Maintenance Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 Yes/No Yes/No Yes/No

Quarterly financial reports submitted timely Yes/No Yes/No Yes/No

SubProgramme: 1004 Moroto Rehabilitation Referal Hospital Output: 81 Staff houses construction and rehabilitation No. of staff houses constructed/rehabilitated 10 10 30

Output: 82 Maternity ward construction and rehabilitation No. of maternity wards constructed 1 1 1

No. of maternity wards rehabilitated 3 3 3

Cerificates of progress/ Completion 3 3 3

SubProgramme: 1577 Retooling of Moroto Rehabilitation Referral Hospital Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .1 .15 .18

IX. Major Capital Investments And Changes In Resource Allocation

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

FY 2019/20 FY 2020/21 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Vote 175 Moroto Referral Hospital

Program : 08 56 Regional Referral Hospital Services

Development Project : 1004 Moroto Rehabilitation Referal Hospital

Output: 08 56 81 Staff houses construction and rehabilitation

1. Construction works done Roofing been done 2 site meetings done, Completion of construction works on staff house 2. 2 Site meetings done Supervision and appraisal of works done done 3. 1 Certificates issued External and Internal painting works on staff 4. Supervision on works done house done Plastering and fittings of staff house concluded Landscaping and beautification done 6 Site meetings done 3 Certificates issued Supervision done Total Output Cost(Ushs Thousand) 200,000 26,684 700,000

Gou Dev’t: 200,000 26,684 700,000

Ext Fin: 0 0 0

A.I.A: 0 0 0

208 209 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

SubProgramme: 03 Moroto Regional Maintenance X. Vote Challenges and Plans To Improve Performance

Output: 05 Hospital Management and support services Vote Challenges Assets register updated on a quarterly basis 4 4 4 • The hospital continues to underperform in some diagnostic areas due to lack of specialists to carry out some services Timely payment of salaries and pensions by the 2 Yes/No Yes/No Yes/No • Due to lack of specialists, the hospital cannot have interns who can relieve work load for the available medical officers. • Old, inadequate and dilapidated infrastructure especially wards, administration block and mortuary that are condemned has Quarterly financial reports submitted timely Yes/No Yes/No Yes/No negatively affected service up-take since most clients would prefer not to be admitted in the hospital wards. • Lack of incentives to retain both specialized and support health staffs like hard to reach allowance, high cost of living and high SubProgramme: 1004 Moroto Rehabilitation Referal Hospital cost of accommodation, and lack of social amenities has contributed to poor attraction and retention of the hospital staff. • The constant power outages leading to high consumption of fuel especially for the hospital generator, oxygen plant, pumping Output: 81 Staff houses construction and rehabilitation water and fuel for referrals. No. of staff houses constructed/rehabilitated 10 10 30

Output: 82 Maternity ward construction and rehabilitation Plans to improve Vote Performance No. of maternity wards constructed 1 1 1 • Execute budget within the provisions of the approved budget and service delivery targets with emphasis to quality improvement; No. of maternity wards rehabilitated 3 3 3 • Strict and close Supervision of works and services to ensure quality and value for money working through project management committees (Appointed Project managers) to oversee works. Cerificates of progress/ Completion 3 3 3 • Increase and strengthen support supervision using standard check lists both internally and in the region for improved service delivery. SubProgramme: 1577 Retooling of Moroto Rehabilitation Referral Hospital • Dispose obsolete equipment to create space and allow planning for procurement of new ones; • Carry out routine medical equipment maintenance. Output: 85 Purchase of Medical Equipment • Improve staff welfare by provision of tea, working tools and timely payments of emoluments; Value of medical equipment procured (Ush Bn) .1 .15 .18 • Improved duty coverage using biometric analysis and duty attendance registers; • Lobbying for partner support to fill service delivery gaps. • Improve the working environment, functional equipment maintained, ensure user/patients/workers’ rights and safety. IX. Major Capital Investments And Changes In Resource Allocation • Adhere to procurement regulations and Implement government policies with proper leadership and governance.

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) XI Off Budget Support FY 2019/20 FY 2020/21 Table 11.1 Off-Budget Support by Sub-Programme Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned end Dec Outputs Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Vote 175 Moroto Referral Hospital Budget Estimates Program : 08 56 Regional Referral Hospital Services Programme 0856 Regional Referral Hospital Services 0.00 1.90 Recurrent Budget Estimates Development Project : 1004 Moroto Rehabilitation Referal Hospital 01 Moroto Referral Hosptial Services 0.00 1.90 Output: 08 56 81 Staff houses construction and rehabilitation 410-International Development Association (IDA) 0.00 0.90 1. Construction works done Roofing been done 2 site meetings done, Completion of construction works on staff house 2. 2 Site meetings done Supervision and appraisal of works done done 426-UNICEF 0.00 0.12 3. 1 Certificates issued External and Internal painting works on staff 4. Supervision on works done house done 438-Joint United Nations Programme on HIV/AIDS 0.00 0.51 Plastering and fittings of staff house concluded Landscaping and beautification done 445-World Health Organisation (WHO) 0.00 0.10 6 Site meetings done 3 Certificates issued 451-Global Alliance for Vaccines Immunisation 0.00 0.28 Supervision done Total for Vote 0.00 1.90 Total Output Cost(Ushs Thousand) 200,000 26,684 700,000

Gou Dev’t: 200,000 26,684 700,000 XII. Vote Cross Cutting Policy And Other Budgetary Issues

Ext Fin: 0 0 0 Table 12.1: Cross- Cutting Policy Issues

A.I.A: 0 0 0

208 209 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

Issue Type: HIV/AIDS

Objective : To reduce incidence of HIV infections by implementing the 90,90,90 policy of Test Treat and Supress

Issue of Concern : Increased HIV incidence in the community, among most at risk populations especially Commercial Sex workers, Working class, adolescents, children, youth and women.

Issue of Concern : Babies born with HIV arising from mother to child transmission Planned Interventions : Test every couple during antenatal; Immediate initiation of those found positive on ART; Encourage mothers to deliver in health facilities; Provide incentives for spouses (men) to accompany mothers. Budget Allocation (Billion) : 0.135 Performance Indicators: No. of couples tested and initiated on ART; No. of children tested negative born of positive mothers; No of mothers coming for 4th ANC visit and delivering in the Hospital; No. of men accompanying their wives. Objective : To give HAART to all eligible clients ((90,90,90 policy)

. .

Issue of Concern : Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% of the positives put into care and 90% Viral suppression. Planned Interventions : Implement the Test, Treat and suppress interventions by initiating all positive to care; Viral suppression to avoid transmission through VL monitoring; Counsel clients to adhere to treatment; Provision of pre-PEP for discordant couples .

Budget Allocation (Billion) : 0.060

210 211 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

Issue Type: HIV/AIDS Performance Indicators: No. of clients on full HAART; No of clients counselled; Compliance levels of clients on treatment; No. of clients followed up Objective : To reduce incidence of HIV infections by implementing the 90,90,90 policy of Test Treat and Supress Issue Type: Gender

Issue of Concern : Increased HIV incidence in the community, among most at risk populations especially Commercial Objective : To provide inclusive, equal and accessible health care services to all deserving and ill patients Sex workers, Working class, adolescents, children, youth and women. seeking services despite gender, age, sex and sexual orientation, social economic status or otherwise.

Planned Interventions : Conduct continuous health educations; Conduct HIV/AIDS counseling and testing and TB co- infection screening; Conducting Safe male circumcision; Conduct out reaches to cover most at risk populations; Condom distribution to special groups Issue of Concern : Limited access to maternal child and adolescent health services especially for the most at risk Budget Allocation (Billion) : 0.340 including children, the elderly, pregnant mothers and the disabled. Planned Interventions : Provision of free maternal child health services, Waiver for services in the private wing for Performance Indicators: Number of health education conducted; Number of clients counseled and tested; Number of male mothers, children & the disabled who can’t afford; Profile & follow up Gender based violence circumcisions done; Number of outreaches conducted; Number of condoms distributed. cases in the hospital. Objective : Total Elimination of mother to child infections by implementing E-MTCT + Budget Allocation (Billion) : 0.130 Performance Indicators: No. of deliveries conducted in the facility and children below five treated; No of clients with disabilities treated. Waivers provided in the private wing; No of gender based violence cases reported & handled in the hospital Objective : To sensitise the community on the dangers of late health services seeking behaviour to avoid complications and death of referred patients targeting expectant mothers, the disabled, adolescents and those from risky and unfavourable locations. Issue of Concern : Babies born with HIV arising from mother to child transmission Issue of Concern : Delayed health seeking behaviour resulting into complications, high morbidity and mortality Planned Interventions : Test every couple during antenatal; Immediate initiation of those found positive on ART; especially expectant mothers, the disabled, elderly, destitutes adolescents and the critically sick. Encourage mothers to deliver in health facilities; Provide incentives for spouses (men) to Planned Interventions : Health education at hospital, Community outreaches, special clinic days for adolescents and accompany mothers. paediatrics, Involvement of special groups Capacity building for the old, disabled and Budget Allocation (Billion) : 0.135 incapacitated; Improve referral system, emergency & ambulatory services. Performance Indicators: No. of couples tested and initiated on ART; No. of children tested negative born of positive mothers; No of mothers coming for 4th ANC visit and delivering in the Hospital; No. of men Budget Allocation (Billion) : 0.075 accompanying their wives. Objective : To give HAART to all eligible clients Performance Indicators: No of Gender and Equity education talks held; people and locations/places covered; specialised ((90,90,90 policy) clinics established; Reduction in maternal perinatal death; cases referred by CHWs&peers. . . Objective : To offer inclusive emergency and ambulatory services to all critically ill and deserving patients with due consideration of age, gender, sex and sexual orientations, socio-economic status and Issue of Concern : Total elimination of HIV by Concern to have 90% of the total population tested for HIV, 90% of geographical locations the positives put into care and 90% Viral suppression. Issue of Concern : Limited access to emergency and ambulatory services for critically ill patients due to gender and Planned Interventions : Implement the Test, Treat and suppress interventions by initiating all positive to care; Viral Equity issues. suppression to avoid transmission through VL monitoring; Counsel clients to adhere to treatment; Provision of pre-PEP for discordant couples . Planned Interventions : Stand by functional and fully equipped ambulance for emergency, Waivers for poor and critically ill patients; Improved emergency, critical and accident care. Special considerations for disability, Budget Allocation (Billion) : 0.060 elderly and most at risk cases with budgetary allocations. Budget Allocation (Billion) : 0.050

210 211 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

Performance Indicators: Number of Patients offered ambulatory services, Referred in time Aggregated in Age, sex, disability Emergency cases properly managed in the hospital. Cases handled and locations.

Issue Type: Enviroment

Objective : To eliminate generated infections and sepsis.

Issue of Concern : Facility based infections that result into sepsis

Planned Interventions : Strengthen infection control and prevention with functional committees, supplies and tools; Enforce proper waste management and disposal; isolation of infectious cases; proper sterilization and equipment/protective use &protective gears. Budget Allocation (Billion) : 0.170 Performance Indicators: Functional committees’ Regular supplies, and tools; reduction in hospital infection and septic cases; Reduced average length of stay;

Objective : To have a clean and safe working hospital environment

Issue of Concern : Un hospitable and unsafe hospital environment resulting into accidents, insecurity and infection

Planned Interventions : Provision of safe clean water; constant power; cleaning supervision, QI and enforce 5S. Signages; compound beatification, tree cover; staff in full protective wear and uniforms; routine internal supervision and laundry services; Disposal of obsolete items Budget Allocation (Billion) : 0.005 Performance Indicators: Clean &safe working environment; Availability of water, power Proper waste management, staff protected. 5S implemented.

Objective : To ensure proper hospital waste disposal and management Issue of Concern : Hospital environmental pollution and public safety. Planned Interventions : Proper waste segregation, transportation &disposal, functional sewage system, disposal of expired items, incineration of dangerous wastes. Use of power and water monitored. Budget Allocation (Billion) : 0.005 Performance Indicators: Clean, safe and welcoming hospital environment, Reduced accumulation of expired items, dangerous wastes disposed, reduced water &power bills. XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

212 213 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

Performance Indicators: Number of Patients offered ambulatory services, Referred in time Aggregated in Age, sex, Title Salary Scale Number Of Approved Positions Number Of Filled Positions disability Emergency cases properly managed in the hospital. Consultant (Anaesthesia) U1SE 1 0 Cases handled and locations. Consultant (ENT) U1SE 1 0 Consultant (Medicine) U1SE 1 0 Issue Type: Enviroment Consultant (Paediatrics) U1SE 1 0 Objective : To eliminate generated infections and sepsis. Consultant (Pathology) U1SE 1 0 Consultant (Surgery ) U1SE 1 0 Issue of Concern : Facility based infections that result into sepsis Consultant Psychiatry U1SE 1 0 Consultnat (Public Health) U1SE 1 0 Planned Interventions : Strengthen infection control and prevention with functional committees, supplies and tools; Senior Consultant MEDICAL U1SE 1 0 Enforce proper waste management and disposal; isolation of infectious cases; proper sterilization and equipment/protective use &protective gears. Senior Consultant Peadiatric U1SE 1 0 Budget Allocation (Billion) : 0.170 Senior Consultant SURGEON U1SE 1 0 Performance Indicators: Functional committees’ Regular supplies, and tools; reduction in hospital infection and septic Medical Officer Special Grade U2(Med-1) 1 0 cases; Reduced average length of stay; (Paediatrics) Medical Officer Special Grade( U2(Med-1) 1 0 Obsetrics & Gynaechology) Objective : To have a clean and safe working hospital environment Medical Officer Special Grade U2(Med-1) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 Issue of Concern : Un hospitable and unsafe hospital environment resulting into accidents, insecurity and infection (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 (Orthopaedic Surgeon) Planned Interventions : Provision of safe clean water; constant power; cleaning supervision, QI and enforce 5S. Signages; Medical Officer Special Grade U2(Med-1) 1 0 compound beatification, tree cover; staff in full protective wear and uniforms; routine internal (Public Health) supervision and laundry services; Disposal of obsolete items Medical Officer Special Grade U2(Med-1) 1 0 Budget Allocation (Billion) : 0.005 (Surgeon) Performance Indicators: Clean &safe working environment; Availability of water, power Proper waste management, staff Medical Officer Special Grade U2SC 2 0 protected. 5S implemented. Medical Officer Special Grade U2U 1 0 (Psychiatry) Medical Officer Special Grade U2U 1 0 Objective : To ensure proper hospital waste disposal and management (Radiology) Issue of Concern : Hospital environmental pollution and public safety. Principal Anaesthetic Officer U3(Med-2) 1 0 Planned Interventions : Proper waste segregation, transportation &disposal, functional sewage system, disposal of expired PRINCIPAL ORTHOPAEDIC U3(Med-2) 1 0 items, incineration of dangerous wastes. Use of power and water monitored. OFFICER Budget Allocation (Billion) : 0.005 PRINCIPAL PHYSIOTHERAPIST U3(Med-2) 1 0 Performance Indicators: Clean, safe and welcoming hospital environment, Reduced accumulation of expired items, SENIOR.MEDICAL SOCIAL U3L 1 0 dangerous wastes disposed, reduced water &power bills. WORKER XIII. Personnel Information Procument Officer U4 U 1 0 Senior Nursing Officer U4(Med-2) 15 11 Table 13.1 Staff Establishment Analysis Senior Radiographer U4(Med-2) 2 1

212 213 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital

SECURITY OFFICER U4L 1 0 Senior Laboratory Technologist U4SC 2 1 Senior Ophthalmic Clinical Officer U4SC 2 1 Inventory Management Officer U4U 1 0 Supplies Officer U4U 1 0 Senior Enrolled Nurse U5 SC 1 0 DENTAL TECHNOLOGIST U5(SC) 1 0 NURSING OFFICER (MID U5(SC) 15 12 WIFERY) Nursing Officer (Psychiatry) U5(SC) 2 1 PHYSIOTHERAPIST U5(SC) 1 0 Radiographer U5(SC) 3 2 Assistant Inventory Management U5U 2 1 Officer ASSISTANT ACCOUNTANT U6U 2 0 ENGINEERINGTECHNICIAN U6U 1 0 Enrolled Midwife U7(Med) 20 15 ENROLLED NURSES U7(Med) 40 35 Consultant (Orthopaedic) US1E 1 0 Consultant (Radiology) US1E 1 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ASSISTANT ACCOUNTANT U6U 2 0 2 2 873,354 10,480,248 Assistant Inventory Management U5U 2 1 1 1 745,816 8,949,792 Officer Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (ENT) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Orthopaedic) US1E 1 0 1 1 4,200,000 50,400,000 Consultant (Paediatrics) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Pathology) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Radiology) US1E 1 0 1 1 4,200,000 50,400,000 Consultant (Surgery ) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant Psychiatry U1SE 1 0 1 1 4,200,000 50,400,000 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 DENTAL TECHNOLOGIST U5(SC) 1 0 1 1 1,200,000 14,400,000

214 215 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21 Moroto Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:175 Moroto Referral Hospital Vote:175 Moroto Referral Hospital

SECURITY OFFICER U4L 1 0 ENGINEERINGTECHNICIAN U6U 1 0 1 1 436,677 5,240,124 Enrolled Midwife U7(Med) 20 15 5 5 3,065,790 36,789,480 Senior Laboratory Technologist U4SC 2 1 ENROLLED NURSES U7(Med) 40 35 5 5 3,065,790 36,789,480 Senior Ophthalmic Clinical Officer U4SC 2 1 Inventory Management Officer U4U 1 0 1 1 1,196,439 14,357,268 Inventory Management Officer U4U 1 0 Medical Officer Special Grade U2SC 2 0 2 2 7,277,870 87,334,440 Supplies Officer U4U 1 0 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Paediatrics) Senior Enrolled Nurse U5 SC 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Psychiatry) DENTAL TECHNOLOGIST U5(SC) 1 0 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 NURSING OFFICER (MID U5(SC) 15 12 (Radiology) WIFERY) Medical Officer Special Grade( U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Obsetrics & Gynaechology) Nursing Officer (Psychiatry) U5(SC) 2 1 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 PHYSIOTHERAPIST U5(SC) 1 0 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Radiographer U5(SC) 3 2 (Medicine) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 Assistant Inventory Management U5U 2 1 (Orthopaedic Surgeon) Officer Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 ASSISTANT ACCOUNTANT U6U 2 0 (Public Health) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 ENGINEERINGTECHNICIAN U6U 1 0 (Surgeon) Enrolled Midwife U7(Med) 20 15 NURSING OFFICER (MID U5(SC) 15 12 3 3 3,600,000 43,200,000 WIFERY) ENROLLED NURSES U7(Med) 40 35 Nursing Officer (Psychiatry) U5(SC) 2 1 1 1 1,200,000 14,400,000 Consultant (Orthopaedic) US1E 1 0 PHYSIOTHERAPIST U5(SC) 1 0 1 1 1,200,000 14,400,000 Principal Anaesthetic Officer U3(Med-2) 1 0 1 1 3,100,000 37,200,000 Consultant (Radiology) US1E 1 0 PRINCIPAL ORTHOPAEDIC U3(Med-2) 1 0 1 1 3,100,000 37,200,000 OFFICER Table 13.2 Staff Recruitment Plan PRINCIPAL U3(Med-2) 1 0 1 1 3,100,000 37,200,000 PHYSIOTHERAPIST Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Procument Officer U4 U 1 0 1 1 979,434 11,753,208 Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Radiographer U5(SC) 3 2 1 1 1,200,000 14,400,000 FY2020/21 SECURITY OFFICER U4L 1 0 1 1 601,341 7,216,092 ASSISTANT ACCOUNTANT U6U 2 0 2 2 873,354 10,480,248 Senior Consultant MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Assistant Inventory Management U5U 2 1 1 1 745,816 8,949,792 Senior Consultant Peadiatric U1SE 1 0 1 1 4,500,000 54,000,000 Officer Senior Consultant SURGEON U1SE 1 0 1 1 4,500,000 54,000,000 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Senior Enrolled Nurse U5 SC 1 0 1 1 937,163 11,245,956 Consultant (ENT) U1SE 1 0 1 1 4,200,000 50,400,000 Senior Laboratory Technologist U4SC 2 1 1 1 1,322,163 15,865,956 Consultant (Medicine) U1SE 1 0 1 1 4,200,000 50,400,000 Senior Nursing Officer U4(Med-2) 15 11 4 4 8,800,000 105,600,000 Consultant (Orthopaedic) US1E 1 0 1 1 4,200,000 50,400,000 Senior Ophthalmic Clinical Officer U4SC 2 1 1 1 1,322,163 15,865,956 Consultant (Paediatrics) U1SE 1 0 1 1 4,200,000 50,400,000 Senior Radiographer U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Consultant (Pathology) U1SE 1 0 1 1 4,200,000 50,400,000 SENIOR.MEDICAL SOCIAL U3L 1 0 1 1 902,612 10,831,344 Consultant (Radiology) US1E 1 0 1 1 4,200,000 50,400,000 WORKER Consultant (Surgery ) U1SE 1 0 1 1 4,200,000 50,400,000 Supplies Officer U4U 1 0 1 1 940,366 11,284,392 Consultant Psychiatry U1SE 1 0 1 1 4,200,000 50,400,000 Total 141 80 61 61 141,616,978 1,699,403,736 Consultnat (Public Health) U1SE 1 0 1 1 4,200,000 50,400,000 DENTAL TECHNOLOGIST U5(SC) 1 0 1 1 1,200,000 14,400,000

214 215 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital

V1: Vote Overview I. Vote Mission Statement To contribute to increased efficiency in Quality and Inclusive Specialized Health Care service Delivery through provision of Trauma, orthopaedic and Emergency services, research, training and collaboration at the National Trauma Centre Naguru

II. Strategic Objective 1.To provide quality health care services 2.To strengthen health services research 3.To conduct training of health workers and students 4.To strengthen the supportive role to other health facilities in the region 5.To strengthen hospital partnerships 6.To build a healthy, productive and motivated workforce III. Major Achievements in 2019/20 Staff House construction completion was at 70%. Perimeter wall at Staff residence construction began. The existing equipment and Plants i.e. CT scan, Fluoroscope, Oxygen plant, Mammography functionalization was ongoing.

Inpatients cumulative achievement by Quarter 2 was as follows: target for Admissions was 15213 and achieved 8809, Bed Occupancy Rate (BOR) target was 85% and achieved 121%, 5days. Average Length of Stay (ALOS) was 5days, and Target for major Operations (including Caesarean section) was 4316 and achieved 3743. The best practice that contributed to this achievement was Standards Operating Procedures were in place, weekly clinical audits were done and emergency care refresher Training for staff as well as affirmative action for patients with disabilities were done.

Outpatients target for Specialized Clinic Attendance was 115758 and achieved 76817; Achieved 351 Referrals cases in and target was 240, Total general outpatients attended was 39851 with a target of 156460. This achievement was attributed by the best practice of Training health workers on the management of VHF (Haemorrhagic Viral Fever) with support from the IDI partner. successfully managing a few cases of cholera. The ECG and endoscopy machine were operational for non- communicable related service conditions.

Diagnostics achieved 1729X-rays Examinations with a target of 4506, 5648 Ultra Sound scans with target of 9276, CT Scans were 206, Laboratory tests including blood transfusions and pathology tests had a target of 136459 and achieved 57328. Best practice for this achievement was attributed to reduced turnaround time for both Laboratory and Pathology services which was an indicator of quick response to patients in service delivery. The two Biochemistry equipment’s were serviced by the hospital in partnership with Uganda Cares.

Prevention and rehabilitation target was 27500 and achieved 14491 for Antenatal cases (all attendees), 17551 Children were immunized (all immunizations) and target was 10000 , target of 3997 and achieved 2268 for Family Planning users attended to (new and old), target of 27500 and achieved 6173 for ANC Visits (all visits), 95% HIV positive pregnant women on HAART receiving ARVs for EMCT during pregnancy. This achievement was majorly attributed to the Hospital Community Health workers participation in the national vaccination campaign 16th to 22nd October 2019; that introduced of MR vaccine and OPV; readiness assessment of the districts, training, distribution of vaccines and other supplies.

The hospital received a cumulative delivery of 81% of medicines and medical supplies from NMS and also received a donation of medicines and medical supplies from UNHCR valued at 484,224,904/=.

Support services: Asset register was updated with clinical equipment inventory as main activity. Safety of records further improved with introduction of IICS, HMIS tools were updated and financial reports were submitted by 12th of each month. Timely access to payment of salary (298 staff) and pensions (9 pensioners) by 28th every month. The hospital was able to Update the HRIS (Human Resource Information System). IV. Medium Term Plans The Hospital plans to create more space for Trauma tertiary services to accommodate more Inpatients, Operation rooms and equipment among others. Plans will also entail training staff in trauma emergence care, providing Histopathology lab, ENT, Ophthalmology and High Dependency Unit among others. Construction of more Staff accommodation to enable quick response to emergencies and a installing on the wall fence a Hospital sound proof from the noisy environment.

216 217 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital Vote:176 Naguru Referral Hospital

V1: Vote Overview The hospital will conduct a Specialist support supervision in the central region that will include among others specialist camps, I. Vote Mission Statement mentoring and coordination. To contribute to increased efficiency in Quality and Inclusive Specialized Health Care service Delivery through provision of The hospital will have to acquire a new patient’s ambulance to enable referral of trauma and emergency patients. Trauma, orthopaedic and Emergency services, research, training and collaboration at the National Trauma Centre Naguru The hospital plans to reduce utility bills i.e. electricity reduction through use of Solar, Inverter and administrative measures to II. Strategic Objective reduce unnecessary consumption. Reduction of water bills through Installation of rain water reservoir tanks. The Hospital plans to create more space for Trauma tertiary services to accommodate more Inpatients, Operation rooms and 1.To provide quality health care services 2.To strengthen health services research 3.To conduct training of health workers and equipment among students 4.To strengthen the supportive role to other health facilities in the region 5.To strengthen hospital partnerships 6.To build a healthy, productive and motivated workforce III. Major Achievements in 2019/20 Staff House construction completion was at 70%. Perimeter wall at Staff residence construction began. The existing equipment and Plants i.e. CT scan, Fluoroscope, Oxygen plant, Mammography functionalization was ongoing.

The hospital received a cumulative delivery of 81% of medicines and medical supplies from NMS and also received a donation of medicines and medical supplies from UNHCR valued at 484,224,904/=.

216 217 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 5.988 6.732 3.006 6.732 6.732 6.732 6.732 6.732 Recurrent Non Wage 1.006 1.437 0.508 1.476 1.476 1.476 1.476 1.476 GoU 1.056 1.056 0.157 1.176 0.900 0.200 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 8.050 9.225 3.671 9.384 9.108 8.408 8.435 8.435 Total GoU+Ext Fin (MTEF) 8.050 9.225 3.671 9.384 9.108 8.408 8.435 8.435 Arrears 0.000 0.176 0.176 0.363 0.000 0.000 0.000 0.000 Total Budget 8.050 9.401 3.847 9.747 9.108 8.408 8.435 8.435 A.I.A Total 0.059 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Grand Total 8.108 9.401 3.847 9.747 9.108 8.408 8.435 8.435 Total Vote Budget 8.108 9.225 3.671 9.384 9.108 8.408 8.435 8.435 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 8.169 0.000 0.000 8.169 8.208 0.000 8.208

211 Wages and Salaries 6.889 0.000 0.000 6.889 6.846 0.000 6.846

212 Social Contributions 0.088 0.000 0.000 0.088 0.135 0.000 0.135

213 Other Employee Costs 0.341 0.000 0.000 0.341 0.331 0.000 0.331

221 General Expenses 0.139 0.000 0.000 0.139 0.129 0.000 0.129

222 Communications 0.025 0.000 0.000 0.025 0.025 0.000 0.025

223 Utility and Property Expenses 0.247 0.000 0.000 0.247 0.246 0.000 0.246

224 Supplies and Services 0.231 0.000 0.000 0.231 0.273 0.000 0.273

225 Professional Services 0.004 0.000 0.000 0.004 0.004 0.000 0.004

227 Travel and Transport 0.118 0.000 0.000 0.118 0.144 0.000 0.144

228 Maintenance 0.087 0.000 0.000 0.087 0.075 0.000 0.075

Output Class : Capital Purchases 1.056 0.000 0.000 1.056 1.176 0.000 1.176

281 Property expenses other than interest 0.050 0.000 0.000 0.050 0.050 0.000 0.050

218 219 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital Vote:176 Naguru Referral Hospital

312 FIXED ASSETS 1.006 0.000 0.000 1.006 1.126 0.000 1.126 V. Summary of Past Performance and Medium Term Budget Allocations Output Class : Arrears 0.176 0.000 0.000 0.176 0.363 0.000 0.363 Table 5.1: Overview of Vote Expenditures (UShs Billion) 321 DOMESTIC 0.176 0.000 0.000 0.176 0.363 0.000 0.363

2019/20 MTEF Budget Projections Grand Total : 9.401 0.000 0.000 9.401 9.747 0.000 9.747 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Total excluding Arrears 9.225 0.000 0.000 9.225 9.384 0.000 9.384 Outturn Budget by End Dec Wage 5.988 6.732 3.006 6.732 6.732 6.732 6.732 6.732 Recurrent VII. Budget By Programme And Subprogramme Non Wage 1.006 1.437 0.508 1.476 1.476 1.476 1.476 1.476 Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme GoU 1.056 1.056 0.157 1.176 0.900 0.200 0.227 0.227 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Billion Uganda shillings FY 2019/20 Medium Term Projections GoU Total 8.050 9.225 3.671 9.384 9.108 8.408 8.435 8.435 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Total GoU+Ext Fin (MTEF) 8.050 9.225 3.671 9.384 9.108 8.408 8.435 8.435 Budget 56 Regional Referral Hospital Services 8.095 9.401 3.847 9.747 9.108 8.408 8.435 8.435 Arrears 0.000 0.176 0.176 0.363 0.000 0.000 0.000 0.000 01 Naguru Referral Hosptial Services 7.017 8.319 3.683 8.545 8.182 8.182 8.182 8.182 Total Budget 8.050 9.401 3.847 9.747 9.108 8.408 8.435 8.435 02 Naguru Referral Hospital Internal Audit 0.022 0.026 0.007 0.026 0.026 0.026 0.026 0.026 A.I.A Total 0.059 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1004 Naguru Rehabilitation Referal Hospital 0.900 0.900 0.154 0.976 0.700 0.030 0.027 0.027 Grand Total 8.108 9.401 3.847 9.747 9.108 8.408 8.435 8.435 1475 Institutional Support to Uganda China 0.156 0.156 0.003 0.000 0.000 0.000 0.000 0.000 Total Vote Budget 8.108 9.225 3.671 9.384 9.108 8.408 8.435 8.435 Friendship Hospital Referral Hospital- Naguru Excluding Arrears 1571 Retooling of National Trauma Centre, 0.000 0.000 0.000 0.200 0.200 0.170 0.200 0.200 Naguru VI. Budget By Economic Clasification Total for the Vote 8.095 9.401 3.847 9.747 9.108 8.408 8.435 8.435 Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Total Excluding Arrears 8.095 9.225 3.671 9.384 9.108 8.408 8.435 8.435

211 Wages and Salaries 6.889 0.000 0.000 6.889 6.846 0.000 6.846 Programme : 56 Regional Referral Hospital Services

212 Social Contributions 0.088 0.000 0.000 0.088 0.135 0.000 0.135 Programme Objective To contribute to increased efficiency in Quality and Inclusive Specialized Health Care service Delivery : through provision of Trauma, orthopaedic and Emergency services, research, training and collaboration at 213 Other Employee Costs 0.341 0.000 0.000 0.341 0.331 0.000 0.331 the National Trauma Centre Naguru 221 General Expenses 0.139 0.000 0.000 0.139 0.129 0.000 0.129 Responsible Officer: Dr. Batiibwe Emmanuel Paul - Hospital Director

222 Communications 0.025 0.000 0.000 0.025 0.025 0.000 0.025 Programme Outcome: Quality and accessible Regional Referral Hospital Services

223 Utility and Property Expenses 0.247 0.000 0.000 0.247 0.246 0.000 0.246 Sector Outcomes contributed to by the Programme Outcome

224 Supplies and Services 0.231 0.000 0.000 0.231 0.273 0.000 0.273 1. Improved quality of life at all levels

225 Professional Services 0.004 0.000 0.000 0.004 0.004 0.000 0.004 Performance Targets

227 Travel and Transport 0.118 0.000 0.000 0.118 0.144 0.000 0.144 Outcome Indicators 2020/21 2021/22 2022/23

228 Maintenance 0.087 0.000 0.000 0.087 0.075 0.000 0.075 Baseline Base year Target Projection Projection

Output Class : Capital Purchases 1.056 0.000 0.000 1.056 1.176 0.000 1.176 • % increase in diagnstic investigations carried 100000 2019 4% 5% 6%

281 Property expenses other than interest 0.050 0.000 0.000 0.050 0.050 0.000 0.050 • Bed occupancy 85% 2019 100% 100% 100%

218 219 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital

• % increase of specialised clinics outpatients attendances 100000 2019 6% 7% 8%

SubProgramme: 01 Naguru Referral Hosptial Services Output: 01 Inpatient services No. of in-patients (Admissions) 15,500 15,500 15,500

Average Length of Stay (ALOS) - days 5 5 5

Bed Occupancy Rate (BOR) 85% 85% 85%

Number of Major Operations (including Caesarean section) 4,500 4,500 4,500

Output: 02 Outpatient services Total general outpatients attendance 80,000 80,000 80,000

No. of specialized clinic attendances 120,000 120,000 120,000

Referral cases in 300 300 300

Value of medicines received/dispensed(Ushs bn) 1.2 1.2 1.2

No. of laboratory tests carried out 140,000 140,000 140,000

Output: 04 Diagnostic services No. of patient xrays (imaging) taken 4,500 4,500 4,500

Number of Ultra Sound Scans 9,000 9,000 9,000

Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 Yes Yes Yes

Quarterly financial reports submitted timely Yes Yes Yes

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 28,000 28,000 28,000

No. of family planning users attended to (New and Old) 4,000 4,000 4,000

Percentage of HIV positive pregnant women not on HAART initiated ARVs 0% 0% 0%

Output: 07 Immunisation Services No. of children immunised (All immunizations) 12,000 12,000 12,000

SubProgramme: 02 Naguru Referral Hospital Internal Audit Output: 05 Hospital Management and support services Assets register updated on a quarterly basis 4 4 4

Timely payment of salaries and pensions by the 2 Yes Yes Yes

Quarterly financial reports submitted timely Yes Yes Yes

220 221 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital Vote:176 Naguru Referral Hospital

• % increase of specialised clinics outpatients attendances 100000 2019 6% 7% 8% SubProgramme: 1004 Naguru Rehabilitation Referal Hospital

SubProgramme: 01 Naguru Referral Hosptial Services Output: 72 Government Buildings and Administrative Infrastructure Output: 01 Inpatient services Number of buildings constructed 2 1 1 No. of in-patients (Admissions) 15,500 15,500 15,500 SubProgramme: 1571 Retooling of National Trauma Centre, Naguru

Average Length of Stay (ALOS) - days 5 5 5 Output: 85 Purchase of Medical Equipment Value of medical equipment procured (Ush Bn) .08 1 1 Bed Occupancy Rate (BOR) 85% 85% 85%

Number of Major Operations (including Caesarean section) 4,500 4,500 4,500 IX. Major Capital Investments And Changes In Resource Allocation Output: 02 Outpatient services Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Total general outpatients attendance 80,000 80,000 80,000 FY 2019/20 FY 2020/21 No. of specialized clinic attendances 120,000 120,000 120,000 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Referral cases in 300 300 300 end Dec Outputs Vote 176 Naguru Referral Hospital Value of medicines received/dispensed(Ushs bn) 1.2 1.2 1.2 Program : 08 56 Regional Referral Hospital Services No. of laboratory tests carried out 140,000 140,000 140,000 Development Project : 1004 Naguru Rehabilitation Referal Hospital Output: 04 Diagnostic services Output: 08 56 72 Government Buildings and Administrative Infrastructure No. of patient xrays (imaging) taken 4,500 4,500 4,500 Begin construction of the Perimeter wall at Staff residence Procurement Process continued for construction Construction of Perimeter wall fence at Staff Continuation of Staff House construction of the Perimeter wall at Staff residence. residence completed 9,000 9,000 9,000 Number of Ultra Sound Scans Strategic and investment plan developed for 2020/2021- Best Evaluated bidder was notified and contract Block 2 Staff house construction completion 2024/2025 document signed Output: 05 Hospital Management and support services Continuation of staff House construction to completion was ongoing at 70% completion. Assets register updated on a quarterly basis 4 4 4 Procurement process for master plan development continued and evaluation of best Timely payment of salaries and pensions by the 2 Yes Yes Yes bidder was done Total Output Cost(Ushs Thousand) 900,000 154,264 976,000 Quarterly financial reports submitted timely Yes Yes Yes Gou Dev’t: 900,000 154,264 976,000 Output: 06 Prevention and rehabilitation services Ext Fin: 0 0 0 No. of antenatal cases (All attendances) 28,000 28,000 28,000 A.I.A: 0 0 0 No. of family planning users attended to (New and Old) 4,000 4,000 4,000

Percentage of HIV positive pregnant women not on HAART initiated ARVs 0% 0% 0% X. Vote Challenges and Plans To Improve Performance

Output: 07 Immunisation Services Vote Challenges No. of children immunised (All immunizations) 12,000 12,000 12,000 Need for space for Trauma tertiary services requires expansions to accommodate Inpatients, Operating Rooms, equipment, and developing matching staff skill in Histopathology lab, ENT, Ophthalmology, High Dependency Unit. Construction of more Staff SubProgramme: 02 Naguru Referral Hospital Internal Audit accommodation in the vicinity and a Hospital sound proof from the noisy environment. Output: 05 Hospital Management and support services Medicines and Medical Supplies, from NMS had a cumulative average of 81% delivery. The major gap was in was attributed to Assets register updated on a quarterly basis 4 4 4 the hospital having inadequate funds for the needed medical supplies and the lack of diagnostic supplies from NMS. The budget of 1.2bn/= will be inadequate to handle specialised Trauma services. Timely payment of salaries and pensions by the 2 Yes Yes Yes Specialist support supervision in the central region excludes specialist camps, mentoring and coordination roles, due to inadequate Quarterly financial reports submitted timely Yes Yes Yes funding.

The current Ambulance is grounded with high cost for repair and, therefore, the need for a new ambulance.

220 221 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital

Water consumption is increasing with increased patient numbers and increased electricity bill as a result of high electricity consumption of major equipment’s and plants. This has accumulated utility Arrears.

Electricity and water frequent shortages in the area requires Electricity Back up system of Batteries, Inverters, and distributor panels for Electricity backup system for emergency’s. The Main water reservoir tanks requires major repairs.

There is no funding for oxygen plant maintenance costs, and purchase of expensive cylinder heads, in addition to the costs of production for provision to other health facilities namely Kiruddu, Kawempe, and the lower Health Centres including the private not for profit hospitals.

Plans to improve Vote Performance

The hospital performance will be guided by its strategic objectives and sector priorities and minimise its challenges though the following:

The hospital management intends to drive towards better vote performance by using data centred activities to promote strategy/goal setting and providing regular feedback, to nurture a quality improvement culture. The Hospital will use available resources in the most efficient and equitable way.

Hospital Research and Ethics committee, will enhance new evidence-based practices and processes that have a high impact on quality of care for the patients and clients.

Hospital is on a continuous journey of quality improvement. The Quality Improvement Plan (QIP) will be one of the tools to track performance in a selection of high-priority areas, including patient safety, timely access to effective care and building an integrated health system with our partners. XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.25 0.25 Recurrent Budget Estimates 01 Naguru Referral Hosptial Services 0.25 0.25 507-China (PR) 0.25 0.25

Total for Vote 0.25 0.25

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To contribute to prevention of new HIV infections and to prioritize the primary prevention efforts. Issue of Concern : Preventing new HIV infections and prioritizing the primary prevention efforts. Planned Interventions : Key communication campaigns and messages to clients in hospital. Conduct research designed to identify innovative, cost-effective, and high-impact - strategies needed to protect persons most at risk of HIV infection. Budget Allocation (Billion) : 0.200

222 223 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital Vote:176 Naguru Referral Hospital

Performance Indicators: Increased awareness of HIV, reduced HIV-related stigma, promoted HIV testing and proven HIV Water consumption is increasing with increased patient numbers and increased electricity bill as a result of high electricity prevention strategies consumption of major equipment’s and plants. This has accumulated utility Arrears. Issue Type: Gender Electricity and water frequent shortages in the area requires Electricity Back up system of Batteries, Inverters, and distributor panels for Electricity backup system for emergency’s. The Main water reservoir tanks requires major repairs. Objective : To contribute to equitable, safe and sustainable health care services provided to all age and population groups. There is no funding for oxygen plant maintenance costs, and purchase of expensive cylinder heads, in addition to the costs of Issue of Concern : All population groups and ages accessing health care in equitable, safe and sustainable manner production for provision to other health facilities namely Kiruddu, Kawempe, and the lower Health Centres including the private not for profit hospitals. Planned Interventions : Staff house construction. Train HW in BeMONC, Post abortal care. Priority ANC services to couples. Non-discriminatory health care delivery, Men's involvement in Reproductive Health, Plans to improve Vote Performance Provision of services to the Most At Risk Populations (MARPS) and GBV Budget Allocation (Billion) : 0.400 The hospital performance will be guided by its strategic objectives and sector priorities and minimise its challenges though the following: Performance Indicators: No. of health providers Sensitized on gender issues in service delivery. Data on Incorporated gender concerns at service implementation level. The hospital management intends to drive towards better vote performance by using data centred activities to promote strategy/goal Issue Type: Enviroment setting and providing regular feedback, to nurture a quality improvement culture. The Hospital will use available resources in the most efficient and equitable way. Objective : To provide a safe and healthy environment free of hazards in the Hospital

Hospital Research and Ethics committee, will enhance new evidence-based practices and processes that have a high impact on Issue of Concern : safeguarding all people in the hospital from Hospital Acquired Infection quality of care for the patients and clients. Planned Interventions : Staff awareness of dangers of types of hospital generated waste. Level of compliance with standard Procedures on handling of healthcare waste. Hospital is on a continuous journey of quality improvement. The Quality Improvement Plan (QIP) will be one of the tools to track performance in a selection of high-priority areas, including patient safety, timely access to effective care and building an integrated Budget Allocation (Billion) : 0.230 health system with our partners. Performance Indicators: Lists of items designated as hazardous or other types of waste. Number, location, condition, proper color coding & content of means of collection. % mapped & inspected storage areas & route of XI Off Budget Support transportation. Table 11.1 Off-Budget Support by Sub-Programme XIII. Personnel Information

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Table 13.1 Staff Establishment Analysis Budget Estimates Programme 0856 Regional Referral Hospital Services 0.25 0.25 Title Salary Scale Number Of Approved Positions Number Of Filled Positions Recurrent Budget Estimates Consultant (Anaesthesia) U1SE 1 0 01 Naguru Referral Hosptial Services 0.25 0.25 Consultant (ENT) U1SE 1 0 507-China (PR) 0.25 0.25 Consultant (Obs. & Gyn) U1SE 1 0 Total for Vote 0.25 0.25 Consultant (Surgery) U1SE 1 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues Consultant Radiology U1SE 1 0 Table 12.1: Cross- Cutting Policy Issues Medical Officer Special Grade U2(Med-1) 1 0 (ENT) Issue Type: HIV/AIDS Medical Officer Special Grade U2(Med-1) 1 0 Objective : To contribute to prevention of new HIV infections and to prioritize the primary prevention efforts. (Opthamology) Medical Officer Special Grade U2(Med-1) 1 0 Issue of Concern : Preventing new HIV infections and prioritizing the primary prevention efforts. (Public Health) Planned Interventions : Key communication campaigns and messages to clients in hospital. Conduct research designed to MOSG ANAETHESIA U2(SC) 1 0 identify innovative, cost-effective, and high-impact - strategies needed to protect persons most at risk of HIV infection. Medical Officer Special Grade U2U 1 0 (Psychiatry) Budget Allocation (Billion) : 0.200 PRINCIPAL NURSING OFFICER U3(Med-2) 1 0

222 223 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital

Senior Nutritionist U3(SC) 1 0 Senior Records Officer U3L 1 0 Senior Occupational Therapist U4(Med-2) 2 1 Senior Nursing Officer U4(Med-2) 15 11 Security Officer U4L 1 0 ACCOUNTANT U4U 1 0 Supplies Officer U4U 1 0 Assistant Supplies Officer U5L 1 0 Office Supervisor U5L 1 0 STENOGRAPHER SECRETARY U5L 1 0 Psychatric Clinical Officer U5U 4 3 Senior Accounts Assistant U5U 1 0 Office Typist U6L 2 1 Pool stenographer U6L 2 0 Engineering Assistant U6U 2 1 Senior Stores Assistant (Senior U6U 1 0 Inventory Management Officer) Stores Assitant (Inventory U7L 2 0 Management Officer) ACCOUNTS ASSISTANT U7U 4 2

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT U4U 1 0 1 1 940,366 11,284,392 ACCOUNTS ASSISTANT U7U 4 2 2 2 755,562 9,066,744 Assistant Supplies Officer U5L 1 0 1 1 479,759 5,757,108 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (ENT) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Surgery) U1SE 1 0 1 1 2,785,630 33,427,560 Consultant Radiology U1SE 1 0 1 1 4,200,000 50,400,000 Engineering Assistant U6U 2 1 1 1 436,677 5,240,124 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Psychiatry) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Opthamology)

224 225 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21 Naguru Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:176 Naguru Referral Hospital Vote:176 Naguru Referral Hospital

Senior Nutritionist U3(SC) 1 0 Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Public Health) Senior Records Officer U3L 1 0 MOSG ANAETHESIA U2(SC) 1 0 1 1 2,171,667 26,060,004 Senior Occupational Therapist U4(Med-2) 2 1 Office Supervisor U5L 1 0 1 1 479,759 5,757,108 Senior Nursing Officer U4(Med-2) 15 11 Office Typist U6L 2 1 1 1 424,253 5,091,036 Pool stenographer U6L 2 0 2 2 848,506 10,182,072 Security Officer U4L 1 0 PRINCIPAL NURSING OFFICER U3(Med-2) 1 0 1 1 3,100,000 37,200,000 ACCOUNTANT U4U 1 0 Psychatric Clinical Officer U5U 4 3 1 1 1,539,084 18,469,008 Supplies Officer U4U 1 0 Security Officer U4L 1 0 1 1 601,341 7,216,092 Assistant Supplies Officer U5L 1 0 Senior Occupational Therapist U4(Med-2) 2 1 1 1 2,200,000 26,400,000 Senior Accounts Assistant U5U 1 0 1 1 690,392 8,284,704 Office Supervisor U5L 1 0 Senior Nursing Officer U4(Med-2) 15 11 4 4 8,800,000 105,600,000 STENOGRAPHER SECRETARY U5L 1 0 Senior Nutritionist U3(SC) 1 0 1 1 1,460,248 17,522,976 Psychatric Clinical Officer U5U 4 3 Senior Records Officer U3L 1 0 1 1 902,612 10,831,344 Senior Stores Assistant (Senior U6U 1 0 1 1 1,233,108 14,797,296 Senior Accounts Assistant U5U 1 0 Inventory Management Officer) Office Typist U6L 2 1 STENOGRAPHER SECRETARY U5L 1 0 1 1 479,759 5,757,108 Stores Assitant (Inventory U7L 2 0 2 2 2,025,368 24,304,416 Pool stenographer U6L 2 0 Management Officer) Engineering Assistant U6U 2 1 Supplies Officer U4U 1 0 1 1 940,366 11,284,392 Senior Stores Assistant (Senior U6U 1 0 Total 54 19 35 35 65,094,457 781,133,484 Inventory Management Officer) Stores Assitant (Inventory U7L 2 0 Management Officer) ACCOUNTS ASSISTANT U7U 4 2

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ACCOUNTANT U4U 1 0 1 1 940,366 11,284,392 ACCOUNTS ASSISTANT U7U 4 2 2 2 755,562 9,066,744 Assistant Supplies Officer U5L 1 0 1 1 479,759 5,757,108 Consultant (Anaesthesia) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (ENT) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Consultant (Surgery) U1SE 1 0 1 1 2,785,630 33,427,560 Consultant Radiology U1SE 1 0 1 1 4,200,000 50,400,000 Engineering Assistant U6U 2 1 1 1 436,677 5,240,124 Medical Officer Special Grade U2U 1 0 1 1 3,750,000 45,000,000 (Psychiatry) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (ENT) Medical Officer Special Grade U2(Med-1) 1 0 1 1 3,750,000 45,000,000 (Opthamology)

224 225 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital

V1: Vote Overview I. Vote Mission Statement To increase access to quality specialized health care services resaearch and training in Uganda

II. Strategic Objective 1. To provide specialized health care services 2. To Provide comprehensive , curative, preventive, rehabilitative, promotion and palliative health care services to the people of Uganda 3. To Provide tertiary training and Continuous Professional Development 4. To Undertake and conduct operational research III. Major Achievements in 2019/20 The performance of 2019/20 FY is highlighted below: 1. Inpatients services There were 10,247 admissions compared 10,000 planned target. The average length of stay was 11 days compared to the targeted 5 days because patients stayed longer on the Burns and Surgery ward, Medical wards and ICU because of complicated and critical conditions. The bed occupancy rate was 105% compared to a target of 85% The Major operations were 1398 compared to 500 set target and minor operations were 1852 2. Outpatient services Patients treated in the specialists clinics were 28,895 compared to 44,500 while Patients treated as General outpatients clinics were 20,300 compared a target of 21,150 . 13,651 HIV/AIDS patients in care at the Hospital with 3,940 on first line and 296 on second line ARV regimen. 5,563 Dialysis sessions were processed and a patients association formed to improve physio-social support, coordination and improved health services utilization Medicines and Health Supplies worth 1,2Bn have been supplied and dispensed to patients thereby exhausting the budgetary provision of 1.5Bn for medicines

4. Diagnostics 54,371 laboratory examinations were made compared to 43,300 target 1,755 ultrasound examinations made compared to 1000 ultrasounds examinations targeted 1,303 x-rays and 70 CT scans were made, 1,000 ECHO/ECG examinations made 249 Endoscopy examinations 5 Management and Support services Seven Hospital working committees were constituted to galvanize management functions and improve efficiency and effectiveness of hospital operations. These committees include Top management, Rewards and sanctions Clinical Services committee, Medicines and Therapeutics, Private patient Services, Finance and Planning committee, Space allocation committee, and 5 S .Quality Improvement Committee held monthly meetings. Operationalization of various offices and clinics took place especially Maxillofacial Oral wards and HDU and Theatres Finalization of Hospital 5 Year Strategic Plan to guide Hospital activities in the next five years 2020/21-2024/25 was undertaken Performance reports have been compiled and submitted, Several medical equipment have been repaired especially CT Scan was blown by Electricity, ECG Machine, Autoclaves, BP machines , Level 7 was painted and improved the outlook of the wards Burglar Proofing was completed for Key offices an, Pharmacies and Stores Assets inventory was compiled and in use Repairs of plumbing and other civil works undertaken, 6 Prevention and rehabilitation Four Radio and 3 TV presentations have been made Four Community Engagement meetings were held. 2,010physiotherapy sessions. 7 Immunizations

226 227 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital Vote:177 Kiruddu Referral Hospital

V1: Vote Overview 5,602 Immunizations were carried out compared to 3,360 targeted immunizations 8. Human Resources Management I. Vote Mission Statement 10. Staff totaling to 231 were transitioned from Payroll of KCCA to Kiruddu National Referral Hospital Payroll. 9. Records management To increase access to quality specialized health care services resaearch and training in Uganda Establishing Records management System 10: Audit Function was executed with a help of an Auditor . II. Strategic Objective 1. To provide specialized health care services 2. To Provide comprehensive , curative, preventive, rehabilitative, promotion and palliative health care services to the people of Uganda 3. To Provide tertiary training and Continuous Professional Development IV. Medium Term Plans 4. To Undertake and conduct operational research To complete Construction of Oxygen Plant and piping to all wards III. Major Achievements in 2019/20 To implement the Strategic Plan for 2020/21-2024/25 FYs To procure Medical equipment, furniture and office equipment to functionalise offices offices The performance of 2019/20 FY is highlighted below: to recruit staff especially Consultants 1. Inpatients services To Install Solar power on the wards There were 10,247 admissions compared 10,000 planned target. To construct water harvesting facilities The average length of stay was 11 days compared to the targeted 5 days because patients stayed longer on the Burns and Surgery ward, Medical wards and ICU because of complicated and critical conditions. The bed occupancy rate was 105% compared to a target of 85% The Major operations were 1398 compared to 500 set target and minor operations were 1852 2. Outpatient services Patients treated in the specialists clinics were 28,895 compared to 44,500 while Patients treated as General outpatients clinics were 20,300 compared a target of 21,150 . 13,651 HIV/AIDS patients in care at the Hospital with 3,940 on first line and 296 on second line ARV regimen. 5,563 Dialysis sessions were processed and a patients association formed to improve physio-social support, coordination and improved health services utilization Medicines and Health Supplies worth 1,2Bn have been supplied and dispensed to patients thereby exhausting the budgetary provision of 1.5Bn for medicines

226 227 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 0.000 4.785 2.328 5.785 4.785 4.785 4.785 4.785 Recurrent Non Wage 0.000 7.230 2.582 7.230 7.230 7.230 7.230 7.230 GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Total GoU+Ext Fin (MTEF) 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Total Budget 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Total Vote Budget 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 12.015 0.000 0.000 12.015 13.015 0.000 13.015

211 Wages and Salaries 5.259 0.000 0.000 5.259 6.134 0.000 6.134

213 Other Employee Costs 0.070 0.000 0.000 0.070 0.043 0.000 0.043

221 General Expenses 1.165 0.000 0.000 1.165 1.024 0.000 1.024

222 Communications 0.159 0.000 0.000 0.159 0.037 0.000 0.037

223 Utility and Property Expenses 0.543 0.000 0.000 0.543 0.800 0.000 0.800

224 Supplies and Services 3.802 0.000 0.000 3.802 3.970 0.000 3.970

225 Professional Services 0.020 0.000 0.000 0.020 0.020 0.000 0.020

227 Travel and Transport 0.567 0.000 0.000 0.567 0.532 0.000 0.532

228 Maintenance 0.411 0.000 0.000 0.411 0.446 0.000 0.446

273 Employer social benefits 0.020 0.000 0.000 0.020 0.010 0.000 0.010

Grand Total : 12.015 0.000 0.000 12.015 13.015 0.000 13.015

Total excluding Arrears 12.015 0.000 0.000 12.015 13.015 0.000 13.015

228 229 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital Vote:177 Kiruddu Referral Hospital

VII. Budget By Programme And Subprogramme V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion) Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme FY 2019/20 Medium Term Projections 2019/20 MTEF Budget Projections Billion Uganda shillings 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget by End Dec Outturn Budget End Dec Proposed Budget Wage 0.000 4.785 2.328 5.785 4.785 4.785 4.785 4.785 Recurrent 56 Regional Referral Hospital Services 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Non Wage 0.000 7.230 2.582 7.230 7.230 7.230 7.230 7.230 01 Kiruddu Referral Hospital Services 0.000 11.997 4.887 12.997 11.997 11.997 11.997 11.997 GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Devt. 02 Kiruddu Referral Hospital Internal Audit 0.000 0.018 0.023 0.018 0.018 0.018 0.018 0.018 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Total for the Vote 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 GoU Total 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Total Excluding Arrears 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Total GoU+Ext Fin (MTEF) 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 VIII. Programme Performance and Medium Term Plans Total Budget 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Programme : 56 Regional Referral Hospital Services Grand Total 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 Programme Objective To Contribute to increased efficiency in Quality and inclusive Specialized Health care Services delivery Total Vote Budget 0.000 12.015 4.910 13.015 12.015 12.015 12.015 12.015 : through provision of comprehensive specialized clinical services, burns and plastic surgery, dialysis, Excluding Arrears research and training at Kiruddu National Referral Hospital Responsible Officer: Dr Kabugo Charles VI. Budget By Economic Clasification Programme Outcome: Quality and accessible Regional Referral Hospital Services Table V6.1 2019/20 and 2020/21 Budget Allocations by Item Sector Outcomes contributed to by the Programme Outcome 2019/20 Approved Budget 2020/21 Draft Estimates 1. Improved quality of life at all levels Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Performance Targets Output Class : Outputs Provided 12.015 0.000 0.000 12.015 13.015 0.000 13.015 Outcome Indicators 2020/21 2021/22 2022/23 211 Wages and Salaries 5.259 0.000 0.000 5.259 6.134 0.000 6.134 Baseline Base year Target Projection Projection 213 Other Employee Costs 0.070 0.000 0.000 0.070 0.043 0.000 0.043

221 General Expenses 1.165 0.000 0.000 1.165 1.024 0.000 1.024

222 Communications 0.159 0.000 0.000 0.159 0.037 0.000 0.037

223 Utility and Property Expenses 0.543 0.000 0.000 0.543 0.800 0.000 0.800

224 Supplies and Services 3.802 0.000 0.000 3.802 3.970 0.000 3.970

225 Professional Services 0.020 0.000 0.000 0.020 0.020 0.000 0.020

227 Travel and Transport 0.567 0.000 0.000 0.567 0.532 0.000 0.532

228 Maintenance 0.411 0.000 0.000 0.411 0.446 0.000 0.446

273 Employer social benefits 0.020 0.000 0.000 0.020 0.010 0.000 0.010

Grand Total : 12.015 0.000 0.000 12.015 13.015 0.000 13.015

Total excluding Arrears 12.015 0.000 0.000 12.015 13.015 0.000 13.015

228 229 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital

• % increase of specialized clinic outpatient attendances 20% 2018 5% 10% 15%

• % increase of diagnostic investigations carried out 20% 2018 5% 10% 15%

• Bed occupancy rate 85% 2018 85% 85% 85%

SubProgramme: 01 Kiruddu Referral Hospital Services Output: 01 Inpatient services No. of in-patients (Admissions) 20,000 20,000 20,600

Bed Occupancy Rate (BOR) 85% 85% 85%

Average Length of Stay (ALOS) - days 5 5 5

Output: 02 Outpatient services No. of specialized clinic attendances 91,670 91,670 91,670

Referral cases in 6,044 6,044 6,044

Total general outpatients attendance 43,569 43,569 43,569

Output: 03 Medicines and health supplies procured and dispensed Value of medicines received/dispensed (Ush bn) 3 3 3

Output: 04 Diagnostic services No. of patient xrays (imaging) taken 4,000 4,000 4,000

Number of Ultra Sound Scans 5,000 5,000 5,000

Output: 05 Hospital Management and support services Timely payment of salaries and pensions by the 2 28 28 28

Quarterly financial reports submitted timely 4 4 4

Output: 06 Prevention and rehabilitation services No. of antenatal cases (All attendances) 9

Percentage of HIV positive pregnant women not on HAART initiated ARVs 0% 0% 0%

Output: 07 Immunisation services No. of children immunised (All immunizations) 5,922 10,000 10,000

SubProgramme: 02 Kiruddu Referral Hospital Internal Audit Output: 05 Hospital Management and support services Timely payment of salaries and pensions by the 2 28 28 28

Quarterly financial reports submitted timely 4 4 4

IX. Major Capital Investments And Changes In Resource Allocation

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

230 231 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital Vote:177 Kiruddu Referral Hospital

• % increase of specialized clinic outpatient attendances 20% 2018 5% 10% 15% N/A

• % increase of diagnostic investigations carried out 20% 2018 5% 10% 15% X. Vote Challenges and Plans To Improve Performance • Bed occupancy rate 85% 2018 85% 85% 85% Vote Challenges SubProgramme: 01 Kiruddu Referral Hospital Services The Vote has encountered the following challenges : Output: 01 Inpatient services 1. Shortage of staff especially for Consultants, nurses , and other staff since Mulago NRH has recalled the staff who were initially at Kiruddu NRH 20,000 20,000 20,600 No. of in-patients (Admissions) 2. increased number of patients seeking care with increased expectations Bed Occupancy Rate (BOR) 85% 85% 85% 3. Limited distribution of Oxygen in Hospital wards , clinics and units 4. Increased utility bills especially electricity Average Length of Stay (ALOS) - days 5 5 5 5. No capital or institutional support budget to support procurement of medical equipment 6 No funds provided for recruitment of additional staff Output: 02 Outpatient services 7. Limited Budget for Medicines, Laboratory and radiology reagents and Consumables 8. Limited Budget for Medicines and Health Supplies.current budget is 1.5Bn , no funds for Medicines with NMs beginning March No. of specialized clinic attendances 91,670 91,670 91,670 2020.,he need is 3Bn Referral cases in 6,044 6,044 6,044

Total general outpatients attendance 43,569 43,569 43,569 Plans to improve Vote Performance

Output: 03 Medicines and health supplies procured and dispensed To improve the performance of Kiruddu National referral Hospital we shall undertake the following interventions: 1.Recruit staff to ensure delivery of health services Value of medicines received/dispensed (Ush bn) 3 3 3 2. Intensify support supervision to promote health services delivery 3. Analysis and utilization of Clock in machine data Output: 04 Diagnostic services 4. implementation of Ministry Of Health Quality Improvement initiatives No. of patient xrays (imaging) taken 4,000 4,000 4,000 5. Introduce electronic patient management system 6. undertake short term courses tailored for solving the local challenges Number of Ultra Sound Scans 5,000 5,000 5,000 7.Ensure routine maintenance of all medical equipment 8. improved collaborations and partnerships with academic , professional, research and other health institutions in Uganda and Output: 05 Hospital Management and support services abroad Timely payment of salaries and pensions by the 2 28 28 28 9. Advocate for additional funding for Medicines and Health supplies to improve health services delivery

Quarterly financial reports submitted timely 4 4 4 XI Off Budget Support

Output: 06 Prevention and rehabilitation services Table 11.1 Off-Budget Support by Sub-Programme No. of antenatal cases (All attendances) 9 N/A

Percentage of HIV positive pregnant women not on HAART initiated ARVs 0% 0% 0% XII. Vote Cross Cutting Policy And Other Budgetary Issues Output: 07 Immunisation services Table 12.1: Cross- Cutting Policy Issues No. of children immunised (All immunizations) 5,922 10,000 10,000 Issue Type: HIV/AIDS SubProgramme: 02 Kiruddu Referral Hospital Internal Audit Objective : To increase access to HIV/AIDS Services in the Hospital to both members of staff and community Output: 05 Hospital Management and support services in the catchment area Timely payment of salaries and pensions by the 2 28 28 28 Issue of Concern : High HIV/AIDS Prevalence Quarterly financial reports submitted timely 4 4 4 Planned Interventions : implementing an HIV/AIDS work place Policy for Health workers Increase HIV/AIDS Testing Services on all wards Raise HIV/AIDS awareness among Most at Risk Populations IX. Major Capital Investments And Changes In Resource Allocation promote condom distribution in the Hospital and in the community 0.050 Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Budget Allocation (Billion) :

230 231 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital

Performance Indicators: Workplace HIV/AIDS Policy for Health workers implemented HIV/AIDS Testing Services on all wards introduced HIV/AIDS awareness among Most at Risk Populations raised Condoms distribution intensified at the Hospital and in the community Issue Type: Gender

Objective : To increase access to all health services for all people in need for all age groups, gender, ,tribe, religion, location, refugees status, physical disability in the catchment area Issue of Concern : Gender imbalances at workplace Planned Interventions : increase representatives of all gender staff on hospital committees Provide health services irrespective of age, gender and physical ability. Budget Allocation (Billion) : 0.020 Performance Indicators: Representatives of all gender staff on hospital committees increased Health services irrespective of age, gender and physical ability provided in anon discriminatory manner Issue Type: Enviroment

Objective : To improve environmental protection through improving sanitation standards and greening environment Issue of Concern : Poor Sanitation , Hygiene and Limited beautified environment Planned Interventions : improve supervision of cleaning services follow up construction of Waste Water management system plant more green and flowers in the compound improve compound maintenance and management and sensitization of the public. Budget Allocation (Billion) : 5.000 Performance Indicators: Supervision of cleaning services improved Construction of Waste Water management system followed up More green in the compound planted Compound maintenance and management improved XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Assistant Commissioner -Nursing U1E 1 0 Senior Consultant Radiology U1E 1 0 Consultant (Medicine) U1SE 27 1 Consultant Radiology U1SE 2 0 Senior Consultant MEDICAL U1SE 16 1 Senior Consultant SURGEON U1SE 6 1 Medical Officer Special Grade U2(Med-1) 34 4 (Medicine) Medical Officer Special Grade U2(Med-1) 2 0 (Orthopaedic Surgeon)

232 233 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital Vote:177 Kiruddu Referral Hospital

Performance Indicators: Workplace HIV/AIDS Policy for Health workers implemented Medical Officer Special Grade U2(Med-1) 3 0 HIV/AIDS Testing Services on all wards introduced (Psychiatry) HIV/AIDS awareness among Most at Risk Populations raised Medical Officer Special Grade U2(Med-1) 4 0 Condoms distribution intensified at the Hospital and in the community (Radiologist) Issue Type: Gender PRINCIPAL NURSING OFFICER U3(Med-2) 4 1

Objective : To increase access to all health services for all people in need for all age groups, gender, ,tribe, Business Development Officer U4 1 0 religion, location, refugees status, physical disability in the catchment area Communication Officer U4 1 0 Issue of Concern : Gender imbalances at workplace Economist U4 1 0 Planned Interventions : increase representatives of all gender staff on hospital committees Provide health services irrespective of age, gender and physical ability. Information and technology officer U4 2 0 Budget Allocation (Billion) : 0.020 Inventory Management Officer U4 2 0 Performance Indicators: Representatives of all gender staff on hospital committees increased Nursing Officer U4 75 6 Health services irrespective of age, gender and physical ability provided in anon discriminatory manner Personal Secretary U4 2 0 Issue Type: Enviroment Senior Echocardiography U4 1 0 Technician Objective : To improve environmental protection through improving sanitation standards and greening Systems Administrator U4 1 0 environment MEDICAL OFFICERS U4(Med-1) 43 34 Issue of Concern : Poor Sanitation , Hygiene and Limited beautified environment PHARMACIST U4(Med-1) 2 1 Planned Interventions : improve supervision of cleaning services follow up construction of Waste Water management system SENIOR NURSING OFFICER U4(Med-2) 14 0 plant more green and flowers in the compound improve compound maintenance and management and sensitization of the public. MEDICAL RECORDS OFFICER U4L 2 1 Budget Allocation (Billion) : 5.000 Assistant Nursing officers U5 120 37 Performance Indicators: Supervision of cleaning services improved Dialysis machine technicians U5 3 0 Construction of Waste Water management system followed up Echocardiography Technician U5 1 0 More green in the compound planted Compound maintenance and management improved CLINICAL OFFICER U5(SC) 15 1 XIII. Personnel Information NUTRITIONIST U5(SC) 3 0 Occupational Therapist U5(SC) 2 1 Table 13.1 Staff Establishment Analysis ORTHOPAEDIC OFFICER U5(SC) 1 0 Title Salary Scale Number Of Approved Positions Number Of Filled Positions PUBLIC HEALTH DENTAL U5(SC) 2 0 Assistant Commissioner -Nursing U1E 1 0 OFFICER Senior Consultant Radiology U1E 1 0 STENOGRAPHER SECRETARY U5L 2 0 Consultant (Medicine) U1SE 27 1 ASSISTANT PROCUREMENT U5U 2 0 OFFICER Consultant Radiology U1SE 2 0 POOL STENOGRAPHER U6L 5 0 Senior Consultant MEDICAL U1SE 16 1 Artisan U7 2 0 Senior Consultant SURGEON U1SE 6 1 Customer Care Assistant U7 5 0 Medical Officer Special Grade U2(Med-1) 34 4 (Medicine) Medical Records Assistant U7 18 15 Medical Officer Special Grade U2(Med-1) 2 0 ENROLLED NURSES U7(Med) 140 48 (Orthopaedic Surgeon) Porter U8 10 0

232 233 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital

ASKARI U8L 4 0 OFFICE ATTENDANT U8L 3 0 DRIVER U8U 10 0

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Artisan U7 2 0 2 2 567,826 6,813,912 ASKARI U8L 4 0 4 1 213,832 2,565,984 Assistant Commissioner -Nursing U1E 1 0 1 1 4,200,000 50,400,000 Assistant Nursing officers U5 120 37 83 55 66,000,000 792,000,000 ASSISTANT PROCUREMENT U5U 2 0 2 1 598,822 7,185,864 OFFICER Business Development Officer U4 1 0 1 1 723,868 8,686,416 CLINICAL OFFICER U5(SC) 15 1 14 2 2,400,000 28,800,000 Communication Officer U4 1 0 1 1 723,868 8,686,416 Consultant (Medicine) U1SE 27 1 26 14 58,800,000 705,600,000 Consultant Radiology U1SE 2 0 2 1 4,200,000 50,400,000 Customer Care Assistant U7 5 0 5 3 1,031,376 12,376,512 Dialysis machine technicians U5 3 0 3 1 1,200,000 14,400,000 DRIVER U8U 10 0 10 5 1,185,345 14,224,140 Echocardiography Technician U5 1 0 1 1 1,200,000 14,400,000 Economist U4 1 0 1 1 876,222 10,514,664 ENROLLED NURSES U7(Med) 140 48 92 71 43,534,218 522,410,616 Information and technology officer U4 2 0 2 1 2,200,000 26,400,000 Inventory Management Officer U4 2 0 2 2 1,752,444 21,029,328 Medical Officer Special Grade U2(Med-1) 34 4 30 7 26,250,000 315,000,000 (Medicine) Medical Officer Special Grade U2(Med-1) 2 0 2 1 3,750,000 45,000,000 (Orthopaedic Surgeon) Medical Officer Special Grade U2(Med-1) 3 0 3 1 3,750,000 45,000,000 (Psychiatry) Medical Officer Special Grade U2(Med-1) 4 0 4 2 7,500,000 90,000,000 (Radiologist) MEDICAL OFFICERS U4(Med-1) 43 34 9 2 6,000,000 72,000,000 Medical Records Assistant U7 18 15 3 3 851,739 10,220,868 MEDICAL RECORDS OFFICER U4L 2 1 1 1 601,341 7,216,092 Nursing Officer U4 75 6 69 35 77,000,000 924,000,000 NUTRITIONIST U5(SC) 3 0 3 2 4,400,000 52,800,000 Occupational Therapist U5(SC) 2 1 1 1 1,200,000 14,400,000 OFFICE ATTENDANT U8L 3 0 3 3 641,496 7,697,952 ORTHOPAEDIC OFFICER U5(SC) 1 0 1 1 1,200,000 14,400,000 Personal Secretary U4 2 0 2 2 1,447,736 17,372,832

234 235 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21 Kiruddu Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:177 Kiruddu Referral Hospital Vote:177 Kiruddu Referral Hospital

ASKARI U8L 4 0 PHARMACIST U4(Med-1) 2 1 1 1 3,000,000 36,000,000 POOL STENOGRAPHER U6L 5 0 5 1 424,253 5,091,036 OFFICE ATTENDANT U8L 3 0 Porter U8 10 0 10 7 1,402,072 16,824,864 DRIVER U8U 10 0 PRINCIPAL NURSING OFFICER U3(Med-2) 4 1 3 3 9,300,000 111,600,000 Table 13.2 Staff Recruitment Plan PUBLIC HEALTH DENTAL U5(SC) 2 0 2 1 1,200,000 14,400,000 OFFICER Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Senior Consultant MEDICAL U1SE 16 1 15 7 31,500,000 378,000,000 Scale Approved Filled Posts Posts Cleared for Per Month Salary Senior Consultant Radiology U1E 1 0 1 1 4,500,000 54,000,000 Posts Filling (UGX) (UGX) Senior Consultant SURGEON U1SE 6 1 5 3 13,500,000 162,000,000 FY2020/21 Senior Echocardiography U4 1 0 1 1 2,200,000 26,400,000 Artisan U7 2 0 2 2 567,826 6,813,912 Technician ASKARI U8L 4 0 4 1 213,832 2,565,984 SENIOR NURSING OFFICER U4(Med-2) 14 0 14 14 30,800,000 369,600,000 Assistant Commissioner -Nursing U1E 1 0 1 1 4,200,000 50,400,000 STENOGRAPHER SECRETARY U5L 2 0 2 1 528,588 6,343,056 Assistant Nursing officers U5 120 37 83 55 66,000,000 792,000,000 Systems Administrator U4 1 0 1 1 2,200,000 26,400,000 ASSISTANT PROCUREMENT U5U 2 0 2 1 598,822 7,185,864 Total 595 152 443 266 426,555,046 5,118,660,552 OFFICER Business Development Officer U4 1 0 1 1 723,868 8,686,416 CLINICAL OFFICER U5(SC) 15 1 14 2 2,400,000 28,800,000 Communication Officer U4 1 0 1 1 723,868 8,686,416 Consultant (Medicine) U1SE 27 1 26 14 58,800,000 705,600,000 Consultant Radiology U1SE 2 0 2 1 4,200,000 50,400,000 Customer Care Assistant U7 5 0 5 3 1,031,376 12,376,512 Dialysis machine technicians U5 3 0 3 1 1,200,000 14,400,000 DRIVER U8U 10 0 10 5 1,185,345 14,224,140 Echocardiography Technician U5 1 0 1 1 1,200,000 14,400,000 Economist U4 1 0 1 1 876,222 10,514,664 ENROLLED NURSES U7(Med) 140 48 92 71 43,534,218 522,410,616 Information and technology officer U4 2 0 2 1 2,200,000 26,400,000 Inventory Management Officer U4 2 0 2 2 1,752,444 21,029,328 Medical Officer Special Grade U2(Med-1) 34 4 30 7 26,250,000 315,000,000 (Medicine) Medical Officer Special Grade U2(Med-1) 2 0 2 1 3,750,000 45,000,000 (Orthopaedic Surgeon) Medical Officer Special Grade U2(Med-1) 3 0 3 1 3,750,000 45,000,000 (Psychiatry) Medical Officer Special Grade U2(Med-1) 4 0 4 2 7,500,000 90,000,000 (Radiologist) MEDICAL OFFICERS U4(Med-1) 43 34 9 2 6,000,000 72,000,000 Medical Records Assistant U7 18 15 3 3 851,739 10,220,868 MEDICAL RECORDS OFFICER U4L 2 1 1 1 601,341 7,216,092 Nursing Officer U4 75 6 69 35 77,000,000 924,000,000 NUTRITIONIST U5(SC) 3 0 3 2 4,400,000 52,800,000 Occupational Therapist U5(SC) 2 1 1 1 1,200,000 14,400,000 OFFICE ATTENDANT U8L 3 0 3 3 641,496 7,697,952 ORTHOPAEDIC OFFICER U5(SC) 1 0 1 1 1,200,000 14,400,000 Personal Secretary U4 2 0 2 2 1,447,736 17,372,832

234 235 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital

V1: Vote Overview I. Vote Mission Statement To provide quality specialized healthcare in Obstetrics & Gynaecology, Paediatrics and adolescent health,HIV/AIDS care and enhance research and medical training in line with the ministry of Health Policy.

II. Strategic Objective To offer specialized Health care services to mothers, Pediatrics and Adolescent To operationalize and strengthen management systems through administrative services To contribute to human resource development through training, coaching and mentoring of health workers To contribute to National policy development through operational research III. Major Achievements in 2019/20 The hospital was able to achieve the following: • 33,425 Inpatients Admissions • 10,256 Deliveries • 4027 C/section • 48,903 Out patients seen • 12,804 Antenatal visits • 150,859 laboratory test done • 6,286 units of blood transfused • 3,957 Images done • 41,043 Immunizations done • 878 Physiotherapy patients treated • 965 Occupational therapy patients seen • 338 staff paid salaries • 59% Medicines & Health supplies procured

Other Physical performance • Installation and commissioning of a 1000KVA power stabilizer to address the issue of electricity voltage surges from the transmission mains. • Installation and Commissioning of life saving commodities; baby warmers, Incubators, Ventilators, Infusion and Volumetric pumps, Nebulizers etc. • Operationalization of the Laundry Equipment • Conducted corrective and preventive maintenance for 68 % of all Hospital plants and Equipment • No number of medical equipment incidents was reported in the period

IV. Medium Term Plans In the midterm plans, the hospital envisages to:

--Recruitment of critical staff

--Procurement of more medicines and supplies

--Procurement of transport equipment’s (Ambulance, Service car, staff Van, Director’s car)

--Procurement of medical equipment, furniture and other items (eg Paed beds)

--Short term consultancy services.

236 237 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital Vote:178 Kawempe Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To provide quality specialized healthcare in Obstetrics & Gynaecology, Paediatrics and adolescent health,HIV/AIDS care and enhance research and medical training in line with the ministry of Health Policy. 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 0.000 4.700 2.753 6.025 6.025 6.025 6.025 6.025 To offer specialized Health care services to mothers, Pediatrics and Adolescent To operationalize and strengthen management Recurrent systems through administrative services To contribute to human resource development through training, coaching and mentoring Non Wage 0.000 4.198 1.398 4.198 4.198 4.198 4.198 4.198 of health workers To contribute to National policy development through operational research GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 III. Major Achievements in 2019/20 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 The hospital was able to achieve the following: 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 • 33,425 Inpatients Admissions GoU Total • 10,256 Deliveries Total GoU+Ext Fin (MTEF) 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 • 4027 C/section • 48,903 Out patients seen Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • 12,804 Antenatal visits 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 • 150,859 laboratory test done Total Budget • 6,286 units of blood transfused A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A • 3,957 Images done • 41,043 Immunizations done Grand Total 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 • 878 Physiotherapy patients treated Total Vote Budget 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 • 965 Occupational therapy patients seen Excluding Arrears • 338 staff paid salaries • 59% Medicines & Health supplies procured VI. Budget By Economic Clasification Other Physical performance Table V6.1 2019/20 and 2020/21 Budget Allocations by Item • Installation and commissioning of a 1000KVA power stabilizer to address the issue of electricity voltage surges from the transmission mains. • Installation and Commissioning of life saving commodities; baby warmers, Incubators, Ventilators, Infusion and Volumetric 2019/20 Approved Budget 2020/21 Draft Estimates pumps, Nebulizers etc. Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total • Operationalization of the Laundry Equipment Output Class : Outputs Provided 8.898 0.000 0.000 8.898 10.223 0.000 10.223 • Conducted corrective and preventive maintenance for 68 % of all Hospital plants and Equipment • No number of medical equipment incidents was reported in the period 211 Wages and Salaries 4.987 0.000 0.000 4.987 6.303 0.000 6.303

213 Other Employee Costs 0.029 0.000 0.000 0.029 0.029 0.000 0.029

221 General Expenses 0.881 0.000 0.000 0.881 0.846 0.000 0.846 IV. Medium Term Plans 222 Communications 0.083 0.000 0.000 0.083 0.083 0.000 0.083 In the midterm plans, the hospital envisages to: 223 Utility and Property Expenses 0.998 0.000 0.000 0.998 1.091 0.000 1.091 --Recruitment of critical staff 224 Supplies and Services 0.930 0.000 0.000 0.930 0.930 0.000 0.930

--Procurement of more medicines and supplies 225 Professional Services 0.000 0.000 0.000 0.000 0.040 0.000 0.040

--Procurement of transport equipment’s (Ambulance, Service car, staff Van, Director’s car) 227 Travel and Transport 0.530 0.000 0.000 0.530 0.467 0.000 0.467 228 Maintenance 0.459 0.000 0.000 0.459 0.434 0.000 0.434 --Procurement of medical equipment, furniture and other items (eg Paed beds) Grand Total : 8.898 0.000 0.000 8.898 10.223 0.000 10.223 --Short term consultancy services. Total excluding Arrears 8.898 0.000 0.000 8.898 10.223 0.000 10.223

236 237 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospital Services 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223

01 Kawempe Referral Hospital Services 0.000 8.857 4.145 10.182 10.223 10.223 10.223 10.223

02 Kawempe Referral Hospital Internal Audit 0.000 0.041 0.005 0.041 0.000 0.000 0.000 0.000

Total for the Vote 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223

Total Excluding Arrears 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospital Services Programme Objective To provide specialized maternal and Paediatic services within the catchment population in Central : Region

Responsible Officer: Hospital Director Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

238 239 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital Vote:178 Kawempe Referral Hospital

VII. Budget By Programme And Subprogramme • Bed occupancy rate 90% 2019 90% 90% 90%

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme • % increase of diagnostic investigations carried out 200,000 2019 50% 10% 5% • % increase of specialized clinic outpatient attendances 100,000 2019 50% 5% 5% Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 SubProgramme: 01 Kawempe Referral Hospital Services Outturn Budget End Dec Proposed Budget Output: 01 Inpatient services 56 Regional Referral Hospital Services 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 Average Length of Stay (ALOS) - days 4 4 4

01 Kawempe Referral Hospital Services 0.000 8.857 4.145 10.182 10.223 10.223 10.223 10.223 Bed Occupancy Rate (BOR) 90% 90% 90% 02 Kawempe Referral Hospital Internal Audit 0.000 0.041 0.005 0.041 0.000 0.000 0.000 0.000 No. of in-patients (Admissions) 70,000 75,000 80,000 Total for the Vote 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 Output: 02 Outpatient services Total Excluding Arrears 0.000 8.898 4.150 10.223 10.223 10.223 10.223 10.223 No. of specialized clinic attendances 15,000 20,000 25,000

VIII. Programme Performance and Medium Term Plans Referral cases in 8,000 10,000 12,000 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Total general outpatients attendance 100,000 102,000 105,000

Programme : 56 Regional Referral Hospital Services Output: 03 Medicines and health supplies procured and dispensed Programme Objective To provide specialized maternal and Paediatic services within the catchment population in Central Value of medicines received/dispensed (Ush bn) 4bn 4.5bn 5bn : Region Output: 04 Diagnostic services

Responsible Officer: Hospital Director No. of patient xrays (imaging) taken 2,000 2,500 3,000 Programme Outcome: Quality and accessible Regional Referral Hospital Services Number of Ultra Sound Scans 60,000 7,000 8,000 Sector Outcomes contributed to by the Programme Outcome Output: 05 Hospital Management and Support Services 1. Improved quality of life at all levels Quarterly financial reports submitted timely yes yes yes

Performance Targets Timely payment of salaries and pensions by the 2 yes yes yes Outcome Indicators 2020/21 2021/22 2022/23 Output: 06 Prevention and rehabilitation services Baseline Base year Target Projection Projection No. of antenatal cases (All attendances) 35,000 40,000 45,000

No. of family planning users attended to (New and Old) 17,000 20,000 25,000

Percentage of HIV positive pregnant women not on HAART initiated ARVs 10% 5% 0%

Output: 07 Immunisation services No. of children immunised (All immunizations) 85,000 90,000 95,000

SubProgramme: 02 Kawempe Referral Hospital Internal Audit Output: 05 Hospital Management and Support Services Quarterly financial reports submitted timely yes yes yes

Timely payment of salaries and pensions by the 2 yes yes yes

IX. Major Capital Investments And Changes In Resource Allocation

238 239 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

• Insufficient budget for wage. • Overwhelming number of patients resulting into high utility costs thereby creating Arrears in lectricity. • Inadequate man power with staffing level of 340 staff as opposed to Approved structure of 930 staff. •Inadequate budget for Medicines and other health supplies (Required budget is 4 billion and allocated is 1.5 billion). •High Maintenance costs due to high number of patients.

Plans to improve Vote Performance

• The hospital plans to present the request to MOFPED, public service, MOH and parliament to increase wage allocation. • Advocate the line ministry to functionalize lower health facilities to handle PHC and thereby reduce patient load at the facility • Advocate more budget towards medicines and sundries

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0856 Regional Referral Hospital Services 0.00 1.68 Recurrent Budget Estimates 01 Kawempe Referral Hospital Services 0.00 1.68 RBF 0.00 1.68

Total for Vote 0.00 1.68

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To prevent mother to child HIV/AIDS transmission. Issue of Concern : Low access to HIV care services among expectant mothers Planned Interventions : Avail adequate space and privacy for PMTCT care services Budget Allocation (Billion) : 0.050 Performance Indicators: Number of mothers tested for HIV/AIDS and enrolled to PMTCT services Issue Type: Gender

Objective : To promote male involvement in maternal, adolescent and child health care

240 241 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:178 Kawempe Referral Hospital Vote:178 Kawempe Referral Hospital

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Issue of Concern : low male involvement in maternal, adolescent and child health care services

N/A Planned Interventions : Awareness creation Counselling X. Vote Challenges and Plans To Improve Performance Budget Allocation (Billion) : 0.010 Performance Indicators: Increased number of males involved in maternal, adolescent and child health care services Vote Challenges Issue Type: Enviroment

• Insufficient budget for wage. Objective : To improve on healing environment, cleanliness and waste management • Overwhelming number of patients resulting into high utility costs thereby creating Arrears in lectricity. • Inadequate man power with staffing level of 340 staff as opposed to Approved structure of 930 staff. Issue of Concern : Healing environment •Inadequate budget for Medicines and other health supplies (Required budget is 4 billion and allocated is 1.5 billion). Planned Interventions : •High Maintenance costs due to high number of patients. Planting and maintaining green vegetation Out source cleaning and waste management services Plans to improve Vote Performance Budget Allocation (Billion) : 0.012 Performance Indicators: Flowers and small growing tress planted within the hospital compound. • The hospital plans to present the request to MOFPED, public service, MOH and parliament to increase wage allocation. • Advocate the line ministry to functionalize lower health facilities to handle PHC and thereby reduce patient load at the facility XIII. Personnel Information • Advocate more budget towards medicines and sundries Table 13.1 Staff Establishment Analysis XI Off Budget Support Title Salary Scale Number Of Approved Positions Number Of Filled Positions Table 11.1 Off-Budget Support by Sub-Programme Consultant (Obs. & Gyn) U1SE 1 0

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Consultant Radiology U1SE 2 0 Budget Estimates Senior Consultant MEDICAL U1SE 1 0 Programme 0856 Regional Referral Hospital Services 0.00 1.68 Senior Consultant Obsetrics & U1SE 1 0 Recurrent Budget Estimates Gynaechology 01 Kawempe Referral Hospital Services 0.00 1.68 Senior Consultant Peadiatric U1SE 1 0 RBF 0.00 1.68 NURSING OFFICER (MID U5(SC) 118 32 Total for Vote 0.00 1.68 WIFERY) NURSING OFFICER (NURSING) U5(SC) 131 24 XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues Table 13.2 Staff Recruitment Plan

Issue Type: HIV/AIDS Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Objective : To prevent mother to child HIV/AIDS transmission. Posts Filling (UGX) (UGX) FY2020/21 Issue of Concern : Low access to HIV care services among expectant mothers Consultant (Obs. & Gyn) U1SE 1 0 1 1 4,200,000 50,400,000 Planned Interventions : Avail adequate space and privacy for PMTCT care services Consultant Radiology U1SE 2 0 2 2 8,400,000 100,800,000 Kawempe Referral Hospital Ministerial Policy Statement FY 2020/21 Budget Allocation (Billion) : 0.050 NURSING OFFICER (MID U5(SC) 118 32 86 86 103,200,000 1,238,400,000 WIFERY) Performance Indicators: Number of mothers tested for HIV/AIDS and enrolled to PMTCT services NURSING OFFICER (NURSING) U5(SC) 131 24 107 107 128,400,000 1,540,800,000 Kawempe Referral Hospital Issue Type: Gender SeniorVote: Consultant 178 MEDICAL U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant Obsetrics & U1SE 1 0 1 1 4,500,000 54,000,000 Objective : To promote male involvement in maternal, adolescent and child health care Gynaechology Senior Consultant Peadiatric U1SE 1 0 1 1 4,500,000 54,000,000 Total 255 56 199 199 257,700,000 3,092,400,000

240 241 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital

V1: Vote Overview I. Vote Mission Statement

To provide the highest possible level of specialized health services to all people of Central Southern Region including Entebbe International Airport, VIP Areas and Lake Victoria Islands

II. Strategic Objective 1. To provide comprehensive specialized curative, promotive , preventive and rehabilitative health care services 2. To provide continuous Professional Development, operational and technical research 3. To provide monitoring and evaluation and support supervision in lower Health Facilities III. Major Achievements in 2019/20 5260 Specialized admissions out of 3600 planned specialist admissions, 105% bed occupancy rate and 4 days average length of stay out of 7 planned average length of stay days 32,044 Specialized consultations made out of 22,000 specialized consultations with 66,987 general consultations out of 40,000 planned consultations in the half year. 75% of the specialized health supplies procured and dispensed in the pharmacy. 1,533 Ultra sound scans made out of 1500 ultra scans planned, 776 x-rays conducted out of 500 x-rays planned in the half year. 12 top managements held out of 12 planned in the half year. 24,430 children immunized out of the 26,000 immunized children planned for in the half year. 41,877 Antenatal attendances conducted out of 30,000 planned for the mid half year. 2,437 new family planning users enrolled in the mid half year out of 1500 planned new users of family planning HMIS data updated and reports made in time and quarterly reports are compiled and submitted in time.

IV. Medium Term Plans 1. Improving data management and utilization through conducting data reviews, mentorships and coaching. 2. Digitizing all hospital operations through the use of intergrated intelligence computer systems as well as other electronic data management systems. 3. Continue offering specialized, promotive, preventive and rehabilitative health care services. 4. Continue monitoring and evaluation and support supervision in lower Health Facilities. 5. Providing more specialized training to bridge the skills gap 6. Recruitment of more staff in line with the approved staffing structure. 7. Continous Professional Development through trainings, benchmarkimg, mentorships and coaching . 8. We have plans to lobby for Pension and Gratuity funds.

242 243 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital Vote:179 Entebbe Regional Referral Hospital

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion)

To provide the highest possible level of specialized health services to all people of Central Southern Region including Entebbe 2019/20 MTEF Budget Projections International Airport, VIP Areas and Lake Victoria Islands 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec II. Strategic Objective Wage 0.000 2.309 0.959 2.309 2.309 2.309 2.309 2.309 Recurrent 1. To provide comprehensive specialized curative, promotive , preventive and rehabilitative health care services 2. To provide Non Wage 0.000 1.000 0.615 1.451 1.451 1.451 1.451 1.451 continuous Professional Development, operational and technical research 3. To provide monitoring and evaluation and support GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 supervision in lower Health Facilities Devt. III. Major Achievements in 2019/20 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 5260 Specialized admissions out of 3600 planned specialist admissions, 105% bed occupancy rate and 4 days average length of GoU Total stay out of 7 planned average length of stay days Total GoU+Ext Fin (MTEF) 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 32,044 Specialized consultations made out of 22,000 specialized consultations with 66,987 general consultations out of 40,000 planned consultations in the half year. Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 75% of the specialized health supplies procured and dispensed in the pharmacy. 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 1,533 Ultra sound scans made out of 1500 ultra scans planned, 776 x-rays conducted out of 500 x-rays planned in the half year. Total Budget 12 top managements held out of 12 planned in the half year. A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A 24,430 children immunized out of the 26,000 immunized children planned for in the half year. 41,877 Antenatal attendances conducted out of 30,000 planned for the mid half year. Grand Total 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 2,437 new family planning users enrolled in the mid half year out of 1500 planned new users of family planning Total Vote Budget 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 HMIS data updated and reports made in time and quarterly reports are compiled and submitted in time. Excluding Arrears

IV. Medium Term Plans VI. Budget By Economic Clasification 1. Improving data management and utilization through conducting data reviews, mentorships and coaching. Table V6.1 2019/20 and 2020/21 Budget Allocations by Item 2. Digitizing all hospital operations through the use of intergrated intelligence computer systems as well as other electronic data management systems. 2019/20 Approved Budget 2020/21 Draft Estimates 3. Continue offering specialized, promotive, preventive and rehabilitative health care services. 4. Continue monitoring and evaluation and support supervision in lower Health Facilities. Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total 5. Providing more specialized training to bridge the skills gap Output Class : Outputs Provided 3.309 0.000 0.000 3.309 3.760 0.000 3.760 6. Recruitment of more staff in line with the approved staffing structure. 211 Wages and Salaries 2.439 0.000 0.000 2.439 2.515 0.000 2.515 7. Continous Professional Development through trainings, benchmarkimg, mentorships and coaching . 8. We have plans to lobby for Pension and Gratuity funds. 213 Other Employee Costs 0.007 0.000 0.000 0.007 0.013 0.000 0.013

221 General Expenses 0.169 0.000 0.000 0.169 0.250 0.000 0.250

222 Communications 0.016 0.000 0.000 0.016 0.021 0.000 0.021

223 Utility and Property Expenses 0.303 0.000 0.000 0.303 0.450 0.000 0.450

224 Supplies and Services 0.237 0.000 0.000 0.237 0.302 0.000 0.302

225 Professional Services 0.000 0.000 0.000 0.000 0.005 0.000 0.005

227 Travel and Transport 0.094 0.000 0.000 0.094 0.142 0.000 0.142

228 Maintenance 0.046 0.000 0.000 0.046 0.062 0.000 0.062

Grand Total : 3.309 0.000 0.000 3.309 3.760 0.000 3.760

Total excluding Arrears 3.309 0.000 0.000 3.309 3.760 0.000 3.760

242 243 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 56 Regional Referral Hospitals 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 Services 01 Entebbe Referral Hospital Services 0.000 3.304 1.571 3.747 3.747 3.747 3.747 3.747

02 Entebbe Referral Hospital Internal Audit 0.000 0.005 0.004 0.013 0.013 0.013 0.013 0.013

Total for the Vote 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760

Total Excluding Arrears 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 56 Regional Referral Hospitals Services Programme Objective : 1. To provide comprehensive specialized curative, promotive , preventive and rehabilitative health care services 2. To strengthen the referral system and partnerships for efficient health care services 3. To build capacity of service providers in lower level facilities for better quality health care in the region

4. To improve managerial efficiency in resource allocation, utilization and accountability 5. To undertake disease surveillance and outbreak in the surrounding region

Responsible Officer: Dr. Muwanga Moses Programme Outcome: Quality and accessible Regional Referral Hospital Services Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

244 245 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital Vote:179 Entebbe Regional Referral Hospital

VII. Budget By Programme And Subprogramme • % increase of specialized clinic outpatient attendances 25% 2019 25% 30% 30%

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme • % increase of diagnostic investigations carried out 30% 2019 35% 40% 40% • Bed occupancy rate 85% 2019 85% 85% 85% Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 SubProgramme: 01 Entebbe Referral Hospital Services Outturn Budget End Dec Proposed Budget Output: 01 Inpatient Services 56 Regional Referral Hospitals 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 Average Length of Stay (ALOS) - days 4 4 4 Services 01 Entebbe Referral Hospital Services 0.000 3.304 1.571 3.747 3.747 3.747 3.747 3.747 Bed Occupancy Rate (BOR) 85% 85% 85%

02 Entebbe Referral Hospital Internal Audit 0.000 0.005 0.004 0.013 0.013 0.013 0.013 0.013 No. of in-patients (Admissions) 7,000 6,800 6,600

Total for the Vote 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 Output: 02 Outpatient services Total Excluding Arrears 0.000 3.309 1.575 3.760 3.760 3.760 3.760 3.760 No. of specialized clinic attendances 48,000 50,000 52,000

Total general outpatients attendance 85,000 90,000 95,000 VIII. Programme Performance and Medium Term Plans Output: 03 Medicines and health supplies procured and diispensed Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Value of medicines received/dispensed (Ush bn) 1.2 1.2 1.4 Programme : 56 Regional Referral Hospitals Services Output: 04 Diagnostic services Programme Objective 2,400 2,600 2,800 : 1. To provide comprehensive specialized curative, promotive , preventive and rehabilitative health care No. of patient xrays (imaging) taken services Number of Ultra Sound Scans 3,200 3,400 3,600 2. To strengthen the referral system and partnerships for efficient health care services 3. To build capacity of service providers in lower level facilities for better quality health care in the region Output: 05 Hospital Management and support services 4. To improve managerial efficiency in resource allocation, utilization and accountability Quarterly financial reports submitted timely 4 4 4 5. To undertake disease surveillance and outbreak in the surrounding region imely payment of salaries and pensions by the 2 yes yes yes

Responsible Officer: Dr. Muwanga Moses Output: 06 Prevention and rehabilitation services Programme Outcome: Quality and accessible Regional Referral Hospital Services No. of antenatal cases (All attendances) 75,000 80,000 85,000

Sector Outcomes contributed to by the Programme Outcome No. of family planning users attended to (New and Old) 3,500 4,000 4,500 1. Improved quality of life at all levels Percentage of HIV positive pregnant women not on HAART initiated ARVs 0% 0% 0% Performance Targets Output: 07 Immunisation services Outcome Indicators 2020/21 2021/22 2022/23 No. of children immunised (All immunizations) 45,000 48,000 50,000 Baseline Base year Target Projection Projection SubProgramme: 02 Entebbe Referral Hospital Internal Audit Output: 05 Hospital Management and support services Quarterly financial reports submitted timely 4 4 4

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

244 245 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. The Hospital still has outstanding Domestic arrears on water and electricity. 2. The hospital has inadequate funding to cater for critical services for e.g advertising, small office supplies, IFMS and IPPS expenditures, consultancy, medical expenses to employees etc. 3. Inadequate budget for medicines required to operationalise a regional hospital,There is need for additional allocation of shs 1.2bn 4. The Hospital has no pension and Gratuity funds allocated 5. The Hospital doesnt not have any Capital Development Projects 6. Hospital has inadquete office space, computers and furniture for officers

Plans to improve Vote Performance

1. Hospital management priotized to make full payment of the Utilities consumed each quarter but is also committed to making partial payment for existing domestic arrears on water and electricity. 2.We plan to lobby for more funds to acquire Pension and Gratuity for retiring staff 3.We plan to lobby for capital Development funds to cater for expansion and rehabilitation of the hospital 4.We have created a retooling project to address computers,furniture and other fixture needs XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

N/A

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To give HAART to all Eligible clients (90, 90, 90 policy) Issue of Concern : Increased HIV incidence in the community especially among the most at risk populations ( commercial sex workers (Landing sites), Working class, adolescents, children, youth and women Planned Interventions : HIV health education behavior change& protection; HIV/TB counseling/testing/co-infection screening; Treat STDs& STIs; Conducting Safe male circumcision; Provide PEP to exposed persons; Moon light clinics, out reaches for MARPS and Condoms distribution Budget Allocation (Billion) : 0.050 Performance Indicators: Number of Individuals on HAART, Number of clients tested for HIV, Number linked to care, Number of clients counseled, No of individuals whose viral load is suppressed, Compliance levels, Number of clients followed up. Issue Type: Gender

Objective : To provide inclusive and equal access to health services for all deserving people irrespective of gender, age, sex and sexual orientation, social and economic status and with due to consideration Disabilities and geographical locations. Issue of Concern : Increased HIV incidence in the community especially among the most at risk populations (commercial Sex workers(landing sites), Working class, adolescents, children, youth and women)

246 247 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital Vote:179 Entebbe Regional Referral Hospital

X. Vote Challenges and Plans To Improve Performance Planned Interventions : HIV health education behavior change& protection; HIV/ TB counseling/testing/co-infection screening; Treat STDs & STIs; Conducting Safe male circumcision; Provide PeP to exposed Vote Challenges persons; Moon light clinics, outreaches for MARPs and Condom distribution. Budget Allocation (Billion) : 0.040 1. The Hospital still has outstanding Domestic arrears on water and electricity. Performance Indicators: Health education sessions held/ clients counseled; tested/male; males circumcised; clients initiated 2. The hospital has inadequate funding to cater for critical services for e.g advertising, small office supplies, IFMS and IPPS on ART; exposed clients provided PEP, Condoms issued, HIV talks held Moonlight contacts expenditures, consultancy, medical expenses to employees etc. &outreaches done and Number of couples tested. 3. Inadequate budget for medicines required to operationalise a regional hospital,There is need for additional allocation of shs Issue Type: Enviroment 1.2bn 4. The Hospital has no pension and Gratuity funds allocated Objective : To ensure proper hospital waste disposal and management. 5. The Hospital doesnt not have any Capital Development Projects 6. Hospital has inadquete office space, computers and furniture for officers Issue of Concern : Un-hospitable and unsafe hospital environment resulting into nosocomial infections,accidents and work place insecurity. Planned Interventions : Providing SOPs, Safe water, supervising cleaning services(Q1&5S practiced), Signage, compound beautification, tree cover; proper waste segregation& Disposal. Plans to improve Vote Performance Budget Allocation (Billion) : 0.050 1. Hospital management priotized to make full payment of the Utilities consumed each quarter but is also committed to making Performance Indicators: Clean & safe working environment; Availability of water, proper waste management strategies partial payment for existing domestic arrears on water and electricity. enforced, 5S activities implemented. 2.We plan to lobby for more funds to acquire Pension and Gratuity for retiring staff 3.We plan to lobby for capital Development funds to cater for expansion and rehabilitation of the hospital XIII. Personnel Information 4.We have created a retooling project to address computers,furniture and other fixture needs Table 13.1 Staff Establishment Analysis XI Off Budget Support Title Salary Scale Number Of Approved Positions Number Of Filled Positions Table 11.1 Off-Budget Support by Sub-Programme SENIOR ACCOUNTANT U3U 1 0 N/A SECURITY OFFICER U4L 1 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues ACCOUNTANT U4U 1 0 Table 12.1: Cross- Cutting Policy Issues INTERNAL AUDITOR U4U 1 0

Issue Type: HIV/AIDS HOUSE KEEPER U5L 1 0 STENOGRAPHER SECRETARY U5L 1 0 Objective : To give HAART to all Eligible clients (90, 90, 90 policy) DOMESTIC ASSISTANT U6L 1 0 Issue of Concern : Increased HIV incidence in the community especially among the most at risk populations ( commercial sex workers (Landing sites), Working class, adolescents, children, youth and women OFFICE TYPIST U6L 1 0 Planned Interventions : HIV health education behavior change& protection; HIV/TB counseling/testing/co-infection POOL STENOGRAPHER U6L 1 0 screening; Treat STDs& STIs; Conducting Safe male circumcision; Provide PEP to exposed persons; Moon light clinics, out reaches for MARPS and Condoms distribution ASSISTANT ACCOUNTANT U6U 4 2 Budget Allocation (Billion) : 0.050 DARK ROOM ATTENDANT U8(Med) 1 0 Performance Indicators: Number of Individuals on HAART, Number of clients tested for HIV, Number linked to care, MORTUARY ATTENDANT U8(Med) 3 0 Number of clients counseled, No of individuals whose viral load is suppressed, Compliance levels, ARTISAN MATE U8L 2 0 Number of clients followed up. Issue Type: Gender ASKARI U8L 15 2 DHOBI U8L 5 0 Objective : To provide inclusive and equal access to health services for all deserving people irrespective of gender, age, sex and sexual orientation, social and economic status and with due to consideration KITCHEN ATTENDANT U8L 5 3 Disabilities and geographical locations. OFFICE ATTENDANT U8L 3 2 Issue of Concern : Increased HIV incidence in the community especially among the most at risk populations (commercial Sex workers(landing sites), Working class, adolescents, children, youth and women) PLUMBER U8U 2 0

246 247 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 ARTISAN MATE U8L 2 0 2 2 427,664 5,131,968 ASKARI U8L 15 2 13 10 2,138,320 25,659,840 ASSISTANT ACCOUNTANT U6U 4 2 2 2 873,354 10,480,248 DARK ROOM ATTENDANT U8(Med) 1 0 1 1 313,832 3,765,984 DHOBI U8L 5 0 5 5 1,069,160 12,829,920 DOMESTIC ASSISTANT U6L 1 0 1 1 386,972 4,643,664 HOUSE KEEPER U5L 1 0 1 1 479,759 5,757,108 INTERNAL AUDITOR U4U 1 0 1 1 940,366 11,284,392 KITCHEN ATTENDANT U8L 5 3 2 2 427,664 5,131,968 MORTUARY ATTENDANT U8(Med) 3 0 3 3 941,496 11,297,952 OFFICE ATTENDANT U8L 3 2 1 1 213,832 2,565,984 OFFICE TYPIST U6L 1 0 1 1 424,253 5,091,036 PLUMBER U8U 2 0 2 2 474,138 5,689,656 POOL STENOGRAPHER U6L 1 0 1 1 424,253 5,091,036 SECURITY OFFICER U4L 1 0 1 1 601,341 7,216,092 SENIOR ACCOUNTANT U3U 1 0 1 1 1,131,209 13,574,508 STENOGRAPHER SECRETARY U5L 1 0 1 1 479,759 5,757,108 Total 48 9 39 36 11,747,372 140,968,464

248 249 Entebbe Regional Referral Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:179 Entebbe Regional Referral Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

Table 13.2 Staff Recruitment Plan V1: Vote Overview

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual I. Vote Mission Statement Scale Approved Filled Posts Posts Cleared for Per Month Salary We commit to provide and promote access to quality Specialised Reproductive and Neonatal health care with cutting edge Posts Filling (UGX) (UGX) Research and Training FY2020/21 ARTISAN MATE U8L 2 0 2 2 427,664 5,131,968 ASKARI U8L 15 2 13 10 2,138,320 25,659,840 II. Strategic Objective ASSISTANT ACCOUNTANT U6U 4 2 2 2 873,354 10,480,248 1. To increase the range and quality of super-specialized maternal and neonatal healthcare services thereby reducing referrals DARK ROOM ATTENDANT U8(Med) 1 0 1 1 313,832 3,765,984 abroad. 2. To conduct super-specialized training to health workers. 3. To conduct and promote evidence-based research to guide DHOBI U8L 5 0 5 5 1,069,160 12,829,920 practice in all areas of reproductive and neonatal health. DOMESTIC ASSISTANT U6L 1 0 1 1 386,972 4,643,664 III. Major Achievements in 2019/20 HOUSE KEEPER U5L 1 0 1 1 479,759 5,757,108 INTERNAL AUDITOR U4U 1 0 1 1 940,366 11,284,392 The following outputs were achieved midyear by Mulago Specialised Women and Neonatal Hospital (July - December 2019); - KITCHEN ATTENDANT U8L 5 3 2 2 427,664 5,131,968 i.Inpatient Services: 1850 Admissions, 734 deliveries, 827 surgeries, 302 referral ins, 5.1 Days average Length of Stay, 51% MORTUARY ATTENDANT U8(Med) 3 0 3 3 941,496 11,297,952 Bed Occupancy Rate, 64 patients attended to medical camps. OFFICE ATTENDANT U8L 3 2 1 1 213,832 2,565,984 ii.Outpatient Services: 3875 Specialised Outpatient Attendances, 322 family planning and 2449 immunizations OFFICE TYPIST U6L 1 0 1 1 424,253 5,091,036 PLUMBER U8U 2 0 2 2 474,138 5,689,656 iii.Diagnostic Services: 2,540 Laboratory Tests done; 2452 images done. POOL STENOGRAPHER U6L 1 0 1 1 424,253 5,091,036 SECURITY OFFICER U4L 1 0 1 1 601,341 7,216,092 iv. Hospital Management and support services: •Top management, medicines and therapeutics, rewards and sanctions, training, finance, contracts committees SENIOR ACCOUNTANT U3U 1 0 1 1 1,131,209 13,574,508 established and inducted STENOGRAPHER SECRETARY U5L 1 0 1 1 479,759 5,757,108 •Hospital environment kept clean at all times thereby reducing hospital acquired infections. Total 48 9 39 36 11,747,372 140,968,464 •Security pf hospital equipment, property, patients and staff ensured • Procurement of specialized drugs and sundries

IV. Medium Term Plans In the midterm, and in line with the National Development Plan III objective 1 (Pgs. 190 & 193) which seeks to contribute to the production of a healthy human capital through provision of equitable, safe and sustainable health services the hospital plans are to; i. Continue providing specialized reproductive and neonatal services: ii. Maintain of medical and office equipment: iii .Procure power stabilizers for laundry, sterilization equipment and oxygen plant iv. Procure transport equipment (Station wagon, Hospital Ambulance, Service vans) v. Install Oxygen backup system (Using the existing manifold and installing the oxygen buffer tank) vi.Recruitment of more staff trained in specialized reproductive and neonatal health care management vii.Training of staff to build capacity in customer care, reproductive and neonatal services.

248 249 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital

V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion)

2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 Outturn Budget by End Dec Wage 0.000 7.396 3.394 7.396 7.396 7.396 7.396 7.396 Recurrent Non Wage 0.000 2.000 2.142 7.186 7.186 7.186 7.186 7.186 GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 GoU Total 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Total GoU+Ext Fin (MTEF) 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Total Budget 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Grand Total 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Total Vote Budget 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Excluding Arrears

VI. Budget By Economic Clasification Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Output Class : Outputs Provided 9.396 0.000 0.000 9.396 14.581 0.000 14.581

211 Wages and Salaries 8.386 0.000 0.000 8.386 8.234 0.000 8.234

212 Social Contributions 0.000 0.000 0.000 0.000 0.186 0.000 0.186

213 Other Employee Costs 0.000 0.000 0.000 0.000 0.018 0.000 0.018

221 General Expenses 0.086 0.000 0.000 0.086 0.672 0.000 0.672

222 Communications 0.000 0.000 0.000 0.000 0.114 0.000 0.114

223 Utility and Property Expenses 0.000 0.000 0.000 0.000 1.053 0.000 1.053

224 Supplies and Services 0.865 0.000 0.000 0.865 2.700 0.000 2.700

225 Professional Services 0.014 0.000 0.000 0.014 0.020 0.000 0.020

227 Travel and Transport 0.044 0.000 0.000 0.044 0.320 0.000 0.320

228 Maintenance 0.000 0.000 0.000 0.000 1.265 0.000 1.265

Grand Total : 9.396 0.000 0.000 9.396 14.581 0.000 14.581

Total excluding Arrears 9.396 0.000 0.000 9.396 14.581 0.000 14.581

250 251 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

VII. Budget By Programme And Subprogramme V. Summary of Past Performance and Medium Term Budget Allocations Table 5.1: Overview of Vote Expenditures (UShs Billion) Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme FY 2019/20 Medium Term Projections 2019/20 MTEF Budget Projections Billion Uganda shillings 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget by End Dec Outturn Budget End Dec Proposed Budget Wage 0.000 7.396 3.394 7.396 7.396 7.396 7.396 7.396 Recurrent 60 Mulago Specialized Women and 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Non Wage 0.000 2.000 2.142 7.186 7.186 7.186 7.186 7.186 Neonatal Hospital Services 01 Management 0.000 7.565 3.861 10.751 10.751 10.751 10.751 10.751 GoU 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Devt. 02 Medical Services 0.000 1.831 1.675 3.830 3.830 3.830 3.830 3.830 Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Total for the Vote 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 GoU Total 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Total Excluding Arrears 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Total GoU+Ext Fin (MTEF) 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 VIII. Programme Performance and Medium Term Plans Total Budget 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A Programme : 60 Mulago Specialized Women and Neonatal Hospital Services Grand Total 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 Programme Objective i. To strengthen the Management, Leadership and Governance Capacity of MSWNH. Total Vote Budget 0.000 9.396 5.536 14.581 14.581 14.581 14.581 14.581 : Excluding Arrears ii. To advance relevant research and be centre of excellence and training for University and other Tertiary Institutions VI. Budget By Economic Clasification iii. To foster Stakeholders Partnership and collaboration Table V6.1 2019/20 and 2020/21 Budget Allocations by Item

2019/20 Approved Budget 2020/21 Draft Estimates Responsible Officer: Dr.Evelyn Nabunya Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total Programme Outcome: Quality and accessible Regional Referral Hospital Services Output Class : Outputs Provided 9.396 0.000 0.000 9.396 14.581 0.000 14.581 Sector Outcomes contributed to by the Programme Outcome 211 Wages and Salaries 8.386 0.000 0.000 8.386 8.234 0.000 8.234 1. Improved quality of life at all levels 212 Social Contributions 0.000 0.000 0.000 0.000 0.186 0.000 0.186 Performance Targets 213 Other Employee Costs 0.000 0.000 0.000 0.000 0.018 0.000 0.018 Outcome Indicators 2020/21 2021/22 2022/23 221 General Expenses 0.086 0.000 0.000 0.086 0.672 0.000 0.672 Baseline Base year Target Projection Projection 222 Communications 0.000 0.000 0.000 0.000 0.114 0.000 0.114

223 Utility and Property Expenses 0.000 0.000 0.000 0.000 1.053 0.000 1.053

224 Supplies and Services 0.865 0.000 0.000 0.865 2.700 0.000 2.700

225 Professional Services 0.014 0.000 0.000 0.014 0.020 0.000 0.020

227 Travel and Transport 0.044 0.000 0.000 0.044 0.320 0.000 0.320

228 Maintenance 0.000 0.000 0.000 0.000 1.265 0.000 1.265

Grand Total : 9.396 0.000 0.000 9.396 14.581 0.000 14.581

Total excluding Arrears 9.396 0.000 0.000 9.396 14.581 0.000 14.581

250 251 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

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• Bed occupancy rate 50% 2019 70% 72% 78%

• % increase of diagnostic investigations carried out 50% 2019 15% 10% 5%

• 50% 2019 38% 10% 5% % increase of specialized clinic outpatient attendances SubProgramme: 01 Management Output: 09 Audit Services Number of quarterly comprehensive internal audit reports 4 4 4

Output: 19 Human Resources `Management Services Number of quartely performance management reports 4 4 4

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges i. Inadequate budget for specialized medicines ii. Staffing gaps in the specialized areas like Intensive Care Unit, anaesthesia, diagnostics among other areas iii. Limited medical equipment especially diagnostic equipment to match hospital mandate of offering specialized services iv. Inadequate non-wage recurrent budget to cater for operational activities v. Inadequate medical and office furniture vi. Lack of budget for pension and gratuity vii. Lack of transport equipment

Plans to improve Vote Performance i. Advocate for more budget for specialized medical equipment and supplies required to meet the hospital mandate: ii. Advocate for more budget to cater for retired staff and other operational activities. iii. Submit a request to recruit for more health workers to fill the gaps in Intensive Care Unit, anaesthesia, diagnostics among other areas. iv. Procure transport equipment like ambulances and service vans v. Procure medical and office furniture

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

N/A

XII. Vote Cross Cutting Policy And Other Budgetary Issues

252 253 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

• Bed occupancy rate 50% 2019 70% 72% 78% Table 12.1: Cross- Cutting Policy Issues

• % increase of diagnostic investigations carried out 50% 2019 15% 10% 5% Issue Type: HIV/AIDS • 50% 2019 38% 10% 5% % increase of specialized clinic outpatient attendances Objective : To prevent mother to child HIV/AIDS transmission SubProgramme: 01 Management Issue of Concern : Low access to HIV care services among expectant mothers Output: 09 Audit Services Planned Interventions : i. Avail adequate space and privacy for PMTCT care services Number of quarterly comprehensive internal audit reports 4 4 4 ii. Health education and provision of PMTCT services to pregnant women. Output: 19 Human Resources `Management Services iii. Offer post-exposure prophylaxis to staff Number of quartely performance management reports 4 4 4 Budget Allocation (Billion) : 0.250 IX. Major Capital Investments And Changes In Resource Allocation Performance Indicators: i. Number of mothers tested for HIV/AIDS and enrolled to PMTCT services

Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) ii. Number of staff that receive post-exposure prophylaxis N/A

Issue Type: Gender X. Vote Challenges and Plans To Improve Performance Objective : To increase male involvement during pregnancy and childbirth Vote Challenges Issue of Concern : Low male involvement in reproductive health care services i. Inadequate budget for specialized medicines ii. Staffing gaps in the specialized areas like Intensive Care Unit, anaesthesia, diagnostics among other areas Planned Interventions : Awareness creation iii. Limited medical equipment especially diagnostic equipment to match hospital mandate of offering specialized services Provision of ambiance to males in the hospital iv. Inadequate non-wage recurrent budget to cater for operational activities v. Inadequate medical and office furniture Budget Allocation (Billion) : 0.020 vi. Lack of budget for pension and gratuity vii. Lack of transport equipment Performance Indicators: Increased number of males involved in reproductive health care services

Objective : To provide equal access to specialised health care services despite gender, disability, age and social economic status Issue of Concern : Incidents of maternal and neonatal mortality, Undocumented domestic violence cases, limited Plans to improve Vote Performance access of services at the hospital Planned Interventions : i.Train medical workers in sign language i. Advocate for more budget for specialized medical equipment and supplies required to meet the hospital mandate: ii.Establish a waiver committee to attend to patients unable to pay for services ii. Advocate for more budget to cater for retired staff and other operational activities. iii.Avail a rump and lifts to ease movement of disabled patients in the hospital iii. Submit a request to recruit for more health workers to fill the gaps in Intensive Care Unit, anaesthesia, diagnostics among other areas. Budget Allocation (Billion) : 0.080 iv. Procure transport equipment like ambulances and service vans v. Procure medical and office furniture Performance Indicators: i. -Number of disabled patients attended to: ii. Reduced down time of lifts: iii. Presence of male and female sanitary facilities: XI Off Budget Support Issue Type: Enviroment Table 11.1 Off-Budget Support by Sub-Programme

N/A Objective : To avail a sustainable clean and safe working and healing environment in the hospital Issue of Concern : Facility based infections and safe working environment XII. Vote Cross Cutting Policy And Other Budgetary Issues

252 253 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital

Planned Interventions : 1. Outsource cleaning and waste management services 2. Establish an infection and prevention control committee to enforce infection and prevention activities Budget Allocation (Billion) : 0.700 Performance Indicators: 1. Monthly monitoring tools for cleaning and waste management services 2. Number of quarterly sensitization meetings on infection control and prevention XIII. Personnel Information

Table 13.1 Staff Establishment Analysis

Title Salary Scale Number Of Approved Positions Number Of Filled Positions Assistant Commissioner Nursing & U1E 1 0 Midwifery Consulatnt (Uro- Gynaecology) U1SE 4 2 Consultant (Anaethesiologist) U1SE 5 0 Consultant (Benign Gynaecology) U1SE 4 1 Consultant (Intensive care) U1SE 4 0 Consultant (Maternal Fetal U1SE 6 2 Medicine) Consultant (Neonatologist/ U1SE 4 0 Peadiatrician) Consultant (Paediatric surgery) U1SE 4 0 Consultant (Pathology) U1SE 2 0 Consultant(heamatology) U1SE 2 0 Consultant(Microbiology) U1SE 2 0 Consultant(Reproductive Medicine) U1SE 4 2 Executive Director U1SE 1 0 sen. Consultant (Gyn oncology) U1SE 4 0 Senior Consultant U1SE 2 0 (Anaethesiologist) Senior Consultant (Benign U1SE 2 0 Gynaecology) Senior Consultant (Intensive care) U1SE 2 0 Senior Consultant (Maternal Fetal U1SE 6 1 Medicine) Senior Consultant (Neonatologist/ U1SE 2 0 Peadiatrician) Senior Consultant (Paediatric U1SE 2 0 surgery) Senior Consultant (Pathology) U1SE 1 0 Senior Consultant (Radiology) U1SE 1 0

254 255 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

Planned Interventions : 1. Outsource cleaning and waste management services Senior Consultant(Microbiology) U1SE 1 0 2. Establish an infection and prevention control committee to enforce infection and prevention activities Senior Cosultant (Reproductive U1SE 2 1 Medicine) Budget Allocation (Billion) : 0.700 Senior Cosultant (Uro U1SE 2 0 Performance Indicators: 1. Monthly monitoring tools for cleaning and waste management services Gynoncology) 2. Number of quarterly sensitization meetings on infection control and prevention Medical Officer Special Grade U2 8 2 (Paediatrician) XIII. Personnel Information MOSG (Anaesthesiologist) U2 13 1 Table 13.1 Staff Establishment Analysis MOSG (Benign Gynaecology) U2 6 2 Title Salary Scale Number Of Approved Positions Number Of Filled Positions MOSG (Gyn oncology) U2 4 2 Assistant Commissioner Nursing & U1E 1 0 MOSG (intensive care) U2 4 0 Midwifery MOSG (Maternal Fetal Medicine) U2 10 3 Consulatnt (Uro- Gynaecology) U1SE 4 2 MOSG (Paediatric surgery) U2 4 0 Consultant (Anaethesiologist) U1SE 5 0 MOSG (Paediatrician) U2 8 0 Consultant (Benign Gynaecology) U1SE 4 1 MOSG (Pathology) U2 2 0 Consultant (Intensive care) U1SE 4 0 MOSG (radiology) U2 4 0 Consultant (Maternal Fetal U1SE 6 2 Medicine) MOSG (Reproductive Medicine) U2 10 3 Consultant (Neonatologist/ U1SE 4 0 MOSG(Uro oncology) U2 4 2 Peadiatrician) Pricipal Medical social worker U2 1 0 Consultant (Paediatric surgery) U1SE 4 0 Principal Accountant U2 1 0 Consultant (Pathology) U1SE 2 0 PRINCIPAL HUMAN RESOURCE U2 1 0 Consultant(heamatology) U1SE 2 0 OFFICER Consultant(Microbiology) U1SE 2 0 Principal Internal Auditor U2 1 0 Consultant(Reproductive Medicine) U1SE 4 2 PRINCIPAL NURSING OFFICER U2 2 1 Executive Director U1SE 1 0 PRINCIPAL RADIOGRAPHER U2 1 0 sen. Consultant (Gyn oncology) U1SE 4 0 Principal Research Officer U2 1 0 Senior Consultant U1SE 2 0 Medical Officer Special Grade U2(Med-1) 4 0 (Anaethesiologist) (Radiologist) Senior Consultant (Benign U1SE 2 0 Princ. Aneasthetic Officer U3 1 0 Gynaecology) Senior Consultant (Intensive care) U1SE 2 0 PRINCIPAL laboratory technician U3 2 0 Senior Consultant (Maternal Fetal U1SE 6 1 SENIOR ACCOUNTANT U3 1 0 Medicine) Senior Bio Medical Engineer U3 1 0 Senior Consultant (Neonatologist/ U1SE 2 0 SENIOR BIOSTATICIAN U3 1 0 Peadiatrician) Senior Consultant (Paediatric U1SE 2 0 Senior Communications Officer U3 1 0 surgery) Senior Economist U3 1 0 Senior Consultant (Pathology) U1SE 1 0 Senior Engineer (civil) U3 1 0 Senior Consultant (Radiology) U1SE 1 0 Senior Internal Auditor U3 1 0

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Senior Inventory Officer U3 1 0 senior medical social worker U3 2 0 SENIOR NURSING OFFICER U3 7 2 SENIOR NUTRITIONIST U3 1 0 Senior personal secretary U3 1 0 Senior Procurement Officer U3 1 0 SENIOR RESEARCH OFFICER U3 1 0 Senior systems analyst U3 2 0 SENIOR.PHARMACIST U3 1 0 PRINCIPAL LABARATORY U3(Med-2) 3 0 TECHNOLOGIST Assistant Secertary U4 1 0 Bio Medical engineer U4 1 0 BIOSTATICIAN U4 1 0 Bussiness Development Officer U4 1 0 CATERING OFFICER U4 1 0 Communications Officer U4 1 0 Economist U4 2 0 Engineer(Electrical&Mechanical) U4 2 0 Inventory Management Officer U4 4 0 LIBRARIAN U4 1 0 MEDICAL RECORDS OFFICER U4 2 1 MEDICAL SOCIAL WORKER U4 2 1 NUTRITIONIST U4 2 0 Personal Secretary U4 5 1 PHARMACY ATTENDANT U4 6 0 Planner U4 1 0 Records Officer U4 1 0 RESEARCH OFFICER U4 1 0 Sen. Aneasthetic Officer U4 4 0 Senior Imaging Technologist U4 2 0 Senior RADIOGRAPHER U4 2 0 SENIOR SECURITY OFFICER U4 1 0 Sonographer U4 3 0 Systems Administrator U4 2 0

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Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

Senior Inventory Officer U3 1 0 Systems Analyst U4 2 0 senior medical social worker U3 2 0 SENIOR LABARATORY U4(Med-2) 4 2 TECHNOLOGIST SENIOR NURSING OFFICER U3 7 2 ANAESTHETIC OFFICER U5 10 4 SENIOR NUTRITIONIST U3 1 0 Assistant Nursing Officer U5 415 270 Senior personal secretary U3 1 0 Bio Medical Tehnician U5 3 2 Senior Procurement Officer U3 1 0 Engineering Technician (Plumbing U5 3 1 SENIOR RESEARCH OFFICER U3 1 0 & Electrical) Senior systems analyst U3 2 0 Imaging Technologist U5 2 0 SENIOR.PHARMACIST U3 1 0 Laboratory Technologist U5 2 0 (Heamatologylogy) PRINCIPAL LABARATORY U3(Med-2) 3 0 TECHNOLOGIST Laboratory Technologist U5 2 1 (Histopathology) Assistant Secertary U4 1 0 Laboratory Technologist U5 2 1 Bio Medical engineer U4 1 0 (Microbiology) BIOSTATICIAN U4 1 0 Laboratory Technologist U5 2 0 (Parasitology) Bussiness Development Officer U4 1 0 Laboratory Technologist(Clinical U5 2 0 CATERING OFFICER U4 1 0 chemistry) Communications Officer U4 1 0 Laboratory Technologist(IVF U5 2 0 Section) Economist U4 2 0 Occupational Therapist U5 2 0 Engineer(Electrical&Mechanical) U4 2 0 PHYSIOTHERAPIST U5 2 0 Inventory Management Officer U4 4 0 RADIOGRAPHER U5 7 0 LIBRARIAN U4 1 0 SECURITY OFFICCER U5 1 0 MEDICAL RECORDS OFFICER U4 2 1 SENIOR ASSISTANT U5 2 1 MEDICAL SOCIAL WORKER U4 2 1 ACCOUNTANT SENIOR HOUSEKEEPER U5 1 0 NUTRITIONIST U4 2 0 STENOGRAPHER SECRETARY U5 2 1 Personal Secretary U4 5 1 LABARATORY TECHNICIAN U5(SC) 12 0 PHARMACY ATTENDANT U4 6 0 NURSING OFFICER (MID U5(SC) 72 12 Planner U4 1 0 WIFERY) Records Officer U4 1 0 HOUSE KEEPER U6 2 1 RESEARCH OFFICER U4 1 0 Customer Care Assistant U7 5 0 Sen. Aneasthetic Officer U4 4 0 Mortuary Assistant U7 1 0 Senior Imaging Technologist U4 2 0 Sterilisation Production Assistant U7 5 0 Senior RADIOGRAPHER U4 2 0 Anaesthesia Attendant U8 12 1 SENIOR SECURITY OFFICER U4 1 0 ASSISTANT MEDICAL U8 10 0 RECORDS OFFICER Sonographer U4 3 0 DRIVER U8 9 2 Systems Administrator U4 2 0

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SEAMSTER/TRESS TAILOR U8 2 0 THEATRE ASSISTANT U8 6 2 THEATRE ATTENDANT U8 4 2 OFFICE ATTENDANT U8L 7 4 Assistant Commissioner UIE 1 0 Finance&Administration

Table 13.2 Staff Recruitment Plan

Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) FY2020/21 Anaesthesia Attendant U8 12 1 11 8 2,510,656 30,127,872 ANAESTHETIC OFFICER U5 10 4 6 6 7,200,000 86,400,000 Assistant Commissioner UIE 1 0 1 1 1,657,677 19,892,124 Finance&Administration Assistant Commissioner Nursing & U1E 1 0 1 1 4,200,000 50,400,000 Midwifery ASSISTANT MEDICAL U8 10 0 10 8 3,702,816 44,433,792 RECORDS OFFICER Assistant Nursing Officer U5 415 270 145 100 120,000,000 1,440,000,000 Bio Medical engineer U4 1 0 1 1 2,200,000 26,400,000 Bio Medical Tehnician U5 3 2 1 1 1,200,000 14,400,000 BIOSTATICIAN U4 1 0 1 1 2,200,000 26,400,000 Bussiness Development Officer U4 1 0 1 1 723,868 8,686,416 CATERING OFFICER U4 1 0 1 1 723,868 8,686,416 Communications Officer U4 1 0 1 1 723,868 8,686,416 Consulatnt (Uro- Gynaecology) U1SE 4 2 2 1 5,500,000 66,000,000 Consultant (Anaethesiologist) U1SE 5 0 5 3 13,500,000 162,000,000 Consultant (Benign Gynaecology) U1SE 4 1 3 1 4,200,000 50,400,000 Consultant (Intensive care) U1SE 4 0 4 2 8,400,000 100,800,000 Consultant (Maternal Fetal U1SE 6 2 4 3 12,600,000 151,200,000 Medicine) Consultant (Neonatologist/ U1SE 4 0 4 4 16,800,000 201,600,000 Peadiatrician) Consultant (Paediatric surgery) U1SE 4 0 4 4 16,800,000 201,600,000 Consultant (Pathology) U1SE 2 0 2 2 8,400,000 100,800,000 Consultant(heamatology) U1SE 2 0 2 2 8,400,000 100,800,000 Consultant(Microbiology) U1SE 2 0 2 2 8,400,000 100,800,000 Consultant(Reproductive U1SE 4 2 2 2 8,400,000 100,800,000 Medicine) Customer Care Assistant U7 5 0 5 5 1,718,960 20,627,520 DRIVER U8 9 2 7 4 887,948 10,655,376 Economist U4 2 0 2 2 1,752,444 21,029,328 Engineer(Electrical&Mechanical) U4 2 0 2 2 4,400,000 52,800,000

258 259 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

SEAMSTER/TRESS TAILOR U8 2 0 Engineering Technician (Plumbing U5 3 1 2 2 2,400,000 28,800,000 & Electrical) THEATRE ASSISTANT U8 6 2 Executive Director U1SE 1 0 1 1 5,500,000 66,000,000 THEATRE ATTENDANT U8 4 2 HOUSE KEEPER U6 2 1 1 1 405,239 4,862,868 OFFICE ATTENDANT U8L 7 4 Imaging Technologist U5 2 0 2 2 2,400,000 28,800,000 Inventory Management Officer U4 4 0 4 4 3,504,888 42,058,656 Assistant Commissioner UIE 1 0 LABARATORY TECHNICIAN U5(SC) 12 0 12 4 4,800,000 57,600,000 Finance&Administration Laboratory Technologist U5 2 0 2 2 2,400,000 28,800,000 Table 13.2 Staff Recruitment Plan (Heamatologylogy) Laboratory Technologist U5 2 1 1 1 1,200,000 14,400,000 Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual (Histopathology) Scale Approved Filled Posts Posts Cleared for Per Month Salary Laboratory Technologist U5 2 1 1 1 1,200,000 14,400,000 Posts Filling (UGX) (UGX) (Microbiology) FY2020/21 Laboratory Technologist U5 2 0 2 2 2,400,000 28,800,000 (Parasitology) Anaesthesia Attendant U8 12 1 11 8 2,510,656 30,127,872 Laboratory Technologist(Clinical U5 2 0 2 2 2,400,000 28,800,000 ANAESTHETIC OFFICER U5 10 4 6 6 7,200,000 86,400,000 chemistry) Assistant Commissioner UIE 1 0 1 1 1,657,677 19,892,124 Laboratory Technologist(IVF U5 2 0 2 2 2,400,000 28,800,000 Finance&Administration Section) Assistant Commissioner Nursing & U1E 1 0 1 1 4,200,000 50,400,000 LIBRARIAN U4 1 0 1 1 723,868 8,686,416 Midwifery Medical Officer Special Grade U2 8 2 6 6 22,500,000 270,000,000 ASSISTANT MEDICAL U8 10 0 10 8 3,702,816 44,433,792 (Paediatrician) RECORDS OFFICER Medical Officer Special Grade U2(Med-1) 4 0 4 4 15,000,000 180,000,000 Assistant Nursing Officer U5 415 270 145 100 120,000,000 1,440,000,000 (Radiologist) Bio Medical engineer U4 1 0 1 1 2,200,000 26,400,000 MEDICAL RECORDS OFFICER U4 2 1 1 1 723,868 8,686,416 Bio Medical Tehnician U5 3 2 1 1 1,200,000 14,400,000 MEDICAL SOCIAL WORKER U4 2 1 1 1 723,868 8,686,416 BIOSTATICIAN U4 1 0 1 1 2,200,000 26,400,000 Mortuary Assistant U7 1 0 1 1 283,792 3,405,504 Bussiness Development Officer U4 1 0 1 1 723,868 8,686,416 MOSG (Anaesthesiologist) U2 13 1 12 12 54,000,000 648,000,000 CATERING OFFICER U4 1 0 1 1 723,868 8,686,416 MOSG (Benign Gynaecology) U2 6 2 4 2 9,000,000 108,000,000 Communications Officer U4 1 0 1 1 723,868 8,686,416 MOSG (Gyn oncology) U2 4 2 2 2 9,000,000 108,000,000 Consulatnt (Uro- Gynaecology) U1SE 4 2 2 1 5,500,000 66,000,000 MOSG (intensive care) U2 4 0 4 4 18,000,000 216,000,000 Consultant (Anaethesiologist) U1SE 5 0 5 3 13,500,000 162,000,000 MOSG (Maternal Fetal Medicine) U2 10 3 7 4 18,000,000 216,000,000 Consultant (Benign Gynaecology) U1SE 4 1 3 1 4,200,000 50,400,000 MOSG (Paediatric surgery) U2 4 0 4 4 18,000,000 216,000,000 Consultant (Intensive care) U1SE 4 0 4 2 8,400,000 100,800,000 MOSG (Paediatrician) U2 8 0 8 4 18,000,000 216,000,000 Consultant (Maternal Fetal U1SE 6 2 4 3 12,600,000 151,200,000 MOSG (Pathology) U2 2 0 2 2 9,000,000 108,000,000 Medicine) MOSG (radiology) U2 4 0 4 4 18,000,000 216,000,000 Consultant (Neonatologist/ U1SE 4 0 4 4 16,800,000 201,600,000 Peadiatrician) MOSG (Reproductive Medicine) U2 10 3 7 6 27,000,000 324,000,000 Consultant (Paediatric surgery) U1SE 4 0 4 4 16,800,000 201,600,000 MOSG(Uro oncology) U2 4 2 2 2 9,000,000 108,000,000 Consultant (Pathology) U1SE 2 0 2 2 8,400,000 100,800,000 NURSING OFFICER (MID U5(SC) 72 12 60 40 48,000,000 576,000,000 WIFERY) Consultant(heamatology) U1SE 2 0 2 2 8,400,000 100,800,000 NUTRITIONIST U4 2 0 2 2 4,400,000 52,800,000 Consultant(Microbiology) U1SE 2 0 2 2 8,400,000 100,800,000 Occupational Therapist U5 2 0 2 2 2,400,000 28,800,000 Consultant(Reproductive U1SE 4 2 2 2 8,400,000 100,800,000 Medicine) OFFICE ATTENDANT U8L 7 4 3 3 641,496 7,697,952 Customer Care Assistant U7 5 0 5 5 1,718,960 20,627,520 Personal Secretary U4 5 1 4 4 2,895,472 34,745,664 DRIVER U8 9 2 7 4 887,948 10,655,376 PHARMACY ATTENDANT U4 6 0 6 4 1,255,328 15,063,936 Economist U4 2 0 2 2 1,752,444 21,029,328 PHYSIOTHERAPIST U5 2 0 2 2 2,400,000 28,800,000 Engineer(Electrical&Mechanical) U4 2 0 2 2 4,400,000 52,800,000 Planner U4 1 0 1 1 2,200,000 26,400,000 Pricipal Medical social worker U2 1 0 1 1 1,247,467 14,969,604

258 259 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

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Princ. Aneasthetic Officer U3 1 0 1 1 3,100,000 37,200,000 Principal Accountant U2 1 0 1 1 1,345,330 16,143,960 PRINCIPAL HUMAN U2 1 0 1 1 1,247,467 14,969,604 RESOURCE OFFICER Principal Internal Auditor U2 1 0 1 1 1,345,330 16,143,960 PRINCIPAL LABARATORY U3(Med-2) 3 0 3 3 9,300,000 111,600,000 TECHNOLOGIST PRINCIPAL laboratory technician U3 2 0 2 2 6,200,000 74,400,000 PRINCIPAL NURSING OFFICER U2 2 1 1 1 3,500,000 42,000,000 PRINCIPAL RADIOGRAPHER U2 1 0 1 1 3,100,000 37,200,000 Principal Research Officer U2 1 0 1 1 2,400,000 28,800,000 RADIOGRAPHER U5 7 0 7 7 8,400,000 100,800,000 Records Officer U4 1 0 1 1 723,868 8,686,416 RESEARCH OFFICER U4 1 0 1 1 2,200,000 26,400,000 SEAMSTER/TRESS TAILOR U8 2 0 2 2 400,592 4,807,104 SECURITY OFFICCER U5 1 0 1 1 462,852 5,554,224 Sen. Aneasthetic Officer U4 4 0 4 4 8,800,000 105,600,000 sen. Consultant (Gyn oncology) U1SE 4 0 4 1 4,500,000 54,000,000 SENIOR ACCOUNTANT U3 1 0 1 1 1,046,396 12,556,752 SENIOR ASSISTANT U5 2 1 1 1 528,588 6,343,056 ACCOUNTANT Senior Bio Medical Engineer U3 1 0 1 1 2,300,000 27,600,000 SENIOR BIOSTATICIAN U3 1 0 1 1 2,300,000 27,600,000 Senior Communications Officer U3 1 0 1 1 933,461 11,201,532 Senior Consultant U1SE 2 0 2 2 9,000,000 108,000,000 (Anaethesiologist) Senior Consultant (Benign U1SE 2 0 2 2 9,000,000 108,000,000 Gynaecology) Senior Consultant (Intensive care) U1SE 2 0 2 2 9,000,000 108,000,000 Senior Consultant (Maternal Fetal U1SE 6 1 5 5 22,500,000 270,000,000 Medicine) Senior Consultant (Neonatologist/ U1SE 2 0 2 2 9,000,000 108,000,000 Peadiatrician) Senior Consultant (Paediatric U1SE 2 0 2 2 9,000,000 108,000,000 surgery) Senior Consultant (Pathology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant (Radiology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant(Microbiology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Cosultant (Reproductive U1SE 2 1 1 1 4,500,000 54,000,000 Medicine) Senior Cosultant (Uro U1SE 2 0 2 2 9,000,000 108,000,000 Gynoncology) Senior Economist U3 1 0 1 1 1,046,396 12,556,752 Senior Engineer (civil) U3 1 0 1 1 2,300,000 27,600,000 SENIOR HOUSEKEEPER U5 1 0 1 1 462,852 5,554,224 Senior Imaging Technologist U4 2 0 2 2 4,400,000 52,800,000 Senior Internal Auditor U3 1 0 1 1 1,046,396 12,556,752 Senior Inventory Officer U3 1 0 1 1 1,046,396 12,556,752

260 261 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21 Mulago Specialized Women and Neonatal Hospital Ministerial Policy Statement FY 2020/21

Vote:180 Mulago Specialized Women and Neonatal Hospital Vote:180 Mulago Specialized Women and Neonatal Hospital

Princ. Aneasthetic Officer U3 1 0 1 1 3,100,000 37,200,000 SENIOR LABARATORY U4(Med-2) 4 2 2 2 4,400,000 52,800,000 TECHNOLOGIST Principal Accountant U2 1 0 1 1 1,345,330 16,143,960 senior medical social worker U3 2 0 2 2 1,866,922 22,403,064 PRINCIPAL HUMAN U2 1 0 1 1 1,247,467 14,969,604 RESOURCE OFFICER SENIOR NURSING OFFICER U3 7 2 5 2 6,200,000 74,400,000 Principal Internal Auditor U2 1 0 1 1 1,345,330 16,143,960 SENIOR NUTRITIONIST U3 1 0 1 1 2,300,000 27,600,000 PRINCIPAL LABARATORY U3(Med-2) 3 0 3 3 9,300,000 111,600,000 Senior personal secretary U3 1 0 1 1 933,461 11,201,532 TECHNOLOGIST Senior Procurement Officer U3 1 0 1 1 1,046,396 12,556,752 PRINCIPAL laboratory technician U3 2 0 2 2 6,200,000 74,400,000 Senior RADIOGRAPHER U4 2 0 2 2 4,400,000 52,800,000 PRINCIPAL NURSING OFFICER U2 2 1 1 1 3,500,000 42,000,000 SENIOR RESEARCH OFFICER U3 1 0 1 1 2,300,000 27,600,000 PRINCIPAL RADIOGRAPHER U2 1 0 1 1 3,100,000 37,200,000 SENIOR SECURITY OFFICER U4 1 0 1 1 723,868 8,686,416 Principal Research Officer U2 1 0 1 1 2,400,000 28,800,000 Senior systems analyst U3 2 0 2 2 4,600,000 55,200,000 RADIOGRAPHER U5 7 0 7 7 8,400,000 100,800,000 SENIOR.PHARMACIST U3 1 0 1 1 3,300,000 39,600,000 Records Officer U4 1 0 1 1 723,868 8,686,416 Sonographer U4 3 0 3 3 6,600,000 79,200,000 RESEARCH OFFICER U4 1 0 1 1 2,200,000 26,400,000 STENOGRAPHER SECRETARY U5 2 1 1 1 462,852 5,554,224 SEAMSTER/TRESS TAILOR U8 2 0 2 2 400,592 4,807,104 Sterilisation Production Assistant U7 5 0 5 5 3,065,790 36,789,480 SECURITY OFFICCER U5 1 0 1 1 462,852 5,554,224 Systems Administrator U4 2 0 2 2 4,400,000 52,800,000 Sen. Aneasthetic Officer U4 4 0 4 4 8,800,000 105,600,000 Systems Analyst U4 2 0 2 2 4,400,000 52,800,000 sen. Consultant (Gyn oncology) U1SE 4 0 4 1 4,500,000 54,000,000 THEATRE ASSISTANT U8 6 2 4 4 3,400,000 40,800,000 SENIOR ACCOUNTANT U3 1 0 1 1 1,046,396 12,556,752 THEATRE ATTENDANT U8 4 2 2 2 627,664 7,531,968 SENIOR ASSISTANT U5 2 1 1 1 528,588 6,343,056 ACCOUNTANT Total 853 337 516 409 834,570,268 10,014,843,216 Senior Bio Medical Engineer U3 1 0 1 1 2,300,000 27,600,000 SENIOR BIOSTATICIAN U3 1 0 1 1 2,300,000 27,600,000 Senior Communications Officer U3 1 0 1 1 933,461 11,201,532 Senior Consultant U1SE 2 0 2 2 9,000,000 108,000,000 (Anaethesiologist) Senior Consultant (Benign U1SE 2 0 2 2 9,000,000 108,000,000 Gynaecology) Senior Consultant (Intensive care) U1SE 2 0 2 2 9,000,000 108,000,000 Senior Consultant (Maternal Fetal U1SE 6 1 5 5 22,500,000 270,000,000 Medicine) Senior Consultant (Neonatologist/ U1SE 2 0 2 2 9,000,000 108,000,000 Peadiatrician) Senior Consultant (Paediatric U1SE 2 0 2 2 9,000,000 108,000,000 surgery) Senior Consultant (Pathology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant (Radiology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Consultant(Microbiology) U1SE 1 0 1 1 4,500,000 54,000,000 Senior Cosultant (Reproductive U1SE 2 1 1 1 4,500,000 54,000,000 Medicine) Senior Cosultant (Uro U1SE 2 0 2 2 9,000,000 108,000,000 Gynoncology) Senior Economist U3 1 0 1 1 1,046,396 12,556,752 Senior Engineer (civil) U3 1 0 1 1 2,300,000 27,600,000 SENIOR HOUSEKEEPER U5 1 0 1 1 462,852 5,554,224 Senior Imaging Technologist U4 2 0 2 2 4,400,000 52,800,000 Senior Internal Auditor U3 1 0 1 1 1,046,396 12,556,752 Senior Inventory Officer U3 1 0 1 1 1,046,396 12,556,752

260 261 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

Vote:304 Uganda Virus Research Institute (UVRI)

V1: Vote Overview I. Vote Mission Statement To conduct scientific investigation on viral and other diseases to contribute to knowledge, policy and practice and engage in capacity development for improved public health

II. Strategic Objective To reposition UVRI into a dynamic, internationally competitive research institution, contributing as a centre of excellence in health research to the global challenges of addressing communicable diseases in order to achieve the SDGS and contribute to economic growth and development knowledge. III. Major Achievements in 2019/20 • Viral disease outbreaks Yellow Fever and Rift Valley Fever were followed up. Assessed for predicted broadly neutralization in our HIV key population cohort. Reviewing and development of new protocols for new vaccine trials continued. Quickly diagnosed Yellow Fever and Ebola cases. • Influenza samples (133) collected and diagnosed. andAcute Febrile illness (AFI) sentinel sites actively working. • Analyzed and prepared a baseline report on Prevention of Mother To Child Transmission (PMTCT) Impact evaluation in 206 health facilities in Uganda. Prepared data sets for analysis of follow up data of Prevention of Mother To Child Transmission (PMTCT) impact evaluation in Uganda. • Submitted to UVRI Research and Ethics Committee (REC) for review a protocol on Measuring adult health and mortality in Greater Rakai region. The Polio laboratory was fully accredited by World Health Organization (WHO) • The EPI laboratory carried out laboratory backed Acute Flaccid Paralysis (AFP) and Environmental surveillance of Polio • UVRI EPI laboratory received and tested 1482 stool samples from AFP cases from five different countries: (Burundi: 44, South Sudan 552, Rwanda 54Tanzania 523 and 309 from Uganda) and 91% of the results were reported in time (target is reporting 80% in time). No wild polio virus nor vaccine derived polio virus was detected in any of the stools. • The EPI UVRI laboratory carried out Measles and Rubella surveillance • The laboratory tested 336 serum samples collected from suspected measles cases. Measles was confirmed in 143(42.6%) and rubella in 69(21.8%) cases. Three out of the confirmed 7 measles outbreaks were followed up for collection of samples for virus isolation and characterization. • The laboratory investigated 10 suspected congenital rubella syndrome (CRS) cases, of which six were confirmed to have congenital rubella syndrome ( CRS).

• Performed HIV resistance testing for patients failing on 2nd line ART. Completed testing samples for national antenatal clinic (ANC) HIV sentinel surveillance. • Identified and retrieved samples from young pregnant teenage women for studying trends of Hepatitis B Virus in the population. Support supervision provided to 178 testers in 52 facilities located in 13 districts. • 915 patients were given medical care at UVRI Clinic while204 women received short term family planning methods. UVRI Clinic carried out counselling, testing for HIV and Other laboratory tests involving. 714 clients

IV. Medium Term Plans • Procure nitrogen plant which will help all health science departments handling samples. • Seek funds to construct a research science block and a central sample repository. • Restructuring and Recruitment to fill critical positions. • Rehabilitate the old buildings and laboratories.

262 263 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

Vote:304 Uganda Virus Research Institute (UVRI) Vote:304 Uganda Virus Research Institute (UVRI)

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To conduct scientific investigation on viral and other diseases to contribute to knowledge, policy and practice and engage in capacity development for improved public health 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 1.283 1.541 0.669 1.541 1.541 1.541 1.541 1.541 To reposition UVRI into a dynamic, internationally competitive research institution, contributing as a centre of excellence in Recurrent health research to the global challenges of addressing communicable diseases in order to achieve the SDGS and contribute to Non Wage 4.650 5.248 1.918 5.207 6.249 7.499 8.998 10.798 economic growth and development knowledge. GoU 0.304 2.280 0.077 2.280 2.280 2.280 2.280 2.280 III. Major Achievements in 2019/20 Devt. Ext. Fin. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 • Viral disease outbreaks Yellow Fever and Rift Valley Fever were followed up. Assessed for predicted broadly neutralization in 6.238 9.069 2.665 9.029 10.070 11.320 12.820 14.619 our HIV key population cohort. Reviewing and development of new protocols for new vaccine trials continued. Quickly GoU Total diagnosed Yellow Fever and Ebola cases. Total GoU+Ext Fin (MTEF) 6.238 9.069 2.665 9.029 10.070 11.320 12.820 14.619 • Influenza samples (133) collected and diagnosed. andAcute Febrile illness (AFI) sentinel sites actively working. • Analyzed and prepared a baseline report on Prevention of Mother To Child Transmission (PMTCT) Impact evaluation in 206 Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 health facilities in Uganda. Prepared data sets for analysis of follow up data of Prevention of Mother To Child Transmission 6.238 9.069 2.665 9.029 10.070 11.320 12.820 14.619 (PMTCT) impact evaluation in Uganda. Total Budget • Submitted to UVRI Research and Ethics Committee (REC) for review a protocol on Measuring adult health and mortality in A.I.A Total 0.143 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Greater Rakai region. The Polio laboratory was fully accredited by World Health Organization (WHO) • The EPI laboratory carried out laboratory backed Acute Flaccid Paralysis (AFP) and Environmental surveillance of Polio Grand Total 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619 • UVRI EPI laboratory received and tested 1482 stool samples from AFP cases from five different countries: (Burundi: 44, South Total Vote Budget 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619 Sudan 552, Rwanda 54Tanzania 523 and 309 from Uganda) and 91% of the results were reported in time (target is reporting Excluding Arrears 80% in time). No wild polio virus nor vaccine derived polio virus was detected in any of the stools. • The EPI UVRI laboratory carried out Measles and Rubella surveillance • The laboratory tested 336 serum samples collected from suspected measles cases. Measles was confirmed in 143(42.6%) and VI. Budget By Economic Clasification rubella in 69(21.8%) cases. Three out of the confirmed 7 measles outbreaks were followed up for collection of samples for virus Table V6.1 2019/20 and 2020/21 Budget Allocations by Item isolation and characterization. • The laboratory investigated 10 suspected congenital rubella syndrome (CRS) cases, of which six were confirmed to have congenital rubella syndrome ( CRS). 2019/20 Approved Budget 2020/21 Draft Estimates Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total • Performed HIV resistance testing for patients failing on 2nd line ART. Completed testing samples for national antenatal clinic Output Class : Outputs Provided 6.789 0.000 0.000 6.789 6.749 0.000 6.749 (ANC) HIV sentinel surveillance. • Identified and retrieved samples from young pregnant teenage women for studying trends of Hepatitis B Virus in the 211 Wages and Salaries 1.774 0.000 0.000 1.774 1.800 0.000 1.800 population. Support supervision provided to 178 testers in 52 facilities located in 13 districts. • 915 patients were given medical care at UVRI Clinic while204 women received short term family planning methods. UVRI 212 Social Contributions 0.277 0.000 0.000 0.277 0.327 0.000 0.327 Clinic carried out counselling, testing for HIV and Other laboratory tests involving. 714 clients 213 Other Employee Costs 0.635 0.000 0.000 0.635 0.543 0.000 0.543

221 General Expenses 0.873 0.000 0.000 0.873 0.925 0.000 0.925

IV. Medium Term Plans 222 Communications 0.070 0.000 0.000 0.070 0.070 0.000 0.070 • Procure nitrogen plant which will help all health science departments handling samples. 223 Utility and Property Expenses 1.177 0.000 0.000 1.177 1.133 0.000 1.133 • Seek funds to construct a research science block and a central sample repository. 224 Supplies and Services 0.752 0.000 0.000 0.752 0.800 0.000 0.800 • Restructuring and Recruitment to fill critical positions. • Rehabilitate the old buildings and laboratories. 227 Travel and Transport 0.875 0.000 0.000 0.875 0.867 0.000 0.867 228 Maintenance 0.356 0.000 0.000 0.356 0.285 0.000 0.285

Output Class : Capital Purchases 2.280 0.000 0.000 2.280 2.280 0.000 2.280

312 FIXED ASSETS 2.280 0.000 0.000 2.280 2.280 0.000 2.280

Grand Total : 9.069 0.000 0.000 9.069 9.029 0.000 9.029

262 263 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

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Total excluding Arrears 9.069 0.000 0.000 9.069 9.029 0.000 9.029

VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 03 Virus Research 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619

01 Headquarters 4.421 4.857 1.874 4.816 4.893 5.183 5.471 5.957

02 Health Research Services 1.517 1.782 0.651 1.782 2.738 3.687 4.868 6.082

03 Internal Audit 0.137 0.150 0.062 0.150 0.160 0.170 0.200 0.300

1437 Institutional Support toUVRI 0.137 0.030 0.000 0.000 0.000 0.000 0.000 0.000

1442 UVRI Infrastructual Development 0.167 2.250 0.077 2.100 2.100 2.100 2.100 2.100 Project 1569 Retooling of Uganda Virus Research 0.000 0.000 0.000 0.180 0.180 0.180 0.180 0.180 Institute Total for the Vote 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619

Total Excluding Arrears 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 03 Virus Research Programme Objective To conduct scientific investigations on viral and other diseases for prevention, management, policy and : capacity development Responsible Officer: Prof. Pontiano Kaleebu Programme Outcome: Quality and accessible virus research Services Sector Outcomes contributed to by the Programme Outcome 1. Enhanced competitiveness in the health sector Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

264 265 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

Vote:304 Uganda Virus Research Institute (UVRI) Vote:304 Uganda Virus Research Institute (UVRI)

Total excluding Arrears 9.069 0.000 0.000 9.069 9.029 0.000 9.029 • Propotion of informed research policy and guidelines. 70% 2019 55% 60% 65%

• Propotion of Reseach planned activities 50% 2019 55% 60% 65% VII. Budget By Programme And Subprogramme SubProgramme: 01 Headquarters Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme Output: 04 Administration and Support Services Billion Uganda shillings FY 2019/20 Medium Term Projections Percentage execution of the workplan. 70% 85% 100% FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Quarterly internal audit report produced 4 4 4 Budget SubProgramme: 03 Internal Audit 03 Virus Research 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619 Output: 04 Administration and Support Services 01 Headquarters 4.421 4.857 1.874 4.816 4.893 5.183 5.471 5.957 Percentage execution of the workplan. 68% 70% 75% 02 Health Research Services 1.517 1.782 0.651 1.782 2.738 3.687 4.868 6.082 4 4 4 03 Internal Audit 0.137 0.150 0.062 0.150 0.160 0.170 0.200 0.300 Quarterly internal audit report produced

1437 Institutional Support toUVRI 0.137 0.030 0.000 0.000 0.000 0.000 0.000 0.000 IX. Major Capital Investments And Changes In Resource Allocation 1442 UVRI Infrastructual Development 0.167 2.250 0.077 2.100 2.100 2.100 2.100 2.100 Project Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) 1569 Retooling of Uganda Virus Research 0.000 0.000 0.000 0.180 0.180 0.180 0.180 0.180 Institute FY 2019/20 FY 2020/21 Total for the Vote 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619 Appr. Budget and Planned Outputs Expenditures and Achievements by Proposed Budget and Planned Total Excluding Arrears 6.380 9.069 2.665 9.029 10.070 11.320 12.820 14.619 end Dec Outputs Vote 304 Uganda Virus Research Institute (UVRI)

VIII. Programme Performance and Medium Term Plans Program : 08 03 Virus Research

Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Development Project : 1442 UVRI Infrastructual Development Project

Programme : 03 Virus Research Output: 08 03 72 Government Buildings and Administrative Insfrastructure 44 staff housing units,re-roofed to remove asbestos. The contract for Namibia staff quarters cleared Programme Objective To conduct scientific investigations on viral and other diseases for prevention, management, policy and Renovation of the construction works monitored. by the contracts committee pending further Construction of 64 staff houses for laboratory : capacity development clearance from the solicitor General assistants commenced. Prof. Pontiano Kaleebu quarterly monitoring reports produced Monitoring of renovation of the construction Responsible Officer: works awaits actual start of the work. Programme Outcome: Quality and accessible virus research Services Total Output Cost(Ushs Thousand) 2,250,000 77,408 2,100,000 Sector Outcomes contributed to by the Programme Outcome Gou Dev’t: 2,250,000 77,408 2,100,000 1. Enhanced competitiveness in the health sector Ext Fin: 0 0 0 Performance Targets A.I.A: 0 0 0 Outcome Indicators 2020/21 2021/22 2022/23 X. Vote Challenges and Plans To Improve Performance Baseline Base year Target Projection Projection Vote Challenges

(i) Lack of funds to expand the research portfolio into Non Communicable Disease(NCDs) of viral etiology; hepatitis, and Rota virus research. (ii) Squatters on Kamwanyi Land (part of UVRI land) (iii) Un Fenced Institute Land (iv) Absence of a Liquid Nitrogen Plant (v) Lack of a Research Science block which will house a central sample repository, laboratories. (vi) lack of sample collection vans.

264 265 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

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(vii) Lack of an Enabling Research act to guide research

Plans to improve Vote Performance

-Construction of Support science Block and staff houses in soweto -Look for funds to expand into Non Communicable Disease(NCDs) of viral etiology; hepatitis, and Rota virus research .-Lobby for funds to establish a Nitrogen liquid plant. -Mobilize funds to buy sample collection Vans -Lobby through line ministry for enactment of enabling research act

XI Off Budget Support

Table 11.1 Off-Budget Support by Sub-Programme

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Budget Estimates Programme 0803 Virus Research 0.00 11.39 Recurrent Budget Estimates 02 Health Research Services 0.00 11.39 400-MULTI-LATERAL DEVELOPMENT PARTNERS 0.00 3.04

550-United States of America 0.00 8.35

Total for Vote 0.00 11.39

XII. Vote Cross Cutting Policy And Other Budgetary Issues Table 12.1: Cross- Cutting Policy Issues

Issue Type: HIV/AIDS

Objective : To create awareness of and prevention of HIV/AIDS among staff and their families. Issue of Concern : Where as the institute does alot of research in HIV/AIDS little is done to create awareness about the disease among the staff Planned Interventions : HIV/AIDS awareness meetings Installation of condom dispensers and distribution of condoms within rest rooms Budget Allocation (Billion) : 0.050 Performance Indicators: Number of Hiv/aids awareness meetings , number of dispensers installed Issue Type: Gender

Objective : Mainstreaming gender and equity in viral research Issue of Concern : Its important for UVRI to always embed gender and equity prepositions in its work Planned Interventions : Consider women, men and children in the various research projects Always aggregating data according to gender Budget Allocation (Billion) : 0.020

266 267 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21 Uganda Virus Research Institute (UVRI) Ministerial Policy Statement FY 2020/21

Vote:304 Uganda Virus Research Institute (UVRI) Vote:304 Uganda Virus Research Institute (UVRI)

(vii) Lack of an Enabling Research act to guide research Performance Indicators: Proportion of the UVRI MPS that is gender and equity compliant Issue Type: Enviroment

Objective : To minimize the exposure of the environment to negative effects that may arise from the activities Plans to improve Vote Performance of UVRI. Issue of Concern : In the discharge of its duties, the institute produces bio waste which ought to be disposed off safely. -Construction of Support science Block and staff houses in soweto -Look for funds to expand into Non Communicable Disease(NCDs) of viral etiology; hepatitis, and Rota virus research Planned Interventions : Renovate the incinerator and facilitate the operators to safely dispose waste .-Lobby for funds to establish a Nitrogen liquid plant. Budget Allocation (Billion) : 0.250 -Mobilize funds to buy sample collection Vans -Lobby through line ministry for enactment of enabling research act Performance Indicators: Functionality of the incinerator Number of bins installed Bio waste collected XI Off Budget Support XIII. Personnel Information

Table 11.1 Off-Budget Support by Sub-Programme Table 13.1 Staff Establishment Analysis

Billion Uganda Shillings 2019/20 Approved 2020/21 Draft Title Salary Scale Number Of Approved Positions Number Of Filled Positions Budget Estimates Senior Network Administator U3 1 0 Programme 0803 Virus Research 0.00 11.39 Recurrent Budget Estimates Senior Bio Statician U3(SC) 2 0 02 Health Research Services 0.00 11.39 Senior Epidemiologist U3(SC) 1 0 400-MULTI-LATERAL DEVELOPMENT PARTNERS 0.00 3.04 Public Relations Officer U4 1 0 550-United States of America 0.00 8.35 Bio Medical Engineer U4(SC) 1 0 Total for Vote 0.00 11.39 Senior Laboratory Technologist U4(SC) 7 0 XII. Vote Cross Cutting Policy And Other Budgetary Issues Laboratory Technologist U5 (SC) 20 2 Table 12.1: Cross- Cutting Policy Issues Laboratory Assistant U7 SC 39 15 Dhobi U8 4 0 Issue Type: HIV/AIDS Table 13.2 Staff Recruitment Plan Objective : To create awareness of and prevention of HIV/AIDS among staff and their families. Issue of Concern : Where as the institute does alot of research in HIV/AIDS little is done to create awareness about Post Title Salalry No. Of No Of Vacant No. of Posts Gross Salary Total Annual the disease among the staff Scale Approved Filled Posts Posts Cleared for Per Month Salary Posts Filling (UGX) (UGX) Planned Interventions : HIV/AIDS awareness meetings FY2020/21 Installation of condom dispensers and distribution of condoms within rest rooms Bio Medical Engineer U4(SC) 1 0 1 1 1,131,967 13,583,604 Budget Allocation (Billion) : 0.050 Dhobi U8 4 0 4 1 187,660 2,251,920 Performance Indicators: Number of Hiv/aids awareness meetings , number of dispensers installed Laboratory Assistant U7 SC 39 15 24 7 4,292,106 51,505,272 Issue Type: Gender Laboratory Technologist U5 (SC) 20 2 18 13 15,600,000 187,200,000 Public Relations Officer U4 1 0 1 1 601,341 7,216,092 Mainstreaming gender and equity in viral research Objective : Senior Bio Statician U3(SC) 2 0 2 1 1,204,288 14,451,456 Issue of Concern : Its important for UVRI to always embed gender and equity prepositions in its work Senior Epidemiologist U3(SC) 1 0 1 1 1,315,765 15,789,180 Planned Interventions : Consider women, men and children in the various research projects Senior Laboratory Technologist U4(SC) 7 0 7 5 11,000,000 132,000,000 Always aggregating data according to gender Senior Network Administator U3 1 0 1 1 979,805 11,757,660 Budget Allocation (Billion) : 0.020 Total 76 17 59 31 36,312,932 435,755,184

266 267 501-850 Local Governments Ministerial Policy Statement FY 2020/21

Vote:500 501-850 Local Governments

V1: Vote Overview I. Vote Mission Statement To facilitate the attainment of a good standard of health by all people of Uganda in order to promote a healthy and productive life

II. Strategic Objective To provide quality Primary Health Care Services to all people of Uganda in order to promote a healthy and productive population. III. Major Achievements in 2019/20 1. health workers and administrative staff salaries paid 2. staff appraised 3. monthly outreaches conducted 4. immunization activities strengthened 5. recruitment plan prepared and submitted to MOPS for no objection 6. newly recruited staff accessed payroll 7. 90% coverage for HPVI achieved for girls 8.community awareness and sensitization on health related issues attained 9. civil works commenced in districts having facilities undergoing upgrades from HC II to HC III and are at 20% execution. additionally the 124 HC IIs that were upgraded in 2018/19 are at 77% completion. 10. scale up of results based financing in 131 districts. 11. In terms of quality scores, the average quality score for HC IIIs during the Quarter was 79.9% while that of HC IVs was 82.2%. This represents an overall quality score increment of 3.1% for HC IIIs compared to the baseline (Baseline quality score for HC III = 76.82%) and 1% increment for HC IVs [Baseline quality score for HC IV = 81.3%]. 12. By the end of the Quarter, 579 of the 727 health facilities (79.6%) from 63 of the 79 districts (84.8%) had submitted invoices for validation. 13. Prequalification Assessments were conducted for eligible facilities in 20 of the 50 new districts. 14. the increase in the funds to the health facilities and the district health office has led to improved service delivery as evidenced with the indicators reported in the HMIS tools IV. Medium Term Plans 1. Maintenance and repairs of existing health facilities at all levels 2. Increment in funding for the medicines credit line 3. Recruitment of more health workers in the Local Governments 4. Revision of the staffing norms for the Local Governments 5. Equipping of the newly upgraded health facilities including General hospitals, Health Centre IVs and Health Centre IIIs 6. Functionalization of the recently upgraded facilities 7. Wage enhancement of more cadres 8. Renovation of General Hospitals

268 269 501-850 Local Governments Ministerial Policy Statement FY 2020/21 501-850 Local Governments Ministerial Policy Statement FY 2020/21

Vote:500 501-850 Local Governments Vote:500 501-850 Local Governments

V1: Vote Overview V. Summary of Past Performance and Medium Term Budget Allocations I. Vote Mission Statement Table 5.1: Overview of Vote Expenditures (UShs Billion) To facilitate the attainment of a good standard of health by all people of Uganda in order to promote a healthy and productive life 2019/20 MTEF Budget Projections 2018/19 Approved Expenditure 2020/21 2021/22 2022/23 2023/24 2024/25 II. Strategic Objective Outturn Budget by End Dec Wage 423.944 437.022 219.121 451.723 451.723 451.723 451.723 451.723 To provide quality Primary Health Care Services to all people of Uganda in order to promote a healthy and productive Recurrent population. Non Wage 39.919 56.190 28.092 92.100 110.520 132.624 159.149 190.979 III. Major Achievements in 2019/20 GoU 71.561 56.312 38.437 84.311 84.311 84.311 84.311 84.311 Devt. 1. health workers and administrative staff salaries paid Ext. Fin. 0.000 2.686 0.000 4.740 0.000 0.000 0.000 0.000 2. staff appraised 535.424 549.524 285.651 628.134 646.554 668.658 695.183 727.012 3. monthly outreaches conducted GoU Total 4. immunization activities strengthened Total GoU+Ext Fin (MTEF) 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012 5. recruitment plan prepared and submitted to MOPS for no objection 6. newly recruited staff accessed payroll Arrears 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 7. 90% coverage for HPVI achieved for girls 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012 8.community awareness and sensitization on health related issues attained Total Budget 9. civil works commenced in districts having facilities undergoing upgrades from HC II to HC III and are at 20% execution. A.I.A Total N/A N/A N/A N/A N/A N/A N/A N/A additionally the 124 HC IIs that were upgraded in 2018/19 are at 77% completion. 10. scale up of results based financing in 131 districts. Grand Total 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012 11. In terms of quality scores, the average quality score for HC IIIs during the Quarter was 79.9% while that of HC IVs was Total Vote Budget 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012 82.2%. This represents an overall quality score increment of 3.1% for HC IIIs compared to the baseline (Baseline quality score Excluding Arrears for HC III = 76.82%) and 1% increment for HC IVs [Baseline quality score for HC IV = 81.3%]. 12. By the end of the Quarter, 579 of the 727 health facilities (79.6%) from 63 of the 79 districts (84.8%) had submitted invoices for validation. VI. Budget By Economic Clasification 13. Prequalification Assessments were conducted for eligible facilities in 20 of the 50 new districts. Table V6.1 2019/20 and 2020/21 Budget Allocations by Item 14. the increase in the funds to the health facilities and the district health office has led to improved service delivery as evidenced with the indicators reported in the HMIS tools 2019/20 Approved Budget 2020/21 Draft Estimates IV. Medium Term Plans Billion Uganda Shillings GoU Ext. Fin AIA Total GoU Ext. Fin Total 1. Maintenance and repairs of existing health facilities at all levels Output Class : Outputs Funded 549.524 2.686 0.000 552.210 628.134 4.740 632.873 2. Increment in funding for the medicines credit line 321 DOMESTIC 549.524 2.686 0.000 552.210 628.134 4.740 632.873 3. Recruitment of more health workers in the Local Governments 4. Revision of the staffing norms for the Local Governments Grand Total : 549.524 2.686 0.000 552.210 628.134 4.740 632.873 5. Equipping of the newly upgraded health facilities including General hospitals, Health Centre IVs and Health Centre IIIs 6. Functionalization of the recently upgraded facilities Total excluding Arrears 549.524 2.686 0.000 552.210 628.134 4.740 632.873 7. Wage enhancement of more cadres 8. Renovation of General Hospitals VII. Budget By Programme And Subprogramme

Table V7.1: Past Expenditure Outturns and Medium Term Projections by Programme and SubProgramme

Billion Uganda shillings FY 2019/20 Medium Term Projections FY 2018/19 Approved Spent By 2020-21 2021-22 2022-23 2023-24 2024-25 Outturn Budget End Dec Proposed Budget 81 Primary Healthcare 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012

05 Health 463.863 493.212 247.213 543.823 562.243 584.347 610.872 642.701

1385 HEALTH DEVELOPMENT 71.561 58.998 38.437 89.051 84.311 84.311 84.311 84.311

268 269 501-850 Local Governments Ministerial Policy Statement FY 2020/21

Vote:500 501-850 Local Governments

Total for the Vote 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012

Total Excluding Arrears 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012

VIII. Programme Performance and Medium Term Plans Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21)

Programme : 81 Primary Healthcare Programme Objective To offer quality primary care health services to the people of Uganda : Responsible Officer: Chief Administrative Officers Programme Outcome: Quality of health care and patient safety Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Performance Targets Outcome Indicators 2020/21 2021/22 2022/23 Baseline Base year Target Projection Projection

• Infant mortality rate per 1000 54 2011 30 30 30

• Under-five mortality rate per 1000 90 2011 53 53 53

• Maternal mortality per 100000 438 2011 211 211 211

N/A

IX. Major Capital Investments And Changes In Resource Allocation

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

N/A

X. Vote Challenges and Plans To Improve Performance

Vote Challenges

1. Inadequate equipment in the health facilities 2. Drug stock out caused by the limited allocation to the medicines credit line along side the increasing population 3. Staffing gaps especially the critical cadres in most of the health facilities due to poor attraction and retention of staff in lower Local Government 4. Inadequate supervision and monitoring in the lower level health facilities 5. Poor infrastructure for most of the lower level health units

Plans to improve Vote Performance

1. Effective and well structured support supervision to the local governments especially the lower level units harmonized with the regulatory authorities 2. Advocate for increased financing for medicine credit line for medicines, laboratory supplies and reagents 3. Address the human resource challenge in the Local Governments with emphasis on the critical cadres

270 271 501-850 Local Governments Ministerial Policy Statement FY 2020/21 501-850 Local Governments Ministerial Policy Statement FY 2020/21

Vote:500 501-850 Local Governments Vote:500 501-850 Local Governments

Total for the Vote 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012 4.Advocate for increased financing for infrastructure maintenance and repairs of existing health facilities 5. Advocate for increased funding for medical equipment to the facilities Total Excluding Arrears 535.424 552.210 285.651 632.873 646.554 668.658 695.183 727.012

VIII. Programme Performance and Medium Term Plans XI Off Budget Support Table V8.1: Programme Outcome and Outcome Indicators ( Only applicable for FY 2020/21) Table 11.1 Off-Budget Support by Sub-Programme

Programme : 81 Primary Healthcare N/A Programme Objective To offer quality primary care health services to the people of Uganda : XII. Vote Cross Cutting Policy And Other Budgetary Issues Responsible Officer: Chief Administrative Officers Table 12.1: Cross- Cutting Policy Issues Programme Outcome: Quality of health care and patient safety Issue Type: HIV/AIDS Sector Outcomes contributed to by the Programme Outcome 1. Improved quality of life at all levels Objective : HIV/AIDS main streaming activities in the Local Governments Performance Targets Issue of Concern : Little is being done to create awareness of HIV/AIDS in the Local Governments Outcome Indicators 2020/21 2021/22 2022/23 Planned Interventions : HIV/AIDS awareness meetings, Installation of condom dispensers and the distribution of condoms in the washrooms Baseline Base year Target Projection Projection promote safe male circumcision in the community

• Infant mortality rate per 1000 54 2011 30 30 30 Budget Allocation (Billion) : 0.100 Performance Indicators: Number of HIV/AIDS awareness meetings held • Under-five mortality rate per 1000 90 2011 53 53 53 number of dispensers installed • Maternal mortality per 100000 438 2011 211 211 211 Number of people who accessed safe male circumcision

N/A XIII. Personnel Information

Table 13.1 Staff Establishment Analysis IX. Major Capital Investments And Changes In Resource Allocation N/A Table 9.1: Major Capital Investment (Capital Purchases outputs over 0.5Billion) Table 13.2 Staff Recruitment Plan N/A N/A X. Vote Challenges and Plans To Improve Performance

Vote Challenges

Plans to improve Vote Performance

270 271 Ministry of Health Ministerial Policy Statement FY 2020/21

CONCLUSION

Annex: Recommendations from Parliament for FY 2019/20 and Institutional responses

1. Focusing on disease prevention measures at household and community level.

The sector continues to prioritize health education, disease prevention, hygiene and sanitation as key interventions to reduce the diseases burden. Ministry of health has supported immunization programs that have registered very good results. In FY 2020/21, the sector has earmarked 20% of the Primary Health Care (PHC) grants for health promotion and diseases prevention in Local Governments focusing on community level intervention

2. Operationalization of National Health Insurance:

Ministry of Health has fast-tracked the bill and its currently in Parliament for debate.

3. Attraction of specialist, consultants and senior consultant level positions in various facilities across the country.

This is ongoing, given the salary enhancement some of the specialists have been attracted back in referral hospitals. However, it will take ample time to improve the working conditions to attract more senior specialists given the market demand for their services in the private sector and abroad.

4. The National Policy on Non-Communicable Diseases (NCDs) should be expedited to further widen the scope of preventive measure for the increasing NCDs cases;

The draft National Policy on NDCs is available and will be approved before end of FY 2019/20

5. The low annual sector budget and policy compliance trend must be reversed to avoid challenges of low funds absorption and slow policy implementation.

The low absorption is majorly registered in the externally funded programs. This is caused by in adequate planning and preparedness. Ministry of health has instructed performance measures to address this and so far performance has greatly improved to 63% as compare to 38% for last year.

272 273 Ministry of Health Ministerial Policy Statement FY 2020/21

CONCLUSION

Annex: Recommendations from Parliament for FY 2019/20 and Institutional responses

1. Focusing on disease prevention measures at household and community level.

2. Operationalization of National Health Insurance:

Ministry of Health has fast-tracked the bill and its currently in Parliament for debate.

3. Attraction of specialist, consultants and senior consultant level positions in various facilities across the country.

4. The National Policy on Non-Communicable Diseases (NCDs) should be expedited to further widen the scope of preventive measure for the increasing NCDs cases;

The draft National Policy on NDCs is available and will be approved before end of FY 2019/20

5. The low annual sector budget and policy compliance trend must be reversed to avoid challenges of low funds absorption and slow policy implementation. ANNEX A The low absorption is majorly registered in the externally funded programs. This is caused by in adequate planning and preparedness. Ministry of health has instructed performance measures to address this and so far performance has greatly improved to 63% as compare to 38% for last year.

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278 279 THE REPUBLIC OF UGANDA

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278 279 FINANCIAL YEAR 2020/2021