Caring Together End of Project Report
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MINISTRY OF HEALTH CARING TOGETHER END OF PROJECT REPORT 2015-2018 - EVERYONE IS A LEADER - Copyright © 2018 By Baylor Uganda, Block 5 Mulago Hospital, PO Box 72052 Clock Tower, Kampala, Uganda No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission of the publisher. Compiled by: Éireann O’Sullivan, Kathryn Savage and Sarah Galvin Pepal: www.pepal.org Supported by: Musiime Michael Koima and Dr Leticia Namale Baylor Uganda: www.baylor-uganda.org Layout and Design: Add Value: www.addvaluecreators.com First Published in April 2018 This work was made possible by the generous support of Comic Relief. The content of this manual is the responsibility of Baylor College of Medicine Children’s Foundation- Uganda and does not reflect the views of Comic Relief, Pepal or Janssen Pharmaceutica CONTENTS Introduction ......................................................................................2 Executive Summary .......................................................................3 The Caring Together Approach .....................................................8 Caring Together Activities ...........................................................14 Caring Together Success Stories ...............................................20 Caring Together Results ...............................................................22 Lessons Learned and Best Practices ........................................35 Looking to the Future ....................................................................39 Acknowledgements ......................................................................51 Annexes Acronyms .......................................................................................................................... 52 Caring Together Mentors and Health Facilities......................................................... 53 CARING TOGETHER END OF PROJECT REPORT | PAGE 1 Caring Together recognizes that INTRODUCTION everyone is capable of being a leader, no matter their cadre, and Caring Together recognizes that everyone that each individual should take is capable of being a leader, no matter ownership of the care that they their cadre, and that each individual provide. This creates a culture of should take ownership of the care that responsibility and accountability they provide. This creates a culture at all levels. of responsibility and accountability at all levels. training institutions across Uganda, so that as many people as possible working in the healthcare Health workers, and all support sector can access the tried and tested Caring staff, are critical to the successful Together training modules. When I first trained running of health facilities and Dr. Adeodata Kekitiinwa, Executive Director, Baylor-Uganda as a doctor, all students were sent to Uganda it is vital that they are provided Management Institute for a two week induction with the tools to drive quality Baylor-Uganda is proud to have implemented the into public service; it included a brief orientation improvement in the delivery of Caring Together Project at 270 health facilities on leadership and management. Unfortunately, care. Caring Together recognizes across Eastern and Rwenzori regions from January this has since stopped, but I firmly believe that the that everyone is capable of being 2015 to March 2018. The unique Caring Together Baylor-Uganda Leadership Academy can help to fill a leader, no matter their cadre, approach, which is based around a comprehensive the critical leadership gap in health worker training and that each individual should district-led mentorship scheme, aims to empower in Uganda. take ownership of the care that frontline health workers to deliver high quality As Executive Director, I am confident that Baylor- they provide. services. Health workers, and all support staff, are Uganda has the capacity to become the foremost critical to the successful running of health facilities training provider of healthcare leadership skills in and it is vital that they are provided with the tools this country. I believe that the training provided to drive quality improvement in the delivery of by the Academy will enable other institutions care. Caring Together recognizes that everyone is to effectively use and continuously develop their capable of being a leader, no matter their cadre, human resources for improved healthcare services, and that each individual should take ownership of continuing the legacy of Caring Together. the care that they provide. This creates a culture of responsibility and accountability at all levels. Baylor-Uganda is grateful for the support of Pepal, Janssen Pharmaceutica, Ralph and Ahrabella The Caring Together approach is low-resource yet Lewis, the Cross Sector Leadership Exchange high impact and the impressive learnings from the (CSLE), and Comic Relief UK. Collaboration has project are detailed in this Report. The final project been integral to the success of Caring Together. results show a 57% increase in facilities tracking lateness and a 34% increase in facilities holding We could not be more appreciative of our montly staff meetings. These two crucial factors partnership with the Ministry of Health and their have led to a 27% reduction in staff late arrivals endorsement of the project. We also thank the and a 13% increase in patients’ perceived quality project mentors, district technical and political of care. This model, which capitalizes on resources leaders, Health Unit Management Committees already within facilities, and brings out the full and Sub-County Leaders of Eastern and Rwenzori potential of individuals, should be replicated regions for their continued support of the throughout the healthcare system in Uganda. implementation of this project over the past three years. Leadership and governance are critical building blocks in any health system, and Baylor-Uganda On behalf of the dedicated team that I lead and will continue to place a strong emphasis on this on my own behalf, I pledge our commitment to after the Caring Together Project comes to a close. continue to promote the importance of good The newly established Baylor-Uganda Leadership leadership for the improvement of health service Academy will provide leadership development delivery in the communities of Uganda that we consultancy to other implementing partners and serve. PAGE 2 | CARING TOGETHER END OF PROJECT REPORT his Report documents the progress and achievements of the Caring Together project, which took place between January 2015 and March 2018 at 270 heath facilities in the Eastern and Rwenzori Tregions of Uganda. The joint agenda of Baylor-Uganda, Pepal and Janssen, the Pharmaceutical Companies of Johnson & Johnson, to improve healthcare for patients through sustainable change, was achieved through bringing together diverse skills and expertise in this unique collaboration. With the intention to consciously and continuously learn from project initiatives, and to consequently develop best practices for future scale up within Uganda and further afield, the Caring Together project posits itself as a new approach for better health service delivery. A new approach for better health Caring Together addresses the critical leadership gap in health systems strengthening and is In the Ugandan health sector, it is distinctive in its approach. It improves health widely recognised that poor leadership worker performance, leading to better service and a lack of effective teamwork delivery and more satisfied patients. contributes to poor service delivery Developed by Baylor-Uganda, with the support of and a demotivated workforce. Pepal and Janssen Pharmaceutica, Caring Together However, few front line health workers has generated some impressive results over the delivering services have been trained three years of its implementation including: and supported in their role as leaders. 1. A reduction in patient waiting times from an We have seen fantastic results; Caring average of 61 to 35 minutes per patient Together is changing our approach to 2. A 27% reduction in staff late arrivals health systems strengthening. We are excited to see what the future holds. 3. A 34% increase in facilities holding monthly – DR. ADEODATA KEKITIINWA, staff meetings EXECUTIVE DIRECTOR, BAYLOR-UGANDA Our method Caring Together trains and supports peer leadership mentors to effect change. The Project works to improve teamwork, solve problems and embed a culture of accountability in healthcare systems in three steps. Our Creating leadership Applied and integrated Evidence and learning is mentors; trained in within existing structures, constantly generated, Method leadership, problem whether at a community or which is used to inform solving, and mentoring to district level activities and plans, and lead their peers influence policy makers PAGE 4 | CARING TOGETHER END OF PROJECT REPORT 1. Creating and training leadership mentors District mentors learn leadership skills Modules including Communication and how to work with facility staff and Skills, Time Management and village health teams (VHTs) to improve Teamwork District Mentors motivation, patient care and service Value and purpose of data delivery. Mentoring skills Conducting needs assessment, developing action plans and supporting implementation Project data collection District leaders learn how to guide and Mentoring skills support health facility In-Charges and