USAID’S REGIONAL HEALTH INTEGRATION TO ENHANCE SERVICES IN EAST CENTRAL UGANDA (USAID RHITES-EC) ANNUAL REPORT OCTOBER 1, 2017 – SEPTEMBER 30, 2018 OCTOBER 2018 USAID’s Regional Health Integration to Enhance Services in East Central Uganda (USAID RHITES-EC) Activity is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under Cooperative Agreement number AID-617-A-16-00001. The project team includes prime recipient University Research Co., LLC (URC) and sub-recipients The AIDS Support Organisation (TASO), Communication for Development Foundation Uganda (CDFU), and Youth Alive Uganda. The author’s views expressed in this publication do not necessarily reflect the views of USAID or the United States Government. On the cover: Hajira, a 22-year-old mother from Bulamawo Village in Luuka District, received breastfeeding counseling at a RHITES-EC Family Life School, improving her health and that of her son, Nicholas. (Photo by Louisa K. Nakitende, USAID RHITES-EC Project.) USAID’S REGIONAL HEALTH INTEGRATION TO ENHANCE SERVICES IN EAST CENTRAL UGANDA (USAID RHITES-EC) ANNUAL REPORT OCTOBER 1, 2017 – SEPTEMBER 30, 2018 Submission Date: October 31, 2018 Agreement Number: AID-617-A-16-00001 Activity Start Date and End Date: September 30, 2016, to September 30, 2021 Submitted by: Nathan Tumwesigye, Chief of Party USAID’s Regional Health Integration to Enhance Services in East Central Uganda (RHITES-EC) University Research Co., LLC Plot 1, Bridge Lane, Mpumudde Division | PO Box 5053 Jinja | Uganda Tel: +256 393 217 617 Email: [email protected] Submitted to: Contracting/Agreement Officer’s Representative (C/AOR) AOR Name: Sheila Nyakwezi Copied to: [email protected] This document was produced for review by the United States Agency for International Development Uganda Mission (USAID/Uganda). ACTIVITY INFORMATION Activity Name: USAID Regional Health Integration to Enhance Services in East Central Uganda (RHITES-EC) Project: USAID RHITES-EC Activity Start Date: Start Date: September 30, 2016 End Date: End Date: September 29, 2021 Name of Prime Implementing University Research Co., LLC (URC) Partner: Agreement Number: AID-617-A-16-00001 Name of Sub-Awardees Sub-Awardee Dollar amount and Dollar Amounts: The AIDS Support Organisation (TASO) $5,392,119 Communication for Development Foundation Uganda (CDFU) $2,005,358 Youth Alive Uganda $999,984 Major Counterpart 12 district local governments of the East Central Region Organizations: Uganda Ministry of Health Uganda Catholic Medical Bureau Uganda Protestant Medical Bureau Uganda Muslim Medical Bureau USAID Better Outcomes for Children and Youth (BOCY) USAID Malaria Action Plan for Districts (MAPD) USAID Maternal Child Survival Program (MCSP) USAID Advancing Partners and Communities (APC) USAID Applying Science to Strengthen and Improve Systems (ASSIST) USAID Strategic Information Technical Support (SITES) USAID HarvestPlus Meals for Nutrition in Uganda (MENU) USAID Sanitation for Health (S4H) USAID Defeat TB Key sub-awardee partners – listed in the previous row 11 civil society organizations as sub-grantees Makerere University Obwa Kyabazinga of Busoga Geographic Coverage: 12 districts of the East Central Region: Bugiri, Bugweri, Busia, Buyende, Iganga, Jinja, Kaliro, Kamuli, Luuka, Mayuge, Namayingo, and Namutumba Reporting Period: October 1, 2017 - September 30, 2018 OCTOBER 1, 2018 – SEPTEMBER 20, 2019 | RHITES-EC ANNUAL REPORT III ACRONYMS AND ABBREVIATIONS AGYW adolescent girls and young women IR intermediate result AMELP Activity Monitoring, Evaluation, and Learning Plan JMS Joint Medical Store ANC antenatal care KP key population AOR agreement officer representative LGBTI lesbian, gay, bisexual, transgender, and intersex APC Advancing Partners and Communities LLIN long-lasting insecticide-treated net APN assisted partner notification LQAS Lot Quality Assurance Survey ART antiretroviral therapy LQMS laboratory quality management system ASSIST Applying Science to Strengthen and Improve Systems MAPD Malaria Action Plan for Districts Project MAUL Medical Access Uganda Limited AYG Adolescent Youth and Gender MCSP Malaria Child Survival Program BEmONC basic emergency obstetric and newborn care MDR-TB multidrug-resistant tuberculosis BOCY Better Outcomes for Children and Youth MENU Meals for Nutrition in Uganda Project (HarvestPlus) CDCS Country Development Cooperation Strategy MMS medicines management specialist CDFU Communication for Development Foundation Uganda MNH maternal and newborn health CEmONC comprehensive emergency obstetric and newborn care MOH Ministry of Health CHW community health worker MPDSR maternal and perinatal death surveillance and response CME continuing medical education NACS nutrition assessment, counseling, and support CQI continuous quality improvement NMS National Medical Stores CSO civil society organization OBB Obwa’Kyabazinga Bwa Busoga (i.e., the Busoga DHIS2 District Health Information System 2 Consortium) DHO district health officer ODK Open Data Kit DHT district health team OPD outpatient department DLP defects liability period OVC orphans and vulnerable children DPT diphtheria, pertussis, tetanus PCV pneumococcal conjugate vaccine DQA data quality assessment PEPFAR United States President’s Emergency Plan for AIDS DSDM differentiated service delivery model Relief EC East Central PLHIV people living with HIV EID early infant diagnosis PMTCT prevention of mother-to-child transmission EMR electronic medical records PNC postnatal care EPI Expanded Program on Immunizations PP priority population FP family planning Q quarter FSW female sex worker QI quality improvement FY fiscal year RMNCAH reproductive, maternal, newborn, child, and adolescent health GBV gender-based violence RRH regional referral hospital GH general hospital RUTF ready-to-use therapeutic food GIS geographic information system S4H Sanitation for Health Activity HC Health Centre (e.g., HCII, HCIII, and HCIV) SBCC social and behavior change communication HMIS health management information system SHRH Strengthening Human Resources for Health HRIS human resources information system SIMS Site Improvement through Monitoring System HTS HIV testing services SITES Strategic Information Technical Support Activity IMNCI integrated management of neonatal and childhood illnesses SLIPTA Stepwise Laboratory Quality Improvement Process Towards Accreditation IPT isoniazid preventive therapy (when related to TB); intermittent preventive treatment (when related to SLMTA Strengthening Laboratory Management Towards malaria) Accreditation IPTp intermittent preventive treatment in pregnancy OCTOBER 1, 2018 – SEPTEMBER 20, 2019 | RHITES-EC ANNUAL REPORT IV SPARS supervision, performance assessment, and recognition USAID U.S. Agency for International Development strategy USG U.S. Government TASO The AIDS Support Organisation VHT village health team (sometimes refers to an individual TLE tenofovir, lamivudine, and efavirenz person on the team, based on the context) UDHS Uganda Demographic and Health Survey WASH water, sanitation, and hygiene USD United States dollar WHO World Health Organization UNICEF United Nations Children’s Fund WISN Workload Indicators of Staffing Need U.S. United States of America OCTOBER 1, 2018 – SEPTEMBER 20, 2019 | RHITES-EC ANNUAL REPORT V TABLE OF CONTENTS Activity Information .................................................................................................................................................................................. III Acronyms and Abbreviations ................................................................................................................................................................. IV Table of Contents ................................................................................................................................................................................... VI 1. Introduction ........................................................................................................................................................................................... 1 1.1 Activity Description ............................................................................................................................................................................................... 1 1.2 Performance Analysis .......................................................................................................................................................................................... 2 1.3 Contribution to CDCS Results Framework Progress Narrative ....................................................................................................................... 25 2. Activity Implementation Progress ...................................................................................................................................................... 26 2.1 Summary of Implementation Status .................................................................................................................................................................. 26 2.2 Progress Narrative .............................................................................................................................................................................................. 43 2.3 Partnership, Collaboration, and Stakeholder Engagement .............................................................................................................................