USAID/UGANDA PRIVATE HEALTH SUPPORT PROGRAM YEAR 2 ANNUAL AND QUARTER 4 REPORT: OCTOBER 2014-SEPTEMBER 2015 October 30, 2015 This report is made possible by the support of the American People through the United States Agency for International Development (USAID). The contents of this report are the sole responsibility of Cardno Emerging Markets USA, Ltd. and do not necessarily reflect the views of USAID or the United States Government. USAID/UGANDA PRIVATE HEALTH SUPPORT PROGRAM YEAR 2 ANNUAL AND QUARTER 4 REPORT: OCTOBER 2014-SEPTEMBER 2015 Submitted by: Cardno Emerging Markets USA, Ltd. Submitted to: USAID/Uganda Contract No.: AID-617-C-13-00005 DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. USAID/Uganda Private Health Support Program Table of Contents ACRONYMS ............................................................................................................................................................... V EXECUTIVE SUMMARY ........................................................................................................................................... 7 PRINCIPAL ACHIEVEMENTS ....................................................................................................................................... 7 TASK 1. EXPANDED AVAILABILITY OF HEALTH SERVICES BY PRIVATE SECTOR PROVIDERS .. 10 TASK 1.1. STRENGTHEN HIGH VOLUME SITES TO OFFER COMPREHENSIVE HEALTH SERVICES ............................ 10 1.1.1. Support integration of services at PFP sites ..................................................................................... 10 1.1.2. Capacity building for comprehensive service delivery through performance based grants ....... 14 1.1.3. Strengthen e-MTCT services at private sector facilities .................................................................. 14 1.1.4. Strengthening early infant diagnosis (EID) ........................................................................................ 16 1.1.5. Improve patient retention and adherence in care at PFP facilities ................................................ 16 1.1.6. Support routine nutrition counselling and assessment .................................................................... 17 1.1.7. Increase private sector participation in HIV prevention through grants ........................................ 18 TASK 1.2. EXPAND PRIVATE SECTOR CLINICAL CAPACITY ..................................................................................... 19 1.2.1. Promote team-based on site trainings, coaching and mentorship ................................................. 19 1.2.2. Integration of clinical and business skills ........................................................................................... 20 1.2.3. Online support ....................................................................................................................................... 20 TASK 1.3. ESTABLISH LINKAGES AND FUNCTIONAL REFERRAL SYSTEMS FOR SERVICES...................................... 21 1.3.1. Establish linkages for referrals from low volume to high volume sites .......................................... 21 1.3.2. Establish linkages for referrals from high volume sites to high capacity laboratories and diagnostic centers ............................................................................................................................................ 21 1.3.3. Assessment of laboratory services ..................................................................................................... 21 1.3.4. Partner with National Public Health Laboratory (NPHL) for laboratory capacity building........... 22 1.3.5. Establish systems for test samples transportation ........................................................................... 22 1.3.6. Commodity supply and web-based reporting.................................................................................... 22 TASK 1.4. EXPANSION OF FINANCIAL OUTREACH THROUGH DCA BANKS ............................................................. 23 1.4.1. Expanding financial outreach through Centenary Bank .................................................................. 23 1.4.2. Expanding financial outreach through Ecobank ............................................................................... 26 1.4.3. Expansion of financial outreach through non DCA banks ............................................................... 29 1.4.4. Technical Assistance to DCA, non DCA banks and borrowers ...................................................... 29 1.4.5. Business strengthening support (Provide financial and business training and technical assistance to a network of health clinics) ..................................................................................................... 30 1.4.6. HaaB business counselling outputs ................................................................................................... 32 Challenges in implementation of the HaaB activity ..................................................................................... 33 Lessons learnt under the HaaB activity ........................................................................................................ 33 1.5. SUPPORT INNOVATIVE APPROACHES FOR ORPHANS AND VULNERABLE CHILDREN ....................................... 33 1.5.1. Performance based grants to CSOs .................................................................................................. 35 1.5.2. Capacity building for grantees ............................................................................................................. 35 TASK 1.6. IMPROVE PRIVATE SECTOR PARTICIPATION IN DISTRICT SERVICE DELIVERY COORDINATION .............. 36 1.6.1. Strengthen district PPPH coordination ............................................................................................... 36 1.6.2. Greater participation of private sector in district planning ............................................................... 37 1.6.3. PPPH desk offices functioning ............................................................................................................ 37 Challenges: ....................................................................................................................................................... 37 Recommendations: .......................................................................................................................................... 38 TASK 2. INCREASING AFFORDABILITY OF PRIVATE HEALTH SERVICES AND PRODUCTS .......... 39 2.1. REDUCING THE PRICES OF HEALTH PRODUCTS AND SERVICES ...................................................................... 39 2.1.1. Recommending prices for essential medicines ................................................................................ 39 2.1.2. Developing and disseminating professional fee guidelines ............................................................ 39 2.1.3. Supporting pooled procurement for private health providers .......................................................... 40 2.1.4. Disseminate national treatment protocols ......................................................................................... 40 2.2. REDUCING FINANCIAL BARRIERS TO ACCESSING HEALTH SERVICES .............................................................. 40 2.2.1. Promote health insurance and link it to micro and community health insurance ......................... 40 2.2.2. Promote health savings schemes ....................................................................................................... 41 2.2.3. Increase access to and expand scope of existing franchises and voucher programs ................ 41 2.3. PROMOTING PREVENTATIVE CARE AMONGST PROVIDERS AND CLIENTS ........................................................ 41 2.3.1. Incentivize private providers to provide more preventative care .................................................... 41 2.3.2. Promote early health seeking behaviors among consumers .......................................................... 41 Challenges: ....................................................................................................................................................... 41 Recommendations: .......................................................................................................................................... 41 TASK 3. IMPROVED QUALITY OF PRIVATE HEALTH SECTOR FACILITIES AND SERVICES ............ 42 3.1. DEVELOP A SELF-ASSESSMENT VOLUNTARY QUALITY IMPROVEMENT SYSTEM (VQIS) TO ENABLE PHP PROVIDERS TO DELIVER QUALITY SERVICES ........................................................................................................... 42 3.1.1. Benchmark the tool against international practice ........................................................................... 42 3.1.2. Pilot standards in districts outside of Kampala district..................................................................... 42 3.1.3. Develop VQIS and roll-out plan........................................................................................................... 42 3.1.4. Digitize and produce final standards and assessment tools ........................................................... 43 3.1.5. Launch the VQIS at a high-level workshop ......................................................................................