It has been almost ten months since 150 guests from over 40 health-focused organizations travelled from ten different countries to learn about both the final Caring Together project results and other initiatives impacting healthcare in Uganda at the International Summit on Leadership in Healthcare in Kampala.
The Caring Together project and the Baylor-Uganda Leadership Academy received resounding endorsements from many different stakeholders, including the Prime Minister, Dr. Ruhakana Rugunda, the Ministry of Health, and Centers for Disease Control (CDC).
The Baylor-Uganda team have worked hard to ensure that the legacy of Caring Together continues and that the Leadership Academy becomes reality.
Caring Together is Helping Baylor-Uganda Reach 90:90:90
There has been nationwide progress in Uganda towards meeting the UNAID’s 90:90:90 targets – a vision that by 2020, 90% of people who are HIV infected will be diagnosed, 90% of people who are diagnosed will be on antiretroviral treatment and 90% of those who receive antiretrovirals will be virally suppressed.
While there have been increased efforts to scale up treatment initiatives in Uganda there are still many people living with HIV who are unaware of their status and do not have access to medicines. As of September 2018, Uganda stands at 81:89:78.*
The Ministry of Health, with support from PEPFAR, introduced a SURGE strategy to all implementing partners to encourage progress. Health facilities are now required to find a specific number of new HIV+ cases per week, this ranges from as low as 5 to as high as 30 cases per week depending on the size of the health facility. SURGE requires weekly reporting and using facility level data. Each facility needs to be aware of their goals and able to visualize their progress towards them.
During the Caring Together project, Janssen worked with healthcare practitioners to create tools to like the TPMT (Team Performance Monitoring Tool) to help monitor team performance and increase staff motivation to reach targets.
Adapted by Baylor-Uganda to monitor weekly (rather than monthly) performance, the TPMT is now being used by facilities across the Rwenzori region to track reporting on SURGE performance. Key indicators tracked on the TPMT are number of clients tested, number of positives identified, and percentage of those positive linked into care, which is expected to be 100%. It has empowered facilities to use data, to visualize their results, and to plan well.
During support supervision visits, healthcare practitioners have been reoriented on how to use both monthly staff meeting books and the TPMT, and in facilities which are not regularly using these tools, Baylor staff have noticed that staff are unaware of targets.
The Baylor-Uganda Leadership Academy
Ministry of Health
The Baylor-Uganda Leadership and Governance Team have been working with the Ministry of Health to realize the dream of the Leadership Academy.
In particular, the Commissioner for Human Resources has shown interest in the concept and has recommended a number of future paths for the Academy. During a follow-up meeting, it was agreed that the best path would be to partner with the Health ManPower Development Center (HMDC) that has been restructured to be under Ministry of Health. This would be a sustainable way to extend leadership training to health workers. A revised concept note will be discussed in 2019.
Health Development Partners
Baylor-Uganda were invited to present at the Health Development Partners (HDP) meeting. Dr. Adeodata Kekitiinwa (Executive Director of Baylor-Uganda) presented on the Leadership and Governance agenda at Baylor and was thanked by leading stakeholders at the meeting including WHO, PEPFAR, UNICEF, UNAIDS, World Bank, DFID and CDC for Caring Together’s contribution to health systems strengthening in the country. The meeting was a platform to disseminate learnings from the Summit to those partners who could not attend. The Baylor-Uganda team are in discussions with partners present at the meeting about future collaboration.
11th Joint Annual AIDS Review Conference
Baylor-Uganda were invited to present at the 11th Joint Annual AIDS Review Conference in Kampala on “Innovative Leadership in Community Based HIV programming.” Michael Musiime Koima presented on the Caring Together approaches being used successfully to help Baylor-Uganda reach SURGE targets at facility level.
“Magic in Patient Flow”
The Caring Together patient waiting cards were recognized as an important tool for ensuring efficiency at health facility level by the Programmes Outcomes and Evaluations Coordinator at Baylor-Uganda in early December. Dubbed as “creating magic in patient flow” at Rukunyu Health Centre IV, the patient waiting cards were used as an example of a simple tool creating huge impact in HIV care and treatment at facility level.
Research Published in the Journal of Healthcare Leadership
Research conducted by Musinguzi Conrad, funded by Janssen, has been published in the Journal of Healthcare Leadership.
This cross-sectional study was conducted in three different geographical regions in Uganda - Eastern and Rwenzori regions (where the Caring Together leadership project was implemented), and West Nile region (where the project was not implemented). The study found that transformational leadership styles had a positive impact on stimulating motivation, assuring job satisfaction, and consolidating teamwork among health workers compared with those who demonstrated transactional skills or laissez-faire styles.
As the graph below demonstrates, the paper has proved to be very popular with nearly 2,000 views thus far!