Now that initial COVID-19 restrictions have lifted, we are restarting some high priority activities that we believe we can do safely, in a modified way. This enabled us to launch our first official technical assistance partnership in Uganda in July in collaboration with the Ministry of Health (MOH), Oyam district’s local government and the Malaria Consortium. Through this unique public-private collaboration, Living Goods will train and empower least 1,000 CHWs and 32 supervisors with digital mHealth technology. We are starting with an initial cohort of 200 CHWs, so that we can assess how best to onboard new CHWs in the current environment. The partnership will help standardize the quality of care for patients in the district and provide government and supervisors with critical real-time community-level data to enable quick decision–making and improve health outcomes in Oyam district.
In this co-financed program—initially lasting one year—the MOH will provide an oversight role and offer technical guidance to the district to utilize its World Bank/GFF-funded Uganda Reproductive Maternal and Child Health Improvements Project (URMCHIP) funding to compensate CHWs with a performance-based monthly incentive, calculated and paid out through a quarterly Results-Based Financing (RBF) allocation—which will only pay for results that can be independently verified via district government structures. Previously just used for facilities, this is the first time that URMCHIP funding is being used for a community-level project. Meanwhile, Malaria Consortium, which has been in Uganda for more than a decade and supports MNCH services in 17 Ugandan districts including Oyam, will guarantee a stable supply chain of essential medicines and lead supervision at the community level.
Living Goods will provide CHWs with smartphones loaded with the Smart Health app and support them to standardize and improve their diagnosis and treatment protocols. We’ll also leverage our experience successfully completing the first–ever pilot of an RBF for community health in Uganda and our ongoing work to re-design this RBF for greater scale in three additional districts to build the capacity of government supervisors to manage and sustain results-based data collection and performance management of CHWs.
The MOH and partners including UNICEF and DFID are interested to see the results of this partnership, as it will inform future programming and funding allocations for RBF programs.
Available data shows that Oyam district has significantly lower immunization coverage (43.2%) in comparison to the national average (86.7%), high rates of maternal mortality, and low rates of ANC visits. Additionally, the district has a considerably high proportion of U5 children with acute respiratory infections.