UGANDA IMPLEMENTATION PLAN – UNCoLSC 2013 ...

RECOMMENDATIONS/OUTCOMES/ACTIVITIES Recommendation 1: Shaping global markets Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities UGANDA IMPLEMENTATION PLAN – UNCoLSC 2013 TIMEFRAME Q1 Q2 Q3 Q4 RESP. PARTY RESOURCE REQUIREMENTS Tools, TA, Collaboration, money (CAF, Government, Partner) etc Source of funds BUDGET EST. Amount (USD) Recommendation 2: Shaping local delivery markets Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Activate the Diarrhea and Pneumonia Coordinating Committee (DPCC) and convene on a regular basis [Amoxicillin, ORS and zinc] Activity 2: Work with local manufacturer to reduce ex-­‐factory price of amoxicillin -­‐reduce the price of Amoxicillin dispersible formulation at the retail level and in the public sector X X X X X X X DPCC, MOH -­‐ CH MoH – CH, Private sector distributors and manufacturMeetings and Workshops Meetings and Workshops/TA 10,000 15,000 31 | P age

Activity 3: Explore registration of appropriate packaging and strengths (with accompanying supplies) for injectable antibiotics for neonatal sepsis Recommendation 3: Innovative financing Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities X X X ers MoH -­‐ CHD, Pharmacy, UNICEF TA/Meetings 45,000 Recommendation 4: Quality strengthening Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Conduct a post-­‐market survey on quality of oxytocin products on the market. Working with the national drug authority for inclusion of Oxytocin on the mobile testing kit. Activity 2: Build capacity for post shipment testing of female condoms at national level. We shall acquire technical experts on ISO certification process, build internal capacity for the NDA staff Recommendation 5: Regulation efficiency Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Support review/update and disseminate of Task shifting guidelines to allow delivery of the life saving commodities (e.g. use of Misoprostol, ACS, MgS04, Injectable X X MoH-­‐RH, Pharm NDA, NMS X X X X MoH-­‐RH, Pharm NDA, NMS X X X MoH – HRH, RH, TA/Meetings & Workshops TA/Meetings & Workshops Meetings/Workshops, TA 60,000 250,000 100,000 32 | P age

Antibiotics for neonatal sepsis management, insertion of implants) by nurses and midwives Activity 2: Support review and update of national clinical guidelines include use of life saving commodities. Recommendation 6: Supply and awareness Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Review the immunization guidelines to incorporate oxytocin into the cold chain Activity 2: review the LMIS and inventory management practices for the lifesaving commodities in the public sector X X X MoH – RH, QA X TA/Meetings and Workshops X X Funds, TA/Contract, HR meetings/workshops, Tools Funds, TA, Meetings 90,000 30,000 200,000 Activity 3: strengthen the supply chain system at NMS and health facility including capacity building at district level Activity 4: Develop last-­‐mile logistics management system employing SMS, mobile app, and web-­‐based interfaces and build capacity of health service managers at all levels of forecasting and quantification of for the 13 life saving commodities X Funds and TA 200,000 X X MoH – RH, NMS, TA/Meetings & Workshops 100,000 Activity 3: Develop, print and disseminate job aides and IEC materials on Emergency contraception on proper use of Emergency Contraceptives and female condoms – both private and Public 33 | P age x x x MoH – RH, HP&E Activity 5: Develop indicators and a scorecard, and use this to X X MoH/ NBSC TA/Meetings & Workshops Funds, TA/Contract, 550,000 UNCLSC/CF 70,000

assess progress towards increased access to access to lifesaving commodities (corticosteroids, oxytocin and misoprostol, and female condoms) as per the national guidelines Activity 5: Support use of mobile phone based applications of the national digital health information management system for tracking the 13 lifesaving commodities and availability and use Activity 6: Conduct an implementation research study on use of CHX for cord care to understand specific needs and attitudes of mothers and other family members in order to develop targeted messaging and ensure that the product specifications are in the most acceptable form Activity 8: Support process of integration of ICCM commodities (Amoxycillin ORS and Zinc) into the national supply chain. Activity 9: Conduct an assessment on affordability and willingness to pay for dispersible amoxicillin among consumers Activity 10: Conduct a landscaping analysis for Oxytocin, antenatal corticosteroids – to identify gaps and barriers to access and use of the commodities in health facilities Activity 11: Conduct a KAP study on Female Condoms and Emergency Contraceptives leading to a targeted social behavioral change communication strategy 34 | P age X X X X X X MoH – CH eHealth Committee HR meetings/workshops, Tools Funds, TA/Contract, HR meetings/workshops, Tools MoH -­‐ CH TA UNCLSC/CF UNICEF X X X Funds, TA/Contract, HR meetings/workshops, Tools X X Funds, TA/Contract, HR meetings/worksX X MOH/CH,RH X X MoH-­‐RH, HP&E hops, Tools Funds, TA/Contract, HR meetings/workshops, Tools Funds, TA/Contract, HR 120,000 75,000 300,000 60,000 55,000 200,000

Recommendation 7: Demand and awareness Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Develop and widely disseminate/implement a Social Behavior Change Communication strategy for priority commodities to enhance consumer and provider demand through high-­‐impact marketing and promotion, including private sector providers. The strategy will leverage existing platforms including the VHTs at community level, building on existing programmes like the Child Health Days. Specific target messaging will aim to remove barriers associated with the different commodities in Uganda’s context including the following; • Reproductive Health o To increase acceptance of female condoms and expel myths and misconceptions about it o to create awareness on Emergency Contraception and expel myths and misconceptions about it o To increase awareness and acceptance of contraceptive implants • Maternal Health o To emphasize importance of accessing magnesium sulphate in health facilities for prevention and treatment of preeclampsia and eclampsia o To emphasize importance of accessing misoprostol in health facilities for prevention X X MOH – CH, RH, HP&E meetings/workshops, Tools Funds, TA/Contract, HR meetings/workshops, Tools and collaboration UNCLSC 550,000 550,000 900,000 35 | P age

and treatment of PPH • Child Health o To accelerate care-­‐seeking for cases of suspected pneumonia o To improve caregivers’ knowledge of and preference for zinc and ORS in case of child diarrhea Activity 2: As a behavior change strategy -­‐ induce behavior change through electronic health supportive interventions using mobile phone technology; Real time guidance thru counseling & reminders to patients (reinforced by images, audio or video clips) and behaviors targeted -­‐ treatment regimens adherence, uptake of the 13 LSC x x x x Recommendation 8: Reaching women and children Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Lobby for the inclusion of antenatal corticosteroids, Female Condoms and Emergency Contraceptives into the existing financial protection mechanisms especially the RH voucher system and monitor its performance. Recommendation 9: Performance and accountability Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Develop, print and disseminate a national female condom implementation strategy to include interventions x x MoH/CH/RH TA/Contract work, meetings/workshops x X X MoH-­‐RH TA/Contract/meetings and DFID, SIDA WB 15,000 150,000 36 | P age

eyond use by sex workers Activity 2: To create a conducive policy & regulatory environment for ORS and Zinc, finalize, endorse and disseminate the Protect-­‐Prevent-­‐Treat (PPT) strategy Activity 3: Review and update Essential Medicine List and clinical treatment guidelines to include dexamethasone indication for fetal lung maturation/management of preterm labor, gentamicin and ceftriaxone for neonatal sepsis management at all health facility levels as appropriate [injectable and antibiotics], ORS and Zinc as the appropriate treatment for the management of diarrhea and define appropriate specifications for newborn resuscitation devices at different levels including packaging. The EML should classify the devices as “Vital" and develop, adapt and disseminate job aids, protocols, checklists, messages and social marketing in line with international guidance and systems. Activity 4: Review Helping Babies Breathe (HBB) Plus protocols to include on management of neonatal sepsis and administration of injectable antibiotics to neonates and provide competency-­based refresher training and follow-­‐up supportive supervision including all cadres in the health system on resuscitation devices, latest updates in neonatal sepsis management using injectable antibiotics and print training materials and job aids Activity 5: Review/develop existing pre-­‐service training programs/packages to integrate use of antenatal corticosteroids for lung maturation in preterm labor, misoprostol, resuscitation devices, female condoms, emergency contraceptives and implants, latest updates in neonatal sepsis management using injectable antibiotics and conduct training for tutors, lecturers for medical, nursing and midwifery nursing schools Activity 6: Training, mentoring and supervision of in-­‐service and private providers to safely use oxytocin for management of PPH, female condoms, insertion and removal of implants, use of 37 | P age X X MoH-­‐CH, DPCC x x x x x x x x MoH-­‐CH, NBSC & UMCG MoH – CH & NBSC x x x x MoH – CH, RH & NBSC, MoE&S workshops Meetings and Workshops Meetings and Workshops Meetings/TA/Workshops TA/Contract/meetings and workshops x x x x MoH – RH Meetings and Workshops 15,000 75,000 40,000 90,000 200,000

magnesium sulphate for prevention and management of eclampsia and use of antenatal corticosteroids for lung maturation in preterm labor at all levels of the health system. The training will be delivered as part of the integrated Life Saving Skills/EmOC/AMSL training package. Develop, print and disseminate protocols and guidelines for prevention and treatment of preeclampsia and eclampsia using Mg sulphate Activity 7: To educate and support/supervise public and private providers about use of co-­‐packaged ORS-­‐Zinc in management of childhood diarrhea (Zinc + ORS) and management of pneumonia and promote Amoxicillin as the 1st line treatment in the management of Pneumonia. This training will be delivered as part of the IMCI health worker computer assisted training (ICATT) and ICCM village health team training packages. Develop & print & distribute job aids for public and private health workers (Charts, Treatment algorithms…) including support/supervision tools Activity 8: Engage professional bodies obstetricians and mid wives) in disseminating and mentoring health workers on the management of preterm labor using corticosteroids. Activity 9: Establish procurement, quantification training and supervision programs for reproductive health commodities especially misoprostol and implants Activity 10: Build capacity of health service managers at all levels of forecasting and quantification of implants Female Condoms and Emergency Contraceptives Activity 11: Support implementation of Task shifting strategy for FP specific commodities (Implants insertion and removal) Activity 12: Design simple patient management and referral X X X x x x x MoH-­‐CH, DPCC & ICCM TWG MoH, UPMW, UPA & AOUGU MoH, UMCD Meetings and Workshops Funds, meetings/workshops Meetings and Workshops/Contract and TA X X X X MoH -­‐ RH Meetings and Workshops/Contract and TA x x x x MoH-­‐RH Meetings and Workshops/Contract and TA UNCLSC/CAF 260,000 $ 42,000 35,000 150,000 37,800 38 | P age

algorithms on LSC– designed to be motivating and attention getting and thereby more likely to influence providers behavior e.g. ACS, MgSo4, community management of pneumonia and diarrhea by adapting open access software e.g. m-­‐Allinace/coomcare. Recommendation 10: Performance and accountability Expected outcomes Outcome 1: Outcome 2: Outcome 3: Activities Activity 1: Production of IMCI computer assisted training and adaptation Tool (ICATT) materials; create & print & distribute IMCI, ICCM job aids for public health workers (Chart booklets, wall charts, desk treatment algorithms…) Activity 2: Establish tracking mechanism to measure use as a percentage of preterm births who receive antenatal corticosteroids to facilitate progressive adoption of this best practice including the mobile phone tracking system (m-­‐trac) and digital HMIS in the ministry of health. Activity 3: Explore feasibility of and introduce heat stable/nasal or sublingual formulations and co-­‐packaging of Oxytocin in local setting including implications for scale up Activity 4: Explore feasibility of and introduce use of fixed dose regimens, auto disable syringes, micro needle patch for Gentamycin for managing neonatal sepsis Activity 5:Conduct research on simplified dosage regimens, packaging and administration of MgSo4 X X MoH-­‐CH Funds, Travel, Tools, meetings/workshops x x x MoH-­‐NBSC, RH X X MOH-­‐RH/NDA X X MOH/CH/NDA X X MOH-­‐RH/NDA Funds, Travel, Tools, meetings/workshops/ Contract Funds, Travel, Tools, meetings/workshops, Contact Funds, TA/contract, meetings/workshops Funds, Travel, Tools, meetings/worksUNCLSC/CAF 35,000 45,000 19,000 14,000 10,000 39 | P age

hops, Contact Activity 6: Test the feasibility and acceptability of bio-­‐gradable X X MOH-­‐ Funds, Travel, 18,000 and simplified insertion/removal of implants RH/NDA Tools, meetings/workshops, Contact Cross-­‐cutting costs: Management and Operations Establishment and maintenance of a coordination desk X X X NA 70,000 Coordination and management of a national steering committee X X X NA 45,000 chaired by the Permanent Secretary Coordination and management of Technical Working Groups X X X NA 30,000 Procurement of motor vehicles (3) X NA 160,000 Total 5,935,800 Note: Cost estimates are based on i) past expenditure experiences, anticipated workload and where applicable prevailing consultancy rates. 40 | P age

CONSULTATIVE MEENT ON DEVELOPMENT OF THE UNCoLSC IMPLEMENTATION PLAN FOR UGANDA NAME DESIGNATION ORGANISATION EMAIL 1 Mwigo John D Pharmacist PSU mwigojb@yahoo.com 2 Dr. Simon Lugolobi Coordinator RHU Simonp22002@yahoo.com 3 Dr. Mugasa Anthony RH Advisor MoH Tmugasa2008@gmail.com 4 Mutabazi Miriam Technical Director MSH/STRIDES mmutabazi@msh.org 5 Anny Rwakihembo Ext Relations Manager Marie Stopes Anny.rwakihembo@mariestopes.or.ug 6 Dr. Margaret Nakaketo Neonatologist Kla Children’s Hosp mnakeeto@yahoo.co.uk 7 Patrick Aliganyira Technical specialist, SNL/SCF Save the Children Patrick.aliganyira@savethechildren.org 8 Dr. Peter Mukasa TA -­‐ Fistula UNFPA/MoH mukasapk@yahoo.com 9 Dr. H. N. Sengendo Chief of party SNL Save the Children Hariton.Sengendo@savethechildren.org 10 Muhumza Christine FHRDC Coordinator Makerere Univ cmuhumuza@musph.or.ug 11 Robina Biteyi White Ribbon Alliance Nat Coordinator Biteyi.robina@gmail.com 12 Dr. O. Sentumbwe-­‐ FH & Pop Advisor WHO sentumbweo@who.int 13 Carol Nalugya Secretary MoH (RH) MoH cnmbalire@yahoo.co.uk 14 Kenneth Mugumya Coordinator-­‐UFPC UFPC kennethmugumya@gmail.com 15 Tumuhairwa Juliet MoH MoH Tumuhairwejuliet@gmail.com 16 Kann Kallander Program Coordinator Malaria Consort k.kallander@malaria.consortium.org 17 G. Nakanwagi Sekabira Pharmacist Malaria Cconsortium g.nakanwagi@malaria.consortium.org 19 Rachel Apio Supply Chain Manager UHMG rapio@uhmg.org 20 Jesca Nsungwa Sabiiti Assistant Commissioner MoH/CH Jsabiiti@inforcom.co.ug 21 Doreen Tukamushaba Research Assistant MoH dotukamu@yahoo.com 22 Kenneth Mugumya Advocacy & Networking HEPS Uganda kmwehonge@heps 23 Denis Kinira Coordinator META dkibira@gmail.com 24 Damien Kirchhoffer Essential Child Med CHAI dkirchhoffer@clintonhealthaccess.org 25 Jettgrus2 CD CHAI tyrsz@healthaccess.org 41 | P age

26 Tesfaye Tesserea H & …. specialist Unicef ttesseye@unicer.org 27 Olivia Kiconco APO-­‐RH MoH -­‐RH clareolivia@yaho.co.uk 28 Seru-­‐Moris Pharmacist MoH-­‐Pharmacy serumorries@gmail.com 29 Roselline Achoro NPO-­‐RH UNFPA achola@unfpa.org 30 Lucy A. Asaba Program Medical Associate Engender Health LAsaba@engendehealth 31 Zainab Akol PMO MoH zainabakol@gmail.com 32 Mateeba Tim Nutritionist MoH-­‐RH tmateeba@yahoo.com 33 L. Mulwani Mukombe Program Officer Advocacy Women Living w HIV lydiamukombe@gmail.com 34 Oteba O.M ACHS(Pharm MoH Orukan33@gmail.com 35 Maisa A STA-­‐Sosi MSH amija@msh.0rg 36 Demeter Namuyobo M/C RHU dnamuyobo@rhu.org 37 Naluyiga Hasifa AC RHU hnaluyiga@rhu.or.ug 38 John Cooper Director Marie Stopes Jon.cooper@maristopes.or.ug 39 Moses Muwonge Consultant PPD ARO drmuwonge@gmail.com 40 John Ampeire NPO POPSEC John.ampeire@popsec.org 41 Philip Apio Director PF(CD) UHMG paira@uhmg.org 42 Albert Kalangwa RHCs Coordinator MoH/UNFPA albertkalangwa@gmail.com 43 Yvonne Mugerwa RH Coordinator MoH/UNFPA Yvonne@unfpa.org 44 P. Mukasa Kivunike Tech Spec Fistula MoH/UNFPA kivunike@unfpa.org 45 Maria Najjemba Country Mid Wifery Advisor MOH/UNFPA najjemba@unfgpa.org 46 Balaba Dorothy PACE Uganda PACE Uganda 47 Neelam Terdwar MNH UNICEF 49 Tesfaye MNH UNICEF 50 Collins Tusingwire Ag. Assistant Commissioner MoH/RH 42 | P age

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