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Quarterly Progress Report – FY2012 Quarter 3 (April – June 2012) Submitted by: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU-CCP) & Uganda Health Marketing Group (UHMG) USAID Cooperative Agreement 617-A-00-05-00011-00 TABLE OF CONTENTS INTRODUCTION ....................................................................................................................................................1 1. PRODUCT FACILITY STRATEGIC BUSINESS UNIT ..................................................................................5 2. PROGRAMS CONSULTANCY STRATEGIC BUSINESS UNIT ................................................................ 16 OVERVIEW .................................................................................................................................................................... 16 2.1 MALARIA ............................................................................................................................................................ 16 2.2 MATERNAL, NEWBORN AND CHILD HEALTH (MNCH) ...................................................................... 20 2.3 FAMILY PLANNING ......................................................................................................................................... 25 2.4 HIV/AIDS ........................................................................................................................................................... 29 2.5 SYSTEMS STRENGTHENING, MONITORING & EVALUATION ........................................................... 36 3. CROSS CUTTING ACTIVITIES AND SERVICES ...................................................................................... 39 3.1 3.2 3.3 3.4 3.5 END MARKETING & STRATEGIC INFORMATION (MSI) – BRAND ACTIVITIES .................................... 39 MARKETING & STRATEGIC INFORMATION (MSI) - COMMUNICATION........................................ 49 MSI - Research ................................................................................................................................................. 50 MSI Cross-Cutting Functions - Corporate & External Relations ..................................................... 52 HUMAN RESOURCES & ADMINISTRATION (HRA) ............................................................................... 55 OF REPORT ................................................................................................................................................... 61 i ACRONYMS AIDS CBV CSW DADI DBTA DHO FP GLC HCT HIV HRA KPI MARPS MFP MiP MNCH MMC MSI NMCP PCSBU PEPFAR PFSBU PHA PMI PMTCT RDTm UHMG USAID Acquired Immunodeficiency Virus Community Based Volunteer Commercial Sex Worker District Assistant Drug Inspector District Based Technical Assistance District Health Officer Family Planning Good Life Clinic HIV Counselling & Testing Human Immunodeficiency Virus Human Resource Administration Kampala Pharmaceutical Industries Most At Risk Populations Malaria Focal Person Malaria in Pregnancy Maternal, Newborn and Child Health Medical Male Circumcision Marketing & Strategic Information National Malaria Control Program Programs Consultancy Strategic Business Unit Presidents Emergency Plan for AIDS Relief Products Facility Strategic Business Unit People Living with HIV/AIDS President’s Malaria Initiative Prevention of Mother to Child Transmission Rapid Diagnostic tests for Malaria Uganda Health Marketing Group United States Agency for International Development ii INTRODUCTION This report covers activities undertaken from April to June, 2012, or the third quarter of fiscal year 2012 (FY12) of the AFFORD Health Marketing Initiative in Uganda, funded by the United States Agency for International Development (USAID) Cooperative Agreement 617-A-00-05-00011-00. The award was made on September 21, 2005 to The Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). The AFFORD Health Marketing Initiative that ended its 5 year USAID funded project in September 2010 (AFFORD I) received a 3 year extension until September 2013 (AFFORD II) with the primary responsibility of strengthening UHMG into a sustainable entity. During the project extension period AFFORD II has the primary responsibility to ensure that UHMG is strengthened to become sustainable and develops cutting edge competencies in technical, marketing, financial and institutional areas. AFFORD II through UHMG will continue to consolidate its activities and will focus on the 3 key result areas. Specifically, AFFORD II will build on the foundation of AFFORD I to achieve: 1) Increased organizational sustainability of UHMG; 2) Increased availability, affordability of health services and products; and 3) Enhanced knowledge for self-efficacy and correct use of health services and healthy practices. This report focuses on the performance of the two strategic business units (SBUs) of UHMG—the Product Facility and the Programs Consultancy as well as the cross cutting activities including social marketing, communication, research, human resources and administration, and finance and investment that support the functioning of the two strategic business units. In addition, AFFORD II Capacity Building achievements are summarized below. Result 1. UHMG Capacity Building AFFORD II Capacity Building is designed to help UHMG to achieve increased financial, institutional and market sustainability. Capacity Building focuses on five organizational and management domains: 1. Strengthening Performance Management and Quality Management systems 2. Improving data utilization processes 3. Developing innovative program, product and service strategies 4. Building business development systems 5. Strengthening financial systems Highlights of Capacity Building achievements are summarized below. CAPACITY BUILDING EVIDENCE OF ACHIEVEMENT OBJECTIVE 1. PERFORMANCE MANAGEMENT & QUALITY MANAGEMENT Establish performance management system for enhanced monitoring and supervision by UHMG and BOD Senior Management & supervisors produce clear performance indicators quarterly FY 2012 (Year 2) Achievements MD, Dir Finance and Sr. Mgrs track contract performance monthly Performance monitoring tool developed to serve as Performance-based Contract Scope of Work; tool has been applied by all UHMG Divisions in Qtr 1 - Qtr 3 Summary review and documentation of all technical indicators conducted quarterly and reported to Sponsors and BOD 1 KRA and KPI quarterly and annual review conducted and system documented Managers hold staff accountable for performance to KRAs and KPIs HR Audit being conducted by AFFORD KPMG to re-calibrate staff KPIs and strengthen staff performance appraisal practices Promotion, salary increases or recognition linked to achievement of KRAs and KPIs (occurs case by case) BOD, MD and staff committed to improved stock management practices in PF, assisted by AFFORD/KPMG Stock-counts conducted routinely; variances reduced Debt recovery improved for enhanced cash flow New products assessed for profitability, and adopted accordingly Profitability analyses conducted quarterly; Business Plan progress tracked quarterly by BOD All key strategies developed by Senior Management and operational staff through a consultative process, and vetted by the MD and the BOD; AFFORD KPMG reviews and assists as needed All strategies and their implementation assessed by management and operational staff for effectiveness and cost-efficiency Deliverables produced and quarterly targets achieved, and assessed by BOD and sponsors against UHMG Business Plan and sponsor-supported Annual Workplan BOD, MD and Senior Managers take corrective action within next quarter in the event targets are not being met The product facility operates as a profit center & The programs unit operates as a cost-recoverable consultancy business PF Profitability analysis conducted quarterly; profitability improved over FY2011 (see Financial Systems below). Program Consultancy expands technical strategies and actively seeks new funding for programs (see Business Development below) Hire internal auditor Internal auditor hired; external A-133-Type audits conducted annually Recommendations of internal and external audits systematically pursued with BOD and MD support and AFFORD/KPMG assistance, specifically in the areas of stock management; human resources; financial management; procurement; and IT practices Sr. Mgmt consistently enforce compliance requirements; Sr. Mgmt identifies and takes remedial actions on audit findings within next quarter Staff oriented and coached on compliance principles and practices, with AFFORD/KPMG assistance Staff monitored for compliance every quarter Internal auditor with Dir. Finance and HR conduct quarterly compliance audit review; AFFORD/KPMG conduct quarterly progress reviews Adapt MOH guidelines and protocols for service quality assessment Staff applying MOH quality assessment protocols in the field (e.g., with Good Life Clinics) The PF has been accepted into the process of ISO Certification, and the ISO process has begun Marketing and Strategic Information (MSI) meets with Product facility (PF) to facilitate distribution MSI meets with Programs Division on budgeting to facilitate local implementation MSI meets regularly with finance to facilitate procurement Effective, documented quarterly and annual review process is linked to staff motivation, performance and advancement MD, Directors & Operational managers adopt a ‘private sector’ management practice UHMG operates as a commercial sector company that makes strategic decisions based on profitability as well as risk-reduction and stewardship of capital assets, including product stocks All strategies generated by managers are vetted through organizational approval processes Quarterly Performance Reports (programmatic and financial) submitted to BOD and Sponsors A Quality Management system for enhanced organizational responsiveness conceptualized, implemented and sustained by UHMG staff and Board High level of compliance with internal systems and external regulations according to compliance and audit reports Orient staff on use of mandated protocols and standards; Orient & coach staff on compliance Products certified by international body (ISO) Quality Management: Improved internal communication and coordination Improve internal processes that inhibit or facilitate objective performance 2 Senior Level Management (SLM) has regular and open communication with Managing Director (MD) for improved vertical organizational communication The Board of Directors is advancing its vision of UHMG sustainability through unified, rather than project-driven approaches to management, including unified technical strategies, a unified Management Structure (merger of special projects with Programs), and application of unified financial and administrative systems across projects. 2. DATA UTILIZATION Create a comprehensive monitoring and evaluation systems to form and assess organizational strategies Both strategic business units utilize research data and monitoring tools quarterly to design and evaluate all major product, service and program initiatives Sr. Mgmt use monitoring and evaluation data in all quarterly reviews Tracking tools used by all managers to monitor activities and progress, specifically: product distribution, sales, availability, program implementation, media campaign monitoring, community activities and activities at GLCs Work-plan Implemented Managers utilize tracking tools to monitor activities on a quarterly basis, specifically: the PilplanPlus sales study; initiation of a Retail audit; initiation of Synovate Media Reach reporting; a study of birthing and delivery practices for Saving Mothers Giving Life project; formative research for the Smart Choices Family Planning campaign; preparation for the joint Communication Survey conducted in collaboration with JHU/HCP and other USAID Implementing Partners (IPs). These studies are discussed in more detail in the Research section of the present report Technical staff develop program plans and submit to Research Advisor for feedback Technical staff use program data and research findings to inform programmatic decisions. 3. INNOVATIVE STRATEGIES Ensure mutually beneficial and effective linkages and synergy occurs between UHMG’s business units All Program Division activities link to relevant health products through joint implementation plans and reports Product & program linkages inform strategic decisions and outputs Ensure that all UHMG programs are considered strategic and high quality by donors, clients and staff All strategies based on recent data and information obtained from clients and their communities Refined HIV/AIDS programs in place and judged cutting edge by stakeholders: e.g. HIV Strategies for PMTCT, MARPS and Sexual Network campaign scale-up. Retargeted RH/FP programs operational linking to products and services, e.g., DFID “Smart Choices” Family Planning strategy Retargeted malaria programs operational linking to products and services, e.g., roll-out of “Power of Day One” Malaria test-and-treat campaign Retargeted MCH programs operational linking to products and services and integrating HIV services, products and practices, e.g., Saving Mothers Giving Life (SMGL); Integrated MNCH/FP ‘1000 Days’ Approach Brand Officers and communication officers create strategies with limited external support, e.g., MNCH/FP ‘1000 Days’ Approach Marketing and Brand Mgrs can routinely identify linkages between products and programs; evidenced in joint MSI-PF meetings and in quarterly reports MSI & PF routinely use and update database of suppliers and customers Marketing events taking place per Work-plan Sales increase slower than anticipated due to debt collection and implementation of a ‘closed’ distribution system Increased involvement of clients and communities in UHMG programs Ensure that UHMG marketing strategies are evidence-based and achieve stated targets Establish routine communication with customers and suppliers (relationship marketing) and strengthen related management systems Marketing strategies developed, documented and implemented Increased market demand for services and products and targets achieved Operational database of key customers, used by product and program managers Brand managers develop functional communication strategy with customers 3 Ensure that all Product Facility operations are considered sustainable and dependable by donors, clients and UHMG staff 3-month stock supplies on hand and stock expiry at 0%. Improve systems to track the flow of in bound and out bound stocks A tracking system in place and used to manage logistics supply chain Spot check reports on compliance of procedures and systems; quarterly stock procurement plans in place No stock-outs or shortages in RTP or UHMG products SOPs followed by Product Facility staff to manage stocks and to develop procurement plan Sr. Product Facility mgrs and Finance Team review supply chain system quarterly Negative findings addressed w/in the quarter UHMG has NICRA, resource mobilization strategy, investment plan, resource mobilization team and product list in place (Indirect Costs have been analysed in preparation for UHMG NICRA application, with AFFORD/KPMG assistance) UHMG awarded at least 3 non-AFFORD contracts totalling minimum $2m/year (bids submitted) Working with the BOD on the UHMG Business Plan (Business Plan orientations conducted for BOD and UHMG staff; implementation of Business Plan through BOD Committee Meetings) Strengthening Stock Mgt through KPMG assistance Conducted HR Audits of PF through KPMG assistance Strengthening Procurement and IT Policies and Procedures ISO Process initiated Use of Return To Project (RTP) funds to offset mortgage proposal developed and approved by USAID. 4. BUSINESS DEVELOPMENT Increase and diversify sources of revenue for both business units Substantially increase number of sources and amount of resources generated by both the program and product facility business units. UHMG business practices improved, through BOD support and the assistance of AFFORD (KPMG & Friends Consult) 5. FINANCIAL MANAGEMENT Effectively manage and report on staff time and finances across diversified funding sources Finance unit delivers financial reports by due date for all programs Burn rate across all grants increased to 80% of targets Finance & HR teams develop staff LOE certification procedures Financial control procedures monitored, and compliance enforced Improved debtor’s ratio Improved stock management with no or minimal variances Aging debt reduced between January and May by 44%, with AFFORD/KPMG assistance Improved working capital management position Variances between records and stock on hand reduced significantly for RTP and UHMG products by end-June 25% of PF operating costs covered by revenues generated through PF net margins (excluding Marketing Costs) Finance Team produces documented response to each financial audit finding and recommendation; actions taken in FY12 on all audit items Timely financial reports for all sources of funding Improved (accelerated) burn rate Rare non-compliance with donor financial requirements Improve working capital management by the Product Facility Strengthen financial accountability and compliance External audits verify that UHMG is following international financial 4 1. PRODUCT FACILITY STRATEGIC BUSINESS UNIT Quarter 3 of FY-12 ended with many activities undertaken, all contributing to the improved operations of the Product Facility (PF). Capacity-building assistance was offered by AFFORD for improved stock management practices, a human resources audit, and a comprehensive approach to improved debt collection. UHMG had to withhold products from some major debtors until back-debts were recovered, resulting in a temporary decline in sales achievements for this quarter. A Market Retail Audit survey was also conducted with findings revealing significant distribution reach for UHMG brands in major territories, with gap analyses conducted for the current distribution system. Sales report Table of overall sales achievement of the quarter Product Category USAID Brands UHMG Brands Commercial Brands Total (Ug. Shs) Quarter 1 358,497,920 875,792,833 284,267,614 1,518,558,367 Quarter 2 398,323,300 621,564,428 397,337,730 1,417,225,458 Quarter 3 317,474,200 258,636,350 229,479,225 805,589,775 Targets 523,332,729 757,425,870 1,051,200,000 2,331,958,599 -205,858,529 -498,789,520 -821,720,775 -1,526,368,824 61% 34% 22% 35% Q3 Variance % Achievement Quarter 3 overall performances in contrast with quarter 2 reflect a general 44% decline. The general decline in the quarter resulted from the need to recover outstanding customer balances and reduce the PF debt burden. Performance trends for USAID brands USAID Brands 600,000,000 400,000,000 USAID Brands 200,000,000 0 Quarter 1 Quarter 2 Quarter 3 Targets Quarter 3 reflects a decline due to reduced sales activity. A number of wholesaler customers who had outstanding balances could not be served due to our preemptive credit control exercises. 5 Individual Product performance USAID brands Q Target (Units) Protector Qtr2 % Achieved (+/-) Qtr 3 % Achieved Var (+/-) 4000000 3,385,844.00 84.6 -614,156.00 5,051,000.00 126% 1,051,000 Injectaplan 700000 476,750.00 68.1 -223,250.00 256,950.00 37% 443,050 PilplanPlus 400000 403,661.00 101 3,661.00 303,160.00 76% 96,840 Protector: The sales scored at 126% of the target. The demand was high at the distributor’s points namely Zee pharmacy, Super medic and Blue star pharmacy. Injectaplan: The sales scored at 37%. This sales trend is declining. The major buyers were distributors, mainly Zee, Super medic and Blue star pharmacy in Northern Uganda. PilplanPlus: The sales of Pilplan scored at 76%. This is a 25% decline compared to the previous quarter. Major buyers were distributors namely Zee, Super medic and Blue star pharmacy. It is anticipated that much of the stock was in the trade. Quarter 3 sales performance reflects a declining trend in UHMG brands as shown below. UHMG Brands 1,000,000,000 800,000,000 600,000,000 UHMG Brands 400,000,000 200,000,000 0 Quarter 1 UHMG Brands Zinkid RestORS Aquasafe Condom “O” NewFem SoftSure Quarter 2 Quarterly Target 2500000 500000 1350000 375000 13333 18000 Quarter 3 Total 1529840 121950 367200 78048 1780 1800 Targets % Achieved 61% 24% 27% 21% 13% 10% Var (+/-) -970160 -378050 -982800 -296952 -11553 -16200 6 Moon Beads Cotramox 900 1975000 23 28920 3% 1% -877 -1946080 Individual product performances for UHMG products: Zinkid: The quarterly sales for Zinkid were 61% of the set target. The key customers for Zinkid are usually institutions. The main customers were Astra Pharma who bought 725,760 tablets; this went to an NGO. Other major buyers were JMS, Super medic, and Zee pharmaceuticals. RestORS: Restores scored a 24% achievement. This low achievement was attributed to unfavorable prices competition. The recent sales promotion carried out by the MSI team showed that retailers were willing to stock but were unable to find it stocked at the wholesalers. Aquasafe: Sales registered at 27% of the quarterly target. This too is largely an institutional product. Main customers were Humanitarian care Uganda and Blue star Pharma in Lira. Condom O: The quarter sales recoded were at 21% of the quarterly target. There was a stock out period for more than a month in the quarter. The fresh stock received awaits NDA post shipment testing to make it available for quarter 4 sales activity. NewFem: This Product scored 13% of the target due to inadequate demand creation. This was a drop from last quarter’s performance of 88%. A number of wholesalers know that NewFem is Microgynon and prefer to buy the cheaper brand Pilplan plus. SoftSure: This product registered 10% achievement against the quarterly target. The low sales are attributed to lack of awareness among potential users. Main customers were pharmacies who bought few dispensers. Smart choice campaign and the drive to push the sales into the retail outlets by use of small scale delivery means will improve uptake of these special brands in the market. Moon Beads: This product has scored at 3% against the set target. This was because there was a stock out and new stocks are still waiting branding. The stock is available for sales from second week of July. Cotramox: Sales scored 1% of the target. This is also largely an institutional product and few packets were bought during the quarter mainly through pharmacies. Bulk orders from key institutions are expected in the next quarter given the trends of buyer behavior registered. Unfavorable tablet cost comparison with pack of 1000 renders Cotramox low opportunity for purchase by the institutions. NDA has however, outlawed the 1000 packs for the private market and we are not able to proceed with product development plan to launch Cotramox 1000 tablets in jars. 7 Commercial Brands 1,200,000,000 1,000,000,000 800,000,000 600,000,000 400,000,000 200,000,000 0 Commercial Brands Quarter Quarter Quarter Targets 1 2 3 Commercial Sales Month Target (Ug. Shs) Apr May Jun 350,400,000 350,400,000 350,400,000 1,051,200,000 Actual 65,565,865 98,402,870 65,510,490 229,479,225 % 19% 28% 19% Availability of viable commercial products is a key success factor in sales. A 38% achievement in sales is low and the main reason for this low sale is limited commercially viable products. Many times suppliers of these brands are unable to maintain consistent supply and offer UHMG favorable prices. These include Bendex, Examination gloves, and IV fluids, Anti Malarial to mention but few. Delays in overseas shipments can also lead to delayed sales. An example was the Mosquito Net Consignment that was expected by end of December last year but only arrived in March 2012. A lot of sales especially in the back-to-school period were missed out. Sizeable orders from reputable NGOS’s like World Vision were cancelled due to insufficient or unavailable stocks. Debt collections With stepped up activity of debt collections, much effort was give to the exercise and the followings are the results of collections of both old and current sales debts RTP Collections – 251,423,700/ PF Collections – 885,786,674/ PD. Cheques – 58, 560,550/UHMG implemented a credit control committee to oversee and manage credit controls systems. UHMG established a ceiling above which no credit sales can pass in favour of a customer with pending debts. UHMG also commissioned an independent debt collector who started fieldwork in June and the scope of work includes forensic audit of the accounts record. ACTIVITY PERFORMANCE MONITORING TABLE Activity 1: PF strategies and business development 8 Activity Description Targets/Outputs New products launched: Restors+Zinkid combination kit, Sprinkles, Nutributter New products launched Increase in the profitability of the product facility Operational database of potential suppliers indicating status of negotiations Increased profitability of the product facility Prospect suppliers negotiations documented and tracked in operational database Increase in the product range of commercial brands with detailers fully paid for by manufacturers Increased product range of commercial brands with detailers fully paid for by manufacturers Four (4) new Memoranda of Understandings signed between UHMG and the suppliers of pharmaceutical brands Carry out market surveys to reveal gaps, potentials and opportunities of entry with a brand (November) 4 new MOUs with suppliers Market surveys conducted Limit local purchase to only confirmed orders from the customers Supplier search to achieve sources of highly reputable and quality products, with the Director of the facility taking visits to suppliers inside and outside of Uganda (December) Collect information on logistics and customer demand forecast from both the public and private sector target customers (December-March) Update the current marketing tools used to promote the product facility to reflect the new products that have been introduced (OctoberMarch) Create a link on the UHMG web site for orders and enquiries (Jan-Mar?) Q3 comments COMPRAL from Adcock Ingram, Aminosof syrup DIPI, and Aminofer syrup from Medinomic,; Dazel Kit from Ajanta; Nutributter market survey completed and price quotation requested Gross profitability has been maintained at 23% of gross turnover Database in place. New suppliers in active negotiation are Akacia of south Africa, Athena and Medicamen of India and to sign agreement before September MEDINOMICS AND Adcock Ingram will be meeting retainer costs and staff remunerated by 3% sales commission on sales closed. Staff recruitment is ongoing. 1 – Adcock Ingram contract received. Nutributter survey completed. Extended market trend survey planned for July – September period. Local purchases are still done, though on confirmed orders or clearly projected sales turnover. Supplier searches carried out through contacts and online. Visit will be taken in July. Prospect suppliers trips conducted Logistics and customer demand forecast information collected Current marketing tools updated with new products This survey if for July – September period, next quarter. Commission selling, riding on socially marketed brands are the common strategies being used Link on UHMG website established Websites has not been reviewed, redesigned. A knowledge manager is coming on board to help UHMG achieve this activities Activity Manager: Philip Okello Apira Linkages within UHMG: Marketing and Strategic Information for the website link; Marketing and Strategic Information will help in creating awareness of the products; Programs and Services will help in identification of the product gaps in their areas of interventions and as well forming a channel through which products can be accessed by consumers. Activity 2: Strengthening Product Facility operations Activity Description Targets/Outputs Q3 comments Legal consultation on restructuring strategies for PF as a commercial division of UHMG Legal assessment conducted Establishment of increased HRA and Procurement functions within PF Cost analysis conducted of MSI (Brands) and Programs & Services contributions to PF Sales Establishment of increased HRA and Procurement functions Cost analysis conducted The activity has become obsolete after the directive to maintain the 2strands This plan has become obsolete as we diversify procurement to admin directorate except for inventories. Cost of MSI activities been projected in profit and loss calculation of 9 quarterly finance reports PF attains increased operational autonomy PF attains increased autonomy PF Systems and Standard Operating Procedures (SOPs) established and in use Clear operational status established This development has been reversed due to the new strategy of business unit integration With ISO intervention, KPMG system reviews, SOP is being revised to keep alive importance updates within our operations processes. Activity Manager: Philip Okello Apira Linkages within UHMG: HR/Admin Finance Activity 3: Strengthening management and financial systems Activity Description Targets/Outputs Financial management Hire and install a professional and skilful finance manager to manage the finances of the division Design tally to meet the needs of the product facility Conduct more training of Tally financial software Develop cost drivers and cost absorption strategies to show growth in capacity Deploy a sales daily debt collector Sound financial management and reporting (both cash and inventory) regularly disseminated Good relationships with customers and suppliers perceived resulting from accurate and timely statements Capacity of warehouse staff A team of professional, proactive members of staff developed Warehouse staff trained and oriented to the new challenges Sales force empowered to make a difference in their activities and contribute to achieving overall sales objectives Warehouse Management Train warehouse staff to improve their skills in stock and warehouse management Regularly review SOM for further revision and follow up of implementation Purchase land and construct another 600 sqm warehouse and no longer rent Consult on business portfolio management Consult TransAid for training and installation of necessary systems for effective logistics management ISO Certification Finalize TOR and contract the consulting firm Start to process of ISO Certification in the year: Training, Reporting, Auditing, Certification and Follow up Working Capital management Debt management procedures in place Debt recovery up to 80% within the sales period Credit ceiling by aging analysis and control Daily banking of cash and cash equivalent Selling and invoicing in US Dollars Building Dollar bank balance for overseas supplies payment Tally software designed to meet the reporting needs of the product facility Staff trained in Tally software Financial reporting regularly disseminated Q3 Accurate and timely statements for customers and suppliers Warehouse staff trained and oriented to the new challenges Finance manager recruited, in place. Tally usage reviewed, rights and security control given according to needs and activity processes Tally training done for specific staff, coaching and troubleshooting have been a continuous activities ISO Certification training ongoing, with evaluation completed. Quarterly financial report prepared and presented for discussions Sustainability test in progress Ongoing No further training was conducted Sales target in force and being reviewed for performances tracking Planned coaching and mentorship for the warehouse staff but which has only delayed. Will be undertaken. Staff trained on stock and warehouse management ISO certification attained Process reviews completed, entering into stage 3 – implementation reviews/audits Debt management procedures in place Daily banking of cash and cash equivalent Monthly stock counts and variance management Debt management system in place, Credit control committee in place External debt collector assigned to collect difficult debts and carry out debtors legal status analysis Cash banking takes place daily Dollar account active, but no payment in dollars received in the quarter 10 Renegotiate supplies payment terms Monthly stock counts and variance management Other activities Identify personnel to be in charge of management reports Review the skills and attitudes of staff at the product facility to identify gaps and subsequent gap filling Institute a performance management system as in line with the private sector approaches to managing performances Put in place a staff structure for the Product Facility based on positions, not individuals Activity Manager: Philip Okello Apira Linkages: IT skills from UHMG HR/Admin; Systems audit by internal auditors/external auditors Performance management system in place Director in charge Staff skills will be reviewed by KPMG Draft Balance Scorecard in place, will be implemented in October Activity 4: Sales and distribution Activity Description Targets/Outputs Re-organize the current sales structure to include the position of a key account manager who will focus on relationship selling among Institutions like NGO’s, Corporate among others. In view of the increasing product range, there is need to review the current sales skills mix to identify gaps. Gap filling could be solved by training, hiring/hiring, or re-deployment. Reorganization of current sales structure completed Statusquo remains. Major restructuring to be done with the help of KPMG HR reviews Review of sales skills mix; gaps identified and training conducted Operationalize the regional wholesale pharmacies in Arua and Mbale to increase distribution reach Identify credible wholesalers/distributors that are financially sound and have the ability to sell large volumes of products. Strengthen channel relationship by explicit performance recognition, awards, and networking activities with the distributors during the year Increase in distribution reach in Arua and Mbale Identify credible wholesalers/distributors We have redesigned our job requirements to demand that a person with a medical background be recruited for marketing pharmaceutical products. Going forward, we shall implement this with next recruitment. Regional pharmacies are in operations with the right staff Implementation of closed distribution system being piloted, will be reviewed after September this year. A good regional presence and of UHMG face has been maintained. More meetings are planned through regional trips Market survey for outlet audits and gaps identification in market share and reach for commercial division Vehicles purchased for regional field staff, per UHMG budget, facilitating field work Product Facility targets Channel relationships with distributors strengthened 12 “Good Distribution” certificates awarded to distributors during the year Market survey for outlet audits conducted Vehicles purchased by AFFORD II Sales value achieved in the year – 10 Billion Uganda Shillings. Percentage of revenue from commercially marketed products Number of new commercial product suppliers engaged by UHMG (AFFORD II) Percentage of target retail outlets carrying UHMG products from 50% to 70% Mean self efficacy score based on perception of easiness to obtain and use UHMGpromoted products Percentage of target population who find at least 3 UHMG promoted products Retail audit done. Results show more reach in the west and lack of reach in many locations to below 60% Vehicles have not yet been purchased. Three quarter period showed 37.7% achievement of annual target Retail audit shows about 60% of outlets carrying UHMG brands Achievement is U3.77b out of U10b target Market survey not done for commercial distribution due to lack of finance 11 easy to obtain 70% of targeted outlets stocking products distributed by Commercial Division Annual Sales target of 10.0 Billion UGX achieved Activity Manager: Paul Kagumire Linkages: Link with brand and research teams for better synergies in demand creation and market intelligence Human Resource department for staff recruitment and motivation Link with programs department for uptake of products Link with public relations activities for relationship building and networking Link with finance team for financing activities Activity 5: Supply chain management Activity Description Targets/Outputs Absence of stock outs due to negligence Absence of stock outs due to negligence Good relationships with suppliers resulting from sharing with them the procurement plan in advance and making prompt payment Agreements with key suppliers in place Refer to activity sheet #3 Prepare a dynamic procurement plan for all products Procurements made Post shipment testing of Protector Agreements with key suppliers in place Procurement of: Procurement of RestORS Procurement of Zinkid Procurement of Condom O Procurement of Aquasafe Procurement of Commercial Products Q3 comments Experienced stock out for O, due to delay in payment of advance and not negligence in procurement Relationship with suppliers is good All agreements are complete and signed by both parties Procurements are in process O Condom was received. It is undergoing post shipment testing SoftSure: The supplier experienced some delays. The consignment will be delivered in July Aquasafe in under production with the manufacturer Weekly monitor the performance of the procurement plan Contraceptive procurement tables prepared and submitted to USAID Protector packaging material Procure packaging materials and instruction inserts Injectaplan packaging material Aquasafe packaging material Secondary packaging of Contract the pharmaceutical company to do Condoms secondary packaging Secondary packaging of Pills Secondary packaging of Injectables Secondary packaging of Water purification tablets Activity Manager: Rachel Apio (with R. Kitonsa for secondary packaging) Linkages: Accurate consumption data from the finance team Accurate stock status reports from the warehouse team Coordinate with UHMG MSI directorate Monitor the performance of the procurement plan on a weekly basis by updating it with actual consumption figures and goods received Prepare the contraceptive procurement tables for donated products for submission to USAID Done, ongoing This is an activity for quarter four Done for products The contract is done end of quarter 4 Key Highlights of the Achievements of the Quarter 12 Business Development Activities We entered into an arrangement where we achieve appointment as sole distributor of Adcock Ingram brands in Uganda. Adcock is a relatively experienced pharmaceutical manufacturer and has a global presence with Africa base in South Africa. Recently, they set up their regional office in Nairobi to service the eastern Africa emerging market. This appointment is coming out of a well conducted negotiation that caused a movement of the multinational out of their ad hoc arrangement of supplying the market through 3 local technical representatives to a single LTR, namely UHMG. We coordinated the manufacturing site inspection for GMP visits/renewal with NDA, for FDC India and Nutriset France. Nutriset had been approved and FDC India is yet to be inspected, hopefully in August 2012. We also introduced new products from Medinomics’, India; Aminofer Syrup, Amino Soft Syrup and Dipi (DHA) ant-malaria. We completed the brand specific market survey for Nutributter and are now developing the marketing plan to launch the product in the market. In addition, we have been in high gear negotiation with Mission Pharma, and Akaacia Medical (Pty) South Africa for surgical and medical products. We received most of the suppliers visiting the market, which has exposed us to a number of fronts: Naari AG, Triokaa pharmaceuticals of India, mission Pharma and Nutriset. New Products Registration Reviewed and submitted to NDA, the Malact product dossier files with Reference K 104, (Artemether 20mg + Lumefantrine 120mg) from Medreich India, the manufacturers of Cotramox. The expected approval date for the dossier evaluation is December 2012. We also submitted the product file of Fasile One (Levonorgestrel 1.5mg), under K053, an emergency contraceptive pill from our new partners, NAARI a Multinational pharmaceutical company, with its head offices in Switzerland and manufacturing facilities in India under a re-known manufacturing plants of Jagsonpal Pharmaceuticals, India. Work With Ministry Of Health (MOH) UHMG has been appointed a committee member to the diarrhea pneumonia coordination committee (DPCC) to work with strategic partners to come up with a DPC policy and advise on availability and implementation of prevent protect and treat strategy for the diseases management in the country. This committee will be chaired by MOH but speared headed by CHAI country team. Together with technical working group – medicine procurement and supplies, UHMG as a member, has been highly appreciated for the social marketing strategies implemented and labeled as a strategic partner in the healthcare interventions. Also, as a member of reproductive health task force, we completed the reproductive health commodity alternative distribution strategy development where UHMG is a major and a member of a tripartite –MOHNMS-UHMG distribution system in the RH Commodities distribution strategies. Distribution and value chain We have been implementing the closed distribution system with 14 distributors countrywide including two which are our own branch sales units. Our experience is that the system has offered us less market access and control of pricing down the chain. A number of interventions will be undertaken and this system will be up for evaluation and possible restructuring by September after we shall have piloted it for a t least 6 months. Also, we are advancing internal discussion 13 to finding the most suitable balance between closing and opening partially, social and commercial distribution to provide for best brand specific distribution system for satisfactory results. Regional pharmacies We received approval and offer of operating license and both Arua and Mbale pharmacies are operating well though with a number of challenges akin to their status as new business settings. Progressive sales have been achieved through the regional outlets but which are still below our projections. Supply chain and logistical activities Protector Packaging: there has been a steady supply of protector condoms from KPI. This is attributed to the learning curve dropping significantly and having spare parts on hand. The technicians at KPI have increasingly gained hands on experience in operating the machine. For Injectaplan, PilplanPlus Aquasafe SoftSure Zinkid and RestORS, we achieve zero stock out during the period. Secondary packing went on well achieving the set packaging targets but which built into stock pile up due to the down surge in sales mention above. For all the products mentioned above, we have stock of more than three monthly consumption rates and except for Aquasafe and SoftSure for which their replenishment are on the way to be delivered in July and early august respectively. O went out of stock but by close of the June, an air freighted consignment was arranged and delivered pending NDA post shipment testing. The stock-out of the brand however contributed negatively to the low achievement registered in the quarter. Apart from these, Moonbeads were out of stock for over 1 month after we overshot our target in the previous quarters coupled with delays in delivering our order and production of packaging materials for secondary packaging to be accomplished. A consignment of 5,000 Cycle beads arrived and is ready for sales in July. Third Party Logistics In this quarter, we received additional stock from NMS. We also had IUDs, Implants and condoms directly handled by UHMG on behalf of UNFPA. There were 200,000 female condoms delivered to UHMG after NMS had handled the NDA verification and clearing charges. The invoice of our services for the the period ending June to be presented for payment to MOH amounted to $275,512.48. UHMG started receiving direct RH Commodities supplies from manufacturers on behalf of UNFPA/MOH for the private sector distribution under the alternative distributorship arrangement. In the months of May and June alone, UHMG, on behalf of the ministry of Health, received: Implanon, (Etenorgetsrel 68mg), Jadelle Implants (Levenorgestrel 75mg Implants), IUD’s 380 (Copper T 380 intra Uterine device). Actions Planned for Next Quarter Open up distribution system in Kampala and central region. This will be to allow UHMG command the supply chain in the greater 60 – 70% of our market while continue piloting the closed distribution system in the greater territories outside the central region Apply for Malact special importation permit to provide for Distribution of promotional materials such as, fliers and posters in a number of outlets around Kampala and active brand sampling to prospective outlets and prescribers are expected to increase the visibility of the products and thus increase the sales. Follow up and developing the distributor for our OTC range, i.e. House of Vitamins. 14 Forward and advance the consultations meetings with nutritionists’ at the Ministry of Health to include sprinkles in the National Micro Nutrient Guidelines for Uganda. Continue product detailing amongst doctors, pharmacists and supermarkets to create demand. Give OsteoPro particular emphasis because its sales are the lowest and showing a negative trend. An additional sales person has been recruited to cover a wider reach of potential customers and do more detailing. Follow up closely those existing customers for specific commercial brands and recruit new customers through the above planned activities Director and sales and distribution manager to make field customer visits to interface and pick intelligence from customers to use for further building strategies Supply Chain Planned Activities Prepare contraceptive procurement tables for USAID donated products Streamline the management to third party logistics Procure packaging materials for Aquasafe Prepare the procurement plan for UHMG brands and commercial products 15 2. PROGRAMS CONSULTANCY STRATEGIC BUSINESS UNIT OVERVIEW The programs and services supported by UHMG continue to be the main channel of delivery of health promotion behaviour for disease prevention and provision of high quality services to the target beneficiaries, in key intervention sectors. Focus remains on diseases and conditions that make the largest contribution to the burden of disease in Uganda. Malaria: Malaria control services supported focus on malaria prevention and effective case management, through the private sector. In Quarter 3, UHMG continued to strengthen malaria services delivery in the private health sector through GLCs and drug shops. Focus was on improved diagnosis and case management of malaria, prevention and management of malaria in pregnancy, and increasing demand for malaria services. While the main thrust of malaria control effort was in the 11 focus districts of Eastern and Northern Uganda where malaria is highly endemic, UHMG also extended delivery of malaria quality services in the rest of the GLCs in all the 44 AFFORD priority districts. This was done through integration of malaria activities into other programs services; maternal/newborn and child health (MNCH) mainly due to malaria being one of the big challenges in this target group, as well as HIV/AIDS program activities. This was done as a way to scale up achievements done in the initial 6 focus districts of program year 2012-2011. Maternal and Newborn/Child Health: MNCH interventions aim at making a contribution to the national goal of reducing maternal mortality from 435 to 131 per 100,000 live births by 2015, child mortality by 2/3 by 2015 and increasing the CPR from 26% to 30%. The strategic objectives to be addressed through this program sector component include; Increase the availability, accessibility and utilization of quality skilled care for maternal and child health services in the Good Life clinics; Improve appropriate and timely health care seeking behaviour for maternal and child health services at community level and Increase knowledge, access and correct utilisation of appropriate maternal, child and reproductive health products Family Planning: Scale up of Family planning services is being done with additional support from DFID, under the Accelerating the Rise in Contraceptive (ARC) to cover additional 45 districts, to reach a total of 90 districts and 560 FP service delivery outlets. Short term methods which UHMG has been supporting are being scaled up, in addition to introduction of long acting methods in the choice of methods for the GLC. HIV/AIDS: services scale is being scaled up to include combination prevention, expanding care services to include ART roll out in selected districts and biomedical prevention to include SMC, condom use scale up and PMTC pilot in selected GLC. 2.1 MALARIA Planned activities highlights Promote subsidized RDTs to the GLCs and drug shops Orient 100 health workers on RDT use Conduct integrated support visits to GLCs and drug shops Support malaria services data documentation and reporting through HMIS system. Create demand for malaria services in the private health sector through radio talk shows Participate in the world malaria day national celebrations Activities Implementation Progress Activity Annual Targets Quarterly outputs Comments 16 Q1 Q2 Q3 Q4 Improved Malaria case management through the GLC and GLS Conduct field visits to identify drug shops and Clinics in each of the 5 additional PMI districts Printing and dissemination of job aides for the GLCs and GLSs Develop and print job aides for VHTs 50 drug shops 15 clinics 131 Completed in quarter 1 5 learning centers identified 36 private clinics 95 drug shops were identified Completed in Q1 250 400 250 1,130 Train master trainers on support supervision and case management Subsidizing high quality and affordable RDTs for the GLCs and GLS 15 23 Not applicable 250 12,375 Adapted the MoH existing materials: 500 VHT participants manuals 100 VHT Facilitators manuals 30 VHT Training of trainers guides 500 VHT Job aides Completed in Q2 and exceed the target by 8 because we decided to more trainers to provide effective support. On going, supported through subsidizing RDT Improved prevention and treatment for Malaria in Pregnancy (MiP) in private health sector Facilitate training of 250 private health providers at learning centers on MiP and case management 250 286 Completed in Q2. Integrated training in MiP and Case Management was done for phase 2 PMI districts. Conducting community dialogue meetings Conduct Training of Trainers (MFP,DHE, HE, HI) & GLCs for community dialogue meetings (fees and MOH travel) Number of community meetings conducted 20 20 Completed in Q2 2,388 1,230 Number of people that participated in the community dialogue meetings 49,700 24,252 Completed in Q2. Completed in only 5 districts. Subsequent programming was integrated in model village activities. Completed in Q2. Completed in only 5 districts. Subsequent programming was integrated in model village activities. 0 Formation of Drug Shop Associations Establishment of district based secretariat to coordinate drug shop operators Planned for Q 4 Malaria Communication Conduct Radio talk shows Conduct Radio spots 30 400 30 1040 Q3 output; Focused on 11 PMI districts Q3 output; Focused on 11 PMI districts 17 Monitoring of the communications campaign Reprint and distribute national guidelines and policies for Malaria Management in GLCs Participate in activities to commemorate World Malaria day (WMD) 2000 400 1 0 To be done in Q4 by NMCP 500 250 Reprinted the MoH Clinical guidelines and distribution is planned in the coming quarter. 1 Participated in national World Malaria Day Commemoration that was held in Dokolo District. 1 Service Delivery Outputs Key outputs from the GC during Q3 are summarized below. Monthly results in malaria in pregnancy and case management services Service area April Malaria (suspected OPD attendances) May Total 19,277 5,045 20,651 44,973 809 252 1,305 2,366 1,929 339 2,013 4,281 Malaria in pregnancy First dose(IPT1) June Second dose(IPT2) 1,183 186 1,304 2,673 Malaria microscopy 36,681 11,376 36,864 84,921 5,739 2,730 9,253 17,722 Malaria RDTs As shown in the table diagnosis of malaria is higher than that for malaria suspected cases in the GLCs. This is attributed to the fact that sometimes clients are referred to the GLCs for only malaria tests and services got elsewhere such as the public health sector or drug shops. Some GLCs have also reported that some clients demand for malaria tests without consultation, probably as a way to evade the costs of consultation fees, but more so due BCC demand generation (power of day 1 campaigns) mobilization for suspected malaria lab confirmation before treatment. As part of quality improvement, integrated support supervision was done in the GLCs and drug shops. Health workers from outlets visited were mentored in various aspects of service delivery; especially record keeping and data entry into the HMIs for GLCs and UHMG data collection tool for drug shops. Subsidized UHMG promoted products distribution, including those for malaria such as RDTs, ACTs, LLINs and gloves was also done. Job aides, data collection tools for drug shops and HMIS forms for GLCs were also distributed during these support visits. Promotion of RDT subsidy RDTs subsidy sales for Quarter 3 Month GLC Drug Shop Total April 3,400 1,000 4,400 May 750 1,350 2,100 June 5,875 0 5,875 Total 10,025 2,350 12,375 Grand total of RDTs sold 12,375 18 UHMG also oriented 102 health workers from GLCs on RDT use as an integral part of workshops held for health care waste management, couple HCT and comprehensive HIV care and ART. Job aides were also distributed to these health workers oriented. World Malaria Day On April 25, 2012, UHMG joined the rest of the world to commemorate the world malaria day under the theme “Sustain Gains, Save Lives: Invest in Malaria”. The national event was held in Dokolo which is one of the PMI focus districts for UHMG’s malaria supported activities. UHMG facilitated the Ministry of Health film van and two health educators to mobilize the community and educate them on the dangers of Malaria, reaching 162 people with services out of the 200 targeted. Messages about the Power of day one were highlighted. This helped mobilize the community for malaria case management in Agwatta HC III, and also mobilized them to attend the commemorations of the World Malaria Week on Wednesday 25th April 2012. Over 150 people attended the event. The District Health Officials were facilitated to conduct week long radio talk shows on Malaria Prevention, Treatment and Case management. Increasing demand for malaria services through the private health sector As part of the power of day one, UHMG continue to conduct radio talk shows on four radio stations– Continental FM, Radio Apac, Voice of Teso and Etop FM. In total 30 radio talk shows and 1040 radio spots were aired to enhance malaria prevention and prompt and effective case management, based on confirmed malaria cases through laboratory testing. In addition, 68 Taxis were branded with Power of Day One adverts and they drive through various parts of the Eastern Region, 7 billboards translated into Luo and Atesot erected and placed along various highways, 40 Road stars placed, 66 health workers oriented on the Power of Day campaign (DHOs, DHEs, Master trainers, Midwives, Malaria Focal persons, Village Health team members). UHMG also oriented Radio Talk show Hosts on the Power of Day One campaign to improve their radio talk show facilitation skills ahead of talk show roll out. Malaria Case Management – Progressive Performance; the table below summarizes annual achievements so far for the three quarters. Quarter Oct. to Jun 2012 Malaria Case Management Services Q1 Q2 Q3 Cumm %age Annual 19 Target Suspected Malaria Cases Suspected Malaria Cases tested RDT/ Microscope Cases Positive Positivity Rate 132,308 18,752 59,253 210,313 70% 300,000 122,505 50,237 41 48,789 96,892 268,186 22,204 42,408 45.5 43.8 99% 270000 Trends in Malaria Case Management Oct200,000 June 2012 0 Q1 Q2 Q3 Suspected Malaria Cases Suspected Malaria Cases tested RDT/ Microscope Cases Positive Challenges and Lessons Learnt Data collection in drug shops is still a new concept, thus the need for intensive mentorships and partnerships with the district, to increase district ownership and enhance adherence to reporting requirements. One of the key lessons is that provision of subsidized products increases uptake of RDTs and malaria testing which ensures more rational use of malaria medicines. Plans for next quarter The main focus in Q4 will be to strengthen malaria service delivery in the private health sector and improve data collection from the drug shops in the 11 PMI focus districts. This will be aided by orientation of drug shop operators on how to use to data collection tool developed by UHMG for drug shops. Support for malaria control services will be provided nationally using the GLC and model village approach, taking advantage of national scale up for prompt malaria diagnosis and treatment campaign – the Power of Day 1. 2.2 MATERNAL, NEWBORN AND CHILD HEALTH (MNCH) Support is directed both at the community and facility levels. At the facility level, the department supported 50 Good life clinics through building the capacity of private health practitioners to provide quality ANC, delivery, post natal care, child care including care of the new born, growth monitoring, integrated management of childhood illnesses (malnutrition, diarrhea, Acute respiratory tract infections and malaria, de worming, immunization and micronutrient supplements). Selected GLCs were supplied with basic MNCH equipment as well as facilitation to conduct integrated community outreaches for hard to reach areas. 20 In addition, UHMG supported interventions for community engagement through the model village approach in the districts of Mukono, Mbale, Lira and Serere. Good Life Promoters (GLPs) were engaged in sensitizing households on how to adopt risk reduction behaviors needed to reduce maternal and child morbidity and mortality in the communities. 40 Good Life promoters and 20 mother mentors were trained to mobilize for integrated MNCH interventions in the two new model villages in Kabarole and Kyenjojo. Activity 1: Capacity building of Good Life clinics to provide quality and integrated MNCH services Activity Description Train on Goal oriented antenatal care, safe deliveries, emergency obstetric care, data management Family planning training on short and medium term Hormonal contraceptives through CME sessions Child health training on nutrition, growth monitoring, assessment and management of malnutrition(IMCI) Procure and distribute data collection tools to 50 Good life clinics to include ANC, maternity, FP and OPD registers Annual Targets Quarterly Outputs Q1 50 42 200 0 Q2 Distribute basic MNCH equipment and supplies to 50 Good life clinics 50 GLCs Procure and distribute MNCH job aids and IEC materials to 200 Good Life Clinics 200 GLCs Conduct quarterly support supervision and biannual Continuous Medical Education sessions with the 50 Good Life clinics 50 GLCs Q3 Output Completed 0 200 200 50 GLCs Q3 Target Comments 199 CME sessions focusing on short term and medium term family planning were conducted for 199 health workers from 50 GLCs Completed 188 50 50 - Completed. Replenishment is ongoing integrated with support supervision 50 50 188 50 50 50 50 These include BP machines, Stethoscopes, Fetoscopes, Aprons, Surgical gloves, and bulb syringes. Completed 50 support supervision visits were done for 50 GLCs. This was integrated with CME session was for each of the 50 GLCs. Specifically this was on Short term and medium term family planning methods. Activity 2: Integrated Community Outreaches 21 Activity Description Annual Targets Quarterly Outputs Q1 Conduct integrated community outreaches with 50 GLCs each quarter: 4 integrated community outreaches were conducted by each of the participating Good Life clinics. 200 Q2 Q3 Target 20 25 Comments Q3 Output 18 18 GLCs in Western Region were supported to conduct one day integrated outreaches for hard to reach areas. Activity 3: Community Sensitization on MNCH Interventions through model village concept Activity Description Annual Targets Quarterly Outputs Q2 Q3 target Q1 40 40 Comments Q3 outp ut 60 Training of Community Resource Persons on MNCH interventions to conduct home visits in model villages. Quarterly review meetings will be held to assess the progress of their activities. Run a Maternal and child health oriented radio talk shows involving Health workers from GLCs. 100 Procure and distribute Job Aids for VHT/Community resource persons 200 96 60 60 Conduct school visits within the model villages 20 6 7 0 120 120 60 Good Life Promoters (including 20 mother mentors) have been identified and are being trained in Kyenjojo and Kabarole in the 3rd Qtr. This is in addition to the 40 already trained in Serere and Lira. Strategy developed and piloted in SMGL districts of Kabarole and Kyenjojo. Roll out nationally will be done in Q4. 96 CRPs received job aids, the 60 newly identified GLPs will received the job aids during their training We intend to conduct these school visits in Q4 Service Delivery Outcomes Oct-June 2012 MCH Services Progress Performance Indicator Annual target Quarterly service outcomes Q1 Q2 Q3 cum Remarks % achievement MATERNAL HEALTH Number of mothers attending the first ANC visit at the GLC 40,000 6,162 4,214 7375 17,751 44% Number of mothers attending the 4th ANC visit at the GLC 13,000 2,904 1,922 3601 8,427 65% Number of mothers who received IPT 1 at the GLC 11200 4,545 3,040 5660 13,245 118% 22 Number of mothers who received IPT 2 at the GLC Pregnant women counselled, tested and received HIV results at GLC 6800 3,445 2,153 3729 9,327 137% 11200 2,597 1,907 5518 10,022 89% 8000 2,626 1,744 3406 7,776 97% 376 122 81 161 364 97% 100000 20727 22068 60185 102980 103% Number of mothers delivering at GLC by skilled HW Babies born with low birth weight(<2.5 kgs) CHILD HEALTH Total OPD attendance of children under 5 years Children under 5 years treated for malaria Children under 5 years treated for diarrhea 26744 4362 44.4% of <5 OPD attendance 7.2% of <5 OPD Support supervision Family planning CMEs Support supervision was integrated with other activities conducted by the MNCH department. CME sessions were conducted for 199 health workers in 50 GLCs with a focus on short term and long term family planning methods. Key positive findings included provision of an integrated package of services at all GLCs, presence of a qualified staff to provide MNCH services at all facilities and possession of basic equipment for assessing the clients. Some of the challenges identified were inadequate staffing at the GLCs, inadequate skills on waste management, and inadequate utilization of data by the facilities. These were discussed with the GLC staff to find solutions. Distribution of Basic MNCH Equipment to the GLCs An assortment of basic equipment was distributed to 50 GLCs. These included Blood Pressure machines, stethoscopes, fetoscopes, bulb syringes, aprons and gloves. This was a timely intervention since most of the GLCs had one set of equipment that was being shared across all the departments/stations within the clinic. Conducting integrated community outreaches A total of 18 GLCs were facilitated to conduct 18 integrated community outreaches for hard to reach communities in their catchments. These were St. Mary’s maternity Bukomansimbi, St. Aloysius Ngobya maternity and Munathamat HC III in Lwengo, St. Josephs HC III in Mbarara, Kakoma HC III in Isingiro, Ibanda Mission HC III and Rwenkobwa HC III in Ibanda, St. Mary’s Kyeibuza HC III in Kiruhura, Nyabugando HC III and Kitabu HC III in Kasese, Agetereine Nursing Home, Yerya HC III, Papa’s Medical centre, OTA medical centre, Iruhura HC III, and Nkuruba HC III in Kabarole, Villa Maria and Midas Touch in Kyenjojo. The support was in form of provision of free/ subsidized commodities for the outreaches, IEC materials, data collection tools, transport and lunch for health workers as well as physical presence of the UHMG staff for mentoring at the outreaches. The services offered at these outreaches included Antenatal care, post natal care, immunization, treatment for common illnesses for children below 5 years, Family planning provision, HIV counseling and testing, and Health Education. A total of 2750 clients received services at these outreaches. Community sensitization activities The 96 trained Good Life Promoters (Community resource persons) in the 5 model villages of Kasawo in Mukono district, Bungokho and Nakaloke in Mbale district, Adekokwok in Lira district, and Pingire in Serere district were facilitated to 23 conduct home visits and interpersonal communication activities to promote positive health behavior in an integrated way. They also refer the community members who need services to the GLCs. In addition, two new model villages were formed in the districts of Kabarole and Kyenjojo in the sub counties of Kasenda and Nyantungo respectively. The community interventions in these model villages are coordinated by Iruhura HC III in Kabarole and Midas Touch Medical Centre in Kyenjojo. The respective District Health Teams were sensitized on model village activities and involved in the selection of the sub counties for model village activities. The health workers from the 8 GLCs in the two districts were oriented on integrated MNCH activities in the context of the model village concept. The two coordinating GLCs ( Iruhura and Midas Touch) were then actively involved in identification of 30 Good Life promoters (including 10 mother mentors) from each of the model villages who were trained and facilitated to conduct community sensitization and mobilization for integrated maternal and child health services. Saving Mothers Giving Life campaign UHMG led in designing a communication campaign emphasizing the need for pregnant mothers, their partners and the community to prepare for delivery at a health facility in the districts of Kyenjojo, Kamwenge, Kibale and Kabarole. To kick start the campaign, a communication strategy was developed with guidance from MOH, 5 concepts were developed, 2 pre-tests conducted and 3 partner meetings held. To support the mass media, 60 Good Life Promoters (including 20 mother mentors) have been identified and trained in the districts of Kyenjojo and Kabarole. IEC materials (posters, fact sheets, stickers and job aides) will also be produced. Lessons learnt and best practices 1. 2. Integration of activities with the various departments in UHMG creates a platform for leveraging on the limited resources and time, and allows for efficient delivery of comprehensive health services and products to the target population. Partnerships with the district health office, and other implementing partners in the districts improves program outcomes Planned Activities for 4th Quarter (July-September 2012 Capacity building of Good Life clinics to provide quality and integrated MNCH services a. MN &CH activities: 1. Conduct support supervision of 50 GLCs and follow up of IMCI trainees 2. Support GLCs to conduct 157 integrated community outreaches for hard to reach areas 3. Support selected GLCs to conduct follow up of malnourished children in their homes for nutritional education and support. 4. Support supervision and mentoring health worker in MN & CH services delivery. b. Community Sensitization on MNCH Interventions through model village concept 1. Scaling up model villages to reach 50 GLCs. This will involve all the sectors (HIV, Malaria, MNCH, RH) working through the model village framework. 2. Launching mothers Clubs in Kabarole, Kyenjojo, Kibale and Kamwenge and facilitating monthly mothers’ clubs activities in the four districts. 3. Scale up Saving Mothers Giving Life (SMGL) Campaign in Kyenjojo, Kabarole, Kibale and Kamwenge 4. Conduct a mini evaluation of the model village activities as a baseline for future evaluation of the UHMG model village activities. 24 Administrator Nyakatare HC III receiving equipment from the MNCH manager donated by UHMG to the Good Life Clinic 2.3 FAMILY PLANNING Activity highlights Family planning activities implemented by UHMG/AFFORD received additional support from DFID to scale up operations in additional 45 districts to reach a total of 90. Supported service delivery outlets were to be expanded from an initial 200 to 560. The scale up in family planning service utilization is supported through an integrated approach: Family planning commodities security is supported through product facility operation, UHMG specialized department for health products warehousing and distribution, through a private sector supply chain system, as an alternate to public and private not for profit approaches. Building the capacity of service providers to provide affordable quality services. Mobilization of communities for FP services awareness, dispel myths and barriers, and raise demand for more services utilization Key Activities Result 2: To increase access and affordability to quality family planning services and products Improve quality of service provision at the private clinics. Provision of infection prevention logistics, buckets, disinfectants, injection boxes etc Distribution of IUD Kits, Equipment and supplies and logistics to the private clinics Conduct monthly/quarterly supervisory visits to all network providers to assess provider skills and competency Result 3: To increase knowledge, awareness, demand and utilization of modern FP methods, including long term methods. Recruitment and training of CORPs Facilitate CORPs to carry out community health education on RH/FP Design and implement Smart Choices family planning campaign. Activity Progress Tracking Matrix Results Target Cum. % Q Q Q 1 2 3 Result 2: Increase availability, affordability of FP services and products Mapping of outlets that are 560 32 328 59% capable of stocking 8 reproductive health products Comments Activity These outlets include clinics and drug shops 25 Mapping of facilities capable of providing long term methods 240 - - 13 8 138 Training of service providers in long term methods 240 - - 41 41 MOU signed 240 92 92 38% This excludes MOU with 200 GLC at DFID start (baseline) Distribution of FP commodities, within the region, working with other partners Distribution of long acting FP commodities 240 41 41 17% FP commodities from MoH were distributed (depo 577,pills 1320). Strengthen infection control in clinics and hospitals 240 Support Quality Improvement activities 240 - - 58% 41 trained central 13 western 11, eastern 12 240 - - 12 240 mapped but 138 enrolled awaiting to join GLC 41 17% 12 5% Implants 1628 (MoH stocks), 84 IUCD insertion kits for 41 health facilities distributed (IUCDs were not yet available). 41 sterilizers, Infection prevention commodities and supplies procured fro 41 health facilities Support supervision) by MoH and UHMG) and mentoring of staff in long term methods service provision. In addition CME were conducted in 50 clinics on short term methods. Result 3: Increase knowledge, health behaviors leading to demand and sustained utilization of FP services KAP study for modern FP 1 1 1 100% For Baseline for SMART choices FP methods campaign and message development Design and pre-test campaign concepts and materials Identify , train and facilitate community resource persons 1 720 1 1 100% For Baseline for SMART choices campaign message development 36 were identified, training to follow. 3 volunteers per facility will be enrolled and supported. Progress Result 2: Increase availability, affordability of FP services and products Mapping of service outlets to increase the number of health offering short and long term family planning services. 42 additional districts were mapped, 240 facilities assessed, and 138 selected for services delivery. 92 MOU were signed. Details are provided in the table below. Clinic who are already working with other partners (Profam, Blue star) were not mapped. Training of service providers in long term methods. 41 health workers were trained. Service providers who participated in this training were given start up commodities. These included; 6,600 condoms, 138 cycles of pills, 75 injectables. In addition participants participated in practicum placements in different hospitals in Kampala where 53 IUCD and 125 implants were inserted. 26 Distribution of family planning commodities. During the quarter, free MoH and UHMG brand commodities were distributed in GLC, to enable initiation of service delivery, while waiting stocks to arrive. Details of this activity are provided in the table below. Contraceptive methods IUD Implants (implanon) Injectable 2 ml syringes Pills (microgynon) Amounts sold/free distribution 0 1628 577 577 1320 Strengthen infection control in clinics and hospitals. 12 GLC were supported with infection control kits; sterilizers, gloves, safety boxes and west bins. Building the capacity for long term family planning services delivery. Insertion kits were procured for the 41 health facilities (81 set – 2 per facility). Other items distributed to the 12 facilities listed above in central region include; chloro-hexidine (disinfectant), stainless foot step bin, outpatient registers, FP registers, Antenatal registers (only to facilities providing ANC), bio-hazard safety boxes, sterile and non sterile gloves.2 boxes files and 2 buckets (green and blue). Support supervision was conducted by 2 MOH officials and an RH trainer to ensure competency and proficiency in Family planning service provision in terms of counseling and actual insertion (12 clinics supported) Distribution of MoH job aids and policy guidelines. MOH protocols/Job aids were given out to GLCs clinics. These include; MEC Wheels, Checklists, infection control protocol and complication Management plan. Result 3: Demand creation activities to increase services utilization. Knowledge, attitude and practices study was carried out to set a baseline and identify issues to address in the Family planning campaign communication strategy. Smart choices family planning campaign concept development, pretesting and message approval were completed. Selection of good life promoters to support demand generation activities were identified. Training will be carried out in the next quarter. FP services utilization Services utilization data from G164 GLC called during the quarter is presented in the table below. This data is mainly from original (AFFORD II GLCs). Data from new service outlets will be incorporated in the next quarter reporting. Service provision (from HMIS reports March –June 2012) Contraceptives Oral lofemenal Oral Microglynon Oral ovrette or another POP Oral others Female condoms Male condoms IUCDs Injectable natural Other methods New users 673 1,629 696 564 1458 6826 1,410 4,154 437 704 revisits 492 1299 752 517 868 4826 352 3731 134 142 27 Total family planning users 15,020 10,175 Surgical Methods Utilization Pattern during the quarter Female sterilization (tubal ligation) Male sterilization Implant new users Implant revisits Implant removals 54 8 664 155 136 Participation in World Population Day cerebrations, Hoima District UHMG participated in a world population day celebrations in Hoima where the organization show-cased FP products/services and conducted static activity at God Grace medical centre in Kigorobya trading centre, Hoima. The static activity lasted 2 days, and the following was achievement were realized: implants 12; IUCD 4; depo 15; and implant removal 2. Above, the Prime Minister (PM) Rt Honorable Amama Mbabazi inspecting UHMG exhibition during World Population Day cerebration in Hoima. UHMG staff was detailing family planning choices. The PM received a Genext T-shirt. Challenges and Lesson learned Demand creation activities, especially below line activities for clinics need scale up, to support the multimedia communication campaign for increased services utilization. Services data management need more support to ensure timely data management and reporting, in line with HMIS reporting requirements. Planned activities for Q4 The main activities for the quarter include; Building the capacity of GLC to deliver modern FP services, with emphasis on long term methods Increase access to FP commodities to GLC Increase demand and utilisation of FP services in GLC Document best practices for scale up 28 2.4 HIV/AIDS This quarter, UHMG continued to strengthen HIV prevention, care and treatment services through the GLCs and support for communities, through sub-grantees. This quarter focus was on integration to leverage on available limited resources, linking targeted beneficiaries to the recommended continuum of care in collaborations with other implementing partners in the districts. Planned Activities Support sub-grantees to implement HIV prevention among MARPs, young people and couples Develop the sub-grantee management manual Pilot PMTCT services delivery in the private sector through selected sites. Expand HIV care and treatment services in the private sector to include ART services in selected sites. Conduct integrated support supervision in GLCs; Use SMS media for quality of care support improvement Scale up the get of the sexual network campaign and condom promotion for MARPS, in partnership with DBTAs. Progress of planned activities A summary of to the FY 2012 HIV intervention services progress, main targets and outputs are summarized in the table below. Key activities HIV/AIDS 2012 Activity Tracking Matrix Targets Outputs Q1 Q2 1. Strengthen HCT Services in private Clinics – the Good Life Clinics (GLC) Scale up HCT in GLC 184 174 Train HW in couple HCT Support Post test clubs Support GLCs to conduct HCT outreaches Support HCT services quality through quarterly supervision in GLCs Support printing of HCT services data tools & reporting People tested Procure and distribute safety boxes and waste bins Conduct regular support supervision in GLCs 3. Scale up HIV prevention services for MARPS IPC for behavior change among truckers IPC for behavior change among fisher folks IPC for behavior change CSW Condoms sales targeting MARPS Integrated MMC, STI/FP services for MARPS Q3 Q4 No %age 174 174 95% 100 52 48 100 100% 5 5 5 5 100% 20 0 19 19 95% 174 174 174 174 100% 174 0 174 174 100% 132,000 32800 19556 86,575 66% 82 82 80% 2.Support infection control, medical waste management (MWM) and disposal Train HW in infection control and MWM 100 n/a Support GLC for safe medical waste disposal Cumulative 34,219 184 174 174 174 95% 2785 696 693 693 60% 174 174 174 174 100% 3,500 0 607 726 1333 38% 19,000 3499 2134 8491 14124 74% 1000 89 299 446 834 83% 650,000 45,000 5080 175763 225843 100% 100% 100% 35% 100% 4. Scale up HIV prevention among couples 29 Formation of additional couple clubs Train married couples in couple counseling Train couples in positive prevention 4 0 4 4 100% 48 0 48 48 100% 56 0 56 56 100% 150,000 48,278 22,507 20608 91393 61% 19,800 4024 5144 3,748 12916 65% Integration FP,MMC wrap around activities 1500 262 632 265 1159 77% 5.HIV Prevention among Youth Promote Youth services through GLC clubs 10 0 10 Train Youth peer educators for BCC 80 79 20 Prevention of HIV through IPC BCC 50,000 1780 2436 100,000 15000 Carry out IPC BCC for fidelity among individuals who are couples Support couple HCT services for married couples Condom sales among youth 99% 7345 11561 23% 21900 15737 52637 53% 532 559 1091 7% 2485 6417 51% 174 100% Integrated youth services – MMC, STI & HCT 15,000 6. Scale up HIV Care & Positive Prevention Services PHA receive a least 1 services in care package 12,500 1814 2118 184 174 174 HIV Care quality assessment in GLC Support quality care services in GLC 100% 99 50 0 50 50 50 100% 10500 659 3032 1182 4873 46% 100 0 0 0 0% 50 0 0 32 64% Provide PMTCT services to HIV+ PW in 50 GLC 700 0 0 0 0% Support mothers clubs linked to GLC for PMTCT 50 0 0 0 0% 100 0 0 0 0% 1 0 0 0 0% 1000 76 332 740 9. Scale up prevention services with DBTA Scale up get off sexual network among DBTA’s 4 3 3 0 N/A Promote condom use among DBTA programs 4 3 3 0 N/A Support PHA for PwP services Package. 7. Scale up PMTCT Services Train HW on PMTCT services Pre accreditation of GLC for PMTCT & ART services Train mothers mentors in mothers clubs Design & conduct multimedia PMTCT campaign 8. Demand for MMC generation, with DBTA Referral for MMC 1148 115% Develop and market MMC disposable kit Strengthen HCT Services in Private Clinics UHMG continued to support GLCs to provide HCT through the health facilities and outreaches conducted in the community. Data collection tools, technical support supervision and HCT kits and laboratory consumables were provided to help support GLCs provide HCT services. Oct-June 2012 HCT Services Progressive Performance Category Annual Target Q1 Q 2 Q3 Cum Performance Total counseled 137,400 33,981 20,941 36,416 91,338 66.5 Total tested 134,700 33,100 20,511 35,869 89,480 66.4 30 Received results 132,000 HIV Positive Positivity Rate Tested as couples 19800 32,800 15,143 34,219 2,316 1,298 2,276 7.1 8.6 6.7 4,024 1,270 3,748 82,162 62.2 9,042 45.7 Specifically, UHMG procured and distributed HIV test kits and the consumables to the 174 GLCs. This include; 1,110 Determine, 329 Unigold, 1,430 Vacutainers, 2253 Vacutainers needles, 319 boxes of gloves and 1571 rolls of Cotton wool. To increase access to HCT services, outreaches were done during the quarter by the GLCs targeting MARPs at their work places and the general population. In total, 1086 people were counselled and tested for HIV through outreaches conducted by 10 GLCs. Those who tested positive received starter pack of cotrimoxazole and aqua safe, family planning and condom supplies for one month, depending on their needs. They were also referred for further treatment, care and support to the nearby health facilities. Peer educators who helped mobilize for the activities followed up and tracked all referred clients for actual service delivery at referral sites. The newly diagnosed PHAs were also encouraged to join Post Test Clubs for psychosocial support. Healthcare Waste Management UHMG continued to support GLCs in health care waste management, through distribution of safety boxes for disposal of used/contaminated needles and syringes. In total, 696 safety boxes were distributed to 174 GLCs. Sexual and Other Behavioural Risk Prevention – Truckers UHMG targets truckers and CSWs along the hotspots on high in West Nile (Arua, Nebbi, and Koboko districts) and Kasese district through sub-grants to ASDE-U and NAYODE respectively. Interventions for truckers follow the CHIC center model with outreaches, moonlight HCT camps and visits by park yard volunteers (PYV) at various hot spots where large number of truckers station, to rest from their long journeys or await border point clearances. Achievements for this quarter are summarized below: 252 truckers, 193 CSWs and 500 members from the surrounding communities were reached by 40 park yard volunteers from Hima and Mpondwe in Kasese district. In West Nile, 474 truckers, 253 CSWs and 1,369 members from the surrounding communities reached. IPC focused on integrated HIV prevention with emphasis on consistent condom use, partner reduction, safe male circumcision, family planning for females, and reduction in alcohol consumption. IEC/BCC materials 4000 brochures and 1000 posters) targeting trucker drivers were designed printed and translated into Kishwali and the local language, to educate and inform the target population on the dangers and risk of having multiple sexual partners. Brochures were printed and disseminated to the truckers and the surrounding communities for message dissemination, information sharing on HIV prevention and behavior change in Kasese. 12 SMS messages were sent to 500 truckers registered in five languages in West Nile with emphasis on safe sex practices. Advocacy meeting one was held with 100 hundred local leaders from Kasese district and as a result of one the meetings, Hima and Mpondwe town councils provided the project with buildings for youth centres and promised space for CHICs in future. This was resolved that as the project progress the local council authority will be preparing for permanent homes for the youth and CHIC centres. 31 Equipment items were procured for Youth Centres. These include: 2 TVs, 2 DVDs, 20 benches, 2 chairs 2 TV stands and 2 lockable shelves. In addition, 30 Health workers were oriented on youth friendly services. Through social marketing, 2,400 free condoms from the district were distributed, and 84,000 condoms were sold by peer educators. Sexual and Other Behavioral Risk Prevention – Fisher Folk UHMG HIV prevention interventions for fisher folk and CSWs on landing sites in Kalangala, Wakiso, Mukono and Masaka, were delivered through a sub grant to SSECODA to scale up operations of safe sailing boat project through us of peer educators and partnerships with the beach management units, district offices and other implementing partners such as AMREF. Quarter 3 achievements are summarized below Peer educators conducted routine interpersonal communication among 8491 fisher folk to address Gender based violence and alcoholism prevention messages among other risk factors in HIV transmission. Condom promotion and social marketing was done. 165 CSWs were also reached as an integral part of these activities on hotspots and bars on the landing sites. In partnership with Kalangala Home based voluntary and testing and Kalangala Forum for People Living with HIV/AIDS (KAFOPHANO) HCT outreaches were conducted reaching 753 fishermen with HCT services. Those who tested positive were linked for CD4 testing with psychosocial support provided by KAFOPHANO. Through these wellness outreaches, 231 fisher folk with symptoms suggestive of STIs were referred for care and treatment. These referrals includes; from Katabi sub-county to Entebe Grade B hospital; Mugoye and Bujumba subcounty to Kalangala Health Centre IV. Through partnership with AMREF, fisher folk were mobilized for SMC during SMC camps on the landing sites. These were part of the wellness outreaches in which HCT, STI diagnosis and family planning counseling was provided. Through social marketing, peer educators promoted and distributed 39,000 condoms, 38 moon beads and 53 dispensers of aquasafe. Condom demonstration and education was done as part of these activities. Sexual and Other Prevention-married and Discordant Couples UHMG implemented HIV prevention among couples through a sub-grant to Humanitarian Care Uganda (HCU). Services were expanded to include new 5 districts (Kamuli, Mukono, Mbale, Kyenjojo and Kabrole). This is in addition to 1 st phase districts of Kanungu, Lira, Kabale and Wakiso where services continue to be expended to include addition sub counties and clubs. The overall goal of HCU Faith project is to strengthen the capacity of communities to respond to the HIV/AIDS epidemic, promoting behaviour change towards faithfulness and the support of married couples to popularize and sustain their commitment to fidelity. In total, 20608 individuals were reached in the 9 districts with HIV prevention packages. Achievements of the quarter are summarized below: Advocacy with community leaders was conducted with religious and civic leaders in Mbale, Mukono, Kamuli, Kyenjojo and Kabalore as key influencers to the community for mobilization and also to bring about their buy in into the project. 72 couples from the 5 new districts were trained on promotion of faithfulness and reduction of gender based violence. The training guide developed by UHMG (Families that Prosper) guided the training. The trainees were supported to form four fidelity clubs 32 To address the issue of counselling discordant couples, 72 couples were trained in the 5 new districts. In addition, the same couples were trained on sexual and reproductive health, demand generation and advocacy for MN&CH services, including for family planning Through interpersonal communication activities supported by Hero couples, 20608 couples were reached with BCC messages to promote fidelity, increase couple communication and create demand for HIV/AIDS prevention and MCH/FP services. 801 couples were provided with couple HCT services through outreaches conducted by GLCs. Of those tested 734 couples were concordant negative, 30 couples discordant while 37 were concordant positive. Referrals were made for all positives to health facilities for CD4 tests and chronic HIV care after initiation on cotrimoxazole and counseling on positive prevention. 280 men were mobilized through fidelity clubs for safe male circumcision and referred to health facilities and GLC for SMC. During the quarter, visibility of FAITH project activities, as a USAID UHMG funded project. 1440 T shirts and 900 umbrellas were procured, branded and distributed to Hero couples. In addition 34 signposts branded as USAID funded project implemented by UHMG were distributed in all 9 districts project sites. Sexual and Other Behavioral Risk Prevention –Youth UHMG supports youth programs through boda boda peer educators and youth clubs. Youth clubs are operated through a sub-grant to Health Alert in Amuru, Nwoya and Oyam, while boda boda cyclists are based in the districts of Arua, Nebbi, Moyo, Koboko, Jinja and Mbale with technical support. UHMG’s program focuses on promoting utilization of youth friendly reproductive health services, uptake of safe male circumcision, correct and consistent condom use, early detection and treatment of STIs, family planning and prevention teenage pregnancies. Boda boda cyclists: UHMG continued implementing HIV prevention activities targeting Boda Boda cyclists and their clients at their work places to enable them develop health seeking behaviors, reduce on the risks of HIV infections, behavioral and adopt positive living for those who are Positive. The 99 trained Boda Boda Peer educators are reaching their peers with HIV prevention messages and activities in the districts of Arua, Nebbi, Koboko , Moyo, Jinja and Mbale. Besides reaching their peers, the Peer educators are also reaching their clients, the people they interact with during their work and the surrounding communities with HIV prevention activities and messages. The following are the key achievements for the quarter: Two hundred and ninety (290) boda cyclists in the districts of Moyo, Koboko and Arua were reached with integrated HIV prevention communication and services. Nebbi data had quality issues (Not unique individuals reported) which need to be addressed with the peer educators. HIV Counseling Testing (HCT) outreaches targeting Boda Boda cyclists and their clients were done during this quarter reaching 380 Boda Boda, and 504 community members. Mobilization for the outreach was done by the local leaders and the testing was done by selected Good Life Clinics in the respective districts and in close collaboration with the district officials. Moon light HCT was done in places like disco halls, bars, among other venues frequented by CSWs and their clients. Some outreaches were held at boda boda stages to cater for the mobile and busy nature of boda boda cyclists. 33 Free condoms from the district Health offices in the districts of operations were distributed to boda boda cyclists by peer educators. Apart from the GLCs being supported by UHMG to provide serves to the Boda Boda Cyclists, other service providers were identified and mapped to provide other wrap around service to the cyclists during this quarter. Referrals for STI/STD treatment, SMC, Family Planning and treatment, care and support was provided to the Boda Boda cyclists to help reduce on their risks of HIV infections and provide counselling on positive Living for those who tested HIV positive, respectively. Review meetings were done with the Boda Boda peer educators in the districts of Arua, Nebbi, Moyo, Koboko, Jinja and Mbale to provide technical support to the peers. The meetings aimed at discussing work progress, sharing experiences, challenges and possible solutions to guide the implementation of the project. Stakeholders meetings: Three meetings with the district leaders and other stakeholders were successfully held in the districts of Nebbi, Koboko and Moyo. These meetings were aimed at sensitizing the district leadership on the HIV situation in the sub region, the drivers of this HIV epidemic and goal of the ‘’Get Ready to Roll project” targeting the Boda Boda cyclists and the surrounding communities. The meeting discussed and agreed on various ways of district involvement in the project. Project work plan was shared with the district leaders. Youth clubs: The following were the key achievements under the youth program. 156 young un-married people were referred for the service at various health facilities in the target districts, 144 were circumcised with the support from HA-U. 10 peer support clubs, with each club having 25 members were formed and 05 other groups strengthened in Oyam to enhance peer to peer interactions and sharing of experiences and lessons learnt. IPC awareness creations were conducted and reached 7,345 (4,840males and 2,505females) Among the key messages passed to community includes; benefits of early diagnosis, STIs & HIV prevention, consistent and correct use of condom, family planning services, benefits of medical male circumcision, modes of HIV prevention and transmission, and life skills. 06 sessions of HCT out reaches were conducted reaching 354 (212m& 142f) young people and 07 young people who tested positive were referred for care and treatment. A total 151 (62M&89F) young people were referred for STIs assessment and treatement. 25 (15males & 10females) health workers were trained in delivery of youth friendly health services, pediatric counseling and risk reduction counselling, and communication skills Quarterly Support supervision to Sub-grantees 34 Support supervision was provided to the five (5) sub grantees implementing sexual and risk reduction activities among truckers, CSW, Fisher folks, young people out of school and couples by UHMG to ensure they are implementing their activities as planned. Technical support was provided to these sub grantees to ensure that they were on track and to see the progress of work. Positive Prevention This quarter UHMG supported peer educators in close collaboration with health workers form the GLCs to provide positive prevention (PP) services to PHAs in the communities served by the GLCs. . Service provision was guided by the MOH minimum requirement of emphasizing partner disclosure and testing, safe sex, safe pregnancy, family planning, adherence to cotrimoxazole, treatment of STIs and linkage to support groups for psychosocial support. 1437 PHAs were reached with PP services. Of these 34.4% were male while 65.6% were females. During support visits, peer educators and health workers were mentored on how to use the profiling tool developed by HCP. This tool was used to enable peer educators and HWs understand the need of their clients at the time of encounters. As a result, counseling focuses on the most relevant and urgent needs of the clients. HIV Care UHMG continued to provide HIV clinical care services to PHAs through the GLCs. In total, 2,485 PHAs were reached. All those who tested positive at HCT were provided with a starter pack as highlighted in the HCT section above, and referred to nearby health facilities for CD4 testing. Tracking has been done through peer educators in 30 GLCs. This quarter, UHMG will pilot using SMS for tracking referred clients by providing airtime to 50 selected GLCs. To contribute to the MOH efforts of scaling up ART through the private sector, UHMG partnered with MOH to build the capacity of 45 HWs from the 14 GLCs selected by MOH as ART sites to provide comprehensive HIV care and ART services. HIV care services provided are summarized below. Number of PHAs who received clinical care at GLCs segregated by sex HIV Care Category At least 1 Care Service Total Annual target Q1 Output Q2 Output Q3 Output Q4 Output Total M F M F M M M 12,500 776 1038 1032 1086 12,500 1814 95 15 4 32 2485 2118 F F F 6417 (51%) PMTCT Services In a bid to join national efforts towards virtual elimination of vertical transmission of pediatric HIV, UHMG partnered with MOH to assess GLCs that qualify to provide PMTCT services. Of the GLCs assessed, 32 GLCs were considered ready to start PMTCT service provision as they met most of the criteria for PMTCT site. This will start following PMTCT/EID and IMAI trainings for two HWs per GLC selected. Lessons learnt 1. Over achievement was as a result of; engaging more peer educators and holding regular meetings to find challenges. 35 2. 3. 4. 5. Need to carry out a lot of sensitization and mobilization to inform the public about the existence of the programs we are following. Constant and regular interaction will be very beneficial in getting results for HIV prevention Proper and consistence usage of condoms was demonstrated by fishermen from different landing sites. Mapping HIV/AIDS organizations in the project area has been beneficial to SSECODA and HIV/AIDS organizations for strengthening referral networks. Planned Activities Key activities for Q4 include; Scale up of MAPRS service for truckers, Fish folks and CSW working through subgrantees Expand care and treatment to include ART. Build the capacity for PMTC services in the private sesctor Scale up condom prevention among MARPS and get of sexual network, working with DBTA. Continue HCT services through GLC. 2.5 SYSTEMS STRENGTHENING, MONITORING & EVALUATION Planned activities Distribution of HMIS tools and provision of technical support to the GLCs Completion of training of HMIS for Kampala district and those which missed the training Mentoring of staff from the drug shops being supported in data management and distribution of data management and reporting tools Development of joint work plan with districts where the GLCs are located to provide technical support to the entire private health sector and collect data Re-designing of the UHMG database to capture data generated through the monthly HMIS reporting forms and generation of appropriate reports Collection and compilation of data for the Quarterly review and reporting to UMEMS and bi-annual to MEEPP UHMG database update development MEEPP Bi-Annual Reporting and UMEMS quarterly reporting Bi-annual MEEPP reporting opened the activities for this quarter. Detailed data on activities being implemented by UHMG through the sub grantees and GLCs were reported on through the MEEPP online reporting system. Performance on most areas was below target. This was partly because of the delay in awarding contracts to the sub grantees. The performance in HCT and clinical care was lower than expected because data was collected for 5 months (October 20122 to February 2012) instead of the 6 months of the reporting period. This was because data had to be collected early enough to facilitate reporting. The reporting rate was also lower because many service outlets were using the HMIS reporting forms for the first time and were not used to it. Training of GLC staff in HMIS The training of facility staff from the old GLCs was completed with the training of 23 staff from Kampala facilities. This brought the number of staff trained in HMIS to 190. Some clinics did not send at least one staff for training. These will be mentored from their work places to ensure they appreciate the use of HMIS tools and follow the instructions for proper record keeping and reporting. Distribution is of the tools is a continuous process during support supervision. 36 Printing and distribution of data collection tools In an effort to improve data management in the GLCs, the M & E unit printed and distributed both data management and reporting tools. CLCs have ale requested the printing of tools to cover new service outlets and to ensure continuous supply for at least 6 months. The training, printing, and distribution of the HMIS tools have been appreciated by MOH as it is addressing one of MOH priority areas of getting data from the private service providers. Type and Quantity of HMIS tools printed during the Quarter Name of tool HIV Counseling (HCT) Register Health Unit Outpatient Monthly Report HCT Client Card Pre-Art Register Art Register Health unit Database Health Unit Manual Health Unit inpatient reporting form HMIS Number HMIS 055b HMIS 105 HMIS 055A HMIS 080 HMIS 081 HMIS 108 Quantity Printed 206 206 1,854 50 50 206 206 50 Monthly Reporting/Data collection Data for three months (March to May 2012) were collected during the last month of the reporting period. This is because monthly reporting has just started and the M & E unit not yet put a system in place to ensure that every month reports are collected. The table blow summarizes the returns as received from the field. Region Status Expected Received Old 79 66 New 13 11 Old 42 40 New 11 8 Old 28 24 New 0 0 Old 43 32 Reporting Rate (%) 84 85 Central North New Overall 10 0 226 181 Data collected for only May. The service providers are not yet trained in HMIS 86 Training of new ones in provision LT FP methods not been done 74 0 West Data collected for only May. The service providers are not yet trained in HMIS 95 73 East Comments Some districts were not reached. The 4 service outlets in Ntungamo were not ready to report(Kisoro, Masindi and Hoima) 80 Data collected is reflected in the different program areas of the quarterly report. The data are validated by performing consistency checks on different sections of the HMIS data forms. Challenges in the HMIS Some of the trained service providers in HMIG have moved on. Other service providers have taken it as an excuse for not compiling the reports. 37 Some staff fill they are obliged to compile only the section for HIV counseling and testing, some sections are left unattended to and yet during the training, they were told that all sections referring to services provided by the service outlet must be filled. Some clinics have indicated they are not ready to fill the Monthly HMIS forms because it requires a lot of time. There are some inconstancies in some areas of the HMIS forms. For example between the malaria cases seen and malaria cases tested. Clients seen and quantities dispensed. These are being investigated. Collecting monthly data from 90 districts is a big challenge. It is costly and requires a lot of time. Routine Monitoring of field activities During the quarter, the M & E staff provided technical support to a number of sub grantees implementing the different UHMG projects. Field visits were carried out in the HCU implementation sites in Mukono, Kamuli, Mbale, and Lira districts. The couple trainers tend to appreciate their roles speak a common language which is not the same among the peer educators. The use of the couple trainer’s manual tends to provide clear guidance in addition to the training they get. Mentoring of the SSECODA recruited M & E officer was carried out and the major areas of weaknesses affecting their data were highlighted. The GLCs were supported and those which never participated in the HMIS training were given the HMIS tools and mentored. Supported supervision and mentoring in data management were carried out for the trained drug shop operators. However, during data collection, the drug shop operators had not utilized them. There is therefore need for continued mentorship in data management so that the drug shop operators can appreciate the need to record data on service delivery and compile appropriate report. Re-designing of the UHMG database The process of re-designing the UHMG database to capture data generated through the monthly HMIS reporting forms and generation of appropriate reports started during the quarter. The data entry module was finalized and used to capture the data collected. Other modules one to generate use reports and the other to track work plan activity implementation are being developed. Based on this database, the M & E unit was able to generate service data on all services being supported at the GLCs. For details refer to the different program intervention areas. Development of joint work plan with districts This activity was put on hold until UHMG has signed MOUs with most districts. It has been pushed to year three work plan. Planned activities Distribution of HMIS tools and provision of technical support to the GLCs especially the new ones Training of the service providers from the new GLCs in HMIS Training of HMIS new service outlets brought on board to provide long term FP methods and other services Finalize the M & E data base and generate appropriate report Collection and compilation of monthly data from the GLCs. Compile data for annual review and reporting UHMG database update( Routine activity) Development of annual work plan Support different department during work plan development Installation of ArcGIS 10.1 and training three people Upload of the AFFORD work plan in the UHMG database to facilitate it close monitoring 38 3. CROSS CUTTING ACTIVITIES AND SERVICES 3.1 MARKETING & STRATEGIC INFORMATION (MSI) – BRAND ACTIVITIES Activity Performance Monitoring Table Brand Cotramox Esther Atuuse Activities/Targets/Outp uts Annual target 7,900,000 Q1 & Q2 Achieved 4,900,870 Q3 Targets 2,999,130 Actual 22,620 Quarterly target Progress, Comments 62% Vs Annual Variance 2,976,510 1,975,000 Networking w/decision makers in major institutions and NGOs; increase number from 4 to 8 6 institutions A networking workshop with institutions offering services to PHLAs Started on the process of building contacts. JCRC remained a major supporter. Detailing in health and pharmacy providers; posters to improve brand visibility 459 pharmacies & 120 drug shop calls made 640 pharmacy provider calls & 960 Health providers calls 1106 pharmacy/ drug shop provider calls & 1702 Health provider calls Detailing is currently on going countrywide. Feedback is that distributors requested for more support to deliver to areas social marketing areas that are not economically viable. Regional CMEs and orientation meetings 9 product orientation meetings In the Eastern Region – 556 Providers. 2 Not conducted, a Northern Uganda CME is scheduled. Stock uplift from the trade is still slow. Distribution through 8 institutions and NGOS, pharmacies and health centres 6 Institutions bought Maintain contacts. Will continue to be in touch to prompt more leads. RHU,IRCU ICOBI,STAR SW,JCRU Brand Activities/Targets/ Outputs Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments 39 Restors +Zinkid promotion & uptake in combination use Advocate with MOH targeting DHOs, DHEs, POLs and VHTs on benefits of combination use (UHMG brand) Attending MOH & CHAI meetings for linkages. Detailing to health providers on combination use. 499 health providers Follow ups Popular Paed to endorse & feature on media messages. Participation in CHAI meetings will continue. Esther Atuuse Develop materials for detailing and POS placement. Use radio, TV and billboards for demand creation to run all year. 36 Health provider, 26 GLCs 240 outlets Concepts for new campaign route developed & approved by NDA. In progress. Achieve sales volume of 10,000,000 tablets for Zinkid Producing display racks for the combination. Message Development in final stages. Participate in health conferences for brand visibility Achieve annual sales of 2,000,000 sachets for Restors Media campaign has been booked. On plan. Restors: 459,420 1,040,580 12,648 Restors sales at 23.6% Vs annual Budget. Zinkid: 4,831,900 2,668,000 82,091 49.1% Vs Annual Improve brand awareness of the combination Media production in final stages. Mass media campaign booked from Mid July. Increase availability, accessibility and visibility of RESTORS/ZINKID through 387 (75%) of pharmacies and 1,583 (60%) of drug shops in UHMG database Trainings & CMEs for Restors/Zinkid Esther Atuuse CMEs and trainings of 1,000 HCPs in public & private sectors on diarrhoea management and combination use. 6 facility based CMEs conducted in central region; 147 attended 7 conducted 855 providers reached so far. Product orientation meeting for drug association 40 meetings in Eastern region; 556 providers were trained. Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Condom "O" promotion Open 4,000 additional ‘O’ outlets (supermarkets, dukas/kiosks, hotels, lodges) 1121 Jeanne Marie Nakato Q3 Targets Actual Progress, Comments Demand surpassed forecast supply .Stock orders have been placed & to be forwarded for approval. Barbra ,Joshua A few outlets are still stocked. Sales volume of 1,500,000 pieces 609,792 535,312 1 mass media campaign (DJ endorsements, TV and radio spots) Radio – 7 stations running + TV (NTV) TV ads running On NBS and NTV 14,588 41.7% Vs Annual 328 spots & mentions on NBS & NTV POS placement of 10,000 posters and 5000 metal plates Designs done, production & merchandising to proceed after outlet stocking. 12 regional concert sponsorships 2 1 Participated in NewVision Western Uganda events & O was heavily promoted. 8 ‘O’ theme nights in leading night clubs/bars per region 23 On hold , awaiting promotional campaign Theme nites scheduled to run concurrently with seasonal promo. Weekly supervision visits to monitor activities. Trade visits done in Gulu, Mukono, Mbarara, Bushenyi, Mbale, Masaka, Kasese, Kampala. Pursue corporate social responsibility collaboration. Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets PROTECTOR promotion Achieve sales volume of 16,000,000 condoms. 5,247,780 2,999,180 Actual Progress, Comments 51.6% Vs Annual 41 Coordinate activities with MARPS program, Boda Boda campaign and Boda Boda associations 1 done Conduct mass media (TV and radio) Radio interview carried out on Step and NBS stations Done with STAR-SW Job aide for Boda-Boda is being developed. 5,000 ABS boards at POS, 20,000 t-shirts and caps for trade and consumer promotions Promoted at CBS Procured and distribution on -going. Permanent merchandizing materials were procured & well received in outlets across the country. Merchandizing on- going and distribution of the materials in retail outlets . Distribution through existing networks and retail outlets (dukas, pharmacies and drug shops On-going MITs carried out in Central region over 15 trading centres in the month of July Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments AQUASAFE promotion 5,400,000 tablets sold 1,860,640 1,769,680 208,160 34.5% Vs Annual Jeanne Marie Nakato Promotions at schools 50 50 53 School workshop was hosted for the Northern regions. 53 head teachers were oriented Increase community distribution points to 180 88 Partnerships with NGOs 40 schools oriented, and a major distributor in Soroti is supplying community outlets. 1 - SNV 1 KPI Achieved a Partnership with SNV in west Nile in regards to Sanitation in 13 schools and surrounding communities Oriented the communities around Kikajjo behind Aga Khan university with KPI. 42 1 plantation activations 2 Workplace orientation at KPI. Over 200 staff attended. & Workplaces trainings Plantation habitat training on plan with BIDCO & AAR Day of the African Child. Involvement in Schools Rugby to sample Aquasafe Mass media using radio spots, talk shows and billboards. Trainings & demonstrations for Aquasafe African child day – CSR partnership with Vision group 2 Mass media is running till end of July in central and other regions 7 stations and outdoor Pictorial of the CSR partnership between Vision group and UHMG 830 spots booked for MayJuly in Central, western, Northern, Eastern. 84 Billboards& Sub-urban signs installed. Community orientations. 5 Conducted in Eastern, Central & Northern Uganda. Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments Injectaplan promotion Juliet Rumanyika 2,800,000 vials sold (650,000 CYP) 817,550 991,223 174,470 35.5% Vs. Annual 37 Radio talk shows have been conducted on 7 radio stations 3449 spots booked on Open Gate FM, Rupiny FM, Radio West, CBS, Super FM, Voice of Lango and Liberty FM. 14 Health Providers trained Trainings booked in various hospitals. Jeanne Marie Nakato Mass media (radio talk shows) for Side effects management w/providers 5,000 providers trained on counselling clients Detailing to providers (gyn., midwives, nurses, drug shops, pharmacies) POS material: 5,000 posters, 10,000 provider brochures, 8,000 consumer brochures. 1,250 Radio talk shows by Sr. Gyns are also on ogoing. 1,703 Health providers detailed to 100 health providers and 70 Materials procured brochures, fliers, ABS boardsDistributed. 43 Participate in conferences/exhibitions for visibility On plan. Plan for the Full Woman health camp in Q4. Coordinate with MNCH community interventions to both promote Injectaplan and sales of Injectaplan through GLC ‘s. On-going GLCs promotion starting in Q4 Increase access to Injectaplan through collaboration with NGOs and professional associations. Participating in Obs& Gyn Association events. CMEs Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments Pilplanplus promotion Achieve sales target of 1,600,000 cycles 1,454,430 72,785 214,170 104.3% Vs. Annual Detailing of 5,000 providers 928 & 1572 outlets Exhibit at health conferences 5 2 MUPSA – Mulago school of Medicine and UPMPA – at hotel Africana. Mass media (TV, radio) and billboard Communication messages to be produced POS, promotional and IEC materials, 10,000 provider brochures,8,000 consumer leaflets. Materials were produced, pretested & forwarded to NDA for approval. 8,000 POS posters,1,000 t-shirts 1,000 lab coats,1,500 pens Collaborate with HCP, RHU, FHI, MSH, MOH, ENGAGE, UNAMUganda Nurses and midwives assoc, UPMA to increase access. Trainings & CMEs for Conduct CMEs. 10 conducted with 954 9 conducted with 367 Jinja RRH, Mbale RRH, Tororo RRH, Arua RRH, 44 Pilplanplus providers Juliet Rumanyika health providers Kuluva Hospital, Lacor Hospital, Teso safe motherhood, Louise MMC, Mengo Hospital. Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments Moonbeads Promotion Achieve sales of 3,600 1800 1,254 23 31% Vs. Annual. Sales anticipated to be increased this quarter. Humanitarian Care had a pending order for 576 pieces. Distribute 200 per quarter though JMS 50 Had stock out, 5000 additional pieces have been packaged. Orient HCPs/Trainings and CMEs 320 HCPs oriented 2 CMEs Juliet Rumanyika Tororo RRH, Arua RRH, Kuluva Hospital, Teso safe motherhood, Louise MMC, Mengo Hospital. Coordinate with MNCH program in community interventions On plan. Increase access through FBOs and training schools 1 conducted, with 47 health providers Lacor Hospital Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments NewFem promotion Sales target of 40,000 cycles 8820 15,590 900 30% Vs. Annual Detailing to providers in selective distribution points 1,704 health providers detailed to Activations at corporate workplaces using direct marketing On plan Initial contacts have been made and activities planned with Mama Tendo. Mass media (radio, TV, billboards. 3 Radio stations + 1 TV in central running 655 spots booked on radio, 78 TV spots. 45 Exhibitions 5 2 executed Exclusive—middle class—outlets stocking NewFem. MUPSA – Mulago school of Medicine and UPMPA – at hotel Africana. Conducted sales drive for central region Brand Activities/Targets/Outp uts Q1 & Q2 Achieved Q3 Targets Actual Progress, Comments Softsure promotion 72,000 cycles (4,800 CYPs) 46,680 6320 1,820 64% Booked Planned for Q4 Juliet Rumanyika Activations at ANC, maternity homes and hospitals Target of 10 hospital maternity centers promoting Softsure Booked Mulago. Louise Memorial Nakasero Hospital Mengo Hospital Detailing to HCPs (gyn., midwives, nurses, pharmacy dispensers) at private sector clinics Radio and TV adverts Participate at FP exhibitions for visibility 26 providers reached Countrywide detailing ongoing. 6 Media on- going till en d of July 2 executed MUPSA – Mulago school of Medicine and UPMPA – at hotel Africana. Link Mothers clubs to ANCs with hospitalbased activations Collaborate with MCP program for VHTS and community interventions Access through MSU, RHU, ´NGAGE, FHI, MSH, HCP 46 Partner with fastmoving goods company targeting same audience (young mothers, breastfeeding mothers) Trainings & CMEs for Softsure Conduct CMEs among HCPs 9 conducted, 367 providers reached. Jinja RRH, Mbale RRH, Tororo RRH, Arua RRH, Kuluva Hospital, Lacor Hospital, Teso safe motherhood, Louise MMC, Mengo Hospital. Progress of planned activities CHILD HEALTH Restors + Zinkid Restors is still challenged with a low uptake compared to its competitors, whereas Zinkid is at about 50% of annual target. The Zinkid target set was doubled anticipating a bid award from NMS which we lost. The gap has to be closed by end user and provider demand. Support campaign concepts have been developed and approved by NDA. Production of mass media messages in final stages and media has been booked from Mid July. A merchandizing drive to display combination at outlets is on plan and orders for display racks have been placed. Strategically attending CHAI meetings with MOH for advocacy linkages. Aquasafe Sales were higher in quarter 2 than 3. The re-purchase rate is quite slow and a carton can last a school for a term. Activities to enroll more schools continued. Another school workshop was conducted in Northern Uganda and 53 head teachers were in attendance. We received subsequent invitations to orient several schools and they procured Aquasafe. Old schools were also revisited to motivate new champions and to follow up stocks. This exercise will continue. Advocacy partnerships were also initiated with the Hon. State Minister of Water & Environment who has picked interest and has school sanitation programs. The Hon. Minister of Education was also met and she committed to further discussions. Other partnerships included, SNV, a Northern Uganda NGO with activities in over 40 schools. They invited orientations which were conducted. Also purchased products for donations. HIV/AIDS Cotramox Current buyers are still stocked, more networks to be created to widen base. A networking workshop which is aimed at interacting with institutional decision makers is scheduled next quarter. Good Life Clinics are also targeted for the uptake of Cotramox. ‘O’ Condom 47 Demand surpassed supply and more stocks have been ordered. Distribution and merchandizing to start in the 2 nd week of July. A promo to safe guard earned share & sustain gained sales was developed and pre-tested. Scheduled to run during the festive season. PROTECTOR Stock supplies stabilized and a sales drive to stock outlets was conducted and it is on-going. A media campaign to support is on plan. Protector was heavily promoted during the CBS event promotion (Ekitobeero). FAMILY PLANNING Pilplanplus The market has been very receptive of PilplanPlus although providers approached acknowledged they needed more information to address change in combination and brand name. Provider brochures were procured and are being distributed to Gyn and maternal medics. A brand campaign – “Heritage Route” has been developed and pre-tested. Awaiting NDA approval to launch mass media. INJECTAPLAN Insights from Market impact teams reveal buyer behavior has shifted from bulk stocking to retail and they are indicators that traders need to be incentivized with a higher margin if they are to stock. A trade promotion is proposed to sell at a discounted price to uplift stock. Family Planning radio talk shows kicked off and gyns are promoting Injectaplan and addressing side effect management. Spot Media placement is also heavy countrywide. Also talking to major referrals directly and direct orders have been placed in response. A trainer of trainers program is also on plan with senior medical workers in health facilities. MOONBEADS New stocks have been packaged to supply pending orders and to meet increasing demand. With the new packaging a price increment is anticipated and key customers will be oriented on the new pricing. Focus in the next quarter is going to be on following up bulk buyers with the supporting them to educate their audiences and prompting more referrals. SOFTSURE 3,449 radio spots running in Central, Western, Eastern and Northern Uganda. Discussions with maternity medic workers have been positive with most of them committing to recommend Softsure to the mothers. An advocate team amongst health providers will be oriented to educate mothers on our behalf. Mengo hospital which is highly targeted to kick start these activities receives about 200 mothers a week on immunization and ANC days. Daily deliveries recorded range from 25-50. Corporate activations are also planned in the next quarter to educate working mothers. NEWFEM Media is running. Urban outlets have been stocked and merchandised. Corporate activations are planned. Below the line, Newfem will be promoted with Genext University activations and corporate activations. 48 3.2 MARKETING & STRATEGIC INFORMATION (MSI) - COMMUNICATION Activity Performance Monitoring Table Campaign Small families-GeNext Lea Bwanika/Daudi Mass Media Advocacy Campaign in full gear Phase 2 adverts have been developed in Luo, Luganda, Runyakitara and Atesot and are being pre-tested. English pre-tested and running Radio has been booked for July-Aug on 10 stations both upcountry and in Kampala. Interactive Media/Interpersonal Activations 60 GENEXT advocates trained in Advocacy and Community mobilisation skills An Advocacy Toolkit consisting of 6 documents to provide advocates with guidance during community activations was developed. Advocates will conduct 3 community dialogues each week reaching at least 90 people in next 8 weeks. A total of 1440 community dialogues to be conducted. 43200 people expected to be reached with the message on Smaller families. Other activations to be carried out through community gatherings and events. Interacting and receiving feedback from 33176 GENEXT subscribers on the SMS platform. HCT- Sexual Network Campaign Scale up and condom promotion Daudi/Mariettah Campaign has stopped in urban areas. STAR-SW scale up Campaign has been scaled up in rural areas by STAR-SW in 13 districts of Western Uganda 20 Billboards erected Began 17 months Radio Campaign on 15 Radio stations in western Uganda. 2340 Radio spots aired 3660 Radio adverts aired. Star EC Scale up Star EC running Radio advertisements ANC (Lea Bwanika/Daudi) Media campaign running on 13 Radio stations all over the Western part of the country. 10,128 DJ mentions 10,000 posters printed and distributed Interpersonal communication ongoing. Reached 1,826 people with HIV risk reduction messages and summary is below; STAR EC scale up STAR EC has rolled out campaign in East and Central Uganda and Condom Promotion is on going through community activations and interpersonal communication. Work with SPEAR on scale up has began 1000 posters pinned up 9708 Radio spots aired 94 Radio talk shows conducted 49 PMTCT Communication Strategy developed PMCT Creative briefs developed and forwarded to agency. Concepts developed Power of Day One Media booked for May-July (Lea/Daudi) 30 Radio talkshows aired on 4 Radio stations 1040 Radio spots aired 68 Taxis have been branded with Power of Day One adverts. 7 billboards on various highways 40 Road stars Interpersonal communication stalled for lack of Malaria Program Officer Get Ready To roll Boda-Boda Campaign Follow up for peer educators job aided drafted awaiting approval (Mariettah) MNCH/FP Smart choices campaign Smart choices campaign DJ mentions airing in Hoima ahead of World Population Day. Formulation of model villages in the districts of Kyenjojo & Kabarole (SMGL) Radio announcements for 3 days in Mpigi on FP service provision. Integrated messages in Community sensitization and home visits in Lira, Serere, Mbale and Mukono (Sarah Mutesi) SMGL Campaign Communication strategy developed and 2 concept pre-tests done 3 Partner and 1 district meeting held. Radio scripts developed Job Aides developed Campaign sign off by MOH done. SCIPHA (Ritah Mwagale) Ran 7 Radio takshows Aired 378 Radio spots Run 378 DJ mentions Documentation of SCIPHA activities in Midwest, North and East Run SMS chartroom and developed an implementation plan. 3.3 MSI - Research Retail Audit: The retail audit survey which is meant to Provide information to UHMG about the sales, stock and distribution of its brands and its competitor brands on a quarterly basis; Track end consumer price paid for by consumers for UHMG/AFFORD brands; Track the reach of each of its brands in terms of availability in number of outlets by outlet classification... Health outlets (pharmacies, drug shops, clinics) General Merchandise outlets (dukas, supermarkets, 50 grocery stores) and estimate relative market share of its brands census was commissioned within the quarter. Results of the retail audit; The retail audit census yielded a total of 570 Registered Pharmacies, 2,403 registered clinics and 6,038 drug registered drug shops countrywide. A sample size of 1100 health outlets was derived from the total sample of 9011. The table below shows retail sales for May. North Central North Western South Western South Eastern Total – n=1100 Drug Shop Clinic Pharmacy % per product (all regions) 49 51 56 62 74 93 48 652 60 54 49 59% Pilplan Plus 50 58 45 61 35 45 96 46 642 57 62 40 58% Injectaplan 45 55 21 56 02 0 90 39 536 44 59 41 49% Zinkid 35 51 38 08 30 34 36 32 342 24 43 44 31% Restors 12 27 10 27 11 03 86 14 314 29 26 19 29% Condom O 20 05 09 08 0 0 09 02 86 4 11 36 8% Aquasafe 04 05 24 04 05 09 13 05 83 08 07 09 8% Softsure 11 03 04 05 01 0 08 02 56 03 08 19 5% Cotramox 01 02 0 01 0 0 11 0 26 02 03 04 2% Newfem 03 02 01 02 0 0 06 01 26 01 04 10 2% Moonbeads 03 02 0 02 0 0 0 01 14 01 02 04 1% Central 50 North Eastern Mid Western Protector Products Kampala Table of product overall performance by region by percentages – for May Formative research to examine the knowledge, attitudes and behaviours of commercial sex workers and fisher folk: This study is planned to help UHMG better understand the attitudes and behaviours of these unique populations. Information from these studies will be used to fine-tune the organization’s interventions. These KAPs will primarily use qualitative methods, including focus groups with fisher folk and sex workers. Target groups have been identified, Tools have been developed and refined, and fieldwork is scheduled to be conducted next quarter. Pre-test for GeNext phase II (mobilized by youth) campaign materials: The pre-tests, mainly qualitative in nature, were conducted to get stakeholders’ understanding the materials before final production for dissemination. Pre-testing included determining if the poster is convincing to the target audiences, to find out if the audience understands the 51 translated poster, to establish if the audience relates to the campaign poster, to establish if the posters are offensive or confusing, to establish if the poster is attractive to the audience and to understand if the wording in the poster is appropriate. Concept tests for Saving Mothers Giving Life materials: The overall objective of the concept tests was to select the concepts that best communicate the new campaign. To establish whether the audience relate to the proposed concepts, To establish whether there is anything that is offensive/ confusing in the concepts and establish if the concepts are attractive to the audience and select the one that would be most effective. Finalizing focus group reports inform production of campaign messages. USAID_IP joint BCC survey The study is jointly conducted by implementing partners to evaluate the reach and affects of behaviour change communication efforts by a number of implementing partners. Progress to date: Survey protocol developed and submitted to IRB for approval Tools developed and being refined and submitted to IRB for approval Districts for the survey selected Sample size determined Training manuals developed Next quarter activities MARPS qualitative research Joint USAID BCC-IP’s survey Pre-tests of various communication materials Rapid assessment of brands interventions Coordinate data collection of the retail audit and share findings with the brands and distribution teams. 3.4 MSI Cross-Cutting Functions - Corporate & External Relations Activity Description Outputs Progress, Comments 52 Build Strategic Partnerships to penetrate professional & Local communities Evelyn/Team Organize strategic meetings with potential donors and partner organisations to advance the goals of UHMG Uganda Rugby Union - In advanced discussions of promoting O in events. SNV - Community NGO in N.Uganda, working together to advance Aquasafe in schools. Barclays Bank - Proposal to purchase FP products for hospital donations & joint activations under consideration. IAA - Discussing implementation of joint health fairs. AAR – Discussing BIDCO plantations Kalangala health camps. Newvision & Day of the African Child - Participated in joint CSR at Kireka Special needs home, Aquasafe received publicity. Newvision has also received a proposal to purchase Aquasafe for their CSR. CBS Station - Associated with their prime event (Ekitobeero) to promote Protector & Aquasafe. Pepsi - Receptive in working with UHMG & we expect a briefing on CSR areas of interest. Centenary Bank - Proposal to purchase Aquasafe submitted. Waiting for a response. Mengo Hospital - Invited continuous FP education. Website Upgrade Information dissemination Compiling content, resource technical people identified. Update stakeholders of UHMG’s annual progress Develop & implement GL strategy Copies to be published and disseminated by 20/7. Evaluation Institutional performance Organisation Committee was formed and preps have started. Steer meetings to come up with theme and discussion topics. Abstract submissions received from key stakeholders. Consultation meetings set in July and conference in August. Evelyn/Team Publishing of the Annual report Evelyn/Team Good Life (GL) umbrella brand revamp Evelyn/BCC team Preparation of the AGM- Event set for 10th August Evelyn/Lea/Joyce Kaija Health Marketing Conference Evelyn/Mariettah/Joyce Kaija Strategy approved by BOD, implementation has started with conducting of a Baseline mini study to guide messaging. 53 UHMG and Vision Group partnership - Kireka school for the disabled (orientation of Aquasafe and donations were given by both UHMG and Vision group staff to support the school children on the Day of the African Child) Protector Condom, Condom ‘O’ & Aquasafe Exhibition during CBS event (Ekitobeero) in Nakivubo Protector condom, ‘O’ Condom and Aquasafe exhibition at the CBS Ekitobeero event in Nakivubo where over 10,000 people were exposed to the messages Namilyango School rugby champions celebrate after being energized with Aquasafe treated water at the pitch Team after collaboration meeting with Mengo Hospital Sr. Executive team 54 MNCH & FP CME & Detailing Activities Jinja Regional Referral Hospital Diarrhea management using Restors & Zinkid Orientation on Moonbeads at Lacor Hospital (Gulu) Detailing at Teso safe Motherhood in Soroti Diarrhea Management CME using at Lira Regional Referral Hospital UHMG Products orientation at Lira Regional Referral Hospital 3.5 HUMAN RESOURCES & ADMINISTRATION (HRA) Human Resource Management Recruitment S/N 1. 2. 3. 4. 6. 7. 8. POSITION SCIPHA Project Support Coordinator Finance Manager – Product Facility STRIDES Project Coordinator STRIDES Project Assistant Project Manager – Reproductive Health Driver – Head Office Driver – Product Facility STAFF NAME James Okweny Moses Kafeero Anne Kyomugisha Hadijah Kibirige Dr. Margaret Elang Joseph Kasozi John Moses Mubbale START DATE 1st May 2012 2nd May 2012 2nd May 2012 2nd May 2012 2nd May 2012 26th June 0212 27th June 2012 Exited staff S/N 1. 2. 3. POSITION Transport Officer Malaria Program Officer Driver – Product Facility STAFF NAME Paddy Kabega Anne Kusiima Otedor Godfrey Tusiime END DATE 26th April 2012 30th April 2012 10th May 2012 55 4. 5. Reproductive Health Manager Deputy Project Manager - SCIPHA Sylvia Margaret Namulema (RIP) James M. Mukankusi 13th June 2012 21st June 2012 Closure of the SCIPHA I Project: The SCIPHA I Project ended on 30th June 2012. We held a close-out meeting with the SCIPHA staff to appreciate their efforts towards completing this project, and prepare them for the exit process. Human Resource Audit: Separate meetings were held with the Human Resource Board Committee, as well as with AFFORD and KPMG to review the Terms of Reference for the Human Resource Audit expected to commence in July 2012. This exercise is meant to assess and improve current staff capacity against existing job descriptions and key result areas, and to also assess if the JDs & KRAs are well-aligned to the organization’s goals and objectives Insurance Coverage for all staff: As per policy and statutory regulations, the medical insurance cover was renewed with Jubilee Insurance Uganda Limited for the period 1st May 2012 to 30th April 2013, and Group Personal Accident renewed with Chartis Insurance Company Uganda Limited for the period 13 th June 2012 to 12th June 2013. Staff demise: We lost one our staff (the Reproductive Health Manager) on 13 th June 2012 at International Hospital Kampala due to illness. She was buried on 15th June in Mbirizi along Masaka-Mbarara road. “MAY SYLVIA MARGARET NAMULEMA’s SOUL REST IN ETERNAL PEACE”. Meetings/Workshops held: Four (4) all-staff meetings during this quarter on 30th April, 11th May, 22nd June, and 29th June 2012 to discuss staff and welfare issues, and emphasize policy and compliance requirements. Staff were reminded on 19th June about unallowable costs with the US Government funds. A staff satisfaction survey was conducted in May 2012, and results shared on the employees’ feedback to their working conditions and welfare, health and safety standards, job security, staff credibility, supervisor/supervisee relationship, departmental co-operation, timely communication, employee recognition, job loads, competence, performance standards and feedback, job advancement and professional growth, training opportunities, salary structure and fringe benefits, and current policies and procedures in place. Only 37 out of 91 staff participated in this exercise. During the 29th June meeting, Kellie Klein (the International Finance and Operations Manager with Johns Hopkins University School of Public Health) had a refresher training with staff on accountability, compliance issues, budgeting and planning, performance evaluations, conflict of interest, and unallowable costs among others. We also shared our policies with her for review to ensure compliance with USG donor regulations. The Human Resource & Administration Manager attended a Workshop at International Rescue Committee on 21st June 2012, where better payroll management and staff performance management were discussed with HR professionals in the INGO (International Non-Government Organizations) HR Network. The Managing Director attended the Strategic Leadership training in June 2012 in Baltimore, USA. Performance Monitoring: Staff appraisals continued during the quarter. New staff that successfully completed their probation were confirmed in employment. Staff were also reminded about the importance of time management, and weekly reports on staff time and attendance were shared. Staff Birthdays: We continued to recognize staff birthdays which has motivated staff to belong and feel attached to the UHMG family. 56 Governance Board of Directors and Board Committee meetings: In order to provide further guidance to management on UHMG’s strategic direction, the Board Committees’ quarterly meetings were held between April 16 th and 20th 2012 and the Board of Directors’ meeting on May 5, 2012. We also held a Board of Directors and Founder Members’ retreat during the quarter at Lake Victoria Serena Resort from May 4th to 6th, 2012. The retreat was aimed at addressing the structural and regulatory changes and adjustments required for growing organizations. The Technical Board Committee held a Strategic Retreat on June 8th and 9th 2012 at Country Lake Resort Garuga to discuss the revised strategies on Good Life Clinics, Resource Mobilization, and Communication. The Business Development and Finance & Planning Board Committees held a joint meeting on 16th June 2012, at the UHMG offices to further discuss UHMG’s strategy for sustainability beyond 2013. The meeting was attended by both Board Committee members and staff across the directorates (Product Facility, Marketing and Strategic Information, Finance & Investment, and Human Resource & Administration). The Human Resource, Finance & Planning, and Audit & Risk Board committees held a joint meeting on May 1st 2012 to review the current pay and fringe benefits of employees. They deferred the fringe benefits adjustments to the next financial year in October 2012. Administration Management Office security: We continued to remind staff about their safety, both at and after working hours. Security Group was contracted to provide security for the regional pharmacies in Arua and Mbale. Requisitions were made to procure additional security gadgets. Hotel Survey: The survey to review the corporate agreements with country-wide hotels, and identification of new facilities that started in March 2012 continued. In the quarter, the following districts in the Western and Mid-western regions were covered: Mpigi, Masaka, Mbarara, Kibaale, Hoima, Buliisa, Masindi, Kigumba, Nakasongola and Luwero were covered. Southwestern and West Nile Regions will be done in the first month of the next quarter. Asset Management Proper management of our new office premises was ensured. Minor repairs were done on electricity, office doors and plumbing. We also received and engraved USAID assets from the closed UMEMS project. Procurement Management Annual Procurement Contracts: Excel Forwarders & Transporters Ltd was selected as the providers for vehicle hire services for the period ending 30th September 2013. Africa General, Motors Ltd, Kalumba and Sons, Toyota Uganda Ltd, Cooper Motors, Victoria Motors, Motor Centre were recommended to the Procurement Committee as the service providers for vehicle servicing and maintenance. Service contracts will be endorsed in the next quarter if agreed upon. Annual Procurement Planning: KPMG reviewed our procurement plans, and recommended two versions i.e. Directorate Procurement plans and a Consolidated Procurement plan. During the month of May 2012, KPMG trained staff on how to prepare procurement plans, and their importance. The Consolidated Procurement Plan will be completed in July 2012. Vehicle disposal: Concurrence was received from USAID to dispose off UAK 309Z, the Toyota pick-up that was badly damaged in an accident in February 2012, and eventually recommended as a write-off by the suppliers and insurers. ICT (Information, Communication, and Technology) Management 57 New file server and domain controller: In April 2012, UHMG procured a new file server to replace the old one. The UHMG.ORG domain was installed afresh on this new server. The server was configured as a Domain Controller and as a File Server. In addition, the new server was set up with the new Windows 2008 Server which was an upgrade of the Windows 2003 Server software that was on the old server. All user accounts and domain policies were also reconfigured in line with the upgrade to facilitate more efficient network and systems management. Preparation of HRMIS User Specifications: From the month of April through May, UHMG together with a consultancy firm (Data Care Ltd) prepared the User Specifications for a Human Resource Management Information System (HRMIS). This system is to help UHMG’s Human Resource Directorate and UHMG as a whole to streamline systems and administration processes in areas such as recruitment of staff, employee data management, and systems linkages with other directorates. A corresponding Terms of Reference document is currently being prepared to facilitate the procurement of the above mentioned system in the next quarter. Local Area Network improvement: During the quarter, the UHMG Local Area Network was upgraded, and the Product Facility was connected to the same Local Subnet as the Head Office to facilitate faster data transfers across the network, and timely data back-ups. Upgrade of all Accounting Software: The Tally.ERP9 Software that is used by the UHMG Accounts Team was upgraded in June 2012 from Tally ERP9 release 2.1 to release 3.4. This was done to enhance on the packages that the new Tally.ERP9 release offers and to provide fixes for software bugs in the previous release. Simcard Registration of office phone lines: The compulsory simcard registration required by Uganda Communications Commission was effected in May 2012 when all office phone lines assigned to staff on our CUG (Closed User Group) were registered with Airtel Uganda Limited. This was as a result of a government directive to all Telecom operators in Uganda. Transport Management Additional Vehicles: Two vehicles (UAR 141G and UAR 186G) were received on 4 th June 2012 to support our field activities. Thanks to USAID and AFFORD for their support in the tax exemption registration process. The two Toyota Double Cabin Pickups below are to be branded during the next quarter after canopies have been procured. The procurement process for the branding and canopies is already underway. Back view Front view 58 Vehicle Policy and travel: Improvements were made to the Vehicle Policy and fuel management guidelines shared with “driving” staff. A drivers’ meeting was also held on 6 th June to improve vehicle management and operations. Monthly travel plans for the three (3) months were shared with all staff in advance to improve coordination of field activities. Legal Management Mediation and arbitration meetings: Held meeting with URA officials, our Board of Directors, and our tax consultants (Deloitte and Touché) on 14th June 2012 to defend our request to grant UHMG a tax exemption status. Contract and document reviews: A number of contracts were reviewed and finalized during the quarter; Debt Collector (John Bosco Tugume Bosco), Investigative Auditor (Masiko Kabumba), Daewon Suppliers from India, Excel forwarders and transporters, and addendum for D-mark, KPI and HCU, MSU-4 way agreement, Spear implementing project, teaming agreements with World Vision, CDFU and DSW, HCU-addendum, agreements with the Good Life Clinics), and PHI (to strengthen capacity to GLCs). Completed a third party intermediary questionnaire required by US Foreign Corrupt Practices Act and Local Anti bribery law and submitted it to AFFORD. Research and Opinions: Research was made and opinions written on the status of the pharmacists at registration level with NDA (National Drug Authority); remission of statutory payments of temporary staff with NSSF; relevance of having a third agency (Saatchi & Saatchi) for PR; as well as tax exemption and corporation tax regarding UHMG’s status. Reviewed the legal component of the Jul-Dec 2011 Internal Audit Report, and shared responses with Kisaka and Company on the re-employment of casual laborers, Good Life Clinics (GLCs) contracts, Reputational risks with our partners, Integrity and ethical issues on publishing condoms without set age limits, and the terms of our Memoranda of Understanding (MOUs). Reviewed UHMG’s Income Tax Returns for the period 2006 – 2011 and filed them with URA. CONSTRAINTS AND CHALLENGES IN OPERATIONS Human Resource Management Uncompetitive salary scale within the current market to attract new and motivate current employees. Non-communication of staff absence. Administration Management Storage of materials and products Eating space continues to be a challenge as a canteen is not yet in place. Procurement Management Un-planned activities causing procurement emergencies Delays in supplier payments that discouraged them from engaging in further business prospects ICT Management The delay in the supply of the new File Server by an extra month resulted delayed installation and user migration onto the new system. This has also resulted in delays in upgrades of client operating systems. Transport Management The exit of the Transport Officer and one driver constrained the available human resources. Emergency travel requests continued despite the request for earlier planning. 59 PLANS FOR THE NEXT QUARTER Complete and submit the Work Plan, Budgets, and Procurement Plans for the next financial year (FY8:Oct2012-Sep2013) by August 2012. Governance Finalize Board Manual and Memarts (Memorandum and Articles of Association) Hold the 4th quarter board of directors and board committee meetings in July 2012 Hold the Annual General Meeting in August 2012 Human Resource Management and Development Work with KPMG to commence the Human Resource Audit process Finalize recruitment of the Malaria Program Officer, Brand Officer, and Maternal & Child Health Officer. Interviews were completed Orient staff on the Level of Effort reporting tool Hold annual staff team building event Recognize outstanding employees Administration Management Finalize country-wide hotel survey in Northwestern, Western and Southwestern Uganda and share report with staff Hold Staff and Departmental meetings as per 2012 schedule Disseminate the revised office policy and procedures to all staff after board endorsement Improve administration management systems and operations with KPMG support and guidance Property Management Carry out physical verification of assets and prepare a comprehensive report on all project assets Finalize process of obtaining a tenant for the second floor Procurement Management Finalize the directorate and consolidated procurement plans for 2011-2012 and the 2012-2013 Disseminate the revised procurement policy and guidelines to all staff after KPMG’s revisions and board endorsement Procure two (2) additional vehicles for our field operations Finalize the procurement process for the construction of the warehouse extension ICT Management Upgrade of all user desktop computer operating systems to Windows 7 Procure Wireless Access Point, Microsoft Windows Server 2008 Enterprise, Microsoft Windows Server Operating Client Access License, Microsoft Windows Rights Management Client Access License, Adobe Creative 5.5 Master Suite Software, Resource Centre WorkStation, and Stata (5 licenses) Install the Human Resource Management Information system, and work with Data Care on the staff orientation process and after-sales support Upgrade of Internet link from WiMAX to Fibre optics Orient staff on better file and document management with the new file server Finalize the identification process for an off-site data back-up provider Carry out quarterly equipment maintenance and service Procure two overhead ceiling mounted projectors Disseminate the revised ICT policy to all staff after KPMG’s revisions and board endorsement Transport Management Procure canopies for the new vehicles, brand the new and re-brand some old vehicles 60 Improve the control measures in place for fuel consumption and vehicle maintenance to realize value for money Disseminate the revised vehicle policy to all staff after board endorsement Carry out the defensive driving refresher course for all “driving” staff Dispose-off three vehicles, i.e. two Nissan pick-ups (UAP 705P and UAP 099Q) and one Toyota pick-up (UAK 309Z) that was involved in an accident, following receipt of USAID’s concurrence Legal Management Compile matrix on pending legal issues Complete the endorsement of UHMG’s contracts with the Good Life Clinics country-wide. END OF REPORT 61
