PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
Activity Narrative: Uganda like many developing countries is experiencing a crisis in human resources. The
human resources are inadequate both in number and skill mix to effectively respond to the health needs in
Uganda. The HIV/AIDS epidemic presents additional demand on the human resources because of special
skills required for HIV/AIDS prevention and treatment, and health workers themselves are being affected by
the disease. The Government of Uganda institutional capacity for Human Resource and Health (HRH)
policy and planning is weak. There is no reliable source of HRH information for planning and management.
This makes planning and monitoring of the human resource situation difficult. There is no capacity to
develop, regularly monitor and review HRH policy and plans either at national or district level. HRH
development, deployment and utilization are therefore not guided. This results into mismatch between
service requirements and training, both in numbers and skills, and inequity in the distribution of the available
human resources.
The working condition of health staff is difficult, characterized by poor infrastructure, lack of staff
accommodation, inadequate equipment and supplies, work overload and inadequate remuneration. The
poor working condition is aggravated by weak HRH management. Performance management, regulatory
and disciplinary mechanisms are ineffective. Poor working conditions do not attract staff nor motivate them
to stay. As a result the staff turnover is high, particularly in remote rural districts generally regarded as
difficult-to-reach and difficult to stay in. As a result of poor working conditions the morale of health workers
is low, which in part results in poor attitude towards clients, absenteeism and low productivity. The public
image of health staff has been eroded, the quality of care provided is perceived as poor and the utilization of
health services is not optimal. There are inadequate resources to sustainably support initiatives to address
these human resources issues and the crisis persists in a vicious circle. Despite increased investment in the
HRH sub-sector and health sector in general, the performance of health workers and the quality of
HIV/AIDS and health services are still substandard. Consequently, the utilization of HIV/AIDS services is
low, contributing to low achievement of the indicator targets. The USAID-funded IntraHealth/Capacity
Project (CP) goal is to improve human resources for health in order to contribute to improved access for
HIV/AIDS and other health services. The objectives of the Capacity Project are to enhance capacity for
HRH policy and planning at the central and district levels to ensure adequate health workforce for integrated
HIV/AIDS and health services; strengthen systems for effective performance-based health workforce
development; and identify and promote health workforce management practices for improved performance
and retention.
Progress to-date and achievements: The CP has made significant progress in HRH policy and Planning and
HRH development and management. The CP supported the Ministry of Health (MoH) to establish the HRH
databases at the four Professional Councils of Medical Doctors and Dental Surgeons, Nurses and
Midwives, Pharmacists: and Allied Professionals, and linked the database to the MoH and the two pilot
districts of Apac and Oyam. The CP supported the MoH to review the HRH Strategic Plan 2005-2020 and
further develop the plan into the comprehensive HRH plan. The CP collaborated with the MoH to develop a
Health Sector Master Plan for 2008 -2015 that prioritized HRH, infrastructure, and medicines and supplies
to attract increased funding for health sector. Nine districts of northern Uganda were facilitated to do
detailed analysis of staffing gaps and prepare district specific strategies to address the staffing gaps; while
78 districts developed district specific HRH Action Plans in line with national HRH Policy and Strategy. A
total of 133 members of the Uganda National Association of Nurses and Midwives (UNANM) were trained
as regional trainers in communication skills; while Health Professional Councils and Associations were
supported to develop standards for accreditation of in-service training and continuing professional
development (CPD). The CP supported the MoH to introduce a Performance Improvement (PI) program,
including training of the Technical Resource Team at the central and district levels, development of
reproductive health and PMTCT standards, and performance indicators and tools for PI. Central level
resource team was trained for strengthening performance management based on ROM and open
performance appraisal system in collaboration with the Ministry of Public Service. The MOH was supported
to study the factors that contribute to high staff turnover in public and private-not-for-profit (PNFP) sectors.
Comprehensive strategies for improved retention and motivation, and policy and guidelines for workplace
safety and health are being developed. Bottlenecks in HRH management and solutions for tackling them
were identified. Strategies are being developed to strengthen leadership and management at district, sub-
district and health facility levels.
Activities for FY 2009: With FY 2009 funding, the Capacity Project, in partnership with the line ministries of
Health, Public Service, Education and Sports, and Local Government will:
1. Enhance the capacity for HRH policy and planning at the central and district levels to mitigate the HRH
impact of HIV/AIDS by:
a. Completing the HRIS development and integration by linking the district and PNFP data base to the
MoH Human Resource Management (HRM) data base; link the pre-service training database at the Ministry
of Education and Sports to the MoH training database; and develop an interface of all HRIS information to
the Resource Centre at the MoH. The CP will establish an HRIS planning module at Human Resource
Development (HRD) and Planning Department of the MOH; support regular production and dissemination of
biannual HRH report for decision making; and implement strategies to improve communication between the
central MOH and districts for HRH management.
b. Strengthen the coordination of HRH by providing technical and logistical support to the coordinating
structures, including the Human Resource Working Group (HRWG), the Health Workforce Advisory Board
(HWAB), and other SWAp process. The CP will strengthen the HRD of the MOH by providing technical
assistance for development of the strategy for task shifting; facilitate the HRD and HRM divisions of MOH to
develop plans for follow up implementation of HRH related recommendations of the Mid-Term Review of the
Health Sector Strategic Plan II (2005/06-2009/20100; continue to support the roll out and reviews of HRH
Strategic Plan; and facilitate follow up support of district HRH planning.
2. Strengthen systems for effective performance-based health workforce development by:
Harmonizing pre-service and in-service training of the health workforce; developing and promoting
approaches for effective performance improvement (on-job training, task shifting, mentoring, supportive
supervision, action learning); developing strategies to motivate continuing professional development
including accreditation, certification, licensure; strengthening the role of the health workforce professionals'
Activity Narrative: councils and associations in in-service training and continuing professional development; and providing
technical assistance to the Human Resource Department of the MOH and Health Manpower Development
Center to rationalize training and develop a training plan for pre-and in-service training.
3. Identify and promote health workforce management practices for improved performance and retention by:
strengthening systems for health workforce performance management; enhancing MOH and district
capacity for health workforce management; building capacity for results oriented management (ROM);
developing strategies and systems for improved recruitment and deployment; developing tools and
initiatives for improved job satisfaction and retention; strengthening systems for Performance Improvement
(PI) and support supervision; enhancing systems for community co-management of health services; and
strengthening systems for workplace safety, and protection and care of the health workforce.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14215
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14215 4376.08 U.S. Agency for IntraHealth 6741 3312.08 The Capacity $1,260,000
International International, Inc Project
Development
8429 4376.07 U.S. Agency for IntraHealth 4837 3312.07 The Capacity $1,260,000
4376 4376.06 U.S. Agency for IntraHealth 3312 3312.06 The Capacity $500,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Family Planning
* Safe Motherhood
Refugees/Internally Displaced Persons
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $1,250,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.18:
