Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 3312
Country/Region: Uganda
Year: 2008
Main Partner: IntraHealth International, Inc.
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $1,260,000

Funding for Health Systems Strengthening (OHSS): $1,260,000

Uganda like many developing countries is experiencing human resources for health crisis. 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 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


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 into 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. With FY08 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: strengthening human resource information system (HRIS) at the central level;

enhancing Ministry of Health (MOH) capacity for HRH policy review, analysis and reform; enhancing MOH

capacity for long term strategic health workforce planning, roll-out and reviews; strengthening district

capacity to translate HRH policy and strategic plan into action plans to address HRH priorities at the district

level; strengthening advocacy and strategic alliances for HRH; and supporting initiatives for health

workforce rationalization.

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' councils and associations in in-

service training and continuing professional development; and providing technical assistance to the Human

Resource Department of the MOH to rationalize training and develop a training plan for pre-and in-service


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.

Subpartners Total: $90,000
Johns Hopkins University: $25,000
Management Sciences for Health: $25,000
Not Identified: $40,000