USAID/ RHITES-EC PROGRAM.

USAID/ RHITES-EC:

University Research
Co., LLC (URC), a US-based public health organization working in Uganda since
2005, is implementing the USAID Regional Health Integration to Enhance Services
in East Central Uganda activity (USAID RHITES-EC). The purpose of this project
is to support the implementation of a comprehensive, integrated investment in
regional health, HIV/AIDS and nutrition assistance. This five-year activity
targets 12 districts in East Central Uganda with an estimated total population
of 4.1 million through a district-based integrated package of quality health
services.

Association de santé publique de Genève (UDHA)

UDHA was established
in 2003 to empower, promote and strengthen health and development among needy
communities. In 2005, UDHA was registered as a national NGO under the Uganda
NGO Act, CAP 113 with registration number 5531. Since then, UDHA has expanded
its operations to cover East central Uganda. At UDHA, we envision a society in
which people are fully empowered to manage their health and development needs.
Our work is guided by a mission, ‘to engage a multi-sectoral and professional
approach with strong community participation and ownership for health, rights,
and development’. 

Purpose:

UDHA will work with
USAID/ RHITES-EC, districts and partners to plan, implement, monitor and
evaluate community and facility-based interventions that address gaps in uptake
of critical services and behaviors HIV, MNCH, TB, Malaria, WASH and Nutrition.
The various activities will be implemented to achieve the following objectives:

1. , mobilize various
   target audiences for uptake of promoted health
   services and behaviours.

• Strengthen
  linkage and referral systems between the community and health facilities.
   
• Quality
  Improvement approaches to address gaps identified.

Tasks for UDHA:

Under this grant UDHA will work with USAID/ RHITES-EC, DHTs,
community structures and audience representatives in Banda and
Mutumba sub counties and Namayingo town council in Namayingo district to execute the following activities:

Objective 1: Identify and address social determinants
and barriers andmobilize various target audiences for
uptake of promoted health services and behaviours.

Activity
1.1: Work
with RHITES-EC, DHT and health facilities to enlist 53 community mobilizers including
VHTs, adolescent and youth peers, and other community resource persons in each
of the sub counties that will be deployed to mobilize audiences for services
and promote desired behaviors.  The
breakdown of community mobilizers to be enlisted for each sub county are shown
in the table below:

Sub County	Health Facility	Parish	No. of community mobilizers
Banda subcounty	Banda Health Centre III	Lutolo	4
	Busiro Health Centre III	Buchumba	3
		Bujwanga	4
		Buwoya	3
		Lugala	3
Namayingo Town Council	Buyinja HC IV	Budidi	3
		Nasinu	3
		Nambugu	3
		Namayingo Central	4
		Bulamba	3
Mutumba Subcounty	Bugali Health Centre II	Bulule	3
	Mutumba Health Centre III	Lubira	4
		Mutumba	4
		Mwema	3
		Buchimo	3
		Lubango	3
Total			53

Activity
1.2: Using
guidance provided by USAID/RHITES-EC, DHTs, health assistants, and health
facilities UDHA will conduct
one 2-day orientation for the 53 enlisted community mobilisers attached to the
5 health facilities. The orientations will be convened at 3 project focus sub
counties. The orientation will ensure that the community mobilizers are
equipped with appropriated skills and tools to mobilize communities for the
uptake of the promoted health services and behaviors. The orientations will cover
the following topics:

1. Audience profiling/ mapping/
   targeting
   1. Mobilization skills.
   1. Referral and linkages.
   1. Introduction to various SBCC
      approaches that will be deployed to mobilize audiences including: home and
      station visits, Stepping Stones, Wheel of Practices for Better Living, and
      Family Life Schools among others.
   1. How to use available client-
      provider job aides.
   1. Documentation and reporting.

Activity 1.3: This activity will be conducted in two parts: 1.3A (April – May 2019) and 1.3B (June – July 2019). Using guidance provided by USAID/RHITES-EC, DHTs, health assistants, and health facilities deploy, facilitate and supervise the oriented 53 community mobilizers to identify and address barriers and mobilize the most affected community members to practice the promoted health behaviors/ actions and refer them to facilities for services. The community mobilizers will be deployed at least 4 days a month to implement the following activities between March 1 and July 30, 2019: 

Activity
1.4:
Work with RHITES-EC and DHTs to identify and orient 8 peer facilitators on the
Stepping Stones curriculum. The 5-day orientation will take place at Namayingo
Town Council offices in March 2019.

Activity
1.5:
This activity will be conducted in two parts: 1.5A (April  – May 2019) and 1.5B (June  – July2019). Facilitate the 8 peer
facilitators to facilitate 4 Stepping Stones groups; 2 groups in Namayingo TC, a
group in Banda sub county and a group in Mutumba sub county targeting 100
vulnerable AGYW aged 15 – 24 (25 per group). The identified 100 AGYW will be
expected to attend 10 Stepping Stones sessions between March and July 2019. The
AGYW will also be referred for the relevant HIV and pregnancy prevention
services. UDHA will also use this opportunity to identify sexual partners of
the AGYW and mobilize them for health services including HTS, VMMC and condom
use among others. 

Objective 2: Strengthen linkage and referral systems between the
community and health facilities. 

Activity
2.1:Work
with health assistants and DHTs to support the community-based mobilizers to
facilitate referrals and use linkage tools and processes. Mobilizers will be
introduced to the health facility staff including health workers, linkage
facilitators, expert clients, HMIS focal persons, and health facility
in-charges. The goal is to improve completion of community referrals and ensure
good working relationships between communities and health facilities. Cost
leveraged by UDHA.

Objective 3: Improve reporting, monitoring and evaluation of
community-based interventions to promote ongoing learning and adaptation.

Activity
3.1:
This activity will be conducted in two parts: 3.1 A (March- April 2019) and 3.1B
(May – July 2019). UDHA will work with USAID/RHITES EC staff, DHTs, health
facilities, health assistants and peer leaders to convene quarterly performance
review meetings for the 53 community mobilizers in April and July2019. During
the meetings held at health facilities:

1. The community mobilizers will
   submit activity reports for months preceding meeting.
   1. The gaps identified among the
      community mobilizers identified through supportive supervision will be
      addressed.
   1. The community mobilizers will
      be oriented on any new tools and approaches.
   1. The facility will share the
      overall monthly performance of the facility with the community mobilizers. This
      will focus on the areas for which community mobilizer activities are centred.

Activity
3.2: This
activity will be conducted in two parts: 3.2A (March- April 2019) and 3.2B (May
– July 2019). UDHA will support its staff to attend weekly and monthly
performance review meetings at the health facilities being supported. UDHA staff
will also attend any other critical meetings convened at the district level.

Activity
3.3: This
activity will be conducted in two parts: 3.3A (March- April 2019) and 3.3B (May
– July 2019). To ensure fidelity of the activities implemented UDHA will
facilitate staff to conduct supportive supervision visits to the community
mobilizers. The supportive supervision visits will be used to mentor community
mobilizers on various aspects of their work and address any challenges they are
facing during activity implementation. 
Each community mobilizer will be supervised at least once a month for
the entire implementation period. Cost leveraged by UDHA.

Activity
3.4: This
activity will be conducted in two parts: 3.4A (March- April 2019) and 3.43B (May
– July 2019). UDHA will convene monthly performance review meetings with
RHITES-EC. The meetings will be used to:

1. Review implementation of
   planned activities.
2. Review completed milestones.
3. Address emerging needs and
   challenges.
4. Plan for monthly activities.
5. Document and compile successes
   and learnings from the activities implemented.

Cost leveraged by
UDHA.

Activity
3.5: This
activity will be conducted in two parts: 3.5A (March- April 2019) and 3.5B (May
– July 2019). UDHA will compile and submit weekly activity updates and monthly
reports to USAID/RHITES-EC detailing activities implemented during each of the
performance periods. UDHA will compile and share activity reports regularly as
detailed above to ensure there is adequate and frequent support from the
technical team at RHITES EC. Cost leveraged by UDHA.

Objective 4: Implement quality improvement
approaches to address gaps identified.

Activity
4.1:This activity will
be conducted in two parts: 4.1A (March – April 2019) and 4.2B (May – July 2019).
Conduct
monthly quality improvement team meetings to plan, review and monitor QI
activities. UDHA will implement quality improvement projects to address gaps
for underperforming indicators in selected communities across various thematic
areas as guided by USAID/RHITES-EC. UDHA will collect, update, document and
report improvement data and experiences using standard QI tools.

Activity
4.2: This
activity will be conducted in two parts: 4.2A (March- April 2019) and 4.2B (May
– July2019). With support from RHITES EC, UDHA will conduct two collaborative/mentorship
meetings in March and May 2019 with selected community mobilizers, gate keepers
and staff. The meetings will be used to mentor the community mobilizers and
staff on various areas where gaps are identified.