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A National Impact: Local Ownership of Health Workforce Initiatives in Uganda Print E-mail

Voices from the Capacity Project

Francis NtalaziLet’s start by picturing the scene. It’s March 2008 in a hotel conference room in Kampala. Ministry of Health leaders are conducting a midterm review of the 2005–2010 Health Sector Strategic Plan. They’re presenting recent data from assessments and studies, along with related recommendations to meet Uganda’s human resources for health (HRH) objectives. Throughout the meeting, there is an evident sense of ownership. These are clearly their own results from their own initiatives. Seems perfectly normal, right? So what’s unusual here? And, more importantly, why does this matter?

First, let’s hear from Francis Ntalazi, assistant commissioner in charge of HR management at the Ministry of Health. He points to the important role and impact of the HR Technical Working Group, a highly active forum. “Members who come from distant districts would have found it difficult to attend meetings regularly,” he explains, “but this is moving smoothly due to the facilitation from Capacity Project.”

He continues, “In addition, Capacity Project has helped to fund a number of studies. Case in point is the retention study, leavers study [on health workers who left their employment], assessments in staffing gaps and needs in districts, the study on services for reproductive health and HIV/AIDS—to mention but a few. This will help the Ministry to develop appropriate plans of action in scaling up proper service delivery,” he declares.

Ministry of Health staff during a performance support workshopNext, he turns to the issue of recruitment. “Recruitment to fill the staffing gaps has also been a critical area of support from Capacity Project. First of all, there are big gaps in districts—especially those districts considered hard-to-reach and hard-to-stay. The problem is that districts do not only fail to attract professionals but also lack resources to advertise.” He gives an example: “The Ministry of Health has been returning monies for wages to Ministry of Finance because districts have been failing to complete the recruitment exercise, due to the costs of advertisement. Capacity Project carried out a staff audit to establish the actual staffing gaps and collaborated with stakeholders to finance advertisements and other recruitment expenses in nine districts,” he remarks. “This will contribute significantly towards meeting the targeted staffing level of 80% as per the current Health Sector Strategic Plan.”

And there’s more. “For long,” Ntalazi observes, “there has been [a] need to address the hazards and risks the health workers are exposed to at the workplace. The hazards and risks were identified as one of the causes of low motivation and turnover. Capacity Project came on board to fund and facilitate the development of the Workplace Safety Guidelines,” which are “now being disseminated for use throughout the country.”

Retention study participantsNow let’s go back to that conference room during the midterm review. Quite often, development partner interventions don’t result in a sense of local ownership in the activities or the findings. Yet this is not the case with the Project’s work in Uganda. While the data presented at the midterm review came primarily from Capacity Project assessments, and most of the recommendations to meet HRH objectives came through current Project interventions, Ministry staff displayed strong ownership of the initiatives and study results.

“Our approach is characterized by strengthening and use of existing systems and structures; integrating Project priorities and support into the workplans of counterparts; being sensitive to the identified priorities of the health sector; and participating in government processes,” says the Capacity Project’s Dr. Vincent Oketcho. The Project’s Dr. Pamela McQuide emphasizes that “we collaborate with other key stakeholders in national priority areas.”

The Capacity Project is viewed as a key contributor in Uganda, as Francis Ntalazi makes clear, yet it is the strong local involvement in the Project’s numerous HRH initiatives that has truly made a national impact.

[November 2008. Print a PDF version.]

The Capacity Project, funded by the United States Agency for International Development (USAID) and implemented by IntraHealth International and partners (IMA, Jhpiego, LATH, MSH, PATH, TRG), helps developing countries strengthen human resources for health to better respond to the challenges of implementing and sustaining quality health programs.

The Voices from the Capacity Project series is made possible by the support of the American people through USAID. The contents are the responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.


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