HEALTH, NUTRITION AND HIV UNIT, WVUHEALTH, NUTRITION AND HIV UNIT, WVUTTC 2TTC 2NDND EDITION TOT, APRIL 2015 EDITION TOT, APRIL 2015

WORLD VISION UGANDAWORLD VISION UGANDAttC IMPLEMENTATION UPDATEttC IMPLEMENTATION UPDATE

Uganda CWB at a glance..34.9 MILTOTAL

POPULATION (UN 2010)

14% children under 5

underweight

NMR: 27 per 1000 live

birthsMMR: 438

112 DISTRICTS

6.7 CHILDREN

PER WOMAN

IMR: 54 per 1000 live

births

U5MR: 90 per 1000 live births

33% children under 5 stunted

Disparities associated with rural residence, poverty and low education

Health Strategy Uganda

Village Health Teams Uganda

• Virtual Health Centre 1• Selected by community; consensus or popular vote• VHT: Household ratio of 1:30 (av. 5 per village) ̴�• Voluntary workers• Mixed portfolio: mobilisation, sensistisation, pregnancy

monitoring, referral, drug distribution, health education etc• Basic training: 5 days, no formal certification program• Capacity building, reporting, feedback; quarterly review

meetings• Harmonised data tools since 2010

Institutional Framework

National Stakeholder Forum

National Steering Committee Secretariat, HPE, MoH

District Health Offices

Health Sub District, ADHO & ADHE

Sub county

Health Facility (tech supervision) LC1 & Parish (non technical supervision)

VHTs

COUNTRY ADAPTATION PROCESS: 1. Orientation of WVU technical Team: This focused on the key National office

specialists and technical leads. This was done together with other EARO teams

2. Orientation of MoH Leadership: Resulted into WVU being asked to facilitate the review of the curriculum and adapt it to the Ugandan standards

3. Curriculum Review: working with the MoH (Health Education and promotion, RMH and Child Health division) a facilitators, Participants, Household register and Job Aid were adapted. Training pack for only 5 days evolved.

4. Training of trainers: 23 Ministry of Health Staff mostly from the districts were trained and equipped with training skills for ttC

5. Pilot Project: MoH asked WVU to first pilot this methodology in Kitgum, Busia and Kabale before going full blown, present to the MCH Cluster from time to time for advise.

6. Roll out: Currently working on making sure that ttC is the minimum model of choice for Health, Nutrition and HIV ADPs in the country

AREA OF COVERAGE AND STATUS OF IMPLEMENTATION

ttC IMPLEMENTATION PROCESS

• The progress is guided by the implementation guideline

• This is sent to all ADPs to guide the readiness and roll out

ROLL OUT PROCESS:

ADP VHT Trained

OTHER ADAPTATIONS ARISING FROM IMPLEMENTATION EXPERIENCE

• The curriculum has been made into episodes into key local languages to aid Radio Distance Learning

• The Job AID, Household register, referral form have been translated into local languages as well

KEY FIELD RESULTS

CONT…

KEY CHALLENGES: 1. Very Low VHT literacy levels: This is currently affecting the quality of

reports from them and calling for more intensified efforts in mentoring and coaching.

2. Uncoordinated motivation mechanism: This has resulted into low morale of the VHTs and contributed into the drop out rates and poor follow up of households.

3. Dynamics of policy Changes: This is a new development. The MoH is strategically moving to the Community Health Extension Worker, meaning that as a WVU national office, we may need to change ttC implementation to suite the CHEW