mildmay uganda annual report 2009/2010

MILDMAYTransforming HIV Care

MILDMAY UGANDA

Annual Report

April 2009 - March 2010

iMildmay Uganda - Transforming HIV care

ii Mildmay Uganda - Annual Report April 2009 - March 2010


FOREWORD

Mildmay Uganda Board Members

Rev. Dr Prof. Samuel Luboga Pastor Andrew Mwenge Mrs Florence Kaddu

Rev. Mutebi Hannington Rev. Diana M. Nkesiga Mrs Kityo Vivian

Dr Jeff Sebuyira Mukasa Mr. James Kalibbala


Dr Jeff Sebuyira Mukasa Eng Proscovia M. Njuki Mr David Geoffrey Opiokello

iiiMildmay Uganda - Transforming HIV care

LIST OF ABBREVIATIONS/ACRONYMS/OPERATIONAL DEFINITIONS

AB Abstinence and Being Faithful

Adherence The level at which the patient follows the prescribed drug regimen

ART Anti-retroviral Therapy

ARV Anti-Retroviral Viral (Drugs)

BSc Bachelor of Science

CBV Community Based Volunteers

CDC Centers for Disease Control and Prevention

COP Country Operational Plan

DFID Department of International Development

FBC Full Blood Count

GAP Global AIDS Programme

GSK GlaxoSmithKline

HCT HIV Counselling and Testing

HR Human Resource

HRIS Human Resource Information System

IGA Income Generating Activity

JCRC Joint Clinical Research Centre

LAN Local Area Network

MER Monitoring, Evaluation and Reporting

M&E Monitoring and Evaluation

MDR Multidrug-resistant

MICSA Mildmay International Clients' Support Association

MoH Ministry of Health

MTT Mobile Training Team

NSSF National Social Security Fund

NGO Non Governmental Organisation

OIs Opportunistic Infections

OVC Orphans and Vulnerable Children

PAYE Pay As You Earn (tax)

PEP Post Exposure Prophylaxis

PEPFAR (US) President's Emergency Plan For AIDS Relief

PLHIV Persons Living With HIV

PMTCT Prevention of Mother-to-Child Transmission of HIV

iv Mildmay Uganda - Annual Report April 2009 - March 2010

SQL Simple Query Language

TB Tuberculosis

TEDAS Targeted Evaluation on Drug Adherence and Sexual behaviour risk

reduction

UBOS Uganda Bureau of Statistics

USG United States Government

VCT Voluntary Counselling and Testing

vMildmay Uganda - Transforming HIV care

INTRODUCTION

Mildmay Uganda's Vision Statement:

Mildmay Uganda's Mission Statement:

Mildmay Uganda's Core Values:

Mildmay International is an independent not-for-profit Christian organisation involved in

the provision of HIV and AIDS palliative care services, training in the provision of these

services as well as consultancies worldwide. Mildmay International aims to remain at the

forefront these specialities by demonstrating relevant, culturally sensitive and

innovative models of care and progressive educational programmes for healthcare

professionals and other cadres. In 1993 Mildmay International was commissioned by

the Ministry of Health in Uganda to develop a specialist AIDS Rehabilitation, Palliative

Care and Training Centre in Uganda.

Mildmay Uganda (MU): Opened in 1998, to provide and demonstrate quality holistic,

comprehensive, outpatient care for patients with HIV/AIDS-related health problems, and

to teach and train health workers throughout Uganda and the region in such care. The

facility belongs to the Ministry of Health but is run by Mildmay International. Since 2002,

Mildmay Uganda has been funded by the United States Government, through the

Centers for Disease Control and Prevention (CDC), initially to train Ugandan health

workers in HIV/AIDS care and management and later, through The US President's

Emergency Plan for AIDS Relief (PEPFAR), to provide care including ART to patients.

Since 2004, the funding support from PEPFAR has facilitated the provision of free HIV

care and treatment services leading to increased access to these services, the

extension of some aspects of training, and the channelling of funds to another CDC-

funded project, Reach Out, Mbuya Parish.

“A world in which everyone with HIV can have

life in all its fullness”

“To improve the quality of life of men, women

and children living with HIV primarily in resource-limited settings through provision of

holistic care and training others to provide such care and to provide a centre of

excellence to demonstrate best practice in HIV/AIDS care to Government, NGOs, health

professionals and community programmes and stakeholders”.

The core values of Mildmay Uganda are based on the

Christian faith which is embraced by the MI Founders, Trustees, Executive Directors and

many members of staff past and present and include; ethical clinical standards, a non-

judgmental and non-discriminatory approach to patients as well as honesty and

transparency in all our dealings.

Administratively, Mildmay Uganda has five Directorates; Clinical Services, Training and

Education, Quality Assurance, Resources and Residential Nursing and Day Care, as

well as the Country Director's Office which oversees all MU activities.


1 Mildmay Uganda - Annual Report April 2009 - March 2010

OBJECTIVES AND ACHIEVEMENTS OF THE YEAR

UNDER REVIEW (1 APRIL 2009 31 MARCH 2010)

Objective 1:

The Clinical Services Directorate

Two main objectives provided the basis for the Mildmay Uganda programmes during the

period under review:

1. To provide HIV/AIDS care and treatment services including basic and

comprehensive prevention services, palliative care and ART

2. To deliver an internationally recognised HIV/AIDS Education and

Training programme on the different aspects of HIV/AIDS care at the

Centre and in the districts of Uganda

Through its Directorate of Clinical Services, Mildmay Uganda offers holistic care, using a

multidisciplinary and family approach to HIV-positive clients and their families. The

services include: HIV diagnosis and counselling, specialist medical and nursing care,

pastoral care, physiotherapy, occupational therapy, X-ray and ultrasound, a fully

equipped laboratory, a well stocked pharmacy, social-welfare services, nutritional

advice, dental services and an eye clinic. Mildmay Uganda has developed psychosocial

support services for Orphans and Vulnerable Children (OVC) including counselling and

spiritual guidance. Mildmay Uganda is now one of Africa's leading specialist centres for

the care of children with HIV/AIDS. Other activities at Mildmay Uganda include; provision

of Post Exposure Prophylaxis (PEP) for occupational exposure and rape victims,

strengthening the Prevention with Positives activities and provision of condoms.

2Mildmay Uganda - Transforming HIV care

Objective 1: To provide HIV/AIDS care and treatment services including basic preventive care,

palliative care and ART

21,469

31,547

3,184

10,009

12,328

2,381

4,415

1,997

6,160

189,533

42

19%

20%

28%

65%

23%

123%

38%

Table 1: Key Achievements by the Clinical Directorate

Other Achievements

Patient Care

screening and treatment.

l Opened a fee-for service clinic in l Rolled out the Integrated Mana-

June 2010 to cater for clients who can gement of Acute Malnutrition (IMAM)

afford to pay for their treatment. in the paediatric clinic.

Currently, the clinic is run twice a l The 7th annual dental camp was

week (Monday and Thursday). successfully held from 25th Jan to 4th

l Real time entry of clinic data into RW- Feb 2010 with over 400 children

CAREWare database was fully receiving free dental services from a

implemented. team of 25 volunteers from USA.

l Provision of care continued amidst

funding gaps.

l Sexual Reproductive Health services Outpatient care is provided to all patients

fully operational within the clinic with in care and the clinic is open four days a

many patients receiving family week with the exception of Wednesday.

planning services, cancer screening The clinical directorate handled 74,834

and treatment, PMTCT services with (23% by children) patient visits through

appropriate referral and STI the main site. Most of the stable patients



9,496

have been referred to the community outreach clinics thus decongesting at the main site.

During the year, a total of 5,751 patients were enrolled into care at the various sites.

Enrolment into care was limited by funding during the 3rd and 4th quarters but HIV

positive children and HIV pregnant women and their families were given priority.

Specialised Clinics

The Dental Clinic

The Mental health/psychiatry clinic

(a 14% increase - compared to 604 seen

Specialised services including mental last year). Depression remains the

health, eye care, dental care and Sexual commonest ailment treated in this clinic.

and Reproductive Health (SRH) have

continued throughout the year and have

reduced the need to refer patients to other This year, the dental clinic continued to

centres for such care. offer care to children only .The dental

clinic was shifted to Kwagala house - a

more spacious area. The 7th annual

In May 2009, the psychiatry clinic was dental camp by the visiting US dentists

shifted from Tuesday afternoon to was successfully held in February 2010

Tuesday morning every week after with 472 children receiving care bringing

realising that patients were waiting for the total patient attendances at the clinic

long hours after being seen in the general to 3,643. Dental caries remains the

clinic. A total of 861 (21.3% children) commonest diagnosis at the clinic.

patients were seen in this clinic recording The clinic received a donation of dental

*17% of the new enrolments were children below 18 years.

New Patients enrolled into care by site (Apr 09-Mar 10)



materials from Henry Schien Company. conditions causing severe visual

The materials included consumable impairment were: uveitis, cataracts, optic

(gloves and cotton) and non-consumable neuropathy and chor io re t in i t i s /

(a dental-kit carrier and cleaner) chorioretinal scars. Other diagnosis

materials. These were useful in the included allergic conjunctivitis and dry

operations of the clinic especially in the eye Syndrome.

first quarter and significantly contributed

to the costs of running the clinic. One male 15year old patient (first child

seen at Mildmay main site with active

The dentist also visited Naggalama and CMV retinitis) had both eyes affected.

Mityana satellite clinics to assess the CD4 count was 26 cells/mm3.The right

level of dental services at these sites and eye was already blind (NPL) with retinal

to identify areas where MU could work detachment while the left had vitreo-

with the sites to scale up access to dental retinitis with moderate visual impairment.

c a r e a t t h e H I V / A I D S c l i n i c . He has so far received 5 doses of

Subsequently, monthly visits by the intravitreal ganciclovir. Vision in the left

dentist were initiated at these sites to eye was restored to normal (from 6/18 to

assist them with screening and treating 6/4) and was started on ART.

patients but using the resources available

at those sites.

In June this year, MU opened an

outpatient private wing in an effort to

The eye clinic held on Fridays serves extend services to those who are able to

patients with eye complaints and those at pay. The main objective of this new

risk of getting eye complications of HIV. venture is to deliver managed HIV care of

The goal is to assess for, treat and the highest standard to an expanding

p r e v e n t ( w h e r e p o s s i b l e ) e y e community of people living with HIV

complications associated with HIV/AIDS mainly in th urban towns. These services

so as to improve the individual patient's are currently being offered in a conducive

quality of life. Priority is given to patients environment at its main site in Lweza by

with low CD4 counts and those well-trained, highly motivated and caring

presenting with eye complaints. multidisciplinary teams. The clinic is open

Monday and Thursday every week and

Fewer patients, 578 (compared to 799 provides comprehensive care and

seen last year) were seen in the clinic treatment to both adults and children.

because the sessional eye doctor was

busy conducting eye care camps around

the country organized by the Ministry of The main site managed 510 patients for

Health. TB. Cohorts of patients starting TB

The common HIV/AIDS related eye treatment are followed up and a report

Mildmay Uganda Private Clinic

The Eye Clinic

TB Care programme



compiled at 12 months. Those failing on with TB drugs, laboratory reagents,

treatment are restarted and those specimen containers and stationary

diagnosed with MDR-TB started on (registers) needed for TB activities.

second line drugs.

In partnership with Medecins Sans The Allied Health Services Division exists

Frontiers France (MSF), provision of t o p r o v i d e q u a l i t y d i a g n o s t i c ,

second line drugs for one MDR-patient rehabilitative and pharmaceutical

has continued. The patient has services to all clients attending Mildmay

completed 12 months of the initial phase Uganda main site and its supported sites.

and is currently doing well on continuation The AHS Division is comprised of four

phase. All follow-up sputum examinations departments: Pharmacy, Therapies,

were negative and the patient resumed Radiography and Laboratory.

normal working activities. In partnership l 6 Physiotherapists have trained on

with Médecins Sans Frontiers (MSF), MU the principles of aromatherapy,

managed to start a 40 year old male greatly improving the rehabilitation

patient, diagnosed with MDR-TB in the services for Persons Living with HIV

last quarter, on second line regimen for (PLHIV).

TB. On the initial phase of his treatment l One Labora tory Techno log is t

he is doing well and a follow up sputum r e c e i v e d t r a i n i n g o n B e s t

sample was sent to the national TB Microbiological Practices conducted

laboratory pending results. The second by Center for Development and

patient with MDR-TB, diagnosed the third Management (CDM) Tra in ing

quarter died before starting treatment. A Solutions, a member of South Africa

sputum specimen for a patient from a Quality Assurance Institute.

Satellite clinic was sent to the national TB l Mildmay Uganda Laboratory safety

laboratory for TB culture and sensitivity manual was developed and the

and results are pending. Laboratory is now enrolled on the

Global AIDS Programme (GAP) for

TB-HIV collaborative care activities have HIV-1 DNA DBS Proficiency Testing.

continued involving intensified case l The pharmacy receives ARV and

finding and infection control interventions Cotrimoxazole donations from Clinton

have been intensified both at HCT and in Foundation HIV/AIDS Initiative

the general clinic. Home visits to TB (CHAI) and ARV and other drugs from

patients and linking of newly diagnosed the Ministry of Health (MoH). This has

re-treatment cases to private clinics for increased the number of children on

DOT during the initial phase of treatment ART.

is done by the Home care department in

liaison with the TB office. The district

administration has continued to supply us

Allied Health Services (AHS) Division



The Therapies Department The Nutrit ion Unit provides a

The therapies department comprises of comprehensive package including;

physiotherapy, occupational therapy and nutritional assessments, nutritional

nutritional rehabilitation. Physiotherapy education and counselling, dietary

is offered for patients with residual or planning, food security interventions and

acute pains, limited joint motion, education and support. Various patient

muscular pains/imbalances, nervous categories are served including pregnant

disorders, cardio/vascular disorders, women, lactating/nursing mothers and

respiratory imbalances and skin lesions. infants among others. The unit registered

The patients are helped to regain normal 1,734 (52% by children) patient visits. 665

or near normal independence or function. patients received food assistance

During the period, the department packages, 345 patients received

registered 6,544 (31% by children) nutritional education and four patients

physiotherapy attendances. Most of the received seeds for kitchen gardening.

respiratory conditions presented among Hands-on training for caretakers on the

children while most of the muscular- ward in preparation of infant therapeutic

skeletal dysfunctions were among the feeds such as F100, high energy porridge

adults. Although skin conditions have and kitobeero (a mixture of locally

been the most common, neurological available feeds to make a nutritious meal)

disorders have been the most disabling to was done. The unit received 16kgs of rice

patients. and 26kgs of sugar from Zain and four

Pharmacy technicians compounding creams for external use by clients



cartons of Combined Minerals and purposeful and therapeutic activities. The

Vitamins (CMV) from MoH. Occupational Therapist (OT) helps

patients learn new skills or relearn lost

Occupational therapy is offered to skills (as a result of illness e.g. in HIV

people with physical, mental, emotional infection) to manage daily living.

and developmental disorders through

erapy were administered for pain relief. SUCCESS STORY:Effleurage massage was administered Physiotherapy helps to improve a

and a range of motion exercises done to patient's functional independence

reduce swelling in the feet. As the pain

reduced, she was also started on weight NH, a 38 year old widow was first referred

bearing exercises, walking in parallel to Physiotherapy Department on 2 July

bars and stair climbing. She attended the 09 by a Doctor with severe peripheral

centre gym in addition to counselling and neuropathy in the lower limbs and swollen

occupational therapy provided both at feet. She was in severe pain and cried

home and the centre. NH can walk with with a simple touch on her leg. She could

the support of a walking frame provided hardly stand and therefore using a wheel

by Mildmay. She has resumed her role of chair supported by her mother with whom

full time home maker and is able to fend she lived at that time. Physiotherapy was

for her four children. She continues to initiated with the aim of increasing her

receive care at Mildmay and is being functional independence especially in

prepared for ART initiation. She is grateful walking, transfers and lifting. Initial

for the care provided by the Mildmay assessment indicated that it was difficult

teams.to intervene given the severe pain.

Cryotherapy (use of ice) and aromath-

Satellite Clinics Division (Bishop Asili Kasana, Holy Cross

Kikyusa), Mityana (Mityana Hospital,

The Satellite Clinics were established to Kyantungo HC IV), Mukono (Mukono

help scale-up sustainable access to Church of Uganda HC IV, St. Francis

quality HIV and AIDS care for initially rural Naggalama Hospital) and Wakiso

populations. Mildmay Uganda uses a (Kabubbu HC II).

systems strengthening approach through

partnerships with both MoH and other During the year, Mildmay procured

NGO facilities. Currently, Mildmay laboratory equipment for 5 of the nine

Uganda partners with nine sites in six sites. Each of the site was to get a bio-

districts, Mpigi (Buwama HC III), safety cabinet for processing of TB

Kamwenge (Ntara HC IV), Luweero samples, haematology analyser, CD4



analyser and a chemistry analyser. The Kasana Health Centre III laboratory.

sites are responsible for creating the

space for the equipment, a stabilised

power source as well as installation of an

air conditioning unit. Three of the 5 sites The division supports PLHIV in care and

have already fulfilled these requirements their families through monitoring

with the subsequent delivery and adherence to treatment regimens,

installation of the equipment. These are counselling, pastoral care, overseeing

Naggalama Hospital, Kasana and the provision of OVC services and other

Mukono health centres. This has also social support services to improve clients'

resulted in the reduction in turnaround quality of life.

time for results at these sites as well as a l During the year under review, the

reduction in volume of samples Mildmay Uganda staff, Noah's Ark

processed at Mildmay main site. Choir and Positive Speakers Club

carr ied out sensi t isat ion and

Below are some pictures of the new awareness campaigns.

equipment installed in Bishop Asili

The Adherence and Social Welfare

(ASW) Division



Noah’s Ark Choir together with their leaders outside South Walk Cathedralin London, UK

l The choir participated in discussions International at South Walk Cathedral

on Radio Star and WBS TV and also in London, UK.

attended the 21st Anniversary l Hosted 120 children from Apac District

celebrations of Mildmay International who were addressed by the Mildmay

in London in October. Staff participated Uganda positive speakers on HIV and

in activities to mark the World AIDS AIDS, the importance of HIV testing,

Day 2009. stigma and discrimination.

l Staff and children registered in care l The Kisakye Youth Centre, an

attended the National HIV Conference Adolescent Sexual Reproductive

in November where a children Health Unit at Mildmay Uganda

memorandum was written. opened to the OVC in September 2009

l 280 c l ien ts rece ived PMTCT to address sexual and reproductive

counselling, 31,547 received HIV health needs of the 10 24 year olds. At

counselling and testing and 3,706 the Centre, young people meet and

sessions were held for on-going interact with peers and they get and

support counselling. also share their health related and

l Mildmay Uganda staff together with other problems with health care

Positive Speakers Club members professionals.

sensitized the youth in schools and l Networking with other organisations

communities about stigma and continued; the division worked with

discrimination. 970 students were Watoto Child Care Ministries, National

reached with life skills development Guidance and Empowerment Network

training and HIV sensitisation. of People Living with HIV/AIDS

l In October 2009, Mildmay Uganda (NGEN+), A-Z Charity, Namasuba

Children's Choir entertained guests at College of Commerce and Cherish

the 21st Anniversary of Mildmay Uganda.


Noah's Ark club at one of the Community Clinics (Kajjansi Health Centre III)

where adolescents are given life skills

l OVC care has grown, with Mildmay security and nutrition, care and

Uganda providing support to children support, education, psychosocial

in 8 major core programme areas, support, health, child protection and

namely, socio-economic security, food strengthening capacity of OVCs

The Pastoral Team at Mildmay Uganda; L to R Rev David Galimaka, Imam Kamya Jamil,

Pastor Ben Muziru and Father Joseph Lugobe

The Noah's Ark Choir singing, “He Turned My Mourning into Dancing Again”

at South-Hampstead High School, UK


The Family Welfare Department

(See

appendix 2 a letter of from MAS).

Mildmay Uganda supports an orphan

to live positively with HIV

on anti TB drugs. Due to non adherence

The Social Welfare Unit continues to to the TB treatment, she developed other

follow a family-oriented model in dealing complications and was operated upon

with clients. The purpose is to create twice. She spent six months in hospital

harmony between the individual, their and therefore missed her f inal

family and the community. The examinations which she sat for the

department coordinates the school fees following year (2009). MU continued

programme for children sponsored by supporting her through hospital visits.

Mildmay Uganda, oversees Noah's Ark Through the support counselling, MAS

activit ies, oversees the OGMAC was encouraged and continued living

programme (Our Generation Mildmay positively. Recently, she wrote to the

Adolescents' Club) and handles family managemen t and s ta f f o f MU

issues affecting adherence to treatment. appreciating the support given

The Department handled 1,765 Her

patient/client visits with the common message to the children is that: 'they

issue being need for educational support. should put their hope in God and always

The department also registered several take their medication as prescribed by the

success stories. Doctors in order to live a happy and

healthy life'. If sponsored, MAS will join a

tertiary institution.

MAS (initials), a 17 year old client was Mildmay Uganda in collaboration with

initiated into care at Mildmay in 2002 at a other stakeholders help to build a new

time when she was in P.7. After receiving home for a patient

her results, she was devastated, lost

hope and gave up on life. She was started

on medication and subsequently enrolled

for education support. At that time, she

did not take the results seriously and

never adhered to her medication thinking

that she would be healed from the HIV

infection. She had been advised by her

friends not to take her dugs for they would

reduce her life span. She was also scared

of being seen by other children as she

swallowed drugs every day. It is only

when she caught flu and cough that she

remembered to take her Septrin. In 2008

(when she was in S.6), she was

diagnosed with abdominal TB and started



Agnes’ home before intervention The new home

Nakitende Agnes is a 33 year old widow structure together with her family.

with eight children to take care of after the Mildmay worked in partnership with the

death of her husband. They were both community, the church; the district

registered in care at Mildmay Uganda. probation office, Mukono District and

However at the time of his death, Agnes Standard Chartered Bank. Some

was pregnant and due to the materials were available for i ts

complications she had during pregnancy, completion. Mildmay Uganda contributed

Mildmay met all the maternity charges (in 350,000/= through its welfare fund. Agnes

special private clinic). The new born baby was referred to senior probation officer

was also cared for. Agnes’ family was who linked her to other partners including

identified by one of our counsellors during Standard Chartered Bank which gave a

a home visit to assess her situation at the substantial financial contribution.

same time NTV had broadcasted her Through the joint efforts the construction

story but nobody had yet turned up to of the home was accomplished.

help. She lived in an incomplete muddy Mildmay Uganda supports one of the

registered Children to continue with her education

Mildmay Uganda received funding from the Ministry of Gender, Labour and Social

Development (MGLSD) through the Civil Society Fund to implement an 18 months

project aimed at strengthening the capacity of service providers to improve access and

utilization of quality comprehensive care for HIV positive children in the central region of

KS (Initials) is one of the OVCs (total orphan) supported by Mildmay Uganda. She

receives educational support. She was best student in her school both at O level and A

level. She attained 21 points for her A levels and will be joining Makerere University for

procurement and logistics course.

The Civil Society Fund OVC project



Uganda. The project is funded by The prov iders per sub-county) to

project is being implemented in strengthen the OVC referral system.

partnership with the district Local 1,523 HIV positive children were

Governments and Civ i l Society referred within and out of the circle of

Organizations in 14 districts of Central service providers.

Uganda namely: Wakiso, Kiboga, l 138 service providers were trained in

Luwero, Mityana, Mpigi, Kalangala, child counselling and communication

Mubende, Raka i , Nakasongola , and Monitoring and Evaluation.

Ssembabule, Lyantonde, Masaka, l Conducted an assessment of the

Nakaseke and Kampala. priority needs of HIV positive children,

l Mapped 2,654 OVC service providers compiled and disseminated the

by location and the Core Programme findings at various stakeholders'

Areas (CPA) of focus and designed workshops.

district service provider directories. l The working relationship between the

l Mapped 2,517 households (by district, OVC services coordinating bodies i.e.

sub-county and parish) caring for HIV C o m m u n i t y B a s e d S e r v i c e s

positive children and also identified Department (CBSD), the departments

3,710 HIV positive children to be linked o f h e a l t h a n d D i s t r i c t O V C

to care. Coordination Committees (DOVCCC)

l Established 24 'circles of service has improved following project

providers' (comprising of 3 service activities.

CSF OVC staff during a field visit



”

The Residential, Day Care

and Nursing Directorate

VIA positive 27 (31%) were referred to

Mulago Referral and Teaching Hospital

due to extensive lesions, warts and

large polyps.

l There were an increased number of The Nursing Directorate provides

clients utilising family planning services in the residential and day care

services from 174 in the previous year units. Services provided include adult

to 349 during the year under review.and paediatric triages, treatment rooms,

l 186 clients were identified and treated nurse led clinic, reproductive health

for STIs as a result of the new services, a children's activities area

Reproductive Health Clinic at Mildmay known as Noah's Ark and in-patient care

Uganda. (for children in the acute phase of their

l 40 nurses (from all sections) and two illness requiring intensive care).

“play” therapists were trained in l 10 nurses were trained in cervical

Integrated Management of Acute cancer screening using the visual

Malnutrition (IMAM). Now all children inspection with acetic acid (VIA)

coming to Mildmay for care are being method. Cervical screening at

assessed for malnutrition during Mildmay Uganda started in July 2009

triage. and 1,144 women were screened

l Managed 676 admissions and 584 during the year, 86 (7.5%) of whom

discharges were VIA positive. Of those who were



Success story “Hope's Road to feeds (F75 for 4 days then F100 for 4

Recovery” Hope was born on 14th days), high energy porridge, “Kitobeero”

March 2009 with a birth weight of 2kg to a (mixture of a plant protein, an animal

19 year old HIV positive mother. Six protein and a carbohydrate) plumpy nut

months later Hope became unwell and and fruit juice, daily weight monitoring and

was admitted at Mildmay Uganda with nutrition education for the mother.

severe acute malnutrition, loss of

appetite, vomiting, cough and fever and a Within four weeks after admission Hope

weight of 3kg. Additional points included; gained weight from 3.1kg to 4.3kg. The

no history immunization, failure to thrive, weight to height ratio improved from

meningitis and a positive DNA PCR. below 60% to 80% and the weight for age

from 41.3% to 57.3%. Hope's general

Hope was given intensive nutrition appearance was good as shown in the

rehabilitation on 2-hourly therapeutic pictures below.

Mildmay Uganda multi disciplinary team during one of the Ward Round in the Paediatric In-patient Ward

Hope on Admission

(22/09/2009)

Hope on discharge

5/10/2009


l Four (4) nurses were trained in Family care in hospitals, health centres,

Planning Methods - Level D (providing dispensaries and the community.

condoms, oral pills, information about Training programmes are provided for the

lactational amenorrhea (LAM) method, Uganda Ministry of Health and other

injection and moon beads, insertion of government bodies, NGOs, faith-based

implants and intra-uterine devices, as organisations and companies in Uganda

well as information about permanent and the surrounding region. It is therefore

methods followed by referrals to both a national and a regional training

centres that offer the services). centre.

l The Directorate also participated in the

following workshops: The Training and Education Programme

a. The National Stakeholders Meeting at Mildmay Uganda is done in

on RH/HIV integration assessment. collaboration with the Uganda Ministry of

b. The meeting to share the findings of Health, CDC and other stakeholders,

the study on sexual reproductive comprising short programmes, clinical

health choices for PLHIV placements and modular diploma/degree

c. The Cervical Cancer Stakeholders as well as teaching programmes carried

Meeting during which the Cervical out by the Mobile Training Team (MTT).

Cancer Strategic Plan was The Directorate also delivers the Work-

launched. based Diploma/Degree course in

HIV/AIDS Care and Management,

keeping it updated and encouraging

students to continue to the degree level.

- Facility based

training includes the Mildmay regular

scheduled short courses and tailor-made The Directorate of Training and courses prepared on request by various Education aims to develop initiatives that organisations and the course content and will introduce the knowledge and skills design are made to suit the organisation's needed to provide comprehensive, particular needs. holistic rehabilitation and palliative care

for People Living with HIV/AIDS in a - The Diploma range of settings. Its long-term aim is to Programme is run by the Mobile Training strengthen the educational infrastructure Teams (MTT). The teams offer work-for healthcare professionals in Uganda, based capacity building programmes for thereby improving the existing health health care workers in the rural districts of systems' ability to provide care. It targets Uganda in HIV/AIDS Prevention, Care m u l t i d i s c i p l i n a r y h e a l t h c a r e and Management. The districts included; professionals who are active in HIV/AIDS Wakiso, Mityana, Luwero, Mukono, Kumi,

Objective 2:

The Training and

Facility Based Training Education Directorate

Diploma Programmes



Bugiri, Kanungu, Mbarara, Iganga, and Private sector with a goal of

Mayuge, Kabale, Isingiro, Gulu and training a cohort to offer quality

Kisoro. comprehensive HIV and AIDS services

throughout Uganda.

l Two long modular courses were

l A new course on Paediatric Palliative offered;

Care was launched with funding from o A Diploma in Community HIV/AIDS

The Diana, Princess of Wales Care and Management validated by

Memorial Fund with a faculty of eight Mbarara University of Science and

facilitators from within and outside Technology (MUST)

Mildmay. The pioneer group of trainees o An HIV/AIDS Palliative Care

consisted of 22 health and non-health Course for 58 nursing assistants

care workers from both Government from the districts of Bugiri, Kumi,

Work-based Training

Objective 2: Key Achievements by the Training and Education (T&E) Directorate during

the Year under Review.

Activities Target Group Annual

Targets

%Achiev-ement

Annual

Achiev-

ments

Table 2: Key Achievements by the Training and Education (T&E) Directorateduring the Year under Review.

Kanungu and Mbarara. m o d u l a r D i p l o m a c o u r s e i n

Community HIV/AIDS Care and

l Also offered short courses for various Management will graduate in February

health care workers and community 2011. The students comprised of

based volunteers including two short Clinical Officers, Nurses, Midwives

courses for sixty nursing assistants and Counsellors/Social Workers.

from Ugandan People's Defence

Forces 4th Division in Gulu.

l Fifty-eight students on the long



The AID Control Programme Manager, Ministry of Health, Dr.Zainab Akol officiating

at a Work-based Diploma Graduation Ceremony; in the centre is Irene Kambonesa,

the Director of Training and Education at Mildmay Uganda.

These Directorates support the two core and Support Services). Their main

programme Directorates of Mildmay objective is to enhance and maintain

Uganda. They are the Directorate of efficient systems that support Mildmay

Quality Assurance (M&E, IT and Data and Uganda's core programme areas to

Research) and the Directorate of deliver quality HIV services.

Resources (Finance, Human Resource,

MILDMAY

MILDMAY

Transforming HIV Care

Transforming HIV Care


Support Directorates

Objective 3: To enhance and maintain efficient systems that support Mildmay Uganda's core

programme areas to deliver quality HIV services

Activities Targeted Group Annual

Targets

Annual

Achievments

1,026

522

271

4

1

53

10

9

4

1,394

11

41

23

2

28

Table 3: Key Achievements by the Support Directorates during the year



The Directorate of

Quality Assurance

Pinto village and Kiddukiro building.

l CAREWare launched for real time data

entry by clinic staff.

There are three divisions in the l Databases for Satellite Clinics and

Directorate: Information Systems, Community Services redesigned.

Monitor ing and Evaluat ion, and l A backup server installed to replicate

Research. The core functions include the file server.

Monitoring and Evaluation of the various l New software (Clark Connect)

programmes, IT Systems Administration, deployed for band width management.

Data Management, and Research. l Internet upgraded one additional

Information Systems Division satellite dish & improved bandwidth to

The Division is responsible for the support increased data uploads and

information technology infrastructure that research.

links up to 200 personal computers and l Public folders configured on the MS

laptops which are served by a set of Exchange Server to enhance file-

seven server computers. sharing within Mildmay.

l Skills development for four staff

l Implemented N-computing technology members in network management &

(use of dumb terminals) for data entry. database administration was done.

l Local Area Network (LAN) extensions

installed at the newly commissioned

The Data Team responsible for entry and storage of Mildmay data



Monitoring & Evaluation Division

l

l

l l

l

l

l

The Research Division

l

l

design of data collection tools, data

The role of the Monitoring and Evaluation collection and analysis, reporting and

(M&E) division is to track the progress of basic research.

programme implementation in terms of Carried out support supervision visits

meeting set targets; ensuring the to all Mildmay Uganda supported sites

collection and analysis of data as per set including Reach Out Mbuya Initiative

ind ica tors ; wr i t ing repor ts and to provide technical support in M&E

disseminating findings; following up related issues.

quality improvement issues and Organised training in conjunction with

coordinating programme evaluations. the MoH on the use of the new

The division is also involved in needs HIV/ART data collection tools for the

assessments, strategic planning and Satellite Clinics staff as well as MU

programme design and evaluation. staff. Also coordinated the M&E

training course run by MU in May 2009.

Reviewed data collection tools, P a r t i c i p a t e d i n t h e q u a l i t y

Mildmay Uganda report formats and improvement activities across all areas

compiled all required reports as per the of operation.

revised PEPFAR II indicators and new Enrolled two M&E officers on the

MOH tools. MUSPH CDC fellowship training in

Designed a strategy to monitor Continuous Quality Improvement

progress of data entry at all points of (CQI). Consequently, MU received

data generation at Mildmay Uganda f u n d s f r o m M U S P H f o r t h e

and Satellite Community Clinics. imp lemen ta t i on o f a qua l i t y

Developed SOP for generic data improvement project (ongoing)

analysis and data cleaning for the focusing on 'Improving HIV care/ART

pharmacy, satellite clinics, community data collection at Mildmay Uganda'.

programme and PEPFAR databases

and a SAS code for adherence

monitoring. The Research Division (RD) spearheads

Prepared M&E log frames/matrixes for all research related activates and

Requests for Funding Applications conducts surveys and evaluations to

(RFA) tha t M i ldmay Uganda inform the design of interventions for

participated in. service delivery as well as continuous

The division hosted 10 student interns quality improvement in all of Mildmay

from the Makerere University Institute Uganda's activities.

of Statistics and Applied Economics

(ISAE) as part of capacity building. l Coordinated and managed the

This was part of the ongoing following major studies: -

placement programme at Mildmay o Effect of depression & its treatment

Uganda. The students were trained in on the impact of ART on health



outcomes funded by the RAND The Vienna International AIDS

Conference

o Psychosocial needs of children o Four were presented at The

living with HIV/AIDS Uganda Society for Heal th

o The Targeted Evaluation to Reduce Scientists Conference

Risk and Improve Adherence o One was accepted for the German

(TEDAS) Lung Cancer Conference

o Mildmay paediatric HIV Palliative o One for the APCA Conference in

Care programme evaluation (Diana Namibia

Fund) o One for the Makerere University

o Assessment of legal needs for Conference on Human Capital

patients and pall iative care Development in the 2010s Decade.

providers in collaboration with the

African Palliative Care Association l Participated in writing research

(APCA) proposals;

o Prescr ib ing and dispensing o An assessment of the clinical

practices for medicines in selected characteristics and outcomes of

MOH accredited ART sites in c a r e a m o n g H I V- p o s i t i v e

Uganda in collaboration with individuals attending The Mildmay

Medical Access Centre in Uganda

o Adverse effects of second-line o Improving mental health services in

highly active antiretroviral therapy low income countries submitted to

(HAART) among HIV infected DFID

adults and children treated at o Evaluation of dried blood spots

Mildmay Uganda (DBS) for HIV-1 resistance testing

o Factors Affecting Enrolment and in antiretroviral treated (ART)

Retention into Paediatric HIV Care patients

Services In Wakiso District in o Performance evaluation of the

collaboration with the Uganda AIDS Clondiag HIV NAT test in venous

Commission whole blood

o Equipping parents/caregivers and

service providers to address the l Conducted evaluations and a needs

p s y c h o l o g i c a l a n d s o c i a l assessment;

challenges of caring for HIV- o A needs assessment for Mildmay

positive children HIV/AIDS palliative care satellite

l Reviewed, coordinated and submitted clinic in Wakiso Health Centre

several abstracts to scientif ic o Two clients satisfaction surveys at

conferences (See list of abstracts and Mildmay and at Ntara satellite

conference in Appendix 2). clinics

o Eight abstracts were accepted for O The final evaluation of the

Corporation



Corporation

Zimbabwe/Mi ldmay Nuff ie ld conducting research.

l Submitted applications for the

programme accreditation of Mildmay Uganda

Research Ethics Committee to

l Participated in building capacity for Uganda National Council for Science

conducting research through training and Technology.

Mildmay staff and students on

placement in research, proposal

development, research ethics, data

analysis, monitoring, evaluation and

reporting.

l Participated in the Mildmay training The Human Resources (HR) Division is programme by teaching on operations responsible for providing HR support to all research methods, HIV and AIDS departments including personnel research updates in the era of ART and management support, volunteer services participatory planning, monitoring and and placements administration. evaluation.l Throughout the year, staff establi-l Reviewed Mildmay Staff research

shment gender ratio stagnated at 1:1.7 protocols and provided other forms of (Male to Female) and employee support to advance and implement turnover was 8%.their protocols.

l A total of 23,650 volunteer-man-hours l Coordinated submissions of protocols were realised and 3,080 work days put for review and or approval by the into direct administration of the 749 relevant stakeholders prior to

H I V / A R T P a e d i a t r i c T r a i n i n g

The Directorate of

Resources

Human Resources Division

HIV/ART Paed ia t r i c Tra in ing



Mildmay Tanzania Transport officer and Operations manager (the two on the left)receive a vehicle from Mildmay Uganda

Mildmay Uganda staff donate blood to the Nakasero Blood Bank

persons on placement.

l The Division conducted seven staff

awareness meetings; six general staff

meetings and organised 13 varied This division ensures that all the short courses and other employee r e q u i r e m e n t s f o r t h e s m o o t h related activities. implementation of the organisation's core

l The team created awareness among programmes are met. This is through the staff on the new organisation structure provision of transport, hospitality, as well as HR manual/policies after security, maintenance and storage restructuring. services.

l A new staff Performance Appraisal

system was launched. l The division acquired and fitted the l The number of locum staff was power stabiliser for equipment

reduced from over 75 to less that 10 as protection against destructive power a cost cutting measure. surges.

l As pa r t o f co rpo ra te soc ia l l A site energy audit was conducted to responsibil ity, the HR division cut down the utility costs and its mobilises staff for a blood donation implementation has partly been exercise every quarter. On average, 35 achieved.staff turn up for the exercise every l The sanitation system was improved quarter. Two blood donation exercises by converting the pit latrines into water-were done and 48 units of blood borne toilets.collected. l A power backup was provided in

The Support Services Division

(SSD)



Elizabeth Ward to help ensure l Budget preparation for the year 2010

11 was initiated with the senior

patient ward. management team

l Success fu l l y supe rv i sed t he l A Procurement Committee was set up

construction of the Ntara HIV/AIDS to further strengthen the procurement

Clinic building and handed it to system and

Kamwenge District Administration. l Participated in the budget preparation

for the RFAs submitted by Mildmay

Uganda.

Finance and accounting department

exists to support Mildmay Uganda with

providing funds to enable activities as

planned and to report on those activities

to the decision makers and stakeholders.

l The first joint financial accounts of This department has three main

Mildmay Uganda were sent out to UK objectives: to enhance the effectiveness

following the merging of the MPCC and of Mildmay programmes and networks

TMC accounts since April 09 through advocacy and raise the profile of

l Three of the Division staff enrolled for Mildmay in Uganda regionally and

the professional accountancy exams internationally; resource mobilisation

from the Association for Certified through enhanced knowledge of the

Chartered Accountants donor envi ronment, t rends and

l Trained three work-based placements influences and promote and maintain the

in the purchase ledger procedures mutual relationship between Mildmay

initiated the documentation of a risk Uganda and its stakeholders including

management policy and budget clients.

performance reviews between the

heads of departments and budget l The Division developed strategies for

holders for improved budgetary control

continuous power supply to the in-

The Finance Division

Country Director's Office

Advocacy and Public Relations

Division

A newly opened block at Ntara HC IV, Kamwenge District constructed by Mildmay Ugandawith financial support from The Samaritan's Purse


cont inuous power supply to the in-

Advocacy and Resource mobilisation; clients' calendars (2010), client

information leaflets and Mildmay

approach to HIV programming and Uganda best practises in The New

Programme sustainability. These Vision newspaper and the AIDS Today

strategies will be used as guiding Magazine.

documents during the design and l Negotiated and placed the Mildmay

implementat ion of programme Uganda advert in the Health Care

activities. Directory of 2010, Uganda AIDS

l A team from Crown Agents, a UK Commission and Ministry of Health

based organisation and Mildmay 2010 year planners.

Uganda staff planted 15 trees at the l Mildmay Uganda staff collected some

Mildmay Uganda main site to mark the items to support the landslide victims

United Nations Environmental Day. in Bududa.

l Facilitated the publication and

dissemination of the Mildmay Uganda

brochure, quarterly internal bulletin;

Mildmay Uganda calendars (2010),

Client engagement; Rights-based

The Director of Nursing at Mildmay Uganda, Margaret Awori hands over donations ofnon-food items for Bududa landslide victims to the Red Cross

Coordinator, Kampala South, Richard Walimbwa



Client engagement; Rights-based

The Mildmay Uganda Open Day

The Advocacy and Public Relations Division coordinated the activities of Mildmay

Uganda Open Day that included a memorial service for all Mildmay Uganda clients that

died in the course of the year. The function was attended by the relatives of the deceased

clients; representatives from government Ministries, Diplomats, Sister Organisations,

Faith-based Organisations, the Late Honourable Manuel Pinto's family, the Katikiro of

Buganda and Mildmay Clients and other stakeholders. The Guest of Honour was the

Minister of State for Primary Education, Honourable Kamanda Batarigaya.

Retired Archbishop Mpalanyi Nkoyoyo lighting the first candle during the Annual\Memorial Service for Mildmay Uganda clients that died during the year

On the Open Day ceremony one of the office blocks ' Pinto Village' was officially named

after the Late Emmanuel Pinto one of the key pioneers of Mildmay in Uganda at a

function which was attended by his family and friends



Mildmay Uganda staff pose for a photograph with the Queens Baton relay as it traversed

Common wealth nations including Uganda. Mildmay Uganda had an opportunity to

experience unique and memorable moments on 31 December 2009 during a guided

relay around the main facility.

The widow of the late Hon Pinto and Dr Dumba cut the ribbon to open Pinto Villageat Mildmay Uganda. Looking on is the retired

Archbishop Mpalanyi Nkoyoyo (r) and the Katikiro of Buganda (L)

Mildmay Uganda staff pose for a photo with the queen's baton relay as ittraversed common wealth nations.



Major issues/challenges

Planned activities for FY 2010/11

1. Funding gaps leading to changes in staffing levels especially affecting data

management, reporting, reduction in staff fringe benefits, reduction in patient

care packages, halts in routine enrolment onto ART and limits on the new

enrolments into care.

2. Lack of a full time physician in the clinic

3. Endoscopy unit did not start because the surgeon whom we had identified was

unable to come due to changes in her work schedule

4. Increasing number of patients with socio-economic concerns needing support in

form of IGA start-up capital; school fees/scholastic materials and emergency

food.

5. Limited Laboratory space increasing vulnerability to occupational hazards &

leading to delay of the laboratory accreditation process.

6. Ensuring paediatric adherence to ART.

7. Implementation of the CSF (OVC) project challenged by: a wide geographical

and activity scope yet with limited funds and a short period of time; delayed

release of funds and staff turnover among the partner service providers including

those recently trained to provide psychosocial support to children.

8. Shortage of personnel at the satellite sites despite the new strategy whereby

Mildmay Uganda will mainly play a technical support role.

1. Continue with prevention, care, treatment and training activities

2. Compile the CDC funding agreement close-out report

3. Accomplish and implement the programme strategy for the new CDC corporate

funding agreement.

4. Scale up the private clinic for clients who can afford to pay for their care.

5. Commence Primary prevention of cancer of the cervix with support from Gardasil

Acess programme.



Financial Information for Mildmay Uganda 2010

Mildmay Uganda's 5 year cooperative in the year ended 31 March 2010 of

agreement with CDC was extended to 30 UGX2.9bn was required to cover in part

September 2010. CDC grant in the year the period April to September 2010.The

2009-10 accounted for 83% of income. year the level of grant received in the year

was planned to cover the extended CDC

The surplus of income over expenditure grant period to 30 September 2010.

Balance sheet UGX x 1,000,000

Mar 31, 10 Mar 31, 10

Non Current Assets

Current Assets

TOTAL ASSETS

6,143

7,845

13,989

5,987

3,787

9,774

ASSETS

Funds & Liabilities

Current Liabilities

TOTAL

10,860

3,129

13,989

7,992

1,782

9,774

LIABILITIES

Income and Expenditure UGX x 1,000,000

Mar 31, 10 Mar 31, 10

Client Income

Donations

Grants CDC

Grants MOH

Grants Global fund

Grants Other

Other Income

Training Income

Total Income

352

1,674

26,443

-

-

681

146

996

30,291

236

124

21,982

192

2,181

743

320

629

26,407

Income

Employee Expenses

Overhead costs

Drugs & Lab Supplies

Direct Training Costs

Other Direct Costs

Reach Out Mbuya

Total Expenditure

Surplus/(Deficit)

6,748

4,514

7,507

827

1,772

5,994

27,363

2,928

9,056

2,349

6,716

835

2,361

5,793

27,110

(703)

Expenditure

Percent Expenditure by Category

Grants CDC

87.3%

Training Income

3.3%

Other Income

0.5%

Grants Other

2.2%

Donations

5.5%

Client Income

1.2% Percent Expenditure by CategoryEmployee

Expenses

24.7%

Overhead costs

16.5%

Drugs & Lab

Supplies

27.4%

Direct Training

Costs

3.0%

Reach Out

Mbuya

21.9%

Other Direct

Costs

6.5%



ACKNOWLEDGEMENTS

Mildmay Uganda acknowledges the various stakeholders who play diverse roles

COMPANIES

l Uganda Ministry of Health

l The Centers for Disease Control a n d

Prevention (CDC) & PEPFAR

l African Palliative Care Association

l Africom Net

l Baylor College of Medicine

l Cardno Emerging Markets USA

l Century Bottling Co. Ltd

l Commonwealth Foundation

l Civil Society Fund

l Clinton Foundation

l Diana, Princess of Wales Memorial

Fund

l Mildmay UK

l PACE International Fund

l RAND Corporation Fund- Depression

Study

l Makerere University School of

Public Health, Fellowship Programme

l IAVI (International Aids Vaccine

Initiative)

l Oslo School - Norway

l Samaritan's Purse

l UK Keymed (ACCT)

l PACANET

l HIPS

l Hospice Palliative Care Association

l Hospice Uganda

l Infectious Diseases Institute

l Inter Religious Council of Uganda

l International Childrens' Palliative

Care Network

l Social Responsibility Fund of

Mildmay Uganda staff

l Intrahealth HIV Clinical Services-

Rwanda

l Irish Embassy

l The University of Manchester

l UAP Insurance

l Uganda Dental Mission

l Uganda Martyrs University-Nkozi

l World Health Organisation

l World Vision Uganda

l Mr. And Mrs Atkins

l Christopher and Jodi Blackham

l Cohen Gary

l Education Fund- UK and Uganda

l Armstrong Sue

l Berry Clare

l Carney Laura

l Caudle Claire

l Cooper Mary

l Danter Claire

l Davidson Ian

l Margaret Doy

l Elspeth J & Farthing Trust

l Gooch Kim

l Good Josh

l Griffiths E&D (Trust)

l Mr. And Mrs John Humphrey

l Mr. Herber Martin

l Jones Emma

l Luckey & Pearsons

l Sue and Kevin O'Connor - UK

l Panahpur Trust

l Paul Bateman - UK

l Simpson Helen - UK

l Roger and Jean Tripp

l VETABAILEY

l Tim Elliots

l John Hopkins

INDIVIDUAL DONORS


MILDMAY UGANDA FUNDERS


Partners in the implementation of Mildmay Uganda programme

Programme beneficiaries

Appendix 1:

'The

Need for Sexual and Reproductive Health (SRHh) Services Provision to HIV Positive

Adolescents In Uganda'.

'Outcome evaluation of Mildmay Training on Human

resource capacity Development for Palliative Care in Uganda'.

'Reducing cost of care, stigma and

increasing access to HIV/AIDS care in resource poor settings using a community

approach: Mildmay Uganda Experience'.

'Cervical cancer

screening (CCS) at an HIV/AIDS care centre; The Mildmay Uganda Experience'.

'Using medical records data to assess patient retention on ART - Mildmay Uganda'.

'HIV/AIDS Care for Healthcare-givers: Mildmay Uganda Experience'.

l Ministry of Health

l Uganda AIDS Commission

l Programme for Accessible Health Communication and Education (PACE)

l Regional AIDS Training Network (RATN)

l The University of Manchester

l Mbarara University of Science and Technology (MUST)

l The Local Governments in the districts where Mildmay Uganda runs HIV/AIDS care

clinics, and training activities. Mityana, Kamwenge, Wakiso, Mpigi, Mukono & Luwero

Districts

l The Infectious Diseases Institute (IDI), Mulago

l Baylor College of Medicine

l AIDS Information Centre

l Joint Clinical Research Centre

l The Uganda Cancer Institute

l The National TB and Leprosy Programme

l The beneficiaries (PLHIV and their families)

l The beneficiaries of the training programmes including care givers, health care

workers and other professionals

List of presentation made and abstracts accepted at conferences

Mildmay Uganda abstracts presented/accepted for presentation in 2010 Vienna

International AIDS conference

1. Mbeetah Sarah Kazibwe, Dr. Yvonne Karamagi, Alice Bakunda, Rhoda Suubi;

2. Esther Kawuma, Irene Kambonesa, Dr. Ekiria Kikule, Joyce Achan, Dr. Emmanuel

Luyirika Boniface Okello;

3. Dr. Barbara Namata-Mukasa, Dr. Josephine Nabukeera, Dr. Agnes Bukirwa, Jolly

Nakintu, M. Rugyendo , Esther Kawuma;

4. Joan Nangiya, William Musoke, Margaret Sekyondwa, Margret Awori, Richard

Batamwita, Ekiria Kikule, Emmanuel Luyirika, Esther Kawuma;

5. Boniface Okello, J. Achan, J. Muhangi, P. Busingye, E. Kikule, E. Luyirika

6. W. Katubakire, E. Luyirika, E. Kikule, J. Tripp, J. Muhangi, E. Kawuma, E. Nantongo,

H. Namusoke;



7. Mary Odiit, Dr. Ekiria Kikule, Dr. Emmanuel Luyirika Esther Kawuma;

8. Sarah Nalule Lwanga, Irene Kambonesa, Stella Ongorok, Esther Kawuma;

1. Richard Batamwita, Henry Nsobya, Ali Tibaku, Esther Kawuma, Sarah Kazibwe,

Muhangi Justus, Dr. Ekiria Kikule, Dr. Emmanuel Luyirika;

1. Esther Kawuma, Dr. Ekiria Kikule, Emmanuel Luyirika ( Mildmay Uganda), Joseph

Bitature, Kezia Mukasa, Monja Minsi ( Uganda Reach the Aged association),

2. Richard Batamwita, Esther Kawuma, Wilber Katubakire, Oliver Zawedde, Ekiria

Kikule, Joyce Achan, Emmanuel Luyirika;

3. Joyce Achan, Esther Kawuma, Dr. Ekiria Kikule, Dr. Emmanuel Luyirika;

4. Joyce Achan, Boniface Okello, Lilliane Nabiddo, Dr. Emmanuel Luyirika, Dr. Ekiria

Kikule;

1. Richard Batamwita, Busiinge Phiona, Esther Kawuma, Sarah Kazibwe, Mary Odiit,

Margaret Kasirye and Ekiria Kikule;

2. David Kavuma, Dr. Jane Nakawesi, Esther Kawuma, Dr. Ekiria Kikule, Dr. Emmanuel

Luyirika, Irene Kambonesa, Dr. Barbara Mukasa and Richard Batamwita;

'Mildmay

'Child

counselling skills, a training need for health professionals in Uganda'.

German Lung Conference Accepted

'Using Voluntary

Counselling and testing data to estimate the prevalence of Tuberculosis among first

time clients at Mildmay Clinic'.

Uganda Society for health scientist Conference- June 2010

'Situation Analysis of Home Based Care Services for Older Persons: A Policy and

Legal Provisions Assessment'.

'Task shifting approaches during current

financial crisis; Implications to HIV/AIDS institutions in Uganda'.

'Patient

satisfaction Measurement as a way of quality improvement of health care at Mildmay

Uganda'.

'Improving the Patient Management system at Mityana Hospital HIV clinic'

APCA NAMIBIA Conference accepted for September

Palliative care in Sub Saharan Africa in the 21st

Century: How practical is the family-centred approach? Lessons from Mildmay

Uganda

Carers' and

children's perceptions and attitudes towards pre bereavement support in palliative

care: Implications for Health workers

Uganda's Experience in Rolling out an Electronic Medical Records System'.



Uganda's Experience in Rolling out an Electronic Medical Records System'.



To partner with us, contact;

P.O. Box 24985, Kampala

Tel: +256 312 210200 Fax: +256 312 210205

Email: [email protected]

Website: www.mildmay.org


mildmay uganda annual report 2009/2010

Documents

mildmay uganda mu

testingvmildmay uganda

provision of hiv

mildmay ugandas core

aids palliative care

outpatient care

innovative models of

train health workers