ADVOCACY FOR BETTER HEALTH Cooperative Agreement No: AID -617-A-14-00004

Submitted to U.S. Agency for International Development (USAID), Uganda

Plot 1577 Ggaba Road, Nsambya. Kampala

Submitted by

Moses Dombo Chief of Party

USAID/PATH Advocacy for Better Health Project Tel: +256 312 393200

April 28, 2016

The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government

QUARTER TWO REPORT JANUARY - MARCH 2016

TTAABBLLEE OOFF CCOONNTTEENNTTSS

LIST OF ABBREVIATIONS AND ACRONYMS __________________________________________________ III

EXECUTIVE SUMMARY __________________________________________________________________ 1 1.0 BACKGROUND __________________________________________________________________ 3 2.0 PROGRESS BY RESULT AREA _______________________________________________________ 3

2.1 Result Area 1: Citizens demand improved quality services __________________________ 3 IR 1.1 Increased citizens’ awareness of rights and responsibilities related to health _________ 4 IR 1.2 Community groups advance priorities for improved health and social services _______ 7 IR 1.3 Improved engagement between citizens and duty bearers _______________________ 8 2.2 Result Area 2: CSOs advocate for issues of citizen’s concern in health and social sectors. _ 12 IR 2.1 Increased utilization of evidence by CSOs to inform advocacy _____________________ 12 IR2.2 Effective participation of CSOs in Planning and accountability of health & social services 14 IR 2.3 Enhanced Coordination and Collaboration among CSOs _________________________ 16 2.3 Result Area 3: Institutional capacity of CSOs strengthened ___________________________ 20

3.0 PROJECT MANAGEMENT __________________________________________________________ 26 4.0 PARTNERSHIPS __________________________________________________________________ 27 5.0 ACTIVITIES PLANNED FOR NEXT QUARTER ____________________________________________ 28 6.0 LESSONS _______________________________________________________________________ 29 7.0 TECHNICAL ASSISTANCE NEEDED FROM USAID/UGANDA ________________________________ 29

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LLIISSTT OOFF AABBBBRREEVVIIAATTIIOONNSS AANNDD AACCRROONNYYMMSS AAG Advocacy advisory group ABH Advocacy for Better Health ACODEV Action for Community Development AMELP Activity Monitoring, Evaluation and Learning Plan ARUWE Action for Rural Women Empowerment CAOs Chief Administrative Officers CDFU Communication for Development Foundation Uganda CIDI Community Instigated Development Initiative COP Chief of Party CSO Civil Society Organization DCOP Deputy Chief of Party DHO District Health Officer DMC District Management Committee DO Development Objective GOU Government of Uganda HUMCs Health Unit Management Committees I-DO Integrated Development Options IEC Information, Education and Communication IP Implementing partner IR Intermediate Result JIACOFE Jinja Area Communities Federation KACSOA Kapchorwa Civil Society Organizations Alliance KADINGO Kalangala District NGO Forum KRC Kabarole Research Centre LADA Literacy Action and Development Agency M&E Monitoring and Evaluation MEEPP Monitoring and Evaluation of the Emergency Plan Progress MARPs Most-at-risk populations MOH Ministry of Health MOU Memorandum of Understanding MUCOBADI Multi-Community Based Development Initiative NAFOPHANU National Forum for People Living with HIV/AIDS in Uganda OACA Organizational and Advocacy Capacity Assessment OD Organizational Development RACOBAO Rural Community Based Organization RDC Resident District Commissioner SDS Strengthening Decentralization for Sustainability STF Straight Talk Foundation SUNRISE OVC Strengthening the Ugandan National Response for Implementation of Services for Orphans and other Vulnerable Children USAID United States Agency for International Development USG United States Government TA Technical Assistance VHT Village Health Team NAFOPHANU National Forum of People Having HIV/ AIDS Networks in Uganda

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EEXXEECCUUTTIIVVEE SSUUMMMMAARRYY The USAID Advocacy for Better Health Project operated on the premise that IF citizens’ knowledge and awareness of their rights and responsibilities were increased (to stimulate collective consciousness); and IF the capacity of CSOs was built to effectively empower and represent communities, THEN, citizens would believe and have confidence that they can hold their leaders accountable and influence them to change health and social policies in their favor.

During the quarter (January to March 2016), the project accomplished the following; • Empowering citizens in 35 districts on their rights and responsibilities related to health and

social services, • Conducting hundreds of community dialogues, as an avenue for presenting advocacy issues

related to the quality, availability and accessibility of health and social services to duty bearers and an opportunity for citizens to make their voices heard.

• Participation in nationally and internationally recognized commemorative events such as; the International Women’s day on March 8th and the World TB Day on March 24th as a way of coalescing advocacy voices and efforts around those issues.

• Organizing a high profile breakfast dialogue on March 2nd with media houses to obtain buy-in for critical policy influencing editorial space and coverage

• Ongoing engagement of duty bearers to champion health and social services advocacy issues of citizens’ concern at both district and national level,

• Participation in government planning processes both at national and district levels to ensure that issues undermining quality, access and affordability of health care and social services are incorporated in government plans and budgets,

• Coalescing with like-minded CSOs for a stronger voice on issues affecting health and social services,

• Building the capacity of CSOs through technical assistance in advocacy, governance, human resource management, resource mobilization, organizational policies and procedures to sub grantee CSOs, as a way of strengthening their institutional capacity.

The above performance relates well with the achievements attained on the key indicators as detailed below; Achievements against Y1 (FY 15) targets by indicator, as at 25th April 2016

Source: USAID PRS 2016 as at 27th April 2016

INDICATOR TOTAL BY YEAR REPORT FOR YEAR(S) 2016 - 2016 [Data as at Jan 25, 2016 03:46:29PM Local Time] IP NAME: ADVOCACY FOR BETTER HEALTH

INDICATOR

NUMBER INDICATOR TITLE FY 16

TARGET FY 16 ACTUAL FY 16 %

ACHIEVEMENT 3 ABH1.2.1 % OF SUB GRANTEE CSOS THAT DEMONSTRATE

INFLUENCE ON HEALTH AND SOCIAL SERVICES AGENDA

50% [50/100]

40% [8/20]

80%

11 ABH1.1.2.1 % OF COMMUNITY GROUPS WHOSE ACTION PLANS ADVANCE INTO IMPLEMENTATION PHASE

32% [32/100]

27% [130/479]

85%

12 ABH1.1.2.2 NUMBER OF FUNCTIONAL ADVOCACY FORUMS AT SUB COUNTY LEVEL

300 159 53%

13 ABH1.2.1.1 % OF CSO ADVOCACY INITIATIVES WHICH ARE SUPPORTED BY EVIDENCE

40% [40/100]

100% [8/8]

250%

14 ABH1.2.2.1 % OF CSOS ACTIVELY INVOLVED IN PUBLIC SECTOR PLANNING PROCESSES

40% [8/20]

75% [15/20]

188%

15 ABH1.2.3.1 NUMBER OF CSOS THAT ARE INVOLVED IN JOINT ADVOCACY INITIATIVES

12 11 92%

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Plans for the Next Quarter: In the next quarter, the project plans to implement the following key activities;

• Continue empowering communities on their rights and responsibilities, • Working with community groups to follow up and generate new action plans on additional

issues of health and social service concern. • Supporting communities to organize advocacy forums as platforms of engaging their duty

bearers, • Participation in commemorative events such as the World Malaria Day, • Providing technical assistance to the sub grantee CSOs to implement communication and

community empowerment activities, • Supporting sub grantees to review and update their advocacy strategies, • Engaging duty bearers at national and district levels on the advocacy issues of citizens’

concern, • Participating in district and national level planning processes/meetings, and • Offering needs-based technical assistance to strengthen the institutional capacities of sub

grantee CSOs,

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11..00 BBAACCKKGGRROOUUNNDD The USAID Advocacy for Better Health is a five-year, USD 19,980,735 project implemented by PATH in collaboration with Initiatives Inc. The goal of the project is to improve the availability, accessibility, and quality of health services in Uganda. This goal is being pursued through empowering citizens to demand for better health and social service delivery and enhancing the capacity of civil society organizations (CSOs) to effectively advocate for improved responsiveness and accountability by decision-makers and health and social service providers. The project is designed to directly contribute to the USAID Health, HIV, and Education Office’s Development Objective (DO) of improved health and nutrition status in focus areas and population groups and to enhance an enabling environment for health care. The project covers 35 districts in western, central and eastern regions of Uganda. The project is grounded in the beliefs that IF citizens’ knowledge and awareness of their rights and responsibilities were increased (to stimulate collective consciousness); and IF the capacity of CSOs was built to effectively empower and represent communities, THEN, citizens would believe and have confidence that they can hold their leaders accountable and influence them to change health and social policies in their favor. This empowerment and confidence would motivate citizens to get organized; reach consensus on their priorities and plans of action; and demand for better health and social services from their duty bearers. The persistent collective voice and actions from citizens and CSOs would compel leaders and duty bearers to respond by changing the necessary policies and taking other actions that lead to improvements in the availability, accessibility and quality of health and social services. The project has three objectives: 1. Citizens in 35 target districts participate in district and/or sub-district-level planning and

monitoring to improve the quality of health services, reflecting community-identified demands and solutions.

2. CSOs influence policy change and accountability in the health sector that align with communities’ priorities for improved services.

3. At least four CSOs have the systems and skills to manage large-scale health advocacy projects and qualify as prime recipients for future USAID funding.

The above objectives will be achieved through three Results: 1. Citizens demand improved quality services 2. CSOs effectively advocate for issues of citizens’ concern in the health and social sectors 3. Institutional capacity of CSOs strengthened

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2.0 PROGRESS BY RESULT AREA The section below details the accomplishments for the period October 1 to December 31, 2015.

2.1 Result Area 1: Citizens demand improved quality services Result 1: Citizens demand improved quality services

This result area focuses mainly on empowering communities for their increased involvement in advocating to duty bearers to address issues that affect accessibility, availability and the quality of health and social services. Empowering communities takes the form of sensitizing them on their rights and responsibilities, and giving them skills and techniques of developing advocacy action plans, which they implement through a structured follow-up process to ensure their issues are acted upon by the targeted duty bearers. During the reporting period, all the 21 sub-grantee CSOs worked tirelessly to implement activities under their mandate that contribute towards attainment of the three intermediate results under the project’s result area one as elaborated in the following sections of the report; Intermediate Result 1.1: Increased citizens’ awareness of their rights and responsibilities related to health and social services The project, through its sub-grantee CSOs, conducted a series of activities aimed at achieving the above-mentioned intermediate result. The activities were implemented at both mass media and community levels, with emphasis being put on those that would generate a critical mass of citizens that understand their rights and responsibilities and are able to demand for them. These included; Live Call-in Radio Talk Shows 75 radio talk shows were conducted to raise awareness on rights and responsibilities within the citizenry. The shows were held on local FM stations within districts where the CSOs are operating. The choice of radio stations was based on popularity and geographical reach in implementing districts. All talk shows were conducted based on talking points generated by implementing CSOs, and approved by the project leadership. Majority of the talk shows mainly focused on the Patients’ Charter which remains a major tool that the project is using to create awareness regarding citizen rights and responsibilities. Talk shows were customized to focus on the project’s priority advocacy issues and commemorative events that the CSOs participated in during the quarter. In particular, this quarter focused on World TB Day, and International Women’s Day. Panellists on these talk shows included duty bearers in respective districts as well as other Stakeholders whose voice impacts decision making on health and social services quality and access. For instance, in Kyenjojo and Kamwenge districts, the talk shows that attracted at least 87 callers, hosted district

The Deputy District Health Officer, Mbale and other panellists at a radio talk show at Open Gate FM radio station in Mbale district

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leaders including the District Health Officer (DHO), Resident District Commissioner (RDC), and health facility in-charges, among others, who discussed strategies to end drug stock-outs, absenteeism and late reporting to duty by health workers. All the individuals who called-in during the two radio talk shows expressed satisfaction and hope about improvements in health and services delivery upon full implementation of the Advocacy for Better Health project initiatives. In addition to enhancing project visibility, the radio talk shows were effective in reaching out to decision makers as remarked by the Iganga District Administrative Officer. “I listened to your radio talk show last night and I am impressed with the activities of the Advocacy for the Better Health project. I think they will contribute to increased accountability in the local government”, he said. At national level, the radio talk shows conducted on the Patients’ Charter culminated into actions by government and some citizens. For instance, discussions on the charter involving the Ministry of Health officials sparked off a process within the Ministry to review the Patients’ Charter and fix the gaps that were raised by health workers and patients. In addition, some patients whose rights have, in the recent past been violated, have reported cases to Centre for Health, Human Rights and Development (CEHURD)—a national level sub-grantee CSO, and these have been directed to relevant duty bearers for settlement.

Advocacy messages on FM radio stations The project partnered with 371 FM radio stations at national and district level to broadcast a total of 5,556 spot messages on priority advocacy issues namely; health worker absenteeism, school drop-outs, awareness of rights and responsibilities, drug stock-outs and domestic health financing. The radio spots were produced in English and 8 local languages widely spoken in the 35 collaborating districts. These radio spots augmented the impact realized form live call-in talk shows especially on project visibility because of the unique branding that emphasizes the project’s tagline – Where Everyone is Accountable, Everyone Wins. Radio serial drama under the popular brand name - Rock Point 256 The project produced and broadcast 11 episodes of the above-mentioned popular radio serial drama on 22 FM radio stations across the country. The 10-year-old radio serial drama was adopted by the project because of its popularity within the population, especially young people, who identify with the characters in the drama. It is effective at delivering empowerment messages. Specific advocacy storylines were developed, reviewed and approved by the project for incorporation in the serial drama, to create awareness on rights and responsibilities, but also to empower listeners through characters that model desired behaviours that reflect true empowerment.

The serial drama was translated into three major local languages spoken in the country’s three block regions. These are; Luganda (Central region), Luo (Northern region) and Runyankole-Rukiga, Runyoro-Rutooro (Western region). The drama has given the project national-level leverage where feedback is received from all districts of the country through a toll-free hotline (0800 600 200) that is managed by Communication for Development Foundation Uganda (CDFU) – a sub-grantee CSO on the project. The feedback received so far indicates that citizens have increasingly become aware of their rights and responsibilities and are exercising them. Below are examples of questions that have been asked by callers on the toll-free hotline, after listening to the radio serial drama with advocacy storylines;

1 Capital FM, Radio One, CBS FM, Guide Radio, Radio Messiah, Radio Buwama, Radio Simba, Radio Akaboozi, Power FM, Suubi FM, Impact FM, NBS FM, Radio West, Rwenzori FM, Radio 5, Vision Radio, Millenium Radio, KBS FM, Sabiny FM, Elgon FM, KRC FM, VoK FM, KFM, Step FM, Radio Mboona, Mbabule FM, Voice of Kigezi, Voice of Muhabura, Jogo FM, Eastern Voice, Continental FM

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“Why are female doctors and nurses in Kayunga hospital rude while offering services to clients?” Female caller, 20, Kayunga district.

“I am at Kyenjojo health centre. I arrived here with my wife who is about to deliver but they have refused to work on us. They have told us that if we think it is too urgent we go to a private clinic. What can we do?” Male caller, Kyenjojo district.

“Why is it that there are always no drugs at Lwebitakuli Health Center III?” Male caller, Sembabule district. Forum Theatre Performances on Citizen Rights and Responsibilities and Other Advocacy Issues Through another popular version of the drama known as forum theatre, the project worked with drama groups in the collaborating districts to conduct up to 133 forum theatre shows in communities. Forum theatre is interactive drama that gives the audience chance to participate in the drama and suggest solutions to the problems being highlighted in the drama. The drama was based on a standard script that was developed, reviewed and approved by the project leadership. The content of the drama was premised on the Patients’ Charter as a tool for community empowerment.

For instance in Kamwezi sub-county, Kabale district, after the forum theatre performance, the community members and duty bearers present participated in a discussion on the gaps identified by the drama on the quality of service at their health centre (Kyogo HC III). The in-charge of the health centre responded by providing evidence of the communication he had exchanged with his superiors at the district level, on the need to improve the quality of service. He asked the ABH team to partner with him to challenge the duty bearers at the district level to become more accountable. One such letter regarding unfinished construction work at the facility, was used by the project staff to follow-up at district level with the relevant authorities to ensure the contractor completes his work at the facility.

School-based advocacy and community empowerment engagements The project recognises the fact that children are good change agents if they are equipped with knowledge on issues that affect their health, economic and social wellbeing. The project therefore, in a number of districts, prioritized engagement with primary schools on platforms dubbed “children’s forums”. Central to these forums was the promotion of rights and responsibilities among children especially those in upper primary classes and those who belong to organized school clubs. A total of 57 primary schools were engaged in project activities aimed at creating awareness among school children on their rights and responsibilities. Teachers were equally oriented on the Patients’ Charter and empowered to transfer their knowledge to the pupils through routine school club activities such as drama, sports and other health-related club activities. During discussions, pupils were able to raise issues that affect the quality of their education.

A drama group in Nankoma sub-county, Bugiri district, staging a forum theatre show on rights and responsibilities

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In Namutumba district, Eastern Uganda for example, pupils at Nalende Primary School in Bulange sub-county raised the issue of lacking Primary six and Primary seven classrooms which was causing unnecessary class repeats and school drop-outs. Pupils resolved that their advocacy champion for the sub-county follows up the issues with the Head Teacher for Nalende Primary School to ensure a meeting is convened with the school administration, Parent-Teachers Association, school management committee and sub county leaders to forge a way forward. In Mpigi district, Central Uganda, the project focused on issues that were affecting school retention and performance such as child labour and failure by schools to provide lunch for pupils.

Community Dialogue Sessions The project conducted a total of 145 community-based awareness and dialogue sessions to disseminate the Patients’ Charter and educate citizens on their rights and responsibilities. Apart from the ordinary community members, other participants in these meetings included; opinion leaders, religious leaders, Health Unit Management Committee members, head teachers, clan heads, retired civil servants, village health teams (VHTs), as well as duty bearers especially Community Development Officers, in-charges of health facilities, Sub-county Chiefs, Parish Chiefs and health workers, among others.

“I am surprised to learn that it’s my right to be treated by a named health worker to enhance appropriate follow-up with the service provider just in case. I will seek for this information during my next facility visit”, (community member, from Namwiwa sub county).

The dialogue meetings culminate into development of advocacy action plans that guide the community’s subsequent engagements with the duty bearers.

Printing and dissemination of the Patients’ Charter In a bid to provide citizens with an empowerment tool that talks about their rights and responsibilities, the project adopted the Ministry of Health’s Patients’ Charter and developed an abridged version that is audience-friendly. The process of developing this version involved consultations with representatives of the target audience, who helped in narrowing down to only eight rights and three responsibilities that were considered to be fundamental while accessing health services. The Patients’ Charter was translated into 8 languages, (Luganda, 4Rs, Lukonzo, Lumasaba, Rufumbira, Kupsabiny, Lusoga, Ateso) and pretested with the target audience to confirm its acceptability and appropriateness. It also went through a series of approvals at PATH, Ministry of Health and USAID. A total of 88, 650 copies were printed and the process of disseminating these copies is ongoing in the 35 districts where the project is being implemented.

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Intermediate Result 1.2 Community groups advance priorities for improved health and social services

Development and implementation of advocacy action plans by community groups Community groups are critical in advancing grassroots advocacy agenda in the project. Out of the targeted 479 community groups for the project, sub-grantee CSOs continue to centre their energies on community empowerment based on the groups that have already been identified and trained, while at the same time trying to network with more in additional sub-counties of operation. The main task of these community groups is to meet regularly, discuss and develop actions plans for grassroots advocacy, addressing issues that affect the quality of health and social services. Each group has a leader or an advocacy champion who is tasked with the role of following up on some of the actions with the responsible duty bearers at village and sub-county level. For instance in Bugiri district, Eastern Uganda, two community groups were actively engaged in developing and implementing action plans that were aimed at addressing issues of child marriages and drug stock-outs, among others.

There is already impact resulting from such action plans developed by community groups. For instance in Kaliro district, the in-charge for Bulamogi HC III was transferred to another health facility and replaced with a new in-charge, after community members complained that the health workers he was leading were neglecting patients who sought services at this health facility. Other health workers were compelled to apologise to the community for neglecting their duty. At the same health facility, a duty roster was developed for both day and night duty and at the moment, it is being adhered to strictly. This has translated into improved access and quality of health services at the health facility. In Busanza sub-county, Kisoro district, South Western Uganda, a community group organised a dialogue where they invited duty bearers and engaged them on the issue of the road connecting to Busanza Health Centre IV that had been washed off by the stream for the past 6 months, thus hampering accessibility. In response to the citizens’ demands, the sub-county leadership with the support of the area Member of Parliament renovated the road, and now the health centre is accessible.

Intermediate Result 1.3 increased engagement between citizens and duty bearers Advocacy forums at health facility level Advocacy forums remain a critical component of the project as they continue to provide platforms for citizens to interface with their duty bearers to debate issues that affect service delivery and map out ways of addressing these issues. During the quarter, the project conducted 21 advocacy forums at facility level and these took the form of health facility “open days, face-the-citizen rallies, public hearings and interface meetings. These forums were used to promote mutual accountability between the community members, the health care providers and the

Citizens attending a public hearing at a health facility in Masaba sub-county, Sironko district

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duty bearers. They also provided citizens with a platform to know the range of services offered at their respective health facilities and to appreciate the challenges that health workers go through with no control over them. The leaders also got a chance to witness the status quo of health services at health facilities where the forums were based and this gave them evidence to speak with confidence whenever they would be making commitments. For example in one of the advocacy forums conducted in Busia district, community members accused health workers at Lunyo health centre III of spending too much time on lunch breaks and not working overt the weekends. The District Health Educator (DHE) who was the key duty bearer present observed that health workers are usually not aware of the patient’s rights as enshrined in the Ministry of Health Patients’ Charter. During the forum, a resolution was passed that the health facility starts displaying the duty roster. The DHE also committed that he would disseminate the Patients’ Charter to all health workers in the district. The in-charge for Budadiri HCIV had this to say after participating in an “open day” at his health facility; “I am very happy with the project for having organised the open day. The community had been hostile to all the health workers especially after the transfer of the former Medical Officer accusing staff of having had a hand in his removal which prompted the district to transfer all health workers. Therefore such forums that bring citizens and health workers together provide us with the opportunity to cement our relationships with the community” Dr. Chebet, In-charge, Budadiri HC IV, Sironko district. Another example of positive outcome from the advocacy forums was at Bumadanda HC III in Bubyangu sub-county, Mbale District, where health workers were being accused by citizens of not residing at the facility and yet there are staff quarters. During an advocacy forum, the health workers expressed their challenges as to why they do not prefer to reside at the health facility quarters. They cited theft of their basic necessities as being a source of insecurity, and deterring them from residing in the staff quarters. At the same forum, the community members resolved that they were going to erect a fence around the facility using their local resources. This was done and the health workers have already started staying at the health facility. Advocacy forums at community level In addition to health facility-based advocacy forums, the project conducted 185 advocacy forums at community level. These forums were in form of debates and interface meetings between citizens and duty bearers. CSOs worked closely with leaders of the community groups to ensure these

forums were successfully organized at sub-county level. Citizens got the opportunity to meet and interact with their district and sub-county leaders to raise their concerns and ask them questions related to health and social service delivery.

While new issues and demands were presented by the citizens during the forums, citizens also demanded for updates on issues that had been raised before in the previous forums. For example, Kyarusozi Twomere Tukole People Citizens attending an interface meeting with duty bearers in

Kamira sub-county, Luwero district.

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Living with HIV in Kyenjojo district followed up the DHO regarding the need for a viral load testing machine at Kyenjojo hospital. In response, the DHO promised that the machine will be placed at the facility. This would reduce the cost of accessing the service from elsewhere. In Keihangara sub-county, Ibanda district, community-led advocacy efforts culminated into the health centre securing an emergency room where critically ill patients can rest from as they await to be attended to by health workers. Participation in nationally and internationally recognized commemorative events Sub-grantee CSOs in respective districts have played a critical role in ensuring that the project’s visibility is enhanced while amplifying advocacy voices in relation to the themes of the international commemorative events. For instance, three CSOs (CIDI, KACSOA and MAFOC) participated in commemorating international Women’s day and World TB Day in the districts of Luwero, Bukwo, Sironko and Mbale. On the eve of these events, live call-in radio talk shows were conducted hosting key decision makers in the districts to discuss relevant issues such as maternal and new-born health and availability of drugs for TB patients. CSOs used the events to disseminate advocacy fact sheets to duty bearers on TB drug stock-outs. For instance, in Mbale district, the DHO used the World TB Day event to re-assure the citizens that the district was doing everything possible to ensure that TB drugs are available so as to reduce the prevalence of this highly infectious disease in the district.

Advocacy issues reported through media articles In collaboration with media champions, the project’s sub-grantee CSOs leveraged the power of media to publish advocacy-related stories in both newspapers and on radio. On radio, the popular approach used was to record proceedings of advocacy forums happening in communities and these were relayed on the radio stations that CSOs are partnering with. Such broadcasts, in some of the cases, provoked responses from duty bearers culminating into certain actions to solve the challenges highlighted during the advocacy forums. In newspapers, media champions reported outstanding issues in health and social service delivery that required the attention of decision makers at various levels. Some of the stories are reflected in the articles above. Breakfast dialogue with journalists from major media houses at national level The project conducted a high level breakfast dialogue at Hotel Africana that was officiated by the Minister of State for Health, Hon. Dr. Chris Baryomunsi. The dialogue was aimed at obtaining commitment from the media houses to provide more media space to advocacy-related stories. Up to 15 journalists attended the dialogue, in addition to a cross section of partners from the civil society, government and USAID mission. Addressing the journalists on responsible reporting, Dr. Baryomunsi urged the journalists to always consult the people whom they want to include in their stories.

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Left foreground: Some of the journalists who attended the breakfast dialogue targeting media editors. Right: Minister of State for Health Dr. Chris

“…As the media, you need to be thorough. Do no not be biased. Report facts as they are. Be objective. But most importantly, we are always available to provide any information. Even if you called me at 3.00 am, I will give you the information. Let us all work transparently so that the public is informed appropriately.” said Dr. Baryomunsi.

2.2 Result Area 2: CSOs effectively advocate for issues of citizen’s concern in health and social sectors.

The purpose of this result area is to have CSOs capture citizens’ concerns in health and social services, gather evidence around those issues, and engage duty bearers to take actions in form of policy change, policy formulation or policy implementation, allocation of budgets and putting programs in place to address citizens’ concerns. During the quarter, the project supported CSOs to improve their skills in evidence collection and packaging, decision makers’ engagement, participating in appropriate forums as a way of representing community interests before duty bearers; and coalescing with other like-minded CSOs to influence policy change and accountability in both the public and private spheres. Key achievements Intermediate Result 2.1: Increased utilization of evidence by CSOs to inform advocacy Sub grantee CSOs have increasingly appreciated the power of evidence in advancing advocacy. During the quarter, all the sub grantees continued gathering and updating their advocacy evidence through rapid assessments, desk reviews, fact finding missions, and using community scorecards. This evidence was analysed and packaged well in a user-friendly manner, for consumption of the duty bearers. As demonstrated below, the sub grantees largely packaged this evidence into dossiers, fact sheets, issue papers and policy briefs. Reproductive Health Uganda (RHU) developed factsheets on Adolescent health policy; Coalition for Health Promotion and Social Development (HEPS) developed an evidence dozier on HUMCs’ non functionality; and Straight Talk Foundation (STF) developed policy briefs on teenage pregnancies.

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Engagement with duty bearers: The quarter saw sub grantee CSOs continue to exploit windows of opportunity to engage duty bearers and present their packaged evidence. Engagements ranged from dialogue meetings, one on one meetings, to sector specific meetings. From these engagements, significant results have been reported. In Ibanda district Western Uganda for example, HEPS presented evidence to district officials on Health worker absenteeism and non-functionality of HUMCS. As a result the Chief Administrative Officer (CAO) issued a circular to

all civil servants to adhere to the Uganda Public Service code of conduct of reporting at duty stations at 8:00 am and leaving at 5:00 pm (see circular on the left hand side). In addition, the CAO and the DHO met all HC in-charges to discuss the issue of health worker absenteeism and agreed that Sub-county Chiefs should take up the responsibility of supervising health workers at Health Centre IIs and IIIs. In Isingiro district and as evidenced in the letter on the left, the district leadership took up the issue of non-functionality of HUMCs, with the district council resolving to appoint new HUMCs starting with health Centre III. In Eastern Uganda, one of the sub grantees Multi Community Based Development Initiative (MUCOBADI) used the community scorecard findings to engage the CAO and DHO of Budaka district on the issue of health worker absenteeism, and how it was affecting health service delivery in the district. As a result, both the CAO and DHO took action by serving culprit health workers with warning letters (see the letter below), urging them to refer to their employment contracts.

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In Mpigi district, another sub grantee CSO—Action for Rural Women Empowerment (ARUWE) engaged District Education Officers, District Community Development Officers, District Health Management Teams and District Education Committees to discuss status of OVC and child labor. After presenting evidence and asking duty bearers to take action, district leadership pledged to enact an ordinance on child labor as the sustainable solution in dealing with issues of child labour. This pledge however needs to be pursued and concretized.

At national level, The National Forum of PHA Networks in Uganda (NAFOPHANU) spearheaded engagements with Ministry of Finance, Economic Planning and Development, the Ministry of Health, the Speaker of Parliament and the National Medical Stores to address the issue of ARV stock out. Using evidence gathered from more than twenty districts, NAFOPHANU was equipped with facts about ARVs stock out and how adults were provided with paediatric doses. After a series of meetings with duty bearers, the Global Fund to Fight HIV/AIDS, TB and Malaria front loaded money to address the issue. This move by the CSOs was appreciated by the Ministry of Health (MoH), with the Permanent Secretary pledging to support CSOs, by instituting a platform where updates from MoH will be shared. ABH subsequently hosted a series of meetings with major duty bearers including Ministry of Health and the Executive Director of National Medical Stores to discuss issues of drug Stock-out.

Related to national budget advocacy, a national sub grantee CSO—Centre for Health Human Rights and Development (CEHURD) spearheaded advocacy for an increased health budget for the Financial Year 2016/17. This was attained by bringing together other like-minded CSOs to analyse the budget-framework paper and presenting funding gaps and its effects on health service delivery. In her response, MoH invited CSOs to be represented in her budget working group meetings. Being part of the budget working group at MoH, CEHURD presented priority issues which include the need to; increase human resources for health, increase the budget for health to at least up to 10% to ensure health commodity security (underscoring drug and essential supply availability).

Above: Warning letter from the CAO Bududa to health workers -Bufuma Health Centre III in Bududa

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ACODEV staff makes a presentation during the Kasese DMC meeting

Intermediate Result 2.2: Effective participation of CSOs in local government planning, monitoring and accountability of health and social services

During the quarter, there was increased participation monitoring government planning processes. CSOs continued to make contributions by presenting issues of citizens’ concern that were affecting the quality, availability and accessibility of health and social services to district duty bearers.

The meetings attended included; District Management Committee meetings (DMCs), District

OVC Coordination Committees (DOVCC), district Technical

Planning Committee meeting (TPCs), district Budget Conferences, and Extended District Health Management Team meetings (EDHMT). Below is a table showing district planning meetings attended by CSOs and issues presented therein. Table showing sample district planning meetings attended, and issues presented

Type of Meeting Attended

Districts/CSOs participating Advocacy Issues raised & Discussed

District and sub-county Budget Conferences

Kasese, Mbale Sironko, Nakasongola, Kaliro, Mayuge, Kamuli, Kayunga,

Poor health services at health centers, for example limited beds in the labor ward at Karambi HC for delivering mothers, and fencing of the health facility was presented and incorporated in the budget.

District Health Management Committee

Bugiri, Busia, Kapchorwa Bukwo, Larilo

Joint monitoring of health service delivery

District Management Committee meetings (DMCs)

Kasese, Ibanda, Isingiro, Bushenyi, Rukungiri, Kanungu, Kisoro, Kabale, Kyenjojo, Ntungamo,Kapchorwa, Mayuge, Kamuli, Budaka, Bududa, Mbale, Kamwenge, Bugiri, Kumi, Pallisa, Nakasongola, and Kaliro

-Challenges of health workers’ absenteeism, understaffing and drug shortages in health facilities. -Non-functionality of HUMCs and actions agreed upon including training on roles and responsibilities, full composition and facilitation. -OVC retention in schools. -Child labor.

DOVVCs Isingiro Bugiri, Busia

-Violation of OVC rights.

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Intermediate Result 2.3: Enhanced co-ordination and collaboration among CSOs Sub grantees CSOs have continued working with likeminded CSOs to amplify issues of citizen concern related to health and other social services. A number of functional coalitions and networks have been leveraged to address particular advocacy issues that are being championed under the Advocacy for Better Health Project. For example CEHURD convened CSOs working on budget advocacy to discuss priorities for national advocacy within the health sector. These CSOs agreed that for the coming Financial Year (2016/17) Government of Uganda should prioritize commodity security, and increasing funding for primary healthcare and recruitment of more health workers. NAFOPHANU also worked with other CSOs to sustain the drug stock-out campaign where joint engagements with duty bearers were done. Actions such as frontloading budgets for ARVs, and increasing funding for the HIV/AIDS response were championed.

In Western Uganda, HEPS coordinated other CSOs and formed the Western Uganda Coalition for Health Advocacy (WUCHA) where joint initiatives have been undertaken, such as advocacy to review MoH’s HUMCs guidelines. Similarly, Action for Community Development (ACODEV) engaged the Kasese Civil Society Network (KADDE-NET) and other CSOs and formed a coalition aimed at addressing maternal, neonatal and child health challenges. The formation of these new networks and coalitions will be leveraged to champion t advocacy issues of citizens’ concern. Partners’ Breakfast dialogue: As part of the media breakfast meeting earlier highlighted in the report, the project also organized a partners’ dialogue meeting. This dialogue was intended to bring together duty bearers, stakeholders including media and share the project’s advocacy issues, demonstrate the intervention that it had achieved thus far, and also strategize on how to work together to advance health issues on the decision makers’ agendas. In attendance were the Deputy/Ag PEPFAR Coordinator in Uganda and the USAID HIV/AIDS Team Leader, the Principle Economist from Ministry of Finance, Planning and Economic Development (MoFPED), the Chairman of the Health Commission, the Chairman of the Uganda AIDS Commission, members of the Academia, representatives from sister implementing partners and CSOs. The Hon Minister of State for Health overrepresented the Rt. Hon Prime Minister as the Guest of Honour. The following link provides a glimpse of how the media utilised the outcomes of this meeting to enhance advocacy for better health. https://www.youtube.com/watch?v=8JioTSUTO3c The issues discussed at this meeting included; the HIV/AIDS drug stock out in the country, failed and delayed progress in operationalizing of the AIDS Trust Fund. Other major issues discussed were; the need to increase budget allocation to health underscoring adolescent health, family planning and nutrition programs. The delayed implementation of the proposed National Health Insurance scheme was also raised during the meeting. The major Advocacy ASKs included; 1. The need to increase the Health Sector budget, at least up to 10% of the national budget,

including increasing Primary Health Care (PHC) funding, aiming for the 15% recommended by the Abuja Declaration.

2. The need to approve and operationalize the AIDS Trust Fund, and 3. The call to Pass the National Health Insurance Scheme Bill. In response to the ASKs, the duty bearers made submissions and commitments as follows; • Budget Increase: MoFPED is discussing with MOH and USAID about funding of health sector.

MoFPED representative advised advocates to not only advocate for a blanket budgetary increase, but also clearly specify what it would be used for. She pledged to support this proposal when it reaches her office.

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• The Hon. Minister of Health pledged to continue advocating for budget increase within the Ministry and Parliament. He emphasized the need to increase the PHC budget, much as there has been some increment over the years.

• AIDS Trust Fund (ATF): The Hon Minister of Health indicated that MoH presented the ATF operationalization document to Cabinet, which provided feedback. He mentioned that MoH was working with the Solicitor General to respond to these issues. He also promised to follow this up for approval, before the 10th Parliament is sworn in.

• Regarding national Insurance Scheme: The Hon Minister said that MoH is yet to answer questions raised by MoFPED and soon it will be presented in Parliament for discussion. He pledged to support its approval once presented.

Women’s Day banquet: The project participated in the national banquet organized by Business Day Communications in partnership with Ministry of Gender to commemorate the International Women’s Day. The banquet provided opportunity for the project to present advocacy ASKs to the Chief Guest (The Rt. Hon. Speaker of Parliament, Hon. Rebecca Kadaaga) related to financing for the health sector and the social wellbeing of orphans and vulnerable children. Other key decision makers at the meeting included the Minister of State for Gender, Hon. Lukia Nakadama and Members of Parliament. The Country Director of PATH (Dr. Emmanuel Mugisha) gave an overview of PATH and its programs in Uganda, particularly relating them to the health priorities for women, one of the key thematic areas that PATH was addressing. The project’s Chief of Party (Mr. Moses Dombo) then spoke about ABH, its goal and objectives, the theory of change, coverage and priority advocacy issues. He went ahead to present two major ASKs: Domestic Health Financing. He implored the Speaker of Parliament to consider increasing budget allocation for the health sector from current 8% to at least 10% (although the ideal would be 15% as per the 2001 Abuja declaration). This he said, would be aimed at facilitating the provision reproductive health/family planning services to women and young girls, as a way of; preventing unintended pregnancies and unsafe abortions, and addressing the rampant health commodity stock-outs. The second Ask was to ensure that social service provision for Orphans and Vulnerable Children is prioritised again. Remarks from the Rt. Hon. Speaker of Parliament: Rt. Hon. Speaker of Parliament, in her key note address, responded to PATH’s presentation on health sector financing by saying that Parliament had done a lot to pass budgets and bills that should cause improvements in the lives of women and children. She added that she would not become complacent until the health sector is adequately funded to deliver quality health services to the population, underscoring the unmet health needs of women and children. The project will hold follow up meetings with duty bearers to ensure that these commitments and pledges are honoured. The Project Advocacy Advisory Group (AAG) Meeting: The project’s advisory group (AAG) meeting was held to, among others, officially introduce to them the new Chief of Party, updating the Advisory Group on project implementation and eliciting their thoughts on future plans, and learning from a like-minded project funded by UK AID that is implementing a social accountability program—Accountability Can Transform Health, implemented by GOAL Uganda. The major update during the meeting was the successful “Drug Stock Out” campaign that the project championed. Emerging from this meeting were;

• The need for the project to ensure that its community empowerment component complements its national level campaign on the need to address the frequent stock out of health commodities in the country,

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• The need for project to pursue and tease out advocacy issues outlined in the Uganda Global Fund Audit Report,

• The need for the project to align its four priority advocacy issues with the newly rolled out Sustainable Development Goals (SDGs), and

• Much as it is important for the project to focus on advocating for increased budgets and human resources for health, the meeting advised the project to hold government of Uganda accountable for the efficient use of the available resources.

The project will aim at following up these recommendations during the subsequent quarter. 2.3 Result Area 3: Institutional capacity of CSOs strengthened

The project’s Organizational Development (OD) team made a number of technical assistance visits, and provided online and in person support to all 20 CSOs. In addition, the team helped facilitate the Grants Management Collaborative (GMC). Key accomplishments included:

• Governance training and team building session for KADINGO • Final phase of strategic planning for ARUWE • Governance training for JIACOFE • Procurement, finance for non-finance managers and HR training for MAFOC • Governance and supervision training for KACSOA • Strategic planning session for CIDI • Implementation of the Grants Management Collaborative • Review of CSO policy and strategy documents

A. KEY ACHIEVEMENTS OF THE QUARTER

In the period of reporting, the OD team supported CSOs to address prioritized issues according to their OACA action plans. Support was provided through technical assistance visits and online support. Strengthening CSO governance and management systems: Kalangala District NGO Forum (KADINGO), Jinja Area Community Federation (JIACOFE) and Kapchorwa Alliance of Civil Society Organizations (KACSOA) were supported to strengthen governance systems through training of board members and management in governance, team building, policy formulation and development of Human Resources support and operational manuals. Governance training and team building session KADINGO, located on the islands of Kalangala in Lake Victoria, is the ABH implementer in Kalangala district. Board capacity was identified as a major hindrance to organizational development during the 2014 OACA. In January 2016, the OD team facilitated a three-day training for board and staff that included a one-day team building exercise. The latter was added to enhance team work between KADINGO participants and facilitators

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JIACOFE participants responding to a question on how many felt the training was beneficial and well presented?

management and the board, and within management itself, the lack of which, was beginning to undermine project implementation. The training focused on developing good governance. It provided an opportunity for KADINGO to review its organizational structure and discuss challenges or gaps, such as unfilled positions, unclear reporting relationships and inconsistencies in job positions. The training led board members to interact with the staff and to understand better, their own role, which they pledged to play better in future. Roles and responsibilities of board and management were better understood as well as how the two structures could effectively support each other to enhance achievement of organizational goals. Board members received clear terms of reference and other policies to guide management. The team building exercise introduced participatory methods to help staff identify root causes of the tension within the organization. Through use of personality assessments and open sharing, staff and board agreed to improve communication between board and magangement and staff. They agreed that improved planning through weekly and monthly meetings, timely and quality reporting and the use of face to face communication to complement emails and notice board based communication was critical. The Chief of Party (COP), who visited the CSO during this training, encouraged the team to work together to achieve project and organizational results. The OD team has continued to work with KADINGO on action plan issues and there is significant improvement in their work. Board and management training: JIACOFE works in Kamuli and Mayuge districts. In February 2016, the OD team and regional coordinator facilitated a two-day training that improved understanding of board roles and responsibilities and the importance of policies and succession planning. The board was able to identify gaps in their operations and clarify the roles of the board and functional committees, which appear to be duplicated. A review of the vision and mission statement led the board to revise its mission statement to reflect the new focus on youth. The board also developed clear terms of reference to support the constitution, ensure full separation of board and functional committee roles from management, and improve skills in resource mobilization. Going forward, the board will also explore adding selection criteria to increase the range of board expertise and skills, currently limited by the emphasis on community representation. To make this happen, JIACOFE will need to consult with its founding body, Child Fund. The training was participatory and instructive; participants committed to implementing the action plans. Governance and supportive supervision training: KACSOA recognized its need for board orientation and supervision during the initial OACA. The training for board members and management was conducted over two days. Both the board and management attended the governance training and appropriate staff joined the supervisors’ training. The roles of the board were clarified as well as the relationship between management and

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the board. Legal issues were also discussed; the board proposed recruiting a member with legal expertise to help them further on this front. The board felt empowered and immediately embarkd on refining the board terms of reference (TOR) conducting an evaluation of board members’ performance, expanding the board to include legal skills and development of a conflict of interest policy. Staff had not been exposed to supervision training previously; using a case study, participants identified key steps and requirements for supportive supervision. They learned about supervision principles, the importance of systematically following the supervision steps and reviewing the performance management system. The team also developed sample activity guides or standards for supervision. The OD team will provide follow-up support for the action plans, including reviewing performance management tools, developing performance plans and supervision tools. Training in procurement, finance and human resource management: Mbale Area Federation of Communities’ (MAFOC) organizational and advocacy capacity assessment (OACA) findings identified the need to streamline the procurement process, and address financial management and human resources management. Training was designed to strengthen the capacity of the functional committees and MAFOC staff. In a five-day training, the PATH team and OD specialists oriented participants on best practices in the three areas. 1. Procurement The role of the board and procurement committee was clarified; procurement, procurement steps, and the value of documentation were explained. Other topics covered included legal considerations for procurement, procurement rules and regulations and best practices. Key issues discussed included committee composition and duplication of management roles by the functional committee, which they agreed to address. 2. Financial management The non-finance managers training equipped the finance and administration committee, and board and staff with knowledge and skills in financial management. Challenges included the need to fully comply with the finance standards, address role conflict among finance staff, and involve committees in some management roles. Understanding of basic financial statements, the role of management in finance, the role of non-financial staff in the finance process and the legal basis for financial management helped participants learn and demonstrate their understanding in practical and group activities. Staff of CSO in a Role Play

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3. Human resources training This one and half day orientation targeted staff, the HR committee, the finance and administration committee and board. It was clear that many had not been trained in HR previously. Training covered strategic HR planning, recruitment, employee motivation and engagement, performance management, management teams and conflict management. Self- awareness exercises helped staff and board members improve teamwork. An action plan addressed priority issues related to job descriptions for community development officers and assistants, composition of the functional committees and the link to performance appraisal management for staff professional development. MAFOC was pleased with the support.

Grants Management Collaborative (GMC): The Collaborative was designed to increase opportunities for the 20 CSOs to learn from each other and share experiences to improve the approaches they are using in implementing their advocacy and community empowerment work. Two CSO representatives from each CSO, one from the advocacy (program management) and the other from operations (OD side), attended. The two day meeting was facilitated by Initiatives Inc. and the Advocacy for Better Health project staff. As per the model, the session had both expert sessions on key issues identified by the CSOs and allowed for various approaches to CSO sharing. Sessions were prioritized to address the survey monkey findings and looked at the role of the GMC, root cause analysis, government planning processes, evidence-based advocacy and writing success stories. The Plan, Do, Study, Act (PDSA) Cycle helped the CSOs to think through the issues or challenges they have in their work and plan the improvements they want to make. Each of the CSOs was supported to develop a PDSA to guide the process of making the necessary improvements.

Attendees at the Grants Management Collaborative

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Sample PDSA from NAFOPHANU

NAFOPHANU PDSA FORM

Purpose of this cycle:

PLAN the change, prediction(s) and data collection THE CHANGE: What are we testing?

If frequent reminders for drug stock out and health service delivery data collection will lead to timely data receipt, thus by 15th of every month by NAFOPHANU.

On whom are we testing the change?

8 NAFOPHANU district linkage facilitators from Mbale, Bududa, Kumi, Nakasongora, Mpigi, Kalangala, Kasese and Kabale.

When are we testing? From 1st April 2016. Texts reminders will be sent bi-weekly. Where are we testing? Mbale, Bududa, Kumi, Nakasongora, Mpigi, Kalangala, Kasese and Kabale. PREDICTION(s): What do we expect to happen?

To receive timely district reports from the district linkage facilitators of Mbale, Bududa, Kumi, Nakasongola, Mpigi, Kalangala, Kasese and Kabale. The reports will inform NAFOPHANU of stock outs of TB/HIV medicines commodities and supplies hence inform national advocacy. Advocacy will lead to reduction or elimination of stock out of TB/HIV medicines, supplies and other commodities.

DATA: What data do we need to collect?

Data on stock outs of TB/HIV medicines, supplies and other commodities. Also other issues affecting health service delivery and uptake.

Who will collect the data? The district linkage facilitators will collect the data and send the same to NAFOPHANU secretariat for compilation.

When will the data be collected?

Monthly starting April 2016.

Where will data be collected? Mbale, Bududa, Kumi, Nakasongora, Mpigi, Kalangala, Kasese and Kabale. The project will support CSOs to organize GMC learning sessions every six months to review progress on their PDSAs. Quarterly GMC sessions and onsite visits will be conducted to support the CSOs to effectively ensure data is being collected, stored and used. The quarterly GMC sessions will provide an opportunity for CSOs to share and learn, but also to identify areas where they can work together. Strategic planning support to CSOs: In the last quarter, the project supported ARUWE and CIDI to develop their strategic plans. ARUWE had completed phase one while CIDI had developed their plan internally and needed support to ensure a more streamlined process and document. Phase 2 support for ARUWE The OD team with central regional staff facilitated the 2nd phase of the strategic planning process for ARUWE. This phase built on the first and focused on reviewing the CSO’s strategic directions, and developing strategic objectives and interventions for achieving the objectives. The team developed a monitoring and evaluation framework, as well as plans for strategic implementation, stakeholder engagement and human resources. The team was supported to start costing the strategic plan. The new strategic plan outlines ARUWE’s direction; board participation assisted the planning. ARUWE

Date: 17th March 2016 Initiated by: Salome Atim Cycle: #1 This cycle is for: Other purpose

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appreciated the support which built their capacity to develop strategic plans on their own in the future. ARUWE has received feedback on their first draft and the final strategic plan is expected in the next quarter. Support to CIDI to review their strategic plan CIDI implements in Nakasongola, Luwero and Kayunga districts. The CSO undertook a strategic planning process on their own but midway requested project support to refine the draft plan based on comments from the OD team. In a two-day session, the OD team focused on ensuring that the strategic plan followed a systematic process and addressed weak areas. The focus was on conducting an external and internal environment assessment. Key issues related to policies, political, economic, health and HIV were identified and analyzed. A SWOT analysis was conducted and the team went through a “dreaming” exercise to ensure a more objective way of determining CIDI’s strategic direction. The vision and mission statement was reviewed; CIDI preferred to keep the vision, but do more internal consultation on the mission statement. Templates for developing the implementation plan, monitoring and evaluation framework, human resource plan, and costing were provided. Offsite support is being provided to enable the team to complete its strategic plan. Review of draft strategic plans In addition to facilitating strategic plan development, the OD team supported three CSOs to review and improve their draft documents. HEPS, Integrated Development Options (I-DO) and MUCOBADI submitted their draft strategic plans for review. The OD team reviewed and provided comments to the three CSOs on areas for improvement. The review for IDO and HEPS may require additional support. Visits to HEPS and IDO will be planned in the next quarter. Support to develop resource mobilization strategies: In the last quarter the team supported seven CSOs to review n their draft resource mobilization strategies. Some CSOs submitted revised strategies for further review. This quarter, KADINGO and CEHURD submitted their Resource Mobilisation strategies, which were reviewed by the team and feedback provided to the CSOs. Support to develop policies and procedures: The OD team with other staff continue to support CSOs to strengthen systems, and policies that lack key sections, especially regarding USG compliance requirements. This quarter CEHURD reviewed its monitoring and evaluation policy, HIV/AIDS workplace policy and human resources manual. IDO also received support to develop and review its financial manual and volunteer policy while ARUWE refined its travel policy and constitution to take care of actions agreed at the governance training. Some CSOs have been holding meetings with staff and board members to review their policies and monitor compliance. Finalising and approving policies is a long process; the team will continue working with the CSOs to ensure they complete their required policies.

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3.0 PROJECT MANAGEMENT

Staff Changes: The project’s Finance and Grants Manager stepped down from her role to pursue another career path. The project has since hired a replacement for her. M&E support through coaching and mentoring: The project M&E team sustained the provision of ongoing mentorship to the sub grantees, more so by reviewing their reports and providing guidance for the execution of their M & E plans.

Monitoring of context indicator reports: The M & E team has continued with the process of upholding and updating respective data bases, with support of other technical staff and the regional teams. This is all aimed at ensuring that project activities are conducted in a timely manner, and are compliant with standard operating procedures. AMELP Data capture: The table below summarizes the indicators captured and reported quarterly in the USAID PRS;

ACTUALS Data - IPs that entered data for reporting period Quarter 2 in 2016

IP # of All Indicators

% of Required Indicators

Entered for Quarter 2,

2016

% of Required

Indicators Not

Entered for

Quarter 2, 2016

Data Entry Completion Verified by

Supervisor?

COR ALT COR

1 Advocacy for Better Health

15 100% [6/6] 0% Yes. WILBERFORCE OWEMBABAZI

WILBERFORCE OWEMBABAZI

Source: USAID PRS 2016

4.0 PARTNERSHIPS

During the quarter, the project participated in a number of partnership meetings as articulated below; Nutrition Advocacy Partner’ meeting organized by the USAID FANTA Project: The purpose of the meeting was to discuss Uganda nutrition agenda for the next two years. Issues focused included;

• Need for scale up of social behavioural change communication at lower levels to increase the responsiveness to the challenges facing nutrition.

• The need for a platform for in-depth conceptualization of the Uganda Nutrition Advocacy and Communication Strategy, and addressing critical and contentious issues raised by partners.

• The need to review and fix gaps in the draft National Nutrition Policy before it is tabled before Cabinet.

Meeting with the JSI-AIDSFree Project: This meeting explored opportunities for joint advocacy for increased budgetary allocation for management of healthcare waste. Discussions still ongoing.

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World Malaria Day Commemoration and collaboration with MoH: As part of the World Malaria Day commemoration in the country, the project was approached by MoH to support them in the effort to roll malaria back onto the table and out of households, especially in light of the recommended test and treat approach. It was agreed to jointly organize a policy makers’ advocacy meeting that will largely be aimed at addressing the following advocacy issues;

• Taxation of Rapid Diagnostics Test (RDT) kits that has implications on the test and treat, and • Inadequate from government for Artemethanine Combination-based Therapies (ACTs)

The project will continue working with MoH to ensure that this advocacy event is executed and the desired outcomes obtained. Other collaborating partners include Church of Uganda and CHAI.

5.0 KEY ACTIVITIES PLANNED FOR NEXT QUARTER

In the coming quarter, the project will dedicate its efforts to; • Empowering communities on their rights and responsibilities, • Working with community groups to follow up earlier commitments from duty bearers and

generating new action plans on issues of health and social services that affect them, • Supporting communities to organize advocacy forums, • Participation in commemorative events such as the World Malaria Day, • Providing technical assistance to the sub grantee CSOs to implement communication and

community empowerment activities, • Supporting sub grantees to review and update their advocacy strategies, • Engaging duty bearers at national and district levels on the advocacy issues of citizens’

concern, • Participating in district and national level planning processes/meetings, • Coalescing with like-minded CSOs to champion project related advocacy issues that will be

aimed at improving the quality, availability and accessibility of health and social services, • Conducting board orientation and training for selected sub grantee CSOs, • Offering strategic planning support for selected sub grantee CSOs, • Conducting Second round of Organizational & Advocacy Capacity Assessments, • Supporting sub grantee CSOs to finalize their Resource mobilization strategies • Mentoring and coaching all sub grantee CSOs through technical assistance visits and online

support to finalize policies and system development, • Visiting the sub grantee CSOs, and validating data reported in their quarterly reports, and • Providing technical assistance through integrated supervision and monitoring in an

integrated and or coordinated way • Ongoing collaboration with other Implementing Partners to keep pushing on critical

advocacy issues 6.0 LESSONS/CHALLENGES

The following are some of the major lessons drawn/ challenges faced during the quarter;

• The political electoral period affected implementation of project related activities, more so engagement with duty bearers who were engrossed in the political campaigns,

• A couple of sub grantee CSOs still exhibit gaps in documenting and reporting change stories resulting from their project interventions. The project will sustain the provision of regular support in this area.

• There was slow progress on the implementation and ownership of the OACA action plans by sub grantee CSOs. The project will continue providing technical assistance to the CSOs and

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engaging with their respective management teams, to ensure that these action plans are implemented.

• The reduction of the project’s year two budget from the initial submission of approximately US dollars 4.4 million to approximately US dollars 3.5 million affected the accomplishment of major project activities. The project endeavoured to address this challenge by re-prioritizing and rescheduling activities in the work-plan.

• CSOs have many competing priorities, especially in project implementation; but ABH will continue working with them to maintain focus

7.0 TECHNICAL ASSISTANCE NEEDED FROM USAID/UGANDA

The project will continue working with the Agreement Officer Representative (AoR) and other technical staff of the Mission, to receive guidance and support on project related activities. A consideration to increase budgetary allocations to the projected annual expenditure levels coupled with timely obligation of funds will undergird the momentum of the project.

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