• Improving Essential Newborn Care in Uganda

    Annie Clark

    Senior QI Advisor MNCH, USAID ASSIST Project/URC

    In Uganda, the MoH requested that the Health Care Improvement Project (HCI) improve essential newborn care (ENC), including newborn resuscitation utilizing the Helping Babies Breathe (HBB) methodology and tools, in Luwero and Masaka districts. I was privileged to provide technical assistance to the HCI Uganda team to respond to the MoH request. 

  • Bringing Women on Board in Safe Male Circumcision in Uganda

    Jude Thaddeus Ssensamba

    Quality Improvement Officer, Uganda, USAID ASSIST Project/URC

    As part of our discussion with facility health workers during a technical support visit to eastern Uganda Nankoma Health Centre IV, Bugiri District, I asked for some experiences on cases where women have not been involved in Safe Male Circumcision. One of the health workers in the group had this experience to share:

  • The Human Experience of Supporting a Humphrey Fellow

    Emily Lanford


    Beginning on May 1, 2013, the health workforce development (HWD) unit at University Research Company (URC), LLC began its six week sponsorship of Madhavi Dwivedi, a Humphrey Fellow from India whose host was Emory University.  The objective of her work was to identify ways to strengthen the existing engagement tool that is being applied to URC’s Community Support activity in Uganda.   As a part of her work at URC, she conducted a literature review on engagement and influencing factors such as supervision and feedback.  Additionally, Madhvi identified existing M-health initiatives that are cu

  • Keeping mothers and babies in care to eliminate transmission of HIV

    Nigel Livesley

    Regional Director for South Asia, USAID Applying Science to Strengthen and Improve Health Systems (ASSIST) Project, University Research Co., LLC (URC)

    My colleagues in Uganda are working with rural clinics to improve their capacity to prevent mother-to-child transmission of HIV.  Recently, we visited one rural clinic whose records showed that 177 exposed babies had been born in the clinic or had come there for care at some point in the past 18 months.  Yet only 9 had come back to the clinic in April 2013.

  • Improving uptake and retention of PMTCT services

    Rhea Bright

    Quality Improvement & Human Resources for Health Advisor, USAID Bureau for Global Health Office of Health Systems
    AIMGAPS nurse explains CHSS in Tanzania

    An AIMGAPS facility nurse explains the Community Health Systems Strengthening Model (CHSS) to her colleagues during a training session in Iringa, Tanzania, where these nurses are being prepared to serve as community QI coaches for their catchment areas.

    Photo by Rhea Bright, URC

    Under the USAID Health Care Improvement Project (HCI), my colleagues in Tanzania and I have been working with the Ministry of Health and Social Welfare (MOHSW) and EngenderHealth in the Iringa Region of Tanzania to improve uptake, retention, and the quality of prevention of mother-to-child transmission (PMTCT) of HIV services. Rather than focusing solely on improving care at one point of service along the PMTCT continuum, our improvement efforts looked at improving PMTCT services across the entire continuum of care, from the antenatal period, through the entire breastfeeding period, until the HIV status of the exposed infant is definitively determined at 11 facilities in Iringa.

    In order to address the gaps in PMTCT care that were identified at the 11 facilities, a data system was developed, quality improvement (QI) teams were formed, and facility QI teams began to track indicators for various PMTCT services that should be delivered during antenatal care (ANC), labor and delivery as well as in the post-natal/infant follow-up period.  Providers began testing changes at their respective facilities to address areas in need of improvement.  However, we noticed that some indicators improved (i.e. HIV positive pregnant women started on ARV or ART; and definite testing of the HIV exposed infant), while others lagged behind (i.e. early booking for antenatal care (ANC); male partner involvement; exclusive breastfeeding; and infant and child follow-up visits).  After providers tested several different changes at the facility level and saw little to no improvement in those indicators, it became apparent that improvement efforts would need to go beyond the facility.