Uganda’s Health Care Quality Improvement Journey

Uganda, a country in East Africa of around 44 million people, represents a unique example of a low-income setting with a long history of national efforts to improve quality of care. Indeed, the current quality movement in Uganda started in earnest in 1994 with the establishment by the Ministry of Health (MoH) of the national Quality Assurance Program (QAP), catalyzing over two decades of work to improve care and institutionalize a culture of quality. These efforts have involved many implementing partners and have incorporated action at all levels of the health system, from building leadership capacity within national and subnational administrations to implementation of numerous quality improvement (QI) projects at health facility and community levels. Furthermore, this focus on quality has been sustained despite the sometimes fragile political and social environment, communicable and non-communicable diseases, long periods of uncertainty, and inconsistent funding. Through this vast body of work, there are numerous examples of successful implementation and scale-up of QI activities, as well as challenges.

Many lessons can be drawn from this rich Ugandan experience. While significant effort has been made to share learning within Uganda on specific projects and approaches, there is no comprehensive record of the broader journey of quality in the Ugandan health system across the past two decades.

This report is a resource for other ministries of health, government and public health officials, local and international non-governmental organizations, community-based organizations, practitioners, policymakers, and health care workers who are interested in understanding how to apply lessons learned from Uganda’s experience of integrating QI within their health system.

Ultimately, it is Uganda’s ownership and sustained commitment to fostering continuous service improvement at all levels of its health care system that fuels its QI journey. This commitment has served and continues to be a powerful tool to enable the institutionalization of a culture of quality and mobilize the MoH and supporting partners with a common vision and language to provide quality health care for Ugandans

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