Us | Strategic
Approaches, Results & Achievements |
Key Project Areas
Key Project Areas
During 2001-2002, DISH focused on five priority components
of reproductive and child health: (1) safe
motherhood, (2) promoting
the use of LTPMs, (3) immunization,
(4) HIV/AIDS, and
(5) malaria. In addition,
the project developed institutional capacity in five
critical areas: (1) quality
of care (QOC) improvement; (2) district-level
drug management and logistics; (3) data
utilization for decision making; (4) establishing
a local behavior change communication (BCC) organization;
and (5) dissemination of
DISH best practices and products.
A. Priority Components of Reproductive and Child
- Safe Motherhood
High maternal mortality remains a great concern
in Uganda. Knowledge of pregnancy-related
complications remains extremely low among
men and WRAs, and most rural women continue
to deliver at home despite high attendance
for antenatal care at health facilities. The
project implemented an innovative strategy
that promoted birth preparedness, goal-oriented
antenatal care, malaria prevention and control
during pregnancy, and deliveries at health
facilities. Goal-oriented antenatal care ensures
that pregnant women receive a set of key services
during each of four specified visits.
- Promoting Use of Long-Term and Permanent
Family Planning Methods
According to the 2000/2001 DHS, approximately
36 percent of WRAs do not want more children,
yet only 2 percent had opted for tubal ligation
(TL). DISH developed a marketing and service
delivery strategy for making Norplant, TL,
and vasectomy more accessible. The project
strengthened selected sites providing routine
LTPM services. It also implemented scheduled
outreach services at 44 sites and supported
this service with community-based mobilization
and multimedia communication messages.
Immunization coverage has continued to decline
in Uganda, mainly because of insufficient
demand for immunization. Building on the wealth
of available research materials on immunization
in Uganda, the project developed and implemented
service delivery and BCC strategies for improving
immunization coverage in DISH-supported districts.
The project also took advantage of regular
supervision to facilitate performance improvement
among service providers.
Despite important gains in the fight against
AIDS, HIV prevalence remains very high in
Uganda and has a significant impact on infant
and adult mortality. During this fiscal year,
DISH implemented HIV/AIDS interventions targeting
pregnant women to prevent mother-to-child
transmission of HIV/AIDS (PMTCT) as part of
ongoing IRH activities. DISH also expanded
demonstration sites offering adolescent-friendly
reproductive health services (AFRHS) to all
12 DISH-supported districts, with particular
emphasis on prevention of STDs, HIV/AIDS,
and unwanted pregnancy. These AFRHS complemented
major efforts targeting outside clinics and
implemented by projects such as Africa
Youth Alliance (AYA) or Africa Alive.
Malaria remains the main cause of morbidity
and the number one cause of death among children.
Many districts continue to face malaria epidemics.
Following the training of a critical mass
of service providers in IMCI and IRH, the
project placed priority attention during supervision
visits on proper case management of malaria,
intermittent preventive treatment (IPT) of
malaria during pregnancy, and promotion of
insecticide-treated materials. It also focused
on facility management to improve organization
of services and the availability of first-
and second-line drugs, including malaria drugs.
Finally, the project integrated malaria control
messages into radio, print, and video materials.
B. Capacity-Building and Sustainability
- Quality of Care (QOC) Improvement: The Yellow Star Programme
QOC is one of the most important variables driving the use
of services. Building on the strategy and materials developed
for QOC improvement during the first 18 months of DISH II, the
project supported supervision and a major multimedia communication
- Enhance service provider confidence and performance.
- Institute a team approach to support quality improvement.
- Involve communities in quality improvement.
- Achieve and maintain 35 QOC standards through a system
of monitoring and rewards.
- Strengthening Drugs Logistics and Management
Effective drug management and logistics are essential to
improved service quality. Districts continue
to face regular stockouts of essential drugs.
In collaboration with the MOH, DANIDA, and
the Deliver project, DISH supported the implementation
of a joint workplan for improving district-level
drug management and oriented a range of district
staff in the use of the manual on drug logistics
and store-management procedures.
- Improving Data Utilization for Decision Making
Use of the HMIS for decision making remains limited at district
and national levels. Following HMIS capacity-building
activities at district headquarters, the project
supported data utilization activities, including
on-site technical assistance (TA) for data
analysis and decision making.
- Establishing a Local Private Sector BCC Organization: CDFU - Communication for Development Foundation Uganda
DISH established a private sector BCC organization capable
of managing development communication activities.
There is currently no local private sector
organization with the capability and skills
needed to manage strategic health communication
programs. To learn more about CDFU click
- Supporting Wider Coverage and Adoption of DISH Best
Practices and Products
The project documented, produced and distributed dissemination
materials regarding best practices including
strategies, tools, methodologies, training
curriculum and communication products developed
by the project since its inception in 1994.
For more information visit the Best practice
For more details on achievements to date, key targets
and key activities please view the DISH
II Final Workplan. Top