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 Health

1. 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.

2. 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.

3. Immunization

   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.

4. HIV/AIDS

   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.
   

   

5. Malaria

   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. Top

B. Capacity-Building and Sustainability

1. 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 campaign to:

   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.

2. 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.

3. 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.

4. 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 here

5. 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 pages.

For more details on achievements to date, key targets and key activities please view the DISH II Final Workplan. Top