Tibamwenda Emmanuel
Makerere University School of Public Health, Uganda
Title: Evaluation of the implementation process of integrated service model in Uganda. The AIDS information center experience
Biography
Biography: Tibamwenda Emmanuel
Abstract
In 2010, the Uganda AIDs Information Center (AIC) designed an integration service model of the sexual reproductive health, HIV and maternal health, and piloted this in Katakwi and Mubende districts. However, there isn’t any information about the implementation process to guide model scale-up. This study evaluated the implementation process of the integrated model in the two districts to come up with suggestions for improved delivery of integrated services. A descriptive qualitative study was conducted during May to July 2014. Key informant interview were conducted with 21 health district managers and health workers, and 10 Focus Group Discussions (FGDs) with service users each comprising 6-10 members. A records review of monthly reports and health registers at districts for period 2010-2013 and in the health facilities for 12 months was done. Data were manually analyzed following a thematic framework approach. Several challenges were faced in the attempt to provide integrated services. Such included staff related challenges: staff shortage and absenteeism, knowledge gaps among health workers and high expectations of mothers. Other challenges were system related: limited space, stock outs of supplies and informal service charges; and service user’s challenges: failure to uphold confidentiality by health workers and unfriendly services for young mothers. The pilot implementation process of the integrated service model experienced several setbacks. Program managers at AIC need to pay much attention to these challenges prior to further scale-up to any other districts of Uganda.