Institutional Capacity Assessment of the aids control Program Uganda

List of Acronyms

ACP - AIDS Control Program

AIDS - Acquired Immune deficiency syndrome

CDC - Centers for Disease control and prevention

GOU - Government of Uganda

HIV - Human immunodeficiency virus

HSHASP - Health Sector HIV/AIDS Strategic Plan

IEC - Information, education and communication

IPs - Implementing partners

MARPS - Most at risk populations

MOH - Ministry of Health

NDC - Naional disease Control

PMTCT - Prevention of Mother to child transmission

STD - Sexually transmitted diseases

UAC - Uganda AIDS Commission

UNFPA - United Nations population fund

UNICEF - United Nations International Children's Emergency Fund

List of Tables & Figures

Table 1: Projects overseen or implemented in collaboration with ACP

Table 2 Focus, methods and respondents in the ACP assessment

Table 3 Individual Summary Ranking

Table 4: Staffing and Human resources Management

Table 5: Governance and Leadership

Table 6: Structure: Roles and Responsibilities

Table 7: Strategic and operational planning

Table 8: HIV/AIDS Mainstreaming

Table 9: Health Sector Response Coordination and Partnerships

Table 10: Financial Planning & budgeting

Table 11: Accounting, recordkeeping, Cash & Banking

Table 12: Accountability

Table 13: Resource Mobilization and Use

Table 14: Procurement, Distribution, Stock & Inventory Management

Table 15: Quality Control of critical drugs, equipment and supplies

Table 16: Monitoring & Evaluation

Table 17: Management Information system

Table 18: Adequacy of physical infrastructure

Figure 1: Domains Covered by the ACP institutional assessment

Figure 2: Summary of consensus score for 15 domains of assessment

Figure III: Percentage mean score for 3 mandate areas

Executive Summary

HIV/AIDS epidemic in Uganda has witnessed some changes over the recent years. Early successes in scaling up treatment programs to many infected people has now been replaced with a growing concern on how to ensure continued access to the life-saving drugs to the great majority of people already enlisted in treatment. Together with this, changes in the political and administrative structures in the country and the HIV/AIDS response landscape prompted the Ministry of health to call for the re-examination of the health sector response. As a result this, the Health Sector HIV/AIDS response assessment was conducted.

The STD & HIV/AIDS program (ACP) is the lead government agency with the mandate to lead and direct the health sector response to the HIV/AIDS epidemic in the country. Currently there are questions as to whether ACP has the requisite capacity to manage the health sector response. Therefore as part of the larger health sector HIV/AIDS response assessment exercise, an institutional assessment of the ACP was carried. The rationale for the institutional assessment was to provide specific information on the capacity of the ACP in relation to its mandate.
The objective of the study was to describe and make recommendations on the institutional capacity of the AIDS control program in relation to its mandate.
The main data for this study was collected through a qualitative self assessment of the capacity of ACP in 15 different organizational domains. This was supplemented with data collected through key informant interviews and short survey of the perspectives of staff members of the department of National Disease Control.
The results of the self-rated capacity of the STDs/HIV/AIDS Control Program in the 15 domains shows that ACP capacity in terms of HIV/AIDS mainstreaming scored the lowest (20%) while capacity in the areas of Governance & Leadership as well as Record keeping, cash & banking respectively scored the highest at 75%. Only 3 domains, Staffing and human resources, HIV/AIDS mainstreaming and financial planning & budgeting, scored below the 50% mark. Furthermore, 4 domains scored 50% each, and 8 domains scored above the 50% mark.
The results of the assessment indicate that ACP as currently organized is not well suited to adequately address all areas of its mandate. Major gaps exist in ACP’s capacity for technical management and sectoral response coordination. A restructuring of the ACP is recommended as part of other interventions to strengthen its institutional capacity. Secondly, it is recommended that ACP management should initiate a deliberate de-emphasis of direct service projects and a refocus on strengthening ACP capacity for core health sector response management and coordination. Technical assistance should be provided where necessary.


Major Recommendations

S/N	Recommendation	Responsible Party
1	Clarify ACP mandate and revise organogram to cover all mandate areas.	National Disease control department
2	Develop and implement an HR plan for ACP	ACP Management
3	Develop a policy to provide for appropriate authority for ACP management in line with its role in health sector response coordination.	National Disease control department
4	HSHASP should be costed and aligned to the HSSPIII and the NSP. Furthermore, technical assistance should be provided for integrated and multi-stakeholder planning.	ACP Management & development partners
5	Establish and implement an accountability framework for ACP and partners. For ACP this should include annual publication of audited financial report and programmatic achievements/progress against HSHASP	ACP Management
6	In collaboration with UAC and other relevant agencies, ACP should develop and implement a resource mobilization plan based on analysis of resource gaps within the health sector	ACP Management & UAC
7	Harmonize Donor and government procurement and supply systems to reduce wastage	ACP, UAC, NMS to provide leadership
8	ACP should work with relevant development partners to harmonize data systems for HIV and integrate this into the national health information system.	ACP and UAC to provide leadership

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