PMID- 18058688
OWN - NLM
STAT- MEDLINE
DCOM- 20080205
LR  - 20080314
IS  - 1469-5804 (Electronic)
IS  - 1357-6283 (Linking)
VI  - 20
IP  - 2
DP  - 2007 Aug
TI  - Promoting unity of purpose in district health service delivery in Uganda through 
      partnerships, trust building and evidence-based decision-making.
PG  - 58
AB  - CONTEXT: The Uganda Program for Human and Holistic Development (UPHOLD), a 
      USAID-funded project which supports health services in 34 Ugandan districts, was 
      conceived at a time when promising interventions could not be expanded due to 
      fragmented systems. This paper focuses on how the program addressed fragmentation 
      to improve service delivery in the health sector. APPROACH: UPHOLD achieved 
      results by utilizing grants and technical support to strengthen capacity in a 
      decentralized setting to foster institutional behavior change, promote 
      strengthened partnerships among stakeholders in health, and produce increased 
      transparency and accountability. In addition, the Lot Quality Assurance Sampling 
      (LQAS) survey methodology was institutionalized to promote a culture of 
      evidence-based decision-making at the district level. RESULTS: Evidence-based 
      decision-making and partnership-oriented implementation led to programmatic 
      results and institutional behavior change in districts through synergetic 
      relationships between local governments and Civil Society Organizations. The use 
      of Insecticide Treated Nets increased from 11.2% in 2004 to 17.2% in 2005, 
      clients utilizing HIV/AIDS counselling and testing services increased from 6,205 
      in 2004 to 85 947 in 2005 and using Lot Quality Assurance Sampling methodology 
      has begun to positively influence district and national staff mind sets leading 
      to more evidence-based planning and decision-making. CONCLUSION: The pillars of 
      'evidence-based decision-making' and 'partnerships', together with approaches 
      which strengthen existing synergies, produced more results, faster. Programs 
      designed to work with fragmented settings should consider using the same pillars 
      and blocks to ultimately make a difference in the lives of program beneficiaries.
FAU - Orobaton, Nosa
AU  - Orobaton N
AD  - The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland. 
      nosaorobaton@yahoo.com
FAU - Nsabagasani, Xavier
AU  - Nsabagasani X
FAU - Ekochu, Elizabeth
AU  - Ekochu E
FAU - Oki, Judith
AU  - Oki J
FAU - Kironde, Samson
AU  - Kironde S
FAU - Lippeveld, Theo
AU  - Lippeveld T
LA  - eng
PT  - Journal Article
DEP - 20070820
PL  - India
TA  - Educ Health (Abingdon)
JT  - Education for health (Abingdon, England)
JID - 9607101
SB  - IM
MH  - Community Health Services/*organization & administration
MH  - Community-Institutional Relations
MH  - Delivery of Health Care/*organization & administration
MH  - Evidence-Based Medicine/*organization & administration
MH  - HIV Infections/prevention & control
MH  - Health Services Accessibility/organization & administration
MH  - Humans
MH  - *Interprofessional Relations
MH  - Malaria/prevention & control
MH  - Models, Organizational
MH  - Mosquito Control/organization & administration
MH  - Organizational Case Studies
MH  - *Organizational Culture
MH  - Organizational Innovation
MH  - Quality Assurance, Health Care
MH  - Sampling Studies
MH  - *Trust
MH  - Uganda
EDAT- 2007/12/07 09:00
MHDA- 2008/02/06 09:00
CRDT- 2007/12/07 09:00
PHST- 2007/12/07 09:00 [pubmed]
PHST- 2008/02/06 09:00 [medline]
PHST- 2007/12/07 09:00 [entrez]
AID - 58 [pii]
PST - ppublish
SO  - Educ Health (Abingdon). 2007 Aug;20(2):58. Epub 2007 Aug 20.