Table 3 Summary of projects implemented by medium-term fellows, 2008 – 2011

Monitoring and Evaluation Track

Establishing/strengthening the M&E system

15

· Strengthening M&E systems (13)

Project title: Consolidating the M&E System at a local non-government organization

· Establishing M&E system (1)

Aim: To contribute to the continuous improvement of the M&E function through consolidating the M&E system

· Developing M&E plan (1)

Project time-frame: October 2008 – March 2009

Key Outputs:

· Defined the purpose and scope of the M&E system

· Developed the M&E Matrix

· Reviewed the logical framework

· Reviewed report formats

· Documented the critical reflection schedule

· Designed a schematic presentation of the M&E system

· Defined indicators & documented indicator reference sheets

Improving data management and reporting

13

· Improving data management and quality of data collected (7)

Project title: Improving quality of HIV/AIDS and related data at a District Local Government

· Improving the reporting system (4)

Aim:

· Strengthening health data & information management systems (2)

· Improve completeness of in-patient reporting from the district to the Ministry of Health from 53% to 85% & out-patient reporting from 84% to 100%

· Improve timeliness of reporting from the district to Ministry of Health from 75% to 100%

Project time-frame: September 2010- Feb 2011

Key Outputs:

· In-patient reporting completeness improved from 53% to 82.8%

· Outpatient reporting completeness improved from 84% to 96.5%

· Timeliness of reporting improved from 75% to 80%

· Improved district ranking in national district league table from 61^st to 45^th during the project period.

Other M&E-related areas

04

· Enhancing the performance tracking system of reproductive and HIV/AIDS care programs (3)

Project title: Enhancement of the performance tracking system of the Reproductive Health Component of a donor-funded program at a government department

· Strengthening the community component of an organization’s M&E system (1)

Aim: To improve the performance tracking system for effective tracking of programme performance

Project time-frame: September 2009 – February 2010

Key Outputs:

· Developed an M&E coordination mechanism

· Developed the M&E system

· Harmonized and agreed on key performance indicators

· Developed M&E Matrix

· Developed the Results Chain

Continuous quality improvement

Reducing proportion of clients who miss scheduled clinic visits or services

10

· Reducing waiting/turn-around time for clients to receive HIV prevention, care and treatment services (5)

Project title: Reducing patient waiting time for clients attending the ART clinic at a regional referral hospital

· Reducing the proportion of clients who miss their scheduled clinic visits (2)

Aim: To reduce the patient waiting time to receive ART services at the clinic from six hours to four hours so as to improve quality of health care services at the clinic.

· Improving availability of staff on duty to provide ART services (1)

Project time-frame: September 2008 – February 2009

· Decreasing the proportion of patients lost to follow-up (1)

Key Outputs

· Improving tracking of clients’ medical charts (1)

· The average waiting time at the ART clinic reduced from 348 minutes to 220 minutes, a 36.8% reduction in overall clinic waiting time.

· Specifically, there was also a 42.4% reduction in waiting time at the Clinician & Laboratory stations (waiting time reduced from 257 minutes at baseline to 148 minutes at the end of the project)

Improving data collection, management and reporting

06

· Improving HIV care/ART/OVC data collection & reporting (2)

Project title: Enhancing Data Management by improving the client identification system at a local NGO

· Improving the data management system (2)

Aim: Improve data management through improving the client identification system

· Improving the quality of program reports (2)

Project time-frame: October 2010 – March 2011

Key Outputs:

· The proportion of client charts with one consistent identification number increased from 11% to 100% during the project period

· The proportion of clinic charts with two numbers decreased from 61% to 0%

Improving TB diagnosis and treatment

04

· Improving Tuberculosis (TB) treatment success rate (1)

Project title: Reducing the proportion of TB suspects bringing less than 2 sputum samples at a local NGO

· Improving TB diagnosis among persons living with HIV (1)

Aim: To increase the proportion of TB suspects bringing 2 sputum samples from 40% in November 2009 to 90% by April 2010

· Reducing the number of TB suspects bringing less than 2 sputum samples (1)

Project time-frame: November 2009 – April 2010

· Reducing patient waiting time to initiate TB treatment at a Regional Referral Hospital (1)

Key outputs:

· Proportion of TB suspects bringing 2 sputum samples increased from 40% to 83% in April 2010, and reached 97% by July 2010

· Reduction in waiting time from 6 to 2 hours

· TB infection control measures were strengthened

· TB suspects’ and patients’ follow-up improved during the project period

Improving capacity for program staff and community volunteers to deliver HIV services

03

· Improving the capacity of community care givers to provide quality Positive Health, Dignity and Prevention services among HIV-positives (1)

Project title: Enhancing the capacity of a local non-government organization’s staff to develop and deliver effective health messages for adolescents

· Enhancing capacity of a local non-government organization’s staff to develop and deliver effective health messages to adolescents (1)

Aim: Increase the proportion of staff with knowledge and skills in message development from 45% to 80%.

· Increasing the number of planned faithful house trainings for married persons implemented at a donor-funded Project (1)

Project time-frame: October 2011 – March 2012

Key outputs:

· The proportion of staff with skills in effective message development and delivery increased from 45% at baseline to 75% at the end of the project

· Staff employed a multi-channel approach in the delivery of messages

Streamlining appointment system

02

· Streamlining patients appointment system at a local HIV/AIDS Initiative (1)

Project title: Improving the proportion of clients honoring their appointments at an HIV care and treatment facility

· Improving the proportion of clients honoring their appointments (1)

Aim: To improve the proportion of clients honoring their appointments from 48.2% to at least 80% in six months

Project time-frame: March – September 2011

Key outputs:

· Proportion of clients keeping appointments from 48.2% to 81%

· Developed standard operating procedures for clinicians emphasizing the importance of appointments’ keeping

· Redesigned the clients’ prescription form to include ‘next appointment date’ and reason for the visit

· Designed weekly appointment schedules and circulated them to all clinicians

· Developed information, education & communication (IEC) messages and materials emphasizing the importance of keeping appointments

· Designed a patient flow chart to guide patient flow

· Conducted daily health education sessions where the issue of appointments’ keeping was emphasized

Improving proportion of individuals utilizing HIV prevention services

02

· Increasing male circumcision uptake among referred study participants (1)

Project title: Increasing the proportion of medical male circumcision uptake among study participants at a research site

· Increasing the proportion of counseled clients tested for HIV at an outreach site (1)

Aim: Increase uptake of medical male circumcision among study participants from 20 to 34%

Project time-frame: March – September 2011

Key outputs:

· Uptake of medical male circumcision increased from 20.5% at baseline to 32.4% at the end of the project

· Two male circumcision notification strategies were used: phone contact and physical re-notification. Phone contact notification was found to be cheaper than physical re-notification

Improving psycho-social support for people living with HIV

02

· Strengthening psychosocial support through increasing enrollment and participation of children in Kids’ Clubs in Kigarama sub-County, Sheema District (1)

Project title: Increasing participation of psychosocial groups in PMTCT activities through couple-to-couple strategy at a local NGO

· Increasing enrolment and participation of psychosocial groups in Prevention of Mother-to-Child HIV Transmission activities in Kabwhole-Itendero Town Council, Sheema District (1)

Aim: Increase the general enrolment into psychosocial groups from 47% to 70% by the end of the project

Project time-frame: February – August 2012

Key outputs:

· General enrolment into psychosocial groups increased from 47% to 87% by August 2012

· Proportion of male partners participating in PMTCT activities increased from 21% to 30%

· Trained 16 model mentor couples to provide outreach PMTCT services in the community

· Built capacity of psychosocial groups to support community members in coping with the effects of HIV/AIDS

· Strengthened referral systems between the community and health facilities.

Improving access to Prevention of Mother-to-Child Transmission (PMTCT) of HIV services

02

· Improving access to comprehensive PMTCT services at a Regional Referral Hospital (1)

Project title: Improving linkage to PMTCT at a private-not-for-profit hospital

· Improving linkage to PMTCT care at a private-not-for-profit hospital (1)

Aim: To improve linkage to PMTCT for HIV-positive pregnant mothers attending antenatal care services from 40% to 70%

Project time-frame: August 2011 – January 2012

Key outputs:

· Proportion of HIV-positive pregnant mothers linked to PMTCT increased from 40 to 78.2%; 95% of these mothers got ARVs

· Time for provision of PMTCT services at the antenatal care clinic declined from 7 to 4.5 hours

Other CQI-related areas

04

· Increasing the proportion of eligible clients initiated on antiretroviral therapy (ART) at a government health center in Jinja district (1)

Project title: Increasing the proportion of eligible clients initiated on ART at a government health center in Jinja district

· Improving the procurement process for ART supplies at a local HIV/AIDS Initiative (1)

Aim: To increase the proportion of eligible clients initiated on ART from 26.7% in August 2008 to 75% by January 2009

· Improving ART adherence assessment at an HIV clinic at Mulago Hospital, Kampala, Uganda (1)

Project time-frame: August 2008 – January 2009

· Improving efficiency and quality of home visit services at a faith-based hospital in Kampala, Uganda (1)

Key outputs:

· By April 2009, all eligible and pending clients attending the clinic were initiated on ART

· ART logistics orders were made timely and no stock outs were reported during the project period

· Two clinic days were established with each clinic designated to see 25-30 patients per day compared to 60 patients before the project: this increase the client-provider interaction time

· Increased monthly attendance at the clinic from 162 in October 2008 to 253 by April 2009.