Uganda’s extensive work in monitoring progress in reproductive, maternal, newborn, child and adolescent health (RMNCAH) and other health services includes regular comprehensive annual health monitoring reports by the ministry of health, the district league table system to track local performance in place since 2003, and high-quality research by Makerere University.
The Uganda Countdown country collaboration is led by Dr. Peter Waiswa, associate professor of health policy planning and management at the Makerere University School of Public Health, who was profiled in The Lancet in September 2022.
“Despite major efforts in monitoring, much remains to be done to strengthen data and analysis to inform national and district programs, especially through close collaboration between the university and ministry of health,” said Prof. Waiswa. The Countdown collaboration – a partnership that includes analysts from the ministry of health and researchers from Makerere University, Canada’s Hospital for Sick Children, the University of Manitoba, and the London School of Hygiene and Tropical Medicine – advances analysis in support of health.
The midterm review of Uganda’s health sector development plan 2015/16-2019/20 took place in late 2018. The Countdown collaboration produced a comprehensive analysis of progress and performance based on all relevant data. This included thorough analyses of health facility data, which the team also published in a scientific journal. The statistical report was a critical input into the midterm review and was presented at multiple review meetings. “When I met the minister of health, she told me that she was very pleased with the work done by Makerere University and the Countdown for the ministry of health and stressed the value of the synthesis of all data,” Prof. Waiswa said.
Rather than relying on fly-in fly-out consultants to conduct an endline review of Uganda’s first reproductive, maternal, newborn and child health investment case, the ministry of health and World Bank’s Global Financing Facility (GFF) turned to the Countdown collaboration in 2020. The team focused on district data to measure the effects of the prioritization and phased implementation of the investment case. In general, the effects were still disappointingly small as explained in the review report, primarily because program implementation had taken off slower than anticipated. As part of the endline review, Prof. Waiswa and his team mobilized social scientists at Makerere University to gain insights from selected districts and provide context for the slow progress. The findings played an important role in the development of the next phase of the investment case and led to Uganda’s Reproductive, Maternal, Newborn, Child, Adolescent and Healthy Aging Sharpened Plan II 2022/23-2027/28.
The Uganda team also participated in multicounty efforts around assessing the impact of COVID-19 on health services, examining maternal child health among the urban poor, and strengthening analysis of health facility data.
According to Prof. Waiswa, “In the next phase of the Countdown collaboration (2023-2025), we will continue to focus on responding to needs for analytical work expressed by the ministry of health, which is critical for uptake and use of the results of our work.” Based on discussions with the ministry’s health sector technical review group, several priority areas have been identified, such as assessment of the progress and performance of districts and regions with a focus on primary health care and RMNCAH. This should contribute to the improvements of Uganda’s district league table system. Other areas of interest include the performance of referral hospitals with a focus on quality of the maternal and newborn health services and multi-sectoral monitoring, in line with recent plans of the government to advance the universal health coverage agenda of the country and the new program-based budgeting/multisectoral approach.
- Midterm review
- Policy brief (2019)
- Fact sheets
- Report of 2019 Meeting
- Endline Review (2022)
- Health facility data analysis (2022)