Global Projects, Uganda project directors lead in-country teams of University of California, San Francisco (UCSF) researchers who work closely with in-country partners, either as project staff or in supporting administration of research and training projects.
Health Informatics and Technology
Under the Monitoring and Evaluation Technical Support (METS) project, Global Programs supports MakSPH in upgrading OpenMRS, the electronic medical record system adopted by Uganda. The upgraded OpenMRS will include all standardized information on HIV care and treatment, derived from paper-based HMIS (health management information system) forms, and will allow direct export of aggregated data into the national DHIS-2 electronic reporting system. OpenMRS will also support HIV case-based surveillance.
Global Programs provides support to the MakSPH as it upgrades the SMS (text messaging) system for capturing data on initiation of HIV-infected pregnant women on antiretroviral therapy (Option B+). This system is to be expanded to collect data on TB/HIV care, HIV treatment of children, and initiation and retention of adults on ART.
Program Monitoring & Quality Improvement
In collaboration with MakSPH, CDC-Uganda, HEALTHQUAL and the Uganda Ministry of Health, Global Programs organized and sponsored a Quality Improvement Learning Exchange that brought together participants from Uganda, Mozambique, Tanzania, Kenya and Rwanda for a dynamic, participant-driven opportunity to explore best practices, shared challenges and innovative strategies for the use of data for quality improvement in national HIV programs, especially large data sets being generated from PEPFAR and epidemiologic surveys.
Global Programs supports MakSPH in applying a Continuous Quality Improvement approach (CQI) to improve the quality of Voluntary Medical Male Circumcision (VMMC) services in Uganda. This process enabled 68 sites performing VMMC to evaluate services against quality standards, develop concrete implementation plans to rectify gaps and improve practices and procedures to meet quality standards.
Research and Evaluation
Global Programs assisted MakSPH to conduct an evaluation of the initial roll-out of Option B+ for prevention of maternal and child HIV transmission in the central region of Uganda in 2015. This evaluation identified factors contributing to poor follow-up, including stigma and discrimination; fear of reprisal from spouse and partners; and poor treatment by healthcare workers.
In collaboration with MakSPH and the Makerere University School of Medicine, Global Programs also completed an assessment of the prevalence and predictors of HIV-associated neurocognitive disorders (HAND) among HIV-infected individuals in Uganda
Global Programs will also conduct an evaluation of DREAMS, a global partnership between PEPFAR, Girl Effect and the Bill & Melinda Gates Foundation to reduce new HIV infections in vulnerable adolescent girls and young women. This evaluation will use the Stepping Stone implementation guidelines, including quantitative surveys and qualitative interviews to assess intervention effect and reach and program acceptability within target communities.
Global Programs supports MakSPH and the UCSF Preterm Birth Initiative-East Africa with implementation research in six health facilities in the Busoga region. The project evaluates the effectiveness of an interventions package that includes a customized version of the World Health Organization’s (WHO) Safe Childbirth Checklist; simulation and team training for providers through PRONTO International (preparing clinicians to better identify and manage preterm births); and training for health facility staff in quality improvement cycles.
Surveillance
Global Programs, through the Monitoring and Evaluation Technical Support (METS) project, provides technical assistance to the initial roll-out of HIV case-based surveillance, specifically through upgrading the national electronic medical record system (Open MRS) to provide aggregate data for use in facility, district and national monitoring; the linking of files using unique identifiers; and the development of databases for analysis of de-identified data to evaluate the care cascade.