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Meeting with the Ministry and UNICEF Country Office

March 23, 2010

Uganda, Kampala, Monday, 03/22/2010

UNICEF Country Office & Ministry of Health Visit

After a weekend spent typing up notes and exploring downtown Kampala, our team set off early Monday morning for the UNICEF Country Office. Today was the big day to be introduced to the UNICEF staff at their Monday Morning Meeting and meet with officials from the Ugandan Ministry of Health. At the meeting we saw a prototype of the “digital drum”, a low-cost UNICEF version of the South African made “digital doorway”, a project to bring indestructible internet stations to rural communities. Impressive! Made out of empty oil drums, it can be produced at a fraction of the cost.

At UNICEF, we had one meeting focused on nutrition and health. We learned more about the proposed new package for the Village Health Teams (VHTs) and the timeline of the current health facilities reporting system.  One hope is that a SMS-based system could reduce the time it takes for data to reach the Ministry. Another way SMS could be used is to supervise and motivate the Village Health Team members. Also, by tracking referrals it would hopefully become easier to see whether the children referred by the Village Health Team member actually reach the nearest health facility to receive treatment. A patient identification system would tremendously help with the tracking efforts, as would higher rates of birth and death registrations.

Our first meeting with the Ministry of Health was focused on information management. What was particularly interesting at this meeting was to hear the high prevalence of improvised mobile phone use for reporting currently. According to the information we heard at the meeting, many health facilities already use SMS to text in their weekly reports to the next higher level. However, this is done manually and there exists no system so far to enter this data directly into a database as it is sent. Rather, each level forwards the reports manually. Nevertheless, this should make the acceptance of a SMS-based system easier. We also learnt that under the current system, the reports from the community based Village Health Teams (VHTs) stay at the district level and do not move up to the Ministry level.

The second meeting we had with Ministry officials was more focused on nutrition. The lack of consistent reporting was identified as a major challenge which the proposed system could hopefully help remedy. We also came across an important new consideration. Currently, the UN-proposed Global Impact Vulnerability Alert System (GIVAS) aims to monitor the same vulnerability indicators worldwide. In many of the Ugandan projects we have been researching, the efforts seem to be aimed at harmonizing the indicators nation-wide. However, at today’s meeting it was pointed out to us that the most effective indicators are likely differ from region to region, possibly even within a district, depending on the source of food, etc. For example, the level of rainfall might be more important in terms of food security in one region than in another, depending on whether the local population relies on purchased food, subsistence farming or possibly depends on food aid, as is the case in some parts of Eastern Uganda. It was also suggested that it would be important to work together with other ministries, such as the Ministry of Agriculture or Education, in order to combine efforts.

It will be interesting to bring what we have learned in Uganda back to New York to discuss with the Iraq group and the UNICEF HQ Team. As always, we have learnt a lot today but are left with many new questions and thoughts. Thankfully, we still have another day in Uganda.

Greetings from Kampala,

Karoline (Uganda Team)

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