KCCA/CDC Urban Health Project and Models of Care over view

Background

Previously, KCCA has been a sub-recipient to a Kampala region comprehensive mechanism where the institution has been receiving an PEPFAR funds (Annual average of UGX 500 Million since the year 2016) to mainly support coordination activities as the legal entity responsible for public health programs in Kampala Capital City. However, in this new funding support arrangement, The CDC/President's Emergency Plan for AIDS Relief (PEPFAR) program is piloting the first Government to Government (G2G) model/ approach in Uganda by supporting Kampala city in the CDC’s first direct award to KCCA with a goal of attaining the UNAIDS 95-95-95 targets. CDC will directly fund KCCA through a G2G agreement within its legal mandate to build capacity for coordination, partnerships, governance, human resource capacity for HIV and TB service delivery, integration of HIV and TB services with other disease programs, and integration of health information systems integration for surveillance, M&E, and laboratory systems strengthening. This G2G approach will further enable integration with other public health programs in public, private for profit, and private not for profit health facilities while strengthening KCCA governance and partnerships structures for sustainability.

Objectives of the project

This project intends to strengthen Urban Health Services and Models of Care in Kampala Capital City Authority (KCCA) by achieving 4 general objectives. These include; (1) Strengthening partnerships and governance in Kampala and the Metropolitan area in order to efficiently utilize available resources; (2) Improving the HIV and TB service delivery in Kampala city in order to have better health outcomes; (3) Strengthening the integration of HIV and TB with other diseases in order to improve health services delivery;(4) Improving the Health information systems integration for surveillance, M&E, and Lab systems strengthening in order to realize better decision making and accountability.

Target population

Given the uniqueness of the grant, the target population will include the following categories: (1) City Residents especially those from the informal settlements/ slums; (2) Persons accessing the city for service during the day time; (3) Adolescents and Youth (persons aged between 10-24 years as defined by the WHO) that constitutes 38.4% of the Kampala population as stated in the KCCA statistical abstract 2019 that are deemed as vulnerable when exploring livelihoods from the city. All these categories will benefit from the project approach either directly or indirectly by increasing their access to high quality and efficient health services.

Implementation Approach

The project implementation will be hinged on the following 5 key pillars: (1) Leveraging from and strengthening the existent cluster model of surveillance; (2) Continued engagement and organization of the private sector that is the largest sector in the city in terms of infrastructure; (3) The One Health Model approach that focuses on integration and harnessing the benefits from the medical health aspects and the preventive health aspect; (4) Strengthening and aligning the partner efforts to the wider KCCA strategic agenda; and (5) Strengthening the capacity of the division health teams to plan for resources, track resources and respond to the emerging urban health issues. All the above pillars will focus on the urban pro-poor specific interventions and address challenges faced by the urban poor staying in the city.

Cluster model as the project blue print

As highlighted in the DPHE strategic plan (2019/20 to 2024/25), the Cluster model is part of the broader Public health strategy that KCCA intends to deploy in the city in order to realize efficient health services delivery. The cluster model will be the blue print for this project by enabling the process of demarcation of the Divisions into smaller manageable portions referred to as clusters. Through the cluster methodology and approach, all known and emerging concerns in the area of HIV programming; TB programing; Health Management Information Systems(HMIS); the wider private sector engagement; comprehensive partner mapping; and others will be handled and managed locally through the clusters. Therefore, project will financially and technically support the operationalization of the cluster model within the city.

Projected Long term outcomes of the project

The envisioned long term Outcomes will include: Increased efficiency in lobbying for resources and tracking the resources at the city and division level; Improved Urban Health regulatory frameworks; Improved HIV, TB and health services delivery in the city; Robust and Responsive surveillance system at the division and city level; Improved capacity and preparedness for case detection, prevention, control and management of HIV, TB and other infectious diseases.

Collaborations

KCCA will collaborate with the following key stakeholders: Infectious Diseases Institute(IDI) as the comprehensive HIV partner for Kampala city; USAID Defeat TB project as the comprehensive TB partner for Kampala city; UNAIDs; UNICEF; WHO as the technical partner in the city supporting Integrated Diseases surveillance and response; Wakiso District Local Government; Mukono District Local Government; Citywide Inclusive Sanitation Program (CWIS) currently supporting innovative sanitation interventions in the city; The City Public Health Emergency Operations centre facilitated by AFENET and IDI; Makerere University School of Health Sciences; Ministry of Health; Public Health Fellowship Program (PHFP)/ Field Epidemiology Training Program (FETP); Uganda AIDS Commission; MOH- AIDS Control Program(ACP); MOH- National TB and Leprosy Program (NTLP); Medical Bureaus ( i.e. UCMB; UPMB; UMMP); Registration councils (UMDP; AHP); and Uganda National Health Laboratory and Diagnostic Services (UNHLDS). All these stakeholders will sign collaborative agreements with KCCA.