About Baylor Uganda

Baylor College of Medicine Children's Foundation

Above & Beyond

Who We Are

Baylor College of Medicine Children’s Foundation-Uganda (BU) is a leading provider of Integrated, High-Quality, High Impact comprehensive HIV, TB, RMNCAH and global health security (GHS) services in Uganda.

Baylor Uganda is an indigenous, not-for-profit organization established in 2006,

Baylor Uganda has a long track record delivering strong return on investments with >USD 130 million donor funds efficiently managed.

We are affiliated with Baylor International Paediatric AIDS Initiative (BIPAI), a network of Paediatric HIV care and treatment at Children’s Clinical Centers of Excellence (COE).

Our technical program areas that include: Comprehensive HIV prevention and treatment; Global Health Security and Emergency Management; Reproductive Maternal Child and Adolescent Health; Health Systems Strengthening, Capacity building for health professionals and Research.A1

. Geographical Coverage and Programs

Geographical Coverage and Programs

Figure 1: BU’s Geographical Coverage and Services

A1. Expertise to manage unique needs of subpopulations: We serve the general population (including partners in serodiscordant relationships and PBFW) with a focus on KP, PP, men, AGYW and children, to address gaps in case finding, retention and viral suppression. Baylor Uganda cares for 75% of all Uganda’s children and adolescents living with HIV: 14% at its Center of Excellence (COE) and 61% through its regional mechanisms.[1] Baylor Uganda implements the Men-stars (Male Champions) approach which uses influential men to identify and educate high-risk men in their communities and workplaces and link them to HIV services. Baylor Uganda also implemented the Key Population Investment Fund (KPIF) in partnership with KP-led/leaning civil society organizations (CSOs) that focus services to KP (FSW, MSM, TGW); and PP (fishing communities, highly mobile populations, etc.).

A2. Current and Past Experience: Since 2010, BU has successfully implemented the following programs (Table 1):

Baylor Uganda’s current and past experience in implementing comprehensive HIV/TB and Global Health Security projects

Grant	Donor/ Timeline/ Budget	Project Description
1. Local Partner Health Services Eastern Activity (LPHS-EA)	Donor: USAID Project Period: Oct 2021-Oct 2026	Region: Eastern; 15 districts and 1 city Coverage: 161 Health facilities (HFs) Population: General, focus on children, AGYW, men, and KP/PP. Approach: Supports districts/HFs/CBOs via DLP/HSS to increase access to quality comprehensive HIV services for epi control.
2. Accelerating Epidemic Control in Fort Portal Region in the Republic of Uganda under PEPFAR (ACE–Fort project) COAG # 1NU2GGH002111	Donor: CDC Project Period: Apr 2019-Sep 2023	Region: Fortportal; 9 districts and 1 city Coverage: 151 HFs Population: General, with focus on children, AGYW, men, and KP/PP. Approach: Supports districts/HFs/CBOs through DLP and HSS approaches to increase access to quality comprehensive HIV services for epidemic control.
3. Accelerating and Sustaining HIV Epidemic Control in Hoima Region in the Republic of Uganda	Donor: CDC Project Period: Sep 2020 – Oct 2025	Region: Hoima in 8 districts and 1 city Coverage: 106 Health facilities Population: General population with focus on children, AGYW, men and women, and KP/PP Approach: Supports districts/HFs/CBOs via DLP/HSS to increase access to quality comprehensive HIV services for epidemic control.
4. Global Fund /TASO HIV Project	Donor: Global Fund/TASO Project period: Jan 2021-Dec 2023	Regions: Mid-West, Western, Central Coverage: 27 districts Population: AGYW, HIV+ pregnant and lactating women, fisher folk Approach: Community prevention intervention focusing on high burden and underserved locations and populations.
5. Improving Health Security/ Building Intn’l Health Regulations core capacities in the Republic of Uganda Global Health Security	Donor: CDC Project Period: Sep 2020-Oct 2025	Region: Western (Hoima) in 8 districts and Rwenzori in 9 districts Coverage: 17 districts Population: General population with a focus on public health emergencies
6. Strengthening technical and management capacity of DLGs RMNCAH, WASH and education services in 10 districts in Western and East Central zones of Uganda	Donor: UNICEF Project Period:	Regions: Kampala at the BU COE; Rwenzori in 7 districts Coverage: 10 districts Population: General population (children and adolescents, women, refugees, caregivers). Approach: TA to MoH, districts using HSS to increase access/use of quality RMNCAH, WASH, education services.

Global Health Security (GHS)

Baylor Uganda works with Ministry of Health Uganda, CDC, WHO and other IPs to strengthen prevention, detection and response to public health emergencies at national, regional, district and community levels. Our key expertise in GHS includes:

B.1. Core GHS capacity: Strengthening surveillance and laboratory systems including sentinel and community-based surveillance systems, antimicrobial resistance prevention, Border Health Security, mass vaccination support including microplanning and implementation, community mobilization and conducting population movement assessment across borders to inform surveillance systems.

B.2. Emergency response: Our team have capacity and have collaborated with MOH to conduct rapid risk assessments and situation analysis, support and deploy surge team, participate in IMT including in the different pillars, establish regional emergency operation centers and functionalize regional coordination mechanisms, support train and operationalize district rapid response teams, and train and coordinate emergency medical services. We also have capacity to support risk communication and community engagement during outbreaks and community-based disease surveillance and response. We also have capacity to support After Action Reviews and we are currently co-developing SIMEX with MOH, WHO and CDC.

Key successes:

Supported MOH to develop a strategic plan for the department of Integrated Epidemiology, Surveillance and PHEs; Adapt 3rd IDSR guidelines and establish national integrated sentinel surveillance.
Established Fort Portal REOC which effectively coordinated COVID-19 response.
17/17 District health task forces and subcommittees functionalized for COVID-19 response.
17/17 districts led capacity building and implementation of eIDSR, IPC, COVID-19 RDT use and homebased care.
Rolled out 3rd edition IDSR in 17/17 districts. 6) COVID-19 vaccine uptake 1st dose-84% and 2nd dose 56%.
COVID-19 contact tracing using GoData in 63 districts (14 in Soroti) through WHO funding. 8) Provided flexible funds for PHE response at national and district level.
Strengthened border health security including assessing population connectivity assessments in 2 regions.
Established and built infection prevention and control committees in >300 health facilities in all the 17 supported districts.

Continuity of essential health services: We have capacity to support delivery of emergency medical outreach services to ensure continuity of care especially for the most vulnerable (children and mothers), and strength integrated community case management including strengthening surveillance for malnutrition among children. Below is an example of how we supported access to medical services in flood and landslide districts in Uganda, with WHO support:

Emergency Medical Outreaches (EMOs) and integrated Community Case Management (iCCM) in flood and landslide affected districts of Bududa, Sironko and Bundibugyo

Baylor Uganda with funding from WHO implemented a project to improve the treatment of Malaria, Pneumonia, and Diarrhoea among U5s, by VHTs, and extend essential medical services to hard-to-reach and underserved communities through iCCM and EMOs in flood and landslide affected Bundibugyo, Bududa, and Sironko districts. We worked with districts to establish the hard-to-reach and most affected sub-counties, and constitute 2 medical teams of 4 people each per district (clinical officer, lab, nurse/midwife and records officer). We conducted integrated PMTCT/EID and immunization outreaches to outreach sites and hard-to-reach villages. We also trained and provided required equipment, medicines and diagnostics to 1 VHT per village to provide iCCM (240 per district).

Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH)

Saving Mothers Giving Life (SMGL): From 2012-2018, with funding from CDC, BU implemented the $16.6 million SMGL Proof of Concept and Project in Kabarol e, Kyenjojo, and Kamwenge districts. The objective was to reduce Maternal Mortality by 50% in the three districts, and to improve access to and utilization of quality obstetric and newborn care services. Key Successes included:

Built the capacity of health providers in Rwenzori region in various topical areas, including Emergency Obstetric and Newborn Care (EmONC), Long term methods of family planning; Quality Improvement; Infection Control and Prevention; and Maternal and Perinatal Death Surveillance and Response.
Set up 7 skills labs at HC IVs and hospitals to ensure maternal and newborn skills maintenance. Each received a neo-Natalie, a mama-Natalie, and standard operating procedures to enable health providers at the host unit and those from lower facilities to practice their skills frequently.
Refurbished and equipped 12 functional operating theatres, 5 neonatal special care units, and 5 maternity wards between 2012 and 2017. Geographical access to Comprehensive Emergency Obstetric Care services increased from 3 to 12 health facilities in the Rwenzori region, leading to a 16% increase in the number of women within 2 hours of accessing emergency obstetric care.
Over 23,500 health worker encounters (including over 3,700 for EmONC) and 5,000 para-social workers benefitted from pre-and in-service trainings and mentorships in the period 2012 – 2017 to improve knowledge and skills in selected areas for quality service provision.
Sustainability: The established infrastructure, the skills labs, and the trained regional mentors were resources left in place at project closure to foster sustainability. Districts were also encouraged to incorporate RMNCAH within their annual district budgets to maintain the project gains further.

Strengthening technical and management capacity of District Local Governments for Reproductive, Maternal, New-born, Child, Adolescent Health (RMNCAH), WASH and education services in 10 districts in Western and East Central zones of Uganda (April 2021-June 2022): With funding from UNICEF, BU has supported ten districts (Mubende, Kasese, Kikuube, Isingiro, Ntungamo, Kamwenge, Kyegegwa, Tororo, Kamuli and Namayingo) to improve the quality of maternal and new-born care at primary healthcare level. Facilities implemented at least 3 interventions (labour and delivery care, Kangaroo mother care (KMC) and new-born resuscitation).

Key Successes:

Some districts such as Kasese registered improvement of skilled birth attendance of 93%, from 80% at inception (National target is 89%).
Best practices from Kasese include continued community dialogue and communication around skilled attendance; discouragement of unskilled attendants at delivery and training/converting Traditional Birth Attendants (TBAs) to VHTs to refer pregnant women to health facilities.
Provision of KMC to low-birth-weight infants has progressively increased from 58.8% at inception to 91% at closure in at 10 districts, attributed to capacity building of health workers on managing small new-borns;

Consultancy services for Clinical Skills Updates and Mentorship for RMNCAH (March-December 2022):

BU currently provides consultancy services for Clinical Skills Updates and Mentorship for RMNCAH in the Bunyoro-Tooro (mid-western) region in Uganda funded by the Ministry of Health’s (MoH) Uganda Reproductive, Maternal, and Child Health Services Improvement Project (URMCHIP)/ World Bank.

BU has to date facilitated training in Operative Obstetrics and SAFE anaesthesia;

Health Systems Strengthening (HSS) across a facility-community continuum

HSS and District Led Programming (DLP): BU uses community and health systems strengthening to improve comprehensive HIV services across a facility-community continuum to reach the UNAIDS 95-95-95 targets

D1. Health service delivery: BU provides comprehensive HIV/AIDS services to all populations with a special focus on subpopulations with poorly performing indices, such as children, AGYW, KP, PP and men. Its community-facility bi-directional linkage framework model links HIV+ clients to health services.

BU has strengthened FSWs’ capacity for peer mobilization, case identification, and referral and linkage to health services, leading to improved adherence and stigma reduction. BU has recruited, trained, mentored 32 CSOs staff in Fort portal and Hoima regions and used referral maps to link each HF (252) to a CSO; This has led to >44,000 successful referrals every quarter.

Our Miles in HSST

Determined Resilient Empowered AIDS-free Mentored (DREAMS) Lite intervention: BU has implemented DREAMS Lite interventions targeting AGYW in all sub counties of Kyegegwa District to control HIV infections, GBV, teenage pregnancies and improve PMTCT outcomes.
Non-communicable diseases integration experience: BU integrates noncommunicable diseases (NCD) screening and management into HIV/TB service delivery (Text Box 2).
Expertise in telemedicine (call centre and KP hot line): BU created the first national pediatric and adolescent call center. The call center supports HWs to provide high quality HIV/TB care, SRHR and VMMC services. BU runs a 24-hour KP 24-hour toll-free hotline to provide timely support for access to KP services.
Flexibility, adaptability, responsiveness to rapidly changing global, national & PEPFAR guidance: BU has successfully responded to rapidly changing guidelines using qualified staff and 50 trained district mentors in the Fort portal and Hoima regions.
BU scaled evidence-based differentiated service delivery models (DSDM) for client-tailored services and recency testing at regional, district, HF, and community levels.

Essential Commodities and new technologies

Strengthening district and HF supply chain systems: BU partners with national health supply chain mechanisms to ensure optimal stocks of ART/other health commodities.
Strengthening laboratory quality management: BU has trained 16 SPARS technical assistance

teams to monitor laboratory service quality and performance.. All 7 (100%) lab hubs in the Fort portal region have attained SANAS accreditation; 3) A College of American Pathologists certified laboratory at our COE that continues to maintain accreditation.

Health Management Information Systems (HMIS): Our M&E team trains and mentors DHTs/CSOs to use national and PEPFAR tools for planning. We have strong experience in project monitoring, Continuous Quality Improvement (CQI) and data quality assessments and conduct monthly/ quarterly district review meetings to promote data us

Continuous Quality Improvement (CQI): BU supports institutionalization and sustainability of CQI practices through DLP and HSS

Health Financing:

BU has managed >400 sub-grantees at district, municipality, HF, CBO, and PLHIV-network levels in 4 regions.

D5. Leadership and Governance: BU with Pepal (2015-2018), implemented ‘Caring Together’ project in all 8 Soroti and 9 Fortportal districts. BU trained frontline HWs on basic leadership tenets to improve HF functionality.

Support for District and community structures: We have supported reactivation of accountability and monitoring structures at district and community levels.
District Led Programming (DLP): BU pioneered the DLP framework to reinforce district and municipality public health response for epidemic control; signs Partnership Framework Agreements with districts; supports districts to update their HIV epidemic profiles; works with the RRHs community department to provide joint, targeted, culturally sensitive TA, by embedding technical staff into District Health Teams (“twinning approach”); and has set up a community of practice network for cross-learning across districts and regions via e-health platforms.
Support to Fort portal and Hoima Regional Referral Hospital (FRRH & HRRH): As the regional IP, BU has supported FRRH to successfully transition from BU support to government to government (G2G) funding. BU developed and disseminated the transition plans for FRRH; provides good oversight, coordination, and support supervision to districts; planning and budgeting for HIV services is data-driven and collaborative; and the RRH provides quality HIV service delivery (HTS, PMTCT, ART, and TB treatment).

Health and Community Workforce: BU HW capacity building includes virtual training, blended virtual and in-person training (for practicum), onsite and remote mentorship, and support supervision.

Our Capacity Building Systems and Approach

BU has over a decade of experience implementing capacity building programs for health care workers in Uganda. BU has implemented this approach through collaborative work with the Ministry of Health and professional associations like the Association of Obstetricians and Gynaecologists of Uganda, Uganda Paediatrics Association, Uganda Private Midwives Association and the Uganda Society of Anaesthesiologists, regional referral hospitals and districts.

Experience using Internet based communication platforms for remote training, mentoring, and monitoring health services to reduce costs and improve efficiencies: BU installed ECHO zoom facilities in Fort portal (45) and Hoima (8) for online meetings, CMEs and training/mentorship with positive feedback from trainees. Echo zoom presents 73-85% cost saving compared to in-person training and review meetings respectively, based on preliminary data. BU, Pepal and Janssen Pharmaceutica have innovatively digitalized leadership training modules onto an online low-cost, Learning Management System called ‘Kajabi’ for HW training and certification.

Adolescent sexual and reproductive health capacity building:

We have a robust community strengthening program with experience in mobilizing and working with adolescent/youth peer groups to deliver services. Through successive grants from PEPFAR CDC/USAID and Global fund for comprehensive HIV/TB programs, including SRHR, Adolescents girls and young women, ELMA Philanthropies for child and adolescent health, URMCHIP/World Bank, UNICEF for RMNACH services and Pepal/ Waamu project,

Baylor-Uganda has gained vast experience implementing adolescent health programs, district-level technical assistance and training in RMNACH for health workers and young people in various regions of Uganda, including Ankole, Buganda, Bugisu, Bukedi, Bunyoro, Busoga, Elgon, Karamoja, Rwenzori, Sebei, Teso, Toro, and West Nile.

Research Capacity

Baylor-Uganda has a robust research capacity. Our current researches include randomized clinical trials for investigation new drugs especially for pediatric HIV treatment and COVID-19 vaccine trials. We also conduct studies on diagnositics. More recently we are conducting a studies on TB diagnositics in children. Our other expertise in research includes conducting implementation science research and conducting surveys and program evaluations.

Building capacity of local indigenous organizations to lead the HIV response: BU has partnered with the Inter Bureau Coalition and Women’s Organization Network for Human Rights Advocacy to implement the ACE-Fort project.

Vision

A world where children and their families live a healthy and fulfilled life.

Mission

To provide high-quality family-cantered health care, education and research worldwide.

Goal

To reduce morbidity and mortality from infectious and non-communicable diseases, maternal and childhood conditions

Value Position

A center of excellence for family-centred health services, education, and research

Core Values

In the process of delivering on its mandate, Baylor-Uganda shall observe the following;

Care: We treat each person we serve in the same way we would want to be treated; being courteous, friendly, and respectful. We aim to be kind and patient at all times, with all the clients we serve and with one another. We shall be true to our calling of upholding the and human rights of all our clients.
Integrity: We are fair and honest in all interactions, trustworthy and truthful. We seek to adhere to the highest ethical standards and conduct. We aim for transparency, impartiality, and equity in all our dealings and are open and honest in our communication. We accept our responsibilities and strive to achieve those things for which we are accountable
Teamwork: We support one another to reinforce each other’s competencies towards achieving Baylor-Uganda’s vision, mission, and strategic objectives.
Excellence: We strive for excellence in all we do as we deliver high-quality, high-impact, and highly ethical health care, education, and research. We constantly work to enhance ability and competence and to achieve continuous quality improvement. We aim for efficiency in our application of resources to derive the best possible value.
Loyalty: We bear true faith and allegiance to Baylor-Uganda’s vision and mission, management, and fellow workers. We support the leadership and stand up for fellow staff and programs.
Innovation: We are creative in applying methods and technologies in problem-solving, constantly looking for ways to improve. We recognize the opportunity in every challenge; we focus on solutions rather than problems. We are committed to generating new knowledge and practices as well as showcasing.

Baylor College of Medicine Children's Foundation

Who We Are

Geographical Coverage and Programs

Figure 1: BU’s Geographical Coverage and Services

Global Health Security (GHS)

Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH)

Health Systems Strengthening (HSS) across a facility-community continuum

Our Capacity Building Systems and Approach

Research Capacity

What We Do

Where we Work:

How we Work:

Vision

Mission

Goal

Value Position

Core Values

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Governing Board

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Baylor College of Medicine Children’s Foundation-Uganda

Rwenzori Regional Office

USAID LPHS - Eastern Region Activity

Bunyoro Regional Office

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