Draft strategic plan jan 15


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Draft strategic plan jan 15

  1. 1. Strategic Plan2013 – 2017April, 2013Theme: “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx”
  2. 2. Baylor-Uganda Strategic Plan (2013 -2017) ii
  3. 3. TABLE OF CONTENTSBaylor-Uganda Strategic Plan (2013 -2017) iii
  4. 4. ACRONYMS AND ABBREVIATIONSAIDS Acquired Immune Deficiency SyndromeART Anti-Retroviral TherapyARV Anti-RetroviralBIPAI Baylor College of Medicine International Paediatric AIDS InitiativeHIV Human Immuno-deficiency VirusM&E Monitoring and EvaluationNGO Non-Governmental OrganisationPIDC Paediatric Infectious Diseases clinicPLWHA People Living with HIV&AIDSPMTCT Prevention of Mother to Child Transmission of HIVSP Strategic PlanSTD Sexually Transmitted DiseaseSTI Sexually Transmitted InfectionTB TuberculosisToC Theory of ChangeVCT Voluntary Counselling and TestingBaylor-Uganda Strategic Plan (2013 -2017) iv
  5. 5. Baylor Uganda VisionMissionValuesBaylor-Uganda Strategic Plan (2013 -2017)A health and fulfilled life for every HIV and AIDS infected andaffected child and their families in Africa.Baylor-Uganda is committed to provide high-quality, high-impact, highly ethicalpediatric and family-centered health care, health professional training and clinicalresearch, focused on HIV/AIDS, Tuberculosis, malaria, malnutrition and otherconditions impacting the health and families worldwide.Care, integrity, excellence, innovation, teamwork and accountabilityv
  6. 6. Executive SummaryBaylor-Uganda Strategic Plan (2013 -2017) 6
  7. 7. 1.0 IntroductionThis document presents the strategic direction for Baylor Uganda (2013-2017), which is shared by theBoard, stakeholders and staff members. The primary purpose of the strategic plan is to provide apathway for those responsible for making strategic decisions and mobilizing resources within BaylorUganda.The secondary purpose of the document is to communicate our strategy to peadiatric HIV&AIDSservices through strengthened programming, advocacy, research and information sharing within thecountry and the region.Baylor Uganda will use this strategic plan to define unmet needs and priorities in peadiatricHIV&AIDS services in Uganda and the region; as well as allocate new resources, as they becomeavailable.This plan has been developed through a process of self-assessment and drawing from the evaluationof the previous Strategic Plan (2007-2012), with a focus on Baylor Uganda’s goal and coreobjectives. The self-assessment and the evaluation considered Baylor Uganda’s current practices, theeffectiveness of strategies employed to date and the challenges that lie ahead. The process was highlyparticipatory and transparent to ensure that all stakeholders collectively own the resultant Plan.The document is organized as follows: Section 1 provides the Background Information in terms of theburden of peadiatric HIV&AIDS in Uganda and the mandate of Baylor Uganda to address thechallenge peadiatric HIV&AIDS for effective response. Section 2 presents the review of the previousStrategic Plan (2007-2012) in terms of achievements, challenges and lessons, and the findings of theSWOT analysis, which informed development of this Strategic Plan. Sections 3 and 4 present theStrategic Direction in terms of Vision, Mission, Objectives, Strategies and Baylor Uganda Theory ofChange (ToC). Finally Section 5 focuses on institutional arrangements for implementing, funding andmonitoring the Strategic Plan. The Logical Framework Matrix is presented as an Annex and gives asummary of interventions proposed in this Strategic Plan.BackgroundBaylor College of Medicine Children’s Foundation-Uganda (Baylor – Uganda) is a child health, not -for - profit NGO committed to delivering high quality, high impact and highly ethical paediatrics andfamily HIV&AIDS prevention, care and treatment services, health professional training and clinicalresearch in Uganda. It is affiliated to Baylor College of Medicine International Paediatric AIDSInitiative (BIPAI) based in Houston, Texas, USA. It emerged from a technical capacity buildingsupport and partnership between BIPAI, Mulago Hospital Paediatric Infectious Diseases clinic(PIDC) and Makerere University Department of Paediatrics and Child health in August 2003. PIDCexisted since 1988 as a Mulago hospital clinic offering Paediatric HIV&AIDS services. In November2004, PIDC was officially initiated into the BIPAI network at their annual networking meeting inGaborone, Botswana.In 2005, BIPAI signed memoranda of understanding with Ministry of Health, Mulago Hospital andMakerere University Department of Paediatrics and child health to support the expansion ofBaylor-Uganda Strategic Plan (2013 -2017) 7
  8. 8. paediatric and adolescent HIV services in Uganda. It was then that Baylor College of MedicineChildren’s Foundation – Uganda (Baylor – Uganda) was formed and registered as a Non-GovernmentOrganization.The Vision: A health and fulfilled life for every HIV&AIDS infected and affected child and theirfamilies in Africa.The Mission: Baylor-Uganda is committed to provide high-quality, high-impact, highly ethicalpediatric and family-centered health care, health professional training and clinical research, focusedon HIV/AIDS, Tuberculosis, malaria, malnutrition and other conditions impacting the health andfamilies worldwide.Core Values: These values include: care, integrity, excellence, innovation, teamwork andaccountability.Baylor-Uganda as Model for peadiatric HIV&AIDS services in UgandaThere are several local organizations with mandate in the area of HIV&AIDS operating in Uganda.But Baylor-Uganda is a very unique model for peadiatric HIV&AIDS in line with governmentpriorities. It is the major provider of peadiatric HIV&AIDS services in Uganda accounting for 23% ofthe total population of children served. Among other factors, its uniqueness lies in the followingfeatures: (a) delivery of family centred comprehensive peadiatric HIV&AIDS psychosocial andclinical services in its centres of excellence (b) unique focus on health systems strengthening fordelivery of quality peadiatric HIV&AIDS (c) national and district level advocacy to tackle systemicbarriers to addressing policy gaps in peadiatric HIV&AIDS service delivery; and (d) conduct ofoperations research to inform programming and policy.a) Delivery of family centred comprehensive peadiatric HIV&AIDS servicesThrough its centre of excellence in Mulago, Baylor-Uganda provides comprehensive peadiatricHIV&AIDS services to families using the child as the entry point. This takes into account the familymembers including mothers and other household members. Right from prevention of mother to childtransmission of HIV, the services cover EID, HCT and management of OIs, psychosocial support,ANC and PNC, targeting children and adolescents as the primary focus. Using its community systemsstrengthening strategy, beneficiaries are identified by community resource persons who includeVHTs, referred and followed up for service uptake. Baylor-Uganda has equally establishedpartnerships with community based organizations to strengthen the referral network.b) Health systems strengthening for delivery of quality peadiatric HIV&AIDSAt national level, Baylor-Uganda works with the Ministry of Health to strengthen the national levelpeadiatric HIV&AIDS response through supporting the human resource function to plan andimplement paediatric HIV&AIDS policies and programmes. To this end, a desk was established topromptly respond to peadiatric issues at national level. At District level, Baylor-Uganda supportsLocal Governments health care delivery structures through provision of infrastructural development,human resources for health, equipment and supplies; and training of health workers. A sub grantingmechanism is also used to support implementation of peadiatric HIV&AIDS interventions.Baylor-Uganda Strategic Plan (2013 -2017) 8
  9. 9. c) Policy advocacy for peadiatric HIV&AIDS service deliveryBaylor-Uganda peadiatric HIV&AIDS policy advocacy agenda focuses on strengthening the HIVresponse at national and district local government levels. This is through participation in nationalevents, technical working groups and development of national strategic plans/frameworks. Theadvocacy initiatives focus on service awareness creation, lobbying for increased service access, bestpractice benchmarking and provision of key information, education and communication materials.d) Clinical researchBaylor-Uganda develops and conducts research to investigate particular elements within the clinicalcare services. The research findings are used to inform programming and the peadiatric HIV&AIDSadvocacy agenda.Baylor-Uganda Institutional FrameworkAs of 2012, Baylor-Uganda had an established national office located at Mulago National ReferralHospital; which also doubles at the centre of excellence for delivery of peadiatric HIV&AIDSservices. In terms of governance, Baylor-Uganda is made up of the following key organs: i) Board ofDirectors and ii) the Secretariat. The Board of Directors is comprised of 7 individuals who meetquarterly to provide policy and strategic direction. The Board has sub-committees which support itsroutine functions. The Secretariat is responsible for the overall day-to-day management of Baylor-Uganda’s work and the implementation of the Strategic Plan. It is composed of an ExecutiveDirector(ED) who has the implementing and controlling role. The ED sets the climate and tone of thestrategic planning process, establishes the planning group, and ensures the Action Plans are completed ontime and have appropriate control and measurement systems in place.Directors, Programme Managers and support staff. It has regional offices in Rwenzori region where ithas consolidated its programmes after the rationalization process. However, other interventions arerunning in different districts of Uganda.Contextual issues of peadiatric HIV&AIDSThe HIV prevalence in Uganda is currently 7.3% and incidence stands at 130,000 new infections peryear; maternal and neonatal morbidity and mortality remained high (MMR=435/100,000 Livebirths)1. Prevalence of HIV among children below 5 years is 0.7% of children are HIV-positive.Thirteen percent of women and 12% of men age 15- 24 had sexual intercourse before age 15. About4% of young women and men age 15-24 are HIV-positive. HIV prevalence among young women ismarkedly higher than among young men, except for youth age 15-17 where there is nearly nodifference in HIV prevalence between women and men. Among young women age 15-24, HIVprevalence is higher among those living in urban areas, while among young men age 15-24 HIVprevalence is higher among those living in rural areas.1National HIV indicator survey 2011Baylor-Uganda Strategic Plan (2013 -2017) 9
  10. 10. Baylor Uganda’s response to dateA participatory evaluation of Baylor-Uganda work since 2007 was carried out between March andOctober 2012. The external evaluators concluded, among other things, that the overallimplementation and achievement of objectives in the programmes were consistent with the planningdocuments. The lessons from this evaluation have been used to improve Baylor-Ugandaprogramming work.Achievements and challengesDespite the challenges faced in peadiatric HIV&AIDS service delivery and policy advocacy,tremendous strides have been made by Baylor-Uganda in its attempt to scale up the access to qualityservices in Uganda.Below is a summary of Baylor-Uganda’s key achievements during the implementation of theStrategic Plan 2007-2012:• Baylor-Uganda has been at the forefront of the planning for the annual National PaediatricHIV&AIDS conferences. Each of these has brought together policy makers, NGO representatives,activists and scholars to share best practices and lobby for increased services.• The children’s advocacy team has been instrumental in raising awareness for paediatricHIV&AIDS during national events like the World AIDS day and high level advocacy meetings.• The advocacy team has participated in the development and review of key documents-ThePositive Living Communications strategy and the Community Mobilisation Strategy forPaediatric HIV&AIDS in Uganda.• Overall there were 5,749 health workers were trained in the different courses aimed at equippingservice providers at the community, health facility, regional and national level with skills tosupport expansion of paediatric services• ART adherence assessment increased from 53% to 92% between September 2009- June 2010• ART access in eligible patients increased from 43% to 87% between Dec 2009 to June 2010• Growth monitoring in children < 5 years increased from 28% to 87% between June 2009 to June2010• Improved access to ITNs by 60-80% of the targeted population during the period June 2008 andJune 2011• Baylor-Uganda provided substantial support to towards the improved data management at thehealth facilities. It supported printing of over 100,000 ART revised cards for use at the supportedsites.• Reduced morbidities among children followed from over 30% at enrolment to less than 10% after12 months of follow-up. This shows significant increase in quality of life of children living withHIV&AIDS.• There was a reduction in mortality among patients enrolled and followed-up on the program fromover 15% to less than 2% after 12 months.• There was improvement in growth monitoring, TB assessment and ART adherence assessmentduring the period June 2008-June 2011 to levels above 80% in service centresBaylor-Uganda Strategic Plan (2013 -2017) 10
  11. 11. Baylor-Uganda has been able to achieve such an impressive set of results due largely to thededication of programme staff and management, the partnerships it has developed as well as strategicalliances with other actors responding the peadiatric HIV&AIDS service delivery needs in thecountry.Challenges faced by Baylor-Uganda (2008-2012)a) Restrictions and delay in the release of funds by CDC, and also delayed financial disbursementsto health facilities from the districts affected timely delivery of services like conductingoutreaches in the communities.b) Inadequate human resources for health could not be addressed entirely by NEP and continued toaffect delivery of quality and integrated services.c) Rationalization of USAID implementing partners was not characterized by a systematicallystructured exit strategy that allowed both the incoming and outgoing partners to exchange groundat the project sites.d) Logistical and infrastructural support to the districts increased the recurrent costs for healthfacilities which are not catered for in their annual budgets.e) Implementation of project activities was associated with considerable institutional overheadswhich were not reflected in the approved budgets that were funded by CDC.f) Limited use of condoms among discordant couples and limited disclosure of one HIV statusamong couples continue to affect the uptake of prevention of sexual transmission of HIV relatedactivities including adherence to treatment.g) Limited funding and failure to use the child status index tool affected the provision of qualityOVC services.Lessons learntThe following were the major lessons learnta) It is very challenging to strengthen district health care delivery systems when there is limitedgovernment funding and support to sustain the gains made under project mode of operation.b) Working through established district structures delivers sustainable results. However, the civilservice culture can slow down implementation processes even when they are meant to facilitateservice delivery. Any strategy for systems strengthening should be cognisant of this limitation.c) Community involvement is central in the success of HIV&AIDS programs. Community mappingmakes it easier to locate patients in the community and also to identify and engage communitystructures.d) Mentorship to health workers contributes in transferring knowledge into skill. It also improvessystems that facilitate identification, enrolment and initiation on HAART of HIV+ childrenBaylor-Uganda Strategic Plan (2013 -2017) 11
  12. 12. Strategic AnalysisThe strategic analysis was informed by the contextual assessment of peadiatric HIV response as wellas from the evaluation of the Baylor-Uganda Strategic Plan (2007 – 2012). Several stakeholders’meetings and interviews were also held as part of the process of developing the Strategic Plan. Thissection presents summary outcomes from this process in the form of the SWOT analysis, stakeholderanalysis and the options analysis and the strategic implications on prioritizing Baylor-Ugandaprogrammes.SWOT AnalysisBelow are the key strengths, weaknesses, opportunities and threats identified and an analysis of theirstrategic implications:Strengths Strategic ImplicationsVisualized as a national leader in peadiatric HIV&/AIDScare, treatment and preventionFurther strengthen advocacy andprogramming to reflect this image.The Baylor-Uganda linkage to BIPAI has significant localand international valueUse image to leverage resourcesTested capacity building support initiatives for healthworkers in improving knowledge and skills in themanagement of children with HIV&AIDSReview training curricular and trainingapproaches to reflect the dynamisms inpeadiatric HIV&AIDS management and theskills needs of health workersStrengthened capacity of health facilities to deliverintegrated services for HIV&AIDSSeek more government budget support tosustain the gains so far madeVey committed and competent staff at national andregional levelsRegularly review the staff development planto match the service delivery needsAn established Children’s Clinical Centre of Excellence(COE) in Mulago and regional centres of excellenceUse the centres to develop more innovativeprogrammes to address peadiatricHIV&AIDS service deliveryStrategic location of the national centre of excellence inMulago National Referral CampusDraw from the expertise in Mulago Hospitaland training institutions to improve thequality of peadiatric HIV&AIDS servicesLong-term support and partnership commitment from theMoH and collaborating partners including Mulago hospital,Makerere University Department of Peadiatric, etcFurther strengthen ties to further improveleveraging of resources and advocacyWeakness Strategic ImplicationsBaylor Uganda does not have an organizational wide M&EframeworkThis strategic plan should be used as thefoundation for developing an organizationalwide M&E planInadequate human and financial resources to support andsustain the necessary growth in the operationsStrengthen resource mobilization efforts inorder to develop and deliver qualitypaediatric HIV&AIDS servicesInadequately developed training and research Review the training and research elements toreflect the same levels as clinical services.Lack of provision for institutional overheads in CDCfunded projectsStrategically engage other partners supportedby CDC to advocate for a policy shifttowards inclusion of institutional overheadsin supported projectsOpportunities Strategic ImplicationsBaylor-Uganda Strategic Plan (2013 -2017) 12
  13. 13. The There is still global commitment to a scaled-upHIV&AIDS response specifically in sub-Saharan AfricaStrategically identify specific gaps in theresponse to paediatric HIV&AIDS in orderto attract programme supportThere is now a national renewed vision for combinationHIV prevention approach targeting key populations.Ensure programming maximizes delivery ofservices to key populationsAccess to a pool of highly qualified technical supportwithin the Mulago Hospital staff and Makerere Universityfaculty; and in the BIPAI networkStrengthen programming and research whichtap into these skillsExisting and growing demand for paediatric HIV&AIDScareDesign appropriate programmes that addressun-met need for peadiatric HIV/AIDS careand treatment servicesMultiple stakeholders in HIV&AIDS care keen onpartnershipDevelop a partnership and coordinationframework to bring together all partnersadvocating for peadiatric HIV&AIDSactivities to further strengthen advocacy andprogrammingThreats Strategic ImplicationsUncertain long-term financial support due to internationaldonor support and direct government funding threatened bycompeting needs globally, regionally and in-countryWiden the resource base through developinga resource mobilization planThere are challenges in HIV prevention among HIVpositive adolescents.Design specific programs for children livingwith HIV transitioning into adolescenceStakeholder AnalysisStakeholders play a critical role in strategic plan implementation by providing support in the form offunding, materials, technical assistance, advocacy, participating in programmes and providinggoodwill and a facilitating environment. Baylor-Uganda will continue to collaborate with its partnersand other stakeholders in the implementation, monitoring and evaluation of the strategic plan. Belowis a summary of key stakeholders and their roles:Baylor-Uganda partnering CSOsBaylor-Uganda works in partnership CSOs which support health worker training, programming aswell as peadiatric HIV&AIDS research. These include but not limited to IDI, TASO, ChildFund andSave the Children Uganda. Baylor-Uganda will continue its partnership with these CSOs whileidentifying other strategic partners during the strategic planning period.Line MinistriesBaylor-Uganda supports Ministry of Health and Ministry of Local Government service deliverysystems at policy and service delivery levels. This is through health systems strengthening andHIV&AIDS decentralized coordination mechanisms. Baylor-Uganda further support efforts byMinistry of Gender, Labour and Social development through the social protection component of theSocial development sector Strategic investment Plan 2 focusing on the well fare of children andadolescents. Baylor-Uganda will further strengthen these relations continuously endeavor to influencethe relevant Ministries to give high priority to peadiatric HIV&AIDS services.Baylor-Uganda Strategic Plan (2013 -2017) 13
  14. 14. Development partnersThese include multi nationals, international NGOs and global health initiatives – e.g. CDC, UNICEFetc. These stakeholders provide funding and material support to Baylor-Uganda programmes. Baylor-Uganda will endeavor to attract and maintain the support of a number of donors to its programmes.Its sustainability strategies rely on the diversification of the funding base so that more donors areattracted into its fold.Baylor-Uganda Strategic OptionsBased on the results of the environmental scan and experience from implementation of the lastStrategic Plan, Baylor-Uganda identified the following strategic options to find the strategic directionit needs to pursue in the next five years.Expansion in scope and scaleBaylor-Uganda has taken strategic decisions to widen its scope and scale of interventions to meet theever increasing demands from its constituents. This option is based on a better understanding of theevolving peadiatric HIV&AIDS service needs in the country, the rapidly changing responselandscape, the results of the evaluation of the 2007-2012 Baylor-Uganda strategic plan, the SWOTanalysis and feedback from a wide range of stakeholders. The cost of not taking the expansion optionwould imply that Baylor-Uganda will remain under funded and with an un-recognizable impact bothin service delivery and resource utilization.Shift from project to programme approachInitially Baylor-Uganda operated as a project but with the changing peadiatric HIV&AIDS serviceneeds in the country, the scope and scale of work led into its transformation to a programme basedplanning. This has had the effect of creating more directorates to facilitate effective implementationof the Baylor-Uganda mandate. The shift will further strengthen the programme and institutionalsustainability that will see Baylor-Uganda becoming a more dynamic and adaptive organizationtaking leadership in peadiatric HIV&AIDS service delivery in Uganda.Baylor-Uganda Strategic Plan (2013 -2017) 14
  15. 15. Baylor-Uganda Strategic DirectionIn view of the results of the SWOT analysis and the strategic directions agreed to by Baylor-Ugandastakeholders, the strategy indicates the intended operational direction and emphasis of Baylor-Ugandawork during this period 2013 to 2017. This section outlines in details what Baylor-Uganda expect toachieve over the next five years and what strategies will be adopted to realize the expected results inthe short and intermediate terms. The organizational theory of change developed throughparticipatory approaches involving Baylor-Uganda staff defines the programming logic which will beadopted during the next five years.Baylor-Uganda theory of change (ToC)Baylor-Uganda’s ToC illustrates how its interventions will generate the desired changes given theassumptions about how these changes will happen. The overall goal of this strategic plan is tocontribute to the HIV&AIDS response in Uganda as follows:To contribute towards the reduction of morbidity and mortality due to HIV&AIDS andrelated diseasesThe main strategies which Baylor-Uganda will adopt to achieve the above goal are identified underthe following directorates:(A) Directorate of Clinical and Community ServicesRationaleIn order to address the increasing HIV prevalence and incidence; and contribute to reduction ofmaternal and neonatal morbidity and mortality, this programme area will scale up combinationprevention, maternal and child health, care and support and retention in care especially for children,mothers and adolescents. Given the higher HIV prevalence among young adolescents living in urbanareas, specific interventions will be designed to address this age category. A family centred approachwhere the children will be used as a portal of entry into the household will be applied to addressingmaternal and child health issues through comprehensive services2. With high levels of HIV&AIDSrelated stigma being registered in communities, Baylor-Uganda will provide psychosocial care toenable them cope given that HIV affects all dimensions of a person’s life i.e. physical, psychological,social and spiritual wellbeing. Orphans and vulnerable children will be supported through vocationaland life-skills interventions.Strategic objectives (SO)SO 1.1: Support psychosocial wellbeing of children infected and affected by HIV&AIDS andtheir familiesSO 1.2: Strengthen the capacity of community systems and structures to provide psychosocialsupport to children and families infected and affected by HIV&AIDS2Comprehensive services include; addressing children’s rights, nutritional support, support to formal and informal education, livelihood improvementthrough vocational and life skills, HIV testing and counseling, adherence support, peer support, mentorship and training of mentees and ongoingcounseling to support psychosocial issues, follow-up, linkage and referral; capacity building of community structuresBaylor-Uganda Strategic Plan (2013 -2017) 15
  16. 16. SO 1.3: Increase access to and utilization to peadiatric HIV&AIDS; and MCH servicesStrategies• Strengthen service delivery at the COE and Baylor supported sites• Sub granting to districts• Consolidating the regional service delivery approach• Decentralization of services• Infrastructure improvement• Strengthening and improving accreditation of all Health centres III and some health centre--provide comprehensive HIV services.• National accreditation of all laboratories commensurate to their level of services.• Community systems strengthening (VHTs, OVC committees, family support systems, PHAnetworks, Health workers etc).• Provision of adolescent and child friendly services• Capacity building for health workersExpected results• Increased access to biomedical combination preventions.• Increased access of HIV care and treatment.• Increased client retention in care and treatment• Improved access and utilization to MCH services• Improved quality of laboratory services.(B) Directorate of Research and Knowledge ManagementRationaleBaylor-Uganda will generate new knowledge through operational research in order to position itselfas the foremost and authoritative source of knowledge related to peadiatric HIV&AIDS; and maternaland child health in Uganda from a civil society perspective. This knowledge will be used to improvesthe quality of peadiatric HIV&AIDS care; and maternal and child health interventions in addition toinforming policy making and practice.Strategic objectivesSO 2.1: Improve evidence-based knowledge for the management of peadiatric HIV&AIDS; andMCH servicesStrategies• Organize and expand the research unit to directorate level• Development of human resource capacity for research• Strengthening the resource and documentation center• Expand the scope of research beyond clinical research• Strengthen collaboration with other research entities• Ease the process of IRB approvals by engaging BCM in adjusting requirements beforeapprovalBaylor-Uganda Strategic Plan (2013 -2017) 16
  17. 17. • Initiation and development of an in-house IRB for Baylor Uganda• Grants and proposal writingExpected results• Utilization of research results for improved programming and advocacy• Strengthened human resource capacity in research• Functional resource and documentation center• Increased funding for research(C) Directorate of Capacity BuildingRationaleThis will deal with regular updating of health worker knowledge and skills for both internal staff andother service providers given the changing disease patterns and priorities; changing technologies andchanging policies and guidelines. Baylor-Uganda will contribute towards production of more healthworkers so as to address scarcity of human resources for health in the country through innovativeapproaches including but not limited to mentorships, coaching, internships and experiential trainings.Trainings will also be designed to contribute to the financial sustainability of Baylor-Uganda.Strategic objectiveSO 3.1: To improve knowledge and skills of healthcare providers in peadiatric HIV&AIDS;and MCH service deliveryStrategies• Customized training programs• Provision of training consultancy services• Establish a training centreExpected results• Increased income generation from commercial courses• Increased uptake of training courses• Improved peadiatric HIV&AIDS; and MCH service delivery(D) Directorate of Institutional DevelopmentRationaleInstitutional Development Programme provides supportive functions to other directorates in additionto executing specialized roles. It brings together all directorates to ensure systematic, coordinated andeffective execution of organizational mandate. The overall objective of this programme area is to;improve the performance of Baylor-Uganda to coordinate, implement, monitor and evaluate thestrategic plan.This program area will address eight key components including; resource mobilization, humanresource development, finance, grants and logistics management, public relations and advocacy,continuous quality improvement; and monitoring and evaluation.Resource mobilisationBaylor-Uganda Strategic Plan (2013 -2017) 17
  18. 18. Baylor-Uganda will strengthen its resource mobilization unit increase funding through appropriatepackaging of its priority areas and explore financial support from other funding partners beyond thetraditional donors. Internal revenue generation will be enhanced through tailored trainings,consultancy services and specialized clinical services for the high income earners.Human resource developmentEffective implementation of this strategic plan will require significant improvements in theorganization’s institutional capacity (technical, operational and management capacity). Baylor-Uganda will review its organizational structure, reskill and retool its human resources to deliver onthe new mandate. Human resource capacity shall be enhanced through short term tailor-made courses.Finance,This will be strengthen through policy reviews, streamlined budgeting and financial managementAudit function; this needs to be an independent unit not to be subsumed under finance departmentGrantsGrants management will be improved through regular reviews based on experience gained duringimplementation.Logistics managementHere the organization is most interested in being efficient, effective and accountable,Collaboration’ describes the various ways in which councils and other public bodies come together tocombine their buying power, to procure or commission goods, works or services jointly or to create sharedservices. Its major benefits are economies of scale and accelerated learning.Partnering’ means the creation of sustainable, collaborative relationships with suppliers in the public, private,social enterprise and voluntary sectors to deliver services, carry out major projects or acquire supplies andequipmentStrategies;• Examine opportunities for collaborative procurement of partnerships – Joint approaches should alwaysbe examined. See Rethinking Service Delivery for guidance on the governance of joint projects.• Build continuous improvement into contracts – Structure incentives for continuous improvement intocontracts, including linking payment for performance against Key Performance Indicators.• Follow best practice in the partnership procurement process – Partnership procurement processesshould follow the step-by-step guidance to best practice set out in Rethinking Service Delivery and theservice-specific guidance contained in the 4ps procurement packs.• Adopt a structured approach to project and risk management – Baylor Uganda should adopt an approachto procurement management based on the core principles of effective project management, including adedicated project manager, and apply risk management techniques to projects and programmes.Baylor-Uganda Strategic Plan (2013 -2017) 18
  19. 19. • Streamline procurement processes – The organization should seek to reduce the total time and cost toprocure partnerships by streamlining the process, eliminating unnecessary red tape and reducingdependency on external advisors. In particular they should seek to reduce the time from notice tocontract award.• Manage relationships as well as the contract – Rethinking Service Delivery contains important guidanceon the building and management of relationships with suppliers, which is a vital ingredient to thesuccessful delivery of services within the framework of a partnership.Quality improvementThis docket will aim to continuously improve the quality of goods and services delivered by Baylor-Uganda in all programmes and departments. Standard operating procedures, guidelines and qualityimprovement indicators will be developed for effective monitoring and evaluation.Monitoring and Evaluation System (M&E)The sector shall strengthen the knowledge and information management through developing andoperationalizing an organizational wide M&E plan. The management information system will bestrengthened by redesigning the thematic area databases, training of the staff and realigning thereporting and feedback mechanisms. In all cases, efforts shall be geared towards creation of userfriendly ICT systems for access by the different stakeholders within the organization.A strengthened monitoring and evaluation system shall be the basis upon which strategic planimplementation will be tracked to specifically focus on the objectives and the set targets. It shall alsobe a management tool for performance measurement over the next five years.Public relations and advocacyHarmonized internal and external communication will be enhanced through the public relationfunction. This will aim at ensuring correct information flow within and outside the organization. As acivil society peadiatric HIV&AIDS; and maternal and child health advocate in the country, Baylor-Uganda will drive a national advocacy program that allows it to accentuate the voice of civil societyin peadiatric HIV&AIDS; and maternal and child health. The content of the advocacy program willdraw on the linkages, processes and new knowledge generated through research.Strategic objectivesSO 4.1: To improve the performance of Baylor-Uganda in coordinating, implementing,monitoring and evaluating the strategic planSO 4.2: Improve the resources requirements to implement the strategic planStrategies• Development of human resource strategic plan• Programme communications, lobbying and social mobilization• Review of policies, guidelines, standard operating procedures, systems and structures• Staff capacity development• Strengthening the grant, finance and logistics management functionsBaylor-Uganda Strategic Plan (2013 -2017) 19
  20. 20. • Regular review of the M&E system• Strengthen the risk management frame work and internal audit functions• Strengthen continuous quality improvement systemsExpected results• Increased financial resources to deliver on the strategic plan targets• Effectiveness in achievement of the strategic plan targets• Efficiency of resource use• Strengthened M&E system• Improved organizational imageThe results generated under each strategy include both short- and longer-term effects reflected atdifferent levels such as individuals, households, organizational, systems and communities. These aredetailed in the outcome map (Appendix X where is it ??????)Target groupsIn order to equitably deliver peadiatric HIV&AIDS; and maternal and child health services, Baylor-Uganda will target the following categories of beneficiaries:1. Excluded groups (e.g. people with disabilities, sex workers, orphans, children headinghouseholds)2. Adolescents3. Children affected and infected by HIV&AIDS4. Mothers of exposed childrenImplementation ArrangementsCoordination of strategic plan implementationBaylor-Uganda secretariat will be strengthened to co-ordinate implementation of this strategic plan. Itwill be supported by the Board through the technical working groups/committees.SustainabilityThe sustainability of Baylor-Uganda will mainly be at three levels namely: Institutional;Programmes; and Financial sustainability. Each of the levels is described in detail as follows.Institutional SustainabilityDuring the strategic planning period, Baylor-Uganda will set into motion processes to establish andstrengthen most of the elements required for a sustainable organization. To achieve this, Baylor-Uganda will restructure the organogram, retool and reskill the human resource in line with thestrategic plan mandate.Programme SustainabilityProgramme sustainability will involve venturing into new programmes to address emerging needs inHIV&AIDS; and maternal and child health services and application of an evidence-based approachacross all its programme areas. The monitoring and evaluation system shall be strengthened to guidethe implementation of this strategy.Baylor-Uganda Strategic Plan (2013 -2017) 20
  21. 21. Financial SustainabilityResources will be mobilized to implement this strategy through engaging more development partnersand strengthening internal revenue generation. Cost containment strategies and risk managementinterventions will be developed to sustain the organization.Monitoring and evaluationSystematic monitoring is important to track and analyze activity implementation and providefeedback on performance. Baylor-Uganda will monitor and evaluate its programs through a reliableand functional M&E system to capture achievements of its interventions. The monitoring andevaluation system shall be strengthened through development of a comprehensive managementinformation system to bring together the various directorates.Evaluation of this strategic plan will be carried out to make a comparative assessment of the results(outcomes and impacts) of the interventions at mid and end term. Annual reviews and experiencesharing shall be conducted to provide regular updates.Baylor-Uganda Strategic Plan (2013 -2017) 21
  22. 22. Resource requirementsBudget to be developed after identification and costing of activitiesAppendix 1: Baylor-Uganda Theory of ChangeBaylor-Uganda Strategic Plan (2013 -2017) 22
  23. 23. Appendix 2: Results-Based Logical FrameworkBaylor-Uganda Strategic Plan (2013 -2017) 23