Background:

Uganda Community Based Health Care Association (UCBHCA) is an Umbrella Organization for nonprofit nongovernmental organizations. It was formed in 1986 by 86 nongovernmental organizations (NGOs) local and international which were involved in implementing Primary Health Care in Uganda that had come together to share their experiences in implementing PHC and Joint training.

It was registered under the national NGO board in April 1986 as national Non Governmental
Organizations (NGO) operating at national level in all parts of Uganda.

Unicef contracted AMREF based in Nairobi Kenya to train the member organizations in Community Based Health Care approach to implement PHC at Community level with emphasis to community participation and involvement.

The Ministry of Health of Uganda offered UCBHCA a plot in Entebbe where to construct its head office. Donors including Unicef, World Neighbors and others donated money to construct its head offices.

UCBHCA is a major partner with the Ministry of Health of Uganda in implementing the national Health Policy, Health Sector Strategic Investment Plan (HSSIP) through its member health centres and Community based organizations operating in districts in Uganda.

1.1 UCBHCA’s Vision is: To improve the quality of life of all the people.

1.2 Mission Statement:
To promote and coordinate sustainable community based health and development initiatives through gender responsive planning and community participation.

UCBHCA strives to achieve the above mission by;
1. Promoting the growth of Community Based Approach to Community Development as the most effective and sustainable long term way to achieve maximum Socio-economic development.

2. Empowering communities to manage their own health and development initiatives through capacity building at all levels i.e National, District, County, Sub-county, Parish and Village) in integrated Primary Health Care and social development.

3. Serving as a focal point for nonprofit health centres and Community Based organizations involved in community development activities and undertaking coordination, training, monitoring and evaluating activities of member organizations and giving them necessary technical support and guidance.

4. Facilitating co-operation, networking, and partnerships and strengthening the existing communication and information sharing among member organizations themselves, Government, Development partner agencies and Donors through provision of a forum for sharing knowledge, experiences and Best practices.

5. Undertaking Advocacy at all levels for health policy and Primary Health Care using Community Based Health Care approach as the pre-requisite for sustainable development.
6. Acting as a link between NGOs /CBOs, Government, Development partners and Donors and advising them on available opportunities

Core Values: Transparency, Accountability, Integrity, Honest, self respect and respect for others for sustainable development

Organization Culture: People First everybody has a right to health and sustainable development.
UCBHCA ensures that people must be served first and are always at the centre of their health and development. Gender equality is priority

Mandate of UCBHCA:
The Ministry of Health mandated Uganda Community Based Health Care Association to coordinate the implementation of the partnerships between the civil societies and the Ministry of health in implementation of essential primary health care service delivery and Offering technical insight to the Ministry in formulation of guidelines for all community based organizations.
Assist in identifying and selecting organizations for funding by the Ministry of Health
Convening consultative meetings on health matters and offering technical support and capacity building of member organizations to effectively implement the national health policy and Health Sector Investment plans and supported projects at community level
Provide technical capacity building to nonprofit, nongovernmental organizations in areas of health policy and implementation of HSSIP PHC programs including Routine Immunization, Sexual Reproductive
Health and Rights, Maternal Child Health, New born Care and Child development, Antenatal Care, Family Planning, prevention of Malaria, HIV/AIDS, TB, Food and Nutrition Security, Water and Sanitation, Community Based Management information system, Community Based Rehabilitation Monitor the performance of nonprofit nongovernmental organizations and offering technical advice and capacity to effectively implement funded projects, Evaluating NGO implemented projects.

The member organizations include nonprofit Health centres and Community Based nongovernmental organizations (NGOs/CBOs) implementing Primary Health Care at Community level. They include 270 nonprofit health centres and 250 NGOs/CBOs operating in all districts in Uganda

UCBHCA National Secretariat:
The association has a national secretariat which is the technical unit of the association responsible for the day to day management of the operations of the association and offering technical services to member organizations and non members.
The secretariat is headed by the Executive Director assisted by a team of 9 technical full time staff assisted by a team of 40 part time national facilitators who are always called upon to take key assignments to meet client demands.

Implementation methodology:
UCBHCA has adopted the concept of Primary Health Care which emphases community empowerment and participation in matters concerning their health and social economic development.

The strategy of Community Based Health Care (CBHC) was adopted to extend PHC services beyond the
Health centers deep in rural and hard to reach areas to enable the community members including marginalized groups of people like women, children, youth and people with disabilities to fully participate and benefit from health services delivered in their communities and development services. Community Based Health Care (CBHC) is a people centered approach which enables the community members to fully participate in identifying community problems, planning, implementing, monitoring, evaluating and sharing benefits, to sustain health and development interventions in their homes.

The UCBHCA Secretariat is responsible for building capacity of the organizations and their structures at different levels District, Sub County, Parish and Village level.
The nonprofit Health Centres are required to implement health services at facility and also go out to communities to open out Community based Outreach centre where to provide health services like routine immunization, family planning and treatment of malaria within easy reach to enable mothers and children to walk very short distances to access free health services within easy reach.

Community Based Health Workers
The Health centres work jointly with Community Based Health workers who help them to mobilize the community members and mothers to bring their children for routine immunization. The Community Based Health Workers or Village Health Teams trained by trainers from UCBHCA.

Promoting nonprofit Health Centres in Uganda:
The role of UCBHCA is to promote, protect, represent, advocate and develop the standards of nonprofit

Supply Chain:

To strengthen the supply chain for medicines and commodities from Governmental National Medical stores to our Health centres, UCBHCA has established strong partnership with the Ministry of Health to enable its member nonprofit Health centres to easily access the supply chain of medicines and commodities particularly for the essential drugs from National Medical stores through Joint Medical Store at Nsambya. The drugs are supplied by Government of Uganda and Donors.

UCBHC has now secured a five year grant support from USAID Presidential Malaria Initiatives to support 270 nonprofit Health centres to provide free quality medicines to all poor needy people in Uganda including people with disabilities based in rural and hard to reach areas in Uganda. USAID has also contracted Joint Medical stores at Nsambya to deliver the drugs to our facilities where they are located in remote rural areas.

The package of drugs includes free ARVs, ACTs, RDTS, HIV testing kits, Male circumcision testing kits, long lasting Insect Treated nets. The medicines are free to all the needy people are free to get free treatment from our PNFP health centres operating in all districts in Uganda.
We have also worked closely with the Ministry of Health to plan and budget for the PNFP Health Centres to get HMIS Tools to record patient data and report through District Health Information management system DHIS 2 monthly. Ministry of Health HMIS department to train Health centres in quality data recording and timely reporting through mTrac funded by Unicef. All data officers from each Health centre will be equipped with skills in quality data recording, analysis and DHIS 2 and access Codes. This is a web based data system. This will require each health centre to get a computer or use Smart phones. The Ministry of Health HMIS department has agreed to support our health centres. UCBHCA has been given an access code and rights to access data.

Reproductive Health:

Contraceptive prevalence rate is low 34% in Uganda. Only 24% of mothers are able to easily access family planning services and products within easy reach. 52% mothers in rural areas have no access to quality family planning services. Child bearing and motherhood starts early among 18% of adolescent women age 15-19 with short birth intervals occurring within 24 months of previous birth in about 25% which puts women and teen age girls at high risk. Teen age pregnancy and motherhood is a major health and social challenge in the country resulting into higher morbidity and mortality for both the mother and children.

To address the above challenge UCBHCA strategy is to improve delivery of Sexual Reproductive Health and Rights (SRHR), Family planning services and Adolescent Health and Rights to enable women of reproductive age including women and girls with disabilities to easily access quality services within easy reach in rural and hard to reach areas in Uganda.
We strengthen capacity of health workers and equip them with modern quality contraceptives to increase access to users in the rural areas through our health centres. Create awareness of importance family planning to help women delay, space, and limit pregnancies. Family planning is a cost-effective intervention that saves the lives of mothers and their children and saves thousands of dollars in healthcare spending every year.

Maternal child health services:
Majority poor pregnant mothers in rural areas do not have access to health centres with appropriate commodities and delivery equipment and beds with skilled health works. Mother also delays to visit health centres due to poor services and cultural beliefs. This has resulted into many women delivering in villages attended by Traditional Birth attendants or relatives while others deliver in facilities not attended by any skilled health workers. The most effective way is to ensure that women have access to the care and commodities needed to ensure the safety of mother and child at birth.

UCBHCA aim is to improve Maternal Child Health Services to increase women’s access to quality
MCH services through well equipped health centres to protect women from dying from preventable causes related to pregnancy and delivery. Strengthen capacity of Midwives and Nurses to equip health centres with more well trained and skilled Midwives, Nurses and Community Health Workers equipped with quality medical delivery equipment and commodities and friendly and affordable MCH health services within easy reach in Uganda
Empower pregnant women and their families with positive attitudes and behaviors to seek for health care early, practice healthy behaviors to access quality health services early during pregnancy, childbirth and postnatal period especially within the first two days after birth and partner support. Ensure that the nonprofit Health centres meet the required set standards to provide quality MCH services to increase community access to low cost MCH services. We believe that when women have access to high-quality care and trust in the health providers, they can seek care early for themselves and their families.

To save mothers and babies at birth including premature babies UCBHCA has identified a new incubator which works without electricity to save premature babies at birth. It is produced by Warmilu Company based in USA. It is a life-saving medical device that is safe to use in areas with no electricity and can be reused to save life of premature babies and infants. This is the best device for our nonprofit Health centres located in rural and hard to reach areas where there is no power. UCBHCA has now established partnership with the agent called Relief Africa and imported the device to save premature babies in Uganda. It costs 110 Dollars for the small size premature baby and 125 Dollars for the new born. See device attached pictures and information. We have also introduced it to the Ministry of Health and is interested in the device.

Prevention of Malaria:
Malaria poses a significant health challenge in many countries in the world particularly those from developing countries in Africa including Uganda affecting women and children. Among pregnant mother malaria causes miscarriage and premature deliveries and in children malaria causes anemia and mental disabilities and absenteeism at school and poor performance. At place work malaria affects the work force performance due to regular absent seems at work.
Given the above malaria challenges in the world, UCBHCA developed the concept of community based management of malaria and strategy aimed at reducing the high rates of morbidity, mortality and disability due to malaria in 1994. The research was designed and conducted in Uganda by Christopher Bakiika Ssengendo who initiated it. The research study findings proposed the new strategy to prevent, treat and
Manage malaria. It was funded by WHO and Unicef. This new strategy also improved malaria drug doses and packaging of malaria drugs in right doses according to weight and age. It is now adopted by WHO.

In 2002 UCBHCA launched a pilot project to implement the strategy in seven malaria endemic districts in Uganda up to 2006 when the project was evaluated it registered success in prevention and management of malaria. This concept and its strategy has been adopted by WHO and spread to other countries. The project was funded by WHO through Ministry of Health of Uganda.

Community Based nonprofit NGOs/CBOs

UCBHCA promotes nonprofit NGOs/CBOs. They have established grassroots strictures which are
Extended deep in the rural communities. The NGOs/CBOs mobilize communities to sensitize about Health, Agriculture, Water and Sanitation and other development initiatives. They work with communities to select Community Based Health Workers who are trained to go out to carry out home visiting. These structures are trained to implement Community Development interventions in their communities and sustain them.

At District level all member organizations in each district come together to form a district association which coordinates the member activities in each district and report to national secretariat. All members are elected democratically.

Entrepreneurship Skills Development Training Pregame

Based on the economic outcry in Uganda, the Youth are vulnerable to poverty. They are not
Economically self reliant. They needed economic empowerment. Therefore UCBHCA initiated
‘Entrepreneurship Skill Development Project’ (ESD) project which is a non-formal education intervention for Youth out of school. It is aimed at empowering youth with skills to identify viable projects to start self employment through generating income to reduce poverty to meet their needs.

The program was started to empower the youth and adults with entrepreneurship skills to earn income not only to finance their treatment bills but also to feed nutritiously to be healthy, dress properly, meet health bills whenever needed and also meet education fees for their children and meet other needs.

This is in line with Sustainable Development Goals (SDGs) which are focused on poverty eradication to reduce vulnerabilities of the poor, including women, youth boys and girls, unemployed persons with Disabilities, Orphans, indigenous people, older people and local Communities.

Target Group: This project is targeted at Youth aged 15 – 35 years out of school, school drop-outs and non-schooled Youth including Girls and boys who never went to school including those with disabilities and Orphans and adults.

Goal: To build entrepreneurship capacity among youth and adults for sustainable development.
General Objectives:
i) To equip youth and adults with entrepreneurship skills,
ii) To enable youth and adults identify, initiate and manage and sustain viable business,
iii) To enable youth and adults monitor and evaluate their business performance

Enable participants acquire key competencies below:
of Enable participants acquire entrepreneurships knowledge and skills in, business planning,
Business accounting, record keeping and monitoring skills,
 Enable participants acquire knowledge and skills to carry out market survey locally and externally including IT computer market survey and marketing skills to sale produce locally and also export goods and services,  Enable participants acquire negotiation and marketing skills for their good and services, Enable participants establish a market survey data bank and required products, Enable participants practically produce goods and services based on acquired technical skills to produce and meet identified market demands,
 Enable participants start and manage their own identified income generation project under
Mentorship for one year, Enable participants keep proper records, monitor and evaluate project performance

Student Internship program:
UCBHCA started an internship program in 2008 which is intended to induct young professionals into PHC and CBHC concepts as future development workers and leaders. This program has attracted many students from many Universities from countries including UK.

Developing Training Manuals:
The secretariat develops training materials and manuals for training health workers in the country and organizing workshops for training; National Facilitators, Trainers of trainers (TOTs), Nurses, Midwives, CHWs to equip them with technical facilitation skills in Primary Health Care, Community Based Health Care, Community mobilization, Community dialogue and empowerment and Behavior change communication just to mention a few packages, the rest are indicated below. We thank our current Donors and supporters USAID, Ministry of Health of Uganda. USAID/PHS, USAID/IntraHealth Strengthening Human Resources for Health which has donated new IT system to UCBHCA head office secretariat in Entebbe to establish Human resource information system to integrate
staff data from our health centers into the Ministry of Health Integrated Human Resource Information System for national planning and decision making.

Way Forward in the next Five Years:

New Five Year Strategic Plans 2018 - 2022:
In our new five year strategic plans we have planned to sustain all our past efforts to save
Mothers and babies at birth and in addition to the past work we shall intensify our efforts in
Implementing programs focusing on child growth and development from infancy up to teen age,

Reduce communicable diseases: Malaria, STI/HIV/AIDS, TB, MDR-TB, TB/HIV, malnutrition and stunting in children under five which currently at 33% and among vulnerable groups including people with disabilities and chronic illnesses,

Rehabilitate children and Adults with disabilities in the Community.
We are looking for partners to jointly improve the quality of life of mothers, children including people with disabilities in Uganda. Thank you