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The Mild May Human Resources for Health project is a partnership between Uganda Protestant Medical Bureau (UPMB) and Mild-May Uganda. The health sector faces challenges of renumerations, retention, capacity development and motivation.
The project manages payroll for select health workers from Namutamba HC III and Lulagala HC III in Mityana district. The project also ensured the recruitment and retention of supported staff at 100% by July 2021.
Table 11: Supported Health Workers By Cadre
| Cadres | Number | No of facilities |
| Clinical officers | 2 | 2 |
| Enrolled midwives | 1 | 1 |
| Total | 3 | 3 |
UPMB implemented the Uganda Health Systems Strengthening in partnership with Palladium. The project supported 86 health workers in 39 health facilities in 11 Dioceses. The benefiting dioceses include; Ankole, Kinkiizi, West Ankole, Busoga, North Karamoja, Mbale, Kitgum, North Kigezi, Kigezi, Lango and Sebei. Under this project, five hospitals benefited namely, Bwindi, Kisiizi, Rugarama, Rushere and Ruharo hospital.
Table 10: Supported Health Workers By Cadre
| Cadres | Current Number |
| Medical Officers | 4 |
| Clinical officers | 7 |
| Lab Technicians | 4 |
| Lab Assists | 2 |
| Enrolled Nurses | 44 |
| Enrolled midwives | 25 |
| Total | 86 |
The Human Resource for Health is implemented by Uganda Protestant Medical Bureau under the Inter-Bureau Coalition (IBC) with the purpose of recruiting and retention of high caliber human resource; managing payroll and providing support to participating health facilities to institute human resources standards.
| District | Cadre | |||||||
| Clinical | Laboratory | Pharmacy | Management | Social service | Lay | Other | Total | |
| Bundibugyo | 4 | 1 | – | – | 1 | – | 5 | 11 |
| Bunyangabu | 5 | 1 | – | – | 1 | – | 4 | 11 |
| Kabarole | 25 | 8 | 1 | 9 | 10 | – | 13 | 66 |
| Kamwenge | 6 | 2 | – | – | 3 | – | 7 | 18 |
| Kasese | 41 | 11 | – | 1 | 35 | – | 39 | 127 |
| Kyenjojo | 9 | 2 | – | – | 8 | – | 8 | 27 |
| Kyegegwa | 5 | – | – | – | – | – | 3 | 8 |
| Kitagwenda | – | – | – | – | – | – | – | – |
| Ntoroko | 3 | – | – | – | – | – | 2 | 5 |
| Overall | 98 | 25 | 1 | 10 | 58 | – | 81 | 273 |
Table 8: Number of PEPFAR Supported staff by cadre by the end of the year July 2020-June 2021.
Strengthening UPMB Member Health Facility Systems for Sustainability (SUMS) is a three (3) year project, Project No. A-UGA-2019-0104 with a total budget of €1,380,000 funded by Bread for the World (BFdW) – €1,000,000 (72.46%) with co-financing from UPMB of €380,000. The project commenced on 1st March 2019 and is expected to end in February 2022.
The Project GOAL is: A healthy and productive population that contributes to socio-economic growth and national development through quality universal and accessible health care.
The project objectives are:
(a) Strengthened Health Systems with a special focus on the Lower level Member Health Facilities by 2022.
(b) Strengthened research, innovation, learning and adaptation within UPMB and MHFs by 2022
(c) Strengthened Strategic Partnerships, Advocacy and Networking by 2022.
UPMB recognizes that as an organization that serves those mostly in rural and remote areas, many of the people in these target areas are often unable to pay out of pocket for the services they need, and often make difficult decisions about accessing health care that perpetuate ill-health or result in poverty. UPMB intends to seek effective alternatives in order to provide rural households a permanent solution to the problem of accessing health care. UPMB facilities are currently working on a cost sharing basis where all clients that visit these facilities contribute a very minimal token in form of user fees for the services. Research has proved that this model is not effective in promoting access and utilization of health care services.
Through Community Health Insurance (CHI), communities contribute a premium fee (subscription, usually at flat rate) towards their medical treatment to a specified medial facility. These schemes allow funds to be pooled to reduce financial barriers for those who need to use services they could not otherwise afford. These CBHIs mainly offer emergency care but not chronic care. The CBHIs have helped to create community ownership and organized structures that facilitate the implementation of primary health care by incorporating public health and behavior change initiatives through these pathways. Additionally, the public health and health promotion activities are made possible and sustained through the CBHIs premiums. This is seen as a good investment in promoting health and well-being of communities while greatly reducing the burden of disease and improving health seeking behavior.
At the national level, UPMB is actively involved in advocating for the mainstreaming of CHIs into the NHIS with partners such Health Partners, Save for Health and other Medical Bureaus. UPMB strives to improve access to health care among the poor; and protect the poor from indebtedness and impoverishment resulting from medical expenditures. CHI schemes involve prepayment and the pooling of resources to cover the costs of health-related events.
UPMB CHI schemes generally targets low-income and quite diverse populations, ranging from people living in the same town or district, to members of a micro-finance groups. These schemes are implemented by member health facilities, and target residents from the surrounding area. CHI initiatives are based on the following characteristics: voluntary membership, non-profit objective, linked to a health care provider (often a member health facility in the area), risk pooling and relying on an ethic of mutual aid or solidarity. This solidarity and trust stir up members who are susceptible to risk to put together their resources for common use. Therefore, UPMB supports its member health facilities to identify and leverage on the already existing social capital in the communities it serves.
Overall goal: To increase access to affordable quality health services in communities through establishing functional Community Health Insurance Schemes in at least 80% of the Member Health Facilities.
Objectives:
More than 42 facilities within the UPMB network have ongoing prepayment schemes in the form of Community Based Health Insurance schemes with a membership of 96,192 individuals enrolled. UMPB has a network of 302 health facilities. Majority (80%) of these are located in rural and remote areas and include 19 hospitals; 10 Health Training Institutions; 10 HC IVs; 263 lower-level health facilities.