Introduction:

Familia Nawiri is a 2-year follow on Novartis funded partnership (July 2022-July 2024) implemented by the Uganda Protestant Medical Bureau. Familia-Nawiri is a Kiswahili translation for “Healthy Families” in line with the focus of the program. The partnership includes co-creation and execution of a pilot Health Program that encompasses population health approaches. This Health Program is implemented via a hub and spoke model; anchored on tertiary FBO health facilities under UPMB as the program hubs. Program year one focuses on building capacity for 12 hub facilities and its community structures while program year two will extend the program reach to build capacity at 24 targeted spoke facilities attached to the hub facilities. The program focuses on building awareness, capacity and service quality for select non communicable diseases.

Broad objectives of the Partnership: The Partners will collaborate to implement initiatives/interventions geared towards Disease Awareness and Education, Capacity Building and Training of HCWs as well as Sustainable Access to Quality Healthcare. Program Activities, Outputs and Outcomes: 12 Program Hubs in Year 1: Entry, awareness and capacity building activities for targeted therapeutic areas shall be implemented in year one at the 12 hub facilities and their communities.

Plus 24 Program Spokes in Year 2: The 12 hub facilities will be supported in program year 2 to build capacity at the selected 24 beneficiary (spoke) facilities in the targeted therapeutic areas.

Key activities:

1. Facility team trainings and mentorships
2. Community engagement support: dialogues, psychosocial support, awareness and referrals, media engagement
3. Learning sessions and cross learning visits
4. Provision of IEC materials
5. Engagement of leadership: Ministry of Health, Health facility and political leadership

Targeted program Sites:

Proposed Tertiary FBO Health Facilities under UPMB (Program Hubs):

The program shall implement a hub and spoke approach to providing technical support to lower-level health facilities. 12 UPMB member hospitals with specialized clinicians and experience implementing the respective clinics shall provide technical support to lower member health facilities.

The program hub facilities include: Mengo Hospital Rugarama Hospital Kagando Hospital Ngora Hospital Bwindi Hospital Kiwoko Hospita Kisiizi Hospital Kuluva Hospital Ishaka Hospital PAG Hospital Amudat Hospital Mukono COU Hospital

24 spoke sites will be supported to scale up learnings and experiences from the 1^st year of the program with support from the hub sites.

Overall expected impact of the Program:

1. Improved awareness on NCDs, referrals and access to target services
2. Quality improvement for target NCD services
3. Establishing Centers of Excellence
4. Building referral networks
5. Establishing community support structures
6. Scaled up best practices to be rolled out at the UPMB member facilities

The UPMB – Healthy Heart Africa Non-Communicable Diseases (NCDs) partnership is a two-year project, with a total budget of USD 500,000 funded by AstraZeneca, AZ. The project start date was 1^st July 2020 and ended 30^th June 2022. The project focused on capacity building for health workers and village health teams (VHTs) on prevention, screening, diagnosis and management for hypertension and COPD/ Asthma, community sensitization, healthy lifestyles and the need for early detection for hypertension and COPD/ Asthma; in addition to timely linkages to care as well as increased availability and access to affordable and quality medicines for hypertension and COPD/ Asthma.

The overall project goal was to contribute to the prevention and control of hypertension and COPD/ Asthma and decreasing the burden of cardiovascular disease (CVD) in Uganda by 2022. Program Objectives include;

• To empower health workers and VHTs with the right knowledge and tools to conduct comprehensive screening for hypertension and COPD/ Asthma at facility and in the community households by June 2022.
• To increase awareness and education on healthy lifestyles and prevention of CVD risk factors by June 2022
• To increase availability and variety of affordable quality medicine for hypertension and COPD/ Asthma by June 2022
• To decongest hospitals and drive care for hypertension and COPD/ Asthma to lower levels of care in the health system through establishment of comprehensive patient referral pathways using data by June 2022.

This project contributes to the Ministry of Health efforts to reduce premature mortality arising from Non-Communicable Diseases by 25% by 2025. The project is being implemented in 35 health facilities including 4 public facilities (3 regional hospitals and 1 district hospital), while the rest are UPMB Member Health Facilities (6 hospitals, 1 HC IV, 14 HC III and 9 HC II) in Mbarara, Mityana, Kampala and Jinja regions; the representation of the different levels of service delivery was purposed to allow effective referral pathways for hypertension and COPD/ Asthma cases.