HEALTH AND DEVELOPMENT AGENCY UGANDA

HHHHEE

STRATEGIC PLAN 2012-2016

TRANSFORMING COMMUNITIES

TABLE OF CONTENTS.
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LIST OF ACRONYMS ACKNOWLEDGMENTS... EXECUTIVE SUMMARY

1. INTRODUCTION 2. SITUATIONAL ANALYSIS..

3. STRENGTHS, WEAKINESSES, OPPORTUNITIES AND THREATS. 4. STRATEGIC DIRECTION..

5. STRATEGIC INTERVENTIONS.. Key Thematic area 1: INNOVATIVE HIV/AIDS PREVENTION APPROACHES AND ACCESS TO ADOLESCENT REPRODUCTIVE HEALTH.. Key Thematic Area 2: QUALITY RESEARCH FOR INFECTIOUS DISEASE PREVENTION , OVC PROGRAMMING AND COMMUNITY DEVELOPMENT. Key Thematic Area 3: HEADA UGANDA TECHINICAL AND MANAGEMENT CAPACITY BUILDING.. Key Thematic Area 4: COMMUNITY DEVELOPMENT..

6. ASSUMPTIONS AND RISKS.

7. KEY THEMATIC AREAS MONITORING.. 8. RESOURCE MOBILISATION AND MANEGEMENT.

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APPENDIX I. STRATEGIC INTERVENTIONS LOGICAL FRAME WORK. APPENDIX II: CONCEPTUAL FRAMEWORK

LIST OF ACRONYMS

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ACKNOWLEGEMENTS

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EXECUTIVE SUMMARY

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PART 1. INTRODUCTION. 1.1 Background 1.2 Mandate 1.3 Achievements 1.4 Contextual Analysis. 1.4.1 The Uganda National Development Plan. Ugandas vision 2035 is a transformed Ugandan economy from a peasant to a modern and prosperous economy with in 20 years (NDP 2010/11-2014/15). The NDP highlights critical issues to be addressed with HIV/AIDS, OVC, Reproductive Health and prosperity for all forming just a small fraction. The theme for HEADA Uganda Strategic Plan 2012-2016, Transforming Communities is in tandem with the Vision of the NDP mentioned herein. HEADA Uganda will contribute to the following objectives of the NDP; Objective 1: Increasing household incomes and promoting equity Objective2: Increasing access to quality social services. This includes a reduction in incidence of communicable diseases particularly HIV/AIDS. 1.4.2 The Millennium Development Goals. HEADA Uganda works towards contributing to the fulfillment of MDGs number 1, ,5 and 6 which includes eradication of extreme poverty and hunger, improving maternal health and combating HIV/AIDS, malaria and other diseases respectively, of which Uganda is a signatory. MDG1: To reduce extreme poverty and hunger. We will strive to deliver on target1A (Halve the proportion of people living on less than 1 dollar per day). MDG5: Improve maternal health. HEADA Uganda will focus on contributing to Target 5B i.e. Achieve universal access to reproductive health by 2015. MDG6: To combat HIV/AIDS, Malaria and other diseases. HEADA Uganda will over the next five contribute to the achievement of the following targets;
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Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS, Target 6C: Have halted and begun to reduce the incidence of malaria and other diseases. 1.4.3 The National Health Policy; Page | 7 The Health Sector Strategic Plan III 2010/11-2014/15 is a policy frame work with a goal of attaining a good standard of health for all people in Uganda in order to promote a healthy and productive life. The HSSP III highlights Reproductive health, Child health, Health Education and promotion, Control and prevention of HIV/AIDS, Malaria and Tuberculosis and Health Systems Strengthening as key result areas. HEADA Uganda will over the next five years contribute to the delivery of clusters 1, 2,3, 4 and 6 of the Uganda Minimum Health care package which is one of the guiding principles of HSSP III. Cluster 1: Health Promotion, Environmental Health and Community-based initiatives. Cluster 2: Maternal and Child health Cluster 3: Communicable Disease control. Cluster 4 Cluster 6 The vision of NSP 2011-2015 Zero New infections, Zero discrimination and Zero AIDS related deaths by 2015 identifies increased adoption of safer sexual behaviors, attaining critical coverage & utilisation of biomedical interventions, a strengthened and enabling sustainable environment that mitigates underlying factors that drive the HIV epidemic and strengthened information systems for HIV prevention as key result areas and its objectives that HEADA Uganda will contribute to include; Objective 1 : To increase adoption of safer sexual behaviors and reduce risk taking behaviors. Objective 2: To expand critical coverage of biomedical prevention interventions. Objective 3: To create a sustainable enabling environment that mitigates underlying socio-cultural and other structural drivers of the epidemic. Objective 5: To strengthen information systems for HIV prevention at all levels. The Adolescent Health Policy Guidelines and Service Standards 2011 will shape HEADA Ugandas Adolescent Reproductive Health promotion frame work with the ultimate goal of mainstreaming adolescent health concerns in the National
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Development process in order to improve their quality of life and standards of living. The following objectives of adolescent policy will be put into perspective as HEADA Uganda implements this strategic plan. Objective1: To provide and increase availability and accessibility of Page | 8 appropriate, acceptable, affordable quality information and health services to adolescents. Objective 2: To influence positive behavioral change among adolescents. In the next five years, HEADA Uganda will contribute to the process of underpinning the Core Program Areas (CPAs) stipulated in the NSPPII 2011/122015/16 with particular emphasis on OVC household Economic Strengthening. HEADA Uganda will contribute to the delivery of the following objectives of the NSPPII. Objective1: Strengthen the capacity of families, caregivers and other service providers to protect and care for orphans and other vulnerable children. Objective2: Expand the provision of essential services for orphans and other vulnerable children, their caregivers and families/households. 1.5 The Strategic Planning process With the ultimate desire of creating a transparent priority setting process, HEADA Uganda used an inclusive and participatory process to develop this five year strategic plan. The process was divided into three phases; Phase 1: Establishment of Strategic plan Development Steering Committee (SPDSC). This included technical staff from the HEADA Ugandas executive and Board members. The committee was chaired by the Executive Director. The committee adopted a four steps classical approach to strategic plan development. Step 1: Where are we now? Step 2: Where do we want to get to? Step 3: How are we going to get there? Step 4: How will we know when we get there?. Under step 1(Where are we now?), The committee resolved to do the following in phase 2 and three; Situational Analysis. This was to be done in terms of the organisation profile, previous strategies, financial assessment to establish the stability of the funding sources, and governance structure.
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 Stakeholders Analysis.

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This was done to identify individuals and organisations that the committee considered key in the draft and implementation of the Strategic Plan and utilize them using the matrix above adopted from Sally Markwell. PEST trends analysis. It was agreed that this assesses the external environment by breaking it down into what is happening at the Political, Economic, Social, and Technological levels. Benchmarking. The committee also resolved that comparison of HEADA Ugandas work with peer organisations in the specific areas be done and put into context during the drafting process. SWOT Analysis This was to be done to identify Strengths, Weaknesses, Opportunities and Threats. Under Step2 (Where do we want to get to?), the SPDC planned to develop the strategic direction including the Vision, Mission raison dtre, Core values, guiding principles, and strategic objectives meeting the SMART criteria. Under Step 3(How are we going to get there?), the SPDC agreed to develop Implementation strategies, risk identification and forecast necessary resources. This would be the route map to step 2 above. Under Step 4 (How will we know when we get there?), the SPDC recognized that it was prudent to develop an M&E matrix to track the progress as well as
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adoption of the PDSA(Plan Do-Study-Act)model to encourage timeliness and flexibility during the next five years as HEADA Uganda delivers on its strategic objectives. The SPDC designed a timeline and action steps to effect the above plans.
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Phase 2: Strategic plan Design Workshops. Three workshops were held and the above were discussed following a vigorous literature and Government of Uganda policy document review that progressively resulted into the final draft of the strategic plan. This involved the Board Members (some were contacted online), the Executive and the ordinary members. Phase 3: Strategic Plan Validation exercise. This phase involved careful review of the draft plan that was edited to produce the final document. PART 2. SITUATIONAL ANALYSIS. Uganda has a rapidly growing population, currently estimated at 30 million with a growth rate of 3.3%,the second highest in the world. The population is predominantly young with 50% under age of 15 years(UBOS 2006). The sustained economic growth in Uganda has since 1990 contributed to a progressive reduction in poverty levels with number of people living below the poverty line reducing from 56% in 1992/93 to 31% in 2005/06, despite this significant progress, the current poverty levels are unacceptably high(UBOS 2008). Of the Ugandas 31% under the poverty threshold, 62% are children. According to the OVC situation analysis report 2010, the level of vulnerability is at 96% National wide largely attributed mainly to poverty and ,HIV/AIDS, which far outstrips the fragmented National response to the key drivers of children vulnerability (NSPP II 2011/12-2015/16). The magnitude of child vulnerability in Uganda with 2.43 million orphaned of whom 45.6% are due to HIV/AIDS and 105,000 children between the ages of 0-14 years are HIV Positive ,elimination of this growing tragedy needs concerted efforts and HEADA Uganda will over the next five years strive to ensure that OVCs are supported according to prevailing National guidelines . Orphan hood in Uganda remains a big challenge with the
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proportion of children that are orphaned increasing from 11.5% in 1999/2000 to 14% in 2009/2010 For a quarter of a century, Uganda is experiencing an HIV/AIDS epidemic which Page | 11 is now mature and generalized with 1.2 million people infected,57% of them female and 13% children under 15 years (MoH 2010) . At the height of escalating number of new Human Immunodeficiency Virus Infections, estimated at 124,000 in 2009 and 128,000 in 2010, the number of eligible patients receiving ART is less than 50% which is far outstripped by number of new infections(NSP 2011-2015). The Ministry of Health also estimates that in 2005 alone, about 132,500 people got infected with HIV, including 27,000 of them through motherto-child, its worth noting that 60% of new HIV infections occur with in marriage. Cumulatively, I million Ugandans have died from AIDS since its advent, spawning about 2 million orphans in its wake. The prevalence of HIV in Uganda is estimated to be 6.4%(UHSBS 2004-2005) and current estimates show that prevalence is still the same but absolute numbers of infected people is increasing perpetuated by high population growth rate. This status quo is as a result of key drivers of the epidemic which include multiple concurrent partnerships, couple sero-discordance, lack of SMC, and high risky sexual behaviour. More recent data also show heterogeneity of HIV prevalence among population groups with sex workers at 37%(Vandepitte et-al 2011), fishing communities at 22%( Opio et-al 2011), men who have sex with men 13% and men who operate motor cycle transport/Boda Bodas at 8%(MUSPH&CDC 2009). The NSP 2011-2015 alludes that long distance truck drivers are among the MARPs mentioned above but their HIV burden has not been well studied. HEADA Uganda will over the next five implement interventions to curtail the growing epidemic putting particular emphasis to key drivers of the epidemic and combination prevention strategies. This 5 year strategic plan represents HEADA Ugandas renewed zeal to make a significant contribution to Adolescent reproductive Heath, through contributing to the national efforts expedited for the purposes of achieving Objectives number 1, 2, 3,5,and 6 of the Adolescent Health Policy and Service Standards 2011. The provision of quality information and friendly health services to adolescents will be the overarching goal central to this endeavor. PART 3. STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS STATUS WAY FORWARD
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STRENGTHS. a)Governance. The organisation is blessed with a team of competent founders, board of directors, with vast experiences in health, resource mobilization, financial compliance, leadership, public health, and strategic partnerships. b) Policies and Systems. HEADA Uganda has sound Human Resource policy manual and Financial Policy manual. The duo guide the organisation in management and development of Human resources and financial compliance respectively. In addition, a sound performance evaluation system that is frankly transparent enables the organisation to continuously monitor and improve work products. c)Relevance. The organisations Key thematic areas are in tandem with the national plans making them relevant for donor support. WEAKINESSES.

All the strengths have been applied in setting the strategic interventions. In the vanguard match of progress towards our undivulged destination, these strengths are the milestones, levers and keys that will unlock untapped opportunities for growth.

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This strategic plan presents an opportunity for HEADA Uganda to a) Governance and structures re-invigorate our business acumen are not yet matching best over the next five years to deliver practice. The manuals are not on the Key Thematic Areas yet fully operational. mentioned herein, a yardstick unto which our success shall be b) Measurement of HEADA measured. Ugandas contribution to local districts response to
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infectious disease, OVC, and community development is a big challenge.

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c) Lack of fulltime staff committed to the work of the organisation day in, and day out. This is because the grants received by the organisation are small and not covering overheads and salaries. d) Dependency on donor support makes the organisation vulnerable to changing donor priority areas of focus. OPPORTUNITIES a)Relevance. HEADA Ugandas Key Thematic Areas are in line with the national priority areas of focus which include Malaria, HIV, Reproductive Health, Organic farming and Community development. b) Advocacy for funding. HEADA Uganda has strategically selected Key Thematic areas that the donor community is interested in. c) Management Capacity Strengthening. HEADA Uganda is on the vanguard of attracting quality staff who will
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These opportunities have been put into perspective as HEADA Uganda developed its strategic direction.

accentiuate,re-invigorate and consolidate its strategic direction. THREATS

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a)Competition HEADA Uganda is competing with other organisations implementing similar projects in malaria, reproductive health, HIV and Community development. b)Global Economic Down turn The global economic crisis that recently spread across the globe has resulted into a dwindled amount of monies available to donor agencies. c)Staff attrition. The current statusquo at HEADA Uganda makes it difficult to retain high quality personnel due to inability to cover overheads and salaries. d)Political Instability. The political instability in Africa for example Somalia and the recent terrorism threats to Uganda, may erupt into social unrest making it difficult for HEADA Uganda to execute its activities.

Strategic partnerships for responding to Funding Opportunity Announcements(FOAs), as consortia will take HEADA Uganda a long way to circumvent some of these stumbling blocks. Some of the threats that are with in HEADA Ugandas sphere of control have been incorporated in the strategic interventions.

PART 4. STRATEGIC DIRECTION

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HEADA Uganda has identified four Key Thematic Areas as priority areas of intervention over the next five years guided by the following vision, mission and core values. 4.1 Vision Page | 15 To be a regionally recognized leader in promoting health and development in south western Uganda. 4.2 Mission To play a leading role in empowering communities to synthesize peoplecentered, feasible, sustainable, evidence-based and innovative solutions to community problems. 4.3 Core Values a) Dynamism Innovativeness and being visionary will be the overarching driver of HEADA Ugandas interventions in the next five years. b) Altruism HEADA Uganda treasures human beings in the implementation of its programs and will continue to do so with no discrimination. c) Transparency HEADA Uganda will continue to engage with stakeholders in its interventions at all stages and accountability to the communities we serve will be the Achilles heel of our anticipated growth. d) Efficiency Cost effectiveness and doing more with less will be the central principle of HEADA Ugandas interventions over the next five years. 4.4 Guiding principles.

a) To develop replicable, sustainable and feasible Infectious Disease prevention and care models and systems particularly for MARPs. b) Doing more with less. HEADA Uganda will strive to seek effectiveness, value for money, transparency and accountability. c) To develop strategic, mutually beneficial local, regional, national and global partnerships for purposes of leveraging efforts in tandem. d) Community-based people centered interventions will enable coherent and concerted response to Infectious Diseases particularly HIV/AIDS, Improve
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access to Reproductive Health, Promote Organic Farming and Value addition, and reduce the suffering of OVCs. e) Collaboration, Learning and Adapting (CLA); documentation of best practices and innovations as well as collaboration with other development Page | 16 partners to replicate tested and successful interventions for purposes of avoiding duplication of efforts and developing a cohesive response. Part 5. Strategic Interventions. In order to make a recognizable contribution to attainment of the governments current five year plans and policies and taking into account to the identified realities, HEADA Uganda will continue to deliver under the following four Key Thematic Areas. Key Thematic Area 1: Innovative HIV/AIDS prevention approaches and increased access to quality Reproductive Health Services. Goal: To contribute to achievement of Ugandas NSP 2011-2015 vision of zero new HIV infections, zero discrimination and zero related AIDS deaths, and improve access to reproductive health. Strategic Objective 1.1: To increase uptake of safer sexual behavior and facilitate reduction in risky sexual behavior. The ultimate outcome of risky sexual behaviors including Multiple concurrent sexual partnerships, transactional sex, Men who have sex with Men(MSM), incorrect and inconsistent use of condoms, cross generation sex, casual sex, extra-marital sex ,widow inheritance and wife replacement is an escalation in the level of new HIV infections. Key Milestones. i. Percentage reduction in level of Multiple concurrent sexual partnerships. ii. Number of people using condoms during risky sexual encounters. iii. Percentage reduction in the level of cross generation sex. iv. Percentage reduction in the number of people practicing transactional sex. v. Number of people who engage in sex for the first time at 18 years. Implementation Strategies. i. Promotion of and increasing access to Social Change and Communication interventions(SCC) to address cultural and societal norms, practices and values that affect individual behavior. This will address contextual factors driving the HIV Epidemic including widow inheritance, wife sharing, early marriages, excessive alcohol intake, and domestic/ sexual violence,
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Promotion of peer-led communication for behavioural change and building the capacity of BCC community-based groups through effective IEC. This will include age-appropriate behavioural change interventions as well as interventions for MARPs including Boda-Boda cyclists, fishing communities, Page | 17 MSM, widows, CSWs, and OVCs among others. iii. Adoption and promotion of strategic linkages and networks so that vulnerable groups access livelihood and economic empowerment. iv. Expansion and promotion of PHDP (Positive Health, Dignity and Prevention) to prevent onward transmission of HIV among PLHIV. This will be ensured through M/GIPA in HEADA Ugandas interventions, and distribution of IEC materials on PHDP giving messages on the implications of acquiring new viral strains as regards development of drug resistance and ARV treatment failure. Rationale The trend of HIV epidemic in Uganda can be divided into three phases Phase I, 1980s to 1992 which was characterized by rising HIV prevalence with antenatal HIV prevalence of 25%. Phase II, 1992 to 2000, which was characterized by declining HIV prevalence which was attributed to increased age of sexual debut, reduction of sexual partnerships, faithfulness among married couples and correct and consistent condom use. Phase III 2000 on wards has been characterlised by a stable HIV prevalence rate of 6-7% ( Kirungi W.L. et-al 2006). The decline in HIV prevalence in 1992-2000 in Uganda was due adoption of safer sexual behavior ,and its against this background that HEADA Uganda seeks to contribute to a reduction of new HIV infections in south Western Uganda over the next five years. Strategic Objective1.2: To contribute to increased critical coverage and utilization of biomedical prevention interventions. The key biomedical interventions include; SMC, PMTCT, PrEP, PEP, ART, condom promotion, STI treatment and prevention and, Family Planning Key Milestones i. The proportion of adult males who are circumcised. The proportion of adults who test for HIV and receive their results . ii. The percentage of HIV positive mothers and their exposed infants who access PMTCT according to national guidelines. iii. The proportion of adults using condoms consistently during risky sexual behavior.
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ii.

The proportion of discordant couples using at least one biomedical intervention. Implementation Strategies . i. Improving access to and quality of HIV testing and counseling through Page | 18 modalities that will include but not limited to; home-based HCT, Community camping for HCT targeting MARPs, PICT, among others. Among the fundamental pillars of combination prevention of HIV is HCT since its an entry point for most of the other biomedical interventions like SMC, PMTCT,ART and others. In Uganda, 57% of HIV Sero-positive individuals have HIV Serodiscordant partners(Gray et al 2001), and this signifies that the country urgently needs intervention targeting discordant couples given the low rate of condom use in marriages and long term relationships. ii. Increasing coverage and effectiveness of PMTCT with regard to the four prongs of PMTCT which include; primary prevention of HIV women of reproductive age and their partners, provision of family planning for HIV positive women, HCT and HAART for pregnant mothers living with HIV and their exposed infants (Option B). Over the next five years, HEADA Uganda will implement interventions to increase ANC attendance ,male partner involvement in ANC and PMTCT, referrals and linkages for HIV Sero-positive mothers and their exposed infants , community involvement through support groups for stigma reduction and accentuation of PMTCT uptake. iii. Increasing access to SMC through outreaches, surgical camps, mobile teams, and formation of peer driven SMC clubs at the community level. The 2004/5 UHSBS found 25% of males were circumcised national and only 7.6% in South Western Uganda were circumcised. Targeted communication through use of different media including radios, news papers, IEC materials and bill boards will be employed to increase up-take of SMC. iv. Promotion of proper and consistent use of condoms. This will involve interventions that will set the ball rolling to underpin barriers to condom use including ; stigma and inaccessible outlets. Currently the outlets for condoms include clinics, supermarkets, pharmacies, shops , hospitals and drug shops. Over the next five years, HEADA Ugandas will implement interventions to diversify condom distribution outlets tailored to prevailing situations, for example saloons, Bars, Hotels, Lodges, and night clubs. The distribution will also address gender issues including increasing access to female condoms to enable women negotiate safer sex and targeted condom distribution to
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iv.

MARPs including CSWs, Boda Boda operators, Long distance truck drivers, and fisher folks. Rationale:
Page | 19 Strategic Objective1.3: To contribute to creation of a sustainable and feasible

enabling environment for HIV prevention. The factors that act as stumbling blocks to HIV prevention include cultural, social and economic features of the environment (Gupta et al 2008). There are several contextual factors that act indirectly to influence individual behavior or vulnerability to engage in high risk sex or unprotected sex. They include; Socio-economic and cultural Factors; like poverty that fuels transactional sex, excessive alcohol in take with Uganda ranking highest in the world in the area of alcohol consumption, early marriages, widow inheritance, wife sharing especially among the Bahiima clan, and gender/sexual violence. Key Milestones i. Percentage of women who make decisions on the sexual and reproductive health independently. ii. Percentage reduction in widow inheritance iii. Percentage of survivors of SGBV accessing care. Implementation Strategies. i. Advocacy for change in cultural and social norms driving the HIV epidemic. This will be achieved through involvement of cultural, religious leaders, and local government leaders. ii. Integration of HIV prevention activities in community activities for example marriage ceremonies, funeral rites, and worships as well as organized groups like Savings and Credits associations, Informal Savings groups, farmers groups like the NAADS Farmers Forum and community Funeral associations. This will be implemented through peer education and community based support groups/clubs. iii. Building the capacity of VHTs to engage in community mobilization and sensitisation as well as referrals for HIV prevention services. Strategic Objective 1.4: To promote interventions geared at Health Systems Strengthening . The coordination of HIV /AIDS response at the community, District and national level has constraints , and is not well streamlined to curtail the epidemic. HEADA Uganda will over the next five years contribute to the consolidation of Health Systems in South Western Uganda at the community, Health Facility and District
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level. Its unfortunate that the unprecedented political leadership that saw a dwindling HIV prevalence in the I990s taking Uganda to the lime at the global scene has now dwindled to a trickle too. It should be apparent henceforth that rejuvenating such political leadership in HIV/AIDS response will have farPage | 20 reaching effects in reducing the prevalence of HIV which is currently static but alarmingly high with heterogeneity. Key Milestones. i. Proportion of Districts whose DATs receive capacity building support from HEADA Uganda. ii. Proportion of Districts whose PLHIV networks receive support from HEADA Uganda at village, Parish, Sub-county and District level. iii. Percentage of local government leaders and civil servants receiving capacity building training from HEADA Uganda. Implementations Strategies i. Strengthen HIV coordination at village, parish, sub-county and District levels. ii. Track the overall impact of HIV prevention based on surveys and data disseminated to stakeholders annually. Rationale Strategic Objective 1.5: To improve access to Reproductive Health services. Key milestones i. Proportion of women of reproductive age who access family planning methods. ii. Proportion of adolescents receiving adolescent friendly services. iii. Number of advocacy meetings held with the District Committee on Adolescent Health (DICAH). Implementation Strategies. Communication for behavioural Change. This will be intended to dispel myths and misconceptions about family planning, harmful cultural and social norms in the context of reproductive health. Establishment of an adolescent resource centre. HEADA Uganda will over the next five years seek to establish an adolescent resource centre that will have facilities for vocational training, recreational activities, an adolescent and young persons clinic dealing with reproductive health issues including provision of emergency contraception services, post abortal care services, and STI treatment.
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i.

ii.

iii.

iv.
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Establishment of referral linkages and networks to create an enabling environment that decreases vulnerability of adolescents, young persons and women of reproductive age. Establish family planning outlets at the community level through building the capacity of health workers at the lower units and organizing outreaches for delivery of planning services. Rationale

Source: UDHS 2006. The Uganda demographic Health survey is a tool that is used to measure progress on some the vital indicators of health namely total fertility rate (TFR), Contraceptive Prevalence Rate (CPR), Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR) among others. The figure above generally shows that between 1995-2006 , CPR increased from 15.4% to 24.4%, but this is still unacceptably high. The reasons for this status quo are complex and need a multi-faceted and concerted approach which HEADA Uganda intends to adopt. The TFR has not changed much from 6.9 to 6.5 in 1995 and 2006 respectively, this contribute to high population growth rate, making it difficult for the G.o.U to provide social services as the population far outstrips the Gross Domestic Product(GDP).

Rationale:
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Key Thematic Area 2: Quality Research for Infectious disease prevention , OVC programming and community development. Page | 22 Goal: To contribute to national efforts geared at venturing into new and potentially effective prevention modalities and new approaches to OVC programming and community development in south western Uganda. Strategic Objective 2.1: To develop, pilot, and scale up evidence-based infectious disease prevention and community development modalities. Key Milestones i. Number of on- going studies. ii. Number of published articles in reputable journals.

i. ii.

Implementation strategy: The HEADA Uganda grants searching and writing committee shall vigorously look for research grants in infectious disease prevention. The Directorate of Research programs shall seek to initiate and maintain good relationships with reputable journals to foster publication of our work, while maintaining the quality of research.

Rationale: Strategic Objective 2.2: To contribute to the national response to reach critically and moderately vulnerable children. Key Milestones i. Proportion of families, care givers and other service providers whose capacity is strengthened to protect and care for OVCs. ii. Proportion of OVCs, their households, and households accessing essential services. iii. Proportion of OVCs , their care givers and households accessing legal services. Implementation Strategies. i. Supporting and strengthening the capacity of households and other caregivers to protect and care for OVCs. HEADA Uganda will implement interventions for sustainable economic empowerment, and food security systems for OVCs and their households.
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Strengthening community-based responses for the care, accessibility to social services, legal services and protection of OVCs. Attempts shall be made to improve early identification of OVCs and developing the capacity of the communities to respond to their needs. Page | 23 iii. Strengthening research and strategic partnerships for quality OVC programming. HEADA Uganda shall seek to develop, pilot and scale up replicable best practices and approaches to OVC programming. Key Thematic Areas 3: Technical and Management capacity of HEADA Uganda Goal: To create a robust , strengthened human resource and institutional capacity that can stand the test of time as HEADA Uganda delivers on its key thematic areas. Strategic Objective3.1: To strengthen HEADA Ugandas governance structures and systems to underscore the Key Thematic Areas. Key Milestones i. Number of HEADA Uganda Board Steering Committee meetings held to review HEADA Ugandas performance and progress reports thereof submitted to the Executive Committee for implementation of recommendations. ii. Number of HEADA Ugandas Resource Mobilisation Committee meetings held and number of development partners contributing to HEADA Ugandas funds. iii. Proportion of positions of the Board and the Executive filled by persons of distinguished caliber, skill and irrevocable achievements in management, Research, Infectious Disease Control and Prevention, OVC,Organic Farming, Community Development and Resource Mobilization & Management. iv. Proportion of staff facilitated to undertake training in technical and management aspects. Implementation Strategies. i. Strengthen , and fully operationalise HEADA Uganda management systems and structures. ii. Mobilize and sustain human, material and financial resources. iii. Periodic preferably annual review of HEADA Ugandas relevancy, effectiveness, performance scored against set targets and designing of annual work plans that puts the aforementioned in context. Rationale
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ii.

Key Thematic Area 4: Community Development Goal: To create a society where people are empowered to meet the basic needs of life in a sustainable and environmental friendly manner.
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Strategic Objective 4.1: To contribute to the national efforts for prosperity for all through promotion of organic farming and value addition and other proven interventions Key Milestones i. Number of agricultural technology incubation centers (ATICs) established. ii. Number of breeds and crop varieties promoted for use by farmers. Implementation Strategies To ensure effective delivery of advisory services and improve technology for increased agricultural production. Agriculture has for a long time been a core sector in Ugandas economy in terms of its contribution to GDP and employment. Agriculture contributed 47% of total exports in 2007 and 23.7% of GDP in 2009. There is evidence that if agriculture grew at a rate of 2.8% per year, the poverty rate in Uganda would be reduced to 26.5% by 2015(Benin et-al 2007). Table 1 Type of Live Uganda Western Region % contributed stock by Western Region Exotic Cattle Goats Sheep Chicken Local Cattle 10,643,620
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i.

700,030 151,839 25,240 4,609,310

317,850 51,037 5,930 481,500

45.4 33.6 23.5 10.4

2,212,210

20.8

Goats Sheep Pigs

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12,278,220 3,385,130 3,184,300 32,834,580

3,380,297 561,480 778,350 6,728,620

27.5 16.6 24.4 20.5

Chicken

Source: UBOS 2009, The National Livestock census 2008. As can be seen from table 1 above, western Uganda contributes significantly to the GDP through agriculture. Over the next five years, HEADA Uganda will strive to strengthen this contribution through farmer centered technologies and technical assistance for increased agricultural production including farm-field schools where research is carried out on farmers fields for neighbouring farmers to visit regularly and learn new approaches to farming and value addition including promotion of better breeds and crop varieties. Strategic linkages and partnerships with NARO, NAADS and micro-finance institutions will be created to leverage cohesive efforts to foster agricultural productivity. This shall also include support for bee keeping through provision of technical assistance on issues like spacing of hives, harvesting of honey in a way that is friendly to the environment, processing and packaging honey. There shall also be efforts to promote fish farming to provide alternative sources of income. ii. Promotion of commodity chains and agribusiness development, this shall be designed to enhance producers knowledge in areas of quality control, postharvest management and marketing, and to provide the associated technical expertise and infrastructure, including in agroprocessing. It also aims to promote agribusiness development Strategic Objective 4.2: To empower indigenous people to start small scale enterprises (SMEs) that are sustainable and profitable. Key Milestones i) Number of SMEs receiving support from HEADA Uganda. ii) Number of people employed by the supported SMEs. iii) Number of Savings and Internal Lending Groups formed at the community level. Implementation Strategies

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i)

ii)
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Establish operational Business Development Services (BDS) in targeted areas to offer access to finance training, market information, business advisory clinics, market information and training on bookkeeping. Put in place mechanisms to enable SMEs access business financing through Savings and Internal Lending groups and linkages with microfinance institutions. Rationale

Three out of four poor people in developing countries live in rural areas. Most rely directly or indirectly on agriculture for their livelihoods. Agricultural development is vital to achieving the Millennium Development Goals, particularly those related to poverty and food security and to environmental sustainability. Agriculture contributes to development as an economic activity, as a source of livelihoods, and as a provider of environmental servicesroles that were spelled out in substantial detail in the 2008 World Development Report Agriculture for Development (World Bank 2008a) Business cluster development is widely regarded as one of the most effective ways of encouraging and supporting inter-firm collaboration, institutional development and industry-wide growth. Such collaboration can optimize SME structures and facilitates utilization of knowledge and expertise and access to the latest technologies, equipment and financial products and services. PART 6. RISKS AND ASSUMPTIONS. 6.1 RISKS a) Failure to secure the required resources including human and financial may impede the achievement of our strategic objectives. b) Political instability may erupt in western Uganda making it difficult to implement HEADA Uganda activities. c) Change in government policies may make it difficult to implement HEADA Uganda activities through for example public private partnership (PPP). 6.2 ASSUMPTIONS a. Donors will remain committed to funding HIV, Reproductive Health, OVC, Organic Farming and Value addition, SME development and Research. b. HEADA Uganda will be able to recruit and retain skilled human resource c. There will political stability in Uganda PART 7. KEY THEMATIC AREA MONITORING. The performance of HEADA Uganda shall be judged by achievement of its objectives, outputs and by use of Objectively Verifiable Indicators (OVIs) mentioned hereafter in the Log frame matrix.
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HEADA Uganda will develop a monitoring and evaluation system to track progress towards achievement of the stated objectives and goals of this strategic plan. The HEADA Uganda Board Steering Committee will provide guidance on the Page | 27 road map towards achievement of the set goals and objectives. The Executive committee will meet monthly to review performance and will compile a quarterly report which will be reviewed by the Board steering committee which will meet quarterly to discuss the reports and make recommendations on the way forward. Annual M&E reports will be generated by the Executive under the leadership of the M&E officer and these will provide benchmarks for development of annual work plans. A midterm review of progress will be done preferably by a contracted M& E agency or firm and this will determine the areas where the performance has been good and those ones where it has been weak. This will result into intensive discussions between the Executive and the Board as well as development partners to mitigate measures and plan for the next phase of the strategic plan. There shall also be a final review of the strategic plan to determine HEADA Ugandas performance on the objectives and goals stated herein and will guide the development of the next strategic plan. PART 8. RESOURCE MOBILISATION AND MANAGEMENT 8.1 Costs and Funding plan 8.1.1 Costs Estimated Cost of the Strategic Plan. Key Thematic Areas. 2012/13 2013/14 2014/15 2015/2016 2016/17 Total Percentage
Innovative HIV/AIDS prevention approaches and increased access to quality Reproductive Health Services Quality Research for Infectious disease prevention , OVC programming and community development Technical and Management capacity

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of HEADA Uganda Community Development

Total(Ug. Page | 28 Shs.) Eq. US. Dollars 8.1.2 Funding Plan. Goal: To create robust, sustainable centre of excellence in program implementation in which funders feel confident to invest. Strategic Objective 8.1.2.1: To strengthen HEADA Uganda Grants searching and writing committee. The grants searching and writing committee lead by the Fundraising coordinator in liaison with the Board Grants Writing Technical Working Group will develop a grants searching and writing work plan annually and generate progress reports quarterly and submit to the Board. Key milestones. i. Number of grants awarded to HEADA Uganda. ii. Number of new development partners iii. Number of existing partners maintained. Strategic Objective: To develop new and strengthen existing partnerships with other CBOs and NGOs. For purposes of leveraging efforts in program implementation, HEADA Uganda will position its self for strategic partnerships in order to gain expertise from other organisations that have been in operation for a long time whiling maximizing outputs. Strategic Objective 8.1.2.2: To form strategic partnerships with other organisations for purposes of having a competitive advantage for grants. Key milestones. i. Number of Partnership Agreements signed between HEADA Uganda and other CBOs and NGOs. ii. Number of Consortia formed between HEADA Uganda and other organisations.

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Appendix I. Implementation Strategy Logical Framework. Out comes

Strategies

Objectively Verifiable Means of Assumptions/Risks. Indicators Verification Key Thematic Area 1: Innovative HIV/AIDS prevention approaches and increased access to quality Reproductive Health Services Goal: To contribute to achievement of Ugandas NSP 2011-2015 vision of zero new HIV infections, zero discrimination and zero related AIDS deaths, and improve access to reproductive health. Strategic Objective1.1: To increase uptake of safer sexual behavior and facilitate reduction in risky sexual behavior Promotion of and Increased safer i.Percentage Performance Effective IEC will result increasing access sex behavior reduction in Multiple progress in behavioral to Social Change and reduced Sexual partnerships. reports & change. and risky behavior ii.Percentage Surveys Communication reduction in interventions(SCC) transactional sex. to address cultural iii.Percentage and societal reduction in cross norms, practices generational sex. and values that iv. Percentage affect individual reduction in casual behavior sex. Promotion of Effective & i.Number of Activity and The community shall peer-led Sustainable community-based project embrace HEADA communication message peer groups for BCC reports. Ugandas for behavioral delivery to formed. interventions. change and targeted ii. Number of peer building the population groups that comprise capacity of BCC groups. of PLHIV. community-based groups through effective IEC Adoption and Vulnerable i.Number of Activity & Linkages will be promotion of groups access vulnerable groups Project created with other strategic linkages livelihood and accessing livelihood reports. service providers
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and networks so economic and economic providing economic that vulnerable empowerment empowerment. empowerment. groups access livelihood and economic Page | 30 empowerment Expansion and Increased i.Number of VHTs or Activity & Stigma shall not limit promotion of uptake of PHDP CVs trained in Project access to PHDP PHDP (Positive interventions PwPs/PHDP reports. services. Health, Dignity among PLHIV. ii. Number of clients and Prevention) reached with PHDP to prevent services including onward CRCS(comprehensive transmission of HIV risk reduction among PLHIV counseling services) Strategic Objective1.2: To contribute to increased critical coverage and utilization of biomedical prevention interventions. Improving access Contribute to i.Number of people Activity Communities shall to and quality of universal access accessing HCT Project embrace the HIV testing and to HCT in the annually. reports & different HCT counseling targeted ii. Number of Surveys modalities. through communities. categories of MARPs modalities that will reached for HCT. include but not limited to; homebased HCT, Community camping for HCT targeting MARPs, PICT, among others Increasing Reduce Mother Proportion of HIV Project Resource shall permit coverage and to Child positive mothers reports implementation of all effectiveness of Transmission of receiving the four prongs of PMTCT with HIV. comprehensive PMTCT. regard to the four PMTCT services prongs of PMTCT annually. which include; primary prevention of HIV women of reproductive age
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and their partners, provision of family planning for HIV positive women, HCT and HAART Page | 31 for pregnant mothers living with HIV and their exposed infants (Option B) Increasing access to SMC through outreaches, surgical camps, mobile teams, and formation of peer driven SMC clubs at the community level Promotion of proper and consistent use of condoms

Increased uptake of SMC

Proportion of adult males circumcised annually.

Project reports

Adequate resources available and communities accept SMC interventions.

Proportion of people Surveys and Adequate resources engaging in risky FGDs sexual behaviors engaging in risky sexual behavior Strategic Objective1.3: To contribute to creation of a sustainable and feasible enabling environment for HIV prevention. Advocacy for change in cultural and social norms driving the HIV epidemic. This will be achieved through involvement of cultural, religious leaders, and local government leaders. An enabling environment created. i.Proportion of cultural leaders trained and engaged in advocacy for HIV Prevention. ii.Proportion of religious leaders involved in HIV prevention activities. Project reports and FGDs. Adequate resources mobilized.

Increased use of condoms

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Integration of HIV prevention activities in community Page | 32 activities for example marriage ceremonies, funeral rites, and worships as well as organized groups like Savings and Credits associations, Informal Savings groups, farmers groups like the NAADS Farmers Forum and community Funeral associations. This will be implemented through peer education and community based support groups/clubs. Building the capacity of VHTs to engage in community mobilization and sensitisation as well as referrals for

Link HIV Prevention into community activities.

Proportion of community groups like funeral associations, NAADS Farmers groups, Community-based health insurance schemes and other groups involved in HIV prevention activities.

Project reports and FGDs

Adequate resources available

Empower VHTs to mobilize communities for HIV prevention.

Proportion of VHTs trained to mobilize communities for HIV prevention

Project reports

MoUs signed with local health authorities to involve VHTs in HEADA Ugandas work.

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HIV prevention services Strategic Objective 1.4: To promote interventions geared at Health Systems Strengthening Strengthen HIV Empower health Proportion of districts Project Resources permit systems for whose DATs receive reports HEADA Uganda to coordination at Page | 33 effective capacity building undertake such village, parish, delivery of HIV from HEADA Uganda interventions. sub-county and prevention at all local District levels. services. government levels Track the overall Empower DHMTs Proportion of Local Project impact of HIV (District Health government reports prevention based Management authorities receiving on surveys and Teams) to make quarterly project data informed reports disseminated to decisions. stakeholders annually Strategic Objective 1.5: To improve access to Reproductive Health services Communication Positive behavior Proportion of women Activity that embraces of reproductive age reports and for behavioral family planning. reached with FGDs. Change. This will behavioral change be intended to messages. dispel myths and misconceptions about family planning, harmful cultural and social norms in the context of reproductive health. Establishment of an adolescent resource centre. HEADA Uganda will over the next five years seek to Provide One Adolescent AFHS(Adolescent resource centre Friendly Health established Services) The local government authorities uses provide data in planning.

Enough resources mobilized.

Performance Adequate Resources reports Mobilized.

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establish an adolescent resource centre that will have Page | 34 facilities for vocational training, recreational activities, an adolescent and young persons clinic dealing with reproductive health issues including provision of emergency contraception services, post abortal care services, and STI treatment. Establishment of referral linkages and networks to create an enabling environment that decreases vulnerability of adolescents, young persons and women of reproductive age. Establish family planning outlets at the community level through Leverage efforts and avoid duplication of responses. i.Number of MoUs Annual Prospective partner (Memoranda of performance organisations agree Understanding)signed reports to sign such MoUs. with Partner Organisations ii.Number of referred clients.

Increase access to family planning.

Number of such outlets created

Annual Development performance Partners continue to reports fund family planning

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building the capacity of health workers at the lower units Page | 35 and organising outreaches for delivery of planning services. Key Thematic Area 2: Quality Research for Infectious disease prevention , OVC programming and community development Goal: To contribute to national efforts geared at venturing into new and potentially effective prevention modalities and new approaches to OVC programming and community development in south western Uganda Strategic Objective 2.1: To develop, pilot, and scale up evidence-based infectious disease prevention and community development modalities. The HEADA Uganda grants searching and writing committee shall vigorously look for research grants in infectious disease prevention. The Directorate of Research programs shall seek to initiate and maintain good relationships with reputable journals to foster publication of our work, while maintaining the
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Mobilise resources to support research programs.

quality of research Strategic Objective 2.2: To contribute to the national response to reach critically and moderately vulnerable children Supporting and Page | 36 strengthening the capacity of households and other caregivers to protect and care for OVCs. HEADA Uganda will implement interventions for sustainable economic empowerment, and food security systems for OVCs and their households. Strengthening community-based responses for the care, accessibility to social services, legal services and protection of OVCs. Attempts shall be made to improve early identification of OVCs and developing the capacity of the communities to respond to their
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needs. Strengthening research and strategic Page | 37 partnerships for quality OVC programming Key Thematic Areas 3: Technical and Management capacity of HEADA Uganda Goal: To create a robust , strengthened human resource and institutional capacity that can stand the test of time as HEADA Uganda delivers on its key thematic areas Strengthen, and Efficient and i.Number of HR Annual There shall be Competitive guidelines developed performance enough funds to fully Management annually. reports and budget for capacity operationalise systems in place. ii.Number of trainings quarterly building HEADA Uganda attended by the progress management Human Resource reports. systems and Manager. Training structures. iii.Number of OCAs reports. (Organisational Capacity Assessments) carried out by a contracted consultancy firm. Mobilize and An organisation i.Proportion of Annual Donors will remain sustain human, in which donors proposals developed performance committed to material and feel confident to annually that attract reports and funding infectious financial invest. funding. quarterly disease resources ii.Number of staff that progress prevention(HIV/AIDS& receive training in reports. Malaria), OVC, resource mobilization. Training Reproductive Health, iii.Number of Financial reports. related research & Management community Guidelines(FMG) development developed. initiatives. iv.Number of resource mobilization committee meetings held annually. Periodic Monitor HEADA i.Number of annual Annual Expertise shall permit preferably annual Ugandas performance reports performance designing of review of HEADA performance generated. reports. appropriate tracking
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Ugandas ii.Number of HEADA relevancy, Uganda Board effectiveness, Steering Committee performance meetings held scored against set annually. Page | 38 targets and designing of annual work plans that puts the aforementioned in context Key Thematic Area 4: Community Development

Board minutes records.

tools to enable generation of authentic performance reports.

Goal: To create a society where people are empowered to meet the basic needs of life in a sustainable and environmental friendly manner. Strategic Objective 4.1: To contribute to the national efforts for prosperity for all through promotion of organic farming and value addition and other proven interventions. To ensure increase access Proportion of farmers Project Adequate resources effective delivery to advisory accessing advisory reports mobilized. of advisory services among services for improves services and Farmers agricultural improve production. technology for increased agricultural production Strategic Objective 4.2: To empower indigenous people to start small scale enterprises (SMEs) that are sustainable and profitable.

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N.B This table will be filled according to the objectives developed above. Appendix II: Conceptual Framework (The Egg Model)

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