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School of Public Health
College of Health Sciences, Makerere University

The Department of Health Policy Planning and Management

About HPPM

The HPPM department is one of four departments of the Makerere University School of Public Health (MakSPH). The department is involved in: 1) Teaching, 2) Research, and 3) Community Service. The department also services other departments by facilitating courses within programmes hosted by other departments. This includes courses such as Health Systems Management, Monitoring and Evaluation, Economic Evaluation, Cost-Effectiveness Analysis, Health policy, Health Economics, among others. More information on the department can be found on https://www.hppm.musph.ac.ug/

Academic programmes:

Master of Public Health (MPH)

It has been noted that more than 60% of the burden of disease in Uganda is preventable. This means strategic effort must be focused towards public health prevention, promotion and communication to avert this burden and reduce the cost and health care expenditure in Uganda. Additionally, the

need to ensure global health security, means that emerging pandemics and disease outbreaks must be detected and contained early enough before they can spread to the rest of the world given the high level of connectivity. The Master of Public Health programme trains specialists in public health with skills for public health programming, health systems leadership and management, disease surveillance and control, among other skills. Since its inception in 2004, the MPH programme has graduated more than 600 public health specialists and practioners. Health services in Uganda are structured and delivered through a decentralized arrangement where districts (Local Governments) hold the mandate to deliver services to the population. Each district has a health system superintended over by a District Health Officer (DHO). More than 70% of Uganda’s DHOs have been trained through the MakSPH MPH programme. The MPH Program also provides training in Field Epidemiology, a component that is supported by the Field Epidemiology training program (FETP). Through the FETP, the MPH officers have been equipped with skills which have enabled the officers to play significant roles in disease surveillance and epidemic control. A number of MPH graduates have contributed critically to addressing the Ebola crisis in West Africa, through the IOM and the US CDC. The MPH graduates have also held and continue to hold key positions in

Academia, Research institutions, Ministry of Health (MOH), Districts, Non-Governmental Organizations (NGOs), Civil Society, private sector, and international organizations, including the WHO, World Bank, among others. The MPH graduates from MakSPH have also played critical roles in shaping Uganda’s health system reform agenda, HIV Programming and financing, The PHC, MDG, and now the Universal Health Coverage agenda in Uganda. Please read more about outputs from the MPH programme in the tracking study.

Master of Public Health Monitoring and Evaluation (MPHME)

Globally, there is immense demand for governments and organizations to demonstrate results towards achievement of Sustainable Development Goals (SDGs). To this end, there has been a surge in the demand for skilled Monitoring & Evaluation practitioners. The MPHME programme has been designed to contribute to skills development in the area of Monitoring and Evaluation, to monitor and evaluate public health policies and complex health systems programs. The MPHME programme aims at producing gradates with the highest professional standards, equipped with the most contemporary methods, tools, and skills in monitoring and evaluation. Admission to the MPHME Programme is open to both upcoming and already existing M&E practitioners, managers, planners and professionals with at least a Bachelor’s degree in the applied health sciences, social sciences and management sciences. The first cohort of the MPHME Programme started this academic year 2019/2020 with 21 students.

Masters in Health Economics (MHE)

Opportunities for training in health economics are still limited across the African continent. Yet, skills and expertise in health economics are necessary and needed more than ever before, in programming, policy and implementation. Most Universities in Africa offer health economics or related courses as part of other graduate training programmes (for example in Master of Public Health, Master of Health Services Research, or Master of Health Policy). Limited programmes offer specialized training in health economics. MakSPH has developed a Masters in Health Economics (MHE) Programme, expected to commence in academic year 2021/2022. In view of the increasing demand on limited health care resources, health economics finds its place as a critical input into policy and decision-making at all levels of not only the health system, but also across the whole of government. This program will train and equip graduates with state-of-the-art analytical capacity, skills, and tools, necessary for policy and decision making, costing and resource analysis, economic evaluation, econometrics, and health systems research skills.

PhD Programme

The department as part of the school supports the Doctor of Philosophy (PhD) in Public Health. This is a Research- based PhD Programme. The focus of the HPPM department is in the area of health systems. The current PhD Fellows are pursuing various topics within this broad area of health systems. For more information about how to enrol for this programme, potential students should contact the department for further information and guidance.

Short Courses

The HPPM offers a arrange of short courses – including Health Systems Management, Health Policy & Analysis, Advocacy and Policy Influence, Cost-Effectiveness Analysis, Vaccines Economics, Social Network Analysis, Political Economy of Decision making, Health Systems Research, among others. These are offered periodically. For more information, feel free to contact the department.

Research, Consultancy & Service to Community

Research, consultancy and service to community are key components of HPPM work. The department has conducted research and consultancy work that has been beneficial to the government, the global community, and non-state actors. Several research programmes are led by members of the department, either as individual standalone awards, or awards to the department and the school, or collaborative projects within regional and international consortia. Departmental research over the years, has covered the entire spectrum of the WHO health system building blocks (service delivery; health workforce; health information systems; medicines & supplies; financing; and leadership/ governance). Various research teams within the HPPM department, have also been consulted by and/or received funding from several agencies including the MOH, World Bank, The European Union, USAID, DFID, IntraHealth, WHO, BTC, UNFPA, Rutgers WPF, Cordaid, Comic Relief, Bill and Melinda Gates Foundation, etc. Some of the ongoing research projects include the following:

Some of the current Research Projects in the HPPM Department are highlighted below.

Research Projects

Summary

PLACE-USD

Priorities for Local AIDS Control Efforts (PLACE) is a research project that aims at identifying and mapping venues and events attended by persons who have high rates of sexual partnerships. The project team then engages with the patrons/clients and workers of these venues, so as to identify the most important gaps in HIV prevention among populations most likely to acquire and transmit HIV infection, so as to aid HIV programming.

SPEED Project

The Strengthening Policy Engagement for Evidence based Decisions (SPEED) is funded by the European Union (EU). SPEED aims to strengthen capacity for policy analysis, advice and influence at Makerere University School of Public Health (MakSPH) and Partner institutions; and to contribute to accelerating progress towards universal health coverage (UHC) and health systems resilience in Uganda. SPEED is a strategic partnership involving MakSPH, National Planning Authority, Economic Policy Research Centre, Uganda National Health Consumers’ Organisation, Institute of Tropical Medicine, Antwerp (Belgium) and Human Sciences Research Council of South Africa.

In-depth Network Maternal/ENAP Project

The INDEPTH Network Maternal and Newborn Working Group (MNWG) was set up to support multi-site, multi-country generation of evidence to inform policy and programmes, specifically focusing on maternal and newborn health and survival in low income countries. Its technical secretariat is hosted by the Department of Health Policy, Planning and Management in the School of Public Health, Makerere University, Uganda. Currently, there are 33 Health and Demographic Surveillance Sites (HDSS) forming the MNWG.

PTBi

The Preterm Birth Initiative (PTBi) is working to reduce the number of preterm births and save the lives of preterm infants and their mothers, by improving quality of care and engaging in discovery research in regions of Uganda, Kenya and Rwanda. In Uganda the study sites include the Jinja Regional Referral Hospital, Iganga Hospital, Kamuli General Hospital, Bugiri Hospital, St Francis Hospital Buluba and Kamuli Mission Hospital.

COMONETH

Being implemented in Luuka District with support from the British Charity Comic Relief, the Community in which Mothers and Newborns Thrive (COMONETH) project aim is to design and implement a community owned but facility-linked district-wide intervention that promotes high coverage with preventive care and improves quality of clinical care equitably leading to impact on maternal, perinatal and neonatal mortality in rural Uganda. The project envisions sustainable and scalable empowered communities and responsive health facilities that care about outcomes for mothers and newborns.

Pre-conception study

Nested in the COMONETH Study, this study aims to explore the policy and program context of preconception health/care in Ugand and to pilot an intervention package on preconception care among mothers receiving health care services in Luuka District.

MANeSCALE

MANeSCALE aims to improve clinical outcomes for mothers and babies in existing public and private not for profit hospitals. It is implementing an improvement change package which includes a new advanced newborn care training and mentorship course, an electronic data system with easy feedback to managers for decision making as well as leadership engagement in quality improvement and referral. The study is in 6 high volume Health Centre IVs and 6 hospitals in Eastern Uganda.

MaNE Project

The Kampala Slum Maternal Newborn (MaNe) Project is a 3-year (2019-2021) implementation research project aimed at generating evidence on the most effective and feasible approaches to improving Maternal and Newborn Health (MNH) for the urban poor. The project is a collaboration of Kampala Capital City Authority, Population Services International and Makerere University School of Public Health in the divisions of Rubaga and Makindye in Kampala City. The project is funded by the United States Agency for International Development.

DOVE

The decade of vaccines study is acollaboration between MAKSPH and JHU. It aims at estimating the economic burden of measles, pueumonia and diarrhea.

VSL (Value for Statistical Life Study)

This study is a collaboration between Makerere University and the University of Northern Carolina. The study aims to rank citizens preferences for resource allocation across different sectors, including the health sector, compare citizen preferences to actual government expenditures across sector and estimate the economic value of a statistical life based on citizens’ willingness to pay for mortality risk reduction.

PHFS-HIV Free survival project

The Partnership for HIV-Free Survival (PHFS) was conceived by the World Health Organization (WHO) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to accelerate the adoption and implementation by countries of the WHO 2010 guidelines, with the ultimate goal of increasing HIV- free survival. The six-country initiative is supporting current national efforts to improve PMTCT, maternal and infant care, and nutrition support for HIV-positive women and their exposed infants. The member countries are Kenya, Lesotho, Mozambique, South Africa, Tanzania, and Uganda.

FHS UNICEF (Evidence Based Analysis)

This study was done in collaboration between FHS and UNICEF, It aimed at designing a community engagement approach that would enhance recognition and inclusion of community problems.

Village Ambulance Project

This project aims at improving acess to maternal health services by partnering with the districts of Kibuku, Pallisa and Kamuli to improve referral of pateints using Bicycle ambulances.

CBH (Cross Border Healthcare ) Access Study

The study is exploring the current legal-institutional context and how it facilitates or constrains access to healthcare services for communities residing along the borders in the East African region. The study objectives are; to explore the health systems’ constraints and implications for serving border communities; To determine how border resident communities, navigate the legal-institutional and health systems constraints to health service access and; To explore feasible solutions to advance the access and coverage agenda to services for the communities residing along East African Community borders. Study countries are Uganda, Kenya, Tanzania and Rwanda.

MEASURE EVALUATION

The project creates, implements and facilitates state-of-the-art methods for and approaches to improving monitoring and evaluation, health information systems, and data use.

The project assists country programs to improve health system performance through increased demand for health information, improved tools and data collection practices, improved analysis, and most especially, improved use of information. JSI has helped build capacity in M&E at the individual and organizational levels, developed harmonized M&E tools that address challenges in implementing health projects, and strengthened health management information systems as a means to improving health programs through routinely available and useful data.

DOVE II Project- USD

The DOVE (Delivery of Oral Vaccine Effectively) Project aims at treating and controlling Cholera.

Mobile Phone Surveys

Evaluation of mechanisms to improve mobile phone surveys (2016 – 2019)-The main objectives of this project are to adapt the use of Mobile Phone Surveys for Non-Communicable Disease (NCD) risk factor surveys and to assess the feasibility, quality, and validity of NCD mobile phone surveys. This project aims to strengthen the collection and use of critical public health information. Similar projects are being done in Bangladesh and Tanzania.

FHS CSC

Community score card was a two-year social accountability feasibility study conducted in Kibuku district in Eastern Uganda. In this study the community members were empowered through sensitization and community dialogues to hold the service providers accountable for service delivery. This project was implemented in 5 sub counties and one town council in Kibuku district and 5 health facilities serving the selected sub counties. The team is now working with the district to sustain the CSC implementation.

Perform 2 Scale

The aim of the five-year PERFORM2scale initiative is to develop and validate a costed national scale-up process for the management strengthening intervention (MSI). The expansion/ scaleup strategy includes working with government and other employers, and relevant stakeholders to integrate the initiative into existing national level management structures to sustain the implementation of the MSI at district level in Uganda. For More details, please visit www.perform.org

MHealth TB Tobacco

The mHealth for TB-Tobacco is an approach to reduce tobacco use among TB patients.

The goal of the project is to use mHealth solutions to integrate tobacco control into TB programmes to reduce tobacco use and improve TB treatment outcomes in Uganda. The primary objective is to support TB patients to quit tobacco use. The project is implemented under the Makerere University School of Public Health – Centre for Tobacco Control in Africa (MakSPH-CTCA) in collaboration with Ministry of Health, World Health Organization (WHO)(Afro and Headquarters) and East Tennessee State University (ETSU) in USA. It will be implemented in all the 13 referral hospitals in the country, six other health facilities in Kampala and some other general hospitals in Uganda.

SOAR Project

Supporting Operational AIDS Research (SOAR)-USG has rolled out a new programming strategy that prioritizes funding based on the HIV burden (pivot). This project aims at evaluating how this was done in Uganda and its short and medium term effects on service delivery.

Epilepsy

This is a study that is developing a referral network between the formal health services and the community to assist in the management of Epilepsy.

The Urban Family Planning Project

The overall objective of this study is to determine the prevalence of modern contraceptive use among the urban poor in Kira Municipality, Wakiso district. Additionally, the study will map existing FP services and explore the perceptions of the different stakeholders on family planning services and its connection to urban planning.

Strategic Purchasing for Primary Health Care (SP4PHC)

This is a multi-country, multi-year project funded by the Bill and Melinda Gates Foundation (BMGF) and implemented in partnership with ThinkWell and Ministry of Health to improve how governments spend funds for Primary Health Care (PHC) services, with a focus on family planning (FP) and maternal, neonatal and child health (MNCH). The overarching goal of the SP4PHC project in Uganda is to improve FP and MNCH outcomes within the context of PHC service delivery by supporting MOH to develop and implement a more coherent approach to purchasing that draws from the experience of ongoing results-based financing (RBF) and voucher projects, and leverages the full range of public and private health facilities in the country.

Sabin Initiates Locally-Led Vaccination Acceptance Research

The project is analyzing the effectiveness of peer group participation models to improve human papillomavirus (HPV) vaccine uptake in poor urban settings. Set to take place in Kisenyi Slum in Kampala, the study will empower adolescent girls who have received the HPV vaccine by offering them training to advocate effectively with their vaccine-hesitant counterparts. This study will inform the design of social-behavioral interventions to overcome vaccine hesitancy in order to contribute to achieving universal health coverage in Uganda and beyond.