Baylor Foundation Uganda implements a district-led programming approach of strengthening health systems in its supported districts through the provision of:

• Health financing to ensure equitable and efficient resource use
• Leadership and governance to strengthen accountability and decision-making at all levels
• Capacity building through continuous training, mentorship, and re-skilling of health workers
• Health information systems to enhance data-driven planning and reporting
• Laboratory systems strengthening for timely and accurate diagnostics
• Quality improvement initiatives to elevate standards of care
• Supply chain management to guarantee the availability of essential medicines and commodities

Health Financing

We support districts to optimize resource mobilization, allocation, and utilization, ensuring health facilities have the financial capacity to deliver quality services. Interventions focus on strengthening financial management systems, promoting transparency, and ensuring accountability in resource use.

Leadership and Governance

Baylor Foundation Uganda builds the capacity of district and facility-level leaders to improve planning, coordination, and monitoring of health services. Initiatives include:

• Leadership Mentorship Program for Facility Managers: Over 145 facility in-charges were paired with 38 experienced district mentors. Mentors provided guidance on decision-making, team management, and data-driven governance using Team Performance Monitoring Tools (TPMT). As a result, over 80% of facilities now hold regular meetings, with more than 87% reviewing performance data and recognizing staff achievements.
• Virtual Leadership Training: In partnership with Pepal and Janssen Pharmaceuticals, BFU developed virtual leadership modules via the Kajabi platform. In 2023/24, 175 health workers completed all nine modules, including doctors, nurses, allied health professionals, and support staff, enhancing leadership skills across the health workforce.

Capacity Building

The BFU Capacity Building Program targets improving knowledge and skills to ensure sustainable, high-quality service delivery through training, mentorship, and support supervision. Key interventions include:

• Training Programs: In 2023/24, 22 major trainings were conducted across supported regions, covering topics such as Biosafety-Biosecurity, HIV Guidelines, Integrated Community Approach, NCD/HIV services integration, DREAMS tailored trainings, KP/PP friendly services, IPC, CRPDDP, ISO15189:2022, VMMC, HTS for religious leaders, EID-EPI integration, and maternal retesting. A total of 5,054 participants (1,863 males, 3,191 females) from 372 facilities were reached, achieving a median positive knowledge gain of 24%.
• Mentorships: A pool of 417 district-certified mentors in the Fort-Mubende region was mapped to thematic areas such as ART services, EMTCT, quality improvement, nutrition, TB services, medicines management, and data management. Last year, 3,311 mentees benefitted from on-site mentorships and biweekly performance review meetings, resulting in improved service indicators, including viral load suppression (VLS) among children and adolescents.
• Internships and Clinical Attachments: 53 students completed internships with a 100% completion rate, and 5 participants engaged in clinical attachments.

Health Information Systems

Baylor Foundation Uganda strengthens the availability, quality, and use of health data for decision-making. Key interventions include:

• ECHO/Zoom Virtual Training: Expanded to 61 sites, supporting continuous professional development, project-level trainings, and meetings.
• Integrated Human Resource Information System (iHRIS) Support: Assessments identified sub-optimal functionality. BFU provided technical assistance to improve system use, updating processes, and guiding district health teams on actionable improvements.
• Data Quality and Use: Joint data quality assessments with MOH and METS ensured accurate, complete, and timely data. District-led site-level data cleaning, validation, and response action plans improved reporting standards.
• Digitalization of Health Information: Technical support enabled health facilities to transition from paper-based to electronic data systems, including Uganda EMR, enhancing reporting, visualization, and information exchange. EMR functionalities were upgraded for VL, Recency, SMS reminders, and mortality surveillance. Mobile EMR devices support community-level data capture. Challenges such as unstable power supply are being addressed in collaboration with METS.

Quality Improvement

• Continuous Quality Improvement (CQI) for Staff Attendance: Piloted in nine health facilities in Kiryandongo District, facility gatekeepers monitored staff arrival times using a color-coded balanced scorecard. Early attendance recognition and biometric monitoring at Panyadoli HCIV led to increased punctuality and reduced absenteeism—for example, Kigumba HCIII improved early arrival from 16% in April to 75% in December 2023. Improvements reduced client waiting times and overcrowding.
• Performance Reviews: On-site mentorship and biweekly facility performance meetings contributed to service delivery improvements such as better continuity of care, reduction in client misclassification, and improved follow-up within seven days.

Laboratory Systems Strengthening

Baylor Foundation Uganda works to enhance diagnostic capacity and ensure reliable, timely laboratory services across supported districts. Key initiatives include:

• Laboratory Staff Training: Over 120 laboratory personnel were trained on proper use, maintenance, and quality assurance of diagnostic equipment, resulting in improved test accuracy and reduced turnaround times.
• Quality Management Systems: Laboratories underwent regular proficiency testing and internal audits to meet ISO15189:2022 standards. This strengthened adherence to standardized procedures, enhanced data reliability, and facilitated evidence-based clinical decision-making.
• Impact: These interventions led to a reduction in sample referral delays, with previously centralized tests now being processed locally, cutting average result turnaround from 5–7 days to 24–48 hours.

Supply Chain Improvement

BFU strengthens procurement, storage, and distribution systems to guarantee consistent availability of essential medicines, laboratory supplies, and equipment. Notable interventions include:

• Optimized Supply Chain Processes: Facilities were supported to improve inventory management, implement stock monitoring tools, and track essential commodity levels.
• Training and Mentorship: Over 70 health workers across 50 facilities received training on medicines management, cold chain maintenance, and stock reporting.
• Integration with Data Systems: Supply chain data was linked to HMIS and iHRIS systems, enabling real-time monitoring of stock levels and proactive replenishment.
• Impact: Stock-outs of critical HIV and RMNCAH commodities decreased significantly. For example, ART stock-outs were reduced from 18% to 4% across supported facilities, while availability of maternal and child health supplies increased from 72% to 95%. Timely supply of commodities also supported uninterrupted service delivery, contributing to improved patient satisfaction and health outcomes.