Initial Programmatic Implementation

Now that the contracts are signed, the scope of work solidified, and action plans verified, implementation of our integrated health project has begun. Although this is a health project and I’m new to the health sector, I’m currently tasked to support my partner organization, Action for Relief and Development (ARD), implement. Through this USAID funded health program, implementing partners are tasked to support the Ministry of Health by strengthening community-based networks to increase access and continuous utilization of government health services.  The targeted health issues include HIV/AIDS, tuberculosis (TB), malaria, maternal, newborn, and child health (MNCH), reproductive health, family planning, and water, sanitation, and hygiene (WaSH).

Family Life School Approach

Although this task seems broad, our approach to achieving the objective is precise. Using Family Life Schools (FLS) we look to identify, mobilize, and refer patients in rural areas with these health challenges to linked health centers. A family life school consists of a group of women that have been joined together and targeted based on their proximity to one another and based on their pregnancy status or age of youngest child. As the base of the family and the most at risk to health challenges, pregnant women are the key target population. By forming groups of expecting or new mothers in rural villages we are able to work with them as a group to address their pressing needs and health challenges. Additionally, by working as a group, these women are able to learn together and from one another as we host a wide variety of health education sessions addressing the targeted health issues of the project.

Group Formation

Last week in the field we worked to create and solidify three family life schools in three different villages. Identifying pregnant women and mothers with newborns in remote villages seemed to me like a daunting task since we had no knowledge of our surroundings, but it proved to be easy with the help of Village Health Teams (VHTs). A VHT is a member of a rural community who works voluntarily with a health center to provide health education and medical assistance to their community members. Although they are not medical professionals, their core competency is their knowledge and the trust of their community members. By utilizing the core competencies of the VHTs, we were able to create three family life schools consisting of more than 40 women each in just two days. In addition to the VHT identifying our key target population and mobilizing them for group formation, they will also be the family life school instructor responsible for educating and referring their community members to program linked health facilities. In essence, we train the VHTs and they train their communities.

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Dr. Nelson, Health Team Lead, sharing a laugh with a FLS

At each family life school entry meeting, our team met with the newly formed group to give the women an overview of what they can expect from us over the course of the year. Our goal was to share with them the knowledge they will soon gain to motivate strong attendance to trainings and group adherence. Not only will these women receive various health topic trainings, but they will also receive tools, resources, and trainings in ARDs core competency, economic empowerment. These groups will be more than educational cohorts, they will also be Village Savings and Loans Associations (VSLAs) with supplemental income as we teach them about savings and investment, income generating activities (IGAs), fuel efficient cook stoves, and kitchen gardens.

Through this targeted group approach, mothers will gain the knowledge and skills required to raise healthy families along with supplemental income and savings to manage health emergencies as they arise.

Health Center Capacity Assessment

Forming the family life schools through a targeted approach is our method for identifying, mobilizing, and referring women to health facilities to fulfill our objective to increase access and utilization of government health services, but we also need to ensure continued utilization.  This part requires us to confirm health facilities linked to various family life schools have the resources required to perform their tasks. While visiting newly formed family life schools in the field, we also spent considerable time reviewing the records of the linked health facilities and listening to the challenges they have. By doing a capacity assessment at each of the linked health facilities we are now able to advocate with them to receive the resources and training required to properly fulfill their tasks. We look monitor these health centers to see if obtaining resources and training will create positive health care service experiences for their community members to subsequently ensure continuous utilization.

Rosette, Nutrition Officer, leading the Health Center capacity assessment.
Next Steps

With 3 of our targeted 96 family life schools securely established we have plenty of work ahead of us. As new groups in different geographic locations are formed we will also focus on supporting VHTs to provide weekly trainings and referring community members to linked health facilities when required.


Pleasure doin’ business with ya

Being awoken at 5:04am by a text from my counterpart, Dr. Nelson, is not how I intended the morning to begin. We agreed as we were leaving the office at dusk the previous evening that he would pick me up at 5:30am for our day trip to the far east districts of Tororo and Manafwa. I had set my alarm that night thinking we agreed on 5:30am, so there is no way we leave any earlier than 6:00am, but I’ll be prepared for 5:45am only because I get anxious if I’m not early. So I set my alarm to get up at 5:15am in order to be early and prepared at 5:45am for our scheduled 5:30am departure.

The text at 5:04am said “Are you awake? It is 5am.” To which I replied before getting out of bed, “Good morning. I’m awake and nearly dressed.” After throwing some water on my face to get the blood flowing and beginning the teeth brushing portion of the morning routine I glanced back down at my phone to see that he immediately responded, “In the next 25 minutes we should be at your place.” I had to give my head a shake while brushing my teeth to figure out if this was just another anxiety dream or if I was actually running late for something here in Uganda. I went back over our conversation as we were leaving work the night before in my head, ran the numbers to see where I had made an error, and continually I kept coming to the same conclusion. I should be sitting around aimlessly for at least 15 minutes this morning and not rushing out the door.

Lesson learned. Dr. Nelson is always on time and therefor I need to start getting back in that habit when I’m working with him.

Our early morning, on time departure was to ensure that we had enough time to meet with the District Health Officer in both Tororo and Manafwa, which are near the Kenyan border. Meeting with district level government is part of the process to receive access to the district before program implementation. These meetings are less than a pitch, but more of an informational discussion with the key players. If all goes well, hands shake and an MoU is signed by my organization and the district stakeholder commencing programmatic implementation.

Dr. Nelson admiring his project booklet before the meeting in Manafwa.

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Race for micro-finance by Haley Block

Last weekend I had two exciting events happen. First, I successfully ran down a bus in dress flats. And two, I represented my organization at a FinTech for Agriculture event in Kampala. (FinTech = Financial technology)

I’ll start with the bus.

I found out about the event in Kampala a few days before it was going to happen. It looked like an  interesting networking opportunity for my org and after talking with my supervisor, we decided I should go try to build some connections. However, in order to go, I had to get approval from Peace Corps.

Friday morning, the day of the event, I get up thinking I’m going to have a normal day at work. As of that morning, I still had not received approval from Peace Corps. The event started at 2:30 PM and Kampala is a 5-hour bus ride from my site – it seemed like a lost cause.

However, as I am setting up my desk to begin my day, I refresh my inbox. To my surprise, there’s an email saying I have approval to go to Kampala. It’s 9:00 AM and buses aren’t exactly on demand. So, thinking I still won’t be able to make it to Kampala in time, I go tell my supervisor. He had a different opinion.

I quickly pack up my things, rush home, put on some dress pants, and throw the makeup I haven’t touched in two months into a bag. Now, looking fresh in my business casual uniform (it felt so good to be wearing my black dress pants again) I’m standing at the paved road that goes through my town asking when the next bus to Kampala is. With the help of my supervisor, we figure out that next bus won’t pass through until 11 AM. But, if I were to catch a ride to Kamdini I might be able to catch the bus coming down from Gulu.

At around 9:45 I’m in the front seat of a mini van to Kamdini. At 10:20, I arrive in Kamdini – just as is the bus from Gulu to Kampala is passing by. I toss my schillings to the driver and jump out of the car waving frantically, but the bus doesn’t stop. So, I start running. As I’m running, people are cheering, laughing, pointing, and I feel like the Macy’s Day Parade. Just as it reaches the edge of the town, the bus finally stops. I jump on, out of breath, but trying to hold it together. The man I sit next to doesn’t seem too pleased with my presence but I’m ecstatic. I’m officially en route to Kampala.

The event.

The event was called FinTech4Ag hosted by the UNCDF at the Kampala Design Hub – a swanky, restored warehouse building full of 20 something’s with laptops and plaid shirts. It felt like I had stepped back into the States.

The meat of the event was a panel of leaders in the micro-finance industry in Uganda: a FinTech startup founder, an international trust executive, a micro-finance banker, a finance software company executive, and a manager of an invoice-financing firm. What followed was a very interesting discussion about the role of each of these organizations in the industry, market trends, and how to reach the “missing middle.”

However, as the discussion continued, a few people in the crowd became agitated. Here we were talking about how best to improve access to financial services for rural farmers yet there were no farmers in the room. Nor was there anyone on the panel who worked directly in rural communities. Of all the SACCO managers in the country, (arguably the only bankers who live and work in rural farming communities) two were present in the crowd.

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Ugandans for Uganda – a fixer

Through the series Ugandans for Uganda, Ugandans I meet and work alongside will receive the spotlight for their efforts leading, supporting, teaching, or helping Ugandans in Uganda. This ongoing series was created after being asked, in our Peace Corps reporting tool, to finish this sentence: “The one thing I wish Americans knew about my country of service is…”

My immediate response was…  there are many Ugandans tirelessly working to better the livelihoods of the disenfranchised in Uganda. Ugandans for Uganda looks to bring action to this sentiment.

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Sharif guiding a team through a SWOT Analysis

Sharif, previously introduced as a driver is everything including a driver. At ARD and Uganda in general people wear multiple hats at their multiple jobs from their multiple income streams. The population is extremely entrepreneurial. In addition to a main career, most people also have a small business or do consulting work on the side. This leads many people to be a jack of all trades. Sharif is one of them.

To give you an idea of some of the roles Sharif played while on our trip to the field I’ll list them all before diving into a few. Driver, mechanic, translator, negotiator, student, educator, mobilizer, logistician, financial manager, cross cultural liaison, safety and security manager, advisor, colleague, and friend.

Since heading to the field with Sharif was the first time I was responsible for all the activities, I heavily relied on him for assistance. As my work colleague and cross cultural liaison he was always proactive in ensuring everything always worked out for us. This meant being the liaison between me and the field staff to ensure the trainings went as logistically sound as possible, between me and the cooperative executives ensuring the training was properly translated and understood, between me and the lunch caterers ensuring timely delivery of everyone’s lunch at the trainings, between me and the guest house managers ensuring I did not pay too much for my room, between me and the office in Jinja ensuring I had the resources and support required to execute the activities. In essence, anytime I was unsure of something he was always there to provide an answer, but most of the time he was there to fix a problem before I was even aware there was a problem arising.

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Surprise, you’re going on a field trip!

Denis, ARD Field Coordinator, giving closing remarks at the WFP Grain Store in Kito, Nakaseke

Action for Relief and Development (ARD) is preparing to implement a health and nutrition program in the Busoga/Eastern region of Uganda and because this preparation is an all hands on deck situation, I was asked to go on a solo mission back to the Central region to prepare the newly formed farmer cooperatives for handover of the UN World Food Programme (WFP) grain stores. A grain store is a warehouse and office space provided by the WFP for each cooperative to manage, store, and sell the grain from as well as manage the operations of the cooperative. This activity is part of our livelihood project in partnership with the WFP where we are assisting small scale farmers to increase the value of their maize harvest through better post harvest handling practices and facilitating the creation of farmer groups and cooperatives, so these farmers can work collectively to sell their harvest at a premium directly to the WFP. Ring a bell? Hopefully!

ARD has just completed the profiling phase of the project and has submitted data on the 1025 participating farmers, from 111 farmer groups represented by three Farmers’ Cooperatives located in three different geographical districts. The next step in the project is to provide trainings at the farmer, group, and cooperative leadership level. The mission I was sent out on was to fully prepare each of the executive teams, from the three Farmers’ Cooperatives, to properly manage their cooperative and grain store. It seems like quite the task, but when given to me at 2pm on Friday with the expectation of providing a budget and lesson plan for review by 4pm in order to begin these trainings on Monday, I didn’t have much time to worry and had to get to work. Being given this task with such little time to execute ended up being one of the many surprises to come.

Within the two hours I was able to submit my budget for approval and write a general outline for a half day management lesson. In hindsight, I grossly underestimated the expenses that I would incur throughout the week and the lesson plan was too long for the anticipated training timeframe. Surprisingly, everything still worked out.

Once the budget and lesson plan got cleared I managed to get on the phone with each of our field coordinators from the three districts including Mubenda, Kiboga, and Nakaseke to ensure they could get the executive teams from their respective district cooperatives and key governmental district stakeholders to the trainings. Since I have never dealt with mobilizing farmers and government workers, I was anxious and nervous that a training scheduled this late notice would be poorly attended. Surprisingly, that was not the case.

After working through the weekend, Sharif, a driver for ARD, and I left on Sunday morning to head to Mubende to sleep before the first training there on Monday morning. Our 11am departure scheduled us to arrive at the guest house just at dinner time, which would give us enough time to eat, pick up last minute items, and prepare for the training the following morning. Roughly halfway into the road trip the car broke down. The car was fixed by 11pm and we made it to Mubende at 1am. Sleep came right away with lesson prep and last minute material pick up really becoming last minute happened early in the morning before the lesson. Surprisingly, on Monday morning I felt rested and we were prepared for the trainings.

Each of the three trainings went in similar fashion logistically. The training scheduled to start at 9am promptly started at 11:15am, which was not a surprise. The number of executives budgeted to show up at the training was significantly higher than anticipated, which was a surprise. Since ARD was reimbursing travel expenses and providing lunch at the half day training, the incentive really drove up the attendance rate and the subsequent costs. The training was long and exhausting, yet the executive teams were extremely participatory and engaged.

Chairman of the Madudu Farmers’ Cooperative working on their business plan.

Continue reading “Surprise, you’re going on a field trip!”