1
January 2013 
This publication was produced at the request of the United States Agency for International Development. It 
was prepared independently by REEV Consult International 
THE HEALTH INITIATIVES FOR THE PRIVATE 
SECTOR (HIPS) PROJECT 
FINAL EVALUATION REPORT 
2
REEV Consult 
FINAL EVALUATION OF THE HEALTH INITIATIVES FOR THE PRIVATE SECTOR 
(HIPS) PROJECT 
AUGUST 2012-JANUARY 2013 
Submitted by: 
REEV CONSULT INTERNATIONAL 
Prof. Augustus Nuwagaba 
Dr. Simon Sentumbwe 
Charles Rwangoga 
Sam Rutahindwa Bamuhiiga 
Submitted to: 
USAID/Uganda 
Order No: 
AID-617-0-12-00014 
DISCLAIMER 
The author’s views expressed in this publication do not necessarily reflect the views of the United States 
Agency for International Development or the United States Government. 
ii
CONTENTS 
Acronyms iv
EXECUTIVE SUMMARY 1
1. BACKGROUND, EVALUATION PURPOSE, EVALUATION QUESTIONS 5
1.1 Project Background 5
1.2 Purpose of the Evaluation 6
1.3 Evaluation Questions 6
1.4 Evaluation Methods and Limitations 6
1.4.1 Evaluation Design 6
1.4.2 Methods of Data Collection 6
1.4.4 Data Management and Analysis 7
1.4.5 Limitations of the Evaluation 7
2. FINDINGS 8
2.1. Were the Desired Results Achieved? 8
2.2 Effectiveness of HIPS in Addressing Capacity Building and Service Delivery Needs in a 
Challenging Private Sector Environment 17
2.2.1 Introduction 17
2.2.2 Continued Challenges 19
2.3 Effectiveness in Strengthening Coordination and Partnerships. 20
2.4 Most Effective Approaches and Innovations for Scale Up 22
2.4.1 Accreditation 22
2.4.2 Use of the Disease Cost Calculator in Expanding GDA partnerships 22
2.4.3 Support to Existing MOH Policies and Plans 23
2.4.4 The Supply Chain /Out growers model 23
2.5 Sustainability of Health Service Provision through Companies 23
2.5.1 HIPS Sustainability Goals 23
3. CONCLUSIONS 25
4. RECOMMENDATIONS 26
Annexes 28
ANNEX 1: HIPS COVERAGE 28
ANNEX 2: STATEMENT OF WORK FOR EVALUATION OF THE HEALTH INITIATIVES 
FOR THE PRIVATE SECTOR (HIPS) PROGRAM 29
ANNEX 3: EVALUATION METHODS AND TOOLS 36
ANNEX 4: DATA COLLECTION INSTRUMENTS 42
iii
ANNEX 5: LIST OF DOCUMENTS REVIEWED 72
ANNEX 6: SUMMARY OF HEALTH FACILITIES SAMPLED FOR THE EVALUATION 73
ANNEX 7: LIST OF PERSONS INTERVIEWED AND PARTICIPANTS IN FOCUS GROUP 
DISCUSSIONS 75
ANNEX 8: SUMMARY MATRIX FOR ACHIEVEMENTS OF THE CAPACITY BUILDING 
COMPONENT OF HIPS 80
ANNEX 9: MAPPING CHANGES ARISING FROM IMPLEMENTATION OF HIPS 83
ANNEX 10: COMPANY AFFILIATION TO UMA/FUE 85
ANNEX 11: HIPS PARTNER CLINICS THAT RECEIVED MEDICAL AND DIAGNOSTIC 
EQUIPMENT 89
iv
Acronyms 
ACP AIDS Control Program 
AIC AIDS Information Centre 
AIDS Acquired Immune Deficiency Syndrome 
ANC Antenatal Care 
ART Antiretroviral Treatment 
ARVs Antiretroviral Drugs 
BCC Behavioral Change Communication 
CBOs Community Based Organizations 
CBVs Community–Based Volunteers 
CDC Centre for Disease Control 
CSR Corporate Social Responsibility 
CYP Couple years of protection 
DBFP District Budget Framework Paper 
DCA Direct Credit Authority 
DDP District Development Plan 
DHO District Health Officer 
DHTs District Health Teams 
DOP District Operational Plan 
DOTS Directly Observed Treatment 
EMG Emerging Markets Group 
FGD Focus Group Discussion 
FP Family Planning 
FUE, Federation of Uganda Employers Association 
GDA Global Development Alliance 
HCT Home based Counseling and Testing 
HCT Home based Counseling and Testing 
HIV Human Immune Virus 
HMIS Health Management Information System 
HSSP Health Sector Strategic Plan 
IAA International Air Ambulance 
IEC Information, Education and Communication 
IGAs Income Generating Activities 
IUDs Intra-Uterine Devices 
JCRC Joint Clinical Research Centre 
JHU Johns Hopkins University 
JMS Joint Medical Stores 
KCCL Kasese Cobalt Company Ltd 
LLINs Long Lasting Insecticide Treated Nets 
LTPM Long Term and Permanent methods 
MCP Malaria Control Program 
MGLSD Ministry of Gender, Labour, Social Development 
MIP Malaria Treatment and Prevention in Pregnant Mothers 
MOH Ministry of Health 
MOUs Memorandum of Understanding 
NGOs Non-Governmental Organizations 
NSHS National Social Health Insurance Scheme 
NTLP National Tuberculosis and Leprosy Program 
OGAC Global AIDS Coordinator 
v
OVC Orphans and vulnerable children 
PACE Program for Accessible Health, Communication and Education 
PLHA People Living With HIV/AIDS 
PMP Performance management plan 
PMTCT Prevention of Mother to Child Transmission 
PNC Post-Natal Care 
PPP Public Private Partnership 
PPPH Public Private Partnerships for Health 
RH Reproductive Health 
RVZ Royal Van Zanten 
SMC Safe Male Circumcision 
STIs Sexually Transmitted Infections 
SURE Securing Ugandans’ Right to Essential Medicines 
T&C Testing and Counseling 
TASO The AIDS Support Organization 
TB Tuberculosis 
TEC Total Estimated Cost 
TPC Technical Planning Committee 
UGACOF Uganda Coffee factory 
UGX Uganda Shillings 
UHF Uganda Health care Federation 
UHMG Uganda Health Marketing Group 
UMA Uganda Manufacturers Association 
USAID United States Agency for International Development 
USG United States Government 
VCT Voluntary Counseling and Testing 
WHO World Health Organization 
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EXECUTIVE SUMMARY 
The health sector in Uganda has been overwhelmed by a growing demand for services. Although there 
are an adequate number of health units, the services provided in the public sector are often of low 
quality. As a result, the private sector has played a growing role in providing health services. However, 
the private sector is disjointed and regulatory frameworks for quality are lacking. Further, no 
coordination framework exists to support linkages between private and public care. Thus, the significant 
number of patients seeking care in the private sector may also receive inadequate care. 
Contrary to the popular belief that the poor are unable to pay for health services, there is evidence 
showing that when health care is needed, 36% of the population first seek care in private sector facilities 
(UNHS1, 2011). To increase the quantity and quality of health care services available, it is critical to 
incorporate both the public and private sector in quality improvement initiatives. It is against this 
backdrop that USAID made a strategic decision to support strengthening and expansion of services 
provided by the private sector as a key intervention. 
HIPS is a dynamic project designed to be responsive to the unique demands of supporting the private 
sector in Uganda. Under this project, HIPS aims to increase access to and use of HIV/AIDS, 
tuberculosis, reproductive health/family planning (FP) and malaria services through mid and large size 
employers within the private sector. Working in 57 districts across Uganda, HIPS partnered with over 
111 companies and 100 clinics (50% company clinics and 50% private clinics).The strategies HIPS 
adopted to achieve this objective included: expanding the number of global development alliance (GDAs) 
partnerships; supporting initiatives to strengthen private sector workers’ organizations to support health 
initiatives; and to implement innovative approaches to support orphans and other vulnerable children 
through the private sector. 
USAID/Uganda commissioned the HIPS project final evaluation in August 2012 to assess the 
effectiveness of the approaches implemented under the project and identify factors for success. 
The final evaluation was designed as a cross-sectional descriptive assessment using mixed methods. 
Qualitative data was collected through the use of in-depth interviews (1062) and focus group discussions 
with beneficiary groups. Observable findings were recorded. Quantitative data was collected through 
exit poll interviews with randomly selected facility clients (343). 
Findings of this evaluation indicate that HIPS has largely achieved its overall objective of expanding access 
to key services, including: HIV/AIDS, Tuberculosis (TB) and malaria; as well as reproductive health/family 
planning by increasing the number of clinics, improving the quality and expanding the menu of services 
provided. 
 As a result of increased number of HIPS supported private sector facilities providing HIV/AIDS 
testing and counseling services (from 29 in 2008 to 100 in 2012) and increased outreach, over 
90,824 clients were counseled, tested and received their results in 2012, a significant increase 
from 11,441 people tested in 2008. 
 
1Uganda National Household Survey (UNHS), 2010; conducted by the Uganda Bureau of Statistics (UBOS) 
2The distribution of key informants was as follows: Companies (60); Private Clinics (30); DHOs (8); Ministry of Health (4) and 
Collaborating Institutions (4). Collaborating institutions included: Federation of Uganda Employers (FUE), Uganda manufacturers
Association (UMA); Uganda Health marketing Group (UHMG); Johns Hopkins University and Mildmay 
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 Through the provision of technical assistance, equipment and brokering partnerships with 
service providers, HIPS has supported 88 companies to get accredited to provide ART services 
and 45 companies to provide TB treatment, a service area previously dominated by the public 
service. HIPS partners have registered a 150% increase in the number of clients currently
receiving ART services; from 2,363 in 2008 to 5,916 in 2012. HIPS facilitated referrals to clinics 
where employees could be treated through insurance schemes or direct fee-for-service referral 
arrangements. The TB case detection rate increased from 30 TB cases in 2008 to 393 TB cases 
in 2012, reflecting increased screening of patients among HIPS trained providers. 
 The number of clients who utilized family planning for the first time increased from 500 in 2008 
to 12,137 in 2012. Couple Years Protection (CYP) during that period increased from 934 in 
2008 to 43,868 in 2012. 
 Through the HIPS partner outlets, 17,986 insecticide treated nets have been distributed to 
citizens’ especially pregnant women and children under 5 years. Free intermittent presumptive 
treatment (IPTp) for malaria was provided to all pregnant women, including company employees, 
dependents and surrounding communities by HIPS partners. 
Peer education and behavioral change communication led by the beneficiary companies and facilities 
were effectively used to create demand for utilization of services within the companies and neighboring 
communities. Overall, set targets for the expansion of the different health services were achieved and 
in many instances exceeded. The absence of comprehensive and up to date data on the scope and 
operations of the health private sector and a project specific baseline assessment to inform planning may 
have affected the establishment of ambitious project targets. There were missed opportunities during 
the two program extensions in 2010 and 2011 to strategically review progress, synthesize emerging 
lessons to inform adjustments in the program targets. More could have been achieved if these targets 
had been revised. 
To protect the health and productivity of their employees, businesses need to address the continuum 
between the workplace and surrounding communities. HIPS leveraged private resources to address the 
needs of Orphans and Vulnerable Children (OVCs) resident in the surrounding communities. By the 
end of the HIPS program, 4,260 OVCs were exposed to opportunities to strengthen skills and explore 
improved livelihoods through corporate sponsorship programs (donations to OVC support 
organizations to support education and nutrition), supply chain out-grower programs (companies 
purchase crops from OVC households), and market access programs (including formation of grower 
associations and training to improve quality). 
From this evaluation, it is apparent that private companies can and will contribute resources towards 
private health care initiatives, when presented with clear and compelling evidence. Using evidence from 
a study on costs of ill health on the productivity of companies, HIPS demonstrated to companies the 
profitability of investing in health care of their employees. With HIPS support, companies have 
developed a clear way of assessing the unit cost of providing health services and are now more aware of 
the impact of health on employee productivity. This was coupled with the use of Global Development 
Alliance (GDA) as a mechanism for leveraging private sector resources for workplace health programs. 
GDA partnerships entailed a 1:1 financial and in kind contribution from USAID and the company 
towards mutual objectives. HIPS increased the number of GDA partnerships from 5 to 52 by 2012 
mobilizing over $1.9 million from the companies, 90% more funds than had been anticipated. To date, 
83% of these GDAs are currently active. Anecdotal evidence showed that the minimum requirement of 
$5000 locked out some potential partners. 
Umbrella organizations like Uganda Manufacturers Association (UMA) and the Federation of Uganda 
Employees (FUE) are strategic entry points towards mobilizing affiliate companies to commit resources 
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and sustain health initiatives in the private sector.These organizations represent important sustainability 
mechanisms. HIPS has worked with these organizations to build their capacity as lead providers of 
workplace health programs to their member organizations. Through their newly established health 
business development units, UMA and FUE are mobilizing resources from affiliate companies and other 
development partners. These resources will facilitate continuous capacity building for health programs 
within the affiliate companies even after the close of HIPS. By 2012, 63% of HIPS active partners were 
receiving support formerly provided by HIPS. 30 partners are already paying for services directly from 
UMA and FUE which is an indication of their demand for their services. The noted challenge has been 
the ability of UMA and FUE to attract long term funding for the workplace activities. FUE and UMA 
membership is only limited to companies and excludes some of the private health facilities. This means 
that these facilities will not be able to access the support including the capacity building initiatives being 
provided by UMA and FUE after the close of HIPS. 
Private sector capacity to provide services has been improved as demonstrated by the increase in 
services provided to different target groups and the satisfaction of clients with the quality of these 
services. This has been achieved through targeted training and mentoring of staff, provision of critical 
equipment, brokering of partnerships with service providers and increasing partnerships with the key 
service providers. 82% of HIPS supported companies have developed and are implementing HIV 
workplace policies that provide a framework and resources for companies to implement workplace 
health programs and protect employees against discrimination. Improved reporting of private sector 
contribution towards health outcomes is being achieved through a mobile technology platform to report 
performance information, monitor stock outs and share health information. New equipment provided 
by HIPS on a cost share basis in 57 companies has created ownership and supported the expansion of 
menu of services provided and improved quality and utilization of services. 95%of clients interviewed in 
the exit polls said they were satisfied with the quality of services received in the company clinics and 
private facilities. Only 5% reported dis-satisfaction. Clients of private clinics were more satisfied (65%) as 
compared 29% of clients at company clinics. This is evidence of the increasing role of the private clinics 
in providing quality health services and justifies the need for continued support. 
Staff attrition, irregular supplies of key commodities like ARVs and costs of services are still key 
constraints to ensuring a sustained provision and use of services provided by the private sector. Nearly 
2 of every 3 company clinics and private facility staff members trained under the HIPS program has left 
the job. Drug stock outs of ARVs and TB policy restrictions in 2010-2011 and still occurring 
irregularities in drug supply affect service provision and long time commitment of the private sector 
facilities to provide some of these critical services. 45% of the accredited companies to provide ARTs 
are not doing so partly due to staffing problems and drug shortages. Over 28.5% of clients in the exit 
polls determined that cost was one of the barriers to using the services provided by these facilities. 
With the support of HIPS, the Public Private Partnerships for Health (PPP-H) policy was passed in 2012 
to create a more conducive environment for the private sector to contribute significantly to health 
service delivery. The newly created PPP unit in the MoH will need ongoing support to ensure successful 
operationalization of the PPP-H policy at various levels. 
Within the private sector itself, important strides have been made in establishing a coordinating body 
and a voice for the sector. HIPS supported the creation of the Uganda Health Federation (UHF) in 2011 
bringing together existing private sector health entities under one umbrella recognized by government. 
UHF is now working together with different stakeholders to develop a sound regulatory framework and 
standards for quality of care in the private sector. UHF is expected to play a critical role in the roll out 
of these standards amongst its members once the process is completed. Sustainability of HIPS supported 
initiatives in improving the quality of services in the private sector will be dependent on the capacity of 
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the UHF. UHF will continue to need support in expanding its membership and rolling out the self￾regulatory mechanism once completed. 
Several important factors facilitated HIPS’ success. First, there was a strong project design from the 
outset, which made it easier to secure buy-in from key stakeholders. The design promoted a model 
where each party contributes according to their resources and market leverage. Secondly, HIPS 
supported existing MoH policies and plans, working to help government achieve goals already outlined in 
the national strategic plans. Finally, HIPS had a strong operational focus, working to broker partnerships 
as a key strategy, ensuring partners worked together to achieve important project goals. 
Key recommendations for future private sector strengthening initiatives in Uganda include: 
1. USAID and other developing partners should continue to support both company clinics and 
private clinics because of their different, yet synergistic approaches to service delivery. For 
example, private clinics largely serve paying clients, mainly in the more urban settings. Company 
clinics, on the other hand, mainly serve employees, their dependents, and lower income 
members of the surrounding communities, often in rural areas. 
2. GDA partnerships to leverage private sector resources were very successful and should be 
scaled up in related future programming by USAID. 
3. Performance based grants should be introduced for private clinics to ensure full utilization of the 
capacity built by programs like HIPS. Within a regulatory structure that promotes quality, 
performance based grants ensure that providers continue to expand services while maintaining 
national standards for care. In addition, incentives for quality performance can be used to 
motivate staff and mitigate staff attrition. 
4. To facilitate stronger public-private partnerships at the national level, the MoH together with 
USAID and other development partners should strengthen the PPP Unit in the roll-out of the 
PPP-H policy at both national and district levels over the coming years. 
5. Future programming in health for the private sector should continue to support UHF as a 
critical platform to improve coordination and build on current efforts in improving regulation 
and quality of care within the private sector. 
6. Future projects implemented by USAID should invest in conducting an inventory of private 
health facilities and a detailed baseline assessment to establish better the scope and depth of 
their interventions to inform more realistic project benchmarks. A cost-benefit analysis (CBA) / 
cost effectiveness analysis to establish value for money and return on investment for similar 
initiatives would be instrumental in mobilizing support for investments in the health private 
sector. 
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1. BACKGROUND, EVALUATION PURPOSE, EVALUATION QUESTIONS 
1.1 Project Background 
The health sector in Uganda has been overwhelmed by a growing demand for services. Health service 
delivery has been dominated by a strained public sector. Although there are an adequate number of 
health units, the services provided in the public sector are often of low quality. As a result, the private 
sector has played a growing role in providing health services. However, the private sector is disjointed 
and regulatory frameworks for standardizing quality of care are lacking. The situation is exacerbated by 
the diverse nature of private sector establishments and weak country systems for enforcing standards of 
practice. There is no formal coordination framework to support linkages between private and public 
care. Thus, the significant number of patients seeking care in the private sector may also receive 
inadequate care. 
A Survey of Private Health Facilities in Uganda (2005) reported 2,156 registered private clinics, excluding 
drug shops, whereby 68 percent of them are in the central region and Kampala alone, which accounts 
for 45 percent of all private clinics in the country. Over 90 percent of private clinics provide outpatient 
curative services. Although health infrastructure in the private sector has expanded, the vast majority of 
health facilities is not fully functional, lack equipment and staff, and is poorly maintained. 
Contrary to the popular belief that the poor are unable to pay for health services, there is evidence 
showing that when health care is needed, 36% of the population first seek care in private sector facilities 
(UNHS3, 2011). Clearly, the private sector is filling an important gap in provision of health services. To 
increase the quantity and quality of health care services available, it is critical to incorporate both the 
public and private sector in quality improvement initiatives. 
The Ministry of Health (MOH) in Uganda has recognized the significance of the private sector. MOH 
acknowledges the role of private sector as a major partner in national health development and service 
delivery in the Health Sector Strategic Plan (HSSP) III. 
It is against this backdrop that USAID made a strategic decision to support strengthening and expansion 
of services provided by the private sector as a key intervention point. USAID interventions in the 
private sector were first piloted under the BUSINESS PART program (November 2004 to September 
2007) partnering with five companies to provide HIV/AIDS services. On October 1, 2007, the USAID 
Uganda Mission signed a $8,689,764 three year contract, with Emerging Markets Group (EMG) Limited 
to engage the private sector through a new Health Initiatives for Private Sector program (HIPS) with the 
option of two additional years. This project has since been extended twice to now end on March 31, 
2013 bringing the Total Estimated cost (TEC) to $17,189,764. 
The goal of the HIPS project is to improve access and utilization of health services. HIPS is a dynamic 
project designed to be responsive to the unique demands of supporting the private sector in Uganda. 
Under this project, HIPS aims to increase access to and use of HIV/AIDS, tuberculosis, reproductive 
health/family planning (FP) and malaria services through mid and large size employers within the private 
sector targeting company employees, their dependents and surrounding communities. 
 
3Uganda National Household Survey (UNHS), 2010; conducted by the Uganda Bureau of Statistics (UBOS) 
6
HIPS works in 57 districts across Uganda, partnering with over 111 companies and 100 clinics (50% 
company clinics and 50% private clinics). The detailed coverage map is attached as part of Annex 1. 
As the first comprehensive health private sector program in USAID/Uganda, HIPS provides valuable 
lessons on best practices and approaches that can be integrated in future programming within the 
Mission and the Ministry of Health to support national efforts in strengthening the health private sector 
to provide accessible and quality health services to the citizens of Uganda. 
1.2 Purpose of the Evaluation 
USAID/Uganda commissioned the HIPS project final evaluation in August 2012 to assess the 
effectiveness of the approaches implemented under the project and identify factors for success. 
Specifically, the evaluation aimed to: 
a) Assess the effectiveness of approaches implemented under HIPS and factors for success; 
b) Document what worked well and what could have been done better, as well as limitations and 
challenges; 
c) Establish lessons learned and good practices that can be adopted and scaled up; and 
d) Generate information to inform the design of future programs by USAID and the Government 
of Uganda. 
1.3 Evaluation Questions 
The final evaluation of the HIPS project answered the following questions: 
1. Have the desired results been achieved? 
2. Has HIPS effectively addressed the capacity building and service delivery needs of a challenging 
private sector environment? 
3. How effective has HIPS been in strengthening existing private sector coordination structures 
and partnerships between the public sector and government bodies at the national and district 
level? 
4. What are the most effective approaches and innovations that should be scaled up? What factors 
will contribute to the success of these approaches? 
5. What factors have contributed to success or failure of the project – what worked or did not 
work? 
6. To what extent has HIPS strengthened the sustainability of private companies/entities and their 
ability to continue to provide health services after the close of the program? 
A detailed SOW is contained in Annex 2. 
1.4 Evaluation Methods and Limitations 
1.4.1 Evaluation Design 
The final evaluation study was designed as a cross-sectional descriptive assessment, analyzing inter￾linkages between program processes, outputs and outcomes. 
1.4.2 Methods of Data Collection 
The study used mixed methods to collect data. The use of mixed methods was to enable triangulation 
of data from different sources hence validating the authenticity of the data. 
Qualitative data was collected through the use of in-depth interviews (106) and focus group discussions 
(6). Key informants included: the HIPS implementation team, In-Charges of the health facilities (head 
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staff); District Health Officers; Ministry of Health Officials; Human Resource Managers of beneficiary 
companies; officials of Uganda Manufacturers Association (UMA) and Federation of Uganda Employers 
(FUE); and training officers at Mildmay Uganda. Interviews were also conducted with the relevant USAID 
staff. 
The evaluation team conducted focus group discussions with several groups representing women, men 
and youth at the Kakira Sugar Works sites in Jinja and at the Farmers Centre in Lira. Observable findings 
were also recorded. 
Qualitative data was augmented with quantitative data collected through exit polls with facility clients. 
Three hundred forty three (343) interviews were conducted with randomly selected clients at facilities 
visited. Primary data from the field was triangulated with information from secondary sources for 
comparison purposes and validation. Relevant documents were accessed from the various stakeholders 
and reviewed for this purpose. 
A purposive sample of 60 facilities involved in the project (30 company clinics and 30 private clinics) was 
drawn for collection of facility level data. The main criteria for selection included: location of facilities 
(rural/urban), service delivery mix (prevention, treatment, care and support for HIV, TB, malaria & 
reproductive health services); and type of health facility (company/private clinics). 
Detailed information on the participants in the in depth interviews and focus group discussions, list of 
documents reviewed, summary of health facilities sampled can be found in Annex 3-7. 
1.4.4 Data Management and Analysis 
Different methods of data analysis were used. These included: content analysis (for secondary sources); 
thematic analysis (for key informant interviews and focus group discussions); and descriptive analysis (for 
client exit interviews). 
1.4.5 Limitations of the Evaluation 
 Busy schedule of key informants at the health service delivery points 
Key informants interviewed as part of this evaluation were often the in-charges of the health 
facility or service point. The health facilities had a backlog of patients waiting to be seen. As a 
result, health workers divided their available time between the patient and our interviewer. This 
limited the interview time available. To address this limitation, the evaluation team followed-up 
by phone when interviews could not be completed at a single sitting. 
 High staff turnover, resulting in difficulty in tracing health workers that were trained under HIPS 
Two out of three health workers trained under HIPS had changed employers by the time the 
project was complete. The turnover was reportedly due to better opportunities elsewhere. The 
consulting team endeavored to locate the respondents who had changed work places, but this 
was not always possible, as contact information (such as cell phone numbers and primary 
residence) had changed. 
 Stigma related to HIV and TB led many clients to decline interviews or limit their responses. 
Consequently, 343 clients out of the originally planned 480 clients were interviewed. To address 
this challenge, the team worked to build a stronger rapport with clients before asking sensitive 
questions. 
These limitations notwithstanding, the consulting team obtained sufficient information for the evaluation. 
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2. FINDINGS 
2.1. Were the Desired Results Achieved? 
The core objective of the HIPS project was to increase access and uptake of key health services, HIV, 
tuberculosis, reproductive health, family planning (RH/FP) and malaria)through medium and large size 
employers within the private sector. To achieve this objective, HIPS project sought to undertake the 
following tasks: 
i) Expand and strengthen access to and utilization of health and HIV/AIDS services in the private 
sector; 
ii) Expand the number of Global Development Alliance (GDA) partnerships; 
iii) Support initiatives to strengthen the capacity of private sector organizations to support health 
initiatives; 
iv) Implement innovative approaches to support orphans and other vulnerable children through the 
private sector 
2.1.1 Expanding and strengthening access to and utilization of health and HIV/AIDS 
services in the private sector. 
Unlike the previous Business PART program that focused on only HIV/AIDS, the HIPS approach 
towards expanding access of services provided by private sector was to enable them provide a holistic 
package of preventive and curative care (including palliative care)centered around HIV, TB, malaria and 
RH/ FP. By 2012, over 80% of the supported health facilities were providing an integrated health care 
package comprising: HIV treatment and care services; TB screening and/or treatment; malaria 
prevention and treatment for pregnant mothers; and RH/family planning services. HIPS provided a 
combination of training and capacity building support, equipment, brokering of partnerships and linkages 
with relevant service providers all geared at enabling the partner company clinics and private for profit 
facilities provide accessible and quality health services. 
a) HIV/AIDS 
HIV Testing and Counseling 
By 2012, 100 of the HIPS supported facilities were providing testing and counseling services, up from 29 
sites in 2008. Over 90,824 clients have been 
counseled, tested and received their results, a 
significant increase from 11,441 people tested 
in 2008. 51% of the clients were male, 49 % 
female. Over 90% off the clients were over 
18 years. Some focus has been made over 
the years to target most at risk populations 
like fishing communities, truck drivers and bar 
workers. These results are reflective of 
similar improvements in HCT from the 2011 
Uganda Aids Indicator Survey that showed 
that the proportion of women age 15-49 that 
have ever been tested for HIV and received 
results has increased from 13% in 2004/5 to 
66% in 2011 and for men from 11% to 45%. 
Counseling and testing achievements 
exceeded the performance management plan 
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targets annually. The HIPS project facilitated the training of 289 counselors by the AIDS Information 
Centre. The high level of achievement was also enabled by VCT outreaches in the surrounding 
communities conducted by company supported clinics. 
HIV treatment 
Uganda has experienced high HIV prevalence levels over the past twenty years, increasing from 6.4 
percent in 2004/5 to 7.3 percent in 2011. This heavy burden demands substantial investment in ART 
treatment to reduce the HIV related 
mortalities. Prior to 2008, provision of ART 
services was the domain of the public sector. 
With the MoH already accrediting private 
facilities to provide HIV/AIDS services, USAID 
has invested in strengthening capacities of the 
private companies to build their eligibility for 
accreditation and thereby ability to provide 
services. HIPS trained staff and supported 
clinics to secure equipment and infrastructure 
necessary for provision of quality services in 
accordance with the national standards. By 
2012, HIPS had expanded the number of 
accredited facilities to 100 (63% company 
clinics, 37% private clinics) from 19 achieved 
by BUSINESS PART to provide ART. 
Accreditation also implies access to free drugs from government. This significantly increased access to 
quality HIV/AIDS treatment services that meet national standards. ART sites accredited with HIPS 
support are located across 57 districts of Uganda. These initiatives supported existing MoH plans to 
accredit private clinics. 
HIPS-supported facilities registered 134.5% increase in the number of adults and children who had ever 
started on ART over the course of the program. The number currently on ART increased from 2,363 in 
2008 to 5,916 in 2012 including HIV positive women who received ARVs for Prevention of Mother to 
Child Transmission (PMTCT) services. This reflects a 150% increase in the number of clients currently
receiving these services among HIPS partner clinics over the course of the project. In order to increase 
access to HIV treatment services, HIPS facilitated linkages between companies with small or no on-site 
treatment clinics to organizations that could manage or provide these services. Insurance agencies like 
IAA and Microcare took over management of health services of selected companies i.e. KCCL, RVZ, 
Hima Cement, and UGACOF. Similarly, HIPS has helped companies identify clinics for companies to 
refer their employees to, sometimes involving insurance schemes or direct fee-for-service referral 
arrangements. 
Currently, only 55% of the accredited company clinics / private facilities are providing ART due to the 
unreliability of ARVs and loss of trained staff. This has affected the availability of services. More on these 
issues is discussed in subsequent sections. 
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b) Tuberculosis (TB) 
In Uganda, the authority to approve facilities to dispense TB drugs is provided by the National 
Tuberculosis and Leprosy Program of the MOH (NTLP) and thus the need for accreditation. Between 
2008 and 2012, HIPS supported 
accreditation of 45 private and company 
clinics to offer TB-DOTS services in 
accordance with national standards. The 
program experienced challenges during 
some periods (2009-2011) in achieving its 
targets due to policy restrictions from the 
NTLP that affected the supply of TB drugs 
to private sector facilities and thus affecting 
the pace of accreditation. To date, only the 
45 facilities are accessing drugs from the 
public sector. Nevertheless, during the 
period 2008-2012, 20,773 HIV positive 
clients were screened for TB in HIPS 
partner clinics and 1,057 clients who tested 
smear positive for TB received treatment through DOTS as illustrated in Fig.2.3. TB case detection 
increased from 30 TB cases in 2008 to 393 TB cases in 2012, reflecting increased screening of patients 
among HIPS trained providers. 
c) Malaria 
HIPS partnered with the Presidential Malaria Initiative to provide intermittent preventive therapy (IPT); 
rapid diagnostic tests (RDT); and insecticide treated mosquito nets (ITNs). HIPS linked partner 
companies to UHMG and PACE, for procurement of subsidized ITNs that were then either distributed 
or sold to company employees. The number of ITNs distributed increased from 685 in 2008 to 17,986 
in 2012 (. Pregnant women and children under 5 years were targeted to receive ITNs. 
Additionally, in partnership with the MoH and district government, HIPS scaled up intermittent 
presumptive treatment (IPTp) for malaria among partner ANC clinics. The clinics provided free IPTp 
services to all pregnant women, including partner company employees, dependents and surrounding 
communities. HIPS also procured commodities for IPT Program including Fansidar tablets, disposable 
cups, water vessels and aqua safe tablets that were used at the ANC clinics. Further, partner facilities 
were monitored to ensure presence of sufficient stocks. The number of women who received 2 or 
more doses of IPTp increased from 685 in 2008 to 17,986 among clients in partner clinics.
d) Reproductive Health/Family Planning 
The number of clients who attended family 
planning sessions at HIPS partner clinics and 
received information on birth spacing, 
method choices, and available products with 
proper instructions for use increased from 
850 in 2008 to 35,270 by 2012. The number 
of clients who utilized family planning for the 
first time increased from 500 in 2008 to 
12,137 in 2012. This huge shift confirms the 
large unmet need for family planning and 
reproductive health services in Uganda, 
estimated at (41%) in 2011 (Reproductive 
11
Health Uganda, 2011). Couple Years Protection (CYP4) during that period increased from 934 in 2008 
to 43,868 in 2012.
Achievements in service utilization have greatly been affected by the peer education. Company clinics 
provided peer education which created demand among surrounding communities. Peer education was 
done through community volunteers and company peer educators to sensitize employees and 
communities to: 
i) seek services 
ii) reduce HIV/AIDS and TB related stigma; 
iii) accept VCT and TB treatment. 
The demand created by peer education for services was evidenced during in-depth interviews among 
clients. For example: 
At first, I did not want to be identified as a PLWHIV until I was helped by my colleague at work, 
who encouraged me to test and be able to receive treatment (ART) in case I was found HIV 
positive. – employee of Kakira Sugar Works Clinic, September 2012 
For me, I contracted TB but had not known of my status. I was advised to undertake TB 
screening which I did after a long time of denial. I was tested and that is when I found that had 
contracted TB. I am very happy that I received treatment. I now encourage people to test and 
know their status since they will receive free treatment. –client of Mpanga Growers’ Tea Factory 
Clinic 
The peer education strategy was very effective because it was cheaper for the companies as the peers 
were workers who acted as volunteers. Workers opened up more easily to their friends/peers about 
their health than they would, to unknown people. The peer educators convincingly advised their affected 
colleagues to seek services. Peer education, therefore in most cases, led to increased utilization of 
services. A study5 conducted by HIPS in 2011 among ten (10) partner companies found a strong 
correlation between peer education and service utilization. 
To further increase demand for services, HIPS worked with the companies and clinics to provide 
employee and community sensitization on HIV/AIDS, TB, malaria and RH/FP. Recipient companies 
predominantly paid for printing of materials while HIPS provided technical assistance. An analysis of 
project reports shows that estimated 60,000-170,000 community members were reached annually 
through health fairs and exposure to health messages promoting behavior change. 
Overall, set targets for the expansion of the different health services were achieved and in many 
instances exceeded. The absence of comprehensive and up to date data on the scope and operations of 
the health private sector and a project specific baseline assessment to inform planning may have affected 
the establishment of ambitious project targets. There were missed opportunities during the two 
program extensions in 2010 and 2011 to strategically review progress, synthesize emerging lessons to 
inform adjustments in the program targets. This challenge could also have been mitigated through a 
 
4Couple years of protection (CYP), estimated as protection provided by contraceptive methods during a one-year period, 
based upon the volume of all contraceptives sold or distributed free of charge to clients 
5 Behavioral Change Communication (BCC) Best Practices Study, 2011 
12
more in-depth participatory planning process with stakeholders at project inception and a formal mid￾term review to revise targets. 
2.1.2 Expanding the Number of Global Development Alliance (GDA) Partnerships. 
The Global Development Alliance (GDA) is a market-based business model for partnerships between 
the public and private sectors to address jointly defined business and development objectives. Alliances 
are co-designed, co-funded, and co-managed by partners so that the risks, responsibilities, and rewards 
of partnership are equally shared. 
A well-constructed GDA furthers the objectives of the USAID mission while benefiting the business 
interests of the resource partner. A partnership is considered a GDA when it meets the following 
criteria: 
 At least 1:1 leverage (in cash and in-kind) of USAID resources; 
 Common goals defined for all partners; 
 Jointly-defined solution to a social or economic development problem; 
 Non-traditional resource partners (companies, foundations, etc.); 
 Shared resources, risks and results, with a preference for increased scale of impact; and 
 Innovative, sustainable approaches to development. 
HIPS GDA partnerships were governed by MOUs and/or subcontracting agreements that clearly 
articulated each partner’s roles and responsibilities and outlined a cost structure for services, including 
each partner’s financial and in kind contribution—with a minimum of 1:1 resource matching. 
The GDA partnerships approach was modeled on Business PART6 that had MoUs with five private 
companies. The GDA approach was essentially a way to leverage private sector resources (in addition 
to donor funds) for health initiatives targeting not only employees, but also their dependents and the 
surrounding communities. 
The number of GDA partnerships increased from 5 under Business PART to 55 through HIPS by 2012. 
Currently 46 (83%) of the GDA partnerships are currently active7. Through HIPS, $1 million USD was 
used to leverage $1.9 million USD from the private sector. However, anecdotal evidence showed that 
the minimum requirement of contributing $5,000 (1:1 cost sharing requirement) could have locked out 
some potential partners who were unable to meet this criterion. Other partnerships have fallen out 
along way due to failure to meet the requirements set out in the MoUs. 
Using the disease cost calculator, HIPS was able to demonstrate to private companies that it was more 
profitable to invest in health care for their employees, rather than incur financial losses associated with 
prolonged absenteeism, death, low productivity and attrition; culminating in constant recruitment and 
training of new staff. 
 
7 GDA partnerships are renewed annually based on extent to which mutual obligations are being met including the investing the 
minimum requirement of USD 5000 
13
HIPS conducted research8 to establish the actual cost of ill-health to company productivity. The 
outcomes suggested that companies with larger numbers of employees were more vulnerable to costs 
associated with ill-health, particularly those with many low-cadre workers. In addition, some companies 
had stronger ties with the community that made community health a higher priority. For example, most 
companies in the agricultural sector had important linkages with communities through out-grower 
schemes. Based on the evidence that ill-health among employees leads to higher costs for the company, 
businesses were convinced to commit more resources and engage with the HIPS project to improve the 
health of employees, their dependents and the community. Through the GDAs, HIPS was able to 
leverage 1.9 million from the private sector; 90% more than anticipated. 
CEOs and Business Leader days were instrumental in exposing the specific organization leaders to the 
array of services their companies could benefit from if part of a GDA and helping them to appreciate the 
benefits that would accrue to their organizations. 94 CEOs and 136 members of companies’ top 
managements were involved in these events over the years. Indeed, the consulting team found that 
CEOs who participated in these days appreciated the role of VCT and supported their organizations to 
benefit from HIPS project. 
HIPS worked with the Uganda Manufacturers Association (UMA) and the Federation of Uganda 
Employees (FUE) to broker alliances with their member organizations and encourage them to enlist for 
the GDA partnerships. Both these organizations are extremely strategic as they bring together a wide 
membership of private sector organizations and employees in Uganda. 
2.1.3 Supporting Initiatives to Strengthen the Private Sector Workers’ Organizations to 
Support Health Initiatives 
HIPS worked through the Uganda Manufacturers Association (UMA) and the Federation of Uganda 
Employees (FUE), the lead employment organizations to build their capacity as lead providers of 
workplace health programs to their member organizations. UMA and FUE were seen as strategic entry 
points to their affiliate companies. HIPS encouraged partners to affiliate to UMA or and FUE regardless 
the companies’ capacity to raise the $ 5,000 contribution to become GDAs. 
Under this arrangement, companies affiliated to UMA (22) and FUE (40) joined the partnership9. (see 
Annex 10 for details). The HIPS project emphasized strengthening the institutional, financial and 
programmatic capacities of partner organizations for efficient delivery and sustainability of services. 
UMA and FUE were strengthened to support workplace health programs in their member organizations. 
This has included provision of training in non-clinical services including health promotion and preventive 
services for HIV, TB, malaria and RH/FP and other health services. With HIPS support, both 
organizations have now established health business development units to mobilize resources for 
continued capacity building of member organizations and service delivery after the close of HIPS project. 
 
8A study (The Impact of ART on Employer Costs Related to AIDS) by Paul Bukuluki, 2009found that the average annual cost of 
ART to a partner company is 0.13% % of the total annual cost of labour, compared to 0.14% (of the total annual cost of labour) 
attributable to worker attrition
9 Note that a partner company was free to affiliate to either UMA or FUE or both.  
14
As indicated in Table 2.1, both FUE and 
UMA have generated USD 63,056 and 
42,504 respectively from workplace 
health activities throughout the project 
life. HIPS also built capacity of partner 
organizations to attract funding from 
other development partners for health 
activities. For instance, FUE generated 
USD 141,280 in grants over the final 3 
years of the project; GTZ (7,680); 
Uganda AIDS Commission (46,880); 
Respond (62,400); and ILO (26,400). The 
developed capacity of FUE and UMA helps build sustainability beyond the life of the HIPS project. 
However, the FUE and UMA membership is only limited to companies and excludes some of the private 
health facilities. This means that these facilities will not be able to access the support including the 
capacity building initiatives being implemented by UMA and FUE after the close of HIPS. The Uganda 
Health Federation (UHF) described later becomes an entry point then to rolling out support to the 
private for profit facilities. 
2.1.4 Innovative Approaches to Support Orphans and other Vulnerable Children through 
the Private Sector 
To protect the health and ensure productivity of their employees, businesses need to address the 
continuum between the workplace and surrounding communities. Recognizing the value in this 
comprehensive view of corporate citizenship, HIPS engaged companies to sponsor disease awareness, 
prevention, testing and treatment activities in the surrounding communities. Further, HIPS extended 
OVC programs to the communities where employees and their families live. Since companies source 
their labor from these surrounding communities, better health for the community means better health 
for employees and their dependents.
HIPS involvement in care and support for OVCs focused on using partnerships with private companies 
to leverage resources through Corporate Social Responsibility (CSR) strategies. HIPS developed three 
models for implementing OVC programs: corporate sponsorship, supply chain and market access 
models. In each model, HIPS identified community-based organizations to implement the planned OVC 
activities, ensuring that appropriate strategies were used to reach beneficiaries. 
HIPS provided matching grants to corporate donations for implementation of OVC activities. In addition 
HIPS provided technical direction and capacity building for implementing organizations. HIPS monitored 
the activities to ensure quality service delivery and compliance with the National Strategic Program/ Plan 
of Interventions for OVC. 
By 2012, 4,260 OVCs have been exposed to opportunities to strengthen skills and explore improved 
livelihoods. With increased household incomes, OVCs may be better able to access services from 
private health facilities and improve household nutrition. Each of the models is described in more detail 
below. 
Table 2.1: Revenue from FUE and UMA 
 Workplace Health Activities
Year Organizations Revenue (US $)
FUE UMA 
2008
2009 5,292 
2010 12,240 6,080 
2011 24,426 7,738 
2012 26,390 23,394
Total 63,056 42,504
15
a) The Corporate Sponsorship Model 
The private sector partners provide cash and in-kind support to OVC implementing organizations as 
part of their corporate social responsibility (CSR) program. HIPS then provides matching grants to 
leverage the private sector resources. HIPS matched those corporate contributions 1:1. This 
arrangement enhanced access to education and nutrition services for 3,273 children, of whom 1,599 
were male, while 1,674 were female. Education assistance included the purchase and distribution of 
scholastic materials, and follow up of OVC at school to ensure regular school attendance and to 
minimize school dropout, hence improving children’s access to education. Food and nutrition 
interventions focused on enhancing access to food, improved farming methods, school feeding programs 
and setting up demonstration gardens at school and in the community. In addition, OVC were provided 
with psychosocial support, health care services, and apprenticeship skills training. 
Partners used sports, debates, poems and one–to-one peer support to reach vulnerable children. 
Through these approaches, the children were able to develop their communication skills, learn more 
about sexual and reproductive health, decision making, and HIV and AIDS. 
HIPS built the capacity of 11 partners in basic financial management, resource mobilization and project 
planning and management among others: Kakira Sugar Works (KORD), Cornerstone Development 
(African Children’ Mission), Kinyara Sugar Ltd (Kinyara Client Group), Bead for Life, Caring Hands, 
Mpongo Company Ltd (Fishing Communities Health Initiatives), and Farmers’ Center. Capacity building 
for organizations supporting OVC helps build sustainability beyond the life of the HIPS project. 
b) Supply Chain Out-growers Model 
The supply chain out-growers model 
worked well for smallholder farmers who 
produce raw materials for industries. The 
company worked through established 
infrastructure, such as farmer associations 
and out grower associations to help identify 
OVC households. The model links 
individual farmers who produce raw 
materials into the company’s supply chain, 
thereby keeping more small-scale farmers 
in business while supplying needed 
materials to companies. Out growers associations (544 members, 261 males/283 females) supported by 
KORD earned USD 511,094 from sales over the project life as indicated in Table 2.2. Farmers also 
received key information on income generating activities to improve their livelihoods. 
To further improve the economic independence and livelihoods of OVC families, HIPs has through the 
farmer and out grower associations’ encourgaed OVC caretakers to form Village Savings and Loan 
Associations (VSLA) to increase access to credit for income generating activities and addressing other 
socio-economic needs. By 2012, 42 VSLA have been established under the program. These groups have 
managed to mobilize total savings of Uganda Shillings 18, 68,600 (HIPS Annual Report 2012). At the 
KORD, an out-growers youth group acquired a jaggery mill and a maize mill; while the women out 
growers group bought a 6-acre piece of land with profits from the village savings and loans association 
(VSLA).Box 2.1 narrates the success story of Kyabaja Tobona group that benefited from OVC programs 
implemented Kakira Out-growers Rural Development (KORD). 
Table 2.2: Revenue earned by Out growers 
 through KORD 
Year Revenue (USD)
2008 88,113
2009 123,585
2010 137,283
2011 136,679
2012 113,547
Total 511,094 
16
These achievements (jaggery mill, maize mill, land and an established VSLA) will be sources of financial 
sustenance for their programs. In addition, to economic empowerment, HIPS used these groups to 
disseminate health messages. These included messages on prevention of HIV/AIDS, VCT, prevention and 
mitigation of child labor. 
c) The Market Access Model 
The market access model was focused on helping OVC households develop capability to produce for 
the markets as a way of strengthening the social economic security of the household. Over the 5-year 
grant, 1,458 OVCs formed associations which negotiated for higher prices for their goods. The role of 
the private sector companies was to provide technical assistance, training in quality standards, and link 
OVC households to local and international markets including the companies themselves. The 
implementing partner, in turn, worked directly with OVC households to build their capacity to produce 
for the market including training and monitoring. HIPS provided technical direction and capacity building 
for the implementing organizations, monitored the activities to ensure quality services delivery, ensured 
compliance with the National Strategic Program/ Plan of Interventions for OVC and provided a matching 
grant to implement the OVC activities. 
Through the Market Access Model, Bead for Life has doubled the price paid for shea nuts collected by 
women in Otuke County from USD 0.24 (UGX 600) to USD 0.48 (UGX 1,200) and this has increased 
the amount purchased and thereby improving sales and incomes of OVC households 
Caring Hands has also supported OVC households to improve on the quality of beads produced by the 
OVC’s which they sell on the international market. The quality and quantity of beads bought from the 
bead makers improved and the OVC caretakers realized an increase in average take home in sales from 
USD 96 (UGX 240,000) to USD 104 (UGX 260,000).
Kyabaja Tobona’ group was supported under the Kakira Sugar Works/KORD Partnership. With 30 
members, the group began its first round of activities in April 2010 after receiving training in VSLA. 
During weekly meetings, members contribute UGX 200 for to the welfare fund and UGX 1,000 as 
mandatory savings with a maximum of UGX 5,000, which is counted as shares. Each share of UGX 
1,000 is stamped into the pass book with a total of five shares maximum per member. 
By the end of the 1st cycle, the group had collected UGX 320,000 as welfare funds and UGX 
6,426,750 as savings. With support from the Community Development Officer, the shares due to each 
group member were calculated and recorded, and the members decided not to share out, but to use the 
savings to buy a younsel mill worth Ushs 4,500,000. The younsel mill was to be used to add value to the 
sugar cane they produce by making molasses. The group decided to use the balance of the funds to rent 
10 acres of land for six years - an undertaking that cost them UGX 3,000,000. The group had planted 
sugarcane and intercropped it with maize on this land. 
The group was in the process of registering a CBO under the name “Busalaama Sugarcane Growers 
Association”. This, they said, would enable them access funding and support as a group. The group 
commenced the second cycle of saving and loans in June 2011, and had saved UGX 1,487,700. The 
group’s future plans included buying a lorry to transport their sugar cane and production of molasses for 
which they had ready market in Lira. The group also nurtured two other groups - “Tibakwina” and 
“Kibike Kiryamugenzi” - each with 30 members, who were also engaged in VSLA activities.
17
The effectiveness of these models is highly dependent on the organizational capacity of the implementing 
organization, the extent to which the members of the community (target beneficiaries) felt ownership 
and confidence and trust in it. This may partly explain why some implementing organisations like KORD 
which is fully owned by the sugar cane out-growers were apparently more successful than others. Other 
challenges to the supply chain and market access model are on the capacity and thereby long term 
sustainability of the groups and associations, as is common with many community based groups. 
2.2 Effectiveness of HIPS in Addressing Capacity Building and Service Delivery Needs in 
a Challenging Private Sector Environment 
2.2.1 Introduction 
The HIPS project was designed to develop the organizational and institutional capacities of the company 
clinics and private providers to expand access and availability of quality health services. Capacity building 
needs were identified at the company and facility level to enable provision of HIV, TB, malaria and RH/FP 
services to employees, their dependents and the surrounding communities. Umbrella organizations 
(UMA and FUE) facilitated the identification of needs among their affiliate companies. The institutional, 
programmatic and financial capacity needs are presented in Table 2.1. 
Table 2.1: Capacity Gaps Identified, Interventions to close the gaps and the results 
realized 
Capacity Gaps Interventions to close the gaps and the results realized
Institutional
 Companies did not have workplace 
HIV/AIDS policies, which affected 
employee comfort level in accessing 
services
 Weak / absence of a regulatory 
framework for enforcement of standards 
for quality care in the private sector 
 Many clinics had weak internal record 
keeping systems 
 Private clinics’ contribution to health 
sector indicators was not captured by 
the HMIS; yet, studies (UDHS, 2011) 
have indicated increasing utilization of 
private health facilities
 Limited opportunities for staff 
professional development in the private 
sector
 Government gives low priority to 
accreditation of the private sector to 
 82% of HIPS supported partner company clinics have developed
HIV/AIDS workplace polices. These have helped to protect 
employees against discrimination. Records show that no 
employee has been dismissed on health grounds since the 
policies came into effect. 
 HIPS supported creation of the Uganda Health Federation (UHF) 
to advocate for recognition of private health sector contribution. 
UHF was established in 2011 to bring together existing private 
sector health entities under one umbrella recognized by 
government10. HIPS is now supporting UHF and the Ministry to 
develop a sound regulatory framework and standards for quality 
of care in the private sector. UHF is expected to play a critical 
role in the roll out of these standards amongst its members once 
the process is completed.
 Provision of mobile access, training and roll out of use of the 
national Health Management Information System (HMIS) have 
improved reporting11 of private sector contribution toward 
national health performance indicators. 
 HIPS built capacity of partner clinics to meet accreditation 
 
10In the past two years, UHF has experienced substantial growth rate, both in organization, membership and reach. It hosted 
the inaugural East Africa Healthcare Federation in Uganda, which has further propelled its reach in the private health sector, 
not only nationally but regionally. Activities on a local and regional basis for instance include representation on the PIRT 
(Presidential Investor’s Round Table) and continues to have sustained and direct communication path with top level 
government officials in the ministry of health. 
11Partner clinics sent data to HIPS and the latter relayed it to MoH.
18
Capacity Gaps Interventions to close the gaps and the results realized
provide ART and TB services. criteria. 88 clinics are now accredited to provide ART services 
and 45 clinics to provide TB treatment.
Programmatic
 Partner clinics lacked staff with 
specialized skills in delivery of ART and 
TB services, including safe male 
circumcision for HIV prevention
 Private clinics were not allowed 
dispense ARVs and provide TB services 
 Private clinics lacked important medical 
and diagnostic equipment, affecting its 
ability to provide specialized services. 
 HIPS has trained and equipped private sector health workers 
with skills to provide specialized services including delivery of 
ART (929) and TB services (363) in accordance with the national 
standards. 
 57 HIPS supported facilities were equipped with necessary 
medical and diagnostic equipment to enable them provide quality 
services. Equipment included CD4 machines, hematology 
analyzers and others. (See Annex 11 for details). Partner clinics 
are meeting the operational and routine maintenance costs of 
the equipment. The equipment has expanded the menu of 
services and improved quality and subsequent utilization of 
services.
Financial
 Company clinics did not have long-term 
commitment of resources for health 
care of employees. 
 Private clinics did not have sufficient 
resources to invest in: medical and 
diagnostic equipment such as CD4 
machines, hematology analyzers. 
 Limited access to low interest credit by 
private health facilities to finance 
investment in health infrastructure and 
equipment. 
 Companies have made long-term commitments to finance health 
programs for employees, their dependents and surrounding 
communities through annual budgets. For example, Rwenzori 
Commodities in Kabarole had an average budgetary provision of 
USD 2,400 (UGX 6 million) per month. 
 HIPS provided equipment and appropriate infrastructure using a 
50:50 cost sharing model. 
 HIPS has brokered access to credit for private health facilities 
through Centenary Rural Development bank though clinics are 
yet to receive the funding. HIPS is providing technical assistance 
to potential loan beneficiaries within the private sector using the 
USAID loan guarantee through the Direct Credit Authority 
(DCA) mechanism. 
Improvements in the capacity of the 
private sector health service providers 
has resulted into improved quality12 of 
HIV, TB, RH, and malaria services for 
pregnant women. The majority (96%) 
of clients interviewed in the exit polls 
(comprising of very satisfied and 
satisfied) said they were satisfied with 
the quality of services received. Only 
4% reported non-satisfaction. 
 
12Quality of services comprised availability and utilization of diagnostic equipment, shorter time for diagnosis and care as
revealed by clients interviewed, observed national standards and guidelines in diagnosis and treatment in the visited facilities.
Other quality indicators included: lead time from arriving at clinic to receiving sought service; privacy during diagnosis and
treatment; counseling or guidance accorded to the client
19
Further analysis of these results revealed differences in the perceptions of quality of health care among 
different types of clients. Clients of 
private clinics were more satisfied 
(65%) as compared 29% of clients at 
company clinics. This is evidence of the 
increasing role of the private clinics in 
providing quality health services and 
justifies the need for continued 
support. Indeed majority of clients 
(68.5%) in urban settings 
(predominantly private clinics) also 
expressed high satisfaction level. On 
gender, females (63%) more than the 
males (28.4%) were satisfied with the 
services received. This underscores the 
relevance of the HIPS menu of services to women particularly malaria and family planning services. 
The reported improvement in quality of services is consistent with the findings of the Afro barometer 
Survey Round 5 in which 78% of the population acknowledged improvements in services provided by 
private sector facilities (Afrobarometer Survey, March 2012). 
2.2.2 Continued Challenges 
Despite the investments and results of the capacity building interventions, high staff attrition remains a 
major deterrent to ensuring sustained access and provision of quality services at private health facilities. 
On average, 2 out of 3 employees at the 60 partner clinics visited who had benefitted from HIPS training 
had left organizations under which they were trained13. This issue is not surprising given that wages are 
not regulated in the Uganda health sector, resulting in significant differences in remuneration for the 
same set of skills. It is likely that health workers that trained under HIPS found opportunities with other 
clinics that offered better pay and benefits. 
It was reported that despite the capacity 
built with HIPS assistance to provide 
quality services and scale-up, there still 
existed low demand for their services 
due to lack of ability or willingness to pay 
for the services at private clinics. This 
information is confirmed in the exit polls 
that determined that the major barrier 
to use of private facilities is cost and 
distance to the facility. 
While HIV/AIDS workplace policies have 
been developed in most of the GDA 
partners, these policies have not been translated into appropriate dialects (to reach the majority of the 
 
13The scope of this study did not allow the team to establish the whereabouts of the trained staff that had left the organizations 
under which they were trained. 
20
workers). This has limited employee participation in operationalization of the HIV workplace policies in 
some companies. 
2.3 Effectiveness in Strengthening Coordination and Partnerships. 
HIPS used a public private partnership model to strengthen coordination and partnerships between the 
private health sector and government. HIPS sought to strengthen health systems in the private sector 
and improve coordination with government by focusing on improving provider performance within the 
core components of Health Systems Strengthening (HSS) including: healthcare delivery system; health 
workforce; health information system; procurement, supply chain management and logistics system; 
health financing system; leadership and governance system. 
a) Leadership and Governance 
Recognizing that private providers play an important role in raising the quality of health care in Uganda, 
HIPS worked closely with government to develop a clear policy around public-private partnerships for 
health (PPP-H). The aim of the PPP-H policy was to formalize and streamline the relationship between 
government and private sector health providers. To address this gap, HIPS partnered with the PPP-H 
unit at the MoH to advocate for full development of the policy that was eventually adopted in 2012, the 
final year of the HIPS project. Currently, implementation of the PPP-H policy is still underway, with key 
players working to drive the private sector health agenda at both national and district levels. 
b) Service Delivery 
Among private sector providers, quality of care was variable and in some settings, access to key services 
was limited. To address this, HIPS facilitated the accreditation of 88 private sector clinics to offer ART 
and 45 clinics to offer TB services. Regular joint monitoring and supervision of the newly accredited 
facilities by the MoH, the District Health Officer and HIPS helps improve the visibility of the private 
sector and is also a positive step towards harmonization of the private and public sector. 
HIPS also helped establish the health umbrella organization UHF to develop private sector regulatory 
standards and framework. These standards are expected to be rolled out among the private sector 
health providers, to establish a way to evaluate the quality of private sector care. Sustainability of HIPS 
supported initiatives in the roll out of the standards is dependent on the capacity of the UHF, which is 
still a relatively new organization. 
c) Medicines and Technologies: Procurement, Supply Chain Management and 
Logistics System, Diagnostics 
One barrier to quality care in both the private and public sectors is lack of access to drugs and other 
health commodities. Additionally, lack of robust drug logistics management systems led to stock outs of 
ARVs and other important drugs. Some providers in the private sector lacked critical laboratory 
services for quality diagnosis of HIV/AIDS, opportunistic infections and HIV treatment monitoring. To 
address these gaps HIPS brokered partnerships between the private sector and several key 
21
organizations, including: Securing Ugandans Right to Essential Medicines (SURE)14, a USAID project; Joint 
Medical Stores (JMS); Africa Affordable Medicine (AAM); Uganda Health Marketing Group (UHMG); 
MoH/GF and PACE to improve the supply chain of ARVs, HIV test kits, FP supplies and other health 
commodities. The HIPS accredited facilities are now on the government’s master list to receive free 
ARVs. This has improved access to ARVs and other commodities in HIPS partner clinics (more analysis 
on access to ARVs is contained in Section 2.4.1). Under a partnership between the SIMS medical center 
and Central Public Health Laboratory (CPHL), HIPS funded the establishment of the private sector HIV 
reference laboratory15which is expected to be operational by early 2013. 
d) Health Information Systems 
There was inadequate reporting by the private sector on key health service provision performance 
indicators to the district and national HMIS. As a result, the MoH was not able to quantify the private 
sector contribution to health performance. In January 2012, HIPS piloted Mhealth partnerships16: a 
platform to collect and analyze data using cost effective smart phone-like devices (Mi-Fones) and user 
friendly tailored SMS based platforms to report patient data, program results and commodity inventory. 
Results of the pilot indicated significant improvements in reporting of all key indicators—70 partners 
were able to share timely and complete data within eight months of introducing the system. This has 
improved accuracy, efficiency and cost effectiveness in reporting data to HIPS and eventually to MoH. It 
is not clear how this information will continue to be relayed to MoH after the close of HIPS. Mobile 
technology is also being used by 8 HIPS supported partners under a pilot phone referral program to 
facilitate critical health information exchange between community-based peer educators, private health 
clinics, and the AIDS Treatment Information Center (ATIC). The challenge is going to be around 
meeting the costs of this system after the close of HIPS. 
e) Health work force 
Private sector had limited skilled and motivated staffs that were responsive, fair and efficient in providing 
HIV/AIDS, TB, malaria and RH/FP health services. Health workers in the private sector lacked 
specialized training in management of ART and TB according to national standards. HIPS, in partnership 
with Mildmay and AIC has provided training to health workers in the private sector in HIV and TB 
management. In order to ensure that partners continue accessing services, HIPS and Mildmay designed a 
training package for the private sector and HIPS disseminated it to partners. Furthermore, in partnership 
with UHMG and PACE, private sector providers were trained in family planning and reproductive health. 
As noted in earlier sections, issues of attrition especially where people are moving into the public sector 
or other forms of employment affects the capacity of the private sector work force. 
 
14 The overall goal of the SURE project is to ensure that the population of Uganda has access to adequate quantities of good 
quality essential medicines and health supplies (EMHS) by strengthening the national supply chain for essential health 
commodities 
15Once the HIV reference laboratory is complete and operational, it will undertake the following activities i) providing HIV 
laboratory diagnosis and treatment monitoring among private sector ART clinics; ii) training in laboratory skills and 
management among laboratory staff in private sector and iii) conduct operational, laboratory and clinical research, and 
surveillance of HIV Drug Resistance.(HIVDR) in private sector clinics. 16The pilot demonstrated that private sector health actors can overcome obstacles to data flow of health indicator data on time 
and help clinics, donors and MoH monitor potential drugs stock outs in the private sector 
22
f) Health Financing 
Prior to HIPS, accessing funds for development was a major challenge to private health providers. This 
was because of high financing requirements for health related investments. These financing gaps 
manifested differently depending on the nature of the private health facility: 
 Company clinics were reluctant to provide long term HIV and TB services which were expensive 
and yet with no direct returns. On the other hand, companies perceived reproductive health 
services as mandate of the public sector or a personal issue. HIPS used the disease cost calculator to 
demonstrate the relevance a comprehensive health care package for company staff. 
 Private clinics lacked sufficient resources to invest in expensive medical and diagnostic equipment. 
To address these gaps, HIPS advocated for insurance companies to list HIV/AIDS on their health 
premium. Furthermore, HIPS brokered a partnership with Centenary Bank to provide long term 
credit17 to private health providers and secured USAID guarantee. 
2.4 Most Effective Approaches and Innovations for Scale Up 
The evaluation identified the following as the most effective approaches and innovations under HIPS for 
replication and scale up. 
2.4.1 Accreditation 
Accreditation of private sector health facilities for ART and TB related services was the most effective 
approach for expanding access and utilization of services. Before HIPS, only few private sector clinics 
were accredited to provide ART and TB care. With accreditation, there has been increased access and 
utilization of health services (HIV/AIDS, TB, Malaria and RH/FP) as indicated in Figures 2.1-2.4. 
Accredited facilities are entitled to free ARVs from government stores thereby improving availability of 
drugs for clients at free or minimal costs. Accreditation provides a good standard platform for ensuring 
quality services as it makes provisions for regular supervision visits by the MoH and the DHO. 
Unfortunately the over-reliance on drugs from the public sector has caused disruptions in service 
delivery since 2010 when there was a breakdown in supplies. Findings of a study conducted by the HIPS 
program on frequency of stock outs in 2012 revealed that only 13.3% of companies reported that they 
have never experienced stock outs. 50% have borrowed drugs from neighboring hospitals or 
government health centers when stocks are low. These clinics also refer clients to government health 
centers. 28.5% have purchased drugs during stock outs from 2010 to date amounting to USD 7,317 
(UGX 18,292,376). Though companies are establishing own mechanisms for dealing with stock outs in 
the short run, a long term solution is required to ensure regular provision of ART in the private sector 
for all kinds of clients and thereby enable a regular provision of services. 
2.4.2 Use of the Disease Cost Calculator in Expanding GDA partnerships 
The most effective approach used in expansion of GDA partnerships was the use of the disease cost 
calculator18 in helping private companies understand the cost implications of employee illness on their 
business. With HIPS support, companies have developed a clear way of assessing the unit cost of 
 
17The program for accessing credit facilities by private sector health providers is yet to be launched. 
18 In terms of determining the losses incurred by the company due to poor health of employee 
23
providing health services and are now more aware of the impact of health on employee productivity. 
The disease cost calculator empowered private companies to appreciate health of employees as an 
economic commodity. Since HIPS began, 46 companies established GDA partnerships and now have 
annual budgets that include their contributions to health service provision to employees. 
2.4.3 Support to Existing MOH Policies aand Plans 
The project was in line with the national Health Sector Strategic Plan (HSSP), strategic plans for HIV, 
tuberculosis and laboratory development. The project supported the development of the national PPP-H 
policy and made important contributions to national health indicators. Subsequently, the MoH was 
willing to embrace private sector initiatives under the HIPS project. The National AIDS Control 
Program (ACP) and the National Leprosy and Tuberculosis Programme (NLTP) offered support for 
ART and TB accreditation and participated in joint supervision of private sector facilities. 
2.4.4 The Supply Chain /Out growers model 
HIPS rolled out three models to support OVC i.e. corporate sponsorship, supply chain/out-growers 
model and market access models. Within the project, the most widely recognized and appreciated 
model (by companies and OVC alike) was the supply chain/out-growers model. This model benefited 
smallholder farmers who produced raw materials for industries. For instance, at Kakira Sugar Works the 
company encouraged and supported OVC and their households to produce cane as out-growers and in 
return, companies bought the cane. The company provided additional support including: training and key 
inputs such as improved seed through the farmers associations. Under this approach, a total of 935 
OVCs benefitted (HIPS Final OVC Report, 2012). For example, HIPS supported the formation of the 
Kakira Out-growers Rural Development (KORD) group to organize OVC households involved in 
outgrowing. To leverage their new-found income from outgrowing, the KORD women’s group started 
a Village Savings and Lending Association (VSLA), and then used their pooled savings to buy a six acre 
piece of land which they are using for income generating activities. Similarly, the KORD youth group has 
acquired a jaggery mill and a maize mill which create an ongoing source of income for group members. 
2.5 Sustainability of Health Service Provision through Companies 
2.5.1 HIPS Sustainability Goals 
The main objective of HIPS was to build the capacity of partner originations to expand access and 
utilization of health services and carry on the provision of those services beyond the close of the HIPS 
program. In the context of this evaluation, sustainability was assessed at the following levels institutional; 
programmatic and financial management. 
Ultimately, sustainability was also measured by the level of ownership of interventions and ability to 
carry them on without HIPS support 
a) Institutional 
i. HIPS facilitated partner companies to develop HIV/AIDS workplace policies. These policies are 
operational in 82% of the companies surveyed. The work place policies lay out commitments from 
the employer in the form of health services and benefits and financial resources that will be allocated 
to health programs within the company. The HIV/AIDS workplace policies have helped to protect 
employees against discrimination. 
ii. HIPS strongly supported the completion of the PPP-H policy, which had been in the process of 
approval for more than 10 years. The policy provides a regulatory framework through which the 
private and public sectors collaborate in the provision of health services. The MoH has established a 
24
unit to effectively coordinate private sector health activities. The PPP desk at the MoH has limited 
capacity to support private sector activities independently. This MoH body will need ongoing 
support to ensure successful operationalization of the PPP-H policy at various levels. 
iii. HIPS built the capacity of partner clinics to meet accreditation criteria through provision of medical 
training for staff, mentoring, provision of equipment and tools. Subsequently, 88 partner clinics were 
accredited to offer ART and TB services. The accredited partner clinics have expanded access and 
utilization of services and are expected to continue to provide these services after the HIPS 
program. 
iv. HIPS-supported umbrella entities like UMA, FUE, and UHF are key sustainability platforms. 
HIPS made a strategic decision to work with and strengthen UMA and FUE, local membership 
organizations to provide health services to their respective members. UMA and FUE already have 
large memberships and appropriate mechanisms for continuing to mobilize members and provide 
ongoing support. Both organizations have benefitted from technical, institutional and organizational 
development support to become leaders in provision of workplace health programs. Through their 
newly established health business development units, UMA and FUE are mobilizing resources from 
affiliate companies and other development partners. These resources will facilitate continuous 
capacity building for health programs within the affiliate companies. By 2012, 63% of HIPS active 
partners were receiving support formerly provided by HIPS from the two organizations. 30 
partners are already paying for services directly from UMA and FUE which is an indication of their 
demand for their services. The noted challenge has been the ability of UMA and FUE to attract long 
term funding for the workplace activities and thereby affecting income flow and long term financial 
standing of the associations. Most of the grants received so far support implementation of initiatives 
of activities for no more than 12 months. 
HIPS supported the formation of Uganda Health Federation (UHF) as a key cornerstone of private 
sector sustainability and the organization is already serving a significant group of stakeholders. HIPS 
support of UHF initiatives in developing a self-regulatory mechanism for the private sector signifies an 
investment in ensuring standards of quality care even after the close of HIPS. There is need to recognize 
that UHF is still a new organization and will continue to need support in expanding its membership and 
rolling out the self-regulatory mechanism once completed. 
b) Programmatic Strengthening 
Sustainability created through HIPS was analyzed at two levels: company clinics and private provider 
clinics, as the two types of clinics provided services under different arrangements. Whereas company 
clinics provided services to employees, their dependents and the surrounding communities; private 
clinics were open to any member of the public willing to pay for services. 
i) Company Clinics 
HIPS supported companies to train staff and provided equipment to raise the quality and 
scope of services provided. Additionally, HIPS supported companies to develop HIV/AIDS 
workplace policies which link with the National HIV/AIDS Policy and Strategic Plan. Further, 
HIPS brokered partnerships between private companies and umbrella organizations (UMA and 
FUE) and other collaborating institutions (JMS, MoH, UHMG, Mildmay and PACE). These 
partnerships are key for sustainability of health-related activities. HIPS brokered additional 
collaborations between partner clinics and the Central Public Health Laboratory for quality 
assurance, quality control and training of laboratory technicians. This is an ongoing relationship 
that will continue to grow after the HIPS project has closed. 
25
ii) Private Provider Clinics 
HIPS initiated a collaborative arrangement with private clinics on a 50:50 cost-sharing basis. 
Because private providers were expected to match HIPS funds, a greater sense of ownership 
was created while allowing clinics to purchase needed equipment they could not afford on 
their own. All 30 private clinics visited had undertaken service maintenance and met 
operational costs of equipment—for example, partners like Wagagai clinic and Sims Medical 
Centre that acquired hematology analyzers were meeting the operational and maintenance 
costs. Due to the 50:50 cost sharing, the beneficiary clinics provided the HIPS menu of 
services at subsidized rates. 
c) Financial Management Strengthening 
Establishment of health business development units within UMA and FUE will help to sustain resource 
mobilization for planned health initiatives in the coming years. These organizations have already had 
success in mobilizing resources and are poised to continue raising funds to cover ongoing costs needed 
to sustain programs. 
HIPS has also provided initial support to the roll out of a Direct Credit Authority (DCA) facility that will 
improve access of finances for private sector facilities. Under this arrangement, partner clinics will 
receive funding from Centenary Rural Development Bank. HIPS will provide technical assistance to 
potential loan beneficiaries within the private sector using the USAID loan guarantee. Subsequent 
reviews on investments in the private sector should assess the effectiveness of this facility in 
strengthening access to finance and improving access to services provided by the private sector. 
3. CONCLUSIONS 
The main objective of the HIPS project was to improve access and utilization of HIV/AIDS, TB, malaria, 
and reproductive health/family planning services within the private sector. The strategies HIPS adopted 
to achieve this objective included: expanding the number of global development alliance (GDAs) 
partnerships; supporting initiatives to strengthen private sector workers’ organizations to support health 
initiatives; and to implement innovative approaches to support orphans and other vulnerable children 
through the private sector. 
From the findings of this evaluation, HIPS has largely achieved its overall objective. The initiative has 
expanded access to key services, including: HIV/AIDS, TB and malaria; as well as reproductive 
health/family planning by increasing the number of clinics and expanding the menu of services provided. 
Further, services were being utilized by the intended beneficiaries. More could have been achieved in 
the expansion of services if more realistic targets had been set and or re-adjusted over the course of the 
program. 
Accreditation of company and private clinics has increased access to health services amongst employees 
and surrounding communities. 
Private companies can and will contribute resources towards private health care initiatives, when 
presented with clear and compelling evidence. Coupled with a renewed positive attitude towards staff 
health, GDAs have proved to be an important mechanism for the leveraging of private sector resources 
to provide workplace health programs 
Umbrella organizations like UMA and the FUE are strategic entry points towards mobilizing affiliate 
companies to commit resources and sustain health initiatives in the private sector. Capacity building 
26
services and work health program support provided by these organizations will be critical in sustaining 
initiatives started by HIPS. Mechanisms for ensuring long term financial independence of these 
organizations need to be identified. 
Private sector capacity to provide services has been improved as demonstrated by the increase in 
services provided to different target groups and the satisfaction of clients with the quality of these 
services. Staff attrition, irregular supplies of key commodities like ARVs and costs of services are still key 
constraints to ensuring a sustained provision and use of services provided by the private sector. 
Peer education was an effective strategy for creating demand for use of services among company 
employees. The use of company employees as peers and the willingness of workers to open up to their 
peers made it easier and cheaper to mobilise employees to utilise services. 
The PPP-H policy has been rolled out and this creates a conducive environment for the private sector to 
contribute significantly to health service delivery. The capacity of the newly created PPP unit needs to be 
strengthened to ensure successful operationalization of the PPP-H policy at various levels. 
Further, the UHF provides a regulatory framework to ensure provision of quality health services within 
the private sector. UHF will continue to need support in expanding its membership and rolling out the 
self-regulatory mechanism once completed 
The rationale of the OVC component was to empower the OVCs to improve their livelihoods. This 
proved true as the former OVCs had established income generating activities and are now able to even 
access health services from the private sector. 
4. RECOMMENDATIONS 
On the basis of conclusions drawn from the evaluation and the lessons learned; the following 
recommendations are made to guide the designing of similar programs in future. 
ACTION RESPONSIBLE 
PARTY 
1. Brokering partnerships to improve service delivery is an excellent model 
that should be adopted and scaled up by programs aiming to expand 
service delivery in the private sector. As a platform for implementation, 
the partnerships created confidence, interest, commitment, and improved 
coordination among partner organizations. 
USAID, MOH, 
other 
development 
partners 
2. Continue to support both company clinics and private clinics because of 
their different, yet synergistic approaches to service delivery. For example, 
private clinics largely serve paying clients, mainly in urban settings. 
Company clinics, on the other hand, mainly serve employees, their 
dependents, and lower income members of the surrounding communities, 
often in rural areas. 
USAID, other 
development 
partners 
3. GDA partnerships to leverage private sector resources were very 
successful and should be scaled up in related future programming. 
USAID 
4. Performance based grants should be introduced for private clinics to 
ensure full utilization of the capacity built by programs like HIPS. Within a 
regulatory structure that promotes quality, performance based grants 
USAID, other 
development 
27
ACTION RESPONSIBLE 
PARTY 
ensure that providers continue to expand services while maintaining 
national standards for care. In addition, incentives for quality performance 
can be used to motivate staff and mitigate staff attrition. 
partners
5. To facilitate stronger public-private partnerships at the national level, the 
PPP-H Unit should be strengthened. This unit is an important entity to 
drive the public-private partnerships agenda in health and promote 
continued national development in this area. The PPP-H Unit is also 
essential to completing the roll-out of the PPP-H policy at both national 
and district levels over the coming years. 
6. Future programming should also focus on strong joint planning, monitoring 
and support supervision between the private sector and the MoH and 
District Health Offices. 
MOH, USAID, 
Development 
partners 
7. Scale up use of the disease cost calculator in the private sector to further 
promote the evidence that addressing employee health is important for 
companies’ bottom line. 
UMA, FUE
8. Future programming in health for the private sector should continue to 
support UHF as a critical platform to improve coordination and build on 
current efforts in improving regulation and quality of care within the 
private sector. 
USAID 
9. Future projects should invest in conducting an inventory of private health 
facilities and a detailed baseline assessment to establish better the scope 
and depth of their interventions to inform more realistic project 
benchmarks. A cost-benefit analysis (CBA) / cost effectiveness analysis to 
establish value for money and return on investment for similar initiatives 
would be instrumental in mobilizing support for investments in the health 
private sector. 
USAID 
28
ANNEXES 
ANNEX 1: HIPS COVERAGE 
29
ANNEX 2: STATEMENT OF WORK FOR EVALUATION OF THE HEALTH 
INITIATIVES FOR THE PRIVATE SECTOR (HIPS) PROGRAM 
I. BACKGROUND 
The private sector plays a very important role in many developing countries where health is considered 
a public good with services provided either free or at minimal charge. Contrary to popular belief that 
the poor are unable to pay for health services, there is evidence showing that they do. In Africa, 50% of 
total health expenditures go to private providers, and 60% of health care financing comes from private 
sources. This shows that the private sector is filling an important gap in public sector provision of 
health services and people are paying out of pocket for these services. Furthermore, the market for 
healthcare is expected to increase by more than double by 2016, up to $35 billion. In Uganda, out of 
every four shillings spent on health care, three shillings are private outlays, mostly out-of-pocket 
payments direct to providers. To increase the quantity and quality of health care services, one must not 
ignore the private sector. 
The Ministry of Health (MOH) in Uganda has for some time now recognized the significant importance 
of the private sector. In the draft Health Sector Strategic Plan (HSSP) III, the MOH acknowledges the 
role of private sector as a major partner in national health development and service delivery. The 
private sector is increasingly becoming a major source of health services to the populace. A study 
conducted in 2005 on “Understanding the Impact of Eliminating User Fees; Utilization and Catastrophic 
Health Expenditure in Uganda” reported that when sick, 53% of the people turn to the private sector 
for treatment, 24% to the public sector, 4% to others and 19% do not seek care. The MOH further 
identifies the biggest challenge to strengthening public-private partnerships as the fact that the Public￾Private-Partnership in Health (PPPH) policy is still in draft form. In the absence of a concrete policy, the 
MOH has tended to provide more support to the private not-for-profit sub-sector as compared to the 
private for profit sub-sector. A Survey of Private Health Facilities in Uganda (2005) reported 2,156 
registered private clinics, excluding drug shops, whereby 68 percent of them are in the central region 
and Kampala alone, which accounts for 45 percent of all private facilities in the country. Over 90 
percent of private facilities are clinics that provide outpatient curative services. Although health 
infrastructure in the private sector has expanded, the vast majorities of health facilities are not fully 
functional, lack equipment and staff, and are poorly maintained. 
As part of the US Government (USG) efforts to support the private sector, on October 1, 2007, the 
Mission signed a $8,689,764 three year contract, with an option to extend for two years with Emerging 
Markets Group (EMG) Limited to engage the private sector. The option to extend for two years with 
CardnoEM was approved on June 15, 2010 bringing the new ceiling to $15,689,764. Effective September 
26 2011, the Health Initiatives for the Private Sector (HIPS) project was extended for six additional 
months from September 30, 2011 to March 31, 2013 bringing the Total Estimated cost (TEC) to 
$17,189,764. 
The goal of the HIPS project is to improve access and utilization of health services. The project 
provides support to the private sector company employees, their dependents and surrounding 
communities at both medium and large size levels. 
HIPS is a dynamic project designed to be responsive to the unique demands of supporting the private 
sector in Uganda. Under this project, HIPS aims at increasing access to and use of HIV/AIDS, 
tuberculosis, reproductive health/family planning (FP) and malaria services through mid and large size 
employers within the private sector. 
Specific components of the HIPS program are to: 
30
 Expand and strengthen access to and utilization of health and HIV/AIDS services in the private 
sector; 
 Expand the number of Global Development Alliance (GDA) partnerships; 
 Support initiatives to strengthen the private sector workers’ organizations to support health 
initiatives; 
 Implement innovative approaches to support orphans and other vulnerable children through the 
private sector; 
HIPs works in 57 districts spread across Uganda. The program HIPS works with over 100 companies on 
a cost sharing basis and 100 clinics (50% company clinic and 50% private clinics). The detailed coverage 
map is attached as Annex 1. 
As the HIPS program draws to a close, USAID/Uganda is interested in conducting an evaluation that will 
establish the effectiveness of the intervention and a documentation of what has worked or not. HIPS’, 
being the first fully fledged health private sector program in USAID/Uganda, is expected to provide 
lessons on best practices and approaches that can be integrated in future programming within the 
Mission and the Ministry of Health to support national efforts in strengthening the health private sector 
to provide accessible and quality health services to the citizens of Uganda. 
II. PURPOSE OF THE EVALUATION 
USAID/Uganda is commissioning HIPS project final evaluation to assess the effectiveness of the 
approaches implemented under the project and identify factors for success. The evaluation will 
document major achievements (what has worked well) and opportunities (what could have been done 
better), limitations and challenges; and establish lessons learned and good practices. Information from 
this evaluation will be used to inform designs of future program work by USAID and the Government of 
Uganda. 
III. KEY EVALUATION QUESTIONS 
The evaluation should answer the following specific questions: 
 Have the desired results been achieved? 
 Is HIPS effectively addressing capacity building and service delivery needs in a challenging private 
sector environment? 
 How effective has HIPS been in strengthening existing private sector coordination structures and 
partnerships with the public sector at the national and district level (private sector companies, 
Government of Uganda – GOU, etc.)? 
 What are the most effective approaches and innovations that should be scaled up? What factors will 
contribute to the success of the effective approaches? 
 What factors have contributed to success or failure of the project – what is working / not working? 
 To what extent has HIPs strengthened the sustainability of the private companies/entities and their 
ability to continue to provide health services after close of the program? 
31
IV. PROJECT INFORMATION AND DOCUMENTS 
The following information documents and sources are available and relevant to the evaluation: 
USAID: 
 Original Request for Proposal for the HIPs program 
 USAID program and financial reporting requirements 
 USAID Country Development Cooperation Strategy 2011-2015 
HIPS: 
 Program Description 
 Annual and quarterly reports 
 Annual work plans 
 Performance Management Plan 
 Baseline survey report 
 Other surveys and assessments undertaken. 
Other information documents outside USAID and program: Health Sector Strategic Investment Plan/ 
Heath Sector Performance reports, Private Sector reports/policies/guidelines from GOU and other 
Development Partners, and updated private sector assessment report.
V. EVALUATION METHODOLOGY 
The Offerer may propose a mix of qualitative and quantitative methods to conduct an evaluation that 
meets the stated purpose and responds to all the evaluation questions listed above. Proposed 
methodology should bear in mind the wide coverage and diverse group of stakeholders and show clearly 
how reliable and meaningful information will be collected in an efficient manner. 
The submitted proposal should include a detailed evaluation design that looks at each question, defines 
the methodology to be used, main features of the data collection instruments, sampling methodology 
where necessary and the data analysis plan. Where possible gender disaggregated information should be 
collected and analyzed. A sample design matrix is attached as Annex 2. 
With regard to data quality, the evaluation team is expected to be familiar with USAID data quality 
standards for objectivity, validity, reliability, precision, utility and integrity and be able to apply them in 
the final report, by identifying such data limitations as may exist with respect to these standards (ADS 
78.3.4.2 – http://www.usaid.gov/policy/ads//500/578.pdf) and ADS 203.3.5.1- 
http://www.usaid.gov/policy/ads/200/203.pdf). 
Initial findings of the evaluation will be shared within the Mission and with the Implementing Partners. 
The final report will be shared with the Government of Uganda and other development partners. The 
Contractor is expected to submit the final approved report to the USAID’s Development Experience 
Clearing House (DEC) within three months of approval of the final report. 
VI. DELIVERABLES 
1. In Briefing: Introduction of the evaluation team, discussion of the SOW and initial presentation of 
the proposed evaluation work plan. 
2. An Inception report detailing the Contractor’s interpretations of the assignment, an evaluation 
design and methodology, analytical plans, sampling, tools and work schedule to be submitted within 
7 working days of the in briefing. 
3. Weekly Progress Reports: Brief informal reports summarizing progress, challenges and constraints 
and describing evaluation team’s response. 
4. Oral Presentation: Power Point presentation (including hand outs). The oral presentation should, at 
a minimum, cover the major findings, conclusions, recommendations, and key lessons. The 
32
evaluation team will liaise with the mission to agree on the dates, audience, venue and other 
logistical arrangements for this briefing. The presentation shall be held within 35 days after the in 
briefing. 
5. Draft Evaluation Report: The report should comply with the USAID’s Evaluation Report standards 
set out in Annex 3. The report is expected within 7 days after the oral presentation. 
6. Final Draft Report: Complete report incorporating comments from USAID and other stakeholders 
submitted within 5 days of receipt of the comments. 
7. Final Report: The contractor will submit a final report incorporating final edits for wider sharing 
within two days. The approved final report should be cleared by USAID before submission to the 
DEC. 
* Draft and Final Evaluation Reports should be provided in four (4) hard copies and one (1) electronic 
copy. 
VII. DURATION OF THE ASSIGNMENT 
The evaluation will begin on or about 05/29/2012 and end by or about 08/13/2012. The offeror 
shall propose a work plan based on their interpretation of the statement of work. 
VIII. LOCATION OF ASSIGNMENT 
HIPS office(s), USAID/Uganda and site visits conducted in the private sector facilities. There may 
be need to visit public sector organizations and health facilities for information and comparison 
purposes. 
IX. EVALUATION TEAM COMPOSITION 
The offeror is expected to propose a multi-disciplinary team of evaluators, health, HIV/AIDS and private 
sector programming and research expertise to conduct the evaluation. The following are required 
members of the team; 
 Team Leader/Lead Evaluator: Consultant with demonstrated professional experience in the 
design, management and implementation of evaluation studies over the past 10 years. Additional 
expertise in health and HIV/AIDS development work is required. S/he must possess good writing 
skills. Knowledge of key USAID policies and procedures is desirable. S/he will be responsible for 
leading the team in the design of the methodology, execution, reporting and have overall 
responsibility for preparation of the final product and presentation to the Mission. 
 Health Private Sector Expert: consultant with demonstrated international experience in health 
private sector design, management or evaluation in developing countries, particularly sub Saharan 
Africa is required. The offeror may propose other members as they deem fit to execute the job. 
X. MANAGEMENT ROLES AND RESPONSIBILITIES 
The USAID/Uganda PPD M&E Adviser will have primary administrative and technical responsibility of 
the evaluation process. This also includes making the necessary arrangements for USAID inputs and 
briefings. The Contractor will liaise closely with the Contract Officer’s Representative (COR) for HIPS 
and the Senior Strategic Information Advisor (SSIA) for the Health, HIV and Education Team. 
Emerging Markets will contribute to the design and planning of the evaluation, provide logistics for 
implementation (documents, meetings, interviews), participate in the oral presentation and review the 
draft and final reports. 
Emerging Markets and all sub-contractors/sub-awards, USAID and other stakeholders will not interfere 
with the evaluation team’s capability to collect objective information and to conduct independent 
investigation relevant for this evaluation, analyze data and make inferences, conclusions and 
recommendations. 
33
XI. EVALUATION CRITERIA 
The list below serves as the standard against which all technical information shall be evaluated and 
serves to identify the significant matters which offerors shall address; 
A. Technical approach 
B. Key personnel 
C. Past Performance 
2) Technical Approach 
Sub-Criteria in order of importance 
1. Extent to which the proposed technical approach is clear, logical, well-conceived, technically 
sound, reflects an appreciation for the likely problems to be encountered during the evaluation 
and directly addresses the steps in the Statement of Work. 
2. Extent to which the proposed technical approach demonstrates an understanding of the 
implementation context. 
B. Personnel 
1. Extent to which the proposed key personnel meet the required qualifications demonstrating the 
Offeror’s ability to effectively conduct the evaluation. 
C. Past Performance 
1. The extent to which the offeror demonstrates successful implementation of evaluation of similar 
health sector programs or similar projects and application of relevant lessons learned to this 
evaluation. 
XII. COST PROPOSAL EVALUATION 
The evaluation of the offeror’s cost proposal shall deal with cost realism analysis. This shall consist of a 
review of the cost portion of the offeror’s proposal to determine if the overall costs proposed are: 1) 
realistic for the work to be performed; 2) reflect the offeror’s understanding of the requirements; and 
3) are consistent with the technical proposal. Evaluation of cost proposals shall consider, but not be 
limited to the following: 
1. Cost realism and completeness of cost proposal and supporting documentation. 
2. Overall cost control evidenced by the proposal (such as avoidance of excessive salaries, 
excessive field visits, and other costs in excess of reasonable requirements). 
34
HIPS Coverage 
35
 SAMPLE EVALUATION DESIGN MATRIX 
Evaluation 
Question 
Sub 
question 
(will help 
you 
answer 
the key 
evaluation 
question) 
Indicator / 
Performance 
Measure 
(information 
needed to 
answer the 
question 
Data 
Source 
(primary 
and or 
secondary) 
Data 
Collection 
Instrument 
Data 
Analysis 
Plan 
Comments 
 
Criteria to Check the Quality of the Evaluation Report 
 The evaluation report should represent a thoughtful, well-researched and well organized effort 
to objectively evaluate what worked in the project, what did not and why. 
 Evaluation reports shall address all evaluation questions included in the scope of work. 
 The evaluation report should include the scope of work as an annex. All modifications to the 
scope of work, whether in technical requirements, evaluation questions, evaluation team 
composition, methodology or timeline need to be agreed upon in writing by the USAID 
technical officer. 
 Evaluation methodology shall be explained in detail and all tools used in conducting the 
evaluation such as questionnaires, checklists and discussion guides will be included in an Annex 
in the final report. 
 Evaluation findings will assess outcomes and impact on males and females. 
 Limitations to the evaluation shall be disclosed in the report, with particular attention to the 
limitations associated with the evaluation methodology (selection bias, recall bias, unobservable 
differences between comparator groups, etc.). 
 Evaluation findings should be presented as analyzed facts, evidence and data and not based on 
anecdotes, hearsay or the compilation of people’s opinions. Findings should be specific, concise 
and supported by strong quantitative or qualitative evidence. 
 Sources of information need to be properly identified and listed in an annex. 
 Recommendations need to be supported by a specific set of findings. 
 Recommendations should be action-oriented, practical and specific, with defined responsibility 
for the action.
36
ANNEX 3: EVALUATION METHODS AND TOOLS 
APPROACH AND METHODOLOGY 
Scope of the Study 
The project for conducting an evaluation of the effectiveness of the approaches implemented under the 
HIPS project and identifying factors for success adopted a systems analysis model for evaluation of the 
performance of HIPS project. The model comprised the following as indicated Fig.1.1. 
Figure 1.1: Systems Analysis Model to be used in Execution of the Assignment. 
The model indicated in Fig 1.1 was based on systems analysis. Under this model, the success of HIPS 
project was measured on the basis of achievements, impact, effectiveness, efficiency and the 
sustainability of project activities. More importantly, however, was the sustainability of different strategy 
impacts and outcomes focused on the private sector operators’ capacity to continue to provide services 
after the end of program. They included strengthened private sector coordination and innovations that 
needed to be scaled up and maintained beyond HIPS support. 
SUSTAINABILITY OF THE 
HIPS PROJECT 
Ability of private companies to 
continue with after the close of 
the program 
Impact 
Improved health 
and disease 
outcomes 
Process 
Activities implemented Outcomes 
 Different results 
realized 
 Quantitative and 
qualitative measure 
of the results 
 Distribution of the 
results across 
targeted 
stakeholders 
 Offshoots 
(unanticipated 
results)
37
1.2 Overview and Approach to the Evaluation Process 
The final evaluation of HIPS Project was conducted as a collaborative evaluation process involving a wide 
range of HIPS project partners; the Ministry of Health; USAID/HIPS staff; and a team of consultants. The 
assignment was carried out in 4 stages namely: 
i) Preparatory phase 
ii) Field work 
iii) Data analysis report writing 
iv) Workshops for validation and debriefing 
1.3 The Evaluation Design 
The final evaluation study was cross-sectional descriptive assessment focusing on the programme 
processes, outputs, outcomes and impact using participatory evaluation techniques. Triangulation was 
used to compare the information from participants (target clinics & population and project staff) in the 
field evaluation and information from desk review or secondary sources. 
1.3 Sampling 
1.3.1 Sampling Frame 
HIPS project supported private clinics fell into two major categories: i) Company clinics providing 
services to company staff, their families and/or neighboring communities; ii) Private Clinics providing 
services to individuals, families, corporate clients and surrounding communities. Therefore, clinics from 
both strata were enrolled in the study. 
Additionally HIPS Project has been collaborating with other institutions and Umbrella organizations of 
the business community and Private health service providers during project implementation. These were 
interviewed in the final evaluation study. Multiple methods of data collection were used to meet the 
TORs. The methods of data collection yielded a plethora of both qualitative and quantitative data 
required to accomplish the task. A participatory approach involving wide consultations with all 
stakeholders was emphasized throughout the final evaluation study. 
Data collection was done among HIPS project staff; partner company clinics; collaborating institutions; 
USAID and its partners; and focal persons of Ministry of Health programs and departments. The table 
below shows the sample of institutions for the evaluation: 
Table 1.1: List of Institutions selected for the evaluation 
Government Institutions HIPS and Partner 
Private Clinics 
USAID and Collaborating 
Institutions 
AIDS Control Program (ACP-MoH) HIPS Project staff USAID and Partners (Strides, 
Respond) 
Tuberculosis and Leprosy Control 
Program (TLCP-MoH) 
Company clinics Joint Medical Stores (JMS)
Malaria Control Program (MCP-MoH) NGO Clinics Mild May Centre 
Department of Reproductive Health 
(MoH) 
Private Hospitals UHMG
Central Public Health Laboratory 
(CPHL-MoH) 
Private Clinics John Hopkins Bloomberg
District Health Officer (DHO) of 
selected districts 
OVC Programmes Uganda Manufacturers’ Association
38
PPP Desk/ TWG (MoH) Federation of Uganda Employees
Uganda Health Care Foundation
1.3.2 Selection of Heath Facilities for the Interviews 
Altogether, data collection was undertaken in 60 facilities consisting of 30 Company clinics, and 30 
Private Clinic (For-Profit health facilities); which were selected through the following steps: 
a) The consulting team reviewed the HIPS supported companies and clinics inventory and compiled a 
list of health facilities that consistently worked with HIPS project to provide services since the 
project started. 
b) The following criteria were used to select health facilities to be interviewed: 
Table 1.2: Criteria for Selection of Health Facilities 
Criteria Consideration Criteria
Location Rural/ urban mix
Remote areas 
Service delivery site mix Prevention, treatment, care and support; community outreach 
services and livelihood/OVC support 
Level of care/type of services Hospital Vs Clinic level services
HIV, TB, Malaria & RH services 
Type of service provider Private Clinic
Company Clinics 
Accreditation status This will facilitate comparing performance and issues between 
the accredited clinics with HIPS support; those accredited 
without HIPS support and currently non-accredited clinics. 
1.3.3 Sample Size Estimation for Exit Poll Interviews 
A representative sample of clients served by HIPS project partner clinics will be enrolled for client exit 
interviews. Sample size calculations will be based on the national prevalence rates of the HIV/AIDS based 
on the following reasons i) HIPS Project used HIV/AIDS disease as an entry point for four main diseases 
of focus (HIV, Tuberculosis , Malaria and reproductive health problems) of the HIPS project for which it 
has undertaking health systems strengthening for improved disease outcomes, ii) HIV/AIDS is the least 
prevalent of the four diseases/conditions mentioned above and estimations based on HIV prevalence 
would enrol a representative sample of clients who receive services for all the four conditions iii) HIV 
occurrence takes a longer time to change and thus harder to detect changes.. The Sample size will be 
calculated to yield 80% power of the study at a level of 99% level of significance ( α at 0.01 and β at 
0.20). . The occurrence of HIV among clients will be analysed as a dichotomous variable and results 
expressed as a confidence interval around the estimated proportion (P) of clients with disease. The 
desired precision or total width (W) of the confidence interval will be 0.1 (0.05+0.05). 
Sample size calculations will be based on current prevalence of HIV of 6.7% (AIDS Indicator Survey, 
2011-MoH) in the general population. The following formula will be used to estimate the sample size 
(Stephen. B.et al, 1998): 
N = 4 Zα2 P(1-P) ÷ W2
Where; 
P= expected proportion who have the variable of interest = 0.067 
(According to the 2011 Uganda AIDS indicator survey 6.7% Ugandan aged 15-49 years are HIV positive) 
W= desired total width of the of the confidence interval = 0.1 
Zα = the desired normal deviate for a two-tailed α, where (1-α) is the confidence level (for 99% confidence level, Z = 2.576). 
Thus, N = 4 x (2.576)2 x 0.067 (1-0.067) = 166
 (0.1)2 
39
Using the above formula, a sample size of 166 clients will be interviewed. However, this will be 
corrected with the design effect of 2 (there are 2 categories of facilities: Private for profit and Private 
Not for Profit) Thus 6 clients (3 men and 3 women) exit interviews will conducted at each of the health 
facilities visited giving a total of 360 client exit respondents. 
1.4 Phases of the Evaluation and Data Collection methods 
1.4.1: Phase 1. Preparatory Activities: 
The first phase of the final evaluation study involved HIPS Project Staff, USAID Staff and the consulting 
team. The tasks accomplished in the first phase included: 
i) Preliminary Meetings 
This involved consultations and debriefing meetings with focal persons of HIPS Project and 
USAID staff regarding overall process of the project evaluation. The purpose of these meetings 
was to get consensus on the evaluation methodology and study tools. The meetings were also a 
forum to finalize on administrative aspects of the assignment. 
ii) Desk review, 
 HIPS project documents including the Project log-frame and M&E plans; M& E reports; 
annual and assessment reports; survey reports; feasibility studies; and other documents 
made available by HIPS, MOH and collaborating institutions. Secondary quantitative data: 
summary of project quantitative key indicators of HIPS project; quantitative data from 
partner clinics and collaborating institutions. 
iii) Training of the Research Team 
Prior to field visits, the consulting team participated in a four day workshop during which 
they were oriented on the evaluation methodology and data collection tools. 
1.4.2 Phase 2: Field based Evaluation 
This involved field visits to HIPS partner health facilities and collaborating institutions. Three (3) field 
teams each headed by a field supervisor were constituted as follows: 
Respondent Category Responsible Person/s Remarks
Government/Ministry of 
Health and USAID Technical 
Working Group 
 Augustus Nuwagaba
 Simon Ssentumbwe 
 Sam Rutahindwa 
These were high level respondents that 
held interviews with the consultants in 
the specialist areas 
HIPS staff and Partner 
companies/clinics and USAID 
collaborating institutions 
 Augustus Nuwagaba
 Simon Ssentumbwe 
 Sam Rutahindwa 
 Associate Research Staff 
These were the major and biggest 
number of respondents for the study. 
Therefore the consulting team added 
associate research staff (highly trained) 
to beef up the data collection team. 
Clients (for client exit 
interviews) 
 Field Staff These constituted persons trained in 
data collection that was always engaged 
by REEV Consult International. 
At the end of each day of field work, the supervisors met their respective teams to review the quality of 
data collected and where gaps existed, the interviewers were requested to go back and fill in missing 
data gaps. The team leader on daily basis kept contact with the supervisors for feedback and met the 
40
field interviewers at least once every week to get feedback from the field work. The following data 
collection methods were used: 
i) Key informant in-depth interviews: 
Key informant interviews were conducted with participants who were purposively chosen for their deep 
knowledge of the project being evaluated. Interviews were conducted using a set of key informant 
interview guides for different categories of partners and institutions: Private Sector Partners (Health 
facilities), Funding and implementing agency (HIPS/USAID), Collaborating institutions and Ministry of 
Health (relevant programs & PPP-TWG), and OVC programme. 
ii) Client Exit Poll interviews 
Client exit interviews were conducted among respondents seeking services at the HIPS Project 
supported Health facilities. 
iii) Focus Group Discussions 
FGDs were conducted among the following 
a) Beneficiaries of the OVC (Orphans and vulnerable children) in Kakira and Lira supported by 
HIPS Project. 
b) Adults Men: these included men aged 20-45 within the OVC programme areas 
c) Adult women: these included women aged 18-49 within the OVC programme areas. 
The focus group discussions were used to explore the group perceptions on how employees and their 
families, individuals and community had benefitted from OVC activities supported by the HIPS Project 
iv) Case Study: 
After key informant interviews, the consulting team conducted a case study of OVC at Kakira Sugar 
works which was a good performer. This was done alongside the Focus Group Discussions that were 
conducted on OVC activities. 
v) Observation during field visits: 
Observational techniques using a check list was used as a data collection method in this evaluation study. 
Directly observed service provision, infrastructural support and equipment provided was documented 
with observers marking observations against a checklist. 
i) Data Management and Analysis 
All completed questionnaires were entered in EPIDATA V.3.1 software which had been fitted with a 
range and consistency checks. The data was then exported in STATA V9. A team of highly trained and 
experienced data entrants outsourced by REEV consult International under the supervision of a highly 
qualified data manager did data entry and analysis. Observation of security and confidentiality of data was 
at maximum. 
Quantitative data from client exit polls was mainly analysed with descriptive analysis. Quantitative data 
from primary and secondary data sources was presented using graphic representation to show the 
trends of key indicators over time. The appropriate graphical format was utilized to plot key variables 
and assess the trend of key program indicators over time. 
For qualitative data from Key Informant Interviews, Focus Group Discussions, the case study, and 
Observation, thematic analysis was done as follows: 
41
a) Textual data was explored using content analysis. Data was read and re-read by the analysts in 
order to identify emerging themes from the responses. 
b) All relevant data to each theme was identified and examined using the process of constant 
comparison, in which each item was checked or compared with the rest of the data in order to 
establish the analytical theme findings, conclusions and recommendations were guided by the 
Agency Evaluation Policy. 
42
ANNEX 4: DATA COLLECTION INSTRUMENTS 
KEY INFORMANTS INTERVIEW GUIDE 
Ministry of Health 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
43
This tool will be used to interview the key officials at the MoH headquarters and the national level 
Private sector partners; on: 
a) Organization, coordination and management of HIPS Project support to the private sector 
including plans for sustainability 
b) Integration of HIPS Project support to HIV/AIDS/TB/Malaria/ RH/FP and other primary health 
care services 
c) Structures and systems in place to support Private sector activities 
d) Involvement of HIPS Project partners in HIV/AIDS/TB/Malaria/ RH/FP and other primary health 
care services 
The key informants will include: 
a) Director General of Health Services 
b) STD/AIDS Control Programme 
c) Tuberculosis and Leprosy program 
d) Malaria Control Programme 
e) Reproductive Health and Family planning program 
f) Central Public Health Laboratory 
1. Comment about the level Political commitment at national level 
Probe for the following: 
a) Status/prioritization of Private sector in the National Health Policy, Health Sector Strategic Plan 
and National Strategic Plan for HIV/AIDS/TB/Malaria/ RH/FP and Laboratory services 
b) Feedback to policy makers on progress HIPS Project support to private sector contribution to 
Health systems strengthening. 
c) Level of involvement of the Minister of Health and high- level officials at MoH in Private sector 
and HIPS project support to Health sector. 
2. Private Public Partnership (PPP) Portfolio at MoH 
Probe for the following: 
a) Status of PPP Health policy and how it impacts on PPP support activities and initiatives including 
HIPS Project. 
b) Staff assigned to the PPP Unit and PPP focal persons HIV/AIDS/TB/Malaria/ RH/FP and 
laboratory services programs at the national and district level 
c) The chain of supervision of PPP focal persons and linkages with HIPS Project partners from the 
national to the health facility level. 
d) Plans for capacity building to support PPP activities. 
e) Functionality of PPP technical committee (TWG), strengths and weaknesses? How can it be 
improved? 
44
3. HIPS Project support to PPP Activities, coordination and integration into 
HIV/AIDS/TB/Malaria/ RH/FP services 
Probe for the following: 
a) Effectiveness of HIPS Project support to the management and coordination of private sector 
contribution in HIV/AIDS/TB/Malaria/ RH/FP and laboratory services in Uganda 
b) Mechanisms for coordination and linkages between PPP unit, HIPS Project and 
HIV/AIDS/TB/Malaria/ RH/FP and laboratory programs 
c) Innovations and approaches in which the HIPS Project has impacted on the PPP activities 
country wide. How effective have these been?, How can they be scaled up? 
d) For innovations and approaches by HIPS project that are considered successful in delivery of 
HIV/AIDS/TB/Malaria/ RH/FP and laboratory services; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary?
45
KEY INFORMANTS INTERVIEW GUIDE 
District Level (District Health Officer) 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
46
1. HIPS Project support to the Private sector in the provision of 
HIV/AIDS/TB/Malaria/ RH/FP and Laboratory services (Partnerships) at the district 
level 
Probe for the following: 
a) Partnerships that have been developed in implementing the HIPS project at the district level; 
with private sector/practitioners, NGOs, CBOs, other groups, 
b) Involvement of HIPS Project staff, partners/ private sector in the planning for 
HIV/AIDS/TB/Malaria/ RH/FP and Laboratory services at the district level. 
c) Involvement in direct implementation at the district and health facility level. 
d) Involvement of HIPS Project staff and partners in Monitoring and evaluation 
HIV/AIDS/TB/Malaria/ RH/FP and Laboratory activities. 
d) Compliance of HIPS staff and partners with national standards. 
e) Challenges/constraints and successes. 
f) For the HIPS project partners that are considered successful in delivery of 
HIV/AIDS/TB/Malaria/ RH/FP and Laboratory services at the district level; probe for the 
following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary 
2) What are the key private health sector issues in the district and how has the HIPS project 
helped to address them (Probe: district awareness of the role of the private sector; regulation; 
private sector mandate; access to information on private sector activities; existence of and 
effectiveness of district level coordination mechanisms)
2) Feedback on HIPS project approaches and innovations in private health sector support? 
47
KEY INFORMANTS INTERVIEW GUIDE 
HIPS Project Staff 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
48
This tool will be used to interview the key staff at the HIPS Project on the following issues:
a) Organization, coordination and management of HIPS Project support to the private sector 
including plans for sustainability 
b) Integration of HIPS Project support to HIV/AIDS/TB/Malaria/ RH/FP and other primary health 
care services 
c) Structures and systems in place to support Private sector activities 
d) Involvement of HIPS Project partners in HIV/AIDS/TB/Malaria/ RH/FP and other primary health 
care services 
The key informants will include the following: 
i. Chief of Party, HIPS Project 
ii. Team Leader Health Services 
iii. Team leader OVC Program 
1. Comment about the level of Political commitment at national level. 
Probe for the following: 
a) Status/prioritization of support to Private Sector Health facilities in the National Health Policy 
(vertical or integrated programme) and National Health Sector Strategic Plan and National 
Strategic Plan for HIV/AIDS/TB/Malaria/ RH/FP/OVC. 
b) Resource allocation by HIPS Project/ USAID to Private sector support in HIV/TB/Malaria/RH/FP 
and the health sector in general, (proportion of HIV/AIDS/TB/Malaria/ RH/FP/OVC funds 
allocated to Private sector). 
c) Feedback to policy makers on progress in private sector contribution in implementation of 
HIV/AIDS/TB/Malaria/ RH/OVC interventions. 
d) Level of involvement of the Government (MoH of Health) in private health sector support and 
in service delivery. 
2. HIPS Project Support to Partner companies/ private clinics in Health Service 
provision for HIV/AIDS/TB/Malaria/ RH/FP/OVC services
Probe for the following 
a) Specific annual targets for private sector (GDA/ clinics/OVC) expansion and achievements to 
date. 
b) Number of GDAs/Partner company/ private clinic sites and proportion of these facilities 
providing HIV/AIDS/TB/Malaria/ RH/FP/OVC services. 
c) Successes, Challenges/constraints in overall HIPS project support to GDAs/companies/ private 
clinics. 
f) For the HIPS project support to GDAs/companies/ clinics that are considered successful/not 
successful in enhancing service delivery to target communities; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
49
3. HIPS Project support to Capacity building in Private sector companies and clinics: 
Probe for the following: 
HIPS project achievements in training and provision of human resources for service delivery for 
HIV/AIDS/TB/Malaria/ RH/FP/OVC services in private sector health facilities against its project 
plan. 
a) Number of Health workers trained to provide quality HIV/AIDS/TB/Malaria/ RH/FP/OVC 
services among partner companies and clinics. 
b) Adequacy of training given to Health workers to provide HIV/AIDS/TB/Malaria/ RH/FP/OVC 
services among private sector health facilities. 
c) The chain and quality of supervision of HIPS supported private sector clinics from the national 
to the health facility level. 
d) Availability of tools ( policy guidelines, treatment guidelines, job aides, manuals, algorithms and 
HMIS registers at the private sector partner sites. 
4. Coordination and integration into Ministry of Health programs 
(HIV/AIDS/TB/Malaria/ RH/FP) and other primary health care services 
Probe for the following: 
a) Comment on the roles and functionality of the of HIPS Project as an IP responsible for 
management and coordination of USAID support to private sector clinics in 
HIV/AIDS/TB/Malaria/ RH/FP/OVC interventions in Uganda. 
b) Appropriateness of the current organizational structure of HIPS project support to private 
sector clinics for the successful implementation of the HIV/AIDS/TB/Malaria/RH/FP/OVC 
programmes? Explain. (Probe for the umbrella [UFE, UMA, UPPA, UHF, PSF, Direct support to 
clinics] organization is most appropriate). 
c) Mechanisms for coordination and linkages between HIPS supported private sector 
companies/clinics and Ministry of Health (PPP unit, AIDS Control Program, National 
Tuberculosis & Leprosy program, Malaria Control Pragram, RH/FP, Central Public Health 
Laboratory/OVC) at the national level. 
d) Other ways in which the HIPS Project support to private sector has impacted on the 
HIV/AIDS/TB/Malaria/ RH/FP/OVC and other primary health care services in Uganda. 
5. Partnership development (Public- Private Partnerships, International partnerships) 
Probe for the following: 
a) Partnerships that have been developed by HIPS Project in implementing the programme with 
private sector/practitioners, MoH, NGOs, CBOs, other groups international or bilateral 
agencies. 
b) HIPS project support to partners in the planning and policy formulation for private sector 
activities. 
c) HIPS project support to partners in direct implementation at the district and health facility level. 
d) HIPS project support to partners involvement in Monitoring and evaluation of the private sector 
activities. 
e) Compliance of private sector partners with national standards/policies/guidelines. 
50
6. HIPS Project Approaches and Innovations in Health Systems Strengthening among 
Partners (GDAs/Companies/Clinics/OVC ) 
Health system component HIPS support and 
Achievements 
Innovation among 
Partners 
Leadership and governance 
(Coordination, partnerships, 
accountability etc) 
Service delivery 
( increasing access and equity 
of services) 
Health financing (Medical 
schemes, insurance schemes, 
provider fees, grants, co￾financing, contracting out 
services etc) 
Health information (HMIS, 
M&E) 
Vaccines and technologies ( 
Drug & commodity logistics, 
Laboratories and diagnostics) 
Health workforce 
( Human resource) 
7. HIPS Project successes and Failures 
a) Successes, Challenges/constraints in partnerships 
b) For the partnerships that are considered successful in delivery of HIV/AIDS/TB/Malaria/ 
RH/FP/OVC activities; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
8. Sustainability of partnerships and service delivery after HIPS Project 
Sustainability of HIPS project approaches/innovations and plans (institutional/financial/programmatic) and 
potential for continuity of HIV/AIDS/TB/Malaria/ RH/FP/OVC service provision after end of USAID/HIPS 
project support to private sector clinics/comp
51
KEY INFORMANTS INTERVIEW GUIDE 
HIPS Project Partner Companies and Clinics (Health Facility Level) 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
52
This tool will be used to interview the key staffs at HIPS Project Partners (GDAs/Companies/Clinics) on 
the following issues: 
i) Improving quality and access to HIV/AIDS/TB/Malaria/ RH/FP/Laboratory and other primary 
health care services 
ii) Capacity building for HIV/AIDS/TB/Malaria/ RH/FP/Laboratory and other primary health care 
services 
iii) Partnerships/collaborations. 
iv) Creative approaches and innovation in HIV/AIDS/TB/Malaria/ RH/FP/Laboratory service delivery. 
v) Sustainability of services HIV/AIDS/TB/Malaria/ RH/FP/Laboratory service delivery. 
The key informant interviewees will include the following: 
 Health Facility In –Charges. 
 Heads of HIV/AIDS/TB/Malaria/ RH/FP/ Laboratory units. 
 Staff Providing HIV/AIDS/TB/Malaria/ RH/FP/Laboratory units 
A. HIPS Support to Quality and Access to Service delivery 
1. Quality Service delivery of HIV/AIDS/TB/Malaria/ RH/FP/Laboratory services 
Probe for the following: 
a) Capacity building needs among partner clinics 
b) HIPS Project support in availing and utilization of the national HIV/AIDS/TB/Malaria/ 
RH/FP/Laboratory guidelines and protocols at the site; Are the guidelines used at this site? If not 
why not? 
c) HIPS project support of training of staff involved in HIV/AIDS/TB/Malaria/ RH/FP/Laboratory 
activities. 
d) List the cadre of staff who provide HIV/AIDS/TB/Malaria/ RH/FP/Laboratory services 
Title Background HIPS Training 
 
Background – Dr, Clinical officer, nurse, lab technician, counselor etc 
HIPS Training – subject areas in which has received training 
e) Provide details on laboratory capacity at the partner facility (CD4, PCR, hematology, clinical 
chemistry, OI diagnostics, other) and training in use of these equipments. Which tests are 
sources out and where? 
2. HIPS support to Monitoring, evaluations and quality for the HIV /TB/Malaria/RH/FP 
services at the health facility level 
Probe for the following: 
a) Collection, analysis and reporting of data at the partner site. Describe how this is done. Are 
forms and other logistics available at the site? Are staffs trained to do this? 
b) Integration of HIV /TB/Malaria/RH/FP in the HMIS 
c) Data quality; How does the site ensure quality of data collection? 
53
d) Data flow: describe the data flow from the facility to the national level. How often is this data 
provided and how often is feedback received? 
e) Utilization of programme data to inform management decisions. How is the data utilized at site 
level? By whom? How often? 
f) Is regular feedback received from the HIPS Project, district and national level concerning 
implementation data? 
g) Information sharing: How is relevant information shared? What kind of information is shared 
h) Support supervision by HIPS/MoH and frequency 
3. Community Support and involvement in HIPS Project activities 
a) Community initiatives and availability of support groups: Are there HIV /TB/Malaria/RH/FP 
support groups at the facility? Are there community networks available to: 
b) Provide psychosocial support to clients? 
c) Provide food and nutrition support to clients? 
d) Provide livelihood Support (Income generating activities [IGA], Village Saving and Loan 
Association [VSLA] ) 
e) Are there micro-credit interventions available to clients or their families /communities? 
f) Communication with the communities: What regular communication is there between the HIPS 
project partner and the local support groups 
g) Community mobilization for HIPS Project supported services: What community mobilization 
activities are implemented at facilities ; Are they isolated events or sustained programmes at 
selected or all facilities? 
h) Ways in which the communities contribute to the HIPS projected supported services. 
i) What are the constraints to/gaps in support for HIV-infected women in this area? 
j) For the community support activities that are considered successful/not successful; 
probe for the following: 
k) What worked well and why? 
l) What was key in achieving project results? 
m) What didn’t work well and why? 
n) What was key in hindering project results? 
o) If you had to replicate the process which aspect would you retain? 
p) If you were to replicate the process which aspect would you exclude? 
q) If you were to replicate the process which process would you change? 
r) How would you change it? 
s) What other improvements are necessary? 
4) HIPS support to Management of essential HIV /TB/Malaria/RH/FP/laboratory 
commodities at the HIPS partner health facility 
Probe for the following: 
a) Procedures followed in the selection and procurement of commodities test kits, consumables, 
ARVs and discuss successes and constraints). 
b) Availability of ARVs in the health facility; availability of HAART, ARV prophylaxis for PMTCT, FP 
supplies (LTPM), test kits/lab reagents, condoms etc. 
c) Availability of drugs for opportunistic infections at the health facility. 
d) Availability of pediatric ARV formulations at the health facility. 
e) Frequency of stock outs (for ARVs, cotrimoxazole, test kits, other logistics) and contributory 
factors. 
f) Cost for delivery of supplies; cost recovery mechanisms; payment for services and supplies by 
the PMTCT clients. 
54
g) Storage and distribution of supplies; use of stock cards; tracking data around reception and 
distribution and it use for supply planning. 
h) Challenges/constraints/successes which the program is currently facing in logistics management 
of the PMTCT commodities at the health facility level. 
5) HIPS Support to Integration of HIV/AIDS/TB/Malaria/ RH/FP/Laboratory services 
and impact on other primary healthcare services 
Probe for the following: 
a) Accommodation of the HIPS Project supported HIV/AIDS/TB/Malaria/ RH/FP/Laboratory 
services regarding space in existing facilities (has additional space been provided, have other 
services displaced, has there been space sharing, Was space already available). 
b) Other ways in which HIPS project supported activities have impacted onother primary 
healthcare services provided by the company/clinic . 
6) HIPS Support to Partnerships/collaborations 
Probe for the following: 
a) Presence of linkages to other Public sector /Ministry of health 
b) Strategic partnerships that have been developed in HIPS project activities with NGOs, CBOs, 
private sector/practitioners, international and bilateral agencies 
c) For the partnerships that are considered successful in delivery of HIV/AIDS/TB/Malaria/ RH/FP, 
Laboratory and other primary health care services ; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
 Innovations that have evolved during implementation? 
 Plans for sustainability? 
7). Sustainability Plans for HIPS partners at end HIPS Project 
Sustainability plans (institutional/ financial/programmatic) and potential for continuity of 
HIV/AIDS/TB/Malaria/ RH/FP service provision after end of USAID/HIPS project support to 
private sector clinics/companies. 
55
KEY INFORMANTS INTERVIEW GUIDE 
Client Exit Questionnaire 
1 RESPONDENTS IDENTIFICATION NUMBER____________________ 
2 TYPE OF FACILTY (FP/NFP) ________________________________
3 COMPANY/CLINIC IDENTIFICATION NUMBER _________________ 
4 NAME OF INVESTIGATOR ___
 _______ 
 
URBAN 1 RURAL 2 
5 INTERVIEW DATE 2 0 1 1
6 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………...…………………………………… 
56
Respondent is a client exiting a service at a HIPS partner Clinic health facility 
Dear Participant, 
You have been randomly selected to be part of this study and we would therefore like to ask you some 
questions The study is being conducted by REEV Consult International and the information you provide 
will only be used to understand quality of HIV/AIDS/TB/Malaria/RH/FP services offered in this facility; 
and how clients view these services. This information is necessary for the effective planning of improved 
health care delivery in private clinics Uganda. 
You are kindly requested to provide the information required as sincerely as possible. The interview will 
take approximately 30 minutes. You will be asked questions about: 
 Background information 
 Health seeking practice 
 Perceptions about HIV/AIDS/TB/Malaria/RH/FP services 
The information you provide is totally confidential and will not be disclosed to anyone. It will only be 
used for research purposes. Your name is not required. 
Your participation is voluntary and you can withdraw from the study at any time of your choice even 
after having agreed to participate. You are free to opt not to answer any question that is asked in the 
questionnaire. 
Ask respondent if he/she consents, if the answer is yes then proceed with interview (Saying yes indicates 
respondent understands what will be expected of them and their willingness to participate in the survey). 
57
100: Respondent’s Background Characteristics 
Nº QUESTIONS AND FILTERS CODING CATEGORIES SKIP 
TO 
 Sex Male...............................…….…..…….…
……1
Female...………….….…….……….…
……….……..2
101 Age (write the block age) 
........................................................Years 
102 Religious Affiliation Protestant/Anglican……….…..…….
………1
Catholic………….….…….……….…
……….……..2
Muslim………….….……..……………
……………...3
Other 
(specify)….….…………………………
...4
103 Marital Status Married….……………………..............
…….….1
Single…….…..….....…..………………
……..…….2
Separated….…..…...…………………
…..………3
Widowed………......…………….….4
Others (specify)………………..…5
104 Main Occupation Teacher………..………………….…
…………………1
Driver………….……………………..
…………………2
Peasant 
Farmer………………………………
….3
Trader……………….………………
………………….4
Waiter/waitress…………….…………
……….5
Artisan 
………………………………….…..…
………6
Others 
(Specify)………..……………………
…7
105 Level of education of respondent Never went to School …………..…1
Primary ...…………………………..2 
Secondary……..……….….………..3 
Post-Secondary……………..……….4 
Other...................……..……..……….5
58
Nº QUESTIONS AND FILTERS CODING CATEGORIES SKIP 
TO 
106 Level of education of the spouse Never went to School 
………...……………1 
Primary 
...............………………...……….……..
2 
Secondary……………………..………
.….………..3 
Post￾Secondary……………..…………..…
…….4
Other.................……………..…………
..……….5 
107 Can you read and write? 
(Give a respondent something to read) 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
59
200: Health care Practice 
Nº QUESTIONS AND FILTERS CODING CATEGORIES SKIP 
TO 
201 Nature of service received Malaria Services 
……..........…...……………1 
HIV/AIDS /PMTCT services ….……..2
TB services 
...………………..……….….………..3 
Reproductive health/Family planning 
services 
......................…....…………....……4. 
Laboratory services.............................5 
Other..................…...….....…………..…
……...6 
102 Were you given a referral to come to this facility? Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
103 How much time did you spend for your visit at this 
clinic today? _____________________ minutes 
104 What is your view about the time you spent to get 
the service? 
Too 
Much..…..………………….…………
…………1
Just 
Right….……………………..…………
………2
Too 
Short…............…..……………………
…….3
105 Upon your arrival at the clinic did the staff offer you 
HIV/AIDS/TB/Malaria/RH/FP counseling? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
N/A…......................…..………………
………….3
106 How long did the Health provider (or other staff) 
take talking to you during counseling/treatment? _____________________ minutes
107 Is there anything you did not like during the 
treatment/provision of the services? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
108 If yes, please explain more about it ........................................................................
........................................................................
........................................................................
............................................................
60
Nº QUESTIONS AND FILTERS CODING CATEGORIES SKIP 
TO 
109 What were the good things (that you liked) about 
the treatment/service that you received? 
........................................................................
........................................................................
........................................................................
............................................................
110 Did you feel comfortable with your Health service 
provider? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
111 Do you think there was enough privacy during 
treatment / service provision? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
112 Were you comfortable with laboratory services/ 
other tests done? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
113 Was the provider friendly to you? Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
114 What barriers do you think affect you or prevent you 
or other people you know from accessing and 
utilizing the HIV/AIDS/TB/Malaria/RH/FP services 
....................................... 
………...……………1 
.............................………………...……
….……..2 
....................……………………..……
….….………..3 
.............................……………..………
…..……….4 
.............................……………..………
…..……….5 
115 Rank the importance of the following barriers to HIV/AIDS/TB/Malaria/RH/FP services as you 
or any other people you know experience it in this clinic 
 Barrier High Moderate Low
a) Distance & cost from home 
b) Cost of services
c) Lack of privacy in busy
clinics 
d) Perceived lack of skilled health providers
e) Perceived lack of concern on the part of
health staff 
f) Inadequate medical equipment
g) Inadequate laboratory / other testing services
h) Any other barrier 
61
Nº QUESTIONS AND FILTERS CODING CATEGORIES SKIP 
TO 
116 Overall ranking/ assessment of services received Very 
Satisfied……………….………………
……1
Satisfied...….……………………..……
……………2
Not 
Satisfied........…..………………………
….3
Not 
Sure.................…..……………………
…….3
117 In your opinion, what three major things do you 
think should be improved? ....................................... 
………...……………. 
.............................………………...……
….……....1 
....................……………………..……
….….………... 
.............................……………..………
…..……….2 
.............................……………..………
…..……….... 
...................................................................3 
118 Are you aware of HIPS/USAID support to this clinic 
to provide quality and subsidized 
HIV/AIDS/TB/Malaria/RH/FP services to this 
community? 
Yes..............…………………..………
……..………..1
No.......................……………………..
…..……….2
Thank you for your cooperation and time 
62
KEY INFORMANTS INTERVIEW GUIDE 
OVC Programs Supported by HIPS Project 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
63
100: Organization background of HIPS Project Partner 
 Name of organization 
........................................................................
..................................................................
 Name of respondent 
........................................................................
..................................................................
 Position/Responsibility in Organization
........................................................................
..................................................................
 When was the OVC program initiated
........................................................................
.................................................................
 How large is the catchment area of the program ........................................................................
..................................................................
 How many clients are served (Direct/Indirect)
........................................................................
..................................................................
200 Organization Structure of HIPS Project Partner
201 Type of OVC program (NGO,CBO, Company 
affiliated, Clinic affiliated) 
202 Head of program 
203 Who coordinates OVC program 
300 Staff Composition 
301 Permanent staff
302 Part-time staff
 Volunteers 
400 OVC Services and Activities supported by HIPS Project Partners 
a) Nature of clients accepted AIDS orphaned 
…………....……………………1
All 
orphaned………….........…..…………
………2 
All vulnerable children (probe)..........3 
Not 
Sure.................…..……………………
…….3
b) Methods of enrolment Others......................................................1
From hospital/clinic/health facility.2 
From Community....................................3
Self referral..........................................4 
64
 Name of organization 
........................................................................
..................................................................
c) What is the range of services provided and 
supported by HIPS project and partners 
d) Shelter
........................................................................
..................................................................
e) Food and dressing 
........................................................................
..................................................................
f) Education/ school fees/scholastic materials
........................................................................
..................................................................
g) OVC Rights protection 
........................................................................
..................................................................
h) Clinical and nursing care 
........................................................................
..................................................................
i) Counseling, psycho-social support
........................................................................
..................................................................
j) Financial/IGA assistance 
........................................................................
..................................................................
k) Home help 
........................................................................
..................................................................
l) Support groups 
........................................................................
..................................................................
m) AIDS prevention & STI treatment
........................................................................
..................................................................
500 Describe the criteria used for provision on OVC 
support to those in need 
........................................................................
........................................................................
........................................................................
............................................................
600 Capacity building in OVC support by HIPS 
project /Partner 
65
 Name of organization 
........................................................................
..................................................................
601 HIPS project achievements in training and provision 
of skilled personnel in OVC support programs. 
a) Number of people trained in OVC support and care
b) Content and adequacy of training given to OVC 
program providers 
c) Adequacy of trained OVC providers in program
d) The quality of supervision of OVC program
700 OVC innovations among HIPS supported 
programs 
701 What new innovations / initiatives have you 
incorporated to improve in your OVC programs that 
have resulted in high quality impact? 
........................................................................
........................................................................
........................................................................
............................................................
........................................................................
........................................................................
........................................................................
............................................................
702 For OVC support initiatives/activities that are considered successful/not successful; probe for 
the following: 
a) What worked well and why? 
b) What was key in achieving project results?
c) What didn’t work well and why?
d) What was key in hindering project results?
e) If you had to replicate the process which aspect 
would you retain? 
f) If you were to replicate the process which aspect 
would you exclude? 
g) If you were to replicate the process which process 
would you change? 
h) How would you change it? 
i) What other improvements are necessary?
 
703 Partnerships/Collaborations among HIPS supported OVC supported programs 
i) Presence of linkages to other Public sector /government department 
66
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
2) Strategic partnerships that have been developed in OVC program with 
NGOs, CBOs, private sector/practitioners, international and bilateral agencies 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
3) For the partnerships that are considered successful in delivery of OVC care: 
probe for the following: 
 What worked well and why? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 What was key in achieving program results? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 What didn’t work well and why? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 What was key in hindering programresults? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 If you had to replicate the process which aspect would you retain? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 If you were to replicate the process which aspect would you exclude? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 If you were to replicate the process which process would you change? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 How would you change it? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 What other improvements are necessary? 
………………………………………………………………………………………………………………
………………………………………………………………………………………. 
 Innovations that have evolved during implementation? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
 Plans for sustainability? 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
704 Sustainability Plans for HIPS partners at end HIPS Project 
67
Sustainability plans (institutional/ financial/ Programatic) and potential for continuity of 
HIV/AIDS/TB/Malaria/ RH/FP service provision after end of USAID/HIPS project support to private 
sector clinics/companies. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
………………………………………………………………………………………………………………
…………………………………………………………………………………………. 
Thank you for your cooperation and time 
68
KEY INFORMANTS INTERVIEW GUIDE 
USAID Staff (CTO, Team Leader –HIV/AIDS, Team Leader-Presidential Malaria Initiative) 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
69
1. Partnerships 
Probe for the following: 
a) Support to the HIPS Project to expand access and increase utilization of HIV/AIDS/TB/Malaria/ 
RH/FP, Laboratory and other primary health care services among HIPS partner companies 
/clinics. 
b) Support for Capacity building among HIPS project partners in HIV/AIDS/TB/Malaria/ RH/FP, 
Laboratory and other primary health care services delivery 
c) Support to HIPS Project and partners for involvement in the national and district level health 
planning and policy formulation. 
c) Support for direct implementation at the HIPS project partner companies and clinics/facility 
level. 
d) Support in Monitoring and evaluation of the HIPS Project supported activities. 
e) Challenges/constraints and successes. 
f) For the HIPS Project innovation and partnerships that are considered successful in delivery of 
HIV/AIDS/TB/Malaria/ RH/FP, Laboratory and other primary health care services ; probe for the 
following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
 Innovations that have evolved during implementation? 
 Plans for sustainability? 
2. Funding mechanisms for implementation of HIPS Project activities 
Probe for the following: 
a) Amount of funds provided to HIPS Project and HIPS Partners to implement 
HIV/AIDS/TB/Malaria/ RH/FP, Laboratory and other primary health care activities. 
b) Funding modalities used to support HIPS Project and Partners. 
c) Direct support to the HIPS Project partners and challenges faced. 
d) Extent of alignment of the various funding mechanisms to HIPS project partners and National 
strategy (NSP / HSSP). 
f) Challenges/constraints/successes. 
g) For the funding mechanisms that are considered successful/not successful in supporting HIPS 
Project activities; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
 Innovations that have evolved during implementation? 
70
3. Sustainability Plans for HIPS Project partners at end HIPS Project 
Sustainability plans (institutional/ financial/programmatic) and potential for continuity of 
HIV/AIDS/TB/Malaria/ RH/FP service provision after end of USAID/HIPS project support to private 
sector clinics/companies. 
Thank you for your cooperation and time 
KEY INFORMANTS INTERVIEW GUIDE 
HIPS PROJECT COLLABORATING INSTITUTIONS (UMA; FUE; UHMG; MILD MAY 
CENTRE, UHF, JHUB 
 RESPONDENTS IDENTIFICATION NUMBER____________________ 
 COMPANY/CLINIC IDENTIFICATION NUMBER__________________ 
 DISTRICT ________________________________________________ 
 SUBCOUNTY / TOWN ___ 
 
 
URBAN 1 RURAL 2 
 INTERVIEW DATE 2 0 1 1
 LANGUAGE USED DURING THE INTERVIEW (ENGLISH) 01
ENGLISH 
1 
LUO 
2 
LUGANDA 
3 
LUGBARA 
4 
NGAKARIMAJONG 
5 
4 RS 
6 
SUPERVISOR’S APPROVAL………………………………………………………………… 
71
1. Partnerships 
Probe for the following: 
a) Your involvement HIPS Project activities to expand access and increase utilization of 
HIV/AIDS/TB/Malaria/ RH/FP, Laboratory/OVC support and other primary health care services 
among HIPS partner companies /clinics. 
b) Your involvement in Capacity building initiatives among HIPS project partners in 
HIV/AIDS/TB/Malaria/ RH/FP, Laboratory/OVC support and other primary health care services 
delivery 
c) Your involvement in the national and district level health planning and policy formulation among 
HIPS Project partners. 
c) Your involvement in direct implementation by HIPS project partner companies and clinics/facility 
level. 
d) Your involvement in Monitoring and evaluation of the HIPS Project supported activities. 
e) Challenges/constraints and successes. 
f) For the HIPS Project innovation and partnerships that are considered successful in delivery of 
HIV/AIDS/TB/Malaria/ RH/FP, Laboratory/OVC support and other primary health care services 
; probe for the following: 
 What worked well and why? 
 What was key in achieving project results? 
 What didn’t work well and why? 
 What was key in hindering project results? 
 If you had to replicate the process which aspect would you retain? 
 If you were to replicate the process which aspect would you exclude? 
 If you were to replicate the process which process would you change? 
 How would you change it? 
 What other improvements are necessary? 
 Innovations that have evolved during implementation? 
 Plans for sustainability? 
2) Sustainability Plans for HIPS Project partners at end HIPS Project 
Sustainability plans (institutional/ financial/programmatic) and potential for continuity of 
HIV/AIDS/TB/Malaria/ RH/FP service provision and OVC support after end of USAID/HIPS project 
support among partner private sector clinics/companies. 
Thank you for your cooperation and time 
72
ANNEX 5: LIST OF DOCUMENTS REVIEWED 
Cassandra Blazer and Meghan Majorowski (2011): The HIPS Project. Extending Healthcare Through the 
Private Sector in Uganda. AIDSTAR One. Case Study Series. February 2011. 
Emerging Markets Group (2007) Company to community treatment partnerships: an evaluation of 
community AIDS treatment partnerships under the Uganda Business Part project. August 2007. 
Emerging markets Group, A Referral Guide for Peer Educators (unpublished) 
Emerging Markets; Johnshopkins Bloomberg School of Public Health; Centre for Communication 
Programmes; Mildmay International and Obrien and Associates International (2007); Technical Proposal 
for Health Initiatives for the Private sector (HIPS) Activity 
Government of the Republic of Uganda (2005); The Uganda Health Sector Strategic Plan. Kampala, 
Uganda 
HIPS Annual and Quarterly Reports (2008-2012) 
Kelly McCoy, Dithan Kiragga, Barbara Addy and Frank G. Feeley (2011); Costs and outcomes of 
delivering ART in the Private and Public Sectors in Uganda. Kampala, Uganda 2011 
Obrien and Associates International (2011); Health Care Franchising in Uganda, Kampala 
Paul Bukuluki (2009); Impact of ART on employer costs related to AIDS- Report 
Rich Feely, Paul Bukuluki and Peter Cowley (2004); The Role of the Private sector in Preventing and 
Treating HIV/AIDS in Uganda: An assessment of Current activities and the Outlook for Future Action. 
Uganda Health Marketing Group (2011); A Manual for the Training of Trainers of Peer Educators, 
Kampala, Uganda 
Uganda Health Marketing Group (2011); Handbook for Peer Educators, Second Edition, Kampala, 
Uganda 
Uganda Manufacturers Association (2009), Involvement of the Corporate Sector in support for Orphans 
and Vulnerable Children and Reproductive Health in Uganda. 
Wilsken Agencies (2008); Formative Study for HIPS’ Good Life Project, HIPS Uganda 
. 
73
ANNEX 6: SUMMARY OF HEALTH FACILITIES SAMPLED FOR THE EVALUATION 
Health facility Location
Private Health Facilities 
1. Abii Clinic Wandegeya-Kampala 
2. Busabala Road Nursing Home Basabara Road-Kampala 
3. Case Clinic Buganda Road, Kampala 
4. Crane Medical Centre Kampala Road-Kampala 
5. Double Cure Medical Centre Mpigi
6. Good Will Nursing Home Mutungo-Kampala 
7. Ikan Clinic Bukoto, Kampala 
8. Kabalega Medical Centre Hoima
9. Kadik Health Centre Nakulabye, Kampala 
10. Kireka SDA Clinic Kireka, Kampala 
11. Kyaliwajala Clinic Bweyogerere, Kampala 
12. Lambu Clinic Masaka
13. Lukuli Hope Clinic Makindye, Kampala 
14. Mirembe Medical Centre Wakiso
15. Musoke Domicilliary Clinic Ntinda-Kampala 
16. Norvik Hospital Bombo Road, Kampala 
17. Old Kampala Hospital Kampala
18. Paragon Hospital Bugolobi, Kampala 
19. Philomena Clinic Kikoni-Kampala 
20. Safeguard Nursing Home Makindye-Kampala 
21. SAS Foundation Bugolobi, Kampala 
22. SEO Clinic Ntinda-Kampala 
23. Sims Medical Centre Rubaga, Kampala 
24. St. Catherine Clinic Buganda Road-Kampala 
25. St. Charles Medical Centre Mityana 
26. St. Joseph’s Clinic Wandegeya, Kampala 
27. St. Mary’s Medical Centre Entebbe
28. Touch Namwongo Project Namwongo-Kampala 
29. Tropical Clinic Entebbe
30. Victoria Medical Centre Buganda Road, Kampala 
Company Clinics /GDAs 
31. Ankole Growers Tea factory Bushenyi
32. Crown Beverages Kampala
33. FIDUGA- Nsimbe Estates Wakiso
34. Hima Cement Ltd Clinic Kasese
35. IAA Royal van Zanten Mukono
36. Kakira Sugar Works Ltd. Clinic Jinja
37. Kinyara Sugar Works Masindi
38. Kitante Medical Centre Kampala
39. Luweero Industries Nakasongola 
40. Mabaale Growers’ Tea Estate Kyenjojo
41. Makerere University Hospital Kampala.
42. Mt. Elgon Orchard Mbale
74
43. Nakigalala Tea Estate Clinic Entebbe
44. New Forest Company Ltd. Clinic Kiboga
45. Nile Breweries Clinic Jinja
46. NYTIL Clinic Jinja
47. Reco Industries Kasese
48. Roofings Ltd. Clinic Entebbe
49. Rwenzori commodities- Buzirasagama Kyenjojo
50. SCOUL (Lugazi) Clinic Lugazi
51. Tam Teco – Kyamara Kabarole
52. Tam Teco- Kijura Kabarole
53. Tam Teco Mityana Mityana
54. Tilda Rice Ltd Clinic Bugiri
55. Tororo Cement Ltd. Clinic Tororo
56. Tullow Oil Hoima
57. Ugacof Wakiso
58. Uganda Clays Ltd. Clinic Kajjansi (Wakiso) 
59. Uganda Crane Creameries Cooperative Union Mbarara
60. Wagagai Flowers Clinic Kasenyi (Entebbe) 
75
ANNEX 7: LIST OF PERSONS INTERVIEWED AND PARTICIPANTS IN FOCUS 
GROUP DISCUSSIONS
Ministry of Health Program Officer, HIV/AIDS 1. Musinguzi Joshua (Dr) 
Coordinator; RH commodities 2. Albert Kalangwa (Dr) 
Head; Family Planning 3. Rose Akol (Dr) 
Malaria Control Program 4. Albert Peter Okui (Dr) 
5. Myers Lugemwa (Dr) 
Federation of Uganda 
Employers (FUE), 
HIV AIDS Coordinator 6. Asha Nantamu 
Employment Relations Officer 7. Lilian Nyachwo 
Uganda Manufacturers 
Association (UMA 
Coordinator Training 8. Joseph Kyalimpa 
9. Caxton Mayanja 
Uganda Health Marketing 
Group (UHMG) 
Fiona Mahoro 10. Program Officer 
Johns Hopkins University 
(JHUCCP) 
Technical Advisor; BCC 11. Lilian Nakato 
Mildmay Centre Training Manager 12. Edith Akankwasa 
HIPS Chief of Party
Team Leader; Health Services 
Program Manager; OVC 
13. Dithan Kiragga (Dr) 
14. Fred Ntege (Dr) 
15. Jarvice Sekajja 
USAID Contract Officers 
Representative (HIPS) and 
Deputy Health Team Leader 
Program Management Specialist 
/ PMI 
OVC Program Management 
Specialist 
Senior youth and OVC Advisor 
16. P.A Kyambadde 
17. Joel Kisubi 
18. Catherine Muwanga 
19. Wanican Joyce 
HIPS Partner clinics
Private Clinics 
Abii Clinic Enrolled Nurse 20. Kulthum Kisaakye 
Nurse 21. Madina Nakigula
Counsellor 22. Rosette Birungi 
Busabala Road Nursing 
Home 
Clinical Officer 23. Dan Bukenya
Case Clinic General Manager 24. Issa Bulafu
Coordinator 25. Amina Kabuye 
Crane Medical Centre Clinic In-charge 26. Henry Kimaite
Double Cure Medical 
Centre 
Hospital Administrator 27. Lydia Nakitende (Dr) 
Good Will Nursing Home Director 28. Odong-Kulo (Dr)
Ikan Clinic Director 29. Karen Ndahura (Dr) 
76
Kabalega Medical Centre Director 30. Joseph Ruyonga (Dr) 
Kadik Health Centre Nasumba Harriet 31. Midwife/counselor
Kireka SDA Clinic Clinical Officer 32. Parsis Ndagire
Clinic In-charge 33. Alex Kambere 
Kyaliwajala Clinic Enrolled Comprehensive Nurse 34. Lamek Waswa 
Lambu Clinic In charge 35. Nkoyoyo.A (Dr). 
Coordinator HIPS Activities 36. Kalule Siraj 
Lukuli Hope Clinic HIV Counselor 37. Zaituni Namusisi
Mirembe Medical Centre Clinic In-charge 38. Mutebi Bob 
Musoke Domicilliary Clinic Clinic In-charge 39. Imelda Musoke (Mrs) 
Norvik Hospital Doctor 40. Bahauddin
Operations Manager 41. Babu T.
Old Kampala Hospital Clinic In-charge 42. Rehemah N
Paragon Hospital In charge Maternity 43. Juliet Nakawesi
Philomena Clinic Clinic In-charge 44. Henry Byanaku
Safeguard Nursing Home Clinic In-charge 45. Rehemah Nabayunga 
SAS Foundation Nursing officer 46. Nabawanuka Betty
SEO Care Clinic Clinic In-charge 47. Julius Nainywa
Sims Medical Centre Director 48. Simon Sentumbwe 
St. Catherine Clinic Counselor 49. David Bunjo 
Laboratory Technician 50. Kilama Otika 
Accountant 51. Lutuu
St. Charles Medical Centre 52. Ziwa (Dr)
St. Joseph’s Clinic Director 53. Josephine Birungi 
Clinical Officer 54. David were 
Clinical Officer 55. Samuel Mwamia 
St. Mary’s Medical Centre Clinic Administrator 56. May Mbyetsiza 
Touch Namwongo Project Project Administrator 57. Debrah Nanyombi 
Tropical Clinic Director 58. Rogers Amule (Dr) 
Victoria Medical Centre Clinical Officer 59. Okello Newton
Company Clinics
Ankole Growers Tea 
factory 
Enrolled comprehensive 
Nurse 
60. Pascal Thembo 
Crown Beverages Clinic In-charge 61. Jude Thadeus Sekiswa (Dr)
Farmers Centre Area operations Manger 62. Scwici Susan
Project Assistant 63. Atim Sarah 
FIDUGA- Nsimbe Estates In-charge, ART Clinic 64. Aisha Birabwa Kasirye
In-charge IMC FIDUGA Clinic 65. Kevin Nabuuma 
Hima Cement Ltd Clinic Case Clinic 
administrator/incharge
66. Nanette P
IAA Royal van Zanten Clinic In-charge 67. Paul Ngobi
77
Counselor 68. Zigonzaga Lubega 
Human Resource Manager 69. Juliet Kabaitira 
Kakira Sugar Works Ltd. 
Clinic 
Clinical Officer 70. Bukenya Misaki
Kinyara Sugar Works Clinic In-charge 71. Samuel Nsubuga
Kitante Medical Centre Doctor 72. Saul B
Nurse 73. C. Pulkeria 
Counselor 74. Tusiime Christine 
Luweero Industries In-charge 75. John Mwanda
Mabaale Growers’ Tea 
Estate 
In-Charge 76. Philemon Ahabwe 
Makerere University 
Hospital 
HIV/AIDS Nursing Officer 77. Yahya Ndiwalana
Mpanga Growers’ Tea 
factory 
Company Administrator 78. Annah Adong
Clinic In charge 79. Ahaisibwe Margret 
Mt. Elgon Orchard General Manager 80. Bazaale Kethern
Nakigalala Tea Estate Clinic Clinic In-charge 81. Ritah Namubiru
New Forest Company Ltd. 
Clinic 
Programmes Manager 82. Alex Kyabawampi
CSR Manager 83. Kate Sharum 
OVC officer 84. Martin Okello 
Clinical officer 85. M.J. Emma 
Clinical officer 86. Ruth Nalunga 
Nile Breweries Clinic Clinical Officer 87. Koomi George 
NYTIL Clinic Nursing Officer 88. Laker Rosemary 
Reco Industries Human Resource Manager 89. Asiimwe Winnie 
Roofings Ltd. Clinic Clinic In charge 90. Godfrey Busingye
Rwenzori Commodities- Clinic In charge 91. Patrick Ndyanabo 
SCOUL (Lugazi) Clinic Hospital Superintendent 92. Kigula (Dr)
Hospital Administrator 93. Annet Nampiima 
Tam Teco – Kyamara Clinic In charge 94. Grace Namugga 
Tam Teco- Kijura Clinic In charge 95. Julius Twesigye 
Tam Teco Mityana Clinic In charge 96. Cleophus Birungi 
Tilda Rice Ltd Clinic Coordinator 97. Mr. Umar Mukose
Human Resources Manager 98. Mr. Livingston Jushua 
Tororo Cement Ltd. Clinic Coordinator-HIPS project 99. Omeda Arthur
Chief Marketing Manager 100. Alok. R. Kalo 
Tullow Oil Clinic In charge 101. Vincent Bisobolwa
Ugacof Enrolled Comprehensive Nurse 102. Winnie Wanyana 
Uganda Clays Ltd. Clinic Clinic In-charge 103. Godfrey Bazaale (Dr) 
Uganda Crane Creameries 
Cooperative Union 
Field Coordinator 104. Tukamushaba Pison 
78
Wagagai Flowers Clinic Manager 105. Kate Ochom
Administrator 106. Roy Kyabangi 
Laboratory Manager 107. Frederick Emoru 
District Health Officers 
Hoima District Health Officer 108. Joseph Ruyonga (Dr) 
Bushenyi District Health Officer 109. Mwesigye Edward (Dr)
Kabarole District Health Officer (Ag) 110. Mpuuga Hosea (Dr) 
Kasese District Health Officer 111. Samuel Kasimba (Dr) 
Mukono District Health Officer 112. Elli Muhumuza (Dr) 
Focus Group 
Participants 
Jinja Youth 113. Michael Kintu 
114. Baleeke Jane 
115. Muwaseka Samuel 
116. Bagaya Peter 
117. Namugere Christine 
118. Kimbowa Paulo 
119. Matwama (Ms) 
120. Kintu Musa 
Women 121. Doreen Nakazibwe 
122. Gladys Balitumye 
123. Peace Ayagalwa 
124. Christine Ayanga 
125. Justine Kwaga 
126. Judith Kaliiza 
Men 127. David Kasaaga 
128. Philemon Kazunghu 
129. Festus Luganga 
130. Timothy Waiduba 
131. Benard Wamimbi 
132. Anold Kirunda 
Lira Youth 133. Martin Ojok 
134. Ronald Ojul 
135. Denis Ocoka 
136. Susan Aroko 
137. Joan Aciro 
138. Bridget Okot 
Women 139. Matilda Ochola (Mrs)
140. Stella Opio (Mrs) 
141. Susan Owanyi (Mrs) 
142. Juliet Auma 
143. Flavia Anena 
79
144. Hilda Angom 
Men 145. Paul Oloya 
146. Ronald Okello 
147. Jolly Joe Onen 
148. Henry Komakech 
149. Petros Odongpiny
150. Geofrey Okeny
80
ANNEX 8: SUMMARY MATRIX FOR ACHIEVEMENTS OF THE CAPACITY BUILDING COMPONENT OF HIPS 
Activities Expected Results Achievements Analysis 
Expanding FUE and 
UMA scope of 
workplace 
intervention to 
integrate TB,FP/RH, 
and Malaria with 
HIV/AIDS care 
FUE and UMA 
acquire capacity to 
take responsibility 
for project-initiated 
activities. Leading 
collaborating 
organizations 
(UMA, FUE, 
Mildmay, UHMG 
and Straight Talk 
Foundation) take 
leadership role in 
health workplace 
programs. 
 FUE and UMA have successfully brokered partnerships 
with private companies for implementation of project 
activities. Currently, active GDA partnerships are 42 and 
the overall active partners are 95. 
 In addition, FUE and UMA entered Sub-Agreements with 
identified local organizations for specific undertakings 
(SoW) for each organization. 
 FUE and UMA have demonstrated readiness to take 
over the full responsibility the HIPS partnerships, 
evidenced by a significant increase in income generated 
from HIPS partners (an increase of 67% from Quarter 3 
to Quarter 4 alone). 
 Of the 88 total partnerships eligible for migration to FUE 
or UMA management, 74% migrated and are now 
overseen by the associations. 
 FUE and UMA have established firm partnerships with 
Mildmay, UHMG and Straight Talk Foundation for both 
clinical and peer education. 
 Using UMA and FUE; the lead 
employment organizations in the 
country easily mobilized private 
companies for project activities 
as the two easily brokered the 
companies for partnership 
 By leveraging private company 
resources HIPS convinced the 
companies to expand health 
services into new areas 
(HIV/AIDS care TB,FP/RH, and 
Malaria) as the project offered 
support in expanding 
infrastructure and providing 
equipment and drugs 
 The trainings provided by the 
project prepared the health 
workers to handle new 
challenges 
Supporting 
Companies to 
develop and 
implement 
HIV/AIDS and health 
workplace policies 
and programs 
building on best 
practices 
All partner 
implementers have 
in place, workplace 
health policies; 
more so the 
HIV/AIDS 
workplace policy 
The HIV/AIDS workplace policies have been developed 
in most of the partner institutions; 18 of the 22 GDAs 
visited for this evaluation had the policy in place 
 The HIV/AIDS workplace policy 
was one of the main outcomes of 
the project as it protected 
workers against discrimination. 
This gave workers confidence as 
it recognized their right to work. 
 The limitation though, was that 
the policy had not been 
adequately circulated to all 
workers; and where available it 
was not translated in dialects 
81
most understood by the majority 
of the workers 
Calculating the loss 
to for companies 
arising out of the 
sickness of their 
employees 
(absenteeism due to 
mobility or 
subsequent death). 
Establish cost of 
disease per partner 
(on the basis of 
specific company 
data) using the 
disease Cost 
Calculator model 
HIPS conducted research based studies19 to establish the 
actual cost of ill-health to company productivity, It was 
shown that it is cheaper to provide higher health care than 
lose workers or work hours through prolonged 
absenteeism 
 A scientifically calculated cost of 
disease (which recommended 
more services for increased 
productivity) was instrumental in 
convincing the mangers of private 
companies to increase health 
financing 
Brokering linkages 
with key partners 
such as Global Fund, 
to facilitate low cost 
or no-cost 
commodities 
Private sector 
partners have firm 
linkages with Global 
partners to 
facilitate access to 
free or cheaper 
medicines and 
other medical 
commodities 
HIPS successfully advocated for the private sector to access 
ARVs from JMS: and other supplies free or at subsidized 
rates from other suppliers such as… 
 It is pertinent that prior to HIPS, 
private sector health units were 
not permitted to provide ART 
and TB services. With HIPS 
intervening private clinics and 
hospitals provide ART and TB 
services. 
 This is a great achievement as 
this as significantly improved 
access to quality services 
 Access to free ARVs and other 
subsidized key health supplies 
solved the problem of stock outs 
19A study (The Impact of ART on Employer Costs Related to AIDS) by Paul Bukuluki, 2009found that the average annual cost of ART to a partner company is 0.13% % of the total
annual cost of labour, compared to 0.14% (of the total annual cost of labour) attributable to worker attrition
82
at service points which was 
threatening the effectiveness of 
the project especially when NMS 
stopped supplies of ARVs to 
private sector health service 
providers 
Collaborate with 
Ministry Gender, 
Labor and Social 
Development to roll 
out and 
operationalize the 
new HIV/AIDS 
workplace policy 
Have in place 
functional 
partnerships with 
all national 
stakeholders 
HIPS in collaboration with the MGLSD finalized a concept 
on developing the workplace health policy and the national 
OVC policy 
 Development of HIV/AIDS and 
other workplace health policies 
has greatly addressed the issue of 
discrimination and stigmatization 
of HIV/AIDS. 
 Employees were found to be 
free, confident and outgoing in 
their workplace due to the policy 
of non-discrimination. 
 This had a double edged results￾it increased employee confidence 
but also improved work 
productivity. 
 Involvement of the government 
in project work such as 
development of the workplace 
health policy gives the policy 
legitimacy and increased clout 
Facilitate private 
sector support of 
the National Social 
Health Insurance 
Scheme(NSHS) 
A fully developed 
National Social 
Health Insurance 
Scheme(NSHS) 
 The Uganda Healthcare Federation (UHF) was 
formed with strong support of HIPS; as a negotiating 
forum and advocacy body for the private sector 
initiatives
83
ANNEX 9: MAPPING CHANGES ARISING FROM IMPLEMENTATION OF HIPS 
Status Prior to HIPS Project Moderating/intervening variables Observed Change
1. HIV/AIDS 
 No elaborate workplace HIV/AIDS 
policies 
 No Company had established 
collaboration with AIDS treatment 
centers close to them. 
 No partner clinics were accredited 
to offer ART and TB services 
 TB services did not have clear 
referral centers 
 Absence of use of standard 
guidelines from the Ministry of 
Health 
Development of the HIV/AIDS workplace 
policy; and establishment of functional 
collaborative partnerships 
 More than 80% of the sampled and visited GDAs have 
HIV/AIDS Workplace policy in place and disseminated to 
all staff 
 All sampled companies have established collaboration with 
AIDS treatment/referral centers close to the companies. 
 All sampled partner clinics have been accredited by the 
MoH for ART and TB management Partnerships 
established under HIPS have enabled the company clinics 
to refer complicated cases for vital tests (CD4 cell counts, 
viral load tests) and follow up to more competent 
facilities; including public health units. 
 A referral guide was developed and distributed to provide 
relevant information about the existing optional referral 
centers to the company health providers and company 
employees, thereby ensuring continuity of health care 
services to, the workers irrespective of whether they are 
at their work places or away. 
 Use of standard Ministry of Health guidelines and service 
delivery formats has resulted in better management of 
health information 
2. Healthcare for the workers not 
among the top priorities of the 
private sector whose primary 
concern was making profit 
Research and revelations by the Disease 
Calculator that better health services 
improve/protect company productivity 
 Private companies now value the health of employees and 
have willingly committed to increased financing of health 
care for the workers 
3. Private sector health facilities were 
barred from providing TB treatment 
Accreditation of private sector health 
providers (company clinics and private clinics) 
for ART and TB 
 Many private sector health providers now accredited; and 
do manage HIV/AIDS and TB 
4. Training in health care was largely 
clinical; and only organized and 
undertaken by specialized health 
institutions 
HIPS capacity building initiatives focusing on 
the private sector attracted interest of new 
players led by UMA and FUE; in training for 
health 
 There are many training opportunities for workers both 
clinical and non-clinical for health management 
 UMA and FUE have mobilized significant financial resources 
through training in health care services (focusing on 
HIV/AIDS, TB, RH/FP services)to sustain project activities 
 UMA and FUE have developed technical proposals which 
84
have been funded such funding includes funds secured from 
ILO to FUE 
5. Prior to HIPS, insurance companies 
were reluctant to accept HIV/AIDS 
on insurance premium 
A positive multi-sectoral policy spearheaded 
by GoU at the highest political level, with 
advocacy from HIPS 
 Currently, many insurance companies accept HIV/AIDS on 
insurance premium 
6. Private sector contribution to health 
care of employees was minimal; 
although many companies provided 
some of the health services as part 
of CSR 
Existence of CSR with the activity plans of 
private companies operational framework 
HIPS has leveraging the private sector towards 
health programs (to the tune of US$ 
$1M:$2M) 
 Most private companies increased their contributions 
towards the health care programs of the workers 
7. Prior to HIPS, the cost-benefit 
analysis of providing adequate health 
care for workers was not known. 
Development of the disease calculator and 
conducting research/studies showing the Unit 
cost of providing health services such as ART, 
TB or RH/FP 
 It has been established that the cost of providing adequate 
health care for the workers is lower than the cost of 
frequent worker attrition 
8. Poor health information 
management. Prior to HIPS, the 
information collected on health 
services was often incomplete; and 
would be submitted late despite the 
significant resource outlays spent on 
monitoring activities 
 HIPS initiatives such as reporting by mobile 
phone distributed to clinics 
 The data collected using mobile phones is timely, complete 
and cost effective 
9. Availability of ITNs and LLTNs to 
workers 
 Linkages to HIPS partners supplying 
ITNs/LLNs free or at subsidized rates 
 Insecticide treated mosquito nets are purchased and sold 
at a subsidized rates 
 Staff and dependents now have access to insecticide 
treated bed nets 
 Staff and dependents are well informed about treatment of 
malaria 
10. Availability of information and 
subsidized reproductive health 
products 
Partnerships established with institutions 
experienced in that field; including UHMG, 
Straight Talk Foundation and PACE with 
expertise in IEC message development 
Reproductive health products are more available at all levels 
either free or at very affordable cost 
11. Low sensitization of employers and 
communities toward OVC 
 Leveraging corporate resources (by HIPS) for 
implementing community programs including 
OVC. 
Enhancement of the private sector company CSR programs
to include OVC 
85
ANNEX 10: COMPANY AFFILIATION TO UMA/FUE 
No. Name of company Association Migrated To:
FUE UMA
HIPS Managed 1-2/3 Years; Migrated to FUE and UMA 
(These are partners that were initially managed by HIPS only and then migrated to FUE and UMA) 
1 Coca Cola ✔
2 Eskom Uganda ✔
3 Hima Cement ✔
4 James Finlay’s Uganda (Mc Leod Russell) ✔
5 Kakira ✔
6 KCCL ✔
7 Kinyara ✔
8 Luwero industries ✔
9 New Forest Company ✔
10 Nile Breweries ✔ ✔
11 Roofings Uganda Limited ✔
12 Royal Van zanten Flowers ✔
13 Rwenzori commodities ✔
14 Shell Uganda ✔
15 Southern Range Nyanza Limited ✔
16 Tullow oil ✔
17 UGACOF ✔
18 Uganda Clays ✔
19 Wagagai ✔
20 Toro And Mityana Tea Company (TAMTECO) ✔
21 Sugar Corporation of Uganda (SCOUL) ✔
86
No. Name of company Association Migrated To:
FUE UMA
22 Xclusive Cuttings ✔
23 Touch Namuwongo Project ✔
24 Ugarose ✔
13 12
Total 24 Companies 
HIPS Initiated; FUE and UMA Managed 
(These are partnerships that were brokered by HIPS but whose management was immediately transferred to FUE and UMA right from 
the onset.) 
1 Ankole Coffee Processors ✔
2 Centenary Rural Development Bank ✔
3 JP Cuttings ✔
4 Dominion Uganda ✔
5 IITA (Research to Nourish Africa)/FUE ✔
6 Reco Industries ✔
7 Kenya Commercial Bank (KCB) ✔
8 Mpanga Tea growers limited ✔
9 Uganda Crane Creameries Cooperative Union Ltd ✔
10 Uganda Baati ✔
11 Fiduga Flowers Limited ✔
12 Regional Lorry Drivers and Transporters Association ✔
13 BM Technical services Mbarara ✔
Total 13 companies 
FUE and UMA Initiated and Managed 
(These are partnerships that have been brokered by FUE and UMA directly.) 
1 Ericson AB Limited ✔
2 Fish Ways Uganda Limited ✔
3 Ken group ✔
87
No. Name of company Association Migrated To:
FUE UMA
4 Kengrow ✔
5 Kyagalanyi Coffee Limited ✔
6 Mabale Tea Growers Company ✔
7 Multitech Business School ✔
8 Quality Chemicals ✔
9 Sadolin ✔
10 SAIL Uganda ✔
11 TIC Plastics ✔
12 Toyota Uganda ✔
13 Uganda National Road Authority ✔
14 Unga Millers ✔
15 Watsila ✔
16 Wispro ✔
17 Swift ✔
18 Munyonyo Common Wealth Speke Hotel ✔
19 Orange Uganda Limited ✔
20 Comprehensive services ltd ✔
21 SDC Uganda Ltd ✔
22 Tropical Heat Uganda Ltd ✔
23 Uchumi Supermarket (u) Ltd ✔
24 Emirates Airlines ✔
25 Esco (U) Ltd ✔
26 First Insurance Company ✔
27 Child Fund International ✔
88
No. Name of company Association Migrated To:
FUE UMA
28 Steel and Tube ✔ ✔
27 10
Total 28 companies 
Source: HIPS Year 5, Quarter 4 and Annual Report FY 2012 
89
ANNEX 11: HIPS PARTNER CLINICS THAT RECEIVED MEDICAL A
DIAGNOSTIC EQUIPMENT 
No Name of Health Clinic Beneficiary Description
1. Ayiira Nursing Home Electrical Microscope
2. Boots Clinic Microscope Electric  
  
Laboratory Incubator
Laboratory Fridge
3. Buzirasagama Centrifuge(electric)
  
Heamcue with cuvettes
Incubator
Refrigerator
Microscope
4. Bweyogerere Medical Centre Refrigerator
  
Centrifuge
Microscope  
Electric sterliser
5. Case Medical Centre Microscope Electric  
6. Charis Health Refrigerator
  
Electric Sterliser
Centrifuge
Microscope
7. Crane Health Services Autoclave Electric
  
Laboratory Incubator
Electric Rotator
Microscope Electric
8. Double Cure Clinic Autoclave
  
Binocular Microscope
Electrical Centrifuge
Fridge
9. Emmanuel Medical Centre
Microscope
Laboratory Rotator
10. Engari Community Health Care   Binocular Microscope
  
Delivery Bed
Delivery Set‐ 2
Centrifuge Elelctrical
Examination Couch‐ 2
Fridge
11. Family Health Resource Centre Binocular microscope
  
Operation theatre table
Operation Light
Delivery bed
Electrical centrifuge
90
Colorimeter
12. Good Will Poly Clinc Microscope Electric  
  
Electric Centrifuge  
Electric Centrifuge  
Fridge
Auto Clave Bench Top
13. Hima Cement Microscope  
14. IAA/Dunavant CD4 Count Machine
  
Centrifuge (electric)
Microscop Electric  
Hemoglobinometer  +cuvvets  
Colorimeter
15. Kabalega Medical Centre
Microscope
Chemistry Analyser
16. Kadic Hospital   Microscope Electric  
17. Kakira Sugar   Auto Urinalysis Machine
  
Microscope
Refrigerator
18. Kamokya General Clinic Examination Bed
  
Sterilizer Charcoal  
Electrical Microscope
Centrifuge
19. Kitetika Marternity Centre‐Boots Electric centrifuge
  
Carolimeter
Binocular Microscope
20. Kikyusa Health Centre
Examination Couch‐ 2
Maternity Bed
21. Kinyara Sugar
CD4 Machine  
Microscope  
22. Kireka SDA
Microscope
Centrifuge
Fridge
Sterliser
Delivery Bed
23. Kitante Medical Centre Microscope
24. Kyadondo Medical Centre
Chemistry Analyser(50%)
Microscope  
Incubator
Water bath (Van Belgium)
Cyan Haematology Machine (50%)
25. Kyaliwajala   Microscpe Electric
91
Steam Sterliser
Centrifuge Electric  
Fatal Heart Detector
26. Kyotera Medical Centre
Laboratory Fridge
Electrical Microscope
27. Lambu Health Centre
Delivery couch
Refrigerator
Sterliser‐Electric
Vacuum Extractor
Electric Microscope
28. Luweero Industries Clinic Microscope Electric W Mirror
29. Mabale Tea Clinic
Delivery bed
Examination couch
30. Mehta Hospital   Operation theatre table
31. Mellisa Flowers Binocular Microscope
32. Mirembe Medical Centre
Microscope
Chemistry Analyser
Fridgerator
Centrifuge
33. Mpanga Tea Clinic
Microscope
Centrifuge Electric
34. Munobwa Clinic   Refrigerator
35. Nakigalala Tea Estate
Microscope
Refrigerator
36. New Forest Company Clinic
Microscope Electric w mirror
Examination Couch
37. NFC‐ Kirinya
Microscope Olympus
Fridge
38. Nile Breweries  
Microscope  
Fridge
39. Nytil Picfare
Electric Microscope
Refrigerator
Centrifuge
40. Old Kampala Hospital  
Air condition
Operation Light
Electric Microscope  
Chemistry Analyser
Water Bath
41. People's Clinic Kassanda
Electric Microscope
Delivery Bed Standard
Electrical Steriliser 40lts
92
Mobile Surgical Operating Lamp‐ 4
42. Philomena Clinic
Microscope
Electrical Calorimeter
Delivery Bed
43. Rakai Community Based Health Project  
Chemistry Analyser
Electric Centrifuge
44. Safe Guard Nursing Home
Electrical Microscope
Centrifuge Electric Bucket
Autoclave‐Charcoal
Centrifuge  
Sterliser Electric
Autoclave Electric
45. SCOUL Cetrifuge
46. Sims Medical Centre
Electric Microscope
Hematoclit Centrifuge
Haematology Analyser
Binocular Microscope
Operational Table Superior
Operation Light for Reflector
Autoclave Steriliser/Tuttnauer
Diathermy Unit Sutron 160W
Nonin Digital Pulse Oximeter Avant
Seca digital mother & child column
Centrifuge ‐CL008
Refrigerator  
Incubator CL011
Generator
UPS  
Air Conditioner
47. St. Charles Medical Centre
Colorimeter
Sahli's Haemometer
Binocular Microscope
Delivery Bed
Autoclave
48. St. Ambrose Delivery Bed Imorted
49. Tamteco
Fridge
Delivery Bed
Fridge Laboratory
Delivery Bed
Steriliser Electric with Timer
Centrifuge Electric
93
Microscope Electic w Mirror
50. Teso Community Health
Delivery Bed
Examination Bed
Examination Couch
51. Toro Kahuna  
Laboratory Fridge
Haemocue
52. Tororo Cement Serliser‐Non Electric
53. UGACOF
Sterlilizer Electric with Timer
Refregerator
Microscope Electric
54. Uganda Baati
Microscope Olympus
Water bath (Van Belgium)
55. Wagagai Clinic
Electric Microscope
Laboratory Fridge
Autoclave Bench top Microbiology
Vacuum Extractor
Oxygen Concetrator  
Cyanpus ChemistryAnalyser
Semi Automated Steriliser‐ 50%
Heamatology Analyser  
56. White Horse Nursing Home
Electric Centrifuge
Laboratory Fridge
Urine strip Analyser
Incubator
Electric Sterliser
57. Xclusive Cuttings LTD
Steriliser Electric with Timer
Microscope Electric (Humascope)
94
U.S. Agency for International Development 
U.S Mission Compound, South Wing 
Plot 1577 Ggaba Road 
P.O. Box 7856, 
Kampala, Uganda