Hssip 2010 15

GOVERNMENT OF UGANDA
Ministry of Health
Promoting People’s Health to Enhance Socio-economic Development
MONITORING & EVALUATION PLAN

FOR
HEALTH SECTOR STRATEGIC &
INVESTMENT PLAN 2010/11 – 2014/15
Ministry of Health
Plot 6 Lourdel Road, Wandegeya
P. O. Box 7272,
Kampala, Uganda
MAY 2011
i
Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part,
provided the source is acknowledged. It may not be sold or used in conjunction with commercial
purposes or for profit.
Government of Uganda, Ministry of Health: Monitoring & Evaluation Plan for the Health
Sector Strategic and Investment Plan, 2010/11 – 2014/15.
Published by: Ministry of Health

PO Box 7272
Kampala, Uganda
Email: info@health.go.ug
Website: www.health.go.ug
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Executive Summary
The Ministry of Health launched the Health Sector Strategic and Investment Plan 2010/11 –
2014/15 which defines the medium term health agenda and operationalize Uganda‟s aspirations as
outlined in the NDP and the Public Investment Plan (PIP) 2010/11 – 2012/13.
The development of M&E Plan for HSSIP 2010/11 – 2014/15 has been largely informed by lessons
from the Mid Term Review of the second Health Sector Strategic Plan (2005/06 – 2009/10) and was
in conjunction with the development of the HSSIP 2010/11 – 2014/15, which took into
consideration a wide range of policies, the new emerging diseases, the changing climatic conditions,
issues of international health and international treaties and conventions to which Uganda is a
signatory. The process of development of the HSSIP M&E plan was highly consultative,
participatory and transparent. The Supervision, Monitoring, Evaluation and Research Technical
Working Group (SME&R TWG) was responsible for overseeing the development of the HSSIP
M&E plan. Stakeholders from Local Governments, Development Partners (DPs), Civil Society,
private sector and academia were consulted during the development process.
The M&E Plan for HSSIP 2010/11 – 2014/15 aims at establishing a system that is robust,
comprehensive, fully integrated, harmonized and well coordinated to guide monitoring of the
implementation of the HSSIP and evaluate impact.
It is envisaged that this comprehensive M&E plan to which all health partners subscribe shall be the
basis for improving the quality of routine information systems and be used to institutionalize
mechanisms and tools for measuring quality of both facility and community based services. It should
also strengthen dissemination and use of information at both national and sub national levels.
I wish to express my appreciation to all of you who worked tirelessly to develop the M&E Plan for
HSSIP 2010/11 – 2014/15 on behalf of the people of Uganda. I look forward to the acceleration of
the implementation of the M&E Plan for the HSSIP towards attainment of our national and
international health goals.
For God and My Country
DR. CHRISTINE ONDOA

MINISTER OF HEALTH
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TABLE OF CONTENTS
Executive Summary ................................................................................................. ii
Table of Tables ...................................................................................................... vi
Table of Figures ................................................................................................... viii
Acronyms............................................................................................................... ix
Operational Definitions .......................................................................................... xi
1 Introduction ..................................................................................................... 1
1.1 Goal and Objectives of the HSSIP M&E Plan ................................................ 3
1.1.1 Goal ................................................................................................... 3
1.1.2 Specific Objectives.............................................................................. 3
1.1.3 Key Outputs ....................................................................................... 3
1.1.4 Outcomes ........................................................................................... 4
1.2 Process of Development of the HSSIP M&E Plan .......................................... 4
1.3 The HSSIP 2010/11 – 2014/15 Conceptual Framework .............................. 4
1.4 Implications for Sector Monitoring and Evaluation ..................................... 6
2 Monitoring & Evaluation Mechanism for HSSIP 2010/11 – 2014/15 .................. 7
2.1 The General M&E Framework ..................................................................... 7
2.2 The HSSIP Monitoring and Evaluation Tools ............................................... 8
2.2.1 Country Compact for Implementation of the HSSIP 2010/11 – 2014/15

9
2.2.2 Core Indicators for HSSIP 2010/11 – 2014/15 .................................... 9
2.2.3 Programme / Project Specific Indicators ............................................. 9
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2.2.4 HSSIP M&E Plan ................................................................................... 9
2.2.5 Programme and Project Specific M&E Plans ....................................... 10
2.3 Data Management ................................................................................... 14
2.3.1 Sources of Data for Health Sector Monitoring.................................... 14
2.3.2 Critical gaps and challenges in data management............................. 15
2.3.3 Data Collection Methods and Tools .................................................. 16
2.3.4 Data Analysis and Synthesis ............................................................. 18
2.3.5 Data Accuracy and Reliability ............................................................ 19
2.3.6 Data Dissemination .......................................................................... 20
2.3.7 Data Communication ........................................................................ 22
2.4 Responsibilities for Data Management by Level ....................................... 23
3 The HSSIP 2010/11 – 2014/15 Monitoring and Review Process ...................... 27
3.1 Country mechanism for review and action ............................................... 28
3.1.1 Performance Monitoring and Review at Central Level ........................ 30
3.1.2 Performance Monitoring and Review at Regional Level ...................... 31
3.1.3 Performance Monitoring and Review in Local Governments/District

Level 32
3.1.4 Performance Monitoring and Review at Health Sub-District Level ...... 34
3.1.5 Performance Monitoring and Review at Health Facility Level .............. 35
3.1.6 Performance Monitoring and Review at Community Level.................. 37
3.1.7 Performance Monitoring and Review at VHT Level ............................. 37
3.1.8 The National Health Accounts ........................................................... 38
3.1.9 Joint Review Mission ......................................................................... 38
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3.2 Performance Monitoring by the MoFPED and OPM .................................... 39
3.2.1 Performance Monitoring by the MoFPED and OPM at Central Level .... 39
3.2.2 Performance Monitoring by the MoFPED at LG Level .......................... 41
3.2.3 Monitoring Performance of the Supply Chain Management System ... 44
3.2.4 Monitoring by the Health Development Partners ............................... 46
3.3 Linkage between the health sector reviews, disease / programme / project
specific reviews and global reporting ................................................................. 46
3.4 Performance Monitoring and Review for Global Health Grants .................. 47
3.5 Performance Monitoring and Review for Civil Society Organisation and
Private Sector..................................................................................................... 48
3.6 Performance Monitoring and Review for Implementing Development

Partners Sector .................................................................................................. 49
3.7 Routine Feedback to Sub-national and Key Stakeholders ......................... 49
3.8 Reporting Progress against the NDP 2010/11 - 2014/15 ........................ 49
3.9 Reporting Requirements on International Commitments and Resolutions 49
3.10 HSSIP Evaluation .................................................................................. 52
3.10.1 Programme / Project Evaluation .................................................... 52
3.10.2 Mid Term Review........................................................................... 52
3.10.3 HSSIP End Term Evaluation ............................................................ 53
4 Surveys .......................................................................................................... 55
4.1 Surveys Commissioned by the MoH ......................................................... 55
4.1.1 Service Availability and Readiness Assessment ................................. 55
4.1.2 HIV/AIDS Epidemiological Surveillance .............................................. 56
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4.1.3 The Uganda HIV/AIDS Indicator Survey ............................................. 56
4.1.4 Availability of the six tracer medicines study .................................... 56
4.1.5 Uganda Malaria Indicator Survey ....................................................... 57
4.1.6 National Tuberculosis prevalence survey .......................................... 57
4.1.7 Client Satisfaction Surveys ................................................................ 57
4.1.8 Non-Communicable Diseases (NCD) Survey ...................................... 58
4.2 Health related surveys by other institutions ............................................. 58
4.2.1 Uganda Demographic and Health Survey .......................................... 58
4.2.2 The Uganda National Panel Survey .................................................... 59
4.2.3 The Uganda National Household Survey ............................................ 60
4.2.4 National Service Delivery Survey (NSDS) ............................................ 60
4.3 Health Research and Evidence Generation................................................ 61
4.4 Knowledge Management ......................................................................... 61
4.4.1 Use of Knowledge / Translation and Application ............................... 62
4.4.2 Decision Support Tools and Approaches ........................................... 64
5 HSSIP 2010/11 – 2014/15 M&E Plan Implementation Arrangements ............... 65
5.1 Strategies and Key Interventions .............................................................. 65
5.2 HSSIP M&E Plan Performance Indicators ................................................... 66
5.3 The Key HSSIP M&E Plan Implementation Tasks........................................ 66
5.4 Key Stakeholders ..................................................................................... 67
5.5 Roles and Responsibilities for the HSSIP M&E Plan Implementation .......... 67
5.6 Calendar for Monitoring HSSIP 2010/11 – 2014/15 M&E Plan

Implementation ................................................................................................. 74
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5.7 Monitoring the Implementation of the HSSIP M&E Plan ............................. 81
6 Budget ........................................................................................................... 82
7 Annexes ............................................................................................................ I
7.1 HSSIP 2010/11 – 2014/15 Indicators with targets ...................................... I
7.2 Key NDP Indicators ................................................................................. XVI
7.3 WHO Statistical Data .............................................................................. XVII
7.4 UNGASS National Indicators ................................................................... XXII
7.5 ECSA-HC Regional Core Set of Indicator ............................................... XXIII
7.6 Responsibilities, Frequency and Tools for Data Management ................ XXVI
7.7 HC IV Performance Assessment .............................................................. XLI
7.8 Hospital Performance Assessment ......................................................... XLII
7.9 District Ranking.................................................................................... XLIII
7.10 Proposed Time Table for the HSSIP 2010/11 - 2014/15 Midterm Review
XLV
7.11 Proposed Time Table for the HSSIP 2010/11 - 2014/15 End term
Evaluation ...................................................................................................... XLVII
8 REFERENCES ................................................................................................ XLIX
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Table of Tables
Table 1: HSSIP 2010/11 – 2014/15 Core Indicators by Domain ............................................................. 10
Table 2: HSSIP 2010/11 – 2014/15 Core Performance Indicators and corresponding reporting
commitments...................................................................................................................................................... 11
Table 3: Poverty Dimensions and Analysis ................................................................................................... 18
Table 4: HSSIP Monitoring and Review process ......................................................................................... 30
Table 5: Timeframe for the DHO HMIS reporting..................................................................................... 33
Table 6: Timeframe for HSD HMIS Reporting ........................................................................................... 34
Table 7: Timeframe for Health Facility Reporting ....................................................................................... 36
Table 8: Timeframes for Central Government Quarterly Performance Report Submission ................ 40
Table 9: Local Government OBT indicators ................................................................................................ 41
Table 10: Timeframes for Local Government Quarterly Performance Report Submission ................. 43
Table 11: Medicines Management Performance Summary Matrix ............................................................ 44
Table 12: M&E Calendar for HSSIP 2010/11 – 2014/15 .......................................................................... 74
Table 13: Estimated Cost of M&E and Knowledge Management ............................................................ 82
Table 14: HSSIP 2010/11 – 2014/15 M&E Plan Implementation Budget ............................................. 83
Table 15: Key Results Area Matrix ............................................................................................................. XVI
Table 16: Responsibility, Frequency and Tools for HSSIP Performance Data Collection and
Processing .................................................................................................................................................... XXVI
Table 17: Responsibility, Frequency and Tools for HSSIP Performance Data Analysis and Synthesis
........................................................................................................................................................................ XXX
Table 18: Responsibility, Frequency and Tools for HSSIP Performance Data Quality Assessment
.................................................................................................................................................................... XXXIV
Table 19: Responsibility, Frequency and Tools for Data Dissemination and Communication ... XXXV
Table 20: Responsibility, Frequency and Tools for HSSIP Performance Data Translation into Policy
and Decision-Making ...................................................................................................................................... XL
Table 21: Indicators showing functionality of HC IVs ............................................................................XLI
Table 22: Performance Assessement Outputs from General Hospitals .............................................. XLII
Table 23: Performance Assessement Outputs of Regional Referral and Large PNFP Hospitals ... XLII
Table 24: District Rankings for the Various Poverty Dimensions ..................................................... XLIII
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Table of Figures
Figure 1: HSSIP Conceptual Framework .................................................................................................. 5
Figure 2: Monitoring & Evaluation Framework ............................................................................................. 7
Figure 3: Country Health Systems Strengthening Platform .......................................................................... 8
Figure 4: Data Flow Diagram .......................................................................................................................... 22
Figure 5: Framework for reviewing health progress and performance ..................................................... 27
Figure 6: Country-led platform for monitoring & review of the national health strategy ..................... 47
Figure 7: The knowledge management process ............................................................................................ 61
Figure 8: Translating knowledge into policy and action .............................................................................. 63
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Acronyms
AHSPR Annual Health Sector Performance Report

BFP Budget Framework Paper
CAO Chief Administrative Officer
CCM Country Coordinating Mechanism
CHeSS Country Health Systems Surveillance
CPD Continuous Professional Development
CSO Civil Society Organisation
DHIS District Health Information System
DHMT District Health Management Team
DHO District Health Office
DHT District Health Team
ECSA-HC Eastern, Central and Southern Africa Health Community
GAVI Global Alliance for Vaccines and Immunisation
GIS Geographical Information System
GoU Government of Uganda
HC Health Center
HDP Health Development Partners
HMB Hospital Management Board
HMIS Health Management Information System
HRIS Human Resource Information System
HSD Health Sub-District
HSSP Health Sector Strategic Plan
HSSIP Health Sector Strategic and Investment Plan
HPA Hospital / HC IV Performance Assessment
HPAC Health Policy Advisory Committee
HUMC Health Unit Management Committee
ICT Information and Communication Technology
IFMS Integrated Financial Management System
IHP International Health Partnerships and related Initiatives
IDSR Integrated Disease Surveillance and Response
JAF Joint Assessment Framework
JBSF Joint Budget Support Framework
JRM Joint Review Mission
KM Knowledge Management
LAN Local Area Network
LC Local Council
LG Local Government
LTIA Long Term Institutional Arrangements
MDAs Ministries, Departments and Agencies
MDGs Millennium Development Goals
MPS Ministerial Policy Statement
M&E Monitoring and Evaluation
MoH Ministry of Health
MoFPED Ministry of Finance, Planning and Economic Development
MoLG Ministry of Local Government
MTR Mid Term Review
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NCD Non-Communicable Diseases
NDP National Development Plan
NHA National Health Accounts
NHP National Health Policy
NSDS National Service Delivery Survey
NMS National Medical Stores
NPA National Planning Authority
NRH National Referral Hospital
OBT Output Budgeting Tool
OPM Office of the Prime Minister
PEAP Poverty Eradication Action Plan
PHP Private Health Practitioners
PNFP Private-Not-For-Profit Organizations
QAD Quality Assurance Department
RC Resource Center
RRH Regional Referral Hospital
SCMS Supply Chain Management System
SMC Senior Management Committee
SWAp Sector Wide Approach
TPC Technical Planning Committee
TRM Technical Review Mission
TWG Technical Working Group
UDHS Uganda Demographic Health Survey
UNGASS United Nations General Assembly Special Session on HIV/AIDS
UNHRO Uganda National Health Research Organisation
UNPS Uganda National Panel Survey
VFM Value-For-Money
VHT Village Health Team
WHO World Health Organisation
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Operational Definitions
Civil Society Organization: any organisation except the government and the UN system.
Data Management: comprises all processes related to data collection, analysis, synthesis and
dissemination.
Data Quality Assurance: The process of profiling data to discover inconsistencies, and other
anomalies in the data cleansing activities (e.g. removing outliers, missing data interpolation) to
improve the data quality
Evaluation: The rigorous, science-based collection of information about program activities,

characteristics, outcomes and impact that determines the merit or worth of a specific program or
intervention.
Impact: Fundamental intended or unintended changes in the conditions of the target group,
population, system or organization.
Knowledge Management: Is a set of principles, tools and practices that enable people to create
knowledge, and to share, translate and apply what they know to create value and improve
effectiveness.
Monitoring: The routine tracking and reporting of priority information about a program and its
intended outputs and outcomes.
Monitoring & Evaluation Plan: Is an integral part of the component of the national health strategy
that addresses all the monitoring and evaluation activities of the strategy.
Monitoring & Evaluation Framework: Refers to the performance based framework for
monitoring and evaluation of health systems strengthening.
Outcome: Actual or intended changes in use, satisfaction levels or behaviour that a planned
intervention seeks to support.
Performance: The extent to which relevance, effectiveness, efficiency, economy, sustainability and
impact (expected and unexpected) are achieved by an initiative, programme or policy.
Performance measurement: The ongoing monitoring and evaluation of the results of an initiative,
programme or policy, and in particular, progress towards pre-established goals.
Performance management: Reflects the extent to which the implementing institution has control,
or manageable interest, over a particular initiative, programme or policy.
Review: Is an assessment of performance or progress of a policy, sector, institution, programme or

project, periodically or on an ad hoc basis. Reviews tend to emphasize operational aspects, and are
therefore closely linked to the monitoring function.
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1 Introduction
The Health Sector Strategic Investment Plan Monitoring and Evaluation (HSSIP M&E) plan
2010/2011 – 2014/15 has been developed to operationalise the strategic orientation provided for
comprehensive Monitoring and Evaluation (M&E) in HSSIP 2010/2011 – 2014/15. M&E aims at
informing policy makers about progress towards achieving targets as set in the HSSIP. In
combination with other initiatives, the M&E Plan will focus attention of stakeholders and direct
efforts towards the ultimate goal of the sector: to attain a good standard of health for all people in
Uganda in order to promote a healthy and productive life. In order to do so, the M&E plan needs to
provide strategic information to decision-makers, who will combine this information with other
strategic information to make evidence-based decisions. This is relevant to both national and sub-
national (district, sub-district and institutional/facility) levels.
At national level, strategic information will be used by the management and partnership/governance
structures described in the HSSIP 2010/11 – 2014/15 for improved management and service
delivery. In addition, selected information will be provided to the Office of the Prime Minister
(OPM), Ministry of Finance, Planning and Economic Development (MoFPED), National Planning
Authority (NPA) and others, as well as to Health Development Partners (HDPs) in line with
government procedures and partnership commitments. Providing this information is often key for
obtaining funds and other resources for the sector. The MoH also has reporting obligations towards
international institutions such as the World Health Organisation (WHO) and the Eastern, Central
and Southern Africa Health Community (ECSA-HC, among others).
This plan is based on principles intended to institutionalize the use of M&E as a tool for better
public sector management, transparency and accountability, so as to support the overall direction of
the HSSIP and achievement of the results. The underpinning principles include; i) simplicity; ii)
flexibility; iii) progressiveness; iv) harmonization; v) alignment; and vi) enhance ownership
The HSSIP M&E plan describes the processes, methods and tools that the sector will use to collect,
compile, report and use data, and provide feed-back as part of the national Health Sector M&E
System. It translates these processes into annualized and costed activities, and assigns responsibilities
for implementation. However, as the MoH assumes its stewardship role vis-a-vis the health-related
ministries with regard to other health determinants which are part of the responsibility of these
ministries, the HSSIP M&E Plan also describes how key-information will be obtained from these
ministries.
The HSSIP 2010/11 – 2014/15 M&E plan has been developed in a participatory manner and shall
guide all HSSIP 2010/11 – 2014/15 M&E activities. The M&E plan specifies the type of monitoring,
monitoring reports, timing of evaluations, roles and responsibilities for the overall process and how
they interact with the reporting each implementer is required to perform (clear roles and
responsibilities with respect to data gathering and reporting;). It focuses on the main M&E activities
and aligns them to the existing national and international structures and frameworks. It is intended to
document what needs to be monitored, with whom, by whom, when, how, and how the M&E data
will be used. It also outlines how and when the different types of studies and evaluations will be
conducted by the sector.
In addition to the above considerations the M&E plan has been developed to address some of the
M&E challenges identified during HSSP II. While systems for performance monitoring and
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evaluation were in place during HSSP I & II, there were enormous challenges. Most of the challenges
resulted from lack of an M&E plan for the previous strategic plans. The national M&E arrangements
were weak and comprised only a few functional systems at program/project level. They were
characterized by fragmentation; duplication; weak co-ordination; lack of a clear results chain; poor
definitions, tracking and reporting of outcomes and results; use of different formats and approaches
with no common guidelines and standards; lack of national ownership; inadequate feedback and poor
sharing of results across the sector and other stakeholders. Analysis of information was not carried
out in a comprehensive manner, and communication of information was not tailored to the
recipients of information – this was primarily left in reports, or scientific papers. In addition there
was poor use of the data generated; problems related to capacity and resourcing.
It is envisaged that this comprehensive M&E plan to which all health partners subscribe shall be the
basis for improving the quality of routine information systems and be used to institutionalize
mechanisms and tools for measuring quality of both facility and community based services. It should
also strengthen dissemination and use of information at both national and sub national levels.
In order to achieve the above a lot will have to be done to improve recording and reporting, and use
of data at all levels and all stakeholders, public, private and community to effectively monitor and
later evaluate the HSSIP 2010/11 – 2014/15 implementation, including the M&E plan itself.
In the absence of an M&E framework, plan and budget, several system have been operating parallel
to each other, creating not only an additional burden to health workers at service delivery and Local
Government (LG) level, but in some cases bias towards systems that provide incentives. Systems in
place include HMIS; Performance Measurement and Management Plan (PMMP) of the UAC; the
LOGICS tools of the Ministry of Local Government (MoLG); Output Budgeting Tool (OBT) of the
Ministry of Finance, Planning and Economic Development (MoFPED); Office of the Prime Minister
(OPM) Report; Joint Assessment Framework (JAF) report; Ministry of Public Service (MoPS)
performance report; and many localized programme and project systems.
The health sector carries out three types of monitoring which address different stages in the results
chain, namely;
(i) Financial implementation monitoring addresses whether or not budgets have been released
and spent in line with allocations;
(ii) Physical implementation monitoring addresses whether activities have taken place in line
with targets; and
(iii) Outputs, outcome and impact monitoring trace whether or not results are occurring amongst
the target population.
The purpose of the sector monitoring and evaluation system is to coordinate and support the MoH,
related Ministries, Development Partners, LGs and stakeholders to regularly and systematically track
progress of implementation of priority interventions of the HSSIP and assess performance of the
sector and LGs in accordance with the agreed objectives and performance indicators over the
Medium Term (output, outcome and impact monitoring).
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1.1 Goal and Objectives of the HSSIP M&E Plan
The HSSIP M&E plan goal is aligned with one of the main objectives of the HSSIP 2010/11 -
2014/2015 which is; Deepen stewardship of the health agenda, by the MoH. The stewardship
function of the MoH focuses around provision of appropriate guidance to implement health
programs, but also to other sector actors, to what are the priorities for implementation. In order to
do this there is need for an M&E system that provides timely and accurate information to
government and partners in order to inform performance reviews, policy discussions and periodic
revisions to the national strategic and operational plans.
1.1.1 Goal
The goal of the HSSIP 2010/11 – 2014/15 M&E plan is to establish a system that is robust,
comprehensive, fully integrated, harmonized and well coordinated to guide monitoring of the
implementation of the HSSIP and evaluate impact.
1.1.2 Specific Objectives

The specific objectives of the HSSIP 2010/11 – 2014/15 M&E plan are;
1. To provide a health sector-wide framework for tracking progress and demonstrating results
of the HSSIP 2010/11 – 2014/15 over the medium term.
2. To build capacity of the MoH, semi-autonomous institutions, LGs, PNFP/Private facilities
and CSOs to regularly and systematically track progress of implementation of the HSSIP.
3. To facilitate MoH and other stakeholders assess the health sector performance in accordance
with the agreed objectives and performance indicators to support management for results
(evidence based decision making),
4. To improve compliance with government policies (accountability), and constructive
engagement with stakeholders (policy dialogue).
5. To facilitate continuous learning (document and share the challenges and lessons learnt) by
MoH, semi-autonomous institutions, LGs and other stakeholders during implementation of
the HSSIP 2010/11 – 2014/15.
6. To promote the use of locally generated health information.
1.1.3 Key Outputs

The expected key outputs of the M&E framework are:
i) A functional sector-wide unified integrated, harmonized and well coordinated M&E system
with effective and timely feedback to stakeholders.
ii) Performance reports (baseline survey reports, periodic progress reports, annual performance
reports, financial audit reports etc.)
iii) Basic statistical data on health service delivery, resources, outputs and beneficiaries.
iv) Regular updates on core performance indicators.
v) National infrastructure for M&E.
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1.1.4 Outcomes
This M&E Plan should result in:
i) Timely reporting on progress of implementation of the HSSIP;
ii) Timely meeting of reporting obligations to government, DPs and International Partners;
iii) Objective decision making for performance improvement; planning and resource allocation
iv) Accountability to government, DPs and citizens;
v) Policy dialogue with stakeholders.
vi) Evidence-based policy development and advocacy.
vii) Institutional memory on HSSIP 2010/11 – 2014/15 implementation.
1.2 Process of Development of the HSSIP M&E Plan
The development of the HSSIP M&E plan was in conjunction with the development of the HSSIP
2010/11 – 2014/15, which took into consideration a wide range of policies, the new emerging
diseases, the changing climatic conditions and issues of international health. The process also took
into consideration the international treaties and conventions to which Uganda is a signatory more
especially (i) The Millennium Development Goals (MDGs), three of which are directly related to
health and most others address determinants of health; (ii) The International Covenant on
Economic, Social and Cultural Rights; (iii) the Convention on All forms of Discrimination Against
Women; (iv) the International Health Partnerships and related Initiatives (IHP+) which seek to
achieve better health results and provide a framework for increased aid effectiveness; among others.
The aim of reviewing policies and plans during the development of the HSSIP M&E plan 2010/11 –
2014/15 was to harmonize this plan with the other existing sector and inter sectoral M&E plans.
A review of a wide range of national and health sector documents was done to provide in-depth
analysis and understanding of the sector M&E system; such as HSSP II, NDP 2010/11 – 2014/15,
NHP II, HSSIP 2010/11 – 2014/15, programme specific M&E plans, the Health Management
Information System (HMIS) and the Guidelines for Budget Preparation and Reporting Using the
Output Budgeting Tool (OBT), November, 2010.
The Supervision, Monitoring, Evaluation and Research Technical Working Group (SME&R TWG)
comprising of MoH officials, Development Partners (DPs), Civil Society, private sector and
academia was responsible for overseeing the development of the HSSIP M&E plan. A Task Force
(TF) was formed which worked in consultation with all relevant stakeholders in the development
process. The involvement of the different stakeholders was important in order to ensure ownership
of the plan.
1.3 The HSSIP 2010/11 – 2014/15 Conceptual Framework
The overall goal for the Health Sector during HSSIP 2010/11 – 2014/15 is: ‘To attain a good
standard of health for all people in Uganda in order to promote a healthy and productive
life’.
The goal, when achieved, shall lead to acceleration in the improvements in the level, and distribution
of health in the country, as captured in the health impact indicators.
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To achieve this goal, the health sector shall focus on achieving universal coverage with quality health,
and health related services through addressing the following objectives.
1. Scale up critical interventions for health, and health related services, with emphasis on vulnerable
populations
2. Improve the levels, and equity in access and demand to defined services needed for health
3. Accelerate quality and safety improvements for health and health services through
implementation of identified interventions
4. Improve on the efficiency, and effectiveness of resource management for service delivery in the
sector
5. Deepen stewardship of the health agenda, by the MoH.
Investments in human resources, health infrastructure, commodities and management support

(including planning, supervision and M&E) in this period will primarily aim at achieving better results
in the following programme areas: Sexual and Reproductive Health, Child Health, Health Education
and Control and Prevention of Communicable Diseases (HIV/AIDS, Malaria and Tuberculosis). It
is hoped that these strategic objectives together will result in substantial progress in terms of
coverage and demand for services and, ultimately, in an accelerated improvement in the level and
equity of the health status of the people of Uganda.
Figure 1: HSSIP Conceptual Framework
Overall development theme (NDP)
Growth, Employment and Socio-Economic Transformation for Prosperity
Health Policy Goal (NHP II)
Promoting people’s health to enhance socio economic development
HSSIP Goal:
“To attain a good standard of health for all people in Uganda in order to promote a healthy and productive life”
Objective 1: Objective 2: Objective 3: Objective 4: Objective 5:
Scale up critical Improve access and Accelerate quality & Improve efficiency & Deepen health
interventions demand safety improvements effectiveness stewardship
INVESTMENT PRIORITIES
Area 1 Area 2 Area 3 Area 4
HUMAN RESOURCES INFRASTRUCTURE MEDICAL PRODUCTS OPERATIONS
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1.4 Implications for Sector Monitoring and Evaluation
For more sustained and accelerated improvement in the health impact, it is important for the sector
to strategically focus on a comprehensive knowledge management approach. This should guide a
comprehensive look at information needs, analysis and use to better guide decision making for
health. This requires definition of a comprehensive performance monitoring approach for the sector
M&E strategy, which uses input, output, outcome and impact indicators to generate information for
analysis and use.
The sector M&E component should have a supportive institutional environment, with defined roles
and responsibilities for the different stakeholders. There is need for sufficient funding and human
resources with adequate technical capacity to manage the various components of an effective M&E
system in support of progress and performance reviews.
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2 Monitoring & Evaluation Mechanism for HSSIP 2010/11 – 2014/15
This section is comprised of the HSSIP 2010/11 – 2014/15 M&E mechanism including: the general
monitoring framework, the county-led M&E platform, tools for M&E, data management,
responsibilities for data management.
2.1 The General M&E Framework
The HSSIP 2010/11 – 2014/15 M&E plan elaborates a Monitoring Framework for the Sector which
includes a range of indicators at various levels, sources of information, regularity of various reports,
and monitoring structures. The monitoring framework for tracking progress is informed by the need
to comprehensively monitor and review sector progress. The framework for the analysis is based on
the common steps of the M&E logical framework, which shows the way in which inputs may lead to
desirable health impact. The framework is an adaptation of the M&E framework for health systems
strengthening (HSS)1 which was developed by Global Partners and countries. The framework builds
upon principles derived from the Paris Declaration on aid harmonization and effectiveness and the
International Health Partnership (IHP+). It is intended to ensure that all indicator areas - from
inputs to impact - are considered in the analysis, and pathways of influence are clarified (Figure 2).
Figure 2: Monitoring & Evaluation Framework
Monitoring & Evaluation of health systems reform /strengthening
Inputs & processes Outputs Outcomes Impact
Infrastructure Intervention
/ ICT Coverage of Improved
access & interventions health outcomes
services
Governance
Indicator & equity

Financing
Health readiness
domains workforce
Prevalence risk Social and financial
Intervention behaviours & risk protection
Supply chain quality, safety factors
and efficiency Responsiveness
Information
Data Administrative sources Facility assessments Population-based surveys

Coverage, health status, equity, risk protection, responsiveness
sources Financial tracking system; NHA
Databases and records: HR,
infrastructure, medicines etc. Clinical reporting systems
Policy data Service readiness, quality, coverage, health status
Vital registration
Analysis & Data quality assessment; Estimates and projections; In-depth studies; Use of research results;
synthesis Assessment of progress and performance of health systems
Communication
& use Targeted and comprehensive reporting; Regular country review processes; Global reporting
For this, the MoH has identified core indicators to guide analysis of sector progress, at all the
indicator domains – input / process, output, outcome, and impact. Core indicators are defined, and
structured to inform on and compare trends across the different domains. This approach takes into
consideration that the respective indicators are not viewed in isolation, but rather are intricately
linked to provide information on overall progress.
1
WHO, GAVI, Global Fund and the World Bank, Monitoring and evaluation of health systems strengthening:
an operational framework, November 2009, Geneva.
7
The HSSIP is implemented through the Long Term Institutional Arrangements (LTIA), with
emphasis on one country-led M&E platform for the HSSI - also referred to as the Country Health
Systems Surveillance (CHeSS) platform. The country-led platform is expected to bring together the
M&E work in disease-specific programmes, such as TB, HIV/AIDS and immunization, with
crosscutting efforts such as tracking human resources, logistics and procurement, and health service
delivery (Figure 3). The country-led platform aims is to improve the availability, quality and use of
the data needed to inform health sector reviews and planning processes, and to monitor health
progress and system performance. It is the platform for subnational (regions, districts, projects,
CSOs), national and global reporting, aligning partners at country and global levels around a
common approach to country support and reporting requirements.
Figure 3: Country Health Systems Strengthening Platform
2.2 The HSSIP Monitoring and Evaluation Tools
M&E shall be carried out within the National M&E framework using tools that consider outputs and
indicators to be drawn from approved work plans and budgets for the HSSIP 2010/11 – 2014/15.
The tools used for monitoring the sector were agreed to consist of;
1. The Country Compact for Implementation of the HSSIP 2010/11 – 2014/15;
2. HSSIP 2010/11 – 2014/15 Core indicators (26) harmonized with MDGs, NDP & JAF (See
Table 1);
3. Program / Project indicators at various levels
4. A detailed HSSIP 2010/11 – 2014/15 M&E plan
5. Programme and Project Specific M&E plans
Specific indicators from programme M&E plans will be used to supplement the national level
indicators in monitoring specific programme performance.
8
2.2.1 Country Compact for Implementation of the HSSIP 2010/11 – 2014/15
The Country Compact for implementation of the HSSIP 2020/11 – 2014/15 is a memorandum of
understanding between the Government of Uganda and its partners in the health sector for the
purpose of maintaining policy dialogue, promoting joint planning, and effective implementation and
monitoring of the HSSIP 2010/11 - 2014/15. The partners include Health Development Partners,
PNFPs, the Private Health Practitioners (PHP) and CSOs and are collectively referred to as Health
Sector Partners.
The principles guiding this Compact are:

• Ownership and leadership by government
• Alignment of all partner programmes, activities and funding to one national plan (HSSIP) and
harmonized annual health plan
• Use of common management arrangements
• Value for money; and,
• One monitoring framework to promote accountability
The principles are consistent with national policies, with bilateral and multilateral agreements
between the Government of Uganda and its development partners and with international agreements
ratified by Uganda including the Paris Declaration on Aid Effectiveness, Accra Agenda for Action,
Harmonization for Health in Africa Action Framework and the Global International Health
Partnerships and related Initiatives (IHP+).
2.2.2 Core Indicators for HSSIP 2010/11 – 2014/15

Section 8 of HSSIP 2010/11 – 2014/15 has defined 26 core indicators (Table 1 below) and targets
over the five year period for informing progress in critical elements of the health sector framework.
The selected core indicators are based on the following critical variables:
• They reflect all domains presented in the M&E conceptual framework,
• Having broad information on important components of the indicator domain, and
• Alignment to existing sector monitoring commitments.
2.2.3 Programme / Project Specific Indicators

During development of the HSSIP 2010/11 – 2014/15, a total of 262 performance indicators with
targets (Annex 7.1) were developed covering all strategic interventions. The 26 HSSIP core indicators
were selected from the 262 performance indicators. Performance monitoring at programme level
shall be based on the programme specific indicators monitored within the sector M&E plan.
2.2.4 HSSIP M&E Plan

The HSSIP 2010/11 – 2014/15 M&E plan is another tool for monitoring the health sector. Section
3 of this document provides the details of the HSSIP 2010/11 – 2014/15 M&E plan. All
departments, institutions, LGs, health facilities and other stakeholders will develop individual M&E
plans and calendars aligned to the overall sector M&E plan.
9
2.2.5 Programme and Project Specific M&E Plans
Development of programme and project specific M&E plans is a requirement for most donor
supported programmes and projects. Under the country-led platform it is a requirement for these
programmes and projects to develop M&E plans aligned to the overall HSSIP M&E plan and utilize
the MoH data collection and aggregation system. The HSSIP M&E Plan provides the necessary
background for the development of programme specific M&E plans in the sector, e.g. disease
specific plans, hospitals, district or (semi) autonomous institutions plans; it is the overall framework
for M&E plans in the sector.
Table 1: HSSIP 2010/11 – 2014/15 Core Indicators by Domain
INPUT & PROCESS (4) OUTPUT (5) OUTCOME (12) IMPACT (5)
Health financing Service access and
Coverage of interventions Health status
Information, Governance readiness
General Government % of new TB smear + % pregnant women Maternal Mortality Ratio
allocated on health as % cases notified compared attending 4 ANC (per 100,000 live birth)
1 of total government 5 to expected (TB case 10 sessions 22
budget detection rate)
Per capita OPD % of deliveries in public
utilization rate (m/f) and PNFP (n° of Neonatal mortality rate
Workforce 6 11 23
deliveries/expected (per 1000)
deliveries)
Annual reduction in % of health facilities % children under one Infant Mortality Rate
absenteeism rate (m/f) without any stock outs year immunized with 3rd (per 1000)
2 7 12 24
of six tracer medicines dose pentavalent
vaccine
% of approved posts % HCs IV with a % one year old children
filled by trained health functioning theatre Under 5 mortality rate
3 8 13 immunized against 25
(per 1000)
workers (providing EMOC)
measles
% pregnant women who
Infrastructure Service quality and safety 14 Financial risk protection
have completed IPT2
% of villages/ wards % clients expressing % of children exposed
% of households
with a functional VHT, satisfaction with health to HIV from their
4 9 15 26 experiencing
by district services mothers accessing HIV
catastrophic payments
testing within 12 months
% UFs with fever
receiving malaria
16
treatment within 24
hours
% eligible persons
17 receiving ARV therapy
Risk factors and behaviours
% of households with a
18
pit latrine
% U5’s new visits with

19 height /age above lower
line (PR)
20 % children under 5 with
weight /age above
lower line (PR)
21 Contraceptive
Prevalence Rate
10
Table 2: HSSIP 2010/11 – 2014/15 Core Performance Indicators and corresponding reporting commitments
Indicator Indicator Related Source of Reporting Target

domain reports data Frequency
Baseline, (year) 2010/11 2011/12 2012/13 2013/14 2014/15
Health Impact Maternal Mortality Ratio (per 100,000 live birth) MDG, UDHS Every 5 435 (2006) 131
WHO, years
NDP, JAF,
ECSA
Neonatal Mortality rate (per 1000 live births) WHO, UDHS Every 5 70 (2006) 23
ECSA years
Infant Mortality Rate (per 1000 live births) MDG, UDHS Every 5 76 (2006) 41
WHO, years
NDP, JAF,
ECSA
Under 5 mortality rate (per 1000 live births) MDG, UDHS Every 5 137 (2006) 56
WHO, years
NDP,ECSA
% of households experiencing catastrophic health - UNH Every 2 28 (2009) 25 22 19 16 13

expenditures survey years
Coverage for % pregnant women attending 4 ANC sessions WHO, HMIS Monthly 47 (09/10) 50 53 55 57 60
Health ECSA
Services
% deliveries in health facilities WHO, HMIS Monthly 33 (09/10) 40 50 65 75 90
NDP, JAF,
MoFPED
% children under one year immunized with 3rd dose WHO, HMIS Monthly 76 (09/10) 80 82 83 84 85
Pentavalent vaccine (m/f) NDP, JAF,
MoFPED
11
Baseline, (year) 2010/11 2011/12 2012/13 2013/14 2014/15
% one year old children immunized against measles MDG, HMIS Monthly 72 (09/10) 75 80 85 90 95
(m/f) WHO,
ECSA
% pregnant women who have completed IPT2 - HMIS Monthly 47 (09/10) 50 55 60 65 70
% of children exposed to HIV from their mothers - HMIS Monthly 29 (08/09) 35 45 55 65 75

accessing HIV testing within 12 months (m/f)
% U5s with fever receiving malaria treatment within MDG HMIS Monthly 13.7 (09/10) 20 40 60 70 85
24 hours from VHT (m/f)
% eligible persons receiving ARV therapy (m/f) NASP, HMIS Monthly 53 (2009) 55 60 65 70 75
WHO,
UNGAS,
ECSA
Coverage's % of households with a pit latrine - HMIS, Annually 69.7 (09/10) 68.5 69.5 70.5 71.5 72
for other UDHS
health
determinants % U5 children with height /age below lower line MDG, UDHS Every 5 38 (2006) 36 34 32 30 28
(stunting) (m/f) WHO, years
ECSA
% U5 children with weight /age below lower line MDG, HMIS, Annually 16 (2006) 15 14 13 12 10
(wasting) (m/f) WHO, UDHS
ECSA
Coverage's Contraceptive Prevalence Rate MDG, UDHS / Annually 38 (09/10) 39 40 41 42 43

for risk factors WHO, JAF, UNPS
ECSA
12
Baseline, (year) 2010/11 2011/12 2012/13 2013/14 2014/15
Health % of new TB smear + cases notified compared to ECSA NTLP Annually 56 (09/10) 60 65 70 70 70
System expected ( TB case detection rate) (m/f) reports/
outputs HMIS
(availability,
access, Per capita OPD utilisation rate (m/f) NDP, OBT HMIS Monthly 0.9 (09/10) 1.0 1.0 1.0 1.0 1.0
quality, safety
% of health facilities without stock outs of any of the NDP, JAF, Annual Monthly 41 (09/10) 50 55 60 70 80
six tracer medicines in previous 3 months (1st line MoFPED, Drug
antimalarials, Depoprovera, Suphadoxine/pyrimethamine, ECSA availability
measles vaccine, ORS, Cotrimoxazole) survey
% of functional Health Centre IVs (providing EMOC) - HMIS Annually 23 (09/10) 28 33 38 43 50
% clients expressing satisfaction with health services ECSA MoH Biannual 46 (2008) 50 55 60 65 70
(waiting time) survey
Health % of approved posts filled by trained health workers NDP, JAF, HMIS Annually 56 (09/10) 60 65 70 72.5 75
Investments ECSA
and
governance % Annual reduction in absenteeism rate JAF UNPS Annually 46 (09/10) 20 20 20 20 20
% of villages/ wards with trained VHTs, by district - HMIS Annually 31 (09/10) 50 60 75 90 100
General Government allocation for health as % of WHO, MTEF Annually 9.6 (09/10) 8.8 8.6 9.8 10 10
total government budget ECSA
NB: Not all ‘cells’ will have annual data, as indicators obtained from studies and surveys (in particular, impact and risk coverage indicators) will not be collected annually.
13
2.3 Data Management
This section on data management will concentrate on the sources of data, critical gaps and challenges
in data management; data collection methods and tools; responsibility for data collection and
processing; data analysis and synthesis; data quality assessment; data dissemination; communication
and use.
2.3.1 Sources of Data for Health Sector Monitoring

The data needs of the HSSIP 2010/11 – 2014/15 are based on agreed performance indicators (core
and programme specific) to facilitate monitoring, evaluation, reporting and decision-making. The
main data sources will include;
Facility generated data will be collected by all public and private health service delivery
facilities and community. In addition different programs and projects managed at the
MoH/national level shall provide reports to the Resource Centre on program-specific activities.
Health projects managed by implementing partners (DPs and CSOs) at district or community
level shall provide reports through the district health system. This data will be collected routinely
using established data collection methods and tools and aggregated at health facility, HSD,
district and national level.
Administrative data sources will provide information on health inventories, supervision,

management meetings, logistics management, human resource, financial resource flows and
expenditures at national and sub-national levels.
Population based health surveys mainly carried out by Uganda Bureau of Statistics (UBOS)
and other institutions that generate data relative to populations (population studies) as a whole.
Research Institutions and academia that carry out health systems research, clinical trials and
longitudinal community studies will also provide data for interpretation and possible use by the
sector.
Civil registration and vital statistics system is essential for providing quality data on births,
death and causes of death. Efforts will be made to link this system to the Health Information
System. This system is under the Ministry of Justice and specifically managed by the Bureau of
Births and Deaths Registration, which is mandated to collect data on vital events at the
community level, including those related to health. Currently this system is not functioning
adequately and most population based data is obtained from the population based surveys
conducted by UBOS.
Population and Household Census is carried out every ten years and will be the primary
source of data on size of the population, its geographic distribution, and the social, demographic
and economic characteristics. Annual projections at national and sub-national level will be
provided by UBOS.
Overall, the sources of M&E information will be guided by different information needs, particularly
the Government, Parliament, Development Partners, private sector and the community.
The MoH will house the central database for reporting on progress of the HSSIP. The MoH
Resource Center will serve as a repository for all service delivery data and information at national
level. This implies that all health service delivery data and information should be routed through the
14
MoH Resource Center (RC) for validation, analysis & synthesis, and dissemination. Consensus will
be generated on the establishment and location of a back-up data storage facility for the central
repository of information.
2.3.2 Critical gaps and challenges in data management

The HMIS was noted both during the HSSP I & II (HSSP I & II MTR Reports) to have various
weaknesses. The low and declining trends for timelines of monthly reporting by districts (68% end of
HSSP II) was worrying. There were mismatches of data between the key points of data collection
through the various management levels (HSD, district), programs and the RC. Insufficient funds
featured as the major constraint to implementation. The markedly limited government budget funds
for HMIS lead to over reliance on donor project resources often associated with piece-meal
initiatives. Human resource for implementation remains inadequate at all levels of the structure. At
national level, the RC still has approved posts that are not filled since HSSP I; at district level, staff to
handle data remain inadequate. The continuous inadequacy (numbers) of HMIS tools has greatly
affected expectations of having HMIS as a major source of information for monitoring the sector
plans. The HMIS remains manual in most HSDs, which affects quality, timeliness and completeness
of reports. The low level of prioritization of the HMIS at all levels including the centre, and the
inadequate utilization of data is cause for concern.
In addition to the above challenges, there are weak linkages between the various data producers
leading to inadequate sharing of information. Analysis, synthesis, effective dissemination and use of
information to guide policy dialogue and implementation of health programmes remain a challenge.
Following a comprehensive analysis of the HSSP II, a number of recommendations were made for
improving data management;
Improve the level of prioritization of information management in the sector. Appropriate and
strategic advocacy should be carried out for various aspects of sector managers and decision-
makers.
Particular efforts to be made for appropriate funding (level, mechanisms) for information
management.
The human resources issues should be addressed at the various levels: through recruitment for
the vacant posts at the MoH, and advocacy for recruitment for available posts at the local
government (Biostatisticians) and health facility levels (Health Information Assistants).
There should be regular training and updating of skills for health workers.
Availability of HMIS tools must be improved.
Efforts must be made to establish mechanisms of data sharing by all producers.
Use of data should be enhanced through provision of timely analysis and effective dissemination.
There is urgent need to improve the timeliness, completeness and quality of facility generated
data with the help of information technology and supported by an up-to-date national health
facility database that covers all public and private health facilities with data on infrastructure,
equipment and commodities, service delivery, and health workforce.
15
2.3.3 Data Collection Methods and Tools
The methods of data collection will be a combination of quantitative and qualitative methods. As far
as possible, standardized data collection tools and techniques will be used. Most data in respect of
some indicators will be collected annually, and any survey-based indicators will be collected at
baseline, mid-term where possible and in the last year of HSSIP implementation.
The specific tools and techniques will among others, include; the HMIS; Human Resource
Information System (HRIS); Logistics Management Information System (LMIS); and Output
Budgeting Tool (OBT) under the Integrated Financial Management System (IFMS). Specific
questionnaires will be designed for surveys (baseline, mid and end term), and socio-economic studies
(UDHS, UNPS, NHS, NSDS). Standardized checklist will be used to collect data during ongoing
monitoring field visits. Formats shall be applied for case studies, stakeholder meetings, performance
review forums and management meetings. Geographical Information System (GIS) shall be used to
enhance documentation and accountability where applicable.
The main tools and techniques for collection of HSSIP M&E information are explained below.
i) Health Management Information System: data collected during health service delivery
is critical for tracking performance and trend analysis. It cannot be substituted by any other
form of data. It will therefore form an important source of data for measuring progress of
the HSSIP implementation. The HMIS 2010 has the following categories of information:
data on individual clients, information on curative services, information on preventive
services, resource management e.g. inventories (staff list, health facility, equipment),
logistics and commodities, finance / user fees and Village Health Teams (Integrated
Community Case Management).
ii) Human Resource Information System: Is a system for collecting, processing, managing
and disseminating data and information on human resource for health (HRH). In Uganda,
an open-source HRIS is implemented whereby there is linkage with a variety of
independent sources of health workforce data, including data from censuses and other
national surveys, MoH administrative records, district level sources, independent research
studies, and Health Professional Councils‟ data. The HRIS implemented in Uganda's four
Health Professional Councils and at the MoH are valuable sources of information about
health workers deployed throughout the country. The system captures health personnel's
data by organization unit, cadre, etc., and generate various general and aggregated web-
enabled reports in different formats including graphical reporting. The HRIS generates
reports (twice a year in October and April) that display or aggregate the HRH data in
various ways to aid analysis or to answer key HR policy and management questions. It
enables health planners to quickly and easily obtain up-to-date information specific to the
current Ugandan health workforce. The HRIS is the main source of data on staffing levels
in public and PNFP facilities. Data and reports from these systems can be very useful for
health planning at different levels.
iii) Supply Chain Management System (SCMS): A SCMS will be established to strengthen
the information systems for medicines and health supplies. This system should allow
facilities to conduct web based ordering as well as the agencies should find it easy to
disseminate information about ordering, prices and available quantities through the web to
the facilities.
iv) Integrated Financial Management System (IFMS): GoU introduced IFMS, a
computerised financial management system to promote efficiency, secure management of
financial data and comprehensive financial reporting. IFMS is currently operational in
central MoH, Referral Hospitals and some LGs. An IFMS is a fiscal and financial
16
management information system for government that bundles all financial management
functions into one suite of applications, it assists the government and MoH to initiate,
spend and monitor the budget, initiate and process payments and manage and report on
financial activities. It is a core component of financial management systems reforms which
promotes efficiency, security of financial data, management and comprehensive financial
reporting.
v) Surveys questionnaire will be designed and employed from time to time to collect data
from beneficiaries/stakeholders in a structured manner.
vi) Report formats will be used for presentation of periodic reports for the various
stakeholders‟ fora, sector performance reviews, performance reports, monitoring,
supervision, research and evaluations.
vii) Case studies will be used to document life states or segments of events experienced by
particularly target beneficiaries or particular location. These case studies will animate
information generated by the M&E system to allow for in-depth understanding of the
context and human factors behind otherwise over summarized or generalized data
collected through other methods
viii) Field visits using checklists will be used from time to time to obtain information that may
be required to improve performance or even for obtaining insights for example the Pre-
Joint Review Mission Visit and more in-depth investigations. It will also be an aid in the
interpretation of results.
ix) Standardized meeting formats will be used to guide stakeholder meetings and
management meetings. The purpose of these meetings will be to coordinate efforts with
other stakeholders, generate consensus with other stakeholders, and review work plans and
progress in order to ensure ownership, accountability and transparency. Minutes of such
meetings shall be kept for future reference.
x) Geographical Information System: With advancement of technology, GIS enabled
photographic and video recordings may be used to track changes of implementation of
particular programmes of the HSSIP by geographical location. GIS provides a means of
analyzing coverage of general or specific health services in relation to need (e.g. disease
prevalence rates) and how these services are related to communities (e.g. income level), one
another and the larger health infrastructure. M&E data on key health targets at different
levels of health service delivery (e.g. district, health sub district) will be used to generate
maps and other graphics (like bar and line graphs) that show which areas are meeting the
targets or are lagging behind. Overlays of different indicators and further spatial analysis
can also identify the hotspots which would be the basis for prioritization of resource
allocation. Maps showing health indicators at district, HSD, sub-county and even health
facility level can help health planners and managers to identify disadvantaged areas;
examine equity issues; and improve decision making on where to invest.
Data collection and processing is carried out at all levels for different purposes however the
following activities are necessary for all:
i) Performance data collection (i.e. data on inputs-activities-outputs).
ii) Processing (aggregation) of the performance data from various service delivery points
iii) Ensuring quality of reports
Responsibility, frequency and tools for the HSSIP data collection and processing are outlined in
Table 14. (Annex 7.6).
17
2.3.4 Data Analysis and Synthesis
Data analysis and synthesis will be done at various levels of HSSIP M&E (National, sub-national to
health facility) to enhance evidence based decision making. The results obtained will be summarized
into a consistent assessment of the health situation and trends, using core indicators and targets to
assess progress and performance. The focus of analysis will be on comparing planned results with
actual ones, understand the reasons for divergences and compare the performance at different levels
(Quarterly and Annual Progress Reports, OBT, District League Table, mid and end term evaluations,
thematic studies and surveys). In addition health systems research as well as qualitative data gathered
through systematic processes of analyzing health systems characteristics and changes will be carried
out.
Basic indicator information shall be the national average achievement. This is obtained from collating
all the available information from all reporting units into the national average figure. This will be
complemented by more analysis when information2 on gender index by district becomes available.
This is to provide information on the impact of multi-dimensional poverty on actual coverage, and
health status achievements. This shall enable better targeting of strategies to address the multi
dimensional poverty issues impacting on the results being sought. The different aspects of analysis to
be carried out are shown in the table 3 below.
Table 3: Poverty Dimensions and Analysis
Poverty dimension Data disaggregation to be made

Income poverty Disaggregation of achievements by poverty index
Illiteracy Disaggregation of achievements by literacy levels
Gender Disaggregation of achievements by gender index
Poverty of security Regional analysis of data, to compare secure, with less secure regions
Information on indicators will therefore be analyzed in the following lines

- Overall national achievement
- Disaggregation of achievement, by;
o Region and district
o Level of poverty
o Literacy level
o Gender
o Level of security
This shall primarily apply to coverage information for health services, risk factors, and other health
determinants as such, the respective index shall also be disaggregated. The required levels of
disaggregation may not be possible on an annual basis. As a proxy, therefore, the sector will use
2
Information on gender index by district is not yet available. District ranking therefore shall be done when this becomes
available, through UNDP support.
18
district rankings for the different poverty dimensions to separate districts with high, and low
attainment of the respective index. The indicator achievements for the top 10 districts (lowest
poverty index) will be compared with the achievements of the bottom 10 districts (with the highest
poverty index) to illustrate any differences. The districts in the top 10, and bottom 10 will be
determined at the beginning of the HSSIP.
Information on these indices therefore, will be provided annually to compile the district ranking for
various poverty indices, which will be part of the Annual Health Sector Performance Report.
Data analysis reports will be validated by key stakeholders to:-
i) Obtain stakeholder insight on the information generated;
ii) Mitigate bias through discussion of the information generated with key M&E strategy actors
and beneficiaries;
iii) Generate consensus on the data findings and gaps; and
iv) Strengthen ownership and commitment to M&E activities.
Particular attention will be paid to strengthen capacity for data analysis and synthesis within LGs,
MoH Departments, semi-autonomous Institutions, PNFP & PFP facilities and CSOs. Responsibility,
frequency and tools for the HSSIP performance data analysis and synthesis are detailed in Table 15.
(Annex 7.6)
2.3.5 Data Accuracy and Reliability
All reports submitted to the Resource Centre and QAD will be reviewed for accuracy and
clarification sought where necessary. Even where there is no need for clarification acknowledgement
of receipt of reports will be provided before the due date for the subsequent report. Data quality
assurance processes will include periodic Data Quality Audits (DQA) of recorded data by
supervisors; regular training of staff, and provision of routine feedback to staff at all levels on
completeness, reliability and validity of data; and data quality assessment and adjustment which will
be carried out periodically. The objective of data validation is to ensure that the data used by the
health sector to make decisions is sound and accurate. Specific efforts will be made to undertake data
validity including: application of the computed validation/data accuracy index into district annual
reports; specific support for outliers; routine (quarterly) data checks on a sample of districts.
Regular data quality assurance for facility based data including regular review and verification for
accuracy and completeness will be carried out monthly by the health facility in-charges at all levels.
All periodic reports should be checked and endorsed before submission to the relevant stakeholders.
Periodic data validation, training and provision of feedback on validity of health facility data will be
carried out by the MoH, RC. DQA will be carried out at points of data collection, collation and
analysis by the technical staff of the RC for districts and by the District Biostastician within districts.
Standardized DQA tools will be developed for application at all levels. The Assistant Commissioner
in charge of the RC will be responsible for the overall implementation of the activities on behalf of
the sector. The RC will carry out regular training of staff, and provision of routine feedback on
completeness, reliability and validity of data.
DQA for sector evaluation studies shall be carried out using agreed formats by the MoH M&E unit
which is the coordinating entity for the sector evaluation studies. Institutional Review Boards will
have the responsibility of data validation for health systems research carried out in the respective
institutions as guided by the regulations.
19
In addition to the above data checks and validation, the M&E unit under the QAD shall carry out
annual Rapid Data Quality Assessment (RDQA) in which a selected number of health facilities will
be drawn from the master facility for this assessment. RDQA shall be done together with the facility
assessment, conducted 3 months before the JRM. The RDQA will be carried out as a quality
assessment of the entire process of data collection, analysis and synthesis.
A comprehensive Data Quality Assessment and Adjustment (DQAA) exercise will be carried out at
midterm review and end term evaluation. The purpose of carrying out a DQAA is to identify and
account for biases due to incomplete reporting, inaccuracies, non-representativeness. It will greatly
enhance credibility of the results. DQAA will focus on:
Assessment of the completeness of reporting by facilities and districts;

Assessment of the accuracy of district population denominators (obtained from UBOS);
Accuracy of coverage estimates from reported data;
Systematic analysis of facility based and household survey based indicator values.
This process could lead to adjustments of the indicator values, using transparent and well-
documented methods. To ensure transparency and overcome bias the MoH, shall engage
independent institutions like Universities in the DQAA process.
UBOS will be responsible for validating and designating as official health statistical reports generated
by the MoH.
Responsibility, frequency and tools for performance data quality assessment are outlined in Table 16.
(Annex 7.6).
2.3.6 Data Dissemination

Data need to be translated into information that is relevant for decision-making. Data will be
packaged and disseminated in formats that are determined by management at the various levels.
Service delivery data shall be packaged and displayed at the various health facilities using the HMIS
formats already provided. The timing of information dissemination should fit in the planning cycles
and needs of the users.
Annual Health Statistical Report

This report will be compiled from the periodic statistical reports submitted through the District
Health Information System (HMIS). The annual health statistical report provides ample attention to
data quality issues, including timeliness, completeness and accuracy of reporting, as well as
adjustments and their rationale. The RC will be responsible for compiling and disseminating this
report. Detailed data should also be available on the web.
Quarterly Performance Review Reports

Quarterly sector performance review reports will be presented by the various sector technical
working groups and central level institutions during the sector quarterly review meetings. Quarterly
district performance (Quarterly District League Table) will also be disseminated and discussed at this
forum. At sub-national level (RRHs, LG, projects), quarterly assessment reports will be presented
and discussed at the quarterly review meetings attended by the key implementers.
20
Annual Health Sector Performance Report (AHSPR)
The AHSPR is useful in highlighting areas of progress and challenges in the health sector. The
reports will assess progress on the annual work plans and an overall assessment of sector
performance against the targets set in the HSSIP 2010/11 – 2014/15. It will also review progress
against the sector priorities set during the preceding National Health Assembly and Joint Review
Mission (JRM) with stakeholders. The different levels of health care delivery are expected to compile
their reports by the end of July every year, and use them for performance review. The annual
district performance reports are then forwarded to the national level for compilation of the AHSPR
by the end of August every year.
The AHSPR brings together all data from different sources, including the facility reporting system,
household surveys, administrative data (minutes, supervision reports, financial reports, SCM reports,
HRIS reports, etc) and research studies, to answer the key questions on progress and performance
using the HSSIP core indicators and health goals. The AHSPR will present a detailed account of
annual performance against the core and programmatic indicators of the sector strategic plan,
comparing current results with results of previous years, and formulate challenges and
recommendations by cluster and programme. The AHSPR will provide the background and in-
depth information for annual reviews and disease specific reports. It will be presented by MoH to
health stakeholders and discussed at the JRM held October every year.
The AHSPR will include an assessment of performance at and within the different levels using league
tables. Similar to the analysis of progress in programmes, the report shall presents an analysis of the
sector‟s support systems (health financing, human resources, health infrastructure, essential
medicines and health supplies, diagnostic and blood transfusion services, information management &
research) against set targets.
The current format of the AHSPR shall be reviewed in order to present the sector performance
issues in a format that can easily facilitate the knowledge management process. The AHSPR should
also be able to reflect attribution of outputs and inputs to the public and private sectors. The aide
memoire will summarize the findings and agreed actions of the JRM based on the review of the Pre-
JRM filed visits and review of the AHSPR and will provide input in subsequent planning.
The compilation of the AHSPR shall be coordinated by the Director Planning and Development in
the MoH. The budget of collating annual sector performance data and report writing will be
provided for under the sector monitoring budget.
Annual sub-national performance reports shall be presented and discussed at the relevant annual
stakeholders‟ forum.
Dissemination of Survey Findings

Feedback on survey findings will be in form of workshops and dissemination of reports which will
be circulated to relevant stakeholders in hard copy as well as on the MoH website, www.health.go.ug.
21
2.3.7 Data Communication
Data communication shall follow the existing MoH coordination structures. In order to ensure
routine feedback on performance to sub-national and private providers, it is crucial that all service
delivery and administrative structures adhere to the following data flow mechanism.
Figure 4: Data Flow Diagram
SMC→HPAC→TMC→JRM→
MoFPED/OPM
DSS & QAD

Other
studies
MOH/Resource Centre/Programmes
UBOS and other

CHD of Regional Referral Partners
District Health Service Areas
Health Sub-District
Health Facilities
Communities/VHTs
 H/H Surveys
 MIS
 DHS
Household
The MoH will use various communication channels in order to ensure public access to data and
reports. Quantitative and qualitative data will be made publicly accessible through the MoH database
under the RC. The Local Area Network (LAN) installed at the MoH will facilitate inter-departmental
communication. Email accounts were created for all districts and hospitals and should be used for
communication with the center, other districts and Continuous Professional Development (CPD)
activities. The public will also be able to access health information on the MoH website,
www.health.go.ug.
22
In addition to the Information and Communication Technology (ICT) facilities at the MoH,
institutions and districts, the M&E committee shall collaborate with the Health Education and
Promotion Unit in the MoH to translate data and information according to the target audience and
utilize various communication channels e.g. radio, T.V, video conferencing, tele-conferencing,
newsletters, booklets, etc. Responsibility, frequency and tools for performance data dissemination
and communication are outlined in Table 17. (Annex 7.6).
2.4 Responsibilities for Data Management by Level
1. Administrative Data Management
At National Level
The Secretary to a TWG, Supervisor or Programme M&E Officer is responsible for:
• Ensuring compilation and processing of administrative data into departmental / Institutional
records(minutes, inventory) and reports (supervision, activity);
• Analyzing the quality of all reports received and ensuring follow-up in case of incompleteness,
problems with validity, as well as delays;
• Compiling all reports from the Technical Officers into a single departmental / institutional
report;
• Preparing an analysis of the data for discussion during the TWG / departmental / institutional /
programme/ project implementation committee meetings and sector performance review
meetings for decision-making;
• Forwarding the TWG / Departmental / Institutional / programme/ project report to the QAD.
• Providing quarterly feed-back to the TWGs / Departments / Institutions / programmes /
projects.
• Disseminating quarterly TWG reports to Senior Management Committee and HPAC
At District Level
The DHO is responsible for:
• Ensuring compilation and processing of administrative data (minutes, inventory, supervision and
other activity reports).
problems with validity, as well as delays.
• Compiling all reports from the DHT members into a single District Health Office report.
• preparing an analysis of the data for discussion during the DHT / DHMT meetings and district
forum for decision-making.
• Forwarding the District Health Office administrative report to the CAO and QAD.
• Providing quarterly feed-back to the DHT members.
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• Disseminating quarterly administrative reports to DHMT, TPC and Health Committee.
• Dissemination annual administrative report to DHMT, TPC, Health Committee, District forum.
At Health Facility Level

The Facility In-Charge is responsible for:
• Ensuring compilation and processing of administrative data (minutes, inventory, supervision and
other activity reports).
• Compiling all reports from the Technical Officers into a single health facility report.
• Preparing an analysis of the data for discussion during the staff, HUMC / Board meetings for
decision-making.
• Forwarding the health facility administrative report to the DHO.
• Providing quarterly feed-back to the health providers.
• Disseminating quarterly administrative reports to the HUMC or Hospital Board.
• Disseminating annual administrative report to the HUMC or Hospital Board and Sub County
forum.
Service Delivery Data Management

At National Level
The Biostatistician at the Resource Center is responsible for:
• Receiving all district data (including those from the national referral hospitals.
• Ensuring entry of all district data (including those from the national referral hospitals) onto the
District Health Information System (DHIS) software package.
• Compiling all reports from the districts & NRHs into a single national report using the DHIS
software.
• Preparing an analysis of the data for discussion during the SMER TWG meetings and sector
performance review meetings for decision-making.
• Providing quarterly feed-back to the districts / NRHs.
• Disseminating weekly IDSR reports to all stakeholders and community.
• Disseminating quarterly district performance reports at sector review meetings.
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At District Level
The District Biostatistician, or, where this position in not filled, the HMIS focal person, is
responsible for:
• Receiving all health unit data (including those from the general and referral hospitals).
• Entering all health unit data (including those from the general and referral hospitals) onto the
District Health Information System (DHIS) 2 software package.
• Analyzing the quality of all HMIS reports received and ensuring follow-up in case of
incompleteness, problems with validity, as well as delays.
• Compiling all reports from the units into a single district report using the DHIS 2 software.
• Preparing an analysis of the data for discussion by the DHT for decision-making and
participating in the DHT discussion.
• Forwarding the DHIS 2 report electronically to the RC. If not possible, deliver the physical
report by the 28th day of the following month.
• Providing quarterly feed-back on data management to the health units.
• Disseminating quarterly district assessment reports to DHMT.
• Disseminating annual district performance report to District stakeholders‟ forum.
The District Planner is responsible:

• Coordinating the collection, processing, analysis, storage and dissemination of health
data/information to stakeholders under LOGICS.
• Monitoring and evaluation of the performance of the health sector development plans,
programmes and projects.
At Health Sub District Level

The HSD Health Information Assistant is responsible for:
• Receiving all health unit data (including those from the private providers) in the HSD.
• Entering all health unit data (including those from the private providers) into the HSD databank.
• Analyzing the quality of all HMIS reports received and ensuring follow-up in case of
incompleteness, problems with validity, as well as delays.
• Compiling all reports from the units into a single HSD report.
• Preparing an analysis of the data for discussion by the HSD Team for decision-making and
participating in the discussion;
• Forwarding the HSD report to the DHO by the 7th day of the following month;
• Providing quarterly feed-back on data management to the health units.
• Disseminating quarterly HSD assessment reports to HSD Team.
• Disseminating annual district performance report to HSD stakeholders‟ forum.
25
At Health Facility Level
All Health Providers including those from the private and community (VHT) are responsible for:
• Collecting patient data using relevant patient forms.
• Compiling relevant patient data from patient forms and entering it into the patient registers on a
daily basis.
The Health Information Assistant (HIA) or Medical Records Officer, or, where there is no HIA or
MRO, the Health Unit In Charge or a designated person is responsible for:
• Regularly compiling relevant patient data from patient registers including those from the private
providers and community (VHT) into the health facility HMIS database.
• Analyzing the quality of all patient registers and community reports received and ensuring
follow-up in case of incompleteness, problems with validity, as well as delays.
• Compiling all reports from the sections/units / departments into a single health facility report
using the health facility HMIS database.
• Plotting monthly performance on the displayed monitoring graphs.
• Preparing an analysis of the data for discussion within the health facility for decision-making
methods and participating in the discussions.
• Forwarding or delivering the health facility report to the HSD/DHO by the 7th day of the
following month; In case of IDSR data weekly reports should be forwarded every Monday.
• Providing quarterly feed-back on data management to the sections / units/ departments and
community (VHTs).
• Disseminating of monthly performance during monthly facility meetings.
• Dissemination of quarterly facility assessment reports to the HUMC / Hospital Board.
• Dissemination of annual facility performance reports to the Sub County forum.
At Community Level
All Community Health Providers including those from the private and community (VHT) are
responsible for:
• Collecting patient/client, or activity data using relevant forms.
• Compiling data from the relevant forms and entering it into the Community Health / VHT
Register on a regular basis.
• Compiling relevant data from the community health register into the VHT Report.
• Preparing an analysis of the data for discussion within the VHT for decision-making methods
and participating in the discussions.
• Forwarding or delivering the VHT report to the nearest health center by the 5th day of the
following month;
• Disseminating quarterly performance report data to Parish Committee.
26
3 The HSSIP 2010/11 – 2014/15 Monitoring and Review Process
The framework for reviewing health progress and performance covers the M&E process from
routine performance monitoring, quarterly reviews, annual review and evaluation of all the HSSIP
indicator domains (Figure 5). Specific questions will have to be answered during the different review
processes, especially the annual reviews, but also the performance monitoring.
Figure 5: Framework for reviewing health progress and performance
Health progress and performance assessment will bring together the different dimensions of
quantitative and qualitative analyses and will include analyses on: (i) progress towards the HSSIP
goals; (ii) equity (iii) efficiency; (iv) qualitative analyses of contextual changes; and (v) benchmarking.
Progress towards HSSIP goals: The monitoring and review process will measure the extent to
which the objectives and goals of the HSSIP (core indicators and their targets) have been attained.
This will be complemented by a stepwise analysis to assess which policies and programmes were
successful; from inputs such as finances and policies to service access and quality, utilization,
coverage of interventions, and health outcomes, financial risk protection and responsiveness.
Equity: The progress in terms of distribution of health system interventions will involve analyses of
differences within and between population groups, among districts, etc. using a series of stratifiers
and summary measures.
Efficiency: This relates the level of attainment of goals to the inputs used to achieve them.
Efficiency measures the extent to which the resources used by the health system achieve the goal that
27
people value. Efficiency analyses will be part of the end term evaluation of the HSSIP and health
systems strengthening projects.
Qualitative assessment and analysis of contextual change: This takes into account non-health
system changes, such as socio-economic development that affect both implementation and the
outcomes and impact observed. Qualitative information on the leadership, policy environment and
context is crucial to understand how well and by whom government policies are translated into
practice. A systematic and participatory approach will be used to gather, analyze and communicate
qualitative information. This will be combined with quantitative data as basis for a policy dialogue.
This will then become a solid basis to inform planning cycles, regular reviews and M&E.
Such analysis shall include:

- Primary health care reforms and policies stating the importance of assuring service coverage for
all communities;
- A critical assessment of the health sector or disease programme response and adhering to policy
direction to date;
- How cultural and political factors impact on health or multi-sectoral programmes and outcomes;
- Assessment of organizational context, leadership and accountability mechanisms;
- Assessment of the regulatory environment and how it enables or hinders improvements in health
systems and programme delivery.
Benchmarking: Benchmarking refers to comparisons between and within entities to assess

performance. There are different types of benchmarking which may vary according to level of
comparison (national or sub-national comparisons), level of assessment (individual service provider –
facility – care organization – district – region – national), measurement focus (process, outcomes,
quality, performance), and use of data (public reporting, accountability, internal reporting only, self-
learning and improvement).
The MoH will utilize the following league tables for this purpose:
District League Table to be compiled and disseminated quarterly and annually;
HC IV Performance Assessment (Table 19, Annex 7.8) compiled annually as part of the
AHSPR;
General Hospital Performance Assessment Output (Table 20, Annex 7.8) compiled annually;
Regional referral and large PNFP hospital performance assessment (Table 21) compiled
annually;
League tables for assessing MoH headquarters and departments at National and Regional Referral
Hospitals shall be formulated during this HSSIP.
3.1 Country mechanism for review and action
The HSSIP monitoring and review process will be interlinked across the different planning entities.
Service delivery information to feed the monitoring and review process will be derived bottom up.
This process will be based on a national platform approach that: uses the district as the unit of design
and analysis; based on continuous monitoring of different levels of indicators; gathers additional data
before, during, and after the period to be assessed by multiple methods; uses several analytical
techniques to deal with various data gaps and biases; and includes interim and summative evaluation
analyses. This implies that information at each level will be provided from the planning entities below
28
it. Management support, on the other hand, as well as governance/partnership information will be
analyzed at the same level it is to be provided.
Systems in place for monitoring and evaluation of the health sector include; monitoring the
implementation of periodic work plans, Budget Framework Papers (BFP), Ministerial Policy
Statements (MPS) and the sector strategic plan. Regular reporting using the HMIS and other sources
of data will be used to assess progress against the agreed indicators and targets. The following reports
will be generated; quarterly progress reports, annual performance reports, mid-term and end-term
evaluation reports. Quarterly and annual reports will be produced by the different levels and used
both for self assessment and by supervisors to determine progress or lack of it.
The performance review process will be one of the learning mechanisms in the sector. For proper
follow up and learning:
i) All performance reviews and evaluations will contain specific, targeted and actionable
recommendations.
ii) All target institutions will provide a response to the recommendation(s) within a stipulated
timeframe, and outlining a) agreement or disagreement with said recommendation(s), b)
proposed action(s) to address said recommendation(s), c) timeframe for implementation of said
recommendation(s).
iii) All institutions will be required to maintain a Recommendation Implementation Tracking Plan
which will keep track of review and evaluation recommendations, agreed follow-up actions, and
status of these actions.
iv) Institutions which have an oversight responsibility on the implementation of public policy will
monitor the implementation of agreed actions utilizing the Recommendation Implementation
Tracking Plan. These institutions are as follows: Local Councils, LGs, and MoH will monitor the
implementation of Local Government actions, and report on these quarterly to MoFPED/OPM
through the quarterly reviews and OBT. Sector Working Groups will monitor the
implementation of MoH Departments and Institutional actions, and report on these biannually
to MoFPED and OPM through the OBT. MoFPED and OPM will report six-monthly to
Cabinet on progress on implementing these actions as part of biannual Government
performance reports.
Respective reviews will be guided by information developed by the Government management

structures at each level. These will compile the review information with inputs from the other
implementing partners. All reviews will be presented and endorsed at the respective management and
partnership structures for the level. Indicator information will be used to inform different sector
processes. These are illustrated in Table 4 below.
The budget of collating performance data and conducting sector performance reviews will be
provided for under the sector monitoring budget.
29
Table 4: HSSIP Monitoring and Review process
Methodology Frequency Output Focus Level of
monitoring and
review
Performance Quarterly Quarterly progress Done by Joint (public + Inputs, process,
Assessment reports; transmitted to private) Performance output and
next higher level of Assessment Teams and peers, outcome
supervision and planning entity.
A review of progress against

targets and planned activities.
Technical Six months Progress report Done by Joint (public + Inputs, process,
Review after the submitted to next private) Performance output and
meeting JRM higher level of Assessment Teams and peers, outcome
supervision and planning entity.
A review of progress against

targets and planned activities.
Joint Annual Annually Annual progress Done Jointly with development Input, process,
review and reports, transmitted to Partner, key stakeholders, and output, and
planning next higher level of planning entities as from sub outcome levels
supervision; district level onwards
District and hospital Review progress against set

performance league targets outcomes
tables
National Every 2 Progress report and Done by sector. Input, process,
Health years resolutions for the next output, and
Assembly 2 years Review progress against outcome levels
resolutions
Mid Term After 21/2 Midterm Review report Done by sector Review Input, process,
Review years progress against planned output, outcome
impact and impact levels
End Term At end of End Term Evaluation Independent review of Input, output,
Evaluation HSSIP report progress, against planned outcome and
impact impact levels
3.1.1 Performance Monitoring and Review at Central Level

The HPAC will review the following monitoring reports and recommend action to the Top
Management or the Technical Working Groups as appropriate.
Area Teams monitoring reports quarterly

Annual health sector performance report annual
Progress report from Planning Department on implementation of the JRM aide memoires –
quarterly
Technical review meeting reports – quarterly
The HPAC will use indicators for monitoring the HSSIP for monitoring overall performance of the
health sector.
Central level institutions and departments will submit their periodic performance reports to the
QAD before the 7th day of the second month of the quarter after discussion with all main
30
stakeholders of the institution. They will be reviewed by the M&E committee which, will through the
CHS (QA), request for clarifications as necessary.
The Quarterly Sector Performance Review will assess progress on the quarterly work plans of
MoH departments, semi-autonomous institutions, Health Professional Councils, National Referral
Hospitals (NRHs, Mulago and Butabika Hospitals) and LGs. The aim of these reviews is to:
Assess progress made on action points/recommendations of previous quarterly reviews.

Assess implementation of planned activities against set targets.
Highlight budget performance during the quarter (utilization against allocation).
Propose strategies to address challenges in subsequent quarters.
This shall be carried out using a standardized reporting format during the quarterly performance
review workshops, where reports produced by each department/institution and NRHs will be
presented and discussed in plenary sessions. The meetings will be attended by representatives of all
reporting units.
The departmental and institutional reports are to be compiled into quarterly sector performance
reports which will feed into the AHSPR. The QAD will be responsible for organizing the quarterly
review meetings, compiling and disseminating the quarterly reports.
Technical review meetings shall be held six months after the JRMs to review progress against the
JRM aide memoire. The technical review meetings shall be organized by the Planning Department.
Technical reviews and JRMs shall be organized by the Planning Directorate.
National Health Assembly (NHA)

The NHA shall constitute members of the Social Services Committee of Parliament, LC V
Chairpersons, Secretaries for Health, Chief Administrative Officers, officials from the central level
and a few selected DHOs. The objectives of the NHA are; to garner support for mobilizing
resources for health interventions at the Local government level; and to enhance support and
participation, by stakeholders for health interventions at the implementation level. NHA shall be
carried out every two years in conjunction with the JRM.
3.1.2 Performance Monitoring and Review at Regional Level

It is envisaged that with the creation of the proposed regional tier in health services supervision and
monitoring, the Community Health Departments shall be responsible for conducting quarterly
performance review workshops, where reports produced by each district in the catchment area will
be presented and discussed in plenary sessions. The meetings will be attended by representatives of
all reporting districts and development partners.
Regional stakeholders’ fora

Once agreed and adopted the regional level stakeholders will come together to discuss health and
health related issues that affect their region at least once a year based on the district performance
31
reports. The fora will use regional data to discuss performance within the region, and agree on
priorities to guide districts and RRHs in their respective planning and implementation processes.
These stakeholders will include;

- Public and non public health providers within the region
- Development Partners within the region
- CSO groups within the region
- Members of Parliament / Local Councils, and other eminent persons
- Community, and / or cultural leaders within the region
- Representatives of health related sectors
Standardized planning and reporting formats, tools and process shall be provided to all the regional
coordinators, to guide them in their stakeholders meeting.
3.1.3 Performance Monitoring and Review in Local Governments/District Level

Performance monitoring and review in LGs will be carried out using standard planning and reporting
formats. The HMIS remains the routine reporting system for health service delivery in LGs. The
District Biostastician shall be responsible for validation and compilation of health facility
administrative and service delivery reports into district reports. All weekly, monthly, quarterly and
annual reports from HSDs will be compiled into a single district report. The DHO shall be
responsible for verification and analysis of the district reports. These reports shall be used for district
performance review, planning, supervision and resource mobilization. The District Biostastician is
responsible for submission of district reports to the MoH/ Resource Centre. The timeframe for the
DHO HMIS reporting is outlined in Table 5 below. Each report should be received at the MoH by
the date due.
During the monthly DHT meetings performance review should focus on progress of
implementation of the workplans, timeliness, completeness and accuracy of the reports. The district
quarterly assessment reports will be used for performance review during the quarterly DHMT
meetings. The annual district performance report will be presented and discussed during the annual
district stakeholders‟ forum.
Local Governments (Districts / Municipalities) / Technical Planning Committee: LGs shall

be responsible for monitoring frontline service delivery and accountability for results. They shall also
be responsible for reporting on progress of implementation and achievement of planned outputs.
This involves reporting on the process of implementation focusing on implementation
bottlenecks/constraints. Stakeholders in the districts shall come together to discuss health and health
related issues affecting their district quarterly.
District stakeholders’ fora

These stakeholders include;
- Political, administrative and technical leadership within the districts
- Public and non-public health providers operating within the district
- Development Partners/implementing partners supporting, or facilitating activities within the
district
- Critical civil society groups operating within the district
- Representatives of health related sectors
32
The fora shall use data collated at district level to discuss performance within the district, and agree
on priorities to guide districts in their respective planning and implementation processes.
The District stakeholder‟s fora shall be coordinated by the DHO. Standardized planning and
reporting formats, tools and process shall be provided to all the districts, to guide them in their
stakeholders‟ meeting.
Table 5: Timeframe for the DHO HMIS reporting

Timeframe Report Date Due
District Epidemiological Summary HMIS 033c
District Population Report HMIS 122
District Physical Inventory HMIS 200
District Report sent annually 28th August
District Equipment Inventory HMIS 201
District Staff Listing HMIS 203
District Profile (Annual Report) HMIS 128
District Workplan HMIS 020
District Report sent weekly District weekly surveillance report (HMIS Every Tuesday the
District Report sent monthly HMIS 123 033c)
Month following
Date due week
July 28th August
August 28th September
September 28th October
October 28th November
November 28th December
December 28th January
January 28th February
February 28th March
March 28th April
April 28th May
May 28th June
June 28th July
Month Date due
July 28th August
District Monthly Inpatient Report HMIS 124
February 28th March
March 28th April
April 28th May
May 28th June
June 28th July
Quarter 1st Quarter (July-Sep) 2nd Quarter (Oct- 3rd Quarter (Jan- 4th Quarter (Apr-June)
Date Due 28th October Dec)
28th January Mar)
28th April 28th July
33
3.1.4 Performance Monitoring and Review at Health Sub-District Level
Like the district, each HSD shall review their HSD performance based on the HMIS as the routine
reporting system. The HSD Health Information Assistant shall be responsible for compilation of the
HSDs administrative and service delivery reports. All weekly, monthly, quarterly and annual reports
from health facilities will be compiled into a single HSD report. The HSD In-charge shall be
responsible for verification and analysis of the HSD reports. The reports shall be used for HSD
performance review, planning, performance improvement and resource mobilization. The HSD
Health Information Assistant is responsible for submission of the HSD reports to the DHO. The
timeframe for the HSD HMIS reporting is outlined in Table 6 below. Each report should be received
at the DHO by the due date.
During the monthly HSD Team meetings performance review should focus on timeliness,
completeness and accuracy of the reports. The HSD quarterly assessment reports will be used for
performance review during the quarterly HSD Team meetings, whereas the annual district
performance report will be presented and discussed during the annual HSD stakeholders‟ forum.
Health Sub District stakeholders’ fora

Stakeholders in the HSDs shall come together to discuss health and health related issues affecting
their HSD quarterly.

- Political, administrative and technical leadership within the HSD
- Public and non public health providers operating within the HSD
HSD
- Critical civil society groups operating within the HSD
- Representatives of health related sectors in the HSD
The fora shall use HSD data to discuss performance within the HSD, and agree on priorities to guide
facilities and other service providers in their respective planning and implementation processes.
The HSD stakeholder‟s fora shall be coordinated through the facility heading the HSD. Standardized
planning and reporting formats, tools and process shall be provided to all the HSDs, to guide them
in their stakeholders‟ meeting.
Table 6: Timeframe for HSD HMIS Reporting

HSD Population Report HMIS 109
HSD Physical Inventory HMIS 101
HSD Report sent annually 14th August
HSD Equipment Inventory HMIS 102
HSD Staff Listing HMIS 103
HSD Profile (Annual Report) 128
HSD Report sent weekly HSD weekly surveillance report (HMIS 033c) Every Monday the
HSD Report sent monthly HMIS 123 Month following
Date due week
July 7th August
34
February 7th March
March 7th April
April 7th May
May 7th June
June 7th July
Month Date due
July 7th August
HSD Monthly Inpatient Report HMIS 124
February 7th March
March 7th April
April 7th May
May 7th June
June 7th July
HSD Report sent quarterly HSD Quarterly assessment Report HMIS
Quarter 1st Quarter (July- 106
2nd Quarter (Oct- 3rd Quarter (Jan- 4th Quarter (Apr-June)
Date Due Sep)
14th October Dec)
14th January Mar)
14th April 14th July
3.1.5 Performance Monitoring and Review at Health Facility Level

Performance monitoring and review in health facilities (including private health facilities and
community (VHT)) will be carried out using standard planning and reporting formats. The Health
Information Assistant, or where not available a designated person shall be responsible for
compilation of all relevant data from patient registers and compile a health facility report. Health
facility In Charges are responsible for verification and analysis of administrative and service delivery
reports. The generated reports shall be used for health facility performance review and improvement,
planning, and resource mobilization. The Health Information Assistant or designated person is
responsible for submission of the health facility reports to the HSD and DHO. Each report should
be received at the HSD office by the date due. (Table 7)
During the monthly health facility meetings performance review should focus on timeliness,
completeness and accuracy of the reports. The health facility quarterly assessment reports will be
used for performance review during the quarterly HUMC meetings, whereas the annual district
performance report will be presented and discussed during the annual Sub County stakeholders‟
forum.
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Table 7: Timeframe for Health Facility Reporting

HU Physical Inventory (HMIS 101) 7th August
HU Equipment Inventory (HMIS 102) 7th August
HU staff Listing (HMIS 103) 7th August
Health Unit Report sent annually
HU Staffing Summary 7th August
HU HSSIP Indicators 7th August
HU Annual Report (HMIS 107) 7th August
Health Unit Report sent weekly HU Weekly Epidemiological Surveillance Every Monday of the
Health Unit Report sent monthly Report
Monthly(HMIS 033c)
Report HMIS 105 following
Date due week
July 7th August
February 7th March
March 7th April
April 7th May
May 7th June
June 7th July
Health Unit Inpatient Report sent monthly Monthly Report HMIS 108 Date due
July 7th August
February 7th March
March 7th April
April 7th May
May 7th June
June 7th July
Health Unit Report sent quarterly Health Unit Quarterly assessment
Quarter 1st Quarter (July-Sep) Report HMIS 106
2nd Quarter (Oct- 3rd Quarter (Jan- 4th Quarter (Apr-June)
Date Due 14th October 14th Mar)
Dec) January 14th April 14th July
Health facility stakeholders’ fora

Each health facility in the country has a defined catchment area, for which it is responsible for
coordinating delivery of services to implement the HSSIP. All stakeholders in the catchment area of
the facility shall come together to discuss health and health related issues affecting them quarterly
each year.
36
- Other CSO‟s operating within the facility catchment area
catchment area.
- Representatives of health related sectors in the catchment area of the facility
- Community and / or political leaders from the catchment area of the facility.
The fora shall use health unit data to discuss performance of health within the catchment area, and
agree on priorities to guide the facility and other service providers in their respective planning and
implementation processes.
The stakeholders‟ meetings shall be coordinated by the head of the Health Facility. Standardized
planning and reporting formats, tools and process shall be provided to all the health facilities, to
guide them in their stakeholders‟ meeting.
3.1.6 Performance Monitoring and Review at Community Level

Performance monitoring and review in the community will be carried out using standard planning
and reporting formats.
Sub County (SC) stakeholders’ fora
Stakeholders in the Sub counties shall come together to discuss health and health related issues
affecting their SC quarterly.

- Political, administrative and technical leadership within the SC
- Public and non public health providers operating within the SC
SC
- Critical civil society groups operating within the SC
- Representatives of health related sectors in the SC
The fora shall use SC data to discuss performance within the SC, and agree on priorities to guide
facilities and other service providers in their respective planning and implementation processes.
The SC stakeholder‟s fora shall be coordinated through the facility heading the SC (HC III).
Standardized planning and reporting formats, tools and process shall be provided to all the SCs, to
guide them in their stakeholders‟ meeting. In addition, the Subcounties are expected to use the M&E
results to sensitize the community and accountability through the Sub-county “barazas” recently
established under OPM.
3.1.7 Performance Monitoring and Review at VHT Level

Each VHT is required to compile monthly HMIS reports, for use as well as submission to the
nearest health center by the 5th day of the following month. All relevant data from community
registers will be compiled into a VHT report. Performance review and feedback will be carried out
quarterly by the Village Health Committee.
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3.1.8 The National Health Accounts
The National Health Accounts will be institutionalized as a process of generating routine and
standardized health expenditure data to inform HSSIP implementation and policy decisions.
Resources flowing in the health system from all sources managed by all agents and used to provide
services whose primary intention is health will be tracked. Among the objectives to be achieved is,
benchmarking performance against established targets; allocating scarce resources according to
needs; improve accountability and efficiency; planning for future and raising additional funds (based
on gaps and needs) and; ensuring sustainability. A comprehensive NHA with sub accounts (TB,
Malaria, HIV, RH, CH), as deemed necessary by stakeholders will be produced every two years. All
actors in the sector (service delivery levels, MDAs, central level institutions and MoH, Districts,
private providers, PNFPS, CSOs and Development partners) will be obliged to compile, analyze,
utilize health expenditure data and report to appropriate levels. The budget and finance division in
the MoH, under the leadership of Commissioner Planning, will be responsible for coordinating the
whole process.
3.1.9 Joint Review Mission

The JRM is a national forum for reviewing sector performance annually. The annual reviews will
focus on assessing performance during the previous fiscal year, and determining actions and
spending plans for the year ahead (current year+1). These actions and spending should be addressed
in amendments to the Sector Investment Plan operations, and the budget framework papers and
Ministerial Policy Statements of the Ministry. Annual Sector Reviews should be completed by the
30th September each year, to ensure that the findings feed into the planning and budget process of
the coming year, and annual reporting to Cabinet and Parliament. (National Policy on Public Sector
Monitoring and Evaluation, October 2010).
The main purpose is to;
(a) Receive and discuss the previous financial year sector annual performance report against
priorities.
(b) Raise and respond to issues arising from the AHSPR.
(c) Identify and agree on sector priorities for following financial year.
The annual review shall be organized by the MoH in collaboration with Health Development
Partners. The participants include; key Policy makers (Parliamentary Social Services Committee),
Health Service Commission, key MoH staff (SMC) and departments, Professional Councils,
representatives of local governments, other Health Related Ministries (e.g. Ministry of Finance,
Planning and Economic Development, Ministry of Local Government, Ministry of Education and
Sports, Ministry of Lands, Water and Environment, Ministry of Agriculture, Animal Industries and
Fisheries, Ministry of Gender, Labour and Social Development, Ministry of Public Service), UN
agencies, DPs, non-state implementing partners (PNFPs, CSOs, private providers), representatives of
Health Consumers Organizations and CSO advocacy organizations.
The proceedings of the JRM will be documented in the Aide Memoire to be signed by the MoH and
DPs. The budget for conducting annual sector reviews will be provided for under the sector
monitoring budget.
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3.2 Performance Monitoring by the MoFPED and OPM
In order to meet obligations in monitoring the NDP, the MDAs are required to report quarterly,
semi-annually and annually, to the MoFPED and OPM on a limited number of indicators that reflect
performance in terms of service delivery outcomes (health service coverage), contributory outputs
and main actions. The Output Budgeting Tool (OBT) will be the single instrument for monitoring
and reporting to MoFPED and OPM. The OBT enables reporting on the sector outcomes,
performance indicators and is linked down to Vote function outputs and related indicators. The
activities and outputs are presented by vote and vote function and selected from the annual work
plan, and will be reviewed each financial year by the SMER TWG during the development of the
BFP. Of specific importance to this M&E plan is the need to ensure that, output targets and
corresponding indicators, are coherent with those in the HSSIP.
3.2.1 Performance Monitoring by the MoFPED and OPM at Central Level

Performance reporting is directly related to the Performance Contracts which Accounting Officers at
central and local government level now sign (with the PS/TS and PS/MoLG) agreeing to deliver the
outputs approved by Parliament or local council. The OBT has been developed linking the
procurement and requisitions action to budget and work Plan. Detailed forms are available in MS
ACCESS format for both quarterly and cumulative reporting.
Votes must prepare and submit a draft performance report for each quarter within one month after
the close of that quarter. The submission will be reviewed, and revisions requested from MoFPED
(and line ministries for LGs) which will be provided by the end of the second month of the quarter
following the reporting period. (MoFPED, 2010)
i. Votes will then revise their reports accordingly before the 15th day of the last month of the
quarter following the reporting period.
ii. The release for any given quarter will be conditional on a final and acceptable report being
submitted for the previous quarter but one.
In the health sector, the vote holders are: the MoH, The Uganda Cancer Institute, the Uganda Heart
Institute, the NRHs, the RRHs, the Uganda Blood Transfusion Services, National Medical Stores
(NMS), the Health Service Commission and each local government. Vote Holders are responsible for
ensuring that outputs and „actions‟ set out in the Performance Contract are achieved and that
reporting requirements are fulfilled in an accurate and timely manner.
The Semi-Annual Report aims at assisting Cabinet and Parliament in ensuring that agreed targets and
actions are met by the end of the Financial Year. The Government Annual Performance Report also
represents one part of the dual annual review of progress in implementing the NDP which has been
agreed with the Joint Budget Support Framework (JBSF) Development Partner. The Government
Annual Performance Report will be shared with the JBSF DPs, and includes the JAF indicators. The
Annual JAF appraisal by the JBSF DPs in principle will constitute a response to the Annual
Performance Review and will be used to validate the findings of Government. Both reports are
extremely important, as they are the basis for discussions between the Policy Coordination
Committee and the Heads of Mission of the JBSF DPs on continued sector and general budget
support.
A mechanism shall be developed to ensure that Financial Performance Reports from the districts are
reviewed in a rational manner at the MoH and that feed-back is provided timely.
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Timeframes for Submission of Central Government Quarterly Performance Reports
In order to give Votes sufficient time to produce and compile credible performance data, a lag of one
quarter has been incorporated into the cycle. For example, the cash release for Q2 of FY 2010/11
will be conditional on the submission and approval of the Performance Report from Q4 of FY
2009/10. Therefore, instead of Votes rushing to compile accurate performance data by 15th October
(Q2) following the close of the Q1, there will be a lag of one quarter to Q3 when they will be
required to submit Q1‟s performance report to guarantee Q3‟s release. Table 9 below shows the
timeframe for central government reporting and release throughout the financial year.
Table 8: Timeframes for Central Government Quarterly Performance Report Submission

Quarter Date Release Conditions for Release
Q4 (Previous FY) 30th June Q1 Vote Cash Limits from N/A
MoFPED
Q1 30th September Q2 Vote Cash Limits from Q1 Release conditional on approved
MoFPED Q3 (previous FY) performance
report
Q2 31st December Q3 Vote Cash Limits from Q2 Release conditional approved Q4

MoFPED (previous FY) performance report
Q3 31st March Q4 Vote Cash Limits from Q3 Release conditional approved Q1

MoFPED performance report
** NOTE! Reporting is a continuous process! Votes should begin the reporting process immediately when the quarter
closes, not wait until the following quarter to begin reporting for submission**
Reporting in Q4:
Quarter 4 marks the close of the financial year. Annual performance is compiled in this quarter,
alongside the preparation of detailed budget documentation and quarterly work plans for the next
financial year. However, the table above illustrates that the requirements for quarterly performance
reporting is the same in Q4 as it is in all of the other quarters of the year.
The following will be prepared and submitted to MoFPED.
Date Report
15th June Submission of MPS and Performance Contract „Form A‟ with provisional year-
end reporting and annual Cash Plan
31st July Submission of Q4 performance report including actual Q4 outputs and
cumulative performance to year-end
31st July Submission of revised Q1 work plan
** NOTE! The preparation of the Ministerial Policy Statement for submission in June does not supersede the requirement
for a Q4 performance report submission. This is still required to trigger Q2’s release in the next financial year**
40
3.2.2 Performance Monitoring by the MoFPED at LG Level
In addition to the HMIS reports LGs are required to submit quarterly performance reports (OBT) to
MoFPED and copy to MoH.
The MoFPED guidelines for budget preparation and reporting using the OBT (MoFPED,
November 2010) provide details in key operations and functions of various offices in the preparation
of the OBT for planning and reporting at central and LG level. Key performance indicators (Table
10) are determined annually based on the core vote functions and key outputs during the
development of the BFP. Also, mechanisms have to be developed to ensure that performance
reports from districts are reviewed in a rational manner at the MoH and that feedback is provided
timely if required.
Table 9: Local Government OBT indicators
Output Name Indicator Name Indicator Indicator Method of Source of Frequency

Measure Type Measurement Data of
Collection
Medical Supplies for Value and Number of drug Number Quantity Count Records Quarterly
Health Facilities orders processed against
procurement plans
Medical Supplies for Value and Number of drug Number Quantity Count Records Quarterly
Health Facilities deliveries for medicines and
supplies by NMS as per the
published schedule
Medical Supplies for Number of deliveries for Number Quantity Count Records Quarterly
Health Facilities essential medicines and
supplies to health facilities by
the District.
Medical Supplies for Number of health facilities Number Quantity Count Records Quarterly
Health Facilities reporting no stock out of the
6 tracer drugs.
District/General No. of qualified staff and % Number and Quantity Count Records Quarterly
Hospital Services of approved posts filled with Percentage
(LLS) qualified health workers in the
District/General Hospital(s).
District/General Number of inpatients that Number Quantity Count Records Monthly
Hospital Services visited the District/General
(LLS) Hospital(s).
District/General No. and proportion of Number and Quantity Count Records Monthly
Hospital Services deliveries in the percentage
(LLS) District/General Hospital(s).
District/General Number of total outpatients Number Quantity Count Records Monthly
Hospital Services that visited the
(LLS) District/General Hospital(s).
CSO Hospital Services Number of inpatients that Number Quantity Count Records Monthly
(LLS) visited the CSO Hospital
Facilities.
CSO Hospital Services No. and proportion of Number and Quantity Count Records Monthly
(LLS) deliveries conducted in CSO percentage
Hospital Facilities.
CSO Hospital Services Number of outpatients that Number Quantity Count Records Monthly
(LLS) visited the CSO Hospital
Facilities.
CSO Basic Healthcare Number of outpatients that Number Quantity Count Records Monthly
Services (LLS) visited the CSO Health
Facilities.
41
Collection
CSO Basic Healthcare Number of inpatients that Number Quantity Count Records Monthly
Services (LLS) visited the CSO Health
Facilities.
CSO Basic Healthcare No. and proportion of Number and Quantity Count Records Monthly
Services (LLS) deliveries conducted in the percentage
CSO Health Facilities.
CSO Basic Healthcare Number of children Number Quantity Count Records Monthly
Services (LLS) immunized with Pentavalent
vaccine in the CSO Health
Facilities.
Basic Healthcare No. of qualified health Number and Quality Count Records Quarterly
Services (HC IV-HC workers and % of approved Percentage
II-LLS) posts filled with qualified
health workers
Basic Healthcare Number of outpatients that Number Quantity Count Records Monthly
Services (HC IV-HC visited the Govt. health
II-LLS) facilities.
Basic Healthcare Number of inpatients that Number Quantity Count Records Monthly
Services (HC IV-HC visited the Govt. health
II-LLS) facilities.
Basic Healthcare No. and proportion of Number and Quantity Count Records Monthly
Services (HC IV-HC deliveries conducted in Govt. percentage
II-LLS) health facilities.
Basic Healthcare Number of children Number Quantity Count Records Monthly
Services (HC IV-HC immunized with Pentavalent
II-LLS) vaccine.
Basic Healthcare % of Villages with functional Percentage Quantity Count Records Quarterly
Services (HC IV-HC (existing, trained, and
II-LLS) reporting quarterly) VHTs.
Buildings & Other Number of planned health Number Quantity Counts Records Quarterly
Structures infrastructure projects
completed.
Basic Healthcare Number of outreach visits Number Quantity Counts Records Quarterly
Services (HC IV-HC conducted
II-LLS)
Basic Healthcare Number of support Number Quantity Counts Records Quarterly
Services (HCIV-HCII- supervision visits conducted
LLS)
Basic Healthcare Number of health workers Number Quantity Counts Records Quarterly
Services (HC IV-HC trained
II-LLS)
Basic Healthcare Number of health related Number Quantity Counts Records Quarterly
Services (HC IV-HC training sessions held
II-LLS)
Basic Healthcare Number of HCT activities Number Quantity Counts Records Quarterly
Services (HCIV-HCII- conducted
LLS)
Basic Healthcare Number of management Number Quantity Counts Records Quarterly
Services (HC IV-HC meetings
II-LLS) held(HUMC,DHT,DHMT)
Basic Healthcare Number of contacts related to Number Quantity Counts Records Quarterly
Services (HC IV-HC health promotion and health
II-LLS) education
Basic Healthcare Number of EPI child days Number Quantity Counts Records Quarterly
Services (HCIV-HCII- conducted
LLS)
Basic Healthcare Number of HMIS reports Number Quantity Counts Records Quarterly
Services (HC IV-HC submitted in time
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Collection
II-LLS)
Machinery & Value of basic medical Number Quantity Funds spent Records Quarterly
Equipment equipment procured during
the FY
Timeframes for Submission of Local Government Quarterly Performance Reports

As with the Central Government reporting timeframe described above, the LG Performance Reports
are similarly submitted within one month of the close of a quarter, and report approval is required to
trigger the release of funds for the next quarter (Table 11). The Quarterly Performance Reports are
also used by a number of different audiences to monitor and analyze performance of the budget and
institutions at the LG level.
Table 10: Timeframes for Local Government Quarterly Performance Report Submission
Quarter Date Release / Submission
Q1 31st July Draft Q4 Performance Report (previous FY) and draft Budget Performance
Contract
1st to 31st August Review of Q4 (Previous FY) Performance Reports
31st August MoFPED Requests Amendments from Votes
15th September Final Q4 Performance Report
Q2 31st October Draft Q1 Performance Report and final Budget Performance Contract Form
B
1st to 30th November Review of Q1 Performance Reports
30th November MoFPED Requests Amendments from Votes
15th December Final Q1 Performance Report
Q3 31st January Draft Q2 Performance Report
1st to 22th February Review of Q2 Performance Reports
28th February MoFPED Requests Amendments from Votes
15th March Final Q2 Performance Report
Q4 30th April Draft Q3 Performance Report and Q4 work plan
1st to 31st May Review of Q3 Performance Reports
31st May MoFPED Requests Amendments from Votes
15th June Final Q3 Performance Report
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3.2.3 Monitoring Performance of the Supply Chain Management System
The SCMS for medicines and health supplies is critical in ensuring availability of supplies. There are
various stakeholders involved and therefore a Memorandum of Understanding was signed between
GOU represented by the MoH, MoLG and NMS. Performance monitoring will be carried out by the
MoH Pharmacy Division on a quarterly basis.
Table 11: Medicines Management Performance Summary Matrix
Medicines Management Quarter Performance

Year
Performance Summary Matrix Quarter
(HC II – IV & General Hospitals)
Resp. Key Performance Threshold Pass Fail Sanction
Indicator
MoFPED 1. Not less than 100% 99% Under performance
of approved to be communicated
medicines budget to Parliament and
released to NMS Health Development
before the end of a Partners
FY
2. Timely disbursement 95% of budget
of funds under Vote target amount by
116 in two batches quarter.
per FY (Front
loading)
3. Ensure that Medical Ensure 75% For districts and
Directors (MDs), orders reach hospitals failing to
Medical NMS not later submit timely /
Superintendants than 7 working within quarter target
L/Govt
(MS‟s) and DHOs days before allocation orders, the
submit timely and scheduled CAO and MD
complete orders to district delivery should be summoned
NMS. date. to explain.
4. Ensure medicines Ensure 75% is
delivered by NMS to delivered by
District HQ is DHO to lowest
delivered by DHO to HF within 72
lowest HF within 72 hours
hours.
5. Ensure approved list Ensure 100%
of public health districts have
facilities is submitted approved health
to NMS by 30th May facility inventory
each year.
44
MoH 6. To maintain standard List available There should be
list of essential sanctions for the
medicines to be MoH
stocked at the
various levels in line
with EMLU 2007.
7. Communicate Policy 12 months
changes on treatment notice given
at least 12 months before order of
before any new item
implementation
8. Communicate all Communication
Policy changes on copies of all
ordering and delivery communications
of medicines / health
supplies
9. Ensure that range, 100%
quantity and delivery
schedules are agreed
upon between NMS
and MoH for all
third party items.
10. Ensure sharing of
pipeline information
on 3rd party items at
least 3 months in
advance
NMS 11. NMS adherence to % districts Sanction the General
agreed published deliveries on Manager in line with
delivery schedule. scheduled date. Public Service
regulations.
12. Deliver agreed upon 85% range
indicator range and
quantity of essential
medicines and health 85% quantity
supplies in line with
MoH Policies.
13. Ensure utilization of 100% Subsequent
GOU funds made allocation to be in
available to NMS is line with absorption
spent / committed capacity
by FY end
14. NMS adherence to 100% district
agreed prices by 4 accounts debited
month cycle with correct
prices
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3.2.4 Monitoring by the Health Development Partners
The Joint Assessment Framework (JAF) is the approach agreed by the Government of Uganda and
the DPs engaged in budget support (World Bank, Delegation of the European Union, African
Development Bank, and Governments of Belgium, Denmark, Germany, Ireland, Netherlands,
Norway, Sweden, and the United Kingdom). It is a framework that tracks overall government
performance as well as performance in five sectors: health; education; water and sanitation;
transportation and roads; agriculture. Based on the annual assessments, the donor governments make
decisions on sector budget support to Uganda. Sector performance is assessed using two sets of
indicators. Health sector-specific performance indicators (JAF Indicators) are at impact, outcome
and output levels. The MoH reviews and sets annual targets and actions.
All the 8 JAF indicators at the beginning of HSSIP 2010/11 – 2014/15 are among the 26 HSSIP
2010/1 – 2014/15 core indicators and include:
Impact level indicators

1) Infant Mortality Rate
2) Maternal Mortality Ratio
Sector result level indicators

3) Number and proportion of deliveries in health facilities
4) Contraceptive Prevalence Rate
5) Number and proportion of children immunized with 3rd dose pentavalent vaccine
Performance level indicators

6) Proportion of approved posts filled by qualified health workers
7) Absenteeism rate
8) Proportion of health facilities without drug stock outs for 6 tracer drugs
The JAF Quarterly Performance Report is compiled by the QAD, in conjunction with officers from
various departments (both the Resource Centre and user departments) who have the required
information and submitted to the MoFPED.
3.3 Linkage between the health sector reviews, disease / programme /

project specific reviews and global reporting
Detailed program-specific reviews shall be linked to the overall health sector review and contribute
to it. Program-specific review should be conducted prior to the overall health sector review, and help
inform the content of the health sector review in relation to that specific programme area. It is
important that the specific programme reviews involve staff and researchers not involved in the
programme itself to obtain an objective view of progress.
All disease / programme / project reviews shall be carried by the specific M&E Officers and
managers and progress review reports submitted to the MoH M&E unit in the Quality Assurance
Department before the quarterly and annual sector reviews.
46
Global reporting requirements shall be based on ongoing country processes of data generation,
compilation, analysis and synthesis, communication and use for decision making. This has been
clearly spelt out in the Country Compact for implementation of the HSSIP. The HSSIP M&E plan
serves as the basis for all M&E related processes such as the health sector component of the Sector
Wide Approaches (SWAP) and IHP+, for programme activities supported by GAVI, the Global
Fund and other DPs, and for disease- and programme-specific needs.
The figure below shows the common M&E platform for national health strategies with country data
generation and use processes in the centre.
Figure 6: Country-led platform for monitoring & review of the national health strategy
Source: WHO 2011
3.4 Performance Monitoring and Review for Global Health Grants
The HSSIP 2010/11 – 2014/15 has both core and programme specific indicators. Whereas the main
purpose of this M&E plan is to provide a framework for monitoring the HSSIP core indicators,
program managers and other stakeholders are encouraged to develop and implement
program/project specific M&E plans for monitoring their indicators and performance reviews with
linkage to the general health sector review outlined in this plan.
Under the Global Health Initiatives, the health sector is supported through initiatives like the Global
Fund for Tuberculosis, HIV/AIDS and Malaria (GFTAM) and Global Alliance for Vaccines and
Immunization (GAVI) which provide funds based on performance. There are other sector support
projects which also disburse funds based on performance and CSOs which contribute to the overall
sector performance. All these require M&E Plans at the time of Grant/Loan signature and ongoing
disbursements are linked to the achievement of clear and measurable programmatic results.
The Long Term Institutional Arrangements (LTIA) for management of Global Health Grants in
Uganda, (Abridged Version, 2009) outlines the processes and mechanisms for aligning the Global
Health Grants with the overall Government of Uganda‟s national development framework and
NDP. For programme monitoring and evaluation the LTIAs spell out that;
47
M&E shall be carried out within the National M&E framework using tools that consider outputs
and indicators to be drawn from approved workplans and budgets for the HSSIP. Programme
specific indicators from programme strategic and or M&E plans will be used to supplement the
national level indicators in monitoring specific programme performance.
There shall be strengthening of the M&E systems to include an agreed upon and costed M&E
plan developed by the TWGs and coordinated by the Directorate of Planning and Development.
The QAD shall be the secretariat for the SMER TWG and; will be responsible for
implementation of the M&E plan. The Policy Analysis Unit shall be supported to undertake the
role of evaluation.
A mechanism shall be developed to ensure follow up action as needed from reviews and reports
that indicate discrepancies or short comings with observed program results. This mechanism
shall involve spelling clear timelines, responsibility centers and indicators.
There shall be a transparent and documented process to ensure input of a broad range of
stakeholders in the programme monitoring and evaluation. This shall involve joint monitoring
visits.
Programme managers will provide oversight for monitoring implementation of work plans and
preparation of quarterly and annual performance reports.
The M&E specialists will work under the overall stewardship of the SMER TWG. They will be
responsible for analyzing data and assembling reports that will be reviewed and verified by
programme managers before submission to the working group. They will use information
generated by the Resource Center and monitoring reports form Area Team supervision visits.
Specifically for the GFTAM;

The existing framework for performance M&E will be adopted using agreed performance
indicators.
Implementers at national and local government levels will prepare technical reports on a
quarterly basis.
Annual performance reports presented at the JRM and Joint AIDS Review shall capture overall
performance (including GFTAM) and constitute the performance report for the sector for use by
Development Partners and other stakeholders.
3.5 Performance Monitoring and Review for Civil Society Organisation and
Private Sector
CSOs and the private sector contribute significantly to health service delivery in the country. Most
times their input is not captured in the sector performance reports. In order to measure their
contribution to the overall sector performance they will be required to report to the relevant sector
entities using the existing monitoring and review structures. The CSO and Private Providers‟
umbrella bodies will play a coordination role in monitoring all CSOs and private sector providers to
ensure alignment with national priorities. Government will support this process through providing
the necessary M&E tools.
48
3.6 Performance Monitoring and Review for Implementing Development
Partners Sector
Implementing developing partners contribute significantly to health service delivery in the country.
Most times their input and attribution to health outcomes is not captured in the sector performance
reports. In order to measure their contribution to the overall sector performance they will be
required to report to the relevant sector entities using the existing monitoring and review structures.
The MoH M&E Unit will play a coordination role in monitoring all national level Implementing DPs
to ensure alignment with national priorities. DHO will coordinate monitoring and reporting of
district based Implementing DPs. Statistical outputs from these partners should be routed through
the HMIS. Government will support this process through providing the necessary M&E tools and
reporting format.
3.7 Routine Feedback to Sub-national and Key Stakeholders
The advantages of routine performance feedback include; helping local managers, supervisors and
implementers to consider what their own strengths and weaknesses are, and where they need to be
making more of an effort. Secondly, for those collecting the information, seeing how that data is
used, and how it can assist their own work and the cork of their colleagues, helps to motivate them
to improve the quality of information they provide.
Feedback on performance shall be provided for national, regional and institutional level performance
on quarterly basis through performance review meetings and reports and league tables.
3.8 Reporting Progress against the NDP 2010/11 - 2014/15
The health sector M&E plan is informed by the priorities of the NDP and is aligned with the M&E
plan of the NDP. The Key Results Area matrix which requires the sector to report on 22 health
sector indicators (Annex 7.2) provides the annualized expected results (outcomes) for each indicator.
(Monitoring and evaluation strategy for the National Development Plan
(2010/11 – 2014/15)). Of these indicators, those that are also JAF indicators are currently included
in the performance reports submitted to the MoFPED/OPM. A system will be developed to ensure
appropriate reporting for the 22 NDP health sector performance indicators.
3.9 Reporting Requirements on International Commitments and

Resolutions
The NDP reflects and spells out the international initiatives to which Uganda is a signatory and these
include the Millennium Development Goals (MDGs), the International Conference on Nutrition, the
Convention on the Rights of the Child, the UN Convention on the Rights of PWDs, the
International Conference on Population and Development, the New Partnership for Africa‟s
Development (NEPAD), the Paris Declaration on Harmonization and Alignment, the International
Health Partnerships and related initiatives (IHP+), World Health Organization member states and
the Abuja Declaration among many initiatives.
49
Currently in the NDP M&E strategy, it is indicated that there is no M&E framework for
implementation of regional and international agreements and treaties. There is therefore need to
develop and operationalise such a framework.
Millennium Development Goals (MDGs): Uganda is committed to achieving the MDGs by 2015.
The MDGs directly relevant to the health sector are: MDG 4: Child Health; MDG 5: Maternal
Health; MDG 6: HIV and AIDS. The health sector also bears indirect responsibility in the
achievement of MDG 1: End poverty and hunger; MDG 3: Gender equality; and MDG 7:
Environmental sustainability.
The HSSIP follows the principles of the Paris Declaration and the Accra Agenda for Action through
the IHP+ in the interaction and collaboration with national and international development partners.
World Health Statistical Report
The World Health Statistics series is WHO‟s annual compilation of health-related data for its 193
Member States, and includes a summary of the progress made towards achieving the health-related
Millennium Development Goals (MDGs) and associated targets. It‟s compiled using publications
and databases produced and maintained by the technical programmes and regional offices of WHO.
Indicators are included on the basis of their relevance to global public health; the availability and
quality of the data; and the reliability and comparability of the resulting estimates.
Taken together, these indicators provide a comprehensive summary of the current status of national
health and health systems in the following nine areas: mortality and burden of disease; cause-specific
mortality and morbidity; selected infectious diseases; health service coverage; risk factors; health
workforce, infrastructure and essential medicines; health expenditure; health inequities; and
demographic and socioeconomic statistics.
The estimates in these publications are derived from multiple sources, depending on each indicator
and the availability and quality of data. Every effort is made to ensure the best use of country-
reported data – adjusted where necessary to deal with missing values, to correct for known biases,
and to maximize the comparability of the statistics across countries and over time. In addition,
statistical techniques and modeling are used to fill data gaps.
As a member of the World Health Organisation member states, the MoH is required to submit an
annual statistical report on selected indicators. (Annex 7.3). The MoH Global Desk Officer will
compile this report in collaboration with the RC and relevant programme managers. The report will
be submitted by 28th February the following year.
United Nations General Assembly Special Session (UNGASS)
As a signatory to the UNGASS Declaration of Commitment on HIV/AIDS IN 2001, Uganda

continues monitoring progress in combating HIV/AIDS. The Uganda Aids Control Program
(UACP) has developed appropriate M&E mechanisms to assist with follow-up in measuring and
assessing progress, developed appropriate monitoring and evaluation instruments, with adequate
epidemiological data. UACP conducts national periodic reviews involving the participation of civil
society, particularly people living with HIV/AIDS, vulnerable groups and caregivers, of progress
achieved in realizing these commitments and identify problems and obstacles to achieving progress
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and ensure wide dissemination of the results of these reviews. Uganda submits annual reports based
on the UNGASS indicators (Annex 7.4)
East African Community and the Common Market for Eastern and Southern Africa (ECSA)
As a partner state of the ECSA, Uganda‟s health policy has been aligned with existing and new
regional health sector frameworks. The MoH will report progress of the Resolutions to the ECSA-
HC Secretariat against a standard set of indicators, using a uniform format for all future Health
Ministers‟ Conferences (HMC). This is to enable comparison between member states. The reporting
tool has two sets of indicators; the core regional indicators and the resolution-specific indicators. The
core indicators (Annex 7.5) will measure performance in the socio-economic and demographic status
of each member state (10 indicators), the nutritional status (9 indicators), the health system (22
indicators) and the epidemiological status and performance of the health system (46 indicators,
including MDG indicators). The resolution-specific indicators aim at assessing progress on each of
the 10 resolutions made at the previous HMC. Reporting is expected to be done by 30th June every
year for set one, and 30th of September for set 2 (resolutions), ahead of the October HMCs.
The Ministry of Health Global Desk Officer shall be responsible for developing an M&E framework
for implementation of regional and international agreements and treaties as well as compiling and
submitting the reporting requirements on international commitments and resolutions through the
Permanent Secretary.
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3.10 HSSIP Evaluation
Evaluation is a process of measuring the outcomes, impacts and effectiveness of a programmes /

projects as well as documenting experiences and lessons learnt. Evaluations are separately scheduled
activities performed at specific intervals (for example baseline, midterm or at the end of a
programme / project).
3.10.1 Programme / Project Evaluation

A number of health sector investment and intervention projects will be undertaken during the period
2010/11 – 2014/15. All projects will be subjected to rigorous evaluation. The type of evaluation to
be planned for and conducted should reflect the nature and scope of the public investment. For
example, pilot projects that are being conducted amongst a random group of participants shall be
selected for impact evaluation to determine whether or not the investment should be scaled up.
As a minimum requirement, each project in this category will be required to conduct the following:
(i) A Baseline study during the preparatory design phase of the project
(ii) A Mid-term review at the mid-point in the project to assess progress against objectives and
provide recommendations for corrective measures
(iii) A Final evaluation or value-for-money (VFM) audit at the end of the project. A VFM audit
will be carried out for key front-line service delivery projects where value for money is
identified as a primary criterion. All other projects will be subjected to standard rigorous
final evaluation.
The MoH through the specific programme / project managers will be responsible for the design,
management and follow-up of the programme and project evaluations (including baseline and mid-
term reviews). All projects are required to budget for periodic project evaluations. All project
evaluations will be conducted by external evaluators to ensure independence. VFM will be
undertaken by the Office of the Auditor General. Programme / Project evaluation reports shall be
disseminated during the sector quarterly and annual review meetings.
3.10.2 Mid Term Review

A Mid-Term review of the HSSIP 2010/11 – 2014/15 will be done after two and half years (January
– June 2013) of implementation and report finalized by September 2013, for presentation at the
JRM. The purpose of the MTR is to review the progress of implementation; identify and propose
adjustments to the HSSIP and other government policies as required.
The specific objectives of the MTR are to:

2. Assess progress in meeting HSSIP 2010/11 – 2014/15 targets and to make recommendations for
their adjustment if found necessary;
3. Review the appropriateness of outputs in terms of inputs, processes and desired outcomes;
4. Review the costing and financing mechanisms of the HSSIP 2010/11 – 2014/15; and
5. Coordinate the MTR process with the NDP review.
The MTR shall entail extensive review of documents including routine reports and recent studies in
the sector; special in-depth studies may also be commissioned as part of the MTR; and interviews
with selected key stakeholders. The MTR is undertaken in a participatory manner involving
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government line ministries (MoH and related line ministries), national level institutions, service
delivery levels, DPs, civil society, private sector and academia.
The analysis will focus on progress of the entire sector against planned impact, but will also include
an assessment of inputs, processes, outputs and outcomes, using the HSSIP indicators (core and
others). The main result will be a list of recommendations for the remaining HSSIP years. This will
be an internal, joint exercise involving all stakeholders.
The overall responsibility of the process will be with the Director General of Health Services. A
secretariat shall be constituted to support and co-ordinate the MTR process. The secretariat is to be
located in the Health Planning Department of the MoH working closely with the Quality Assurance
Department. A Technical Assistant may be required to support the MTR secretariat.
The review shall be carried out by the Technical Working Groups. Each TWG will be responsible to
undertake a review according their specific Terms of Reference. Issues not covered by any specific
working group will be a responsibility of the MTR Secretariat. External facilitation may be required
to address critical issues identified by the Working Groups. The outputs of the Working Groups shall
be presented to the Health Sector Review Committee. Specific Terms of Reference will be developed
for the Lead Facilitator, TWGs and MTR Task Force.
3.10.3 HSSIP End Term Evaluation

The End Term evaluation will be conducted in the second half of 2014 (four and half years of the
HSSIP implementation) in order to enable the sector to make use of its findings and
recommendations for the formulation of the next strategic plan. Like the mid-term review, the
analysis will focus on progress of the entire sector against planned impact, but will also include an
assessment of inputs, processes, outputs and outcomes, using the HSSIP indicators (core and
others). It will focus on expected and achieved accomplishments, examining the results chain,
processes, contextual factors and causality, in order to understand achievements or the lack thereof.
The evaluation will have to answer questions of attribution (what made the difference?) and
counterfactual (what would have happened if we had not done A or B?) and take into account
contextual changes (economic growth, social changes, environmental factors etc.), as well as policies
and resource flows.
a) Relevance: (i) Did the HSSIP address priority problems faced by the target areas and
communities? (ii) Was the HSSIP consistent with policies of both Health Development
Partners (HDP) and government?
b) Economy: Have the HSSIP inputs (financial, human, Assets etc) been applied optimally in
the implementation process?
c) Efficiency: Were inputs (staff, time, money, equipment) used in the best possible way to
maximize the ratio of input/outputs in HSSIP implementation and achieve enhanced
outputs; or could implementation have been improved / was there a better way of doing
things?
d) Effectiveness: Have planned HSSIP outputs and outcomes been achieved?
e) Efficacy: To what extent have been the achievements of the HSSIP objectives and goal?
f) Impact: What has been the contribution of the HSSIP to the higher level development
goals, in respect of national development goals; did the HSSIP have any negative or
unforeseen consequences?
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Trends in performance will be based on the HSSIP 2010/11 – 2014/15 baseline indicators. Districts
shall be the primary units of statistical analysis for the national evaluation platform approach. A
dose–response analysis that examines (for instance) the association between funding levels and
service coverage shall be carried out to further contribute to the evaluation.
The evaluation will be conducted by a team of independent in-country institutions in close

collaboration with international consultants. The purpose of conducting the evaluation prior to the
conclusion of the HSSIP is to generate lessons and recommendations to inform the next HSSIP.
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4 Surveys
Surveys will be conducted where there are information gaps or outdated information throughout the
HSSIP period as a basis to confirm the occurrence of change. Surveys shall be carried out at all levels
to provide basis for a 'before and after' assessment of the HSSIP 2010/11 - 2014/15 progress. The
results of these studies are supposed to inform decision making hence contribute to improving
delivery of and access to health care and nutrition services. Several institutions conduct health and
nutrition research in Uganda e.g. universities, semi-autonomous institutions and other public
institutions with diverse affiliations and districts. The UNHRO is the Secretariat for health and
related research and therefore has the mandate to coordinate health research activities. UNHRO will
provide guidance to ensure that research data is disaggregated by sex, residence and wealth quintile
among other variables. A gender analysis of the research findings will also be helpful in terms of
contributing to development of policies and interventions.
4.1 Surveys Commissioned by the MoH
These may be carried out directly by programmes under the MoH or contracted out. These will
include; the Antenatal HIV Sentinel surveillance, Uganda HIV/AIDS sero-behavioral survey, Malaria
indicator survey, availability of the six tracer medicines study, client satisfaction surveys, facility
assessment for service delivery, health and human rights, and gender survey, and other operational
surveys.
4.1.1 Service Availability and Readiness Assessment

The service availability and readiness assessment shall be conducted as a rapid survey, just ahead of
the health sector review, to assess/monitor readiness of facilities to deliver services (i.e. to assess if
the necessary medicines, supplies, equipment, trained staff, diagnostic capacity, infection control
precautions etc. are available to provide services such as family planning, MNCH, HIV, TB, malaria,
NCDS). The readiness assessment is conducted using a standard instrument that has been jointly
developed by WHO, USAID and other partners. A record review will also be conducted during the
facility assessment to allow for verification of the quality of routinely reported facility data (RDQA).
The approach serves to;
Fill the data gaps that many countries face in terms of service delivery, generating standard tracer
indicators that are required to plan and monitor scale-up of interventions for key health services
and assess /measure progress in health system strengthening within the broader context of M&E
of the national strategy; and
Systematically assess and verify the quality of routinely reported facility information that goes
into progress and performance reports.
The facility readiness assessment shall be conducted on an annual basis to inform the analytical
reviews. The methodology is based on a random sample of facilities that is nationally representative
and stratified by region, facility type and managing authority. A complete list of public and private
list of facilities is required for the sampling frame. The whole process shall be conducted prior to the
annual JRM (September) every year.
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4.1.2 HIV/AIDS Epidemiological Surveillance
Active surveillance of HIV infection based on annual ANC-based HIV sero-prevalence surveys
conducted in sentinel clinics distributed in all geographic areas of the country. The ANC-based
sentinel surveillance system has evolved ever since it was set up initially in six urban sites in 1989.
The system has expanded over the years to include more rural sites. In 2005, 2006, 2007 and 2010
ANC sero-prevalence data were obtained from 25, 26, 29 and 30 ANC sentinel surveillance sites
respectively.
The methodology of ANC HIV surveillance involves anonymous and unlinked HIV serological
testing of residual blood samples after performing routine ANC serological testing for syphilis at the
clinics. Blood specimens are collected from mothers attending their first visit for ANC during a
defined survey period. The sampling frame is consecutive and therefore all eligible women who
present at the sentinel sites in the sampling period are sampled. A minimum of 300 samples are
collected from each sites. However, in high volume clinics in major urban areas, deliberate over
sampling is conducted to obtain at least 500 samples from each clinic to permit stratified analyses. A
sampling period of ten weeks is observed simultaneously in all clinics. HIV serological tested are
conducted at the Uganda Virus Research Institute HIV Reference Laboratory in Entebbe after all
personal identifiers have been irreversibly removed. Serological tests for HIV are based on a serial
testing algorithm.
HIV/AIDS epidemiological data will be collected from multiple sources. These include the national
ANC HIV sentinel surveillance system, STD sentinel surveillance survey, periodic population based
HIV/AIDS surveys, M&E of HCT, PMTCT and ART programs. The epidemiological data will be
collected annually and presented in an annual report based on calendar year.
4.1.3 The Uganda HIV/AIDS Indicator Survey

The Uganda HIV/AIDS Indicator survey 2011 will be a cross-sectional population based survey that
will be conducted based on a nationally representative sample of adults aged 15 – 59 years and
children aged less than 5 years. This survey will provide data on the prevalence of HIV infections,
Herpes simplex virus type-2 (HSV-2), syphilis and hepatitis B virus (HBV); the risk factors for HIV
infection, programme indicators of knowledge, attitudes, sexual behaviour as well as the HIV/AIDS
programme coverage indicators. The survey will provide national estimates and sub-national
estimates for nine survey regions including the capital city, Kampala. The detailed report of UHSBS
2011 will be disseminated in print and on the website. This report will present summaries of the data
on the magnitude of HIV and STI prevalence. In addition, data on selected behavioural indicators
and some indicators of programme coverage will be presented. The process of data and sample
collection will be conducted from February 2011 to June 2011 and the final report presented by
December 2011.
4.1.4 Availability of the six tracer medicines study

Availability of the six tracer medicines is one of the core indicators of HSSIP to be monitored at
facility level monthly through the HMIS. At national level availability of the six tracer medicines will
also be monitored annually through the six tracer medicine availability study conducted in September
– October in selected districts by the MoH Pharmacy Division. The findings of the six tracer
medicines availability study will be analyzed and reported in the AHSPRs.
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As the MoH works towards increasing access and availability of the essential medicines and health
supplies it is shall use appropriate innovative approaches to improve monitoring and accountability
for medicines and specified items. The information generated shall be used for improving the supply
chain management and feedback will be provided through SMS, printed reports, newsletters and
bulletins to the districts, health facilities and villages.
4.1.5 Uganda Malaria Indicator Survey

The Uganda Malaria Indicator Survey (UMIS) was designed to determine the progress made in
malaria control and prevention in Uganda. It provides data on key malaria indicators, including
mosquito net ownership and use, as well as prompt treatment using ACT.
The key objectives of the UMIS are to:

Measure the extent of ownership and use of mosquito bed nets
Assess coverage of the intermittent preventive treatment programme for pregnant women
Identify practices used to treat malaria among children under age 5 and the use of specific
antimalarial medications
Measure the prevalence of malaria and anaemia among children age 0 - 59 months
Determine the species of plasmodium parasite most prevalent in Uganda
Assess knowledge, attitudes, and practices regarding malaria in the general population
The UMIS will be carried out every two to three years by the Malaria Control Programme during the
months of November and December, using a nationally representative sample of households. The
Survey will provide some of the core HSSIP indicators as well as national and regional estimates of a
range of malaria indicators and thus provides a robust and comprehensive picture of malaria control
in Uganda. It captures both biological and behavioural information relevant to malaria and will
provide a useful reference tool and evidence base for national policy decision making.
4.1.6 National Tuberculosis prevalence survey

This population-based TB disease prevalence survey aimed at establishing an accurate estimate of the
burden of TB disease; estimating the age-sex distribution of prevalent PTB cases; establishing the
proportion of prevalent cases found by the health system; and comparing the health seeking behavior
of prevalent cases that were not being treated to those being treated by the health system. The survey
is planned to take place in 2012.
This will be a cross sectional descriptive study targeting adults aged 15 years and above from all over
the whole country. Preliminary results will be discussed 4 - 6 months after the completion of the
survey using standardized reporting formats provided by WHO Task Force. The prevalence survey is
estimated to cost US$ 2,487,649 of which US$ 2 million is budgeted under GFATM Round 6.
4.1.7 Client Satisfaction Surveys

a) Client satisfaction surveys will be carried out at all levels of service delivery to determine the
quality of services offered in the client perspective. A client satisfaction survey tool shall be
developed by the Quality Assurance Department for incorporation into the HMIS. Facility client
satisfaction surveys will be carried out biannually (December and June every year) and findings
utilized for quality improvement.
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b) The national client satisfaction surveys will be needed to provide the baseline, mid-term and end
of HSSIP 2010/11 – 2014/15 indicators. These national surveys will be carried out in June - July
2011, January – March 2013 and January – March 2015 respectively. A baseline client satisfaction
survey shall be carried out in 2011. The MoH shall collaborate with UBOS and other
stakeholders to identify modalities of conducting more regular population based client
satisfaction surveys.
4.1.8 Non-Communicable Diseases (NCD) Survey

During HSSP II the MoH initiated the process of conducting a national NCD baseline survey on risk
factors and magnitude of non-communicable diseases in the country. The survey is expected to be
completed by 2012. The NCD baseline survey will provide baseline data on the prevalence of NCDs
and their risk factors. This should result in the formulation of evidence based national NCD policies
and strategies as well as the development of a comprehensive and integrated action plan against
NCDs in our population.
Other relevant surveys may be initiated by the MoH during the course of implementation of the
HSSIP.
4.2 Health related surveys by other institutions
The Uganda Bureau of Statistics and the office of Births and Deaths Registration (for Vital
Registration) are invaluable stakeholders that will provide data for sector monitoring, especially for
health outcome and impact indicators. The MoH shall be actively involved in design of population
surveys such as the Uganda Demographic and Health Surveys, Household surveys e.g. Uganda
National Panel Surveys (UNPS), Uganda National Household Survey and National Service Delivery
Survey. Other research institutions and academia may conduct population surveys and share findings
with the MoH.
4.2.1 Uganda Demographic and Health Survey

The UDHS is a national survey carried out by UBOS. The primary objective of this survey is to
provide up-to-date information for policy makers, planners, researchers and program managers, to
use in the planning, implementation, monitoring and evaluation of population and health programs
in the country. The UDHS provides detailed information on fertility; family planning; infant, child,
adult, and maternal mortality; maternal and child health; nutrition; and knowledge of HIV/AIDS and
other sexually transmitted infections. Additional information needed by the sector can be provided in
collaboration with UBOS.
The last survey was conducted in 2006 and the findings were used for setting targets for HSSIP
health status impact indicators and coverage for risk factors. The next UDHS - 5 shall be carried out
in 2011. Data collection process to commence May 2011.
The specific objectives of the UDHS - 5 are as follows:
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To collect data at the national level that will allow the calculation of demographic rates,
particularly the fertility and infant mortality rates
To analyze the direct and indirect factors that determine the level and trends in fertility and
mortality
To measure the level of contraceptive knowledge and practice of women and men by
method, by urban-rural residence, and by region
To collect data on knowledge and attitudes of women and men about sexually transmitted
infections and HIV/AIDS, and to evaluate patterns of recent behaviour regarding condom
use
To assess the nutritional status of children under age five and women by means of
anthropometric measurements (weight and height), and to assess child feeding practices
To collect data on family health, including immunizations, prevalence and treatment of
diarrhoea and other diseases among children under five, antenatal visits, assistance at
delivery, and breastfeeding
To measure vitamin A deficiency in women and children, and to measure anaemia in women,
men, and children
To measure key education indicators including school attendance ratios and primary school
grade repetition and dropout rates
To collect information on the extent of disability
To collect information on the extent of gender-based violence.
A Technical Working Committee with membership from the MoH, UBOS – Directorate of
Population and Statistics, POPSEC, MoGLSD – Probation and Social Welfare Department, MoES,
WHO, UNICEF, UNFPA, USAID shall be responsible for development of the general scope,
methodology and workplan for the UDHS-5. It will also provide technical guidance on development
of the survey instruments; oversee data collection, analysis, report writing, quality assurance,
dissemination and presentation of the survey results. The main survey (field operations) i.e. data
collection entry, analysis and report writing shall take place from May 2011 to May 2012.
To ensure better understanding and use of these data, the results of this survey shall be widely
disseminated at different planning levels.
4.2.2 The Uganda National Panel Survey

The Uganda National Panel survey (UNPS), which is carried out annually over a period of 12
months, is one of the household surveys that shall be carried out by UBOS. The UNPS aims at
producing annual estimates of outcomes and outputs in the key policy areas as well as providing a
platform for the experimentation and assessment of national policies and programs. The survey
collects information on Socio-economic characteristics at household, individual and community
levels.
The survey objectives are;

i) To provide information required for monitoring the National Development Strategy of
major programs.
ii) To provide high quality nationally representative information on income dynamics at the
household level.
iii) To provide a framework for policy oriented analysis and capacity building.
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This survey provides data on two core HSSIP indicators; the contraceptive prevalence rate and
health worker absenteeism. The survey covers all districts in the country and the sample provides
estimates at national level; rural-urban level; and regional level. Analysis and dissemination of the
findings will be carried out by UBOS and report availed to the MoH by October every year.
4.2.3 The Uganda National Household Survey

The UBOS carries out an integrated household survey, popularly known as Uganda National
Household Survey (UNHS) every other year (May to April) since the late 1980s. The UNHS is the
main source of statistical information for monitoring poverty levels, trends and related welfare issues.
The objectives of the survey are;

i) To provide information on selected socio-economic characteristics of the population
ii) To meet data needs of users for MDAs and other collaborating Institutions, donors as well as the
NGO community so as to monitor the progress of their activities and interventions.
iii) Generate and build social and economic indicators to monitor the progress made towards social
and economic development goals of the country.
The survey covers all districts in Uganda and the sample provides estimates at national level, rural
and urban levels, regional level and Kampala district. The survey provides findings on prevalence of
illness, type of illness suffered, days lost due to illness, type of treatment sought, distance to the
health facilities; usage of mosquito nets and prevalence of Non-Communicable Diseases (NCDs)
among others. The socio-economic data collected also provides indicators on household
expenditures include consumption and non-consumption expenditures. The health sector is thus able
to estimate the % of household experiencing catastrophic health expenditures from the UNHS. The
last survey was carried out in 2009/10 and subsequent surveys will be carried out every two years.
4.2.4 National Service Delivery Survey (NSDS)

The NSDS surveys are designed by the Ministry of Public Service of the Republic of Uganda and
implemented by the UBOS as the primary investigator. Other producers are: the Inter-Ministerial
Steering Committee, Cabinet of Uganda, Oversight policy direction and the
Inter-Ministerial Technical Committee, Cabinet of Uganda, Technical Input and coordination. The
NSDS is carried out every four years (2000, 2004 & 2008) to monitor and evaluate the delivery of
public services and to obtain feedback from service recipients, regarding their efficiency and
effectiveness. The NSDS has been institutionalized by Government as a key instrument to that
effect. The overall objective of this survey is to provide a comprehensive assessment of the trends in
service delivery in the areas of Health, Education, Justice, Law and Order, Agricultural services,
Transport services (Road Infrastructure and Water transport), Energy use, Water and Sanitation,
Public Sector Management and Accountability. The specific objectives are to: provide up to date
information about the performance and impact of selected public services at national and local
governments levels; measure changes in service delivery in selected sectors; identify constraints and
gaps in the provision of selected public services by sectors; provide recommendations for
improvement in service delivery; generate and disseminate information about the services offered by
selected government sectors.
The study is conducted in all regions of Uganda. The scope of the NSDS includes;
- HOUSEHOLD: Household and housing characteristics, household listing, immunization for
children aged 5 years and above, water and sanitation, household use of health services,
education, and other service delivery issues.
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- DISTRICT: Service delivery by institutions and accountability in institutions.
- SUB COUNTY: Children's characteristics, birth registration and early learning, vitamin A,
breastfeeding, care of illness, malaria, immunization, and anthropometry, with an optional
module for child development.
4.3 Health Research and Evidence Generation

The HSSP II MTR acknowledges that a lot of research is conducted in Uganda. The results of these
studies are intended to inform decision making hence contribute to improving delivery of and access
to health care and nutrition services. Operational surveys shall be carried as planned on approval by
the relevant institutions and findings disseminated through the existing structures. Operational
research shall encompass a wide range of problem-solving techniques and methods applied in the
pursuit of improved decision-making and efficiency. The UNHRO shall be responsible for
coordinating all the health related research in Uganda. The Secretariat will be responsible for
mobilizing resources, setting, updating and disseminating health services research agenda,
commissioning and organizing health research in collaboration with other research and academic
institutions and NGOs.
The QAD shall coordinate the sharing of research findings in the MoH by liaising with research
institutions, universities and UNHRO which is a member of the SMER TWG. Local Governments
and Institutions will be responsible for identifying research focal persons in each department /
programme / Regional Referral Hospitals. The DHO will promote and coordinate research at district
and lower levels.
4.4 Knowledge Management
One of the recommendations that arose from the comprehensive analysis of the HSSP II was to
undertake a comprehensive knowledge management approach in the sector. This should guide a
comprehensive look at information needs, analysis and use to better guide decision making for
health. The definition of a comprehensive performance monitoring approach for the sector, using
input, output, outcome and impact indicators as outlined in the HSSIP M&E Plan should be able to
generate adequate information for analysis and use. Data and information generated at all levels of
the sector and from different sources will be shared, translated and applied for decision making
during routine monitoring, periodic sector performance review, planning, resource mobilisation and
allocation, accountability, designing disease specific interventions, policy dialogue, review and
development.
Effective knowledge management will be based on the following assumptions; first all relevant data
will be aggregated, synthesized and analyzed for use at various levels of the sector. Second is that all
reports produced through M&E activities, once approved, will be made easily accessible and in a
timely manner to all stakeholders, including OPM, Parliament and citizens, in respect of the Access
to Information Act. Thirdly all M&E results users should be able to translate and use the
data/information for decision making, policy dialogue, review and development.
Figure 7: The knowledge management process
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4.4.1 Use of Knowledge / Translation and Application
The objective of establishing M&E systems is to produce evidence of performance and results which
can inform public policy and ensure the good stewardship of resources. Knowledge needs to be
contextualized to be meaningful, which is why identifying and prioritizing needs of the decision
makers and communities is essential. “Knowledge mapping” (assets, flows and gaps) at all levels will
be used as a means to guide knowledge management work. The MoH will develop tools and
methods for scaling up knowledge translation efforts.
The main users within the health sector comprise MoH management, programs, LGs, health
facilities, local and international partners and agencies. Those outside the health sector include
Cabinet, Parliament, other Ministries/departments such as MoFPED, UBOS, MoLG, MoES, Health
training institutions, individual researchers/students and the general public among others.
Sector Performance Review

Performance review at all levels of the sector will utilize data generated under the sector M&E
framework. This shall include administrative reports, HMIS reports, OBT reports, survey reports
among others.
Planning
On annual basis achievements, best practices and challenges in previous year will be used to identify
priorities for the subsequent year, set new targets for the BFP, Annual Workplan, OBT key
performance indicators and annual JAF indicators and actions.
The MTR performance shall be used to review the HSSIP core indicators for the remaining HSSIP
2010/11 – 2014/15 implementation period. The End Term Evaluation findings shall guide the
development of the subsequent HSSIP.
Resource Mobilization and Allocation

The MoH will move towards evidence based priority setting to guide more effective and efficient
resource allocation levels, rather than proportionate allocation of resources. Currently the MoH uses
a formula that that takes into consideration the population size, infant mortality rate, poverty index
and geographical location (such as border Districts, islands and mountainous terrain) when allocating
resources within the health sector.
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Accountability
i) All departments, institutions and LGs will be held accountable for the achievement of targets set
and agreed upon annually as documented in policy statements and framework papers. These will,
where appropriate, include targets linked to client charters and service delivery standards.
Performance information for departments, institutions and LGs against set targets will be scored,
and institutions will be benchmarked. Success and failure to achieve set targets, upon review, will
impact upon the resources provided to the accountable institution in future budget rounds.
ii) All accounting officers will be held accountable for the use of resources set out in their
Performance Contracts with MoFPED. Failure to account adequately for such resources will
result in sanctions in accordance with Public Finance and Accountability Act and other laws.
iii) All Hospital Directors will be held accountable for the achievement of targets set and agreed
upon in their Performance Contracts with the MoPS. These Contracts will pertain to targets
reflecting adherence to Public Service Code of Conduct and Ethics, and to the contribution to
institutional results linked where appropriate to Client Charters and service delivery standards.
Success and failure to achieve set targets, upon performance appraisal, will impact upon the
individual through the reward and recognition scheme, and in professional career advancement.
Policy Dialogue, Review and Development

Midterm review of the NHP II will be guided by the HSSIP 2010/11 – 2014/15 end term evaluation
report. Other programme specific policy reviews and development will be guided by M&E findings
during periodic reviews, programme evaluations and research findings during the HSSIP
implementation period.
Figure 8: Translating knowledge into policy and action
The HPAC is responsible for discussing health policy and advise on the implementation of the
HSSIP. At national level policy issues / problems are raised through reports presented by SMC to
HPAC which meets every two months. At sub-national level technical committees will be
responsible for generating policy issues / problems for discussion during the TPC meetings and
forwarding to the respective Local Council Committees. The Local Council Committees will be
responsible for analyzing and making policy recommendations to the District / Sub-county Council.
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The MoH will develop a comprehensive approach for translating knowledge into policy and action.
4.4.2 Decision Support Tools and Approaches

Appropriate decision support tools and approaches such as health summary bulletins, health status
report cards, and color coded data presentation techniques will be used to package information for
policy / decision makers. Emphasis will be placed on linking numbers, tables, graphs and charts to
the specific programmatic decisions facing the decision maker.
Health summary bulletins will be used targeted to program managers and other decision makers
with in-depth knowledge of the specific program area. They are an important way to display
synthesized data that provides an overall picture of the health status in the country. The information
is usually presented in tables and graphics with some explanatory text.
Health status report cards will be used to report on core HSSIP indicators or key program areas.
The cards will enable comparison of current progress to set targets or to past trends. This will
provide decision makers with an at-a-glance indication of whether or not a specific service or health
indicator needs attention.
Policy briefs highlight actionable recommendations for decision-making in a 2-6 page format. They
will be used for conveying specific evidence-based policy recommendations to policy makers. The
format should identify a problem, propose a solution and present a compelling and feasible
recommendation. Non-academic language is used and images, quotes, photographs, and bullets are
recommended. The supporting evidence should be highlighted.
Color coding is a technique that allows decision makers to see at a glance, if action is required
around a specific indicator. This technique has been used in assessing performance of the JAF
indicators. Specific numerical ranges are pre-determined for each colour (red, green and yellow), and
indicator based on progress towards a programmatic target.
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5 HSSIP 2010/11 – 2014/15 M&E Plan Implementation
Arrangements
This section describes how the health sector will undertake and coordinate M&E plan for HSSIP
2010/11 – 2014/15 implementation indicating the strategies and interventions; M&E Plan tasks;
clear roles and responsibilities.
5.1 Strategies and Key Interventions
Objective 1: To provide a health sector-wide framework for tracking progress and

demonstrating results of the HSSIP 2010/11 – 2014/15 over the medium term.
Develop a comprehensive M&E Plan for HSSIP 2010/11 – 2014/15.

Disseminate the M&E Plan for HSSIP 2010/11 – 2014/15 to the public and private health
sector.
Objective 2: To build capacity of the MoH, semi-autonomous institutions, LGs, PNFP/

Private facilities and CSOs to regularly and systematically track progress of implementation
of the HSSIP.
Recruitment and deployment of required human resource for effective M&E at all levels.
Conduct in-service training for health managers and workers in M&E.
Provide the necessary tools (M&E tools and computers) for M&E.
Carry out M&E support supervision visits
Conduct data quality audits.
Objective 3: To facilitate MoH and other stakeholders assess the health sector performance
in accordance with the agreed objectives and performance indicators to support
management for results.
Generate appropriate data for effective planning, management and delivery of health services
through the Health Information System.
Develop and disseminate the HSSIP 2010/11 – 2014/15 indicator booklet.
Objective 4: To improve compliance with government policies, and constructive

engagement with stakeholders.
Hold periodic performance review meetings at all levels.
Timely submission of reports and follow up actions
Objective 5: To facilitate continuous learning by MoH, semi-autonomous institutions, LGs

and other stakeholders during implementation of the HSSIP 2010/11 – 2014/15.
Documentation and sharing of the challenges and lessons learnt through various media.
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Dissemination of information to other stakeholders for purposes of improving management,
sharing experiences, upholding transparency and accountability.
Objective 6: Promote the use of locally generated health information.

Good practice and guidance on knowledge translation and scale-up.
Build capability in knowledge management methods in the health sector.
Promote evidence for policy and decision making.
5.2 The M&E Plan Performance Indicators
The following indicators will be used for monitoring implementation of the M&E Plan for HSSIP
2010/11 – 2014/15.
i) A comprehensive M&E plan for HSSIP 2010/11 – 2014/15 developed.

ii) Number of copies of the M&E plan disseminated to the public and private health sector.
iii) Number and % of health managers and workers trained in M&E.
iv) The proportion of implementing partners (CSOs and Private sector) contributing to periodic
reports increased to 90% by 2015.
v) Proportion of planned M&E support supervision visits carried out.
vi) Proportion of planned data quality audits conducted.
vii) Proportion of departments, programmes, semi-autonomous institutions, CSOs and health
facilities submitting timely and complete reports.
viii) Proportion of planned periodic reviews that are carried out increased to 100% by 2015.
ix) Proportion of planned performance review reports compiled and disseminated.
x) Proportion of planned surveys carried out.
xi) Proportion of planned survey reports compiled and disseminated.
xii) Number of policy / decision makers oriented in knowledge management methods.
xiii) Number of performance improvement, planning and resource allocation decisions made
based on the M&E results
xiv) Number of evidence based policy dialogues or briefs made.
5.3 The Key HSSIP M&E Plan Implementation Tasks
The key M&E plan implementation tasks will include;

i) Producing annual results oriented Ministerial Policy Statements (MPSs), linked to the
corresponding SBFPs and HSSIP.
ii) Ensuring that Units assign one or more positions responsible for statistical production,
monitoring and evaluation.
iii) Ensuring that HMIS and other data collection systems and tools are in place and functioning
iv) Training of health workers and managers in M&E.
v) Planning and budgeting for monitoring and statistics annually. A minimum of 3% of the non-
wage recurrent budget and 2% of each project budget will be allocated to monitoring.
vi) Holding quarterly performance review meetings to determine progress towards output targets.
66
vii) Providing, on a quarterly basis, data and explanatory information on progress against
performance indicators to MoFPED and OPM through the Output Budgeting Tool.
viii) Ensuring proper coordination and oversight (monitoring and supervision) of M&E activities in
the sector, in relation to the National Policy on Sector M&E policy, related strategies, norms and
guidance from OPM and other coordinating institutions.
ix) Planning and budgeting for evaluations of all projects and programmes over 70 billion shillings in
line with the rolling 5-year evaluation plan. 3% of each project budget will be allocated to
evaluation.
x) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
xi) Maintaining a Recommendation Implementation Tracking Plan which will keep track of review
and evaluation recommendations, agreed follow-up actions, and status of these actions.
xii) Ensuring that complete and approved M&E reports and health statistical data are made easily
available to the public in a timely manner, while ensuring that the sharing of reports respects the
Access to Information Act.
5.4 Key Stakeholders
There shall be a transparent and documented process to ensure input of a broad range of
stakeholders in the HSSIP monitoring and evaluation. Operationalisation of the M&E plan will
involve institutions at various levels of the health sector as outlined below.
a) Central Level: This level includes Cabinet, MoH, semi-autonomous institutions, referral
hospitals, Development Partners, (i.e. Donors, international development agencies), Private
Sector, CSOs and PNFPs operating at national level.
b) Local Government level: This level includes Districts, Sub-counties, City Council, Municipal
Councils, Division Councils, Town Councils, and Private Sector based at district level.
c) Community level: This level includes the LC III Councils (sub-county level), parishes, village
councils, private sector, CSOs and CBOs.
d) Households: This level includes individual citizens who are the primary beneficiaries of the
HSSIP activities.
5.5 Roles and Responsibilities for the HSSIP M&E Plan Implementation
The sector-wide M&E system for effective tracking, evaluation and feedback on HSSIP 2010/11 –
2014/15 implementation and results will be followed. This implies that Central Government, MoH,
LGs, DPs, CSOs and other stakeholders will be involved directly or indirectly in the M&E activities.
Consequently, a participatory approach that entails the involvement of all key actors and primary
stakeholders will be adopted. This will enable all key actors to fully internalize and own the system as
well as use the results to inform their actions. All other monitoring plans in the sector should be in
line with and input into the overall M&E plan for HSSIP 2010/11 – 2014/15 both at national and
district level.
In order to avoid over-laps, role conflicts, and uncertainty in the M&E function during the
implementation of the HSSIP, roles and responsibilities of key actors are specified below.
Cabinet/Parliament
The Sector shall work closely with the relevant committees of parliament and cabinet for;
67
i) Overall political, and policy oversight.
ii) Review of sector progress in the past year (based on the AHSPR), against the policy imperatives
set out in contribution towards the second NHP and NDP.
The health sector shall interface with parliament and cabinet whenever necessary but in any case,
following the JRM of the Health Sector.
Top Management
The sector top management will be responsible for;
i) Overall political, and policy oversight in the sector.
ii) Providing governance and partnership oversight to the sector.
iii) Reviewing of sector progress in the past year (based on the AHSPR), against the policy
imperatives set out in the second NHP and NDP.
iv) Articulating the policy direction for the sector, taking broader Government objectives into
consideration.
v) Monitoring adherence to the policy direction of the sector.
vi) Mobilizing resources for achievement of the sector policy direction
Office of the Permanent Secretary

Will work through the Office of the Director General for Health Services for guiding technical
direction.
The Director General of Health Services (DGHS): In accordance with its mandate as technical
Head of the health sector, the DGHS will be responsible;
i) Ensure that Units assign one or more positions responsible for statistical production, monitoring
and evaluation.
ii) Monitoring health sector performance and six-monthly reporting to OPM on sector
performance. This performance reporting will be based on the quarterly submissions to OPM on
progress against key actions, and outputs towards outcomes.
Health Policy Advisory Committee

HPAC is a forum for the Government, Development Partners, private sector, PNFPs, CSOs,
academia and related line ministries to discuss and advise on health policy issues and to advise on the
implementation of the HSSIP.
HPAC membership consists of: MoH, Chair of HDP, Co-Chair of HDP, WHO and one other
selected members of HDP, MoLG, NMS, MoFPED, MoES, MoPS, Private health providers, PNFP
representatives, CSO. HPAC co-opts members to address specific issues that may arise. HPAC is
chaired by the Permanent Secretary, who is the Accounting Officer of the MoH. In the absence of
the Permanent Secretary vice chair of HPAC or other designated representative will act in his/her
place.
The Quality Assurance Department (QAD): QAD will be responsible for;

i) Establishing the results framework for the HSSIP, and for ensuring that relevant
departments (and relevant non-state actors) develop results indicators that are consistent
with the HSSIP.
ii) Ensure proper coordination and oversight (monitoring and supervision) of M&E activities in
the sector, in relation to the National Policy on Sector M&E policy, related strategies, norms
and guidance from OPM and other coordinating institutions.
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iii) Training of health workers and managers in M&E.
iv) Quality assurance of the statistical and other performance monitoring reports; and surveys.
v) Organizing regular HSSIP sector review meetings.
vi) Support LGs to organize regular performance review meetings;
vii) Producing the quarterly and annual health sector performance reports,
viii) Providing on a quarterly basis, data and explanatory information on progress against
ix) Maintaining a Recommendation Implementation Tracking Plan which will keep track of
review and evaluation recommendations, agreed follow-up actions, and status of these
actions.
x) Coordinating focused evaluation on emerging concerns and impact assessment studies.
xi) Utilizing M&E findings to inform programme, policy, and resource allocation decisions;
The proposed Monitoring and Evaluation Unit will be under the QAD and will be responsible for
overall coordination and implementation of the HSSIP M&E plan. The program M&E Focal
persons/ Specialists will work under the overall stewardship of the QAD. They will be responsible
for analyzing data and assembling monitoring reports that will be reviewed and verified by Heads of
Departments before submission to the M&E Unit. The M&E unit will use the statistical information
generated by the Resource Center, administrative reports, Area Teams and Technical supervision
reports to generate and disseminate relevant sector reports.
MoH Departments/NRHs/RRHs/Semi-autonomous Institutions:

Central level bodies will be centers for performance monitoring as well as reporting on progress
against BFPs and Ministerial Policy Statements, including against the targets and actions set out in
the NDP. They will also be the direct consumers of the outputs and outcomes of this M&E strategy.
The focus of the central level M&E activities will be on service delivery, compliance with national
standards, outputs and outcomes.
i) Producing results orientated Development Plans and annual Budget Framework Papers.
ii) Ensuring proper coordination of monitoring activities at Departmental / Institutional levels.
iii) Providing timely and quality data on relevant performance indicators to the RC.
iv) Assigning one or more positions responsible for statistical production, monitoring and
evaluation.
v) Training of health workers and managers in M&E.
vi) Maintaining a Recommendation Implementation Tracking Plan which will keep track of review
vii) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Technical Working Groups and (sub) Committees

Actual technical coordination will be through the technical working groups, each focused on specific
technical areas. This will be the forum through which technical issues are debated and agreed and
specific recommendations and actions are implemented. All the technical working groups and
committees will be managed through the Senior Management Committee (SMC).
Technical Working Groups:

1. Health Sector Budget WG;
2. Human Resources WG;
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3. Health Infrastructure WG;
4. Medicines Management & Procurement WG;
5. Supervision, Monitoring & Evaluation WG;
6. Public Private Partnership for Health WG;
7. Mother and Child WG;
8. Environmental Health and Health Promotion WG;
9. National Communicable Disease Control WG;
10. Nutrition WG;
11. Non communicable Diseases WG.
The TWGs will be responsible for;
i) Tracking and coordinating the implementation of the M&E plan and promoting joint monitoring
and evaluation of the HSSIP 2010/11 – 2014/15 for the respective program areas.
ii) Participating in the JRM / NHA and preparation of the AHSPR
iii) Submitting reports for discussion during the monthly SMC meetings and policy issues submitted
for discussion in the HPAC meetings quarterly.
iv) Meeting regularly with partners to track progress of achievement of intended HSSIP 2010/11 –
2014/15 results;
v) Conducting joint field monitoring to measure achievements and constraints that impede the
realization of the HSSIP 2010/11 – 2014/15 targets;
vi) Identifying and document lessons learnt;
vii) Identifying capacity development needs, particularly in areas of monitoring and evaluation.
The Resource Center: The RC will have the primary responsibility of;
i) Coordinating and operationalizing the Health Sector Statistical System at all levels.
ii) Strengthening capacity for collection, validation, analysis, dissemination and utilization of
health statistical data at all levels;
iii) Generating health statistical data on quarterly and annual basis.
iv) Ensure that complete and approved M&E reports and health statistical data are made easily
available to the public in a timely manner, while ensuring that the sharing of reports respects
the Access to Information Act.
Districts and institutions will be required to develop Resource Centers which will serve as
repositories for health data and information at the respective levels.
The Planning Department: Will be responsible for;

i) Producing annual results oriented Ministerial Policy Statements (MPSs), linked to the
corresponding SBFPs and HSSIP.
ii) Plan and budget for monitoring and statistics annually. A minimum of 3% of the non-wage
recurrent budget and 2% of each project budget will be allocated to monitoring.
iii) Providing on a quarterly basis, data and explanatory information on progress against
iv) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Human Resources Management Unit: Will be responsible for;
70
i) Identifying and facilitating recruitment of human resources required to operationalise the
strategy. This will include recruitment of M&E specialists, as well as statisticians where they
are lacking.
ii) Operationalizing the HRIS.
iii) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Other Departments, Programs and Projects: Other Departments will be centres for performance
monitoring as well as reporting on progress against BFPs and MPSs, including against the targets and
actions set out in the HSSIP. They will also be the direct consumers of the outputs and outcomes of
this M&E plan. The focus of the MoH M&E activities will be on service delivery, compliance with
national standards, outputs and outcomes.
i) Heads of Departments will provide oversight for monitoring implementation of work plans
and preparation of quarterly and annual performance reports.
ii) Training of health workers and managers in M&E.
iii) Providing timely and quality data on relevant performance indicators to MoH and relevant
stakeholders.
iv) Sector Working Groups will participate in; preparation of health sector strategic and
investment plans; Mid- and end-term evaluation of HSSIP; preparation for AHSPR,
JRMs/NHA.
v) Maintaining a Recommendation Implementation Tracking Plan which will keep track of
actions.
vi) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Regional Level: The detailed structure at the regional level will be outlined after it has been
determined through an authentic and agreed process. The regional level will be responsible for;
i) Overall coordination of monitoring and evaluation in the region.
ii) Liaison between national level, and the districts on M&E.
iii) Supporting the development and implementation of the M&E plans of the districts and
RRH in the region.
iv) Monitoring and reviewing the implementation of the M&E plans in the region by compiling
and analyzing quarterly and annual reports.
v) Maintaining a Recommendation Implementation Tracking Plan which will keep track of
actions.
vi) Supporting research activities.
Local Governments (Districts): Will be responsible for;

i) Producing results orientated LG Development Plans and annual Budget Framework Papers.
ii) Ensuring proper coordination of monitoring activities at District and Lower Local Government
(LLG) levels.
iii) Training of health workers and managers in M&E.
iv) Providing timely and quality data on relevant performance indicators to MoLG, MoFPED and
MoH.
v) Ensuring that all Local Government Planning Units assign one or more positions responsible for
health statistical production, monitoring and evaluation.
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vi) Maintaining a Recommendation Implementation Tracking Plan which will keep track of review
vii) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
The district Biostastician shall work together with the district planning unit to ensure production of
district statistics and reports.
The Office of the Auditor General (OAG): Will be responsible;

i) Carrying out audits and providing reports on public accounts of all public offices and any public
corporation or other bodies established by an Act of Parliament.
ii) Conducting financial, value for money and other audits, such as gender and environment audits,
in respect of any project or activity involving public funds.
Development Partners (i.e. Donors, International Development Agencies): Will be responsible

for;
i) Providing an external perspective on the health sector performance and results.
ii) Participation in the refinement of indicators, tools and processes.
iii) Integration of development partners‟ monitoring frameworks into Government systems
iv) Providing feedback to domestic and international constituencies on health sector performance
and results
v) Assisting the health sector through financial, technical and other forms of assistance to
strengthen M&E performance.
vi) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Other executing agencies (CSOs and Private sector): The role of the private sector in the
implementation of the HSSIP M&E strategy will be;
Contribution in the development of and adherence to the necessary M&E standards.
i) Participating in public sector planning processes at Local Government and sector level.
ii) Providing quarterly performance reports and quality data to the relevant programme managers /
focal persons at national and district level. These will be compiled as part of departmental reports
to be reviewed by relevant working groups for onward transmission to SMC or District
Technical Planning Committee (TPC).
iii) Participating in discussion and decision-making committees at programme, sector and national
levels that review and comment on public sector performance.
iv) Maintaining a Recommendation Implementation Tracking Plan which will keep track of review
v) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
The CSO umbrella body will play a coordination role in monitoring all CSOs to ensure alignment
with national priorities.
Local Councils: Will be responsible for;

i) Overseeing monitoring activities at District and Lower Local Government (LLG) levels.
ii) Ensuring that the District administration and LLG adheres to the M&E plan.
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iii) Maintaining a Recommendation Implementation Tracking Plan which will keep track of review
iv) Utilizing M&E findings to inform programme, policy, and resource allocation decisions.
Community Level Actors: These comprise Local Councils III (sub-counties), community based
CSOs, administrative units at parish level, and village councils.
Their role is;
i) To provide information on; i) delivery of various services, ii) transparency and accountability of
resources accorded; and iii) challenges and gaps experienced in delivery of various services.
ii) They will also validate outcomes of implementation of the HSSIP in their respective areas.
iii) Communities will also be engaged in the review process using participatory appraisal mechanisms
like focus group discussions and community meetings “barazas” using guidelines provided by
OPM.
Households Actors: These comprise individual citizens and constitute the primary beneficiaries of
the HSSIP strategies and initiatives. The role of the citizens within the M&E strategy is to provide
information on HSSIP implementation and delivery of target outputs as well as validate results
thereof.
Village Health Team (VHT)

The VHT is defined for each village in the country, to guide discussion on health and health related
issues affecting their community.
The VHT shall use data from the Community HMIS to discuss performance within the community,
and agree on priorities to focus on. A standard planning, and reporting format, tools and process will
be provided to the VHT, to guide them in their deliberations.
Uganda Bureau of Statistics (UBOS): Will be responsible for;

i) Coordinating, supporting, validating and designating as official any statistics produced by UBOS,
MDAs and LGs.
ii) Coordinating and clearing all censuses and nationally representative household economic
surveys.
iii) Ensuring production, harmonization and dissemination of statistical information.
iv) Strengthening statistical capacity of planning units in MoH and LGs for data production and use.
v) Ensuring best practice and adherence to standards, classifications, and procedures for statistical
collection, analysis and dissemination in MoH and LGs.
vi) Ensuring that complete and approved M&E reports and health statistical data are made easily
available to the public in a timely manner, while ensuring that the sharing of reports respects the
Access to Information Act.
Research activities by academic institutions that are related to the M&E discipline will also contribute
in this regard.
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5.6 M&E Calendar for HSSIP 2010/11 – 2014/15 Plan Implementation
The M&E Calendar for HSSIP 2010/11 – 2014/15 is given in Table 11. The Calendar has been provided to enhance coordination of M&E activities and
shows the activities, responsible persons, frequency and means of verification of the outputs.
Table 12: M&E Calendar for HSSIP 2010/11 – 2014/15
Activity Responsible 2010/11 2011/12 2012/13 2013/14 2014/15 Means of

Person/Department verification
Compilation Weekly surveillance data Surveillance Focal Monthly Monthly Monthly Monthly Monthly HMIS 033c
and Person
submission of
reports Weekly Maternal and Perinatal Death Health Unit I/C Monthly Monthly Monthly Monthly Monthly MPDR Reports
Audit and Review
Monthly Administrative data All Managers Monthly Monthly Monthly Monthly Monthly Record of Meetings
Record of
supervision
Monthly health unit HMIS Health Unit I/C Monthly Monthly Monthly Monthly Monthly HMIS 105
HMIS 108
Monthly HSD HMIS HSD I/C Monthly Monthly Monthly Monthly Monthly HMIS 123
HMIS 124
Monthly District HMIS DHO Monthly Monthly Monthly Monthly Monthly HMIS 123
HMIS 124
Monthly sector HMIS ACHS, RC Monthly Monthly Monthly Monthly Monthly HMIS Data base
Monthly programme / project (GFATM, Programme / Project Monthly Monthly Monthly Monthly Monthly Programme /
GAVI, UHSSP, PLMP, SHHIP, GSF, etc) Managers Project data base
Monthly Supply Chain Management ACHS, Pharmacy Monthly Monthly Monthly Monthly Monthly SCM Reports
Quarterly Administrative All Managers Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly health unit assessment Health Facility Manager Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, HMIS 106
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Quarterly HSD assessment HSD Manager Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, HMIS 106
Quarterly District assessment DHO Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, HMIS 129
Quarterly LG Financial performance DHO Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Quarterly LG OBT
Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr Reports
Quarterly Sector assessment (HMIS) ACHS RC Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Quarterly Supply Chain Management ACHS, Pharmacy Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Quarterly SCM
Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr Reports
Quarterly Central Level Financial AC, Budget and Finance Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Quarterly CG OBT
performance Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr Reports
Compile Annual Health Unit performance Health Facility Manager July July July July July HMIS 107
report
Compile Annual HSD performance report HSD I/C July July July July July HMIS 129
Compile Annual LG Financial DHO July July July July July Annual LG OBT
performance Report
Annual District performance report (HMIS) DHO July July July July July HMIS 128
Annual programme / project reports Programme Managers July July July July July Programme /
(GFATM, GAVI, UHSSP, PLMP, SHHIP, Project Reports
GSF, etc)
Annual Central Level Financial AC BF & ACHS QA July July July July July Annual CG OBT
performance report Report
Annual Sector Statistical Report ACHS RC Sept Sept Sept Sept Sept Annual sector
Statistical Report
75
Annual Supply Chain Management report Assistant Commissioner, July July July July July Annual SCM Report
Pharmacy
Annual health sector performance report AHSPR Task Force Sept Sept Sept Sept Sept AHSPR Report
Progress of implementation of All Commissioners, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Minutes
programmes / projects during TWG Institutional Managers Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
meetings / SMC meetings and Programme
Managers
National Staffing Levels (Human Resource ACHS (HRD) April, Oct April, Oct April, Oct April, Oct April, Oct HRH Reports
Information System)
Progress of implementation of workplans, Director Planning Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, OBT Reports
BFP and MPS implementation and report Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr JAF Reports
to MoFPED & OPM
Progress of implementation to WHO as a Global Health Desk Jan Jan Jan Jan Jan Report
member state Officer
Progress of Implementation of HMC Global Health Desk April April April April April Reports
Resolutions to the ECSA Health Officer Sept Sept Sept Sept Sept
Community Secretariat
Progress of Implementation of World Global Health Desk May May May May May Progress Report
Health Assembly Resolutions Officer
Progress of Implementation of Africa Global Health Desk Sept Sept Sept Sept Sept Progress Report
Region WHO Assembly Resolutions Officer
Progress of Implementation of IHP+ Global Health Desk Nov Nov Nov Nov Nov Progress Report
Resolutions Officer
Progress of Implementation of other Global Health Desk Ongoing Ongoing Ongoing Ongoing Ongoing Progress Report
Commitments / Resolutions Officer
Data Quality Health Facility Data verification Facility Manager Monthly Monthly Monthly Monthly Monthly Signed Reports
Assurance
HSD Data verification HSD Manager Monthly Monthly Monthly Monthly Monthly Signed Reports
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District Data verification DHO Monthly Monthly Monthly Monthly Monthly Signed Reports
District Data Quality Audit ACHS RC Jan, Apr, Jan, Apr, Jan, Apr, Jul Jan, Apr, Jan, Apr, Jul DQA
Jul Jul Jul
Rapid Data Quality Assessment ACHS QA August August August August August RDQA Reports
Data Quality Assessment and Adjustment University August August DQAA Reports
Data Quality Audit for HSSIP evaluation CHS QA July July DQA Reports
studies
Data Quality Audit for health systems Institutional Review Ongoing Ongoing Ongoing Ongoing Ongoing DQA Reports
research Boards
Feedback Routine feedback to all reporting entities All Facility / M&E Officers Ongoing Ongoing Ongoing Ongoing Ongoing Feedback reports
on reports submitted to higher levels
Routine feedback to sub-national and key ACHS RC Sept, Dec, Sept, Dec, Sept, Dec, Sept, Dec, Sept, Dec, Feedback reports
stakeholders on reports submitted to Mar, Jun Mar, Jun Mar, Jun Mar, Jun Mar, Jun
Resource Center
Performance Quarterly Village Health Team Review VHT Chairperson Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Reviews meetings Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly Health Facility Stakeholders’ Health Facility Manager Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Review meetings Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly Sub County Stakeholders’ Sub Count Chief Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Review meetings Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly HSD Stakeholders’ Review HSD Manager Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
meetings Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly District Stakeholders’ Review DHO Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Quarterly Regional Stakeholders’ Review Area Team Chairperson Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Quarterly Sector Performance review CHS QAD Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
Technical Review Meeting CHS P April April April April April Reports
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National Health Accounts CHS P July July July July July Report
Joint Review Mission DGHS Sep Sep Sep Sep Sep Aide Memoire
National Health Assembly DGHS Sep Sep Sep Aide Memoire
Conduct Service Availability Readiness CHS QA Jul to Aug Jul to Aug Jul to Aug Jul to Aug Jul to Aug Report
Surveys Assessment
HIV/AIDS Epidemiological Surveillance PM ACP Ongoing Ongoing Ongoing Ongoing Ongoing Report
HIV/AIDS Indicator Survey ACHS CD Feb to Jun Report
Availability of the six tracer medicines Pharmacy Division Aug Aug Aug Aug Aug Report
study
Malaria indicator survey PM MCP Nov to Dec Nov to Dec Report
National TB Prevalence Survey PM NTLP Jan to June Report
Health Facility Client Satisfaction Surveys Facility QI Focal Person Dec, Jan Dec, Jan Dec, Jan Dec, Jan Dec, Jan Reports
National Client Satisfaction Survey QAD Jan to Mar Jan to Mar Reports
Non-Communicable Diseases Survey PMO NCD Jan to Jun Report
Uganda Demographic Health Survey-5 UBOS Nov to May UDHS-5 Report
Uganda National Panel Survey UBOS Annual Annual Annual Annual Annual Report
Uganda National Household Survey UBOS Annual Annual Annual Annual Annual Report
National Service Delivery Survey UBOS Jul to Dec Jan to Jun Report
Health Thematic case studies Researchers Ongoing Ongoing Ongoing Ongoing Ongoing Case studies
Research &
Evidence Operational Research Managers Ongoing Ongoing Ongoing Ongoing Ongoing Reports
Generation
Evaluations Specific program / project evaluations Programme Managers Ongoing Ongoing Ongoing Ongoing Ongoing Reports
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HSSIP Mid Term Review DGHS Sept to April MTR Report
HSSIP End Term Evaluation Policy Analyst Jan to Jun ETR Report
Dissemination Weekly surveillance bulletins CHS NDC Weekly Weekly Weekly Weekly Weekly Weekly surveillance
bulletins
disseminated
Health statistical reports – quarterly, ACHS RC Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Statistical reports
annual Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
Quarterly sector performance reports ACHS QA Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Quarterly review
Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr reports
Annual Health Sector Performance Report DGHS Sept Sept Sept Sept Sept AHSPR reports
Mid-Term Review Report DGHS Sept Reports

End Term Evaluation Report PS Sept ETR Reports
Survey Reports Research Institutions / Ongoing Ongoing Ongoing Ongoing Ongoing Reports
Programmes
Health Research UNHRO Ongoing Ongoing Ongoing Ongoing Ongoing Reports
Capacity Printing of the HSSIP 2010/11 - 2014/15 ACHS QA July M&E Plan
Building M&E Plan
Printing of the HSSIP 2010/11 - 2014/15 ACHS QA Aug Implementation
M&E Plan Implementation guide guide
Develop and print an indicator booklet ACHS QA July Indicator booklet
Launching and Dissemination of the PS Oct Report

HSSIP M&E Plan at national level
Orientation and Dissemination of the M&E ACHS QA Oct to Mar Reports
Plan at district level
Conduct in-service training for managers All Managers Ongoing Ongoing Ongoing Ongoing Reports
and HWs on knowledge management
79
(Regional workshops)
Print and disseminated M&E Newsletters M&E Focal Persons Ongoing Ongoing Ongoing Ongoing Ongoing Newsletters
Office equipment and furniture for M&E Responsible Officer Ongoing Ongoing Inventory
Units at Central and Regional Level
M&E Plan SMER TWG monthly meetings DHS P&D Monthly Monthly Monthly Monthly Monthly Minutes
Monitoring &
Evaluation M&E committee meetings M&E Officer Monthly Monthly Monthly Monthly Monthly Minutes
Compile quarterly M&E plan M&E Officer Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Jul, Oct, Reports
implementation reports Jan, Apr Jan, Apr Jan, Apr Jan, Apr Jan, Apr
M&E technical supervision to Institutions M&E Officer Aug, Nov, Aug, Nov, Aug, Nov, Aug, Nov, Aug, Nov, Supervision reports
and LGs Feb, May Feb, May Feb, May Feb, May Feb, May
Midterm and end M&E plan evaluation Jan to Mar Jan to Mar Reports
80
5.7 Monitoring the Implementation of the HSSIP M&E Plan
Existing sector M&E structures will be used for monitoring implementation of the HSSIP 2010/11 –
2014/15 M&E plan. Support supervision, meetings and periodic reports will be used for monitoring
at the various levels as outlined below.
At national Level:
1. Monthly M&E Unit meetings will be carried out to track progress on implementation of the
M&E Plan.
2. Quarterly M&E technical supervision to institutions and LGs.
3. Quarterly M&E progress reports to be presented at the sector review meetings.
4. Mid-term and end evaluation of the HSSIP 2010/11 – 2014/15 M&E plan
At district Level:
1. Monthly District Health Team Meetings to track progress on implementation of the district
M&E plan.
2. Quarterly supervision to Health Sub-Districts.
3. Quarterly district M&E progress reports to be presented at district performance review meetings.
At Health Sub-District level:

1. Monthly HSD Team Meetings to track progress on implementation of the HSD M&E plan.
2. Quarterly supervision to health facilities.
3. Quarterly HSD M&E progress reports to be presented at HSD performance review meetings.
At facility level:
1. Monthly health facility meetings to track progress on implementation of the facility M&E plan.
81
6 Budget
Cost estimates for implementation of the M&E plan are based on the HSSIP costs estimates for
monitoring, evaluation, knowledge management and operational research/ studies. Costs for
managing the health information systems are captured under the MoH/Resource Centre and
respective health information systems (HRIS, SCMS, IFMS) budgets. Over the 5-year period, an
estimated total of 44 billion shillings would be spent on monitoring and evaluation. Of this 5-year
total, operational research would take up 40%, and performance reviews would take 34%.
Table 13: Estimated Cost of M&E and Knowledge Management
Amount (Ug. Shs. ‘000)

Activity 2011/11 2011/12 2012/13 2013/14 2014/15 Total
Compilation and submission
of performance reports 215,068 220,445 225,956 231,605 237,395 1,130,470
Data Quality Assurance 112,092 114,894 147,767 120,711 155,229 650,692
Feedback 560 574 588 603 618 2,944
Performance Reviews 2,961,200 2,676,275 3,110,892 2,811,761 3,268,151 14,828,279
Surveys 2,332,650 5,937,966 2,443,915 6,520,013 366,264 17,600,809
Evaluations 200,000 200,000 400,000 200,000 430,000 1,430,000
Dissemination 647,600 663,790 700,385 697,394 734,829 3,443,998
Capacity Building for M&E 365,940 1,597,613 476,253 178,199 182,654 2,790,659
M&E Plan Monitoring & 359,000 367,975 427,174 386,604 446,269 1,987,022
Evaluation
7,216,265 11,825,611 7,980,161 11,195,303 5,871,031 44,078,371
TOTAL
The budget for the HSSIP M&E plan implementation will be contributed to by the responsible
departments, programmes and stakeholders. The respective national and sub-national level programs
and institutions will budget for the their M&E activities.
82
Table 14: HSSIP 2010/11 – 2014/15 M&E Plan Implementation Budget
Activity Responsible Output Target Unit Cost No. of Amount Ushs. '000 Total Source of
Person / Indicator per Ushs '000 Units Funding
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Compilation Weekly surveillance Health Unit No. of IDSR 52 0.10 3,550 18,460 18,922 19,395 19,879 20,376 97,032 MoH / LG
and submission data I/C reports
of performance submitted
reports Maternal and Perinatal Health Unit No. of MPD 52 0.40 143 2,974 3,049 3,125 3,203 3,283 15,634 MoH / LG
Death Notification and I/C Notification
Review Reports from reports
hospitals and HC IVs
Monthly Administrative All Managers No. of reports 12 2.00 3,550 85,200 87,330 89,513 91,751 94,045 447,839 MoH / LG
data (minutes,
supervision
reports,
attendance)
Monthly health unit Health Unit No. of monthly 12 0.75 3,550 31,950 32,749 33,567 34,407 35,267 167,940 MoH / LG
HMIS I/C HU HMIS
reports
Monthly HSD HMIS HSD I/C No. of monthly 12 0.75 190 1,710 1,753 1,797 1,841 1,888 8,988 MoH / LG
HSD HMIS
reports
Monthly District HMIS DHO No. of monthly 12 0.50 120 720 738 756 775 795 3,785 MoH / LG
district HMIS
reports
Monthly sector HMIS Biostastician No. of monthly 12 0.50 1 6 6 6 6 7 32 MoH / LG
sector HMIS
reports
Monthly programme / Programme / No. of monthly 12 0.50 12 72 74 76 78 79 378 Project
project (GFATM, Project project reports
GAVI, UHSSP, PLMP, Managers
SHHIP, GSF, etc)
83
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Monthly Supply Chain NMS No. of monthly 12 2.00 1 24 25 25 26 26 126 NMS
Management SCM reports
Quarterly All Managers No. of Qrtly 4 2.00 3,550 28,400 29,110 29,838 30,584 31,348 149,280 MoH / LG /
Administrative reports CSOs
Quarterly health unit Health Unit No. of Qrtly 4 0.20 3,500 2,800 2,870 2,942 3,015 3,091 14,718 MoH / LG
assessment I/C reports
Quarterly HSD HSD I/C No. of Qrtly 4 0.75 190 570 584 599 614 629 2,996 MoH / LG
assessment reports
Quarterly District DHO No. of Qrtly 4 0.50 120 240 246 252 258 265 1,262 MoH / LG
assessment reports
Quarterly LG DHO No. of Qrtly 4 0.30 120 144 148 151 155 159 757 MoH / LG
performance (OBT) reports
Quarterly Sector Resource No. of Qrtly 4 0.50 1 2 2 2 2 2 11 MoH / LG
assessment (HMIS) Center reports
Quarterly Supply NMS No. of Qrtly 4 2.00 1 8 8 8 9 9 42 NMS
Chain Management reports
Quarterly Central ACHS (B) / No. of Qrtly 4 2.00 1 8 8 8 9 9 42 MoH / LG
Level performance ACHS QA reports
(OBT)
Report on National ACHS (HRD) No. of 1 15.00 500 7,500 7,688 7,880 8,077 8,279 39,422 MoH / LG
Staffing Levels biannual and
(Human Resource annual reports
Information System)
Compile & submit Health Unit No. of annual 1 0.40 3,550 1,420 1,456 1,492 1,529 1,567 7,464 MoH / LG
Annual Health Unit I/C reports
performance report
Compile Annual HSD HSD I/C No. of annual 1 1.00 190 190 195 200 205 210 999 MoH / LG
performance report reports
84
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Compile Annual LG DHO No. of annual 1 1.00 120 120 123 126 129 132 631 MoH / LG
performance (OBT) reports
Compile Annual DHO No. of annual 1 5.00 120 600 615 630 646 662 3,154 MoH / LG
District performance reports
report (HMIS)
Compile Annual Programme No. of annual 20 15.00 10 3,000 3,075 3,152 3,231 3,311 15,769 Project
project reports Managers reports
(GFATM, GAVI,
UHSSP, PLMP,
SHHIP, GSF, etc)
Compile & submit ACHS BF / No. of annual 20 10.00 1 200 205 210 215 221 1,051 MoH / LG
Annual Central Level ACHS QA reports
performance report
(OBT)
Compile & submit Biostastician No. of annual 10 15.00 1 150 154 158 162 166 788 MoH / LG
Annual sector HMIS reports
report
Compile & submit NMS No. of annual 1 5.00 200 1,000 1,025 1,051 1,077 1,104 5,256 NMS
Annual Supply Chain reports
Management report
Compile & submit DHS P&D No. of annual 1 20.00 1,000 20,000 20,500 21,013 21,538 22,076 105,127 MoH
Annual health sector reports
performance report
Compile & submit All No. of reports 12 0.00 11 0 0 0 0 0 0 MoH
progress reports for Implementers
programmes / projects
for TWGs
Compile progress Secretaries No. of reports 12 0.00 1 0 0 0 0 0 0 MoH
reports for SMC TWGs
85
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Compile report s for HPAC No. of reports 6 0.00 1 0 0 0 0 0 0 MoH
HPAC Secretariat
Compile & submit ACHS BF / No. of reports 4 10.00 30 1,200 1,230 1,261 1,292 1,325 6,308 MoH / LG
progress report on ACHS QA to OPM /
implementation of MoFPED
workplans, BFP and
MPS to MoFPED &
OPM (OBT)
Compile & submit Global Health No. of WHO 1 5,000.00 1 5,000 5,125 5,253 5,384 5,519 26,282 MoH
statistical report to Desk Officer Reports
WHO as a member
state
Compile & submit Global Health No. of ECSA 2 5.00 50 500 513 525 538 552 2,628 MoH
progress report on Desk Officer Reports
implementation of
HMC Resolutions to
the ECSA Health
Community
Secretariat
Compile & submit Global Health WHA 1 5.00 30 150 154 158 162 166 788 MoH
progress report Desk Officer progress
Implementation of report
World Health
Assembly Resolutions
Compile & submit Global Health WHO 1 5.00 30 150 154 158 162 166 788 MoH
report on Desk Officer Assembly
implementation of Report
Africa Region WHO
Assembly Resolutions
86
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Compile & submit Global Health IHP+ Report 1 5.00 30 150 154 158 162 166 788 MoH
progress report on Desk Officer
implementation of
IHP+ Resolutions
Compile & submit Global Health Progress Assorte 5.00 90 450 461 473 485 497 2,365 MoH
progress report on Desk Officer reports d
implementation of
other Commitments /
Resolutions
Subtotal 215,068 220,445 225,956 231,605 237,395 1,130,470
Data Quality Health Facility Data Biostastician No. of reports 4 104.00 112 46,592 47,757 48,951 50,174 51,429 244,903 Unfunded
Assurance Quality Audit -
quarterly
District Data Validation ACHS RC No. of reports 4 655.00 20 52,400 53,710 55,053 56,429 57,840 275,432 MoH
in selected districts -
quarterly
Annual Rapid Data ACHS QA No. of reports 1 655.00 20 13,100 13,428 13,763 14,107 14,460 68,858 Unfunded
Quality Assessment
Data Quality University No. of reports 1 30,000.00 1 0 30,000 31,500 61,500 Unfunded
Assessment and
Adjustment
Subtotal 112,092 114,894 147,767 120,711 155,229 650,692
Feedback Routine feedback to ACHS RC No. of 4 1.00 140 560 574 588 603 618 2,944 MoH
sub-national and key feedback
stakeholders on reports to all
reports submitted to stakeholders
Resource Center -
Quarterly
Subtotal 560 574 588 603 618 2,944
87
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Performance Quarterly Village VHT No. of 4 0.00 5,000 0 0 0 0 0 0
Reviews Health Team Review Chairperson meetings
meetings
Quarterly Health Health Facility No. of 4 5.00 25,130 502,600 515,165 528,044 541,245 554,776 2,641,831 Unfunded
Facility Stakeholders’ In Charge meetings
Review meetings
(HUMCs)
Quarterly Sub County Sub County No. of 4 0.00 1,117 0 0 0 0 0 0
Stakeholders’ Review Chief meetings
meetings
Quarterly HSD HSD In No. of 4 600.00 166 398,400 408,360 418,569 429,033 439,759 2,094,121 Unfunded
Stakeholders’ Review Charge meetings
meetings
Quarterly District DHO No. of 4 1,500.00 120 720,000 738,000 756,450 775,361 794,745 3,784,557 Unfunded
Stakeholders’ Review meetings
meetings
Quarterly Regional Area Team No. of 4 5,000.00 12 240,000 246,000 252,150 258,454 264,915 1,261,519 Unfunded
Stakeholders’ Review Chairperson meetings
meetings
Quarterly Sector CHS QAD No. of 4 25,000.00 1 100,000 102,500 105,063 107,689 110,381 525,633 MoH
Performance review meetings
meetings
Technical Review CHS P No. of 1 150,000.00 1 150,000 153,750 157,594 161,534 165,572 788,449 MoH
Meeting meetings
Joint Review Mission DGHS No. of JRM 1 500,000.00 1 500,000 512,500 525,313 538,445 551,906 2,628,164 MoH
National Health DGHS No. of NHA 1 350,200.00 1 350,200 367,710 386,096 1,104,006 Unfunded
Assembly
Subtotal 2,961,200 2,676,275 3,110,892 2,811,761 3,268,151 14,828,279
88
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Surveys HIV/AIDS PM ACP No. of reports 1 50,000.00 1 50 51 53 54 55 263 ACP
Epidemiological
Surveillance
HIV/AIDS Indicator CHS CDC Survey report 1 0 0 0 0 0 0 ACP / DP
Survey
Malaria indicator PM MCP MIS Report 1 2,000,000 1 2,000,000 2,100,000 0 4,100,000 MCP / DP
survey
National Tuberculosis NTLP Reports 1 5,700,000 1 5,700,000 6,270,000 11,970,000 DP
prevalence survey
Availability of six Pharmacy DAS Report 1 30,000.00 1 30,000 30,750 31,519 32,307 33,114 157,690 MoH
tracer medicines study Division
Service Availability M&E Unit Report 1 30,000.00 1 30,000 30,750 31,519 32,307 33,114 157,690 Unfunded
Readiness
Assessment
Health Facility Client Facility QI CSS Report 1 200.00 333 66,600 68,265 69,972 71,721 73,514 350,071 Unfunded
Satisfaction Surveys Focal Person
(Hospitals & HC IVs)
National Client QAD NCSS Report 1 100,000.00 1 100,000 100,000 110,000 310,000 DP
Satisfaction Survey
Other operational Managers Reports Assorte 10,000.00 10 100,000 102,000 104,550 107,164 109,843 523,557 DP
surveys d
Uganda Demographic UBOS UDHS - 5 1 0 0 0 0 0 0 UBOS
Health Survey Report
Uganda National UBOS UNPS Report 1 0 0 0 0 0 0 UBOS
Panel Survey
Uganda National UBOS UNHS Report 1 0 0 0 0 0 0 UBOS
Household Survey
89
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Uganda National UBOS UNSDS 1 0 0 0 0 0 0 UBOS
Service Delivery Report
Survey
Health Documentation of Implementers No. of case Assorte 500.00 12 6,000 6,150 6,304 6,461 6,623 31,538 Unfunded
Research & thematic case studies studies d
Evidence
Generation
Subtotal 2,332,650 5,937,966 2,443,915 6,520,013 366,264 17,600,809
Evaluations Specific program / Programme No. of Assorte 100,000 10 200,000 200,000 200,000 200,000 200,000 1,000,000 Project
project evaluations Managers evaluations d
HSSIP Mid Term DGHS MTR 1 200,000.00 1 0 200,000 0 200,000 MoH / DP
Review
HSSIP End Term Policy ETR Report 1 230,000 1 230,000 230,000 MoH
Evaluation Analysis Unit
Subtotal 200,000 200,000 400,000 200,000 430,000 1,430,000
Dissemination Weekly surveillance CHS CD No. of 52 1,000.00 12 624,000 639,600 655,590 671,980 688,779 3,279,949 DP
bulletins bulletins
disseminated
Quarterly performance ACHS QA No. of reports 200 15.00 1 3,000 3,075 3,152 3,231 3,311 15,769 MoH
reports printed &
disseminated
Annual Health Sector DGHS AHSPR 1 20.00 1,000 20,000 20,500 21,013 21,538 22,076 105,127 MoH
Performance Report printed &
disseminated
Mid term review DGHS MTR printed & 1 20.00 1,000 0 0 20,000 0 0 20,000 MoH
Report disseminated
End Term Evaluation PS ETE Report 1 20.00 1,000 0 0 0 0 20,000 20,000 MoH
Report disseminated
90
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Survey Reports Research No. survey Assorte 20.00 30 600 615 630 646 662 3,154 Research
Institutions / reports d Institutions /
Programmes disseminated DP
Subtotal 647,600 663,790 700,385 697,394 734,829 3,443,998

Capacity Printing of the HSSIP ACHS QA No. of plans 1 25.00 6,000 150,000 150,000 Unfunded
Building for 2010/11 - 2014/15 printed
M&E M&E Plan
Printing of the HSSIP ACHS QA No. of 1 5.00 6,000 30,000 30,000 Unfunded
2010/11 - 2014/15 implementatio
M&E Plan n guidelines
Implementation guide printed &
disseminated
Develop and print an ACHS QA Booklet 1 10.00 1,000 10,000 Unfunded
indicator booklet developed
Launching and ACHS QA Plan launched 1 10,000.00 1 10,000 10,000 Unfunded
Dissemination of the
HSSIP M&E Plan at
national level
Orientation and ACHS QA No. 1 1,370.00 112 153,440 153,440 Unfunded
Dissemination of the dissemination
M&E Plan at district meetings
level
Conduct in-service ACHS QA No. trained 1 25,200.00 12 0 302,400 302,400 Unfunded
training for managers
and HWs on
knowledge
management
(Regional workshops)
91
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Print and ACHS QA / No. of 1 2.50 5,000 12,500 12,813 13,133 13,461 13,798 65,704 Unfunded
disseminated M&E M&E Focal newsletters
Newsletters Persons printed and
disseminated
Vehicles for Central PS No. of 1 100,000.00 14 1,400,000 1,400,000 Unfunded
and Regional Officers vehicles
procured
Vehicle Maintenance Responsible No. of 1 11,200.00 14 156,800 160,720 164,738 168,856 651,114 Unfunded
and Operation Officer vehicles
maintained
Office equipment and Responsible Assorted 1 2,000.00 14 28,000 28,000 Unfunded
furniture for M&E Units Officer furniture
at Central and
Regional Level
Subtotal 365,940 1,597,613 476,253 178,199 182,654 2,790,659
M&E Plan M&E committee CHS QA No. of 12 0.00 12 0 0 0 0 0 0
Monitoring & meetings meetings
Evaluation
Compile quarterly M&E Focal No. of reports 3 5.00 30 450 461 473 485 497 2,365 Unfunded
HSSIP M&E plan Persons
implementation
reports
Compile annual ACHS QA No. of reports 1 5.00 30 150 154 158 162 166 788 Unfunded
HSSIP M&E
implementation report
M&E technical M&E Focal No. of reports 4 800.00 112 358,400 367,360 376,544 385,958 395,607 1,883,868 Unfunded
supervision and Persons
mentoring to
Institutions and LGs
Mid term and end term Consultant No. of 1 50,000.00 2 50,000 50,000 100,000 Unfunded
evaluation evaluations
92
Department level /
facility 2011/11 2011/12 2012/13 2013/14 2014/15
per
year
Subtotal 359,000 367,975 427,174 386,604 446,269 1,987,022
Total 7,254,590 11,841,524 7,996,472 11,212,021 5,888,167 44,182,775
93
7 Annexes
7.1 HSSIP 2010/11 – 2014/15 Indicators with targets
Objective 1: Scale up critical interventions
Cluster 1: Health Promotion, Environmental Health and Community Health Initiatives
Strategic Intervention 1.1.1: Promote individual and community responsibility for better health.
Indicators
1. Standards and guidelines (including criteria for gender sensitivity) for the production and delivery of IEC
messages developed and disseminated among institutions by 2011/2012.
2. The proportion of districts with trained VHTs increased from 31%to 100% by 2014/2015.
3. The proportion of health facilities with IEC materials maintained at 100%.
Strategic Intervention 1.1.2: Contribute to the attainment of a significant reduction of morbidity and
mortality due to environmental health and unhygienic practices and other environmental health related
conditions.
Indicators
1. The proportion of households in Uganda with pit latrines increased from 67.5% to 72% by 2015.
2. Percentage of households with access to safe water.
3. The proportion of districts implementing water quality surveillance and promotion of safe water
chain/consumption increased from 30% to 50% by the year 2015.
4. The proportion of households with hand washing facilities with soap increased from 22% to 50% by 2015.
Strategic Intervention 1.1.3: Reduce morbidity and mortality due to diarrhoeal diseases.
Indicators
1. The incidence of annual cases of cholera reduced from 3/100,000 to 1.5/100,000 by 2014/2015.
2. The incidence of annual cases of dysentery reduced from 254/100,000 to 1.5/100,000 by 2014/2015.
3. The cholera specific case fatality rate from 2.1% to <1.0% by 2014/2015.
4. The dysentery specific case fatality rate from 0.08% to 0.01% by 2015.
5. The acute watery diarrhoea specific case fatality rate from 0.9% to 0.4% by 2015.
Strategic Intervention 1.1.4: Improve the health status of the school children, their families and teachers
and to inculcate appropriate health seeking behaviour among this population.
Indicators
I
1. The % of schools in Uganda that provide basic health and nutrition services increased to 25 % by 2015.
2. The % of primary and secondary schools with safe water source within 0.5 km radius of the school increased
from 61% and 75% resp. to 80% by 2015.
3. The % of schools with pupil per latrine stance ratio of 40:1 or better increased from 57% to -70% by 2015.
Strategic Intervention 1.1.5: Prevent, detect early and promptly respond to health emergencies and other
diseases of public health importance.
Indicators
1. The proportion of suspected disease outbreaks responded to within 48 hours of notification increased from
52% to 80%.
2. The proportion of districts with functional epidemic preparedness and response committees increased from
76% to 100%.
3. The proportion of districts with epidemic preparedness plans increased to 100%.
4. The timeliness and completeness of weekly and monthly surveillance reports maintained at greater than 80%.
Strategic Intervention 1.1.6: Ensure equitable access by people in PRDP districts [in conflict and post-
conflict situations] to Health Services
Indicators
1. Increased access to functional health facilities: this should enable a larger percentage of the population to be
within 5km or less of the facility.
Strategic Intervention 1.1.7: Scale up delivery of nutrition services
Indicators
1. The proportion of underweight in under five year children reduced from 16% to 10%.
2. Vitamin A deficiency among children 6-59 months reduced from 20% to 10% and women of reproductive age
from 19% to 9%.
3. The proportion of stunted children below 5 years reduced from 38% to 32%.
4. Vitamin A supplementation coverage increased for children aged 6-59 months from 60% to 80%.
5. Deworming coverage for children 1-14 years increased from 60% to 80%.
6. Iodine deficiency eliminated.
7. The proportion of the households consuming iodised salt increased from 95% to 100%.
8. The prevalence of anaemia among children decreased from 73% to 60%, women from 49% to 30% and men
from 28% to 15%.
9. The proportion of underweight women of reproductive age decreased from 12% to 6%.
10. Exclusive breastfeeding at 6 months increased from 60% to 80%.
11. Timely complementary feeding increased from 73% to 80%
12. Accessibility to appropriate and gender sensitive nutrition information and knowledge increased to 100%.
13. Nutrition services to health units and the community scaled up to 100%.
II
Cluster 2: Control of Communicable Diseases
Strategic Intervention 1.2.1: Prevent STI/HIV/TB transmission and mitigate the medical and personal
effects of the epidemic.
Indicators
1. HIV prevalence among pregnant women (19-24 yrs) attending antenatal clinics reduced from 7% to 4%.
2. The proportion of people who know their HIV status increased from 38% to 70%.
3. The proportion of people who are on ARVs increased from 53% in 2009 to 75% by 2015 among adults and
from 10% to 50% in children less that 15 years of age.
4. The proportion of children exposed to HIV from their mothers access HIV testing within 12 months increased
from 29% to 75%.
5. The proportion of pregnant women accessing HCT in ANC increased to 100%.
6. HCT services available in all health facilities including HC IIs, and at community level (Proportion of health
facilities with HCT services; Proportion of community structures with HCT services)
7. PMTCT services available in all health facilities up to HC III‟s and 20% of HC IIs (Proportion of health
facilities with PMTCT services; Proportion of HC IIs with PMTCT services).
8. ART services available in all health facilities up to HC IV and 20% of HC III by 2015. (Proportion of health
facilities with ART services; Proportion of HC IIs with ART services).
9. The proportion of males circumcised increased from 25% to 50% (denominator is number of all males in
Uganda).
10. Reduce the HIV prevalence from 6.7% to 5.5% in the general adult population (15-49 years).
Strategic Intervention 1.2.2: Reduce the morbidity, mortality and transmission of tuberculosis.
Indicators
1. TB case detection rate increased from 57.3 to 70%.

2. TB cure rate increased from 32% to 80% (Treatment success to 85%).
3. TB associated death rate reduced from 4.7 to 2.5%
4. The proportion of TB cases on supervised DOT increased from 48% to 100%.
5. DST uptake among smear positive Relapse cases (CAT II) increased to 75%.
6. High False Negative (HFN) prevalence at DTUs reduced to less than 5% in all districts.
7. Proportion of TB patients tested for HIV increased from 71% to 100%
8. Proportion of TB/HIV patients started on cotrimoxazole increased from 88 to 100%
9. Proportion of TB/HIV patients started on ART increased from 18.5% to 50%
10. Proportion of MDR TB patients started on treatment increased from 0% to 100%
Strategic Intervention 1.2.3: Sustain the elimination of leprosy in all the districts.
Indicators
1. The prevalence of leprosy reduced to less than 1 case per 10,000 people.
2. At least one “Skin Clinic” per Health Sub District (HSD) held on a weekly basis in all HSDs across the country.
III
3. The rate of grade II disability in newly diagnosed leprosy cases reduced to less than 5 per cent.
Strategic Intervention 1.2.4: Reduce the morbidity and mortality rate due to malaria in all age groups.
Indicators
1. Reduce the prevalence of malaria among under fives from 44.7% to 20%.
2. The proportion of under-fives with fever who receive malaria treatment within 24 hours from a VHT increased
from 70% to 85% by 2015.
3. The proportion of pregnant women who have completed IPT2 uptake increased from 42% to 80% by 2015.
4. The percentage of under-fives and pregnant women having slept under an ITN the previous night increased
from 32.8% to 80% and from 43.7% to 80%
5. Proportion of households sprayed with insecticide in the last 12 months increased from 5.5% to 30% by 2015.
6. The case fatality rate among malaria in-patients under five reduced from 2% to 1% by 2015.
7. Proportion of households with at least one ITN increased from 46.7% to 85% in 2015.
8. The percentage of public and PNFP health facilities without any stock outs of first line anti-malarial medicines
increased to 80% throughout the strategic plan period.
9. The percentage of government and PNFP health centres IIs and IIIs without stock out of rapid diagnostic
tests.
10. 100% of planned RBM partnership review meetings held.
Strategic Intervention 1.2.5: Maintain the Guinea Worm free status of the country through maintenance of
high quality post-certification surveillance.
Indicators
1. Timely reporting of guinea worm from villages at risk of importation maintained at 100%.
2. All (100%) rumours of suspected guinea worm cases investigated.
3. Case containment of imported guinea worm cases maintained at 100%.
4. A MoU signed with neighbouring countries on elimination of guinea worm.
Strategic Intervention 1.2.6: Eradicate onchocerciasis and its vector in all endemic districts in Uganda.
Indicators
1. Simulium nivae eliminated in all endemic districts in Uganda.

2. At least 75% therapeutic coverage in all affected communities and 100% geographic coverage achieved in
endemic districts.
3. CDTI activities integrated within their district health plans in all endemic districts to sustain integration.
Strategic Intervention 1.2.7: Achieve the global target for the elimination of trachoma.
Indicators
1. Prevention and control measures for trachoma fully integrated within the district work plans in all endemic
areas during all years of the strategic plan.
IV
2. All endemic districts reached with mass distribution of Tetracycline and Azithromycin during the years of the
strategic plan.
3. The provision of surgical services to patients with trichiasis increased from 10% to 30% by 2015.
4. Number of lid rotation surgeons trained.
Strategic Intervention 1.2.8: Reduce and ultimately interrupt transmission of the disease in all endemic
communities through the use of chemotherapy with Ivermectin and albendazole.
Indicators
1. Therapeutic coverage for the affected people with single annual dose of Ivermectin and Albendazole increased
from 93% to 100% by 2015.
2. Mapping of areas with lymphatic filariasis completed in all endemic districts conducted by 2011/12.
3. Morbidity and disability associated with lymphatic filariasis reduced by 25% by 2015.
Strategic Intervention 1.2.9: Eliminate sleeping sickness as a public health problem in Uganda.
Indicators
1. Access to diagnostic procedures and treatment of sleeping sickness for communities to increase from 40% to
80% by 2015.
Strategic Intervention 1.2.10: Reduce morbidity caused by the worms by decreasing the worm burden
among communities
Indicators
1. Coverage with mass chemotherapy in all the endemic districts increased from 74% to 100% by 2015.
2. All endemic districts integrate prevention and control measures within the district work plans during all the
years of the strategic plan.
Strategic Intervention 1.2.11: Reduce morbidity and mortality due to Leishmaniasis among the endemic
communities
Indicators
1. The magnitude and full extent of the disease in the country is established by 2010/2011
2. Increase early case detection to 60% by 2015.
Strategic Intervention 1.2.11: Reduce the morbidity and mortality due to endemic, emerging and re-
emerging zoonotic diseases
Indicators
1. Zoonotic diseases technical guidelines, developed and disseminated by 2011/2013.

2. The proportion of General Hospitals and RRH conducting proper laboratory diagnosis of brucellosis
increased by 20% and 50% by 2015 respectively
V
Cluster 3: Non-communicable diseases/conditions
Strategic Intervention1.3.1 Prevent Type 1 and Type 2 diabetes and reduce morbidity and mortality
attributable to diabetes and its complications.
Indicators
1. Public awareness on diabetes and risk factors increased by 5% by 2015.

2. Percentage of HCIVs and hospitals equipped with equipment to diagnose diabetes increased by 5% by 2015.
3. Standard diabetes files utilized in 30% of health facilities HCIVs and hospitals by 2015.
Strategic Intervention 1.3.2: Prevent cardiovascular and related diseases and reduce morbidity and
mortality attributable to CVDs.
Indicators
1. Standards and guidelines for CVD prevention and management developed by 2014/15.
2. Public awareness on CVDs and their risk factors increased by 10% by 2014/15.
3. The percentage of health facilities from HC IV and above equipped to diagnose CVDs increased by 5% by
2014/15.
Strategic Intervention 1.3.3: Establish a national framework for cancer control with emphasis on cancer
prevention
Indicators
1. Cancer policy and National Cancer Control Program in place by 2013

2. Increase in cancer awareness activities by 50 % by 2013
3. Availability of cervical cancer screening in all Health centre IV country wide by 2015
4. Establishment of two population based cancer registry and a national cancer data base by 2015
5. Cancer guidelines and SOP for lower level training in place by 2013
Strategic Intervention 1.3.4: Prevent chronic respiratory diseases and reduce morbidity and mortality
attributable to COPD and asthma.
Indicators
1. Increased awareness on COPD and asthma disease and risk factors

2. Improved diagnostic capacity and treatment at all levels of care
3. Improved quality of data on COPD and asthma
4. Increased quality operational research targeted to improve the prevention and management of COPD and
asthma
VI
Strategic Intervention 1.3.5: Reduce the morbidity and mortality associated with sick cell disease.
Indicators
1. Policy and guidelines on Sickle cell disease developed by 2014/15.

2. Sickle cell clinics established in 30% of Regional Referral Hospitals by 2015.
Strategic Intervention 1.3.6: Decrease the morbidity and mortality due to injuries, common emergencies
and disabilities from visual, hearing and age-related impairments.
Indicators
1. Hearing impairment reduced from 8% to 6% by 2014/2015.

2. Visual impairment reduced from an estimated 0.8% to 0.7% by 2014/2015.
3. Assistive devices provided to 80% of PWDs who need them by 2015.
4. The proportion of the population reached with messages on disability prevention and rehabilitation increased
to 80% by 2015.
Strategic Intervention 1.3.7: Ensure increased access to primary and referral services for mental health,
prevention and management of substance abuse problems, psychosocial disorders and common
neurological disorders such as epilepsy.
Indicators
1. Mental Health Law enacted by 2011/12.

2. Mental Health Policy finalised and operationalised by 2010/11.
3. Operationalise Mental Health Units in all RRHs by 2010/11.
4. Community access to mental health services increased from 60% to 80%.
5. A community strategy for prevention of mental health problems developed by 2010/11.
6. Services for alcohol and drug abuse management are available at HC IV by 2013/14.
Strategic Intervention 1.3.8: Improve the oral health of the people of Uganda by promoting oral health and
preventing, appropriately treating, monitoring and evaluating oral diseases.
Indicators
1. Oral health policy implementation guidelines developed and disseminated by 2010/2012.

2. The proportion of HC IVs with well equipped and functional dental units increased from 25% to 80% by
2015
3. The proportion of the population with access to primary oral health care from increased from 20% to 80%.
Strategic Intervention 1.3.9: Improve the quality of life of terminally ill patients and their families especially
the home carers.
Indicators
1. Guidelines and standards for palliative care developed.

2. All hospitals and HC IVs providing palliative care.
VII
3. Adequate stocks of appropriate medication and supplies at palliative care centers are available.
Cluster 4: Sexual, Reproductive Health and Rights and Child Survival
Strategic Intervention 1.4.1: Reduce mortality and morbidity relating to sexual and reproductive health, and
rights.
Indicators
1. The proportion of pregnant women attending ANC 4 times increased from 47% to 60% by 2015.
2. The proportion of women who deliver in health facilities increased from 34% to 90% by 2015.
3. The proportion of health facilities with no stock-outs of essential RH medicines and health supplies increased
from 35% to 70% by 2015.
4. The proportion of health facilities that are adolescent-friendly increased from 10% to 75% by 2015.
5. The % of health facilities with Basic and those with Comprehensive emergency obstetric care increased from
10% to 50% by 2015.
6. The proportion of pregnant women accessing comprehensive PMTCT package increased from 25% to 80%.
7. Contraceptive Prevalence Rate increased from 24% to 35% by 2015.
8. The unmet need for family planning reduced from 41% to 20% by 2015.
9. To increase the proportion of deliveries attended by skilled health workers from 40% to 60% by 2015.
10. To reduce adolescent pregnancy rate from 24% to 15% by 2015.
11. The proportion of mothers who have completed IPT II increased from 18% to 80%.
Strategic Intervention 1.4.2: Improve newborn health and survival by increasing coverage of high impact
evidence based interventions, in order to accelerate the attainment of MDG 4.
Indicators
1. The proportion of neonates seen in health facilities with septicaemia/pneumonia disease reduced by 30%
2. The proportion of newborns receiving at least three post natal care visit during the 1st week Increased to 60%
3. Health facilities implementing more than two thirds of the minimum service standards increased from 20 to
40%
4. Proportion of mothers of newborns 1-2 weeks practicing clean cord and skin care, keeping babies warm,
exclusively breast feeding and recognize danger signs, increased by at least 30% from baseline figures
Strategic Intervention 1.4.3: Scale-up and sustain high, effective coverage of a priority package of cost-
effective child survival interventions in order to reduce under five mortality.
Indicators
1. Probable and confirmed malaria inpatient under five deaths reduced from 0.6 to 0.3%
2. Stunting rates among children under-fives reduced from 38% to 28%
3. Neonatal septicaemia rates in health facilities reduced by 30%
4. Neonatal tetanus rates reduced and maintained at zero
VIII
5. Non Polio Acute flaccid poliomyelitis rates maintained at greater than 2 per 100,000, and cases of paralysis
due to wild polio virus maintained at zero
6. Under-fives who slept under an ITN the previous night increased from 10 to 60%
7. DPT-3/Pentavalent coverage for under 1‟s increased from 74%-85%
8. Measles vaccination coverage by 12 months increased from 75% to 95%
9. U5s with malaria treated correctly within 24 hrs increased from 26% to 60%
10. U5 pneumonia managed with correct antibiotic increased from 17% to 50%
11. Children 6-59 months receiving doses of Vitamin A increased from 36%-80%
12. HIV-exposed infants started on cotrimoxazole prophylaxis within 2 months of birth increased to 80%
13. Mother/newborn pair checked twice in 1st week of life (1st visit within 24 hrs) increased to 50%
14. Exclusive breast-feeding rate by the age of 6 months increased to 60%
15. Diarrhoea cases receiving ORT during illness increased from 37% to 60%
16. Index of U5s managed in an integrated manner at the facility using IMNCI increased from 30%-60%
17. Index of facility availability of tracer drugs and vaccines (anti-malarial, cotrimoxazole, measles vaccine,
sulphadoxine/pyrimethamine, depoprovera and ORS,) increased from 23% to 50%
18. Number of facilities assessed and accredited as baby friendly (BFHI) increased from 15 to 70
19. Health workers who are competent in material resuscitation upon completing of training
Strategic Intervention 1.4.4: Prevent morbidity and mortality due to gender based violence.
Indicators
1. An integrated strategy to address SGBV in the health sector developed and disseminated.
2. Health service provision for survivors of rape scaled up in all district hospitals and 50% of HC IIIs.
3. PEP Kits available in all district hospitals and 50% of HC IIIs.
4. Health workers trained in clinical management of survivors of rape increased to 25% by 2015.
Objective 2: Improve levels, and equity in access and demand
Strategic Intervention 2.1: Improve access to equitable and quality clinical services at all levels in both the
public and private sectors and institutions.
Indicators
1. The functionality of the HC IVs increased from 5% to 50% by 2014/15.

2. Standards for best practice in hospitals established by 2012.
3. Infection control guidelines finalized and being used in all hospitals by 2012/2013.
4. Functional Accident and Emergency Units established in all RRHs by 2014/15.
5. Blood Transfusion Centres set up in all RRHs (2 each year)
6. ICU/CCU established in 40% of the RRHs (1 ICU in RRH each year) by 2014/15
IX
Strategic Intervention 2.2: Attain and maintain an adequately sized, equitably distributed, appropriately
skilled, motivated and productive workforce in partnership with the private sector, matched to the
changing population needs and demands, health care technology and financing.
Indicators
1. Increase proportion of approved filled positions at Local Government from 49% to 75% by 2014/15
2. Increase proportion of approved positions filled by trained health professionals from 51% to 75% by 2014/15
3. Improve the staffing for midwives in HC IIIs in Hard-to-reach areas from 46% to 100% by 2014/15
4. Increase the number of districts with functional HRIS from 19 in FY 2010/11 to 80 districts by 2014/15
5. Core HRHIS subsystems (Local Government, MoH (HRD), MoH (HRM), MoPS, and Professional Councils)
integrated, linked and functional by end of FY 2012/13
6. Develop a database for HRH that captures PNFP and PHP within two years
7. Train 70 health managers in HRH Policy, Planning and Management annually over the next five years
8. Train 70 HRH managers in Leadership and Management annually over the next five years
9. Establish a system for review of curricula by 2012
10. Proportion of bonded pre-service trainees absorbed increased to 100% in 2015, baseline to be determine by
2011
11. Integrated in-service training plan for the sector developed by 2011
12. Mid Term Review of the in-service training plan conducted by 2013
13. Strategy to ensure career development of health workers developed by 2012/13
14. Appropriate management structures at different levels reviewed by the end of FY 2011/12
15. Reduce the time taken to access payroll from 6 months to one month by 2014/15
16. Establish the baseline for Absenteeism Rate by 2011/12
17. Reduce the Absenteeism rate by 20% per year over the next five years
18. Results Oriented Management rolled out to General Hospitals by 2012/13
19. Proportion of functional Health Unit Management Committees (GoU and PNFPs General Hospitals and HC
IVs = 308,) increased to 100% by 2014/15 (establish baseline in 2010/11).
20. Proportion of health managers (RRH, GH, HC IVs) with signed Performance Agreements
Strategic Intervention 2.3: Increase access to essential, efficacious, safe, good quality and affordable
medicines at all times.
Indicators
1. The percentage of health units without monthly stock outs of any indicator medicines decreased from 72% to
20%.
2. The funds in the MOH budget for procurement of EMHS increased from meeting 30% to 80% of need
3. The service level of NMS for all EMHS increased to 80%.
4. The % of NDA budget directly financed by GoU (consolidated funds) increased to 25%).
5. Guidelines for donated medicines developed by 2012.
X
Strategic Intervention 2.4: Provide and maintain functional, efficient, safe, environmentally friendly and
sustainable health infrastructure including laboratories and waste management facilities for the effective
delivery of the UNMHCP, with priority being given to consolidation of existing facilities.
Indicators
1. The proportion of the population of Uganda living within 5 km of a health facility increased from 72% to 90%
by 2015.
2. The number of health facilities increased by 30% by 2015.
3. The proportion of HC IIIs and HC IVs with complete basic equipment and supplies for addressing EmoNC
increased to 100%.
4. The proportion of HCIVs and hospitals with functional ambulances for referral increased to 100%.
5. Sixty percent of medical equipment are in good condition and maintained.
6. 50% of the mobile population physically access health facilities.
Objective 3: Accelerate quality and safety improvements
Strategic Intervention 3.1: Ensure provision of high quality health services and contribute to the attainment
of good quality of life and well-being.
Indicators
1. National supervisory framework operational by July 2011.

2. Reviewed supervision guidelines and tools disseminated by 2012.
3. Proportion of districts where capacity for internal supervision has been built (100% by 2015).
4. Proportion of supervisory reports shared by supervisees increased to 100% by 2015.
5. Proportion of planned visits that are carried out increased to 100% by 2015.
6. Proportion of facilities attaining at least 75% of set standards by 2015.
7. An Inspectorate Division at MoH headquarters created by 2013.
Strategic Intervention 3.2: Ensure effective and efficient utilization of available resources
Indicators
1. National quality improvement framework and performance measurement plan operational by July 2011
2. Yellow Star Programme reviewed by 2012.
3. Appropriate standards, guidelines and tools developed and disseminated by December 2011.
4. Proportion / number of districts implementing the QI strategy (100% by 2015)
5. Number of performance monitoring activities carried out (Annual QI stakeholders meetings).
Strategic Intervention 3.3: Establish dynamic interactions between health care providers and consumers of
health care with the view to improving the quality and responsiveness (including gender responsiveness)
of health services provided.
XI
Indicators
1. Proportion of districts where Health Unit Management Committees in HC II-IV, general hospitals are
functional (meeting at least once a quarter) (75%).
2. Number of surveys conducted to assess client satisfaction and gender responsiveness.
3. Mechanism for client / right holders redress established and operational.
4. Proportion of districts with CSO participation (CSOs structures developed at all levels in 65% of districts by
2015: National, district and sub-county).
5. Clients‟ Charter reviewed by 2012.
6. Patients‟ charter reviewed, translated and disseminated to 100% of district by 2015.
Objective 4: Improve efficiency and effectiveness of services
Strategic Intervention 4.1: Mobilize additional resources to fund the HSSIP.
Indicators
1. Development of a health financing strategy by June 2011.

2. Increase level of Government allocation to Health from 9.6% to a minimum of 15% of the total GOU budget
by 2014/15.
3. Government per capita expenditure on health increased to 12$ by 2014/2015.
Strategic Intervention 4.2: Improve management of development assistance for health.
Indicators
1. Percentage of expected quarterly HDP donor project reports on disbursements and commitments that are
received timely. Target 60% by 2014/15.
2. External funding for health as a percentage of total health expenditure.
3. Proportion of donor project funds budgeted that is on MTEF within the Health sector votes. Target 100% by
2015.
Strategic Intervention 4.3: Ensure effectiveness, efficiency and equity in resource allocation and utilization.
Indicators
1. Percentage of actual releases to Districts, Hospitals, autonomous institutions and other sector spending
agencies deviating less than 5% from the approved budgets.
2. Per capita out of pocket expenditure on health; reduced from US$14 per utilization to US$10 per utilization in
2014/2015.
XII
Strategic Intervention 4.4: Ensure transparency and accountability in resource allocation and management
Indicators
1. Institutionalize the National Health Accounts by 2012.

2. Percentage of quarterly internal audit reports (district, hospitals, central level) prepared and submitted timely.
Target 100% by 2014/15.
3. Percentage of (district, hospitals, central level) quarterly Budget performance reports prepared and submitted
timely by GOU health sector spending agencies. From 70% in 2008/09 to 100% in 2014/15
Objective 5: Deepen sector stewardship
Strategic Intervention 5.1: Strengthen the organization and management of the national health system.
Indicators
1. Increase the proportion of approved filled positions at local government from 49% to 75% by 2014/15.
2. The percentage of government budget allocated to the health sector increased from 9.6% to 15%.
3. Health policies, standards and guidelines for the East African Community harmonized by 2014/15.
4. Joint planning, monitoring and evaluation with various relevant sectors instituted by 2011/2012.
5. No. of service delivery models designed, piloted and established for disadvantaged population groups.
6. The proportion of districts that submit timely HMIS monthly and quarterly reports increased from 68% to
100% by 2014/2015.
7. The percentage of districts with operational VHTs increased from 31% to 100%.
Strategic Intervention 5.2: Enable evidence-based decision making, sector learning and improvement.
Indicators
1. The proportion of implementing partners (NGOs, CSOs, Private sector) contributing to periodic reports
increased to 90% by 2015.
2. Community based HIS established and linked to HMIS by 2015.
3. The proportion of planned periodic review that are carried out increased to 100% by 2015.
4. HMIS timeliness increased to 100% by 2015.
5. HMIS completeness increased to 100% by 2015.
6. Proportion of planned validation studies that are carried out.
7. The proportion of sub national entities (districts, health facilities) that have reported on the key indicators as
planned increased to 100% by 2015.
8. Selected data disaggregated by age & sex with concomitant gender analysis.
XIII
Strategic Intervention 5.3: Create a culture in which health research plays a significant role in guiding
policy formulation and action to improve the health and development of the people of Uganda.
Indicators
1. A policy and legal framework for effective coordination, alignment and harmonization of research activities
developed by 2012.
2. A prioritized national research agenda developed by 2012.
3. Institutions involved in conducting research identified by 2011.
Strategic Intervention 5.4: Review and develop relevant Policies, Acts and regulations governing health
which are gender responsive and human rights compliant and to ensure their enforcement.
Indicators
1. Number of policies reviewed and developed.

2. Number of relevant international legal instruments on health that have been domesticated
3. Number of laws reviewed and developed to make them gender –responsive and human rights compliant.
4. Number of law enforcers trained in new legislation and policies to ensure implementation of legislation and
policies.
5. An effective regulatory environment and mechanism developed.
6. An adequate and functional staffing structure of Professional councils established over the next five years.
7. A Joint Professional Council with decentralized supervisory authorities established and operationalised over the
next five years.
Strategic Intervention 5.5: Effectively build and utilize the full potential of the public and private
partnerships in the health sector.
Indicators
1. The National Policy on PPPH is approved by the Cabinet by 2011

2. Implementation Guidelines tested at district level.
3. Approval of traditional medicine regulatory bill by 2011.
4. All PPPH District Desk Officers appointed by 2012.
5. Number of districts signing service level agreement with the PNFP, PHP and the CSOs, with definition of
targets and outputs.
6. Number of districts which have developed a joint public-private District Health Plan
7. Number of districts in which PHP sub-sector contributes to the HMIS.
8. Number of districts reporting disaggregated output data by public-private contribution.
Strategic Intervention 5.6: Strengthen collaboration between the health sector and other government
ministries and departments, and various public and private institutions (universities, professional councils,
etc.) on health and related issues.
Indicators
1. The structures and methods of consultation with other government Ministries and Departments are defined by
2011.
XIV
2. All new government policies assessed using the HIA tool.
Strategic Intervention 5.7: Implement the national health policy and the Health Sector Strategic Plan
within the Sector wide Approach and IHP+ framework, through a single harmonized in country
implementation effort, scaled up financial, technical and institutional support for health MDGs and
ensuring mutual commitment and accountability.
Indicators
1. A Country Compact signed by the MoH, HDP, CSOs and the private sector.
2. A joint budget support framework instituted.
3. Annual joint reviews and monitoring conducted.
XV
7.2 Key NDP Indicators
Table 15: Key Results Area Matrix
Performance Indicator Baseline 2014/2015
Value
1. Infant Mortality 76 31
2. Under Five Mortality Rate 137 95.7
3. Maternal Mortality Rate 435 127
4. Total fertility rate (2006/07) 6.5 5
5. Contraceptive prevalence rate (2006) 40 46
6. Reduction in communicable diseases 53 0.25
7. Life expectancy 128.7
8. Child mortality 12,500
9. Ratio of Doctors to Population(1:12,500) 7700
10. Ratio of nurses to population(1:7700) 30,000,000
11. Ratio of national referral hospital to 2,307,692

population
12. Ratio of regional referral hospital to 263,157
population
13. Ratio of district referral hospital to the 187,500
population
14. Ratio health centre IV to the population 84,507
15. Ratio health centre III to the population 53
16. OPD utilization 0.8 1.5
17. DPT 3/Pentavalent Vaccine 85 87
18. Deliveries in health facilities % 34 40
19. Proportion of qualified workers 56 85*
20. HIV - Prevalence % 6.7 6.7
21. HCs without medicine stock out 26 65
22. Household latrine coverage 67.4 72
XVI
7.3 WHO Statistical Data
1. Life expectancy and mortality

Life expectancy at birth a Stillbirth rate b Neonatal MDG 4 MDG 4 Adult mortality rate a
(years) (per 1000 total mortality rate a Infant mortality rate a Under-five mortality rate a (probability of dying
births) (per 1000 live (probability of dying by (probability of dying by age between 15 and 60 years
births) age 1 per 1000 live 5 per 1000 live births) per 1000 population)
births)
Both Both M F Both M F Both
M F Both sexes Both sexes M F
sexes sexes sexes sexes
48 57 52 25 31 89 69 79 140 114 128 539 348 449
2. Cause-specific mortality and morbidity
Mortality Morbidity
MDG 5 Cause-specific mortality rate (per 100 000 population) Age-standardized Distribution of Distribution of causes of death among children aged <5 years g,h MDG 6 MDG 6 MDG 6
Maternal mortality rates years of life lost (%) Prevalence of Incidence of Prevalence of
mortality by cause e,f by broader tuberculosis i tuberculosis i HIV among
ration (per (per 100 000 causes e,g (%) (per 100 000 (per 100 000 adults aged
100,000 live population) population) population 15–49 years b
births) per year) (%)
Communicable
Injuries
Communicable
Injuries
HIV/AIDS
Noncommunicable
Noncommunicable
Congenital anomalies
Neonatal sepsis
Other diseases
Birth asphyxia
MDG 6
Prematurity
Pneumonia
Diarrhoea
Measles
Malaria
Injuries
Tubercul
osis
MDG among
6 HIV-
HIV/AI Malar negative
DS b ia c people d
200 200 200 200 200 200 200
2009 2008 2009
8 8 8 8 9 9 9
[240
[150– [77– [12– 88 17 1 1 1 1 1 1 [120– [238– [5.9–
430 – 196 103 29 810 76 6 2 8 7 5 2 3 278 293 6.5
245] 135] 53] 8 9 3 1 8 6 5 8 526] 352] 6.9]
670]
XVII
3. Selected infectious diseases
Number of reported cases
a d e b b b g b i
Cholera Diphtheria H5N1 Japanese Leprosy Malaria Measles Meningitis Mumps Pertussis Plague Poliomyelitis Congenital Rubella Neonatal Total TB Yellow
b c f h b b
influenza encephalitis rubella tetanus b tetanus fever
b
syndrome
b
2009 2010 2009 2010 2009 2010 2009

1,095 … … … 346 9,775,318 1,601 … … … … 2 … … 151 1,304 41,703 0
4. Health service coverage

MDG 5 MDG 5 Births by Neonat Immunization coverage among Children aged Children MDG 5 MDG 5 Antiretrovir MDG 6 MDG 6
d
Antenatal Births caesare es 1-year-olds (%) 6–59 months aged <5 Unmet Contracepti al therapy Case- Smear-
care attende an protecte who received years (%) need ve coverage detection positive
a
coverage (%) d by section d at vitamin A for prevalence (%) rate for all tuberculo
g
skilled (%) birth supplementati family (%) forms of sis
health against on e (%) plannin tuberculo treatment
personn neonata g g (%) sis j (%) -success
el a (%) l rate k (%)
tetanus
c
(%)
MDG 6 MDG 6 With ARI With
Sleeping With sympto diarrho MDG 6
under fever who ms ea Among Among
At At insecticid received taken to receivin HIV- people
least leas MDG 4 e-treated treatment a health g ORT
DTP HepB Hib infected with
1 t4 Measl nets f with any facility e (ORS
3 3 3 pregnant advance
visit visit es antimalari and/or
a,b women for d HIV
sa al f RHF) e PMTCT h infectio
ni
2000
– 2000– 2000– 200 200 2000– 2000– 2000–
2010 2010 2010 2009 2009 9 2009 9 2000–2010 2009 2010 2009 2000–2010 2009 2009 2009 2008
94 48 42p 3.1 89 68 64 64 64 36.4 9 61 73.3 43.4 40.6 23.7 53 39 44 70
XVIII
5. Risk Factors
MDG 7 MDG 7 Population using Low- Infants Children aged <5 years e Adults aged Alcohol Prevalence Prevalence of MDG 6 MDG 6
b
Population using Population using solid fuels (%) birth- exclusiv (%) ≥20 years consumpti of smoking current Prevalence of Population
improved improved sanitation weight ely who are on among any tobacco use condom use aged 15–24
a f
drinking-water (%) newbor breastfe obese (%) adults tobacco among by adults years with
a c
sources (%) ns (%) d for the aged ≥15 product adolescents aged 15–49 comprehensi
g
first 6 years among aged 13–15 years during ve correct
months (litres of adults aged years i (%) higher-risk knowledge of
d h j k
of life pure ≥15 years sex (%) HIV/AIDS
(%) alcohol (%) (%)
per person
per year)
Stunte MDG 1 Overweig
Urba Rur Urb Rur Tot Urba Rur Tot
d Underweig ht M F
n al an al al n al al
ht M F M F M F M F
2000 2000
200 200 200 200 200 2000– 2000– 2000– 1990– – 2000– 200 200 2000– – 2000–
2008 8 8 8 8 8 2007 2009 2010 2009 1999 2009 2009 8 2005 6 2010 2009 2009
91 64 67 38 49 48 95 >95 >95 14 60 38.7 21.5 16.4 4.9 4.3 4.9 11.9 18.9 4.2 17.3 15.3 20 24 38 32
6. Health workforce, infrastructure and essential medicines

a MDG 8 Essential medicines
Health workforce Infrastructure
Hospital Radiotherapy Median availability Median consumer
beds b units c of selected generic price ratio of
Nursing and midwifery Pharmaceutical Environment and Community health medicines d (%)
Physicians Dentistry personnel (per 10 000 (per 1 000 selected generic
personnel personnel public health workers workers population) 000 medicines e
population)
Density Density Density (per Density Density Density
Number (per 10 000 Number (per 10 000 Number 10 000 Number (per 10 000 Number (per 10 000 Number (per 10 000 Public Private Public Private
population) population) population) population) population) population)
2001–
2000–2010 2000–2009 2010
2009
1.2 37 625 13.1 762 0.3 1 042 0.4 … … 4f 0.1 20.0 80.0 …l 2.6
3 361 440 0.2
XIX
7. Health expenditure
Health expenditure ratios Per capita health expenditures
Total General Private General External Social Out-of- Private Per capita Per capita Per capita Per capita
expenditure government expenditure government resources security pocket prepaid total total government government
on health expenditure on health expenditure for health expenditure expenditure plans as % expenditure expenditure expenditure expenditure on
d d
as % of on health as as % of on health as as % of on health as as % of of private on health at on health on health at health
gross % of total total % of total total % of private expenditure average (PPP int. $) average (PPP int. $)
domestic expenditure expenditure government expenditure general expenditure on health exchange exchange
product on health b on health b expenditure on health c government on health rate (US$) rate (US$)
expenditure
on health
2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008
8.4 17.4 82.6 10.5 27.9 0 65.4 0.1 44 112 8 20
8. Health inequities
MDG 4 Under-five mortality rate a,d (probability of dying by age 5 per 1000 live
MDG 5 Births attended by skilled health personnel a,b (%) MDG 4 Measles immunization coverage among 1-year-olds a,c (%) births)
Educational level of Educational level of Educational level of
Place of residence Wealth quintile Place of residence Wealth quintile Place of residence Wealth quintile
mother e mother e mother e
Ratio highest–lowest
Ratio lowest–highest
Ratio lowest–highest
Difference highest–
Difference lowest–
Difference lowest–
Difference urban–
Difference urban–
Ratio urban–rural
Ratio urban–rural
Ratio rural–urban
Difference rural–
Highest
Highest
Highest
Highest
Highest
Highest
highest
highest
Lowest
Lowest
Lowest
Lowest
Lowest
Lowest
lowest
lowest
lowest
lowest
Urban
Urban
Urban
urban
Rural
Rural
Rural
rural
rural
2. 2. 1. 14 11 1. 17 10 1. 16
38 80 43 28 77 48 26 76 2.9 50 67 77 10 66 73 1.1 7 64 82 1.3 18 32 64 91 1.8 73
1 7 1 7 5 3 2 8 6 4
Year 2006
XX
9. Demographic and socioeconomic statistics
Population a Civil Total MDG 5 Adult MDG 2 Gross MDG 1
registration fertility Adolescent literacy Net national Population
coverage (%) rate a fertility rate rate e primary income living on
d
(per (per 1000 (%) school per <$1 (PPP
f
woman) girls aged enrolment capita int. $) a day
e g
15–19 rate (%) (PPP int. (%)
years) $)
Living
Aged
Median Aged Annual in
over
Total (000s) age under growth urban Causes
60
(years) 15 (%) rate (%) areas of
(%) b c
(%) Births death
1999– 2000– 2000– 2000– 2000– 2000–

2009 2009 2009 2009 2009 2009 2009 2009 2008 2008 2010 2010 2009 2000–2008
32 710 16 49 4 3.2 13 21h … 6.3 159 75 96 99 1 190 51.5
Source: World Bank list of economies (December 2010). Washington, DC, World Bank, December 2010 (http://siteresources.worldbank.org/
DATASTATISTICS/Resources/CLASS.XLS).
NB: These summary tables represent the best estimates of WHO – based on evidence available in 2010 – rather than the official estimates of Member States. These estimates have been computed using standard
categories and methods to enhance cross-national comparability. Therefore, they are not always the same as official national estimates, nor necessarily endorsed by specific Member States.
XXI
7.4 UNGASS National Indicators
1. Commitment and Action:

1. Domestic and international AIDS spending by categories and financing sources
2. National Composite Policy Index (Areas covered: gender, workplace, programes, stigma and
discrimination, prevention, care and support, human rights, civil society involvement, monitoring and
evaluation)
2. National Programs:
3. Percentage of donated blood units screened for HIV
4. Percent of adults and children with advanced HIV infection receiving ART
5. Percent of HIV-positive pregnant women who received antiretrovirals to reduce the risk of mother-
to-child transmission
6. Percentage of estimated HIV positive incident TB cases that received treatment for HIV and TB
7. Percentage of women and men aged 15-49 who received and HIV test in the last 12 months and who
know their results
8. Percentage of most-at-risk populations that have received an HIV test in the last 12 months and who
know their result
9. Percentage of most-at-risk populations reached with HIV prevention programs
10. Percentage of orphaned and vulnerable children aged 0-17 whose households received free basic
external support in caring for the child
11. Percentage of schools that provide life skills-based HIV education in the last academic school
3. Knowledge and behavior

12. Current school attendance among orphans and among non-orphans aged 10-14
13. Percentage of young women and men aged 15-24 who both correctly identify ways of preventing
sexual transmissions of HIV and who reject major misconceptions about HIV transmission
14. Percentage of most-at-risk populations who both correctly identify ways of preventing sexual
transmission of HIV and who reject major misconceptions about HIV transmission
15. Percentage of young women and men aged 15-24 who have had sexual intercourse before the age of
15
16. Percentage of women and men aged 15-49 who had more than one sexual partner in the last 12
months
17. Percentage of women and men aged 15-49 who had more than one sexual partner in the last 12
months reporting use of a condom during their last sexual intercourse
18. Percentage of female and male sex workers who report the use of a condom with their most recent
client
19. Percentage of men reporting the use of a condom the last time they had anal sex with a male partner
20. Percentage of injecting drug users reporting the use of a condom the last time they had sexual
intercourse
21. Percentage of injecting drug users reporting the use of sterile injecting equipment the last time they
injected
4. Impact indicators
22. Percentage of young women and men aged 15-24 who are HIV-infected
23. Percentage of most-at-risk populations who are HIV-infected
24. Percentage of adults and children with HIV known to be on treatment 12 months after initiation of
ART
25. Percentage of infants born to HIV-infected mothers who are infected
XXII
7.5 ECSA-HC Regional Core Set of Indicator
SOCIO-ECONOMIC AND DEMOGRAPHIC

1. GDP (current US$ and PPP US$)
2. GDP growth rate.
3. Population dependency ratio (under 15 and over 65 years)
4. Crude birth rate
5. Crude death rate
6. Life expectancy at birth by gender
7. Population growth rate
SOCIAL DETERMINANTS OF HEALTH

8. % of children who enroll and complete primary school
9. % households within 15 minutes of a safe water supply (*)
10. % households with safe sanitation (flush/pit/toilet latrine) (*)
NUTRITION
11. Low birth weight (% of infants with low birth weight)
12. % children with early initiation of breastfeeding (before 1 hour after birth)
13. Infants exclusively breast fed for first 6 months of life
14. % Children aged <5 years underweight for age (*)
15. Stunting (low height for age among < 5 years)
16. Wasting (low weight for age among < 5 years)
17. Iodine deficiency (% of households consuming iodine salt)
18. Vitamin A supplementation coverage
19. Prevalence of iron deficiency anaemia
HEALTH SYSTEMS
Leadership/stewardship/ responsiveness
20. Client satisfaction rate
Health financing
21. General government expenditure on health as % of GDP
22. Total Expenditure on Health as % of GDP
23. General government expenditure on health as % of total expenditure on health
24. Private expenditure on health as % of total expenditure on health
25. Prepaid and pre-pooling funds as % private sector expenditure on Health
26. Out of pocket expenditure as a % of private expenditure on health
27. External resources on health as % of total expenditure on health
28. Total expenditure on health per capita (at PPP international dollar rate)
29. Total government expenditure on health per capita (at PPP international dollar rate)
30. % of public social health insurance to total health expenditure
31. % of private health insurance to total health expenditure
32. % expenditure of primary and secondary level health care services over total government health
expenditure
33. Proportion of population covered by community health financing mechanisms or social health
insurance.
Health Services
34. % of Health Facilities stock-outs of tracer medicines in last 2 weeks
XXIII
Human resources for health
35. No. of doctors per 10 000 population
36. No. of nurses per 10 000 population
37. No. of midwives per 100 000 population
38. Doctor-patient ratio
39. Nurse-patient ratio
40. No. of health workers per 10 000 population
41. % approved posts that are filled at the level of the Ministry of Health
MATERNAL NEONATAL AND CHILD HEALTH/FAMILY REPRODUCTIVE HEALTH

42. Infant mortality rate per 1000 live births (*)
43. Maternal mortality rate per 100 000 live births (*)
44. Neonatal mortality rate per 1000 live births (*)
45. Under five mortality rate per 1000 live births (*)
46. Births attended by skilled health personnel (%) (*)
47. Contraceptive prevalence Rate (%)
48. Full immunization coverage amongst 1 year olds
49. Measles immunization coverage amongst 1 year olds (*)
50. ANC coverage (%) at least one visit
51. ANC coverage (%) at least four visits
52. Unmet need for Family Planning
53. Adolescent birth rate (below 18 years)
54. Total fertility rate
55. % coverage TT2+ (pregnant women)
56. % Caesarian Section rate
57. Couple Years of Protection
MALARIA
58. Malaria mortality rate per 100 000 population
59. % households in malarious areas protected by IRS
60. % of pregnant women sleeping under an ITN
61. % of households with at least one ITN
62. % of <5 children sleeping under an ITN
63. Proportion of children <5 with fever who are treated with appropriate anti-malarial drugs
64. Proportion of fever treated with appropriate anti-malaria
65. Incidence of malaria per 1 000 population
HIV/AIDS
66. Adult (15-49) HIV prevalence percent by country (*)
67. Antiretroviral therapy coverage among people with advanced HIV infection (%)
68. Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
69. Condom use at last high-risk sex
70. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
71. PMTCT coverage
72. HIV/AIDS prevalence among pregnant women 15-24 years
TUBERCULOSIS
73. Tuberculosis prevalence per 100 000 population
74. Tuberculosis mortality rate per 100 000 population
75. Tuberculosis treatment success under DOTS (%)
76. TB detection rates
77. % HIV+ patients screened for TB
78. % TB patients screened for HIV
XXIV
79. TB cure rates
80. TB incidence per 100 000 population
NON COMMUNICABLE DISEASES

81. Death rate due to heart diseases per 10 000 population
82. Prevalence of hypertension (among 25 years and over)
83. Prevalence of smoking among adult population (among 25 years and over)
84. Prevalence of overweight/obesity among adults (among 25 years and over)
85. Prevalence of diabetes (among 25 years and over)
86. Prevalence of mental illness
87. Incidence of cancer disaggregated by gender
88. Death rate due to road traffic accidents per 10 000 population
(*) Provide disaggregation by wealth and urban/ rural residence on asterixed indicators whenever the relevant surveys are
done to produce this data (every 4 - 5 years)
XXV
7.6 Responsibilities, Frequency and Tools for Data Management
Table 16: Responsibility, Frequency and Tools for HSSIP Performance Data Collection and Processing
Activity Responsible Frequency Tools Output Responsible Frequency Tools Output

Person Person
National Level Health facility Level
Administrative Secretary TWG - Monthly Departmental Meetings Minutes All managers / - Monthly Minute format Minutes
data collection / M&E Officer / HOD / HOU
and processing Supervisor - Quarterly - Quarterly
Supervision tools Supervision Supervision tools Supervision reports
- Annual reports - Annual
Duty attendance Register Absenteeism Duty attendance Register Absenteeism report

report
Inventory Tools Health Sector - HMIS 101 Health Facility
(Infrastructure, Equipment, Inventories - HMIS 102 Inventories
commodities, Human - HMIS 103
Resource)
Service delivery Biostastician - Weekly - HMIS 033c - Weekly Community Level
data collection National All community - Daily Record book Register
and processing IDSR based service
database providers
- HMIS 123 Health facility Level
- Monthly - National All service - Daily - Patient Forms - Patient registers
HMIS providers
database
Medical - Weekly - Patient registers - HMIS 033c
Records Officer - Patient registers - MPD Notification
/ Health Form
Information - Monthly - Patient registers - HMIS 105
Assistant
- Annual - HMIS 105 - HMIS 107
XXVI
Person Person
HSD Level
All service - Weekly - HMIS 033c HSD Database
providers
- Monthly - HMIS 105 - HMIS 123
Health - HMIS 108 - HMIS 124
Information
Assistant - Quarterly - HMIS 123 - HMIS 106
- HMIS 124
- Annually - HMIS 123 - HMIS 128

- HMIS 124
District Level
Biostastician - Weekly - HMIS 033c District data base
- Monthly - HMIS 105 - HMIS 123

- HMIS 108 - HMIS 124
- Quarterly - HMIS 123 - HMIS 129

- HMIS 124
- Annually - HMIS 123 - HMIS 128

- HMIS 124
Programme / M&E Focal - Quarterly Programme / Project tools Programme / Coordinators / - Quarterly Programme / Project Programme / Project
Project data Person / Project database Focal Persons tools Database
collection and Specialists - Annual Programme / Project tools - Annual
processing Programme / Project
tools
MoFPED Accountant - Daily Central level OBT Central In- Charge / - Daily Financial Management Financial performance
Performance data Government Accounts Tools data
collection and performance data Assistant
XXVII
Person Person
processing (OBT)
District Level
Accounts - Quarterly - LG OBT - Quarterly LG
Assistant Performance
Reports
- Annual LG
- Annual Performance
Reports
HSSIP Mid Term CHS QA / Once Assessment / survey tools MT Survey
Evaluation data Consultants Reports
collection and
processing
HSSIP End Term CHS QA / Once Assessment / survey tools ET Survey
Evaluation data External Reports
collection and Consultants
processing
Program / Project Managers / Ongoing Assessment / survey tools Periodic Survey Program / Internal / Ongoing Assessment / survey
Periodic Internal / Reports Project Periodic Consultants tools
Evaluations data Consultants Evaluations
collection and
processing
Program / Project External Once Assessment / survey tools ET Evaluation Program / External Once Assessment / survey
End Evaluations Consultants Report Project End Consultants tools
data collection Evaluations
and processing
Data Collection
for Population
based surveys
Uganda National UBOS Annual Survey tools Annual PS Report
Panel Survey
XXVIII
Person Person
Uganda National UBOS Every two years Survey tools UNHS Report
Household Survey
Uganda UBOS Every 5 years Survey tools UDHS Report
Demographic
Health Survey
Data Collection
for Health
Systems
Research
Client Satisfaction QAD / Every 2 years Survey tools Survey Reports DHO / Health Annual Survey tools Survey Reports
Surveys Programme Unit Managers /
Managers
Health Services Research Ongoing Survey tools Survey Reports DHO / Health Periodic Survey tools Survey Reports
Assessment Institutions Unit Managers /
Studies
Thematic Studies Research Periodic Survey tools Survey Reports Research Ongoing Survey tools Survey Reports
Institutions Institutions
Clinical Trials and Research Ongoing Survey tools Survey Reports Research Ongoing Survey tools Survey Reports
Community Institutions Institutions
Longitudinal
Studies
XXIX
Table 17: Responsibility, Frequency and Tools for HSSIP Performance Data Analysis and Synthesis

Person Person
Administrative Secretary TWG - Quarterly - Minutes - Sector TWG All managers / - Quarterly - Minutes - Departmental
data analysis and / M&E Officer / - Supervision reports quarterly HOD / HOU - Supervision reports Quarterly report
synthesis Supervisor - Absenteeism report reports - Absenteeism report
- Health Sector - Health Facility - Departmental
- Annual Inventories - Annual - Annual Inventories Annual report
Health
Statistical
Report
National Level Institutional / Health Facility Level
Service delivery Epidemiologist - Weekly - National IDSR - Weekly, Community Level

data analysis and - Monthly database monthly and
synthesis - Annual annual VHT Monthly Registers HMIS Form (Monthly)
National
IDSR & MPD Health facility Level
Reports
Records Officer - Weekly - Patient registers - HMIS 033c
/ Health - Monthly - MPD Notification
Information - Annual Form
Assistant
ACHS RC - Monthly - HMIS 123 - Monthly Data Manager - Monthly - Patient registers - HMIS 105
- HMIS 124 district
HMIS reports
- Quarterly - HMIS 129 - Quarterly - Quarterly - HMIS 105 - HMIS 106

- HMIS 104
XXX
Person Person
district
performance - Annual - HMIS 107
reports HSD Level
- Annual - HMIS 128 Records Officer - Weekly - Patient registers - HMIS 033c
- Annual / Health
Health Information - Monthly - HMIS 105 - HSD HMIS 123
Statistical Assistant - HMIS 108
report
- Quarterly - HSD HMIS 124 - HSD HMIS 129
- Annual - HSD HMIS 129 - HSD HMIS 107
District Level
DHO / Monthly - HMIS 105 - HMIS 123
Institutional - HMIS 108 - HMIS 106
Head
- Quarterly - HMIS 106 - HMIS 129
- Annual - HMIS 107 - HMIS 128

Programme / Programme / - Quarterly Programme / Project - Quarterly DHO / - Quarterly Programme / Project - Quarterly
Project data Project database Programme / Institutional Database Programme /
analysis and Manager Project Head - Annual Project Reports
synthesis - Annual Reports
- Annual
- Annual Programme /
Programme / Project Report
Project
Report
MoFPED Vote Holder - Quarterly Central Government - Quarterly CG Health facility Level
Performance data performance data Performance Facility In - Quarterly Health Facility Financial - Quarterly Health
analysis and Reports Charge data Facility Financial
XXXI
Person Person
synthesis Performance
- Biannual - Biannual CG Reports
Performance
Reports - Annual - Annual Health
Facility Financial
- Annual - Annual CG Performance
Performance Reports
Reports Vote Holder - Quarterly LG performance data - Quarterly LG
Performance
Reports
- Biannual - Biannual LG
Performance
Reports
- Annual - Annual LG
Performance
Reports
HSSIP Mid Term MTR Task Once MT Survey Reports MTR Report
Evaluation data Force
analysis and
synthesis
HSSIP End Term Policy Analysis - Once ET Survey Reports End Term Review
Evaluation data Unit Report
analysis and
synthesis
Program / Project Researchers / Periodic Periodic Survey Reports Periodic Researchers / Periodic Periodic Survey Reports Periodic Programme /
Periodic Consultant Programme / Consultant Project Evaluation
Evaluations data Project Evaluation Report
analysis and Report
XXXII
Person Person
synthesis
Program / Project Researchers / Once in project ET Evaluation Report End Term Researchers / Once in project ET Evaluation Report End Term Programme
End Term Consultant life Programme / Consultant life / Project Evaluation
Evaluation data Project Evaluation Report
analysis and Report
synthesis
Health Systems Researchers Ongoing Study findings Study reports Researchers Ongoing Study findings Study reports
research data
analysis and
synthesis
XXXIII
Table 18: Responsibility, Frequency and Tools for HSSIP Performance Data Quality Assessment

Person Person
Administrative M&E Quarterly Data quality audit tool Quality assured Supervisor Quarterly Data quality audit tool Quality assured
data quality Committee reports reports
assurance
Service delivery ACHS RC Quarterly Data quality audit tool Data quality audit District Quarterly Data quality audit tool Data quality audit
data validation reports Biostastician / reports
exercises Programme
Supervisors
District Level
MoH Quarterly Data quality audit tool Data quality audit
Biostastician / reports
Programme
Supervisors
M&E Unit Annually Rapid Data Quality Audit RDQA Report
tools
UBOS HSSIP Midterm Data Quality Assessment DQAA Report
and End term and Adjustment
Data Quality Audit M&E Unit Periodically Data quality assessment Data quality
for sector tool assessment and
evaluation adjustment reports
studies
Data validation Institutional Periodically Data quality assessment Data quality Institutional Periodically Data quality assessment Data quality
for Health Review Boards tool assessment and Review Boards tool assessment and
Systems research adjustment reports adjustment reports
XXXIV
Table 19: Responsibility, Frequency and Tools for Data Dissemination and Communication

Person Person
Administrative Secretary TWG - Quarterly - Sector TWG Reports - Quarterly Health Facility - Quarterly - Departmental - Quarterly reports
Reports / M&E Officer / TWG Reports In Charge Quarterly report disseminated to
dissemination Supervisor Disseminated HUMC / Board
and in SMC
communication - Annual - Departmental - Annual report
- Quarterly - Sector TWG Reports - Quarterly Annual report disseminated to
TWG Reports HUMC / Board
Disseminated and Sub County
in HPAC forum
HSD
HSD In Charge - Quarterly - Departmental - Quarterly HSD
Quarterly report reports
disseminated to
HUMC
- Annual - Departmental - Annual HSD

Annual report report
disseminated to
HSD forum
District
DHO - Quarterly - Departmental - Quarterly
Quarterly report administrative
reports
disseminated to
DHMT
- Annual - Departmental - Annual District

Annual report Performance
report
XXXV
Person Person
disseminated to
District
Stakeholders’
forum
Service delivery ACHS CD Weekly Weekly IDSR Reports IDSR Reports Community Level
data disseminated VHT Chairman Quarterly Quarterly Report Quarterly report
dissemination disseminated to
and Parish Committee
communication Health facility Level
Surveillance - Weekly - HMIS 033c IDSR Reports
Focal Person - Monthly disseminated during
- Annual facility and community
meetings
ACHS RH Weekly Weekly MPD Notification MPD Notification Health Facility - Weekly - MPD Notification MPD Notification and
Reports Reports In Charge - Monthly Form Review Reports
disseminated - Annual disseminated during
facility and community
meetings
ACHS RC Quarterly Quarterly district Quarterly district Health Facility - Monthly - HMIS 105 - Monthly
performance reports performance In Charge performance
reports disseminated
disseminated at during monthly
sector review meetings and
meetings, displayed using
feedback to the monitoring
districts (league graphs
table)
- Quarterly - HMIS 106 - Quarterly reports
disseminated to
XXXVI
Person Person
HUMC / Board
- Annual - HMIS 107 - Annual report

disseminated to
HUMC / Board
and Sub County
forum
HSD
HSD In Charge - Quarterly - HMIS 106 - Quarterly HSD
- HMIS 129 reports
disseminated to
HSD Team.
- Annual - HMIS 107 - Annual HSD

- HSD HMIS 128 report
disseminated to
HSD
Stakeholders’
forum
District
DHO - Quarterly HMIS 129 - Quarterly District
Assessment
reports
disseminated to
DHMT
- Annual HMIS 128 - Annual

Performance
report
disseminated to
District
XXXVII
Person Person
Stakeholders’
forum.
Programme / Programme / - Quarterly - Quarterly Programme Reports Focal Person / - Quarterly - Quarterly - Quarterly reports
Project data Project / Project Reports Disseminated Project Programme / disseminated to
dissemination Managers Manager Project Reports DHMT
and
communication - Annual - Annual Programme / - Annual - Annual Programme - Annual report
Project Report / Project Report disseminated to
District
Stakeholders’
forum
MoFPED ACHS BF - Quarterly - Quarterly CG Reports Health facility Level
Performance data Performance Disseminated In Charge - Quarterly - Quarterly Health - Quarterly reports
dissemination Reports Facility Financial disseminated to
and Performance DHMT
communication - Biannual CG Reports
Performance
Reports - Annual - Annual Health - Annual report
Facility Financial disseminated to
- Annual - Annual CG Performance District
Performance Reports Reports Stakeholders’
forum
Accounting - Quarterly - Quarterly LG - Quarterly LG
Officer Performance Performance
Reports Reports
- Biannual - Biannual LG - Biannual LG

Performance Performance
Reports Reports
- Annual - Annual LG - Annual LG
XXXVIII
Person Person
Performance Performance
Reports Reports
Health survey DGHS Once Survey Reports Reports
dissemination Disseminated
and
communication
HSSIP Mid Term DGHS Once MTR Report Reports

Evaluation Disseminated
dissemination
and
communication
HSSIP End Term DGHS Once End Term Review Report Reports
Evaluation Disseminated
dissemination
and
communication
Program / Project Programme / Periodic Periodic Programme / Reports Programme / Periodic Periodic Programme / Reports Disseminated
Periodic Project Project Evaluation Reports Disseminated Project Project Evaluation
Evaluations Managers Managers Reports
dissemination
and
communication
Health Systems Researchers Ongoing Study reports Reports Researchers Ongoing Study reports Reports Disseminated
research Disseminated
dissemination
and
communication
XXXIX
Table 20: Responsibility, Frequency and Tools for HSSIP Performance Data Translation into Policy and Decision-Making

Person Person
Administrative data All HOD / Units - Quarterly - Quarterly Review Plans DHO / Health Ongoing - Departmental Plans
Reports Facility In reports
Charge /
Management
- Annual - Aide Memoire Plans Committees /
Boards
Service / Programme / DHO / Health Ongoing Health Facility / Plans
programme / project Plans Facility In Programme / project
project delivery Managers Annual Aide Memoire Charge reports
data
MoFPED Accounting Ongoing CG Performance Reports Plans Accounting Ongoing LG Performance Plans
Performance data Officer Officer Reports
Population based Top Ongoing Survey reports Plans
survey data Management
HSSIP Mid Term Top Once MTR Report Plans

Evaluation Management
HSSIP End term Top Once End Term Review Report HSSIP 2015/16 –
Evaluation Management 2020/21
Health Systems Top Ongoing Study reports Interventions Institutional Ongoing Study reports Interventions
Research Management Leadership
XL
7.7 HC IV Performance Assessment
Table 21: Indicators showing functionality of HC IVs
Indicator Baseline (2009/10

FY)
Proportion of HC IVs with a functional theatre 52.9% (63)
Percentage of Caesarean Sections done out of the total deliveries in the HC 1.2% (808)
IVs
Proportion of qualified/trained health workers staying at the health facility 52% (921)
Percentage of HC IVs providing at least 10 out of 12 key services 23.5% (28)
recommended for HC IV level
Average length of stay 3 days
Daily Average Occupancy at HC IV level 17 patients
Bed Occupancy at HC IV level 43%
Proportion of HC IVs with a functional surgical ward 16% (9)
Proportion of HC IVs with at least 1 Medical Officer 57.1% (68)
Death Rate (Deaths out of the total patients admitted) 0.7% (1,665)
Maternal deaths 27
Percentage of HC IVs providing ART services 79% (94)
Source: MoH / Resource Centre Annual Reports submitted by 119 HC IVs
XLI
7.8 Hospital Performance Assessment
Table 22: Performance Assessement Outputs from General Hospitals
operations
Immuniza
Inpatients
Caesarian
deliveries
Inpatient
patients
Section
Major
ANC
Beds
SUO
days
tion
Out
Total
Average
Minimum
Maximum
Average 142 8,472 38,722 42,455 1,419 561 3,568 299 8,730 178,777
2009 / 10
Source: Ministry of Health, AHSPR 2009/10
Table 23: Performance Assessement Outputs of Regional Referral and Large PNFP Hospitals
No. started
Average for
Total OPD
Deliveries in
Patient Days
attendances
all hospitals
Immunizati
Admissions
Operations
Total ANC
Planning
on ART
Family
Major
Total
Total
Beds
SUO
Unit
on
Total
Average
Minimum
Maximum
Average 117,410 9,735 4,535 21,038 2,146 381 320 21,856 106,805 1,853 468,752
2009 / 10
Source: Ministry of Health, AHSPR 2009/10
XLII
7.9 District Ranking
Table 24: District Rankings for the Various Poverty Dimensions
Indicator Indicator National Income Disaggregation Literacy level Gender Security level
domain Achievement Disaggregation Disaggregation Disaggregation
Top Bottom Top districts Bottom Top Bottom Top Bottom

districts districts districts districts districts districts districts
Coverage for % pregnant women attending 4 ANC sessions

Health
Services % deliveries in health facilities
% children under one year immunized with 3rd dose Pentavalent vaccine
(m/f)
% one year old children immunized against measles (m/f)
% pregnant women who have completed IPT2
% of children exposed to HIV from their mothers accessing HIV testing

within 12 months (m/f)
% U5s with fever receiving malaria treatment within 24 hours from VHT (m/f)
% eligible persons receiving ARV therapy (m/f)
% of new TB smear + cases notified compared to expected ( TB case

detection rate) (m/f)
Coverage's % of households with a pit latrine

for other
health % U5 children with height /age below lower line (stunting) (m/f)
determinants
% U5 children with weight /age below lower line (wasting) (m/f)
XLIII
Indicator Indicator National Income Disaggregation Literacy level Gender Security level
domain Achievement Disaggregation Disaggregation Disaggregation
Top Bottom Top districts Bottom Top Bottom Top Bottom

districts districts districts districts districts districts districts
Coverage's Contraceptive Prevalence Rate

for risk
factors
Health Per capita OPD utilization rate (m/f)

System
outputs % of villages/ wards with trained VHTs, by district -
(availability,
access, % of health facilities without stock outs of any of the six tracer medicines in
quality, previous 3 months (1st line antimalarials, Depoprovera, Suphadoxine
safety /pyrimethamine, measles vaccine, ORS, Cotrimoxazole)
% of functional Health Centre IVs (providing EMOC) -
% Annual reduction in absenteeism rate
Health % of approved posts filled by trained health workers

investments
General Government allocation for health as % of total government budget
XLIV
7.10 Proposed Time Table for the HSSIP 2010/11 - 2014/15 Midterm
Review
No. Activity Date/Period
1 Agree on the Working Groups / identifying if any additional Working Groups need to be 2nd wk Sept 2012
set up
2 Generic Terms of Reference and specific ToRs developed for each Working Group 1st wk Oct 2012
3 Develop Terms of Reference and recruit a Technical Assistant to assist the MTR 1st wk Oct 2012
secretariat
4 Generic Terms of Reference and specific ToRs for the Working Groups agreed at HPAC 1st wk Oct 2012
5 Meetings with the Working Groups Chairpersons and the Secretariat to discuss and 1st wk Oct 2012
agree the Terms of Reference for each group and set them off to start meeting and
working
6 Each WG to produce Program of Work 1st wk Oct 2012
7 Presentation and endorsement of ToRs at the 19th JRM 3rd wk October 2012
8 ToR for the Lead Facilitator developed and presented to HPAC By end of October 2012
9 Retreat for all working groups to discuss the working groups preliminary reports 2nd wk Dec 2012
-2 days –working in individual working groups
-2 days- plenary for all working groups
Chairperson, Secretary and Facilitator to act as Secretariat for each working group
10 Each secretariat of the working groups to review the respective sections of the HSSIP Dec 12 - Jan 13
using the outputs of the working groups
11 - Circulate the time table for key activities to be undertaken to finalise report, 1 – 10 January 13
- Review WG draft retreat reports and highlight key points, issues and questions
12 Receive final drafts from WGs 14 January 13
13 MTR Secretariat Retreat 4th wk January 13 (3 dyas)
14 Half day meeting with SMC to discuss the Draft 0ne MTR report 12 February 13
15 Incorporate comments from SMC to produce Draft Two Completed by 17 February 13
16 HSRC Meeting to discuss Draft Two 3rd wk February 13
17 Presented Draft Two to Top Management Committee MoH 4th wk Feb 2013
18 Incorporate comments from HSRC Meeting and Top Management Committee to produce Completed by 3 March 2013
Draft Three
19 Circulate Draft Three to HPAC 1st March 2013
20 Discuss Draft 3 at March 2013 HPAC Meeting 1st wk March 2013
21 Incorporate HPAC comments to produce Draft Five 10 March 2013
22 Circulate Draft Five to all Development Partners. 14 March 13
XLV
23 Discuss final comments from DPs at April 2013 HPAC Meeting 2 April 2013
24 Incorporate agreed comments to produce final HSSIP Mid Term Review report Second week of April 2013
25 Printing of final HSSIP MTR report Third and Fourth weeks of

April 2013
26 Distribute final MTR report to all members both within and outside the country. First week May 2013
XLVI
7.11 Proposed Time Table for the HSSIP 2010/11 - 2014/15 End term
Evaluation
1 Agree on the Working Groups / identifying if any additional Working Groups need to be 2nd wk Sept 2014
set up
2 Generic Terms of Reference and specific ToRs developed for each Working Group 1st wk Oct 2014
3 Develop Terms of Reference and recruit a Technical Assistant to assist the MTR 1st wk Oct 2014
secretariat
4 Generic Terms of Reference and specific ToRs for the Working Groups agreed at HPAC 1st wk Oct 2014
5 Meetings with the Working Groups Chairpersons and the Secretariat to discuss and 1st wk Oct 2014
agree the Terms of Reference for each group and set them off to start meeting and
working
6 Each WG to produce Program of Work 1st wk Oct 2014
7 Presentation and endorsement of ToRs at the 21st JRM 3rd wk October 2014
8 ToR for the Lead Facilitator developed and presented to HPAC By end of October 2014
9 Retreat for all working groups to discuss the working groups preliminary reports 2nd wk Dec 2014
-2 days –working in individual working groups
-2 days- plenary for all working groups
Chairperson, Secretary and Facilitator to act as Secretariat for each working group
10 Each secretariat of the working groups to review the respective sections of the HSSIP Dec 12 - Jan 15
using the outputs of the working groups
11 - Circulate the time table for key activities to be undertaken to finalise report, 1 – 10 January 15
- Review WG draft retreat reports and highlight key points, issues and questions
12 Receive final drafts from WGs 14 January 15
13 MTR Secretariat Retreat 29 – 31 January 15
14 Half day meeting with SMC to discuss the Draft 0ne MTR report 12 February 15
15 Incorporate comments from SMC to produce Draft Two Completed by 17 February 15
16 HSRC Meeting to discuss Draft Two 20 – 21 February 15
17 Presented Draft Two to Top Management Committee MoH 27 Feb 2015
18 Incorporate comments from HSRC Meeting and Top Management Committee to produce Completed by 3 March 2015
Draft Three
19 Circulate Draft Three to HPAC 1st wk March 2015
20 Discuss Draft 3 at March 2015 HPAC Meeting 1st wk March 2015
21 Incorporate HPAC comments to produce Draft Five 10 March 2015
22 Circulate Draft Five to all Development Partners 14 March 2015
XLVII
23 Discuss final comments from DPs at April 2015 HPAC Meeting 1st April 2015
24 Incorporate agreed comments to produce final HSSIP End Term Evaluation report Second week of April 2015
25 Printing of final HSSIP ETE report Third and Fourth weeks of

April 2015
26 Distribute final ETE report to all members both within and outside the country. First week May 2015
XLVIII
8 REFERENCES
Guidelines for Budget Preparation and Reporting Using the Output Budgeting Tool (OBT),
MoFPED, November 2010).
Guidance for Monitoring and Evaluation of National Health Strategies, WHO 2010.
Health Management Information System 2010, Manual (Draft) MoH, 2010.
Health Sector Strategic and Investment plan 2010/11 – 2014/15, MoH July 2010.
The Long Term Institutional Arrangements (LTIA) for management of Global health Grants in
Uganda, (Abridged Version, 2009).
Monitoring, Evaluation and Review of National health Strategies: A country-led platform for
information and accountability, WHO, May 2011
Monitoring and Evaluation Strategy for the National Development Plan (2010/11 – 2014/15),
MoFPED, April 2010.
Monitoring and Evaluation of Health Systems Strengthening: An Operational Framework, WHO,
GAVI, Global Fund and the World Bank, November 2009, Geneva.
National Policy on Public Sector Monitoring and Evaluation, October 2010
XLIX

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GOVERNMENT OF UGANDA

Promoting People’s Health to Enhance Socio-economic Development

MONITORING & EVALUATION PLAN

Published by: Ministry of Health

For God and My Country

DR. CHRISTINE ONDOA

Executive Summary ................................................................................................. ii

Table of Tables ...................................................................................................... vi

Table of Figures ................................................................................................... viii

Operational Definitions .......................................................................................... xi

1.1 Goal and Objectives of the HSSIP M&E Plan ................................................ 3

1.1.1 Goal ................................................................................................... 3

1.1.2 Specific Objectives.............................................................................. 3

1.1.3 Key Outputs ....................................................................................... 3

1.1.4 Outcomes ........................................................................................... 4

1.2 Process of Development of the HSSIP M&E Plan .......................................... 4

1.3 The HSSIP 2010/11 – 2014/15 Conceptual Framework .............................. 4

1.4 Implications for Sector Monitoring and Evaluation ..................................... 6

2 Monitoring & Evaluation Mechanism for HSSIP 2010/11 – 2014/15 .................. 7

2.1 The General M&E Framework ..................................................................... 7

2.2 The HSSIP Monitoring and Evaluation Tools ............................................... 8

2.2.1 Country Compact for Implementation of the HSSIP 2010/11 – 2014/15

2.2.2 Core Indicators for HSSIP 2010/11 – 2014/15 .................................... 9

2.2.3 Programme / Project Specific Indicators ............................................. 9

2.2.5 Programme and Project Specific M&E Plans ....................................... 10

2.3 Data Management ................................................................................... 14

2.3.1 Sources of Data for Health Sector Monitoring.................................... 14

2.3.2 Critical gaps and challenges in data management............................. 15

2.3.3 Data Collection Methods and Tools .................................................. 16

2.3.4 Data Analysis and Synthesis ............................................................. 18

2.3.5 Data Accuracy and Reliability ............................................................ 19

2.3.6 Data Dissemination .......................................................................... 20

2.3.7 Data Communication ........................................................................ 22

2.4 Responsibilities for Data Management by Level ....................................... 23

3 The HSSIP 2010/11 – 2014/15 Monitoring and Review Process ...................... 27

3.1 Country mechanism for review and action ............................................... 28

3.1.1 Performance Monitoring and Review at Central Level ........................ 30

3.1.2 Performance Monitoring and Review at Regional Level ...................... 31

3.1.3 Performance Monitoring and Review in Local Governments/District

3.1.4 Performance Monitoring and Review at Health Sub-District Level ...... 34

3.1.5 Performance Monitoring and Review at Health Facility Level .............. 35

3.1.6 Performance Monitoring and Review at Community Level.................. 37

3.1.7 Performance Monitoring and Review at VHT Level ............................. 37

3.1.8 The National Health Accounts ........................................................... 38

3.1.9 Joint Review Mission ......................................................................... 38

3.2.2 Performance Monitoring by the MoFPED at LG Level .......................... 41

3.2.3 Monitoring Performance of the Supply Chain Management System ... 44

3.2.4 Monitoring by the Health Development Partners ............................... 46

3.6 Performance Monitoring and Review for Implementing Development

3.7 Routine Feedback to Sub-national and Key Stakeholders ......................... 49

3.8 Reporting Progress against the NDP 2010/11 - 2014/15 ........................ 49

3.9 Reporting Requirements on International Commitments and Resolutions 49

3.10 HSSIP Evaluation .................................................................................. 52

3.10.1 Programme / Project Evaluation .................................................... 52

3.10.2 Mid Term Review........................................................................... 52

3.10.3 HSSIP End Term Evaluation ............................................................ 53

4.1 Surveys Commissioned by the MoH ......................................................... 55