By Clea Meynell:
IMG recognises that the success of this initiative wholly depends on a number of key partnerships and ongoing collaborations to leverage resources and support. These are as follows:
There are three ongoing collaborations which form the basis of this initiative. The first relates to the unique set-up which exists between the various IMG entities. IAA Healthcare provides a significant regular income, which helps to defray the clinic’s fixed costs, including e.g. staff salaries. IHK provides the overall management and supervision of the clinic, ensuring Patient Safety and Quality of Care. It also ensures reliable provision of drugs and medical consumables. IMG Construction (the team that has built and maintains International Hospital Kampala) has already been deployed to make some minor renovations to the Charis facility and this will be the team used to build the Theatre Suite once funds have been raised. By using our own internal workforce we can control costs and ensure quality and timely delivery. International Health Sciences University (IHSU) will deploy its research students and lecturers to continue inputting into baselines and evaluating the outputs and outcomes at Charis-IMC. This adds an academic and objective rigor to our planning and assessments.
The partnership between Charis-IMC and Fields of Life is another important relationship which is central to the success of this model, and one which would be furthered through the provision of financial support in constructing the operating theatre. It is due to the vision and generosity of those involved in FoL that this clinic has been established in the first place. That vision was for a community hospital serving the poor in these communities and we are now very close to making this a reality.
Dr Joel’s continued involvement brings the additional benefit of his wealth of experience and knowledge of Ugandan Healthcare. Dr. Joel is a well respected local resident in Lira and he is able to help establish the local links and partnerships with the District Health managers and senior staff at many other facilities.
Lastly continued collaboration with the Ministry of Health, both at District and National level will be important to ensure buy-in and to feed back findings to key policy makers.
The portfolio of IMF projects being implemented from Charis IMC will vary over the coming years depending on project length and each project will have a range of stakeholders specific to its focus. At present there are a number of donors who are currently supporting IMF activities at Charis IMC.
The Positive Action for Children Fund (PACF) supports the new Yer Yotkom Project, a 3-year Sexual Reproductive Health (SRH) project being implemented in partnership with the National Community of Women living with HIV/AIDS (NACWOLA). The PACF is a fund set up by two global pharmaceuticals, Pfizer and Glaxo Smith Kline.
Suubi Trust helped to establish the initial charity based work at the Lira IMC. Its funds supported provision of primary care to more than 3,000 patients in the last year, initiated an Immunisation programme and helped meet the cost of some essential equipment.
Hands of Help Australia has been a long-standing donor to IMF with financial assistance being provided for two community projects, one in Jinja and one in Lira. The Aldo Project provides HIV/AIDS prevention, testing and treatment services to community members in Lira. It is a small but successful project which is due to finish in January 2010. IMF are in the process of finding funding to continue and expand this service.
A key gap in service provision for Lira District highlighted to IMF by the Aldo Project was the lack of CD4 machines which were functional in the District. Samples were being sent to Gulu for analysis, causing a high cost onto the patients. Therefore, IMF approached the HIPS Initiative (Health Initiatives for the Private Sector) to partner with IAA Healthcare (IMG) to cost-share on the purchase of a new CD4 machine for Lira IMC. Both parties contributed just over USD 15,000 each. This machine is now successfully installed and in operation. A pricing model has been established in which the margins charged to private and IAA pre-paid clients are used as a cross-subsidy to provide CD4 tests for our community clients at a reduced price.
Voluntary Services Overseas (VSO) have a longstanding relationship with IMG, with IHK receiving numerous VSO volunteers on a regular basis. Three such volunteers have had a considerable input into the development of the Charis IMC model. Dr Richard and Patricia Feinmann were based in Lira for 3 months working with the team to do an assessment of training needs and to develop initial ideas and potential models for the initiative. Diane Lockhart, an experienced midwife, has recently spent 3 weeks with the team up in Lira, focussing specifically on maternity services and related training needs. IMF are currently in the process of working alongside VSO to identify future roles for volunteers to be based at Charis IMC in Lira.
In the pipeline
The vision for Charis IMC is such that the collection of partnerships and collaborations outlined above will be both expanded and formalised in the future. In terms of expansion, there are already a number which are currently being developed through proposals and ongoing discussions. These include:
– Further collaboration with Target TB and Comic Relief to increase the TB-related work that Charis IMC is involved with. TB diagnosis and treatment is a particularly under-resourced area in Lira District and preliminary investigations hint at a problem which is growing, particularly in the urban areas of Lira Municipality.
– As mentioned above, there is a need to find additional funding for the HIV/AIDS related work undertaken in Charis IMC. The IMF team are in the process of approaching a number of donors, namely Civil Society Fund and the Global Fund to fill this gap.
– Recent conversations with the UK Department for International Development (DfID) were particularly positive and there was a great deal of cross-over between the approach described here and their current thinking for support to Northern Uganda, particularly concerning maternal health.
In the long-term IMF is considering the idea of creating a consortia of donors and other stakeholders so as to formalise these relationships and to leverage further resources. This would facilitate easier marketing of the various initiatives involved in Charis IMC and would hopefully attract new interested parties.