In April 2009, PSI/Uganda transitioned to PACE, a local organization and network member of PSI. The vision of PACE is to be a leader in solutions for the Ugandan health market. PACE is an innovative, efficient and impact-oriented organization that works towards realizing a community of Ugandans empowered to sustain healthy behavior, while significantly contributing to Ministry of Health priority health areas including HIV/AIDS, malaria, child health and reproductive health.
PACE has health interventions in malaria, reproductive health, maternal health, youth friendly services, safe water, child survival, and HIV/AIDS care and prevention. PACE uses social marketing to promote products, services and healthy behaviors that enable low-income and vulnerable communities to lead healthier lives.
PACE estimates that in 2015, its products and services helped avert 1,018,872 DALYs, including, by health area:
- 41,405 Malaria DALYs
- 441,075 HIV DALYs
- 514,052 FP DALYs
- 21,614 MNCH DALYs
- 524 WASH DALYs
- 201 NCD DALYs
PACE’s family planning program also provided 762,415 couple-years of protection.
Distribution of long-lasting insecticide-treated nets (LLINs)
With funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria, PACE has worked with the Ugandan Ministry of Health (MoH) for the last four years, to reduce the incidence of malaria through the distribution of long-lasting insecticide treated nets.
In 2015, PACE, in partnership with the Ugandan MoH, The AIDS Support Organization (TASO) and with support from Global Fund, distributed over 340,000 long-lasting insecticide-treated nets (LLINs) to pregnant women. This was done during antenatal care visits in public and private not-for-profit health facilities. PACE conducts community social mobilization of pregnant women and their families, and trains health workers on malaria case management, using rapid diagnostic tests and LLINs in 31 districts in the Northern, Eastern and Central regions.
In addition, PACE trained village health teams (VHTs) to improve their knowledge and ability to communicate with their communities on malaria, TB and HIV/AIDS and supports awareness activities within communities and schools to ensure that the final recipients of these treated mosquito nets know how to use them and repair them to last longer.
These awareness activities were also geared towards increasing knowledge on prevention and treatment of malaria, TB and HIV/AIDS amongst these target populations.
Also with funding from the Global Fund, PACE is undertaking integrated community case management of malaria (iCCM) in 17 districts, mainly in northern Uganda. Under this project, PACE will be supporting the districts to train village health teams , as well as supporting them in community case management of malaria.
The village health teams will conduct household visits in their catchment area, providing each household with information on how to prevent malaria, and steps to take if signs and symptoms of malaria are present. This project will run through 2017.
LLIN Hang-up Campaign
With funding from UKAID and UNICEF, PACE is supporting the Ministry of Health to mobilise communities for mass distribution of long lasting insecticide treated nets (LLINs), and behavior change communication to ensure that the nets are hang up and used in 27 districts in Eastern Uganda.
The entire campaign will see the distribution of 24 million nets to Ugandan households in 2017.
Women’s Health Project
PACE has been implementing the Women’s Health Project (WHP) in Uganda since 2008 to increase access to and demand for affordable, high quality long-term family planning services through a network of private healthcare providers. This network of providers is branded ProFam.
The goal of the program is to reduce maternal mortality by improving the quality of reproductive health services, limiting births through increased use of IUDs and implants, providing harm reduction in the case of unsafe abortions through training health providers in post-abortion care as well as the prevention of postpartum hemorrhage through the distribution of misoprostol.
Cervical cancer screening and preventive treatment
Since 2013, PACE has been supporting 100 privately owned clinics within the ProFam franchise to provide cervical cancer screening using visual inspection with acetic acid (VIA) at an affordable price. Currently, 35 of these clinics have a cryotherapy machine, acting as referral sites for early treatment for cervical cancer, if a client tests positive for pre-cancerous lesions.
In 2016, PACE carried out a pilot for HPV-DNA testing in two districts of Mbale and Soroti.
Youth Friendly Services (YFS) Project
In 2016, PACE partnered with the Pfizer Foundation to begin implementation of a youth friendly program in Uganda. It uses the private sector to reach girls aged 15 to 24 with sexual and reproductive health information and services. This project is being implemented in the districts of Wakiso, Mukono, Buikwe and Kampala. In order to come up with a highly impactful intervention, PACE is using the human centered design process to understand what young people want and need, and how to provide a friendly environment for them to access and use sexual and reproductive health information and services.
Clean delivery kits
PACE produces and supplies clean delivery kits for mothers, containing essential items for safe delivery. The Maama Kit is primarily purchased by relief agencies working with refugees and other priority populations, but is also sold generally through pharmacies.
In 2016, the Maama kit was expanded to include chlorhexidine for umbilical cord care following approval by the Ministry of Health.
MSD for Ugandan Mothers (MUM) Project
Since 2013, PACE has implemented a three-year project with support from MSD for Mothers. It aims at making high-quality maternal healthcare in the private health sector accessible and affordable. Under the MSD for Ugandan Mothers, PACE worked with partners like Transaid, Save for Health Uganda and the Association of Obstetricians and Gynaecologists of Uganda to tackle the three delays that contribute to maternal morbidity and mortality: the delay in decision to seek care, delay in reaching care, and delay in receiving adequate healthcare. The project is transitioning into a sustainable social franchise, Tunza, aimed at providing affordable, quality care, while remaining a viable enterprise for the private health facility owners.
In 2016, PACE began implementing a project to improve maternal and newborn care in Uganda by availing misoprostol for postpartum hemorrhaging (PPH), and chlorhexidine for umbilical cord care in both the public and private health sector. PACE is socially marketing misoprostol and Umbi-gel (chlorhexidine) to ensure that every mother has a chance to protect her life and that of her newborn baby. In addition, health education is provided about these two commodities in communities to increase awareness about prevention of PPH and cord care for newborn babies. This project will be implemented in the districts of Mukono, Luweero, Mpigi, Mubende and Buikwe.
Water, Sanitation and Hygiene
P&G Purifier of Water
PACE socially markets P&G Purifier of Water, formerly, PuR; an affordable and easy-to-use water treatment product aimed at reducing sickness and death caused by diarrheal diseases. P&G Purifier of Water has also been distributed to people living with HIV/AIDS and is available in retail outlets and pharmacies across Uganda.
PACE also socially markets WaterGuard Tab, targeted at the general population in urban and peri-urban areas. A single sodium hypochlorite tablet can treat 20 liters of water; with each dispenser of WaterGuard containing 80 tablets at a cost of 70 cents. The WaterGuard Tab serves to increase the range of point-of-use treatment options available to our target populations including people living with HIV.
Community Driven Response Project
PACE’s Community Driven Response Project aimed at reducing the rate of HIV infections among Ugandans by promoting HIV prevention approaches. The project employed the Ministry of Health’s National HIV Prevention Strategy. It combined service provision alongside addressing the socio-cultural behavioral issues facilitating the spread of HIV.
The specific focus on was on priority populations: female sex workers and their clients, uniform service personnel, pregnant women living with HIV/AIDS, prison inmates, and long distance truck drivers, among others.
Funded by the Civil Society Fund, this project began in 2011 and concluded in 2015. It was implemented in the districts of Iganga, Jinja, Masaka, Lwengo, Oyam, Alebtong, Busia and Kabarole.
Condom social marketing
Since 2006, PACE (then PSI/Uganda) has marketed Trust condoms in a bid to increase accessibility and availability of condoms across Uganda, especially in the rural communities. TRUST Condoms were rebranded in 2015 to include four new variants: TRUST Classic, TRUST Scented, TRUST Studded and TRUST Ribbed.
Positive Living Project
PACE, in partnership with Centers for Disease Control and Prevention (CDC) Uganda and the Ministry of Health (MoH) implemented the Positive Living Project from 2010 to 2016. The project was funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the CDC. The goal of the project was to improve the health status of people living with HIV/AIDS in Uganda through provision of the basic care package and promoting a positive living lifestyle.
The project used simple tools to empower people living with HIV to avert opportunistic infections, delay progression of HIV and prevent transmission. The basic care package included a water vessel and WaterGuard point-of-use water treatment, a long lasting insecticide treated net, condoms and an information leaflet on the positive living lifestyle. Cotrimoxazole prophylaxis was added to the package at the care facility.
- UK Department for International Development (DfID)
- United Nations Children’s Fund (UNICEF)
- The Global Fund to Fight AIDS, Tuberculosis and Malaria
- S. Centers for Disease Control and Prevention (CDC)
- S. President’s Emergency Plan for AIDS Relief (PEPFAR)
- Norwegian Agency for Development Cooperation (Norad)
- Civil Society Fund (CSF)
- United Nations Population Fund (UNFPA)
- MSD for Mothers
- Procter and Gamble
- Bill & Melinda Gates Foundation (BMGF)
- The Pfizer Foundation
- The Maverick Collective
- Ministry of Health
- Uganda AIDS Commission
- Reproductive Health Uganda
- Marie Stopes Uganda
- Marie Stopes International Uganda
- Various CBOs and NGOs
- Quality Issues with Malaria Rapid Diagnostic Test Accessories and Buffer Packaging: Findings from a 5‑Country Private Sector Project in Africa
This paper describes quality problems with buffer and accessories encountered in a project promoting private sector malaria rapid diagnostic test use in five African countries and suggests steps to avoid or more rapidly identify and resolve such problems.
- Ugandan Women’s View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks
This paper presents the results of a cross-sectional survey among 1,505 WRA exiting public and private health facilities in Uganda. We collected information on women’s attitudes, knowledge, and beliefs about the IUD, as well as their perceptions about its availability.
- Webinar: Stimulating the Market for Malaria RDTs in the Private Sector
PSI, UNITAID, Malaria Consortium, FIND, and JHSPH held a webinar to discuss leveraging the power of the private sector to transform the mRDT market in support of universal access to malaria diagnostics.
- Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market.
- Transforming the Private Sector to Support Universal Malaria Diagnostic Coverage
To assure the available and use of malaria rapid diagnostic tests in the private sector, PSI and partners conducted a three-year project between 2013 and 2016 to increase the uptake of quality-assured mRDTs in private-sector markets in Kenya, Madagascar, Nigeria, Tanzania, and Uganda by taking a market development approach to identify market failures.
- Towards Subsidized Malaria Rapid Diagnostic Tests. Lessons Learned from Programmes to Subsidise Artemisinin-Based Combination Therapies in the Private Sector: a Review
Private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. A subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.
- Private Sector Readiness and Performance for Malaria Case Management in Uganda
In a nationally-representative 2015 outlet survey, 1 in 4 private sector outlets had both confirmatory testing and QA ACT treatment available. Among outlets with testing and treatment available, study results suggest positive private sector performance with respect to testing all fever patients, particularly in health facilities and drug stores, however testing was very low in pharmacies. However, not all patients seeking treatment in the private sector can or will be tested for malaria. There is need to further promote confirmatory testing and first-line ACT treatment among patients and private sector providers, as well as discourage the use of non-artemisinin therapies and inappropriate use of injectable artemisinin monotherapies for uncomplicated cases.
- Expanding Access to HIV Self-Testing: A Market Development Approach
PSI envisions a healthy market for HIVST to be one that is supported by multiple buyers and suppliers and that delivers on the 5As (Availability, Assured Quality, Appropriate Design, Awareness, and Affordability) to achieve public health goals. Realizing this vision for the HIVST market will require consideration of two key markets- public and private sectors. While HIV testing has traditionally been driven by the public sector, HIVST opens up the possibility of utilizing private sector pharmacies to expand and extend the reach of testing.
- MSI Experiences of Task Sharing Tubal Ligation by Clinical Officers in Zambia and Uganda
Task-sharing is needed in Zambia to increase access to permanent FP methods by addressing the shortage of health providers who are able to provide
tubal ligations, especially in rural areas, reducing the burden on the doctors and hospitals, and making use of existing healthcare providers through affordable, in-service training. The Zambia study aimed to show that clinical officers can feasibly provide tubal ligation in Zambia, with similar rationale for the Uganda tubal ligation task-sharing study.
- Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in Four Countries
In 2013, PSI started a pilot in four countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. Preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision.