Leadership and Governance


Leadership and governance
SPNO at Kabale RRH makes a presentation on the role of leadership in nursing

USAID/SUSTAIN works with the Ministry of Health (MOH) in Uganda as well as management teams at hospitals to foster local leadership and ownership for HIV service delivery. One of the project’s key objectives is to increase stewardship by the MOH to provide sustainable quality HIV care and treatment, laboratory, prevention of mother-to-child transmission of HIV (PMTCT) and TB/HIV services. This collaboration ensures alignment with national policies and operational guidelines, including the Health Sector Strategic and Investment Plan (HSSIP III), as a critical approach for sustainability. Together with the MOH, hospital management teams are supported to work towards achieving key milestones which will ultimately lead to the hospitals providing HIV services independently without project support.



  • MOH top management officially approved and introduced the USAID/SUSTAIN project to facilities following a series of presentations to the Ministry at the beginning of the project (October 2010).
  • Joint planning with facility and central MOH to build consensus and galvanize ownership and stewardship.
  • Multiple joint planning activities in collaboration with various Ministry departments (CPHL, NMS) to implement the USAID/SUSTAIN laboratory services improvement plan.
  • Hospital management teams (directors, administrators, HIV clinic and laboratory heads and senior principal nursing officers) from supported hospitals completed three-part leadership development course. The course covered organizational performance and culture, leadership styles and management skills. 
  • Hospital directors and administrators completed a five-day “finance for non-finance managers” course.
  • The MOH and Central Public Health Laboratories (CPHL) formally approved USAID/SUSTAIN's laboratory equipment and infrastructure improvement plan, developed jointly with the project and aligned with the national health laboratory policy and infrastructure plans.
  • Health systems strengthening activities and the institutionalization of quality improvement methods into routine practice at the hospitals.
  • Integration of MOH data management systems, supporting MOH to finalize the design of the Open Medical Records System (Open MRS), train central MOH staff and pilot the system at facilities. 
  • Sustainability planning with the hospitals, including conducting meetings with MOH, district and hospital leadership to review milestones.
  • Support for national TB/DR-TB activities to improve care, including participation in the development of standard operating procedures for MDR-TB cohort review, TB performance review meetings and TB/HIV national coordination committee meetings and developing various TB/HIV training curricula.
  • Equipment procurement and infrastructure renovations, leveraging existing efforts to improve laboratories (MOH plans and other partners).
  • Improvements plans that consider MOH long-term availability of inputs (reagents, human resources, equipment maintenance and servicing contracts).
  • Implementation of the chronic care model, building on existing MOH systems such as community linkages structures and data management.
  • Linkages with the MOH supply chain and coordinating drug supplies, using MOH logistics management tools and integrating the supply of drugs into hospital pharmacy and stores management systems.
  • Key stakeholders’ meetings, including partners, hospital managers and central MOH, to build consensus and plan for the transition of hospitals.