Several U.S. Rotary clubs are teaming with Uganda's Kampala Naguru and Gulu Rotary clubs ("the Rotary Consortium") to provide vital signs equipment and training to 125 rural public centers in 5 local government districts in Uganda. (See attached document Exhibit 1: Rotary Uganda Partner & Health Units.) These 5 districts together treat over 890,000 patients per year. The primary objective of this grant is to improve the diagnosis and treatment of illness, and therefore healthcare outcomes, of tens of thousands of patients.
The Ugandan Ministry of Health (MOH) has invested heavily in healthcare infrastructure, with 3,150 medical facilities in a country the size of Oregon. Ugandan patient exit interviews show that 98% of patients rate MOH facilities highly on staff knowledge and competence, but 70% found them unacceptable in the availability of medical equipment and 69% in the availability of the drugs that the clinicians are prescribing.
Vital signs equipment has been part of the standard of care in the West for decades. Unfortunately, given limited resources, the MOH budget does not include vital signs equipment. In addition to the patient exit interviews, a recent healthcare provider survey indicates that only about 3% of patients are currently having vital signs taken, which means that many treatable diseases are going undiagnosed and untreated. The survey also shows that when vital signs equipment is available, 23% of Ugandan adults who had their blood pressure taken were diagnosed with hypertension, a serious but treatable disease.
Through this global grant, the Rotary Consortium will provide basic vital signs equipment and training to approximately one hundred and twenty-five rural Ugandan health centers. To assist in the distribution and training, the Rotary Consortium is working with Bulamu Healthcare International, a US non-profit and Ugandan NGO regulated by the government's NGO Board. Bulamu was founded in 2016 to provide primary medical care to the rural poor in Uganda. Bulamu has developed cost-effective models, partnering with local government Districts, to provide Western medical diagnosis and treatment without charge to impoverished rural residents. PPE is also greatly needed and included in the grant for many facilities. (Copies of the MOH's letter of recommendation and Bulamu's annual report are attached to this application as Exhibits 4 and 6, respectively.)
On average, the donated "kits" with associated training and travel expenses cost $732 per facility, and include digital and infrared thermometers, stethoscopes, weighing scales, height rods, blood pressure monitors, glucometers, glucose strips, oxygen saturation monitors, batteries. Vital signs equipment manufactured in developed countries and imported to Uganda will be purchased locally from established medical equipment suppliers, subject to a competitive bidding process.
All funds from this Global Grant will be used to purchase equipment and train clinicians at health centers in the five districts identified on Exhibit 1. These include two that were already scheduled by Bulamu for the fall of 2021 (Mayuge and Namutumba) and three new districts specifically requested by Kampala Naguru, the Host Club (Isingiro, Amuru and Gulu.) Equipment will be distributed in conjunction with two Bulamu programs, each based on Memorandums of Understanding that it executes with the local government districts: the Clinical Support Team (CST) program, at the 4 largest health facilities in the district, and the Health Center Excellence (HCE) program, which extends these clinical disciplines to the remaining 25-52 health units, many of which are local village clinics staffed by nurses. Because the date when Rotary funds will be available is uncertain, equipment will be distributed as soon as funds are available according to the schedule shown in supplemental document Exhibit 1. The 3 districts Kampala Naguru Rotary Club has selected, where the need is very great, are larger than average (39 health units each vs. 22 per district on average). This means that distribution and training will be more efficient because of the concentration of health units.
While this grant will service a minimum of 125 health facilities, it is likely that the number of health units covered will reach between 140 and 160 facilities. The Rotary Consortium will not know the exact needs of each health unit until Bulamu and members of the Host Club (some of whom are licensed healthcare professionals) are on the scene. If a facility already has an item from the standard vital signs equipment kit that is operational, another will not be provided.
Rotary International will be announced as a partner in all districts where equipment is distributed. Bulamu will pay for any additional equipment and training needed at the districts specified by Kampala Naguru if the grant funds are exhausted. Without the Global Grant, there would not be adequate funding for the additional three large districts requested.