The URC SUSTAIN GRANT- The Mbale experience

Presentation at the SUSTAIN Refresher Workshop 12-14th Sept 2011

By Dr J P M MasabaSENIOR CONSULTANT PHYSICIAN/

COORDINATOR, INFECTIOUS DISEASES CLINIC

Introduction

• MRRH-SUSTAIN partnership began Sept 2010• Grant UGX 50,640,010 for initial 4 months• Grant to cover administration, clinic and

transition issues• Partnership different from previous with JCRC

(parallel vs horizontal integration; no SUSTAIN staff)

• Grant for CY 2011 set at UGX 96m revised to UGX 83.9m later

Compliance with Grant requirements

Activities are best measure but Hqs look at:• Monthly income and expenditures statement• Monthly expenses • Monthly originals of payment vouchers• Copy of cash book summary• Quarterly advance request• Bank reconciliation

Benefits of the Grant

Limited to the grant:• Clinic cover uninterrupted by lunch break(snacks)• Shorter waiting times for clients(volunteers boost)• Patient follow-up enabled• Staff supervision/interaction better• Premises better maintained• Utility bills sorted out• Toiletries available• Child friendly environment ongoing

Challenges• Not all MRRH staff catered for-limited to those on duty

unlike MJAP experience.• Inflation- eating into allocations• Rigid spending regimen• Delayed grant releases-even with submissions up to date• No SDAs for SUSTAIN staff on mentorships• Mentorship allowance not appealing to doctors• Shortage of critical staff e.g. stores• Unplanned transfer of trained accounts staff

Capacity building

• MRRH staff involved in IDC• Knowledge and skills improved at mentorship

sites• Communities empowered• Pediatric and other hospital staff to be

brought on board- SUSTAIN is not forever!

Grant officer visits

• Site personnel advised on best practices • Advised on procurement process• Helped formulate quarterly procurement

request

Some thoughts…

• Inflation erosion of grants-could USDs help?• Schedule for periodic training of accounts

staff?• Avoid delayed payments-or take site issues

into account?• Stipend for extra effort?