Live from Uganda: Field Testing a Rapid Assessment Tool to Improve Health Worker Retention

CapacityPlus Program Officer Laura Wurts is traveling in Uganda for three weeks and shared some of her experiences in the field thus far.

Please tell us about the purpose of this trip to Uganda, and where will you be working.
CapacityPlus is field testing a rapid assessment tool for determining priority retention interventions for costing to inform Ministry of Health policy-making to improve attraction and retention of health workers in rural and remote areas. While in Uganda, we expect to survey 500-600 people. The sample will include both final-year students and practicing health workers in four cadres: medical officers, nursing officers, pharmacists, and lab techs.

We will collect data in Kampala, Jinja, 10 districts around Mbarara town, and 10 districts around Gulu town. Specific universities include Makere University, Mbarara University for Science and Technology, Gulu University, and Jinja School of Nursing and Midwifery.

Can you tell us about someone you’ve worked with in Uganda?
In the first week in Uganda, we’ve met with a variety of Ministry of Health staff, district health officers; and university staff at Makerere, Gulu, and Mbarara. Each of these individuals has shared interesting perspectives and experiences with the health sector in Uganda.

One truly dynamic and spirited individual I’ve met is Gad Ruzaaza, coordinator for the Community Based Education Programme at Mbarara University of Science and Technology. Gad has a vibrant  personality, and is truly committed to improving the health sector and the futures for his students at Mbarara University. He’s been invaluably helpful—forthcoming with contacts and troubleshooting logistics for data collection. At the same time, he’s strongly vocal about his opinion and expectations of what the project should ideally accomplish and the types of sectoral changes that must occur.

What have you learned from working with the health professional students?
My conversations with one student leader for a group of final-year medical students was particularly interesting. We were discussing the intended results of the CapacityPlus assessment—to improve attraction and retention of health workers in rural and remote areas—and the shortages experienced in Uganda. This student leader shared that fewer and fewer of her medical student colleagues are practicing medicine after graduation, but instead working in the public health sector in nonclinical positions.

Not only must rural clinics compete with urban clinics for doctors but they must also compete with nonclinical public health positions. While the importance of public health professionals is undeniable, we must begin to examine the effects and interrelationships with the clinic side.

Sounds like a busy first week. What will you do next?
This week we will begin our first week of data collection. Our team of 11 data collectors (individuals from the Ministry of Health, Ministry of Public Service, and faith-based organizations) will break into four teams. Two teams will travel to Gulu and two teams will travel to Mbarara. These teams will visit health facilities in 10 districts in the western region (Mbarara) and 10 districts in the northern region (Gulu). The teams are traveling with laptops and will administer an innovative computer-based field survey to health workers in three cadres: medical officers, nursing officers, and lab technicians.

In addition to the clinic data collection, I will be working with our principal investigator and the African Population & Health Research Center staff – our research-oriented associate partner – to survey students from all four health cadres at Mbarara University for Science and Technology and Gulu University.

Photo: Laura Wurts. (Week 1 prep visit site: Mbarara University for Science and Technology)