Aim of the project

RCRA is embarking on a critical project to construct a not-for-profit mother and child healthcare facility in Kasese, Western Uganda.  The Kasese region has a population of approximately 750,000 people and is significantly underserved by only three hospitals in the region with a combined capacity of fewer than 600 beds.   In addition, like most government hospitals in the country, the three existing hospitals in Kasese face many challenges including non-functioning equipment, understaffing, poor funding, over-worked staff and slow payment of staff.  This project is aimed at benefitting vulnerable women, children, infants and Congolese migrants across the Rwenzori region.

The rationale for this project is to create and sustain high quality and low-cost health services across the region in line with RCRA’s vision of: ‘Rebuilding our community through quality healthcare and education, thereby securing a more promising future.’ The facility will be designed with a clinical focus on maternal and pediatric care, alongside a capacity for urgent care with easy and equal access for all.

Grace Community Hospital Funding Drive

The not-for-profit hospital will be owned and managed by RCRA and its profits will be used to benefit local communities and ensure sustainable management of the organization. No individual or entity will receive profits from the running of the network. Profits derived from the hospital, after covering management costs, will be reinvested in maintaining delivery of high-quality services and the needs of the community. The not-for-profit hospital will be built during the period of approximately one year. The following graph shows the estimated costs of constructions.

The total cost of construction will be 10,975,788,678 Uganda Shillings (approximately US $2.9M).  The hospital will consist of a Maternity/Children/Lab/Theater Block, Hospital Administration Block, Emergency Research Block, Staff House and Mortuary.

Hospital Governance and Management

The not-for-profit hospital will be owned and managed by RCRA and its profits will be used to firstly benefit local communities and secondly insure the sustainable management of the organization. No individual or entity will receive profits from the running of the network. Profits derived from the not-for-profit hospital by the managing NGO, after covering management costs, will be reinvested into the community.

Grace Community Hospital will be governed by the RCRA Trustees, comprising a panel of experts well equipped to oversee the successful development and operation of the hospital. Although the not-for-profit hospital is an enterprise, the same principles will apply as are customary when working with public or grant funding, to ensure full accountability and transparency, and no individual gain.

The Hospital Director will be responsible to the Executive Director, and accountable to both Advisory Committees through the Executive Director. They will be supported by a senior management, management and technical teams as illustrated below in the organogram.

The senior management team comprises the Executive Director, Hospital Director, Head of Finance, Head of Community Health, Head of Data, Head of policy and advocacy, Medical Superintendent, Deputy Medical Superintendent, and Incharge Nurse. They are responsible for the institution policy issues, strategic planning, donor relations, resource acquisition and contracts negotiations and reports to the Advisory Committees and Board of Directors for guidance, direction and approval.

The management team is made up of section managers; theatre incharge, Radiology incharge, Laboratory incharge, ART (HIV) incharge, Outpatient department incharge, Pharmacy incharge, Pediatric incharge, Maternity incharge, Inpatient incharge, Emergency Medical Services incharge, IT Manager, Security Manager, Head of Cleaners, and Human Resource Manager. The team will carry out the general management functions of the organization: that is, planning, staffing, organisation, direction and control. The team is responsible to the senior management team.

The technical team does the actual implementation of the organizational programmes and activities, and comprises the medical records staff, stores officer, theater staff, radiology staff, laboratory staff, ART staff, immunization staff, OPD staff, pharmacy staff, emergency medical services staff, administrative assistant, accounts Assistant, nutrition staff, community health outreaches staff, Pediatric staff, IPD staff, and social workers.

Services, Products and Programmes

The not-for-profit hospital aims to provide state-of-the art medical care to its patients. The particular focus is care of children and women, especially in regard to maternity. Following this approach, the not-for-profit hospital will offer a full range of available treatments, providing both specialist reproductive, maternity, and child health services as well as offering a range of more generalist services for the wider community.

The not-for-profit will therefore operate the following sections and departments:

  • Children’s section (capacity: 200 bed)
  • Women’s section (specifically maternity) (capacity: 200 bed)
  • Emergency department
  • Community health outreach department
  • Laboratory (capacity: 10,000 samples at a time)
  • Pharmacy
  • Support departments: Administration, Procurement, Finance

 

Three principles will govern the delivery of these services:

  1. Firstly, the offer of the hospital starts with providing services in education and prevention of outbreaks of diseases.
  2. Secondly, the not-for-profit will treat the full range of diseases related to children and women, and in particular for mothers. This includes emergencies as well as standard care.
  3. Furthermore, long-time care will also be offered, both in terms of long-term medical assistance but also education.

Services offered will align to strategic objective 2 of the RCRA, and include the promotion of and interventions on reproductive, maternal, neonatal and child health; nutrition; malaria prevention; family planning; obstetric fistula; mental health; trauma; and HIV/AIDS awareness, care and support to persons infected and affected.

The not-for-profit hospital will also run its own pharmacy in order to fulfil the needs of its patients concerning the access to medicine, and for the best results of treatment of diseases, the not-for-profit hospital will run its own laboratory. This will enable a quick and accurate assessment of patient health conditions.

The hospital will operate a general out-patient department that will treat the wider community health needs, including in communicable and non-communicable diseases. These will include emergency services; cervical cancer screening and treatment; breast cancer screening and treatment; and eye care. In cases where the hospital is not able to admit a patient, a specialist referral will be made to alternative facilities elsewhere.

Equipment

In order to ensure a high quality of services offered, the hospital will use state-of-the-art standard and specialized medical equipment. In regards to maternal healthcare, this includes:

  • Ultrasound machine
  • Amniotic Hook
  • Forceps
  • Scissors
  • Speculum
  • Laparoscopic Sponges
  • Sutures
  • Vacuum
  • Hemostat

The minimum essential medical equipment for pediatric inpatients is as follows (much of this equipment may be used in the care of adults as well):

  • Resuscitation cart containing readily accessible, easily identifiable, necessary weight- or length-appropriate emergency drugs and resuscitation equipment with easily readable lists of pediatric drug dosages
  • Defibrillator designed for pediatric use with paddles for infants and children and easily readable chart indicating joule dosages
  • Scales and stadiometer for infants and older children
  • Thermometers and blood pressure measuring device with a complete selection of cuffs appropriate for the full spectrum of pediatric patients
  • Cardiorespiratory monitors
  • Pulse oximeters
  • Papoose board for immobilization of infants and toddlers
  • Backboard for cardiopulmonary resuscitation
  • Portable lamps for emergency bedside procedures
  • Motor-driven nebulizers and electric suction machines if no suction wall units are available
  • 24-hour access to an electrocardiograph machine
  • Intravenous, phlebotomy, and lumbar puncture trays appropriate for children
  • Wheelchairs, crutches, slings, and splints for all pediatric age groups

The community outreach programme will offer the following services:

  • Family planning and
  • Integrated health services such as
    • Basic health care/ Primary health care
    • Deworming
    • Immunization
    • Voluntary counselling and testing HIV services
    • Peer education
    • Malaria testing and treatment
    • Cancer screening
    • Hepatitis B testing
    • Maternal and child health care

Furthermore, the not-for-profit hospital will establish partnership with other NGOs in order to access reduced-cost or no-cost drugs. These partnerships will be mutually beneficial and will enable other NGOs in return to hand over responsibility for the logistics and distribution of the drugs among those in need, and to benefit from the marketing offered by the not-for-profit hospital.

Staffing

In order to ensure operations are both sustainable and high-quality, the not-for-profit hospital will ultimately require the following staffing:

  • 15 Doctors (shifts of 5)
  • 15 Clinicians (shifts of 5)
  • 28 Nurses
  • 28 Midwives (shifts of day and night basis)
  • 1 Bio statistician
  • 3 Lab technicians
  • 2 Medical Records
  • 4 Pharmacists
  • 4 Receptionists for patients’ admission
  • 1 Administrator
  • 1 IT officer
  • 4 Drivers
  • 4 Gate keepers (security firm)
  • 40 Cleaners

Number of employees= 150

The staff will consist of people from diverse academic backgrounds and professional trainings in order to ensure various medical issues related to child and maternal care can be treated appropriately. Whilst most staff will be local, there will also be opportunities to recruit professionals both nationally and internationally, including offering volunteer opportunities.

Salaries of the not-for-profit hospital staff will be equivalent to standard governmental wages in Uganda (and for doctors increase 10% year-on-year until they reach the top of the salary band).