Promoting Universal Health Coverage for Amputees through Social Enterprise and Engineering Innovation
Medical Research Council
Makerere University
In Uganda, as in many other LMICs, prosthetics services have been developed, and supported by international NGOs (e.g. ICRC), in humanitarian responses to conflict. When support is withdrawn, post-conflict, health systems struggle to integrate and maintain such services. Despite the government's commitment to universal health coverage, Ugandan citizens usually have to provide the cost of materials or devices. Local suppliers are scarce and orders from abroad are only made when a user has paid a percentage of the cost. This drives up costs, compromises quality, introduces delays, uncertainties and additional visit. It also makes maintenance a great challenge leading to poor device utilisation. In reality, many amputees do not have access to prosthetic services, although data on access is extremely poor. The Ugandan government adopted the Public Private Partnership (PPP) as a model for health system strengthening, where foreign partners make a significant contribution to public resources. Until now the PPP approach has only been utilised in the not-for-profit hospitals and large research institutions and has not been tested in public services. Our aim is to determine how engineering and social innovation can improve Uganda's ability to deliver universal health coverage in prosthetic services. We will integrate innovations in prosthesis design, coupled with fine-resolution modelling of demand, to pilot new, distributed prosthesis service models, characterised through our collaboration with Joint Medical Stores via a PPP model. To achieve our objectives, the following work packages are planned: (1) Promoting universal health coverage through health system strengthening and social enterprise; (2) Mapping clinical need, service distribution and quality, and scoping modelling of future services; (3) Evaluating the introduction of appropriate new technology into the Ugandan supply chain; and (4) Engagement and development of a proposal for a follow-on proposal.
8.1 Organisation and delivery of services / Research Grant