In an effort to generate country-wide learning for initiatives that support and institutionalize improvement interventions in Uganda, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project seeks to share knowledge about improvement-related strategies among government agencies and implementing partners. In order to determine the best way to share improvement knowledge, ASSIST conducted an information needs assessment with Ministry and non-governmental organization (NGO) staff working at the national and district levels of the health system from March 2014 to June 2014. Individuals interviewed included policy-makers, program managers, and health care providers. A total of 25 participants were interviewed and asked to share what quality improvement work they are currently undertaking, preferred communication tools, access to resources such as mobile phones and the Internet, and on what quality important topics they need more information for their work.
Knowledge Management (KM) Systems: Few respondents reported a KM system in place at their organization for gathering, synthesizing, and disseminating information. While some respondents said they have a resource center or library, most said new information is usually disseminated through meetings, and that information is not always synthesized or reformatted in a way that is easy to read. Some organizations are developing their own resources, such as guidelines and checklists for staff, but many said they require assistance in the form of funds to develop resources and technical guidance on drafting content.
Quality Improvement: Improvement knowledge varied among participants. Many would like basic information on it, such as its definition and examples. Participants said synthesized quality improvement information and how-to knowledge in the form of practical tools, such as job aids and case studies, would be useful for training staff on designing and implementing improvement strategies.
Existing KM Web Portal: Only Ministry of Health (MoH) employees at the national level expressed familiarity with the MoH’s KM web portal (http://health.go.ug/mohweb/), suggesting that the portal is not widely used outside of the MoH. Some respondents said the portal is not regularly updated, which may be a contributing factor in why few NGO employees were aware of the website.
Internet Access: Internet access varies across the country and is more prevalent at the national level of the health system among government employees. Some respondents reported having to use their own personal resources to ensure consistent access; respondents indicated that demand for professional use has outweighed their organization’s capacity to deliver that access. Internet access is almost nonexistent at the community level.
Email Access and Use: Although email is available at the national level, respondents said it is infrequently used and not the best method for disseminating information. Participants said interpersonal communication at meetings and workshops is effective for sharing information throughout their organizations.
Mobile Phone Use: Mobile phone use is common at all levels of the health system, but network coverage is inconsistent in some areas of the country. Participants reported using phone calls and text messaging for work purposes, the use of which is dependent on personal funds for these services and network coverage in their area. Some organizations have partnerships with telecommunication companies to provide free SMS messages in closed user groups (CUGs).
Exchange of knowledge is an issue at all levels of the Ugandan health system, where limited access to resources, such as the Internet and email, has had an impact on how information is shared. Health professionals seem to rely on mobile phones and interpersonal communication methods for communicating with colleagues and sharing quality improvement strategies.