Freddie Ssengooba
Dados Biográficos
| ID | 1736385 |
|---|---|
| NOME | Freddie Ssengooba |
| PRENOMES | Freddie |
| SOBRENOME | Ssengooba |
| ASSINATURA | SSENGOOBA F |
| AFILIAÇÕES | Makerere University |
| ORCID | 0000-0003-3489-0745 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 43 |
| TOTAL DE CITAÇÕES | 36 |
| TOTAL COMO AUTOR | 43 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Political prioritization of alcohol and sugar-sweetened beverage taxation in Uganda
INTRODUCTION: Uganda faces a rising burden of noncommunicable diseases (NCDs) at a time when pressure to mobilize domestic health financing is increasing. These challenges have become more acute since January 2025, when geopolitical shifts and donor fiscal tightening led to substantial reductions in external health funding. Consequently, policymakers have renewed interest in health taxes as a mechanism both to reduce consumption of harmful produc…
Barriers to raising taxes on tobacco products in Uganda
Raising taxes on tobacco is considered the most effective measure for reducing tobacco consumption. Although Uganda ratified WHO’s Framework Convention on Tobacco control which recommends levying taxes on tobacco products by up to 75% of their retail price, in Uganda taxes on tobacco stagnated at 35% between 2017 and 2024. There is little in-depth research interrogating the political economy underpinning tobacco tax policy in Uganda. The aim of t…
Challenges in the medical oxygen ecosystem of Peru
Medical oxygen is essential in the management of several human disease conditions including acute respiratory conditions across the life course, and yet access remains unequal in many low- and middle-income countries, including Peru. This study explores Peru’s challenges in ensuring reliable oxygen supplies, with a focus on those laid bare or exacerbated by the COVID-19 pandemic, to inform strategies for improving medical oxygen access. Using a p…
What slows the progress of health systems strengthening at subnational level? A political economy analysis of three districts in Uganda
There is increasing recognition that without stronger health systems, efforts to improve global health and Universal Health Coverage cannot be achieved. Over the last three decades, initiatives to strengthen health systems in low-income countries have attracted huge investments in the context of achieving the Millennium Development Goals, the Sustainable Development Goals, as well as Universal Health Coverage. Yet, health system inadequacies pers…
Continuity of maternal and newborn health service provision among private sector players following donor transition. Hope amidst challenging implementation experiences in Uganda
BACKGROUND: Supporting service delivery through the private sector is a policy priority for improving maternal and child health service delivery for UHC. Despite the increased attention, it is not clear how pay-for-performance interventions within the private sector perform post-donor transition. This study aimed to examine the impact of donor transition on private service providers' ability to deliver maternal and newborn health in Uganda. METHO…
From Perform to Perform2Scale
Strengthening management and leadership competencies among district and local health managers has emerged as a common approach for health systems strengthening and to achieve Universal Health Coverage (UHC). While the literature is rich with localized examples of initiatives that aim to strengthen the capacity of district or local health managers, particularly in sub-Saharan Africa, considerably less attention is paid to the science of ‘how’ to s…
The impact of shifts in Pepfar funding policy on HIV services in Eastern Uganda (2015–21)
Although donor transitions from HIV programmes are increasingly common in low-and middle-income countries, there are limited analyses of long-term impacts on HIV services. We examined the impact of changes in President’s Emergency Plan for AIDS Relief (PEPFAR) funding policy on HIV services in Eastern Uganda between 2015 and 2021.We conducted a qualitative case study of two districts in Eastern Uganda (Luuka and Bulambuli), which were affected by…
The unwritten rules and HIV
Introduction: There is increasing appreciation of the need to understand how social and structural factors shape HIV risk. The unwritten rules, also known as informal institutions or social norms, are increasingly recognized as important determinants of HIV transmission. Unfortunately, these informal institutions, especially among high-risk environments for HIV, such as social venues like bars, lodges, remain poorly understood. This study explore…
Geographic prioritisation in Kenya and Uganda
Introduction Donor transition for HIV/AIDS programmes remains sensitive, marking a significant shift away from the traditional investment model of large-scale, vertical investments to control the epidemic and achieve rapid scaling-up of services. In late 2015, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) headquarters instructed their country missions to implement ‘geographic prioritisation’ (GP), whereby PEPFAR investment…
The impact of donor transition on continuity of maternal and newborn health service delivery in Rwenzori sub-region of Uganda
BACKGROUND: The transition of donor-supported health programmes to country ownership is gaining increasing attention due to reduced development assistance for health globally. It is further accelerated by the ineligibility of previously Low-Income Countries' elevation into Middle-income status. Despite the increased attention, little is known about the long-term impact of this transition on the continuity of maternal and child health service prov…
Political economy analysis of subnational health management in Kenya, Malawi and Uganda
The need to bolster primary health care (PHC) to achieve the Sustainable Development Goal (SDG) targets for health is well recognized. In Eastern and Southern Africa, where governments have progressively decentralized health decision-making, health management is critical to PHC performance. While investments in health management capacity are important, so is improving the environment in which managers operate. Governance arrangements, management …
‘Writing budgets for meetings and teas?’
INTRODUCTION: Coordination across policy domains and among government agencies is considered critical for addressing complex challenges such as inequities, urbanisation and climate change. However, the factors influencing coordination among government entities in low-income and middle-income countries are not well known. Although theory building is well suited to explain complex social phenomena, theory-based health policy and systems studies are…
What are the tools available for the job? Coordination instruments at Uganda’s national government level and their implications for multisectoral action for health
Managing sectoral interdependences requires functional tools that facilitate coordinated multisectoral efforts. The pursuit of multisectoral action for health is intrinsically linked to broader efforts in many governments to achieve greater internal coordination. This research explores the nature of coordination instruments for multisectoral action at the national level in Uganda and the complexities of how these tools play out in implementation.…
Not for us, without us
The Ministry or Department of Health (M/DoH) is the mandated government agency for health in all countries. However, achieving good health and wellbeing requires the health sector to coordinate with other sectors such as the environment, agriculture and education. Little is known about the coordination relationship between MoH and other sectors to advance health and development goals in low- and middle-income countries (LMICs). Our study examined…
Multisectoral action for health in low-income and middle-income settings
There is consensus in global health on the need for multisectoral action (MSA) to address many contemporary development challenges, but there is limited action. Examples of issues that require coordinated MSA include the determinants of health conditions such as nutrition (malnutrition and obesity) and chronic non-communicable diseases. Nutrition, tobacco control and such public health issues are regulated separately by health, trade and treasury…
Exploring perceived effects from loss of Pepfar support for outreach in Kenya and Uganda
INTRODUCTION: In 2015, the President's Emergency Plan for AIDS Relief undertook policy shifts to increase efficiencies in its programming, including transitioning HIV/AIDS funding away from low burden areas. We examine the impact of these changes on HIV outreach in Kenya and Uganda. METHODS: Qualitative data collection was conducted as a part of a broader mixed-methods evaluation. Two rounds of facility-level case studies and national-level inter…
‘They say we are money minded’ exploring experiences of formal private for-profit health providers towards contribution to pro-poor access in post conflict Northern Uganda
Background: The perception within literature and populace is that the private for-profit sector is for the rich only, and this characteristic results in behaviours that hinder advancement of Universal health coverage (UHC) goals. The context of Northern Uganda presents an opportunity for understanding how the private sector continues to thrive in settings with high poverty levels and history of conflict.Objective: The study aimed at understanding…
Research for universal health coverage
BACKGROUND: There is international consensus on the need for countries to work towards achieving universal health coverage (UHC) whereby the population is given access to all appropriate promotive, preventive, curative and rehabilitative services at affordable cost. The World Health Organisation (2013) urges all countries to undertake research to customise UHC within national development agendas. OBJECTIVE: To describe the process used to priorit…
Momentum for policy change
BACKGROUND: Results-based financing initiatives have been implemented in many countries as stand-alone projects but with little integration into national health systems. Results-based financing became more prominent in Uganda's health policy agenda in 2014-2015 in the context of the policy imperative to finance universal health coverage. OBJECTIVE: To explore plausible explanations for the increased policy interest in the scale-up of results-base…
The extent to which the design of available reproductive health interventions fit the reproductive health needs of adolescents living in urban poor settings of Kisenyi, Kampala, Uganda
The packaging and mode of delivery of interventions were perceived less holistic to meet the adolescents' needs. Most interventions were designed to address the sexual and family planning needs while ignoring the wider social and livelihood needs. More holistic and outreach-based programming that addresses RH within the broader context of livelihood and sanitation requirements are more likely to be effective
HIV Prevalence and the HIV Treatment Cascade Among Female Sex Workers in Cross-Border Areas in East Africa
Challenges in implementing emergency obstetric care (EmOC) policies
Uganda is among the sub-Saharan African Countries which continue to experience high preventable maternal mortality due to obstetric emergencies. Several Emergency Obstetric Care (EmOC) policies rolled out have never achieved their intended targets to date. To explore why upstream policy expectations were not achieved at the frontline during the MDG period, we examined the implementation of EmOC policies in Uganda by; exploring the barriers frontl…
‘It needs a complete overhaul…’ district manager perspectives on the capacity of the health system to support the delivery of emergency obstetric care in an urban South African district
Background: A high maternal mortality ratio persists in South Africa despite developments in emergency obstetric care (EmOC), a known effective intervention against direct causes of maternal deaths. Strengthening the health systems is one of the focus areas identified by the National Committee for Confidential Enquiries into Maternal Deaths in South Africa. District managers as immediate overseers of the frontline health system are uniquely posit…
Assessing the level of institutionalization of donor-funded anti-retroviral therapy (ART) programs in health facilities in Uganda
BACKGROUND: In the context of declining international assistance for ART scale-up in Sub-Saharan Africa, the institutionalization of ART programs through integrating them in the organizational routines of health facilities is gaining importance as a program sustainability strategy. OBJECTIVE: The aims of this study were; (i) to compare the level of institutionalization of ART programs in health facilities in Uganda and (ii) to explore reasons for…
Government resource contributions to the private-not-for-profit sector in Uganda
GRCs in Uganda have evolved influenced by various factors and the complex interactions between government and PNFPs. The Universal Health Coverage (UHC) agenda should pay attention to these factors and their interactions when shaping how governments work with PNFPs to advance UHC. GRCs could be leveraged to mitigate the financial burden on communities served by PNFPs. Governments seeking to advance UHC goals should explore policies to expand GRCs…
Why performance-based contracting failed in Uganda - An "open-box" evaluation of a complex health system intervention
Decision space for health workforce management in decentralized settings
The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that manager…
How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia
This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied-Uganda, Sierra Leone, Zimbabwe and Cambodia-which were at different distances from conflict and crisis, as well as having unique conflict stories. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research …
Application of social network analysis in the assessment of organization infrastructure for service delivery
In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks-here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the…
Assessing access barriers to maternal health care
BACKGROUND: In low income countries, several barriers exist to the use of health services for child delivery, including distance, transportation, informal costs or low perceived quality. Yet there is rarely information about which barriers are more or less important to the use of a given health facility. This study assessed the relative importance of different barriers to maternal health facility use in rural Uganda through the use of simple indi…
Health Systems Global, the new international society for health systems research
A few underlying facts drove the decision to create a new society for health systems research (HSR). More research is needed to address the reasons for health system weaknesses and the ways and means of improving performance. Further, an increasing number of researchers are focusing their work on health systems research and while there is now substantial research ongoing in this area, there is no regular forum to share findings, methodologies and…
Assessing access barriers to maternal health care
BACKGROUND: In low income countries, several barriers exist to the use of health services for child delivery, including distance, transportation, informal costs or low perceived quality. Yet there is rarely information about which barriers are more or less important to the use of a given health facility. This study assessed the relative importance of different barriers to maternal health facility use in rural Uganda through the use of simple indi…
Building the Field of Health Policy and Systems Research
Following the First Global Symposium on Health Systems Research in Montreux in November 2010, PLoS Medicine commissioned three articles on the state-of-the-art in Health Policy and Systems Research (HPSR). Three Policy Forum articles, authored by a diverse group of global health academics, critically examine the current challenges to the field and lay out what is needed to build capacity in HPSR and support local policy development and health sys…
Building the Field of Health Policy and Systems Research
Following the First Global Symposium \non Health Systems Research in \nMontreux in November 2010, PLoS \nMedicine commissioned three articles \non the state-of-the-art in Health \nPolicy and Systems Research (HPSR). \nThree Policy Forum articles, authored \nby a diverse group of global \nhealth academics, critically examine \nthe current challenges to the field \nand lay out what is needed to build \ncapacity in HPSR and support local \npolicy de…
Exploring new health markets
BACKGROUND: Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access…
Research translation to inform national health policies
BACKGROUND: Research and evidence can have an impact on policy and practice, resulting in positive outcomes. However, research translation is a complex, dynamic and non-linear process. Although universities in Africa play a major role in generating research evidence, their strategic approaches to influence health policies and decision making are weak. This study was conducted with the aim of understanding the process of translating research into …
Research, evidence and policymaking
This study refined an initial MRT on KT in policymaking in the health sector in Uganda that was based on a literature review. It provides a framework that can be used in empirical research of the process of KT on specific policy issues
Health Systems Global, the new international society for health systems research
A few underlying facts drove the decision to create a new society for health systems research (HSR). More research is needed to address the reasons for health system weaknesses and the ways and means of improving performance. Further, an increasing number of researchers are focusing their work on health systems research and while there is now substantial research ongoing in this area, there is no regular forum to share findings, methodologies and…
Why performance-based contracting failed in Uganda - An "open-box" evaluation of a complex health system intervention
Aid alignment
BACKGROUND: Over the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government's own expenditures on health. Yet primary health care and other priorities identified in Uganda's health sector strategic plan remain underfunded. METHODS: Using data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, we examined trends in how d…
Modelling the potential impact and cost of scaling-up male circumcision in resource poor settings
This study modelled estimates of the cost and impact of male circumcision (MC) under different scenarios using the Decision Maker's Program Planning Tool on data from Uganda. Results showed that the number of new adult HIV infections could be reduced by 23 000 if MC could be increased from the current 25% to 80% by 2015. The incidence of HIV could be reduced by 0.2 percentage points over the same period. If a scale up programme is to meet a targe…
The impact of Fogarty International Center research training programs on public health policy and program development in Kenya and Uganda
While FIC has not focused its programs on the goal of policy and program influence, its investments have affected global and national public health policies and practice. These influences have occurred primarily through strengthening research skills of scientists and developing strong in-country networks. Further success of FIC and similar initiatives could be stimulated by investing more in the training of policy-makers, seeking to better align …
Health systems performance assessment in low-income countries
BACKGROUND: The study aimed at developing a set of attributes for a 'good' health system performance assessment (HSPA) framework from literature and experiences in different contexts and using the attributes for a structured approach to lesson learning for low-income countries (LICs). METHODS: Literature review to identify relevant attributes for a HSPA framework; attribute validation for LICs in general, and for Uganda in particular, via a high-…
Ebola in the context of conflict affected states and health systems
Ebola seems to be a particular risk in conflict affected contexts. All three of the countries most affected by the 2014-15 outbreak have a complex conflict-affected recent history. Other major outbreaks in the recent past, in Northern Uganda and in the Democratic Republic of Congo are similarly afflicted although outbreaks have also occurred in stable settings. Although the 2014-15 outbreak in West Africa has received more attention than almost a…
A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda
In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the …
Sub-national assessment of aid effectiveness
BACKGROUND: In post-conflict settings, many state and non-state actors interact at the sub-national levels in rebuilding health systems by providing funds, delivering vital interventions and building capacity of local governments to shoulder their roles. Aid relationships among actors at sub-national level represent a vital lever for health system development. This study was undertaken to assess the aid-effectiveness in post-conflict districts of…
Decision space for health workforce management in decentralized settings
The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that manager…
Application of social network analysis in the assessment of organization infrastructure for service delivery
In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks-here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the…
How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia
This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied-Uganda, Sierra Leone, Zimbabwe and Cambodia-which were at different distances from conflict and crisis, as well as having unique conflict stories. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research …
Assessing the level of institutionalization of donor-funded anti-retroviral therapy (ART) programs in health facilities in Uganda
BACKGROUND: In the context of declining international assistance for ART scale-up in Sub-Saharan Africa, the institutionalization of ART programs through integrating them in the organizational routines of health facilities is gaining importance as a program sustainability strategy. OBJECTIVE: The aims of this study were; (i) to compare the level of institutionalization of ART programs in health facilities in Uganda and (ii) to explore reasons for…
Government resource contributions to the private-not-for-profit sector in Uganda
GRCs in Uganda have evolved influenced by various factors and the complex interactions between government and PNFPs. The Universal Health Coverage (UHC) agenda should pay attention to these factors and their interactions when shaping how governments work with PNFPs to advance UHC. GRCs could be leveraged to mitigate the financial burden on communities served by PNFPs. Governments seeking to advance UHC goals should explore policies to expand GRCs…
‘It needs a complete overhaul…’ district manager perspectives on the capacity of the health system to support the delivery of emergency obstetric care in an urban South African district
Background: A high maternal mortality ratio persists in South Africa despite developments in emergency obstetric care (EmOC), a known effective intervention against direct causes of maternal deaths. Strengthening the health systems is one of the focus areas identified by the National Committee for Confidential Enquiries into Maternal Deaths in South Africa. District managers as immediate overseers of the frontline health system are uniquely posit…
Multisectoral action for health in low-income and middle-income settings
There is consensus in global health on the need for multisectoral action (MSA) to address many contemporary development challenges, but there is limited action. Examples of issues that require coordinated MSA include the determinants of health conditions such as nutrition (malnutrition and obesity) and chronic non-communicable diseases. Nutrition, tobacco control and such public health issues are regulated separately by health, trade and treasury…
Exploring perceived effects from loss of Pepfar support for outreach in Kenya and Uganda
INTRODUCTION: In 2015, the President's Emergency Plan for AIDS Relief undertook policy shifts to increase efficiencies in its programming, including transitioning HIV/AIDS funding away from low burden areas. We examine the impact of these changes on HIV outreach in Kenya and Uganda. METHODS: Qualitative data collection was conducted as a part of a broader mixed-methods evaluation. Two rounds of facility-level case studies and national-level inter…
‘They say we are money minded’ exploring experiences of formal private for-profit health providers towards contribution to pro-poor access in post conflict Northern Uganda
Background: The perception within literature and populace is that the private for-profit sector is for the rich only, and this characteristic results in behaviours that hinder advancement of Universal health coverage (UHC) goals. The context of Northern Uganda presents an opportunity for understanding how the private sector continues to thrive in settings with high poverty levels and history of conflict.Objective: The study aimed at understanding…
Research for universal health coverage
BACKGROUND: There is international consensus on the need for countries to work towards achieving universal health coverage (UHC) whereby the population is given access to all appropriate promotive, preventive, curative and rehabilitative services at affordable cost. The World Health Organisation (2013) urges all countries to undertake research to customise UHC within national development agendas. OBJECTIVE: To describe the process used to priorit…
Global Maternal and Child Health (32 obras) · Economic growth (28 obras) · Medicine (27 obras) · Economics (26 obras) · Political science (26 obras) · Public health (20 obras) · Business (18 obras) · Nursing (18 obras) · Public relations (16 obras) · Healthcare Systems and Reforms (15 obras)