VILLA MARIA HOSPITAL DHA Presentation 2014 Dr. Moses Male Kawuma Medical Director 1

Presentation outline Villa Maria Hospital background, vision, mission, mission, core values Services provided Outputs for 2013/2014 Income and expenditure The Nurses Training School The AIDS Program. 2

Background / History Founded on 8/8/1902 as a catholic faith-based aid post by White Sisters. White Sisters handed to Bannabiikira sisters in i976 Became full fledged hospital 1966 General hospital but offers some specialized services Gazetted bed capacity 126 beds Has a large AIDS Program - 25 years old Has a Nurses Training School started

Mission, Vision, Core values Mission: Our mission is based on the imitation of Christ and His deeds; To promote life to the full and heal Vision: To be the leading provider of quality, affordable, holistic health care in the mother and surrounding districts. 4

Core Values: -Equal opportunity to all in equal need -Uphold and cherish honesty, confidentiality and professionalism -Uphold human dignity and rule of natural justice -Constant improvement -Patient is at heart of everything we do -Value all stakeholders in health 5

Services Rendered Outpatient services Inpatients / admissions Antenatal services Immunization services Surgical services X-ray and ultrasound services AIDS care and Treatment Laboratory services 6

Services Rendered Dental services Maternity services Clinical Pastoral Care services Outreach services. 7

Staffing (critical mass) CadreEstablishmentCurrent NumberShortage Medical Director110 Surgeons110 Medical officers321 Clinical Officers321 Nursing Director111 Nurses (all cadres)38326 Midwives (all cadres)

Staffing Problems Attrition Remuneration Dual employment (local government and VMH) might affect quality of service. Location of VMH not attractive for staff 9

Outputs 2013/2014 Kalungu District / Villa Maria Hospital OutputTotal Kalungu District Villa Maria HospitalPercentage Total Immunization (DPT3) Total OPD Attendance ANC Attendance Admissions Deliveries Caesarian Sections (C/S) Major Operations (including C/S) Counseled for HIV Clients on ART Source: District Biostatician 10

Comment on outputs The hospital makes very big contribution to Kalungu District outputs especially in; -Admissions -Deliveries -Caesarian sections -Major operations -HIV counseling -ART service] -X-ray services (the only provider) 11

Comment on outputs contd…. VMH inadvertently takes the role of district hospital. VMH needs to be enabled to play the role of a district hospital in the spirit of PPPH through; -HRH -PHC – CG 12

VILLA MARIA HOSPITAL INCOME 2013/ Details2013/2014 User Fees930,119,600 PHC Conditional Grant135,456,244 Designated Donations132,497,946 Non Designated Grants/Donations 5,850,000 Other Hospital Income57,638,781 Total Income1,261,562,571

TREND TABLE FOR PHC CONDITIONAL GRANT AS % TOTAL INCOME FOR 2010/ /2014 Financial Year2010/ / / /2014 Government Grants 431,303, ,546, ,891, ,456,244 Total Income 1,118,859,474 1,003,850,381 1,278,188,818 1,261,562,571 PHC as a % age of Total income 39%20%10%11% 14

15

Income notes User fees constituted 73% of income Trend of PHC CG is downward Flat rates still maintained; Maternity -Normal delivery 60,000/- -Nursing 60,000/- -Caesarian 160,000/- all inclusive OPD -Children 8,000/- -Adults 10,000/- Children Ward –Admission 45,000/- per week -Major operation 70,000/- per week 16

Income Challenges Rural nature of catchment population Poverty of the population we serve Decreasing donor support Diminishing numbers of patients; -Poverty -Improvement in service in government facilities. 17

Hospital Expenditure 2013/ No.Expenditure Amount UGX 1Employment Costs 704,268,687 2Supplies & Services 431,646,497 3Property Costs 105,842,362 4Depreciation 82,960,210 5Transport costs 37,004,733 6Maintenance 23,681,590 7Administration Costs 18,691,149 8Governance Costs 12,264,200 9Primary Health Care 2,848,000 10Extra Costs 14,277,800 Total Expenditure 1,433,485,228

Comments on expenditure Employment costs consume 49% Supplies and services take 30% Nothing was spent on capital development Employment costs of 50% and above are not sustainable. 19

Hospital budget 2014/2015 DETAILS APPROVED BUDGET FOR Percentage Contribution INCOME User Fees 1,150,423, PHC CG grant 124,035,071 9 Other Income Generating Activities (IGAS) 69,315,166 5 Designated donations & Grants 74,303,088 5 Total Income 1,418,076,

Hospital budget 2014/2015 Cont… EXPENDITURE APPROVED BUDGET FOR Percentage of Total Expenditure Employment Costs 829,278, Supplies & Services 333,834, Administrative costs 9,688,000 1 Transport & Plant costs 39,598,712 3 Property Costs 106,707,732 8 Governance Costs 26,089,755 2 Maintenance Costs 20,721,433 1 Primary Health Care (PHC) 2,698,000 0 Extra Costs 19,002,800 1 Total Expenditure 1,387,619,

Challenges High wage bills Tight budgets Almost absent donor support (except PHC CG) Falling patient numbers, yet user fees is the main source of income Increasing poverty in the community Slow implementation of PPPH Lack of Gov’t policies enabling PNFP’s to be sustainable Dual employment among some cadres of staff 22