Sustainable Model Village Projects (ESMV)

In 1970, Korea adopted the Saemaul Undong model as a community development method that acknowledges villages as a unit of development that promotes and installs self-help, reliance, and collaboration. In a bid to support the Ugandan government in achieving its strategic goal of unlocking rural growth as a means of increasing agricultural productivity, production, increase beneficiary farmer’s income, reduce poverty and improve living conditions, the Korean government through KOICA and in collaboration with the Ministry of Local Government (MoLG), established a community-based integrated rural development model called Saemaul Undong approach in Mpigi district.

The project that was started in 2015 targeted four outcomes; increased social capital in the targeted villages, increased household incomes, and agriculture productivity, enhanced living conditions, and improved governance among targeted villages. This was first piloted in seven villages from seven Sub-counties of; Tiribo (Muduma sub-county), Kololo (Kiringente sub-county), Nsamu (Mpigi Town Council), Kiwumu (Kamengo sub-county), Kumbya (Buwama), Lwaweeba (Kituntu sub-county), and Lukonge in Nkozi sub-county. In a bid to increase rural incomes and quality of living, the Establishment of Saemaul Model Villages (ESMV) in Mpigi districts was successful.

A total of about 4,765 people from around 1,078 households benefited from the project.

The main activities of the project were determined through community participatory engagements that led to the establishment of Saemaul Undong committees. The activities undertaken during phase 1 of the project include; rehabilitation of rural roads, construction of agriculture infrastructure, improvement of electricity coverage in the villages, and establishment of a coffee processing center.

The implementation of the project registered significant achievements for the period 2015-2018 as follows;

a) Increased social capital in the villages. There was a positive change in the level of trust from the baseline of moderate to high by 2018. The level of trust in the villages rose from 5.8 on a scale of 1-10 to 7.

58 b) The share of belongingness to groups

improved from 54.7 percent in 2015 to 80.1 percent in 2018³⁴.

c) The frequency of community meetings in the villages moved from monthly to weekly.

d) The mean annual income of the beneficiary households increased from UGX 2,037,237 in 2015 to UGX 4,300,878. For instance, household

income from livestock rose from the baseline value of UGX 434,438 to UGX 1,245,683 in 2018 while agriculture income increased from UGX 775,882 to UGX 1,986,331 in the same period. Household income from non-farm enterprises rose from UGX 743,511in 2015 to UGX 1,655,544 in 2018³⁵. In addition, the share of households within the villages that had access to markets increased from 49.7 percent in 2015 to 62 percent in 2018³⁶. e) In regard to health, household access to health care within a 1 km distance increased from

19.6 percent to 26.8 percent in the same period. Equally, household access to safe water in the targeted villages increased from 59.9 percent in 2015 to 89.3 percent in 2018³⁷. f) In regard to improved living conditions and infrastructure, the share of households that

upgraded to permanent and semi-permanent houses rose from 64.5 percent to 96.7 percent in 2018³⁸.

g) The communities in each of the seven model villages were able to initiate the formation of Village Savings and Loans Associations (VSLAs) and raised a total of UGX 43, 296,000³⁹.

The successful implementation of the village model has led to its expansion in other districts such as Mityana, Maracha, Luuka, Kabarole and Bunyangabo. This has enhanced the human capital skills of community members and farmers who have sustained appropriate farming technologies, social capital development and governance. The expansion of the project was at the request of the Ugandan government and to that effect, in 2019, the GoU, through the Ministry of Finance, Planning and Economic Development (MFPED), and ROK through KOICA signed an MoU to scale up the project. To that end, phase two of the Establishment of Sustainable Model Village project was launched on 20^th February 2020 at the National Farmers Leadership Center in Kampiringisa, Mpigi district.

34 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

35 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

36 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

37 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

38 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

39 KOICA Establishment of Saemaul Model Villages Project, end line report, 2018

59

In a bid to combat COVID-19, the Republic of Korea through KOICA donated medical equipment and sanitary supplies to Mityana and Mpigi districts. The donation constituted of USD 20,000, with USD 5,000 provided to each of the districts and USD 15,000 to the three selected parishes.

The medical supplies include masks, gloves, hand sanitizers and thermometers were handed over to the Local Governments while sanitary products were given to the three parishes.

3.1.3.1 Rural Financing

The Establishment of Saemaul Model Villages in the districts of Mpigi and Mityana has led to the realization of rural financing among communities. In collaboration with the Korean Federation of Community Credit Cooperatives rural areas have been strengthened in developing their finances in order to enhance self-reliance and sustainable income generation.

60 Korean Federation of Community Credit Cooperatives (KFCC)

In 2017, through a bilateral agreement between the Republic of Korea and the Government of Uganda, the Korean Federation of Community Credit Cooperatives project begun. The aim was to provide affordable financial services to those living in remote areas and who are excluded from formal financial institutions. A credit union in Korea is termed Saemaul Geumgo which is translated as community credit cooperative. KFCC is running financial projects in three countries of Uganda, Myanmar, and Laos.

In Uganda, the project started in 2017 and KFCC works closely with KOICA. Given the establishment of Saemaul Undong model villages was in Mityana and Mpigi districts, KFCC was also introduced in these districts to monitor the viability of the project.

According to 2018 FINCOPE Uganda findings, 46 percent of the country’s population cannot afford to save money, 20 percent of adults were using only informal financial services and 22 percent were financially extended. To that end, the KFCC established 11 credit cooperatives in the districts of Mpigi and Mityana to improve financial literacy and inclusiveness⁴⁰. The credit cooperatives help communities by providing training to the credit union members and leaders on management practices and Saemaul Geumgo principles. These principles encourage members to contribute towards community development. For instance, during the COVID-19 pandemic, the Bwamulamira MG Saemaul Geumgo credit union in Kamengo Sub- County helped in the donation of foodstuff to the elderly. In addition, the Korean Federation provides access to financial services to 1,677 people that were previously financially excluded⁴¹.

loan worth UGX 3 million from the Jjalamba Saemaul Geumgo credit Union and bought a heifer and also invested in her rice garden.

Nantume says, she is able to feed her family and generate more income to pay school fees for her children.

Box 1: Success story of the Saemaul Geumgo credit union in the districts of Mpigi and Mityana.

Lukooto Abudul, a member of Lukonge Saemaul Geumgo in Mpigi district says that through the credit union he saved money as well as took a loan of UGX 1 million to establish a banana plantation. To that effect, Lukooto generates UGX 600,000 monthly from the plantation. This has enabled him clear his loan and has continued to bank with the credit union.

61 3.2 Health care Management

The global policy bodies and agencies in the recent past have focused more on quality given the adoption and domestication of Sustainable Development Goals (SDGs), which under target 3.8, promotes achievements of Universal Health Coverage (UHC), access to quality health care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. Uganda has made tremendous improvements in health facility coverage and services, though, emergency response systems are still wanting.

In line with the Uganda Health Sector

Development Plan (HSDP 2015-2020), the Korean government through KOFIH established the Health System Strengthening project focusing on emergency medical service systems. The objective of this project was to promote the health of community residents by improving accessibility and quality of regional medical services and enhance the referral system for emergency patients in the areas of Kampala, Masaka, and Bukomansimbi districts.

During the implementation of this project the following achievements were registered.

a) 768 health workers and Village Health Teams from 50 health facilities were trained in 13 emergency medical service courses which include; advanced lifesaving (19), basic lifesaving (27), basic emergency care training of Trainers (19), basic emergency care (379), community first aid response training for trainers (44), community first aid response (60), emergency call and dispatch (15), emergency ambulance crew training (86), COVID-19 critical care training (41), health workers’ quality improvement training for Emergency Medical Service teams (17), establishment of medical major incident response at health facilities in greater Masaka (28)⁴².

b) Referred 1,742 emergency patients to Masaka Regional Referral Hospital (RRH) reflecting 133 percent achievement.

c) 60 percent of equipped emergency medical services standardized by the Ministry of Health (MOH)

d) Out of 187 health facilities, 26 percent of health workers from 50 health facilities trained.

The training in greater Masaka region have remained centered around Health Workers from Health Centre IVs and District Hospitals.

e) Constructed the emergency medical Unit, surgical ward, operating theater, and provided medical equipment such as X-ray, Ultrasound, and Patient Monitors, etc. in the Bukomansimbi district

42 KOFIH 2017-2020 performance report, July, 2021

Figure 3. 10: Emergency Care Framework

62 f) The project also contributed to the development of the following national plans under the health sector; these include; Uganda National Emergency Medical Services Strategic Plan 2018/19-2024/25, Masaka Regional Emergency Medical Service Operation Manual, Uganda Health Sector Development Plan II (2020/21-2024/25), National Pre-hospital Emergency Medical Services COVID-19 guidelines and Ministry of Health Emergency Medical Service Health Information System⁴³.

g) Established the community emergency referral system and two emergency call and dispatch systems in Masaka region

h) Established greater Masaka regional emergency skills training center

i) Disseminated emergency medical services policies, strategy, and referral guidelines j) Contributed towards the establishment of 14 regional ambulance hubs and 12 regional

centre hubs.

k) Established a comprehensive national referral system

l) Supported the assessment of 8 Reginal Referral Hospital ambulance systems and emergency units

m) Supported the Emergency Medical Services Project Midterm Evaluation Survey n) Supported the development of Emergency Care Charts (CPR and First Aid)

o) Contributed towards the establishment of the National Ambulance Station and Call and Dispatch Centre.

In Uganda, Tuberculosis (TB) is one of the leading communicable diseases that have led to the highest deaths. Consequently, in accordance with the National Tuberculosis Strategic Plan (NSP 2015-2019), the Korean government through KOFIH and in collaboration with the MoH and the National Tuberculosis Reference Laboratory (NTRL) launched the implementation of the National Tuberculosis Control Capacity Building Project. This was aimed at improving research conditions at NTRL and assist in capacity building of health workers in TB-prone areas. In addition, strengthen domestic TB control systems and establish strong networks with other African countries.

In Uganda, the project is implemented in Kampala, Masaka, and Bukomansimbi districts. During the period 2017/2021, the project recorded the following achievements;

a) At the NTRL, matching rate of drug susceptibility testing by utilizing MKIT increased by 25 percent, Blinded Rechecking Microscopy External Quality Assurance (EQA) results increased by 9 percent and TB cases detection false positive rate decreased.

b) In Bukomansimbi district, TB case detection improved to 59%, 4,667 sputum samples were examined using either smear microscopy or Genexpert technologies thus increased case finding at facility levels noted, DOT coverage among TB clients greatly improved from 78% in 2017 to 98% thus an increase by 20%. As a goal of the project TB treatment success rate has improved to 89%⁴⁴.

43 KOFIH 2017-2020 performance report, July, 2021

44 KOFIH 2017-2020 project results report, July, 2021

63 c) Turnaround time for DST results using MKIT versus LJ DST reduced from 4 weeks to 2

weeks.

d) The sharing of SRL staff competent in the use of new and improved diagnostics technology-MKIT increased by 20 percent.

e) Trained 48 peripheral laboratory staff in EQA, 89 percent and 75 percent of peripheral facilities in Masaka and Bukomansimbi participated in Blinded Rechecking-Microscopy EQA⁴⁵.

f) 100 percent EQA (Panel Tests for GeneXpert testing for both Masaka and Bukomansimbi districts.

g) False positive rate for participating peripheral labs in Masaka and Bukomansimbi reduced by 0.8 percent and 3.4 percent respectively.

h) Identified, contacted and screened 992 patients with 89 contacts diagnosed with TB and commencing treatment.

i) Constructed two laboratories and purchased one biosafety cabinet, 10 cooler boxes for TB sputum sample and three motorcycles⁴⁶. j) Conducted 52 community dialogues and 35

radio talk shows on TB information. In addition, trained 254 Village Health Teams and 158 laboratory staffs from Masaka and Bukomansimbi.

k) A total of more than 186 Tb patients benefited from TB nutrition supplements and received

transport refund as a way of improving treatment adherence and outcomes.

l) A total of 30 Health facilities in Masaka and Bukomansimbi benefited from support supervision conducted by NTRL in the bid to monitor the progress of TB activities in the laboratories. Additionally, a total of 360 heathworkers benefted from onsite TB mentorships an activity that acquints healthworker with moreknowledge andsolutions to address arising issuesdue to TB.

m) To improve key performance indicators for TB in the district, twelve TB perfomance review meeting were conducted.

n) In regard to Ethiopian laboratory staff capacity building, trained 8 laboratory staff, 2 lab managers, 2 quality officers and 4 lab technologists at SRL

o) Trained 33 Supranational Reference Laboratory staffs in World Health Organization (WHO) SLIPTA by South African Accreditation Agency (SANAS).

p) Supported Uganda NTRL in the development, review and international accreditation of the 13 training programs by the USA based accreditation body (AMSI/ACET 1 2018) with an aim of ensuring continued education and training

45 KOFIH 2017-2020 project results report, July, 2021

46 KOFIH 2017-2020 project results report, July, 2021

64 q) In regard to advanced TB detection, one inspissator machine was procured and donated, supplied 4000 MKIT plates with 3 packets of M-KIT multipette starter kit for use from KIT to SRL, 3 probe assay procured to support MKIT technology