Human-centered Strategic Planning at a Rural Rwandan Medical School: A Case Study for Navigating Institutional Challenges and Strengthening Community and National Population Health in Low and Middle Income Countries

Abstract

our final model indicates significant associations between EM-NCD availability and geographic region, health facility type, managing authority, and range of HIV services. Adjusting for other variables such as facility type and amenities, private for-profit facilities' number of EM-NCD is 124% higher on average than public facilities (p<.001). General hospitals and referral health centers had 80.5% (p¼.017) and 110% (p¼.006) higher EM-NCD counts than the lowest level facilities, respectively. Facilities in the Northern and Eastern regions have significantly lower EM-NCD counts than those in the capital region (p¼0.015 and p¼0.003, respectively.) Offering HIV care and support services was associated with 35% lower average EM-NCD counts (p ¼ 0.006), though offering HIV counseling and testing was associated with 57% higher counts of EM-NCD (p¼0.048).Interpretation: By conducting the first Poisson analysis using SARA data, we have identified multiple disparities in the availability of EM-NCD in Uganda. Our findings can be used by health system planners and policymakers to guide the distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness rather than produce data for statistical analyses, we show that it can also be an important resource for answering more complex research and policy questions. Source of Funding: None.Abstract #: 2.052_HHR