1.0 Background

The SCALE program aims to strengthen mutual health workforce capacity development between the UK and LMICs like Uganda with focus on offering training pathways in clinical subspecialties with critical health workforce need as identified and agreed upon by both the Ugandan and UK government.

The Program operates a two-prong approach including the virtual peer-peer interface that enables the SCALE-Fellows to interact on a regular basis conduct weekly case discussions and share learning on management of conditions common to both clinical settings. The Case discussions are guided by a clinical learning schedule that is developed by SCALE-Mentors in both countries.

The 2nd phase of the program focusses on bilateral professional exchange through the MTI Scheme and the UK Global Health Placements.


Although the Maternal mortality ratio in Uganda reduced from 438 in 2011 to 336 per 100,000 live births in 2016 (UDHS 2016), the rate is still unacceptably high with Hemorrhage, hypertensive disorders, Obstructed labour, Sepsis and unsafe abortions as the leading causes of maternal mortality. An emerging trend of pregnancy related metabolic and cardiovascular complications is on the rise and contributes significantly to Maternal Mortality.

Uganda has majorly put significant efforts in improving access to Antenatal care to detect high risk pregnancies but lacks critical workforce capacity to organise and supervise services at a health system level, provide comprehensive care as well as supporting training and quality improvement in maternal and fetal medicine.

A local Fellowship program has been established Department of Obstetrics and Gynecology at Makerere University to train obstetricians in Maternal-Fetal Medicine but lacks adequate faculty to deliver comprehensive training.

  • Proposed Intervention

To address the need of this critical cadre of health workers, Ministry of Health is working through its existing collaboration with the NHS Health Education England; The Uganda-UK Health Alliance to implement a capacity building program in maternal Fetal Medicine.

The program will establish training pathways between the UK and Uganda as well as opportunities for global placement of UK Health professionals to learn from a rich clinical environment while fostering further opportunities for system, research and institutional collaboration.


To contribute to the collaborative development of critical human resource to improve maternal Fetal Medicine.

Specific Objectives

  1. To develop a distant knowledge exchange and learning program between clinicians in Uganda and the UK on Maternal Fetal Medicine
  2. To enable Ugandan doctors benefit from the Medical Training Initiative (MTI) Scheme in Maternal Fetal Medicine
  3. To facilitate Global Placement of UK professionals to Uganda in Maternal Fetal Medicine.

What SCALE Offers to the Health System

  • Robust Government to Government pathway for health workforce capacity development in MFM
  • Proper evaluation of the health system’s impact of professional exchange between Uganda and UK
  • Strengthened bilateral placement, training and collaborative clinical research in MFM.

What SCALE Offers to Individual professionals

  • Learn and build clinical competence from the diverse clinical environments and healthcare systems between Uganda and UK
  • Develop fine skills in team work, leadership, communication to support MFM clinical care & practice
  • Build robust professional global networks to support MFM care and research
  • Build a career in global MFM care and health systems improvement

Delivery of the Program

Phase one aims to;

  • Fostering the Virtual Global Clinical learning and knowledge sharing between fellows in Uganda and UK in MFM.
  • Build conduits for bilateral collaborative research in MFM for care quality improvement and health advancement.
  • Share internationally recognized standards of practice in MFM to improve quality of care.

Potential Roles of RCOG in Phase 1

  • Identifying SCALE Sites;

Identification of suitable institutions in both Uganda and UK to develop an institutional partnership.

  • Recruitment of SCALE Fellows to Action Learning Set

A maximum of the 15 fellows to be recruited in Uganda and 15 from the UK in MFM under the program and these will form Action Learning Sets

  • Identification SCALE Mentors

Experts in MFM from both Uganda and UK will be attached to each Action Learning Set.

  • SCALE Clinical Lerning Schedule

A clinical learning schedule will be developed and agreed to by the ALS will guide the clinical discussions between the fellow.

Phase two aims to;

  • Enable fellows undertake Short, medium and Longterm placements in both Uganda and UK under MFM through the MTI and GLP schemes for hands on experience.
  • Obtaining subspeciality qualifications where possible in MFM under the SCALE program
  • Participating in Bilateral Clinical Patient centered Research to infom MFM care quality improvement.

Potential Roles of RCOG’

  • Coordination support to global placement of UK professionals in Uganda
  • Logistical support to the MTI Scheme
  • Joint design and implementation of global programs in Maternal Fetal Medicine.