Strengthening TB and HIV&AIDS Responses in East-Central Uganda
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S RESP AID ON & SE V S I IN H D E A N S A T B C T E G N N T I R N A E L H U T G G A N N E D R A T S Strengthening TB and HIV&AIDS Responses in East-Central Uganda (STAR-EC) PROGRAM YEAR II QUARTER THREE PROGRESS REPORT April - June, 2010 Funded by the United States Government through the United States Agency for International Development (USAID) under the terms of Agreement No. 617-A-00-09-00007-00 THE REPUBLIC OF UGANDA Quarter Three Report, Apr - Jun, 2010 | 01 © 2010 Financial support for STAR-EC is provided by USAID, under Co-operative Agreement No. 617-A-00-09-00007-00. The views expressed in this document do not necessarily reflect those of USAID. This program is implemented by JSI Research & Training Institute, Inc., in collaboration with World Education’s Bantwana Initiative, Communication for Development Foundation Uganda, mothers2mothers and Uganda Cares. Table of Contents Table of Contents .............................................................................................................................................i Table of Contents .............................................................................................................................................ii List of Tables ....................................................................................................................................................iii List of Figures ..................................................................................................................................................iv List of Acronyms ..............................................................................................................................................v 1.0 Introduction ........................................................................................................................................1 1.1 Background ........................................................................................................................................1 1.2 Major objectives of STAR-EC ..............................................................................................................1 2.0 Major result areas and progress during the 3rd Quarter ....................................................................2 2.1 Result 1: Increasing access to, coverage of and utilization of quality comprehensive HIV&AIDS and TB prevention, care and treatment services within district health facilities and their respective communities within the six supported districts .........................................................................................................2 2.1.1 Increasing access to and uptake of HIV testing and counseling (HTC) services ..................................2 2.1.2 Prevention of mother-to-child transmission of HIV (PMTCT) ...............................................................5 2.1.3 Care and Support ................................................................................................................................10 2.1.3.1 Umbrella Care ...................................................................................................................................10 2.1.3.2 Clinical Care .....................................................................................................................................11 2.1.3.3 Clinical/Preventive services – additional pediatric .............................................................................12 2.1.3.4 Support Care .....................................................................................................................................13 2.1.4 Antiretroviral (ARV) services ...............................................................................................................14 2.1.3.5 Clinical/Additional TB/HIV ................................................................................................................16 2.1.3.6 TB control activities ............................................................................................................................20 2.1.6 Laboratory Services ............................................................................................................................23 2.1.7 Promotion of HIV Prevention through Sexual and Other Behavioral Risk Prevention .........................28 2.1.7.1 Promotion of HIV Prevention through Abstinence and Being Faithful (AB) ...................................... Programs ............................................................................................................................................28 2.1.7.2 Promotion of HIV Prevention through Other HIV&AIDS Prevention beyond AB ................................30 2.1.7.3 Promotion of HIV Prevention through Prevention with Positives (PwP) programs ................................32 2.1.8 Promotion of HIV Prevention through Biomedical Prevention using Safe Male Circumcision (SMC) ...34 2.2 Result 2: To strengthen decentralized HIV&AIDS and TB service delivery systems with emphasis on Health Centers III and IV as well as Community Outreaches ..............................................................37 2.2.1 Improving leadership and management at district level.......................................................................37 2.2.2 Support to strategic information collection and dissemination as well as strengthening of coordination and collaboration in the 6 East Central districts .................................................................................38 2.2.3.1 Training activities ................................................................................................................................38 2.2.3.2 Continuing medical education (CME), support supervision and mentoring .........................................39 2.2.5 Supporting infrastructure and equipment needs ..................................................................................40 2.2 Result 3: Improving quality and efficiency of HIV&AIDS and TB service delivery within health facilities and civil society organizations ............................................................................................................40 2.2.1 Health Care Improvement (HCI) .........................................................................................................40 Quarter Three Report, Apr - Jun, 2010 | i Table of Contents 2.2.2 Injection Safety and Waste Disposal Interventions ..............................................................................40 2.2.6 Improving Supply Chain Management ...............................................................................................41 2.4 Result 4: Strengthening networks and referrals systems to improve access to, coverage of, and utilization of HIV&TB services ...........................................................................................................................45 2.4.1. Training and facilitation of Village health teams (VHTs) to mobilize communities and conduct referrals ..............................................................................................................................................45 2.4.2. Mapping of TB, HIV& AIDS and other wraparound service providers ..................................................46 2.4.3. Target Beneficiaries and Numbers Served ...........................................................................................47 2.4.4 PLHIV District Forum orientation meetings: ........................................................................................48 2.4.5. Referrals by community support agents and other volunteers ..............................................................48 2.5 Result 5: Increasing demand for comprehensive HIV&AIDS and TB prevention, care and treatment services .............................................................................................................................................50 3.0 Strategic Information .........................................................................................................................56 4.0 Grants and Sub awards ......................................................................................................................58 4.1 Sub-Partners........................................................................................................................................60 4.2 Support to District Health Structures ..................................................................................................60 Appendices .....................................................................................................................................................62 Appendix 1: Showing the general matrix of findings and support provided to the 76 health facilities in the region by STAR-EC during the reporting period April-June 2010. ..................................................................62 Appendix 2: Stakeholders/partners that STAR-EC worked with to strengthen laboratory services during the 3rd quarter PY2 .......................................................................................................................................64 Appendix 3: Showing the youth support clubs formed during this reporting period .........................................68 Appendix 4: Findings according to the various parameters that were assessed during the Laboratory Needs Assessment .........................................................................................................................................69