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 TWO PROGRESS REPORT January - March, 2010 Funded by the United States Government through the US Agency for International Development under the terms of Agreement No. 617-A-00-09-0000700 THE REPUBLIC OF UGANDA Quarter Two Report, Jan - Mar, 2010 | 01 © 2010 Financial support for this program is provided by the United States Government through USAID, under Co- operative Agreement number 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. Contents List of Tables .............................................................................................................................................................iii List of Figures ...........................................................................................................................................................iii List of Acronyms .......................................................................................................................................................iv 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 2nd 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 Lessons learned ..........................................................................................................................................4 2.1.2 Prevention of mother-to-child transmission of HIV (PMTCT) .......................................................................5 Lessons learned ..........................................................................................................................................8 2.1.3 Care and Support ........................................................................................................................................10 2.13.1 Umbrella Care ...........................................................................................................................................10 2.1.3.5 Antiretroviral (ARV) services ........................................................................................................................13 Lessons learned...........................................................................................................................................16 2.1.3.6 TB control activities ....................................................................................................................................16 2.1.6 Laboratory Services .....................................................................................................................................17 2.1.7 Promotion of HIV Prevention through Sexual and Other Behavioral Risk ................................................... Prevention .................................................................................................................................................19 2.1.7.1 Promotion of HIV Prevention through Abstinence and Being Faithful ..........................................................19 Lessons Learned .........................................................................................................................................22 2.1.7.2 Promotion of HIV Prevention through Other Prevention beyond AB ...........................................................22 2.1.7.3 Promotion of HIV Prevention with Positives ................................................................................................24 2.1.7.3 Promotion of HIV Prevention with Positives ................................................................................................26 Lesson Learned ...........................................................................................................................................28 2.1.7.4 Promotion of HIV Prevention through Male Medical Circumcision (MMC) .................................................28 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 .......................................................................29 2.2.1 Improving leadership and management at district level ...............................................................................29 2.2.2 Support to strategic information collection and dissemination as well as strengthening of coordination and collaboration in the 6 East Central districts ..........................................................................................30 2.2.3 Improving human resources for health .......................................................................................................33 2.2.3.1 Training activities ........................................................................................................................................33 2.2.3.2 Continuing Medical Education (CME), support supervision and mentoring ..................................................34 2.2.3.3 Human Resources for Health Planning ........................................................................................................35 2.2.4 Institutional capacity building and strengthening of Civil Society partners ...................................................36 2.2.5 Supporting infrastructure and equipment needs ..........................................................................................36 Quarter Two Report, Jan - Mar, 2010 | i 2.3 Result 3: Improving quality and efficiency of HIV&AIDS and TB service delivery within health facilities and civil society organizations ....................................................................................................................36 2.3.1 Health Care Improvement (HCI) ..................................................................................................................36 2.3.2 Injection Safety and Waste Disposal Interventions ......................................................................................36 2.3.6 Improving supply chain management ........................................................................................................37 2.4 Result 4: Strengthening networks and referrals systems to improve access to, coverage of, and utilization of HIV&TB services ....................................................................................................................................38 Lessons learned...........................................................................................................................................39 2.5 Result 5: Increasing demand for comprehensive HIV&AIDS and TB prevention, care and treatment services ......................................................................................................................................................39 Lesson Learned ...........................................................................................................................................42 3.0 Strategic Information ..................................................................................................................................43 4.0 Grants and Sub awards ............................................................................................................................43 5.0 Conclusion ................................................................................................................................................47 Appendices ..............................................................................................................................................................48 APPENDIX: 1 ...........................................................................................................................................................48 ii | Quarter Two Report, Jan - Mar, 2010 List of Tables Table 1: STAR-EC Quarter Two Achievements versus PYII Targets by technical Area ............................................xi Table 2: HTC services by CSO, nature of services and numbers of individuals served during the 2nd Quarter, PY2 .......................................................................................................................................................4 Table 3: