This activity also relates to 8643-Condoms and Other Prevention, 8338-Palliative Care;Basic Health Care and Support, 8619-Palliative Care;TB/HIV, 8336-OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services; 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Mildmay and Mbuya are faith based organisations that have been providing AB counselling through the existing HIV testing programs. An emerging challenge is prevention counselling for adolescents that have improved as a result of ART (40% of all ART recipients at Mildmay are children < 18 years). Abstinence messages are emphasized for these youth. Family members of Mildmay clients tested through the VCT program are also targeted for AB messages. Couple counselling is offered to all patients and B messages are emphasized for these couples.

In FY07, AB activities will be strengthened targeting youth and adolescents in care, couples, family members of index clients, and health care providers through training. OVCs will be trained in ‘life skills' and positive prevention by practicing AB interventions. Networking with other organisations to mobilise communities will be central in this work. TMC already works with a number of such organisations i.e. World Vision, Compassion International, Kamwokya Christian Caring Community, AIDChild, schools and other

organisations is already in place to ensure maximum benefit for the targeted adults and children. TMC will be developing its AB strategy during the course of the year. The funds will go towards community mobilisation, human resource needs and the training aspects of the programme. The funding in this program area will support the integration and strengthening of existing AB activities, support training of personnel, production of IEC materials, support couple clubs and improve data collection and reporting.

plus ups: Mildmay through Reach Out will expand AB activities in poor suburbs of Kampala. The program will target youths in and out of schools. IEC Materials will be developed and community volunteers trained to provide basic AIDS information and refer cmmunity members to prevention, care and treatment services.

This activity also relates to 8641-AB, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336-OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services; 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organization operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognized internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the program, targeting doctors, nurses, HIV/AIDS counselors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training program reaches participants throughout Uganda via a diploma/degree program, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma program targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular program with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centered approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighborhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO. Mildmay and Mbuya are faith based organizations that have been providing AB counseling through the existing HIV testing programs. An emerging challenge is prevention counseling for adolescents that have improved as a result of ART (40% of all ART recipients at Mildmay are children < 18 years). Age appropriate ABC messages are emphasized for these youth. Family members of Mildmay clients tested through the VCT program are also targeted for AB messages in line with the Government of Uganda and PEPFAR guidelines. Couple and partner CT is offered to all patients to identify discordant couples and provide support to prevent HIV transmission to negative partner. Couples in discordant relationships and other clients in risky situations are targeted with other prevention messages including condom use, STI prevention/ treatment and family planning. In FY07, OP activities will be strengthened by targeting adolescents, youths and couples in care, couples, and family members of index clients through positive prevention interventions. Health care providers, community volunteer and PHA peer educators will receive training to facilitate positive prevention interventions . OVCs will be trained in ‘life skills' to enhance their capacity to deal with challenges of HIV/AIDS. Networking with other organizations to mobilize communities will be central in this work. TMC already works with a number of such organizations i.e.

World Vision, Compassion International, Kamwokya Christian Caring Community, AIDChild, schools and other organizations is already in place to ensure maximum benefit for the targeted adults and children. TMC will be developing its OP strategy during the course of the year with support from TASO- SCOT. The funds will go towards community mobilization, human resource needs and the training aspects of the program. The funding in this program area will support the integration and strengthening of existing AB and OP activities, support training of personnel, production of IEC materials, support couple clubs and improve data collection and reporting.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8619-TB/HIV, 8336-OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health (MOH) since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children who constitute 52% of patients. TMC has had a cooperative agreement with CDC/Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a MOH facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. At TMC 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services CD4 counts and, HIV testing, (cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention), and other palliative care services morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: use of ART in Children; use of ART in Adults; communication with children; palliative care in the context of HIV/AIDS; laboratory skills in an HIV/AIDS context; management of opportunistic infections (OIs) and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts; 1,308 participants have attended courses, and 291 participants came for clinical placements providing 2,146 clinical placement days. Since the rural clinics opened, 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with 110 on ART. A family-centred approach is used in the recruitment of patients for ART at TMC and all willing family members are offered HIV testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART,the majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Mildmay palliative basic care activities are currently implemented at 6 sites (TMC, Mbuya church, Kinawataka, Banda, Naggalama hospital, and Mpigi Health centre IV). To date, >6,000 individuals are in active care across the operational sites (2,148 active patients are receiving cotrimoxazole every month at RO/Kinawataka and Banda, >1,040 at Naggalama, 375 at Mpigi, and >3000 at TMC). By March 2007, the total number receiving palliative care is expected to be over 8,000. The numbers continue to increase as VCT is extended to family members and more patients are referred from the hospitals implementing routine HIV testing and counselling. As part of basic health palliative care and support, patients are offered the basic health care package comprising cotrimoxazole prophylaxis, safe water vessels (supplied through PSI), insecticide treated bed nets (through PSI) , and management of OIs including TB. All patients in acre are regularly screened for ART eligibility using the National MOH ART guidelines and if eligible, are initiated on ART within the clinic. In FY06, a cumulative total of 8,575 mosquito nets had been distributed, 126 clients had been trained in client workshops and 173 participants had attended courses focusing on palliative care for HIV infected individuals. Training for health care providers in

palliative care at Mpigi is ongoing and 996 individuals have been trained to date at Mildmay. Training in palliative care is carried out in collaboration with Hospice Africa Uganda. The target is all cadres of health care providers including counsellors, doctors, nurses, and religious leaders, etc.

During FY07 TMC will carry out care and training activities on site in Wakiso District and at the rural clinic sites at Naggalama and Mpigi. In FY07, 11,000 patients will receive basic health care and support; of these 6,000 will be at TMC, 1,000 each at Naggalama and Mpigi and 3,000 at RO. Six sites will be operational. The funds for this programme area will finance the purchase of drugs for OIs management and prevention, symptom control and pain management, provision of the basic care package (safe water vessel, water sieve, water guard, and mosquito nets), cotrimoxazole prophylaxis and training 1,300 people through formal courses and clinical placements. TMC will work in collaboration with PSI to make the basic care package available to patients that are in need.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Palliative Care;Basic Health Care and Support, 8336-OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

TB services are being provided free of charge to all patients at Mildmay and Mbuya plus the outreach clinic sites. All patients in HIV care (whether on ART or not) are screened for active TB if symptomatic using sputum smears, radiology, and ultrasound techniques. Patients presenting for VCT and ART screening are also evaluated for TB at all sites. TB medications are provided free by the MOH National TB and Leprosy Program (NTLP) which also provides support supervision for all the sites. Mbuya RO, which operates in one urban parish, has a strong TB program that employs a community DOTS strategy using volunteers referred to as Community ART and TB supporters (CATTS) that reside in the same community. These support adherence to both ART and TB and ensure follow-up. TMC follows the national guidelines for TB management. In the year June 2005 to June 2006, TMC performed TB tests on over 600 patients and treated 191 for TB, 64 of who were children. In the same period RO screened more than 500 patients for TB, of whom 112 of have been or are being treated for TB.

In FY07, all TB services will be continued at the six TMC supported sites of TMC, Naggalama, Mpigi, Mbuya RO, Kinawataka, and Banda clinics. The funds under this programme area will be used to procure drugs (to supplement NTLP supplies), laboratory reagents for TB diagnosis, PPD for Mantoux tests especially for children, X-ray films, and processing chemicals for TB care not provided by the National TB Programme. Other expenses include human resources, training and operational costs of contact tracing and follow up. To ensure adherence to TB medications and treatment completion. It is expected that 4,000 patients in total will be screened for TB and over 400 treated in FY07. Collaboration with MOH-NTLP will continue into the coming year in the area of quality assurance, support supervision, and provision of medications. The funding will also support data management and M&E activities. Up to 100 health workers will be trained in TB/HIVactivities.

plus ups: Reachout is a sub partner for Mildmay that provides care for HIV infected individual. The plus up funds will be used strengthen care for HIV positive TB patients through support for CB-DOTS for TB. Health staff will be trained in TB screening, diagnosis, and treatment. An additional 100 HIV positive patients will be reached with TB treatment. The sites will be facilitated to institute TB infection control plan and activities.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8337-CT, 8625-ARV Drugs, 8333-ARV Services, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

By the end of FY06 it is expected that 608 persons will have been trained in CT for children, and that 4,000 children will have received CT and care. Health care for OVCs is covered under palliative care, and treatment; ARV drug and ART services. To date, children comprise 40% of ART recipients at Mildmay and an additional 250 children at Mbuya will be on ART by March 2007. Other services provided to OVCs include HIV counselling and testing, palliative basic health care and support, TB screening and treatment, psychosocial support and ART if eligible. The program follows the national guidelines on OVC supports that are implemented through the Ministry of Gender labour, and Social Development (MoGLSD). OVCs are also linked to other available services for school fees, vocational training etc.

In FY07 it is expected that 5,000 children will be reached with OVC services and a further 80 adults trained in OVC issues and communication with children. It is planned to have 600 children and adolescents informed about sexual and reproductive health issues; to

offer 100 child-headed homes psychosocial support and reach 2,500 school children as part of a school outreach programme. The money under this programme will finance the running of training sessions, provide school tuition for selected children, and help with vocational training support, child advocacy participation, human resource support and recruiting vulnerable children into care programmes.

plus ups: In order to provide comprehensive OVC servicesto HIV+ve children, the partner will expand provision of HIV palliative care to these children as part of the non pediatric treatment OVC activities. With these resources, more HIV infected chidlren will receive OI management, counseling of the child and the family, from skilled service providers, and link them to other OVC services in their communities. As part of the comprehensive OVC services, improving and expanding palliative care for HIV+ve children is a critical service. Reachout, a Mildmay subpartner, will use these funds to expand peds palliative care provision in its facilities adn surrounding communities to reach out to more HIV+ve children and their families. Services will include OI prevention and treatment, pain alleviation, and related supplies, counseling children and their families, relevant immunizations, child nutrition counseling and supplements. Providers will actively link these children and their families to other community OVC services in their catchment areas and conversely the facilities will provide HIV palliative care services to the OVC referred from the Civil Society Ogranizations within their area.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336- OVC, 8625-ARV Drugs, 8333-ARV Services, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART a Mbuya RO.

Counselling and testing activities at TMC include creating awareness of service availability, provision of counselling and testing for children and their caregivers, pre-test and post-test support for adults and training health workers to counsel and test patients. TMC is responsible for procuring test kits, setting up a specimen-referral mechanism and confidential result handling system, implementation of standard MOH guidelines and protocols for all stages of counselling, and conducting tests by TMC's own laboratory staff. By March 2007 the target is to have 7,000 persons provided with Counselling and Testing (CT) at six sites and CD4 testing at one site, and 194 people trained in CT-related issues. TMC views care and training as complementary processes when offering HIV/AIDS services. Training in CT targets doctors, nurses, HIV/AIDS counsellors, pharmacists and pharmacy technicians, laboratory personnel, clinical officers, religious leaders, people living with HIV/AIDS (PLWHAs), school teachers, school nurses and patient carers. The training sensitises health workers, religious leaders, schoolteachers, members of other community NGOs and community leaders and empowers them to refer patients into the service.

Counsellors are equipped with skills to handle pre- and post-test situations in children, adults, and couples. Laboratory personnel are trained to use rapid HIV testing techniques. The training emphasises the importance of linking with and referring patients to other health professionals to improve patient management. As part of the targeted evaluation soon to be implemented at Mildmay before the end of FY06, Mildmay will provide Home based Counselling and testing for index ART children and adults and will test family members within their homes. This not only encourages care and support for all HIV infected family members (including children) but also partner disclosure and positive prevention. HIV infected individuals identified through VCT are linked to care.

During FY07 TMC will continue to strengthen care and training activities on site in Wakiso District and at the rural clinic sites at Naggalama and Mpigi. Counselling and testing will continue to provide an entry point to basic health care and support, laboratory services and ARV drugs and services as well as an opportunity to test other family members. This service will be provided at TMC, the two rural clinics and at Reach Out. Using a family approach 6,000 patients will be provided with CT at TMC and the rural clinics and 4,000 at RO. 250 people will be trained in CT-related issues. Ten counsellors will be trained at RO to cater for the increasing demand at its new service outlets of Banda and Kinawataka. It is expected that more than 40% of those tested at TMC will be children below 18 years. The funding for this programme is for the procurement of test kits for screening and confirmation of HIV status, consumables, the provision of pre- and post-test counselling, human resources, training activities and capacity building, particularly for the rural sites.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336- OVC, 8337-CT, 8333-ARV Services, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Of the total number of active clients in care at all the 6 Mildmay ART service outlets, an estimated 2000 are currently eligible for ART initiation but won't be initiated on treatment due to limited funding. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Mildmay currently procures and distributes ARV drugs to 5 sites (Naggalama, TMC, Mbuya RO Church, Kinawataka and Mpigi HCIV). All ARV drugs are procured through Medical Access. By March 2007 the target is to have 3,500 patients on ART at TMC including (1,300 continuing ART patients as part of PEPFAR at TMC, 1,200 new ART patients expected to be recruited as part of the Targeted Evaluation that is examining various strategies to adherence in adults and children and reduction in sexual transmission risk in patients on ART, and 500 patients at each of the two rural clinics at Naggalama and Mpigi. 40% of all ART recipients at The Mildmay Center and the 2 rural outreach clinics are children below the age of 18 years i.e. OVCs. By March 2007, Mbuya - RO expects to have 715 PEPFAR-funded patients on ART including 250 children. TMC also has 600 patients on

MOH ARVs, 300 patients who purchase ARVs privately and Reach Out has 800 patients receiving MOH ARVs. ARV drug forecasting is done for the whole year but purchase of ARV drugs including a 3 month buffer stock for each patient is done on a quarterly basis. Drugs are delivered by Medical Access, checked and received by the program pharmacist. Stock taking and reporting is done monthly at the points of service.

During FY07 TMC will continue to procure for and distribute ARV drugs to 6 sites through Medical Access. A total of 5,815 patients will be receiving ARV drugs through Mildmay; - 3,500 will be at TMC, 1,200 at the rural sites of Naggalama and Mpigi, 1,515 at Reach Out Mbuya. In addition, buffer stock of ARVs for three months will be maintained to cover 1,830 MOH patients on ARVs at TMC, Naggalama, Mpigi and Reach Out Mbuya. This will ensure continuity of ART for patients supported through the Global Fund/ MOH. 40% of all slots at Mildmay (and the two outreaches of Naggalama and Mpigi) will be reserved for children while Mbuya will maintain the 250 children on ART. Funding under this programme area will mainly go towards logistics and procurement of ARV drugs with a training component for 250 people on ART management.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336- OVC, 8337-CT, 8625-ARV Drugs, 8335- Laboratory, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Since opening in 1998, TMC has registered over 14,000 patients, of whom 2,200 are receiving ART through different sources; - 1,400 patients are on ART through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access palliative basic care and laboratory services. All patients attending TMC have access to: free CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, other palliative care services i.e. morphine and chemotherapy for HIV related cancers and free management of fungal infections and TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. By March 2007 the target is to have 5,915 patients on ART, 4,400 at TMC and its rural sites (being 1,400 continuing ART at TMC, 1,100 newly initiated on ART as part of the Targeted Evaluation, 500 at each of the rural clinics at Naggalama and Mpigi, 600 on MOH ARVs at TMC, 300 private

patients and 1,515 at Reach Out Mbuya, comprising 715 on PEPFAR and 800 on MOH ARVs. All patients in care screened for ART eligibility, and when found eligible, undergo multiple counselling sessions focusing on ART adherence, VCT for family members, partner testing and disclosure. Adherence to ART is monitored by patient report and pill counts on a monthly basis as they come for drug refills. Client adherence support workshops initiated in the past year have been taking place monthly. Patient tracking is carried out by the adherence team for those that have missed visits. Patients on ART are also provided with palliative basic care, TB screening and treatment, and lab monitoring. Mildmay has a fully functional lab able to perform all HIV related tests and follows national MOH guidelines in provision of ARV services. 1362 health providers were trained at Mildmay in ARV service provision in the past year.

During FY07 TMC will carry out care and training activities on site in Wakiso District and at each of the outlying sites at Naggalama and Mpigi. In FY07 it is planned to increase to 7,665 patients receiving ARV services, each having at least 2 CD4 counts a year, 3 Full Blood Counts and 3 Liver Function Tests. It is expected to carry out 12,000 pregnancy tests and 1000 viral loads particularly aimed at pregnant women and treatment experienced patients. The funding for this programme will finance human resources, training, quality assurance issues, infrastructure and logistics. The funding for ART services will go towards recruitment of additional staff, training of care providers, training of PHAs and other support staff, initiation an follow-up of ART recipients, quality assurance and support supervision. Mildmay expects to train up to 1450 health care provider in AERT provision in FY07.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336- OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services, 8640-SI.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Mildmay currently supports laboratory services at 4 sites. Laboratory services are carried out at TMC, the rural clinics in Naggalama, Mukono District and Mpigi Health Centre in Mpigi District, and at Reach Out Mbuya. Services offered include HIV tests, CD4 tests, Full Blood Counts, diagnostic tests for opportunistic infections and chemistries for liver and renal function. TMC has its own well equipped and staffed laboratory on its main site and also has x-ray facilities. However links are maintained with other facilities such as the CDC laboratory in Entebbe, the National TB laboratory and the pathology unit at Nsambya hospital so as to ensure a comprehensive service can be provided for patients and a quality assurance programme to monitor services is in place. Samples from other sites are transported to TMC for analysis. The lab supports patients recruited through the Counselling and Testing programme (7000 in FY06), those in palliative care (>8000 in FY06) and those accessing ARV services (>5000 in FY06). Laboratory screening for opportunistic infections including for active TB especially before they start on ART are essential. Training is provided to laboratory staff at all sites as well as being available to

other staff from other hospitals in Uganda through short courses, and clinical placement schemes.

In FY07 it is planned to increase to 7,665 patients receiving ARV services, each having at least 2 CD4 counts a year, 3 Full Blood Counts and 3 Liver Function Tests. It is expected to carry out 12,000 pregnancy tests, 10,000 HIV tests, 1,000 viral loads particularly aimed at pregnant women and treatment experienced patients. Diagnostic tests for opportunistic infections will be required for approximately 3,000 patients along with other monitoring tests. Funds will be for the purchase of reagents and test kits, maintaining laboratory equipment, quality assurance costs, human resources, training of laboratory workers in HIV related diagnostic skills and transportation of samples from rural sites in Mpigi, Mukono to TMC and to other testing centres as necessary. Training of a minimum of 150 laboratory staff from various health centers will be provided.

This activity also relates to 8641-AB, 8643-Condoms and Other Prevention, 8338-Basic Health Care and Support, 8619-TB/HIV, 8336- OVC, 8337-CT, 8625-ARV Drugs, 8333-ARV Services, 8335-Laboratory.

The Mildmay Centre (TMC) is a faith-based organisation operating under the aegis of the Uganda Ministry of Health since 1998 and managed by Mildmay International. TMC is recognised internationally as a centre of excellence for comprehensive HIV/AIDS care and training, particularly for children, who constitute 52% of patients. TMC has had a cooperative agreement with CDC, Uganda since 2001 to support training in HIV/AIDS care and treatment. From April 2004 the support was expanded to include ART and palliative HIV basic care. TMC also runs two rural clinics: at Naggalama, a Catholic church facility in Mukono District and Mpigi HCIV, a Ministry of Health (MOH) facility in Mpigi district. Since opening, TMC has registered over 14,000 patients, of whom 3,000 are seen monthly on site. 1,400 patients receive ARV drugs through PEPFAR, >500 through MOH/Global Fund, and 300 receive ART paying privately, but are supported to access free palliative basic care package and laboratory services i.e. CD4 counts, HIV testing, cotrimoxazole prophylaxis, a safe water vessel, free mosquito nets for malaria prevention, and other palliative care services i.e. morphine and chemotherapy for HIV related cancers and management of opportunistic infections including TB. Training at TMC is a key component of the programme, targeting doctors, nurses, HIV/AIDS counsellors, pharmacists, laboratory personnel, other health workers, school teachers and nurses, religious leaders and carers of patients. TMC views care and training as complementary processes when offering HIV/AIDS services. The training programme reaches participants throughout Uganda via a diploma/degree programme, mobile training teams (MTTs), clinical placements and short courses run at TMC. Multidisciplinary courses include: Use of ART in Children; Use of ART in Adults; Communication with Children; Palliative Care in the Context of HIV/AIDS; Laboratory Skills in an HIV/AIDS Context; Management of Opportunistic Infections and others. Training through the MTTs covers the same cadres and topics for selected clinics in targeted districts throughout Uganda. The MTTs have to date reached over 30 districts and are currently active in six. The degree/diploma programme targets health workers nationally from government, faith-based and other NGO facilities. The diploma comprises a modular programme with six staggered residential weeks over an 18-month period which can now be extended to a further 18 month period to yield a full degree. The time between modules is spent at the workplace doing assignments and putting into practice what has been learnt. Between July 05 and March 06 more than 1,000 Ugandans received training in HIV/AIDS in more than 60 weeks of training courses based both at TMC and in the rural districts. 1,308 participants have attended courses, 291 participants came for clinical placements providing 2,146 clinical placements days. Since the rural clinics opened 1,040 HIV patients have registered at Naggalama (188 on ART through PEPFAR and 45 through MOH) and 375 patients at Mpigi with more than 110 on ART. A family-centred approach is used in the recruitment of patients on to ART at TMC and all willing family members are offered testing and care within the context of available resources. Reach Out Mbuya (RO) is a sub-partner with TMC in the provision of holistic HIV/AIDS care. It is an initiative of Mbuya Parish in Kampala and is based at Our Lady of Africa Church in a poor urban neighbourhood. RO adopts a community-based approach using volunteers and people living with HIV/AIDS. By the end of June 2006, RO had 2,148 active patients in palliative with 986 on ART, majority of who are PEPFAR funded. By March 2007, an additional 250 children will be receiving ART at Mbuya RO.

Mildmay will implement a targeted evaluation in FY06 in collaboration with USCF and CDC. The evaluation is focusing on strategies at reducing HIV sexual transmission risk among ART adult recipients and also strategies to promote adherence to ART in both adults and children. As part of the targeted evaluation an extra 1,788 patients, both adults and children, will have the opportunity to receive enhanced counselling services. Some will receive additional home visits for home-based counselling and testing to be carried out. Evaluation of the best approach to counselling patients before and after starting ART will be undertaken. The targeted evaluation exercise will cover patients and their families, therefore offering more people an opportunity to access services. The funds under this programme area will finance procurement, human resources, staff training, transport for both patients and staff.