This activity also relates to activities numbers: 8353-Basic Health Care and Support, 8355-OVC.

Population Services International (PSI) is a private non-profit organization with a mission to improve the health of low income people world wide through social marketing. PSI Uganda is an affiliate of PSI with operations in Uganda since 1998. In September 2004, PSI received support from CDC to implement the HIV Basic Care and Prevention package (BCP) program targeting people living with HIV/AIDS (PLHAs) in Uganda. The program goal is to help reduce the morbidity and mortality caused by opportunistic infections (OIs) in PLHA and to reduce HIV transmission. The program purpose is to increase access to and use of HIV Basic Care and Preventive and Palliative Care products and services among PLHAs.

The program combines key informational messages, training and provision of affordable health commodities with evidence-based health benefits, and simple to implement for PLHAs and their families. The commodities include information brochure on the benefits and accessibility of cotrimoxazole prophylaxis for prevention of OIs, 2 long lasting insecticide treated nets for malaria prevention, a safe water system comprising a 20 liter water vessel, filter cloth and water treatment product (WaterGuard), male condoms for adult clients and information brochure on strategies to prevent transmission of HIV to sexual partners and unborn children. PSI manages the manufacture, procurement, packaging and distribution of all commodities to ensure consistent supply of Basic Care starter kits and re-supply of commodities through already existing HIV/AIDS care and support organizations (Implementing partners) in Uganda.

A key activity of the program, complementary to the distribution of the basic care kits, and aimed at supporting and reinforcing usage of the kits is provider training. Service providers, peer educators and drama groups are trained to provide HIV-related palliative care including cotrimoxazole prophylaxis, malaria prevention, prevention of diarrhea and other waterborne diseases, prevention with positives interventions. The training provided to these groups also emphasizes the Information Education and Communication (IEC) materials given to PLHAs. The training provided to these groups also reinforces the Information Education and Communication (IEC) materials given to PLHAs. Another important component of the program is promotion of prevention with positives interventions, in harmony with the overall PEPFAR Other Prevention strategy. Prevention with positives interventions aim to avert HIV transmission to sexual partners and unborn children through promotion of family based counseling and testing, partner disclosure and discordance counseling, safe sex practices including abstinence, fidelity with condom use; sexually transmitted infections management, family planning, and prevention of mother to child transmission of HIV. The output of this activity is to ensure regular and constant availability of condoms to PLHA in Uganda. This will be achieved through the distribution of the complete Basic Care starter kit and annual replenishment of 60 pieces of condoms per adult client. Free condoms for the program are sourced from the Ministry of Health stock. In FY 06 this stock fell short of the national requirements and resulted in disruption of assembly and supply of Basic Care starter kits to PHLAs. Considering the past erratic supply of government condoms, in FY 07, US$250,000 has been allocated to the procurement, shipping, handling, post shipment testing and packaging of a condom buffer stock. This will ensure that PLHA continue to access condoms through the stock out periods. This activity is part of the larger project which includes Basic Health Care and support and OVC.

PSI is currently working with 43 implementing partners, 38 of which are distributing condoms to their adult clients. 51,498 basic care starter kits containing 3,089,800 condom pieces for adult PLHA have thus far been distributed and 20,809 adult clients re-supplied with 1,248,500 condoms. PSI has continued to implement a communications campaign to support the Basic Care and prevention package. The campaign includes development and production of prevention with positives IEC materials for clients, caregivers, health providers and counselors. These materials include posters, brochures, client guides, and stickers in 7 local languages. So far 29,797 clients' guides, 43,750 posters and brochures have been distributed. Development and implementation of IEC interpersonal communication (peer education activities and drama) has occurred with 444 peer education and 264 drama sessions so far conducted. Through these activities PSI has reached 95,877 adults with prevention with positives messages. The Basic care drama-

Lucy's choice video has been produced in 5 local languages and distributed to 43 implementing sites. All 43 sites offering the basic care package have a positive living outdoor signage. To support the IEC print campaign PSI working together with Straight Talk Uganda has supported airing of radio messages in 8 local languages on 27 radio stations countrywide and the parent talk program in 3 local languages on 6 radio stations in the eastern, western and northern regions of Uganda. The messages are aimed at providing information to the general public and PLHAs in particular, and focus on the basic care package components that are opportunistic infection prevention with cotrimoxazole prophylaxis, safe water system use, malaria prevention using the long lasting insecticide treated net and prevention with positives interventions. 19,440 messages that focus on the prevention with positives interventions (family based counseling, disclosure, discordance, FP, PMTCT, STI management, abstinence and condom use) have been aired. PSI has also developed BCP Training of Trainers & Peer Education manuals. To date 2,020 health service providers and counselors and 494 peer educators have been trained. A preliminary BCP component utilization monitoring and evaluation survey has been conducted to further inform program activities. A follow up monitoring and evaluation survey is currently on going.

Planned activities for FY07 include: 1. Procurement of a condom buffer stock for PHAs; 2. Continue to implement the Basic Care Package program at 43 sites catering for 110,000 clients, while expanding to 11 USG supported sites of HIV/AIDS care and treatment implementation partners and 60,000 new clients bringing the total of clients to 170,000 by end of year 3 (FY 07) throughout Uganda. All new clients shall receive a basic care starter kit with 60 condom pieces except the 7,000 children while replenishment of condoms shall be done for the current adult clients. 47 implementing sites shall be involved in condom distribution to the adult clients; 3. Conduct training of new health service providers and refresher trainings for current providers on BCP and prevention with positives interventions; 4.Continue to make available on the open market all the elements of the Basic Care and Prevention package to enhance their availability to all PLHAs and in effect reduce stigma; 5. Ongoing distribution of prevention with positives IEC material to PLHA and health service providers; 6.On going peer education and drama activities to support the uptake and use of the basic care and prevention package; 7.On going airing of radio messages on about the BCP and prevention with positives interventions; 8.On going monitoring and evaluation activities to track program progress.

This activity also relates to activities numbers: 8354-Condoms and Other Prevention, 8355-OVC.

Population Services International (PSI) is a private non-profit organization with a mission to improve the health of low income people world wide through social marketing. PSI Uganda is an affiliate of PSI with operations in Uganda since 1998. In September 2004, CDC began support to PSI to implement the HIV Basic Care and Prevention package (BCP) program targeting people living with HIV/AIDS (PLWHA) in Uganda. The program goal is to help reduce the morbidity and mortality caused by opportunistic infections (OIs) in PLWHA and to reduce HIV transmission. This program will increase the production of HIV BCP and Palliative Care products and services among PLWHAs.

The program combines key informational messages, training and provision of affordable commodities with evidence- based health benefits, and simple to implement for PLWHAs and their families. The commodities include an information brochure on the benefits and accessibility of cotrimoxazole prophylaxis to prevent OIs, 2 long-lasting insecticide treated bednets for malaria prevention, a safe water system comprised of a 20 liter water vessel, filter cloth and water treatment product (WaterGuard), male condoms for adults clients, and an information brochure on the strategies to prevent transmission of HIV to sexual partners and unborn children. PSI manages the manufacture, procurement, packaging and distribution of all commodities to ensure consistent supply of Basic Care starter kits and re-supply of commodities through already existing HIV/AIDS care and support organizations (Implementing Partners) in Uganda.

The distribution of the BCP is supported by a training component in which service providers, peer educators and drama groups are trained to support and reinforce the use of the kits. The training provided to these groups also reinforces the Information Education and Communication (IEC) materials given to PLWHAs.

The outputs of this program include: 1. Increased informed demand for BCP and Palliative Care products and services among PLHA; 2. Increased access to BCP and Palliative Care products and services; 3.Increased awareness among providers the BCP and Palliative Care products and services; 4. Increased social and governmental support for the BCP and Palliative Care products for PLWHA in Uganda. These outputs are achieved through the development and implementation of the following: 1. A communications campaign to support the BCP and Prevention Package-with information for PLWHA on how to improve their quality of life, how to live longer and how to prevent the transmission of HIV to others; 2. A communications campaign to promote the use of Palliative Care Products; and 3. Social marketing & distribution of products as well as information to all PLWHA. This activity is part of the larger project which includes OVC and support and other prevention activities.

PSI is currently working with 43 implementing partners, 38 of which are distributing condoms to their adult clients. 62,502 BCP starter kits have been distributed. PSI has continued to implement a communications campaign to support the use of BCP by PLWHA and their families. The campaign includes development and production of IEC materials for clients, caregivers, health providers and counselors. These materials include posters, brochures, client guides, and stickers in 7 local languages. The IEC materials cover many issues on use; on cotrimoxazole prophylaxis including a compliance calendar to help clients remember to take their daily dose; prevention of malaria through the use of insecticide treated nets; prevention of diarrhea and other water borne diseases through the use of safe water systems including WaterGuard; and prevention with positives through promotion of family-based counseling and testing; safe sex practices including abstinence, fidelity with condom use; family planning and the prevention of mother-to-child transmission of HIV. So far 29,797 clients' guides, 43,750 posters and brochures and 2,836 providers' cards have been distributed. Development and implementation of IEC interpersonal communication activities (peer education and drama) has occurred with 444 peer education and 264 drama sessions reaching 104,322 and 18,059 people respectively. The Basic care drama, "Lucy's Choice" video has been produced in 5 local languages and distributed to 43 implementing sites. All 43 sites offering the BCP have a positive living outdoor signage. To support the IEC print campaign, PSI working together with Straight Talk Uganda has supported airing of radio messages in 8 local languages and dissemination of the Parent Talk program in 3 local

languages. The messages focus on the BCP components that is opportunistic infection prevention with cotrimoxazole prophylaxis, safe water system use, malaria prevention using the long lasting insecticide treated net and prevention with positives interventions. PSI has also developed BCP Training of Trainers & Peer Education manuals. To date 2,020 health service providers and counselors and 494 peer educators have been trained. PSI has also participated at several stakeholder workshops with Hospice Africa, a key local organization in Uganda that offers palliative care in HIV to clear the ambiguity regarding the definition of palliative care and also to avoid duplication of effort by different partners. A preliminary BCP component utilization monitoring and evaluation survey has been conducted to further inform program activities. A follow up monitoring and evaluation survey is currently on going.

Planned activities in FY07 include: 1. Continue to implement the BCP program and expand its distribution through PEPFAR care and treatment implementation partners to 60,000 new clients bringing the total of clients to 170,000 by end of year 3 (FY07) throughout Uganda. 2. Continue to make available on the market all the elements of the BCP package to enhance their availability to all PLWHA; 3. Ongoing distribution of IEC material to PLWHA and health service providers; 4. Ongoing peer education to support the uptake and use of the Basic Preventive Care package; 5. Ongoing airing of radio messages, as well as radio talk shows; 6. Introduction of new implementers including JCRC, Uganda Cares, Save the Children and EGPAF; 7. Refresher training & training for new health service providers; 8. Continued support for palliative care activities through Hospice Uganda by production of palliative care, IEC, BCC and advocacy materials; 9. On going monitoring and evaluation activities to track program implementation. plus ups: "HIV/AIDS Preventive care products There is overwhelming evidence attesting to the effectiveness of preventive care, including chemoprophylaxis, use of bed nets and safe water in delaying HIV disease progression and consequently improving the quality of life for PHA. However, access to these commodities remains low in Uganda. This activity is aimed at expanding access to cotrimoxazole prophylaxis, long-lasting insecticide treated nets as well as safe water systems. $600,000 will be used to train health care providers in preventive care and prevention with positives; procure and distribute preventive care commodities and for communication campaigns on basic care. PHA particularly in rural communities served by USG partners across PEPFAR (DOD/UPDF, Peace Corps, State IMC, State IRC, Walter Reed, IRCU, and Hospice) who have not yet initiated or do not have the full range of preventive care activities will be prioritized.

This activity also relates to activities numbers: 8354-Condoms and Other Prevention, 8353: Basic Health Care and Support.

PSI is a private non-profit organization with a mission to improve the health of low income people world wide through social marketing. PSI Uganda is an affiliate of PSI with operations in Uganda since 1998. In September 2004, CDC began support to PSI to implement the HIV Basic Care and Prevention package (BCP) program targeting people including children living with HIV/AIDS (PLHA) in Uganda. The program goal is to help reduce the morbidity and mortality caused by opportunistic infections (OIs) in PLHA including OVC and to reduce HIV transmission. The program purpose is to increase the production and use of HIV Basic Care and Preventive and Palliative Care products and services among PLHA.

The program combines key informational messages, training and provision of affordable commodities with evidence- based health benefits, and simple to implement for PLHA, OVC and their families. The commodities for children include an information brochure on the benefits and accessibility of cotrimoxazole prophylaxis to prevent OIs, 2 long lasting insecticide treated nets for malaria prevention, a safe water system comprised of a 20 liter water vessel, filter cloth and water treatment product (WaterGuard), and an information brochure on the strategies to prevent transmission of HIV to sexual partners and unborn children. Male condoms are not provided to children. PSI manages the manufacture, procurement, packaging and distribution of all commodities to ensure consistent supply of Basic Care starter kits and re-supply of commodities through already existing pediatric HIV/AIDS care and support organizations (Implementing partners) in Uganda. To avoid missed opportunities basic care kits are also distributed through adult sites to access more children. These sites are provided with basic care kits without condoms. The distribution of the Basic Care kits is supported by a training component in which service providers, peer educators and drama groups are trained to support and reinforce the use of the kits. The training provided to these groups also reinforces the Information Education and Communication (IEC) materials provided.

This activity is part of the larger project which includes Basic Health Care and support and other prevention activities. The activity has increased HIV basic and palliative care products and services to serve children living with HIV/AIDS infected or affected families. Training sessions with focus on the unique needs of the OVC have expanded awareness among health service providers on the benefits of the basic and palliative care products and services.

PSI is currently working with 43 implementing partners 2 of which are pediatric care and support centers. In total 4,321 basic care starter kits have thus far been distributed to children. PSI has continued to implement a communications campaign targeting care givers of children to support the Basic Care and Prevention package. The campaign includes development and production of IEC materials for caregivers, health providers and counselors. These materials include posters, brochures, caregiver guides, and stickers in 7 local languages. The IEC materials mainly cover issues on use of cotrimoxazole including a compliance calendar to help children caregivers remember to give the children their daily dose, prevention of malaria through the use of insecticide treated nets, prevention of diarrhea and other water borne diseases through the use of safe water systems including WaterGuard. To date 4,321 client care giver guides have been distributed. Development and implementation of IEC interpersonal communication (peer education activities and drama) has occurred with 60 peer education reaching 14,090 children and 36 drama sessions reaching 2,414 children. To support the IEC print campaign PSI working together with Straight talk Uganda has supported airing of radio messages in 8 local languages and the parent talk program in 3 local languages. The messages focus on the basic care package components that is opportunistic infection prevention with cotrimoxazole prophylaxis, safe water system use, malaria prevention using the long lasting insecticide treated net. PSI has developed BCP Training of Trainers & Peer Education manuals. PSI has trained 83 health service providers and counselors and 31 peer educators with an OVC focus. A preliminary BCP component utilization monitoring and evaluation survey has been conducted to further inform program activities. A follow up monitoring and evaluation survey is currently on going.

Planned activities for FY07 include:1.Continue to implement the Basic Care Package

program and expand its distribution through PEPFAR care and treatment implementation partners to 7,000 new clients bringing the total of OVC to 18,000 by end of year 3 (FY 07) throughout Uganda. 2.Ongoing distribution of IEC material to PLHA and health service providers; 3.Ongoing peer education to support the uptake and use of the Basic Preventive Care package; 4.Ongoing airing of radio messages as well as radio talk shows; 5.Introduction of new implementers; 6.Refresher training & training for new health service providers; 7. On going monitoring and evaluation activities to track program implementation