In FY2008, the program will cover seven additional districts bringing the total districts covered to 28. In the

seven districts, over 60 PHA groups and networks will be mobilized provided with technical and financial

support to facilitate linkages between home-based and facility-based care and treatment services. Over 100

Network support agents will be trained and attached to health facilities to work as expert clients involved in

ART literacy campaigns, couples counseling and support for disclosure, support for discordant couples,

support for adherence to treatment, prevention with positives and psychosocial support. It is estimated that

through the 28 districts and over 250 networks, the program will provide palliative care to over 80,000

clients and facilitate over 20,000 incidents of linkages and referrals. The trained network support agents will

continue to play a critical role in the task shifting venture that Government of Uganda will be undertaking

with support from OGAC, WHO/Geneva and UNAIDS.

The program will partner with AFFORD, PSI and malaria control partners to provide HIV/AIDS basic care

commodities to their members and households. Commodities include mosquito nets, condoms,

cotrimoxazole prophylaxis and nutrition products

Through the network model palliative care services to households and communities will be provided. The

model aims at enhancing easy access to a wide range of essential services for PHAs and their families. The

Alliance will also work with and link PHA groups and District networks to the wrap around services like

family planning and broader reproductive issues, supplementary feeding, livelihood programs, social and

economic reintegration programs and access to safe water and sanitation using the community engagement

strategy.

In FY2008, the program will train and build the capacity of PHA Networks and groups to set-up a structured

system to support caregivers and provide nutritional assessments, counseling and education.

In FY 2008, in addition to the 21 districts and over 200 PHA groups and networks covered, the program will

support over 100 PHA groups in 7 new districts to integrate tuberculosis (TB) and HIV activities. The PHA

Networks program will continue to support the Community-Based-DOTS program to ensure that all People

Living with HIV/AIDS (PHAs) access screening services for tuberculosis(TB) and that all those that have

TB in the community receive HIV/AIDS Counseling and Testing. Through linkages between facility and

Home-and Community-based care, trained PHAs (also known as Network Support Agents) will increase

awareness of the community on the close relationship between TB and HIV infections. The Network

Support Agents (NSA) will ensure that there those with TB/HIV co-infection access health facilities to be

assessed for ART eligibility. They will also ensure adherence to both ART and TB treatment.

NSA and the PHA groups will work with CB-DOTS supervisors and health facilities to increase access to

cotrimoxazole, diagnosis and treatment of sexually transmitted diseases and the basic care package

including HIV/AIDS commodities like long lasting insecticide treated nets, condoms and safe water. The

program will setup infection control activities in the community focusing on early and timely diagnosis of

both TB and HIV, contact tracing and diagnosis of TB especially among the pediatric age group.

In FY2008, in addition to the 21 districts and over 200 PHA groups and networks covered, the program will

support over 100 PHA groups in 7 new districts to link OVCs in their members' households and the

community to OVC services. The program will implement strategies with other partner organizations

operating in the sub districts to support PHAs, their families and communities in providing an integrated

response in their support for orphans and vulnerable children. Another approach Alliance will use to support

the OVC program is community mobilization to maximize community ownership of the OVC challenge. The

program will establish linkages between PHA groups and District probation officers, Community

Development Officers and their Assistants, Church groups, NGOs and CBOs providing care and support to

OVC and school authorities. Developing linkages and opportunities for synergies with the community allows

children and their families to have access to the range of services that they needs like education,

psychosocial support economic strengthening, health and nutrition as well as support for their social

inclusion.

Where visible and appropriate, linkages will be created between the program and the grantees of the CORE

Initiative for youth, orphans and vulnerable children in Uganda, who are providing care and support to OVC.

Districts, communities, civil society organizations and other providers of quality OVC services will be

targeted by the Alliance model for capacity building. Network Support Agents and health service providers

will be linked to these providers to ensure referrals and backward linkages for OVC services and support

supervision.

Over 1,000 PHAs in the respective networks will be trained as OVC caregivers including making referrals

and overseeing social services provided by other providers. The Network Support Agents will be trained to

monitor OVCs in the seven core areas. The program will provide direct support to over 40,000 OVC with

protection and psychosocial services, and establish mechanisms to support community-based childcare.

At district level, links will be created between community development officers and other OVC related

community services supported by the CORE -initiative. This intervention will lead to improvement in district

level OVC responses and reduce/eliminate duplication of OVC services. Partnership between organization

involved in OVC programs and PHA groups will be encouraged to not only increase the number of children

having access to OVC support services but also to foster PHA involvement in the design and delivery of

OVC support services. NAFOPHANU will support the dissemination of the national OVC policy as well as

the National Strategic Program of intervention of its member PHA groups at district and sub district levels.

This activity is a continuation of activities that are implemented in FY 07.

In FY2008, in addition to the 21 districts and over 200 PHA groups and networks covered, the program will

support over 100 PHA groups in 7 new districts to facilitate family based HIV/AIDS counseling and Testing

(HCT) for members in their households. There will be special focus on couples' counseling and testing,

disclosure of sero-status to spouses and support for discordant couples. The PHA groups and networks will

be trained to provide couples counseling, counseling of OVC and provision of support for discordant

couples. The groups and their representatives at health facilities, also known as Network Support Agents

(NSAs) will ensure that all those that test HIV-positive are linked to palliative care and treatment services.

The PHA groups and networks will also work closely with several HCT providers namely AIC, PREFA,

JCRC, TASO to provide community outreaches for HCT services. The Network Support Agents will be

trained to carry out HIV/AIDS Counseling and Testing and work closely with the Strengthening Counselor

Training (SCOT) program for certification. The NSA will also integrate TB/HIV, family planning, nutritional

assessment and counseling and, reproductive health counseling in HCT services

Post-test clubs (PTC) have for a long-time acted as a transition point between CT services and care,

treatment and prevention services. PTCs also play a critical role in breaking stigma and encouraging

disclosure of sero-status to partners and family members. This activity will build the capacity of PHA

networks and groups to create, support and sustain PTCs and link PTCs to community PHA networks and

groups, and providers of care, treatment and prevention services. Key services will cover STIs diagnosis

and treatment, TB screening and treatment, secondary HIV-prevention and family planning.

Over the course of the year, the PHA networks and groups will be trained to play a supportive role in

providing CT in public health facilities. This will help alleviate the acute shortage of health workers in public

health facilities. The program is working closely with Ministry of Health to develop a set of practices that will

guide the working relationship between the health workers and PHAs - as auxiliary health workers or expert

clients under the task shifting policy in the health sector. It is planned that PHAs will be actively involved in

Pre-test and post-test counseling, rapid HIV testing, running of post-test clubs and management of referrals

and linkages to care, treatment and prevention services. PHA networks will also link their members to wrap

around activities ranging from family planning to IGAs.

As a trained cadre of support staff, Network Support Agents also play a crucial role in prevention work,

which empowers people with HIV to protect their sexual health, to avoid new STIs, to delay HIV/AIDS

disease progression and to avoid passing their infection on to others. Strategies for positive prevention act

synergistically with other prevention, care and treatment efforts.

Lastly, one key role that PHAs within their networks and group will play is to increase community awareness

for CT leading to increased utilization of CT services. Through this program PHAs will also increase

awareness of communities on the value of couples testing and early access to care, treatment and

prevention activities including wrap around services like family planning, nutrition and other social re-

integration services including IGAs.

Emphasis Areas: Select and BOLD all that apply

In FY2008, in addition to the 21 districts and over 200 PHA groups and networks covered, the program will

support over 100 PHA groups in 7 new districts to improve linkages between facility-and home-based

management of ART. PHA Networks and groups are closer to the community and can be used to

communicate their experiences with HIV and the value of ART. ART literacy increases access and early

utilization of ARV services, and the proper use of the ARV drugs. Adherence remains key to successful

HIV/AIDS treatment outcomes. The program through the provision of technical and financial support

through sub-grants, will build institutional and technical capacity of PHA networks to increase their

involvement in the provision of prevention, care and treatment services and in the establishment and

management of effective referral mechanisms to link their members, families and the communities to

HIV/AIDS treatment services.

This activity will use the Community Engagement in ART training course developed by the International

HIV/AIDS Alliance to train 180 PHAs from over 60 sub-district PHA networks and groups as expert clients.

In support of the task shifting initiatives, the program will train clients to work as treatment supporters and

involve them is providing support for adherence and tracking of patients in the community leading to lower

default rates. The Network Support agents (NSAs) will be trained to support the network model and ensure

that those on treatment are linked to prevention with positives initiatives, PMTCT, TB/HIV assessments and

management, disclosure of sero-status, HIV/AIDS counseling and testing for partners, STI diagnosis and

management, home-based care, OVC care and wrap around services like family planning, Income

Generating activities(IGAs) and other social re-integration services for PHAs available in the respective

communities. In Uganda it is well recognized that such linkages that provide a comprehensive and holistic

approach to care of the infected and affected individuals including their families, increase the access,

utilization and adherence to ART.

A key focus for this program will be to support successful ARV outcomes by linking all identified HIV-

positive individuals to HIV treatment services and providing them with the necessary support required to

initiate, maintain and adhere to ARV treatment. This activity will be closely linked to and coordinated with

the IRCU, JCRC, TASO, Nutrition for PHAs activity, HIV in conflict North program, TB/HIV integration

activity, EGPAF, CORE and AFFORD and PSI (for health marketing activities).