PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
As commander in chief of the armed forces, the President of Uganda mandated the UPDF's AIDS Control
Program to oversee and manage prevention, care, and treatment programs throughout the forces and their
families. Although the exact prevalence rates of the military are unknown, it is estimated that approximately
10,000 military are living with HIV with up to an additional 10,000 HIV infected family members.
Additionally, an increasing trend is the utilization of military clinics and hospitals by civilians not affiliated
with the military, with up to 50% of patient visits being non-military. The UPDF HIV/AIDS Control program
is comprehensive, although the PEPFAR support for PMTCT was added more recently in the past few
years. The initial thrust has been to augment PMTCT services at 5 of the military bases with ART clinics.
The activities include sensitization and increased awareness for pregnant women to access services.
Midwives and nurses are being trained in these PMTC centers according to Uganda MOH guidelines.
PMTCT is also used as an entry point to ART services and an avenue to identify discordant couples and
emphasize the linkage to clinical services. For those bases without military PMTCT services, pregnant
service women and spouses are referred to civilian sites.
2. Progress to-date
With PEPFAR funding PMTCT is offered at 5 of the UPDF bases, and limited training of health care
providers has been offered. An assessment is underway to estimate the coverage of Counseling and
Testing of pregnant women, the linkages of PMTCT services to ART and follow-up procedures of the
mother infant pair. One notable observation is the very low level of access to PMTCT services by pregnant
women (less than 40%)—and an even lower level for their families.
3. Activities for FY 2009.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS: During FY 2009, the program will focus on
increasing the coverage of women receiving PMTCT services in the supported UPDF facilities. The target
for this performance period is to reach 75% of pregnant women and 25% of spouses and partners of the
targeted pregnant women with PMTCT services. To do so, the program will strengthen the capacity of
health workers to provide quality PMTCT services including FP and HCT; augment efforts to reach male
partners and enhance their level of involvement in pregnancy and childbirth issues, and; provide easily
accessible education on ways to reduce risk of HIV infection from mother to child before and during
pregnancy, at delivery and during infant feeding. More than 100 service providers will undergo training on
MTCT with a goal of using them to scale PMTCT services for military families. Pregnant women and their
spouses who are found to be HIV-positive will be linked to other services for continued care and support
and where necessary antiretroviral treatment.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16065
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16065 4551.08 Department of US Department of 7336 690.08 $100,000
Defense Defense
8390 4551.07 Department of US Department of 4821 690.07 $100,000
4551 4551.06 Department of US Department of 3156 690.06 $50,000
Emphasis Areas
Military Populations
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
The UPDF is Uganda's national Army. As a mobile population of primarily young men, they are considered
a high-risk population. As commander in chief of the armed forces, the President mandated the UPDF's
AIDS Control Program to oversee and manage prevention, care and treatment programs throughout the
forces. Although the exact HIV prevalence rates from the military are unknown, it is estimated that
approximately 10,000 military are living with HIV with up to an additional 10,000 HIV infected family
members.
The UPDF Prevention program utilizes the post test clubs as one of the cornerstones for prevention
strategies. Formed mainly from persons who have tested positive, the clubs are open to all military
personnel, their families, and the people from the surrounding community who has tested for HIV. The
clubs are also seen as an important link for care and treatment services and for follow-up for psychosocial
support. Another common practice which has been highly effective for the commanders to reach through to
the troops, has been the use of military parades, to pass on information using open discussions with
disclosure by the PTC members. Activities include training of trainers to have ‘focal points' of peer
educators within these PTCs, expanding the peer education program to include an emphasis on gender
issues, family planning, challenging male norms, and addressing stigma and discrimination and ARV
adherence. Distribution of condoms from the Ministry of Health has been extended to 12 centers, which will
continue to be a focus of prevention activities.
Progress to Date - During FY 08, the cadre of peer educators within the PTCs associated with each of the
13 VCTs was expanded, with a concomitant increase in the HIV Prevention activities of awareness,
abstinence and being faithful, and delaying of sexual debut, and pre and post test counseling. An area of
emphasis with VCT counselors has been to encourage disclosure to the spouses of HIV positive soldiers.
Outreach has been extended through a mobile film van which travels to the UPDF units around the country
and incorporates peer education, C & T, sensitization, and condom distribution.
Planned Activities for FY09 - ACTIVITY UNCHANGED FROM FY2008. There will be linkages between
the other Prevention activities of Counseling and Testing and Male Circumcision.
Continuing Activity: 18548
18548 18548.08 Department of US Department of 7336 690.08 $50,000
Table 3.3.02:
a high-risk population. Uganda initiated programs for high-risk groups in the early phases of the epidemic
and continues to promote excellent principles of nondiscrimination in its National Strategic Framework.
Starting in 1987, the Minister of Defense developed an HIV/AIDS program after finding that a number of
servicemen tested HIV positive. As commander in chief of the armed forces, the President mandated the
UPDF's AIDS Control Program to oversee and manage prevention, care and treatment programs through
out the forces. Although the exact HIV prevalence rates from the military are unknown, it is estimated that
approximately 12,000 military are living with HIV with up to an additional 12,000 HIV infected family
members. The UPDF HIV/AIDS Control program is comprehensive and covers the critical elements of
prevention, such as counseling and testing, peer education, condom distribution, and PMTCT; HIV care,
such as palliative care services and ARV services; and human and infrastructure capacity building. More
recently provision of ART has been initiated on a larger scale, in 8 military sites, with drug provision via
JCRC and the Ministry of Health. The UPDF leadership supports this new PEPFAR supported initiative, as
one that has relevance to the active duty military and dependents. Specific activities include coordination
by senior medical UPDF leadership with the Uganda Country team and PEPFAR regional efforts, to include
ensuring training and adopt strategies to the military
2. Progress to-date. The UPDF has had two of its staff trained on basics of sexual and gender based
violence. A work plan is in process for community engagement on sexual and gender based issues and will
be initiated over the next 4 - 6 months.
3. Planned activities for FY 2009. ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS: With FY
2009 COP funding, we plan to establish and strengthen linkages between health, law enforcement, legal,
and community services for delivery of a coordinated response to sexual violence victims and strengthen
the capacity of local partners and institutions to deliver quality health care services including PEP to victims
of sexual violence around and within military facilities.
Continuing Activity: 16067
16067 3967.08 Department of US Department of 7336 690.08 $215,000
8385 3967.07 Department of US Department of 4821 690.07 $150,000
3967 3967.06 Department of US Department of 3156 690.06 $50,000
Table 3.3.03:
members. Additionally, an increasing trend is the utilization of military clinics and hospitals by civilians not
affiliated with the military, with up to 50% of patient visits being non-military. PEPFAR funding has
supported HIV clinical and ART capacity at 8 UPDF hospitals and sick bays across the country. The UPDF
health workers are still using the ordinary disposable syringes which carry a risk of being re-used. Medical
waste management is poor with improper segregation, no color-coding, inadequate containers for waste
collection and general lack adequate knowledge on the part of health workers in relation to injection safety
and waste management. COP08 was the first year PEPFAR funding was provided for injection safety. The
activities scheduled include: undertake a situation analysis and needs assessment, train medical workers,
procure auto-disabling syringes, and proper waste disposal containers.
2. Progress to-date. A needs assessment has been planned and will be implemented followed by pilot
programs at 3 of the UPDF medical clinics.
3. Planned activities for FY 2009. ACTIVITY HAS BEEN MODIFIED TO expand activities promoting
injection safety and proper handling of medical waste to the other 5 military medical facilities. Activities will
include procurement of more auto disabling syringes, training of more health workers, procurement of
medical waste disposal containers, construction of a sample incinerator. This expansion will extend the
coverage to 80 percent of the target population.
Continuing Activity: 16066
16066 8856.08 Department of US Department of 7336 690.08 $50,000
8856 8856.07 Department of US Department of 4821 690.07 $50,000
Program Budget Code: 06 - IDUP Biomedical Prevention: Injecting and non-Injecting Drug Use
Total Planned Funding for Program Budget Code: $0
Program Budget Code: 07 - CIRC Biomedical Prevention: Male Circumcision
Total Planned Funding for Program Budget Code: $1,623,587
Table 3.3.07:
affiliated with the military, with up to 50% of patient visits for HIV care and treatment being non-military.
Thus the demand to provide quality ARV services is continually growing. With PEPFAR support, 8 sites
now provide ART and HIV care services. ARV services have been strengthened through training of health
care providers, via the Infectious Diseases Institute (IDI) based in Kampala, and a partnership with San
Diego DHAPP. A critical cornerstone of safe, effective ARV treatment is high compliance. Military
personnel have unique challenges and obstacles for medication adherence, given barracks living,
deployments, and the stigma associated with HIV/AIDS. A pilot adherence program is being initiated to
specifically address ARV compliance in the military, and will be centered at Bombo Barracks and Mbuya
Hospital.
UPDF continues to have HIV challenges due to a lack of trained clinical staff, an automated medical
information system, and inadequate laboratory diagnostics for OIs and co-infections. These inadequacies
are being systematically addressed via the support from the USG, initially in the Kampala based Bombo
military hospital, and Mbuya military Hospital, with expansion to military medical facilities in Nakasongola
and Wakiso. Drugs for OI prophylaxis and treatment are being procured for these 3 sites. Particular
attention is paid to widows and OVCs that are eligible for services. A course has been developed for
nurses and clinical officers through the Infectious Diseases Institute, Kampala and for the past 2 years this
training has been used to ramp up care in HIV clinical management, to include addressing military specific
issues.
There are currently 4,000 active duty UPDF personnel , family members and civilians followed for ART and
HIV clinical management. Current plans are to support expansion of ARV services in training of UPDF
personnel and modify and extend the adherence protocol to the other 6 treatment sites. This program will
also be evaluated, and clinic procedures modified to include adherence practices as standard protocol.
Additional training of physicians (6) and nurses and clinical officers (25), through the IDI in Kampala and the
DHAPP program (2) will also be conducted. The IDI in collaboration with the UPDF have developed a 4
week (and 2 week respectively) course aimed to ramp up skills in ARV use, recognition and management of
OIs and PMTC. Monitoring of clinical services with a medical information systems (MIS) to optimize clinical
management will be initiated. There will be more of an emphasis on integration of prevention care and
treatment programs; and increasing the availability of materials for client-provider interaction.
Currently these activities (diagnosis and treatment of OIs, drug procurement, training, lab services), are
expanding beyond the 2 major clinical sites in Kampala and 2 outside Kampala sites to all 8 sites within the
military health network providing ARV access. STI diagnostics and therapeutics and training for HCWs is
being initiated. A new and extremely important expansion, given the recent compelling data confirming
efficacy, plans are underway to provide access to the Basic Health Care Package (impregnated mosquito
nets; safe water vessel; co-trimoxazole) to the UPDF HIV positive personnel and family members plus
piloting the use of the BHC package in deployment/field scenarios.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS: A Prevention for Positives program which
includes elements relevant to the military, will be developed and piloted in 2 of the ART sites. This will have
an emphasis on discordant couples as well as factors that increase risky behavior such as alcohol misuse.
Continuing Activity: 16068
16068 3968.08 Department of US Department of 7336 690.08 $134,000
8386 3968.07 Department of US Department of 4821 690.07 $134,000
3968 3968.06 Department of US Department of 3156 690.06 $134,000
Estimated amount of funding that is planned for Water $5,000
Table 3.3.08:
Continuing Activity: 16072
16072 4552.08 Department of US Department of 7336 690.08 $250,000
8391 4552.07 Department of US Department of 4821 690.07 $250,000
4552 4552.06 Department of US Department of 3156 690.06 $250,000
Estimated amount of funding that is planned for Water $20,000
Table 3.3.09:
members. AIDS and war continue to be the topmost causes of death among UPDF personnel and their
families. As a result, the Uganda Peoples Defense Forces has a large burden of orphans that are potentially
infected by HIV, in addition to children in intact families. PEPFAR funding for a UPDF OVC program was
initiated in 2008, and linkages between the OVC program and referral to for Pediatric Care and Treatment
of infected children, will be a program priority. Additionally, as the PMTCT program is strengthened with
PEFAR funding, to include early infant diagnosis (EID), there will be an increased demand for Pediatric HIV
clinical services.
With PEPFAR support, 8 military clinic sites now provide ART and HIV care services. UPDF continues to
have challenges due to a lack of trained clinical staff, particularly in Pediatric management of HIV, and
inadequate laboratory diagnostics for OIs and co-infections. These inadequacies are being systematically
addressed via the support from the USG, concentrating on the Kampala based Bombo military hospital, with
the largest population of HIV patients, with expansion to military medical facilities in Nakasongola, Wakiso,
and Gulu. Drugs for OI prophylaxis and treatment are being procured for these sites. Clinical training for
doctors, nurses and clinical officers, particularly through the Infectious Diseases Institute, Kampala has
been an area of emphasis. This will be expanded to MildMay for Pediatric specific training, with a goal of
training clinical staff in managing pediatric HIV infected patients at each of the 8 ART sites. Access to the
Basic Health Care Package (impregnated mosquito nets, safe water vessel, cotrimoxazole) has been
incorporated into the UPDF HIV clinics.
ART services are in place at 8 UPDF clinics and hospitals, with > 4,000 HIV infected patients, including
children receiving ART of which 579 are children 0-17 years. With the intensified linkages to the OVC,
PMTCT, and discordant couple counseling programs, the number will increase. The Uganda MOH
guidelines for care of pediatric patients are being disseminated to all the ART sites. A Pediatric technical
consultant for the UPDF will be initiating n overall strategy in Pediatric Care and Treatment, to include
assessment of appropriate ART formulation availability and training for health care providers.
ACTIVITY UNCHANGED FROM FY 2008
Pediatric HIV care and treatment services will be integrated into services offered at all the UPDF ART
centres. UPDF will continue to sensitize the community about pediatric HIV care and treatment services,
linking children of HIV positive mothers to Early infant diagnosis service provision centres and provide
ongoing counseling support and management of OIs among children already in care. Health care workers
will be trained to equip them with skills in pediatric HIV care and treatment. UPDF will continue to distribute
the MoH pediatric HIV care and treatment guidelines to reach all healthcare workers involved in the
management of children and adolescents with HIV/AIDS. Community volunteers will be supported to make
home based follow-up of who default on clinic appointments in their families and provide adherence
support.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.10:
1. Activity Narrative - The UPDF is Uganda's national Army. As a mobile population of primarily young
men, they are considered a high-risk population. As commander in chief of the armed forces, the President
mandated the UPDF's AIDS Control Program to oversee and manage prevention, care and treatment
programs throughout the forces. Although the exact HIV prevalence rates from the military are unknown, it
is estimated that approximately 10,000 military are living with HIV with up to an additional 10,000 HIV
infected family members. AIDS and war continue to be the topmost causes of death among UPDF
personnel and their families. As a result, the Uganda Peoples Defense Forces has a large burden of
orphans that are potentially infected by HIV, in addition to children in intact families. PEPFAR funding for a
UPDF OVC program was initiated in 2008, and linkages between the OVC program and referral to for
Pediatric Care and Treatment of infected children, will be a program priority. Additionally, as the PMTCT
program is strengthened with PEFAR funding, to include early infant diagnosis (EID), there will be an
increased demand for Pediatric HIV clinical services.
2. Progress to-date. ART services are in place at 8 UPDF clinics and hospitals, with > 4,000 HIV infected
patients, including children receiving ART of which 579 are children 0-17 years. With the intensified linkages
to the OVC, PMTCT, and discordant couple counseling programs, the number will increase. The Uganda
MOH guidelines for care of pediatric patients are being disseminated to all the ART sites. A Pediatric
technical consultant for the UPDF will be initiating n overall strategy in Pediatric Care and Treatment, to
include assessment of appropriate ART formulation availability and training for health care providers.
3. Planned activities for FY 2009. ACTIVITY UNCHANGED FROM FY 2008
Paedaitric HIV care and treatment services will be integrated into services offered at all the UPDF ART
centres. UPDF will continue to sensitize the community about paediatric HIV care and treatment services,
support. Children will be provided with cotrimoxazole prophylaxis, bed nets and safe water vessels.
Table 3.3.11:
Introduction:
Activity Narrative - The UPDF is Uganda's national Army. As a mobile population of primarily young men,
they are considered a high-risk population. Uganda initiated programs for high-risk groups in the early
phases of the epidemic and continues to promote excellent principles of nondiscrimination in its National
Strategic Framework. Starting in 1987, the Minister of Defense developed an HIV/AIDS program after
finding that a number of servicemen tested HIV positive. As commander in chief of the armed forces, the
President mandated the UPDF's AIDS Control Program to oversee and manage prevention, care and
treatment programs through out the forces. Although the exact HIV prevalence rates from the military are
unknown, it is estimated that approximately 10,000 military are living with HIV with up to an additional
10,000 HIV infected family members. Additionally, civilians without military affiliation can access UPDF
medical care, and represent up to 50% of all visits for some of the clinics. The UPDF HIV/AIDS Control
program is comprehensive and covers the critical elements of prevention, such as counseling and testing,
peer education, condom distribution, and PMTCT; HIV care, such as palliative care services and ARV
services; and human and infrastructure capacity building. Co-infection with TB is a substantial challenge for
the medical management of HIV infected patients in the UPDF. The UPDF hopes to further strengthen the
control and management of TB in the military with the initiation of PEPFAR funds in FY 2008.
Progress to Date - The army leadership is being mobilized in the management of TB to improve on
adherence to therapy with promotion of DOTS in health care facilities. Overall strategies underway with this
new activity include: enhanced detection of TB cases in HIV positive clients and strengthening referrals for
TB treatment; HIV counseling and testing of TB suspects and TB cases; and ensuring that those found to
be HIV positive are linked to HIV care and ARV treatment. All of this is being done in coordination with the
national health system in the roll out of the Ugandan MOH TB/HIV policy. Additional elements include
addressing the adequate and constant supply of anti TB drugs and reagents, which is accomplished
through the SCMS.
Planned Activities for FY 2009 - During FY 2009, the project will continue to make significant progress in the
integration of TB and HIV management through the linkage between Counseling and Testing service
delivery points, chronic care clinic and the TB clinic in all supported facilities. TB/HIV activities will be
expanded to 6 more new health facilities and it is expected to reach 2,000 individuals over the year 2009. At
the same time we will further consolidate the provision of TB/HIV services in the supported health facilities.
The program will continue to support efforts that provide cross-referral and integrate diagnosis, treatment
and support services for TB and HIV in the target facilities. HIV-positive individuals will be actively screened
and treated for TB at initial diagnosis and during follow up at the chronic care clinics. We will further
strengthen the laboratory and radiological investigation to improve case detection. HIV counseling and
testing will be offered to all patients in the TB clinics.
We will strengthen the capacity of health facilities staff to better understand policies and guidelines for
integrating TB/HIV collaborative activities. This will lead to better understanding and improved case
management of TB/HIV co-infected patients, to maximize TB case detection, increase treatment compliance
and adherence to TB and ART. TB Infection control measures in HIV care clinics will be enhanced through
literacy campaigns for patients and staff, and enhanced TB case-finding. We will also support supervision
and on-job training will be done to strengthen TB/HIV integrated services
Continuing Activity: 16069
16069 8987.08 Department of US Department of 7336 690.08 $100,000
8987 8987.07 Department of US Department of 4821 690.07 $50,000
Table 3.3.12:
1. Activity Narrative:
with the military, with up to 50% of patient visits being non-military. AIDS and war continue to be the
topmost causes of death among UPDF personnel and their families. As a result, the Uganda Peoples
Defense Forces has a large burden of orphans that are either infected by HIV or vulnerable to being
infected. Most of these orphans are enrolled within the army schools. Little attention has to-date been given
to this vulnerable group, and 2008 was the first year year of PEPFAR funding for the UPDF orphans and
vulnerable children (OVC). A central strategy is initiating support activities for the OVC as a school based
program through health education about abstinence, as well as increasing the coverage of counseling and
care services in the schools, and fighting stigma against those infected, especially those on ART. In
achieving this, the teachers are specifically trained and empowered to enable them incorporate the activities
in their routine teaching curriculum. PHA's households are targeted to ensure that the OVC are linked to
OVC services as well as care and treatment.
2. Progress to-date: For FY08, a needs assessment is being done to better define the UPDF OVC
population, including those not enrolled in the army school, and document current services and HIV C & T
and clinical services coverage. Given the varied needs of UPDF OVC (both from HIV and conflict-related
causes) part of the needs assessment effort will be defining the scope of program support to provide for
OVC and their families. Clear and easy to use guidelines for integrated delivery of OVC programming in the
military will be developed and disseminated. This being a new area during FY08, the program will
commence on training activities for OVC school based programs that will be expanded in FY 09.
3. Activities for FY 2009. Innovative programs that target both in and out of school UPDF OVC will be
scaled up during FY 2009 to empower the vulnerable children in coping up with the challenges of being
affected and infected by HIV/AIDS. Activities will include training young people in life skills, reproductive
health skills, stigma reduction, and income generation for teenage OVC. Opportunities for linkage of OVC
intervention with other prevention, care, treatment and impact mitigation efforts that are underway in the
military communities will be sought to ensure sustainable delivery of quality programs.
Continuing Activity: 16070
16070 8853.08 Department of US Department of 7336 690.08 $150,000
8853 8853.07 Department of US Department of 4821 690.07 $50,000
Table 3.3.13:
they are considered a high-risk population. As commander in chief of the armed forces, the President
personnel and their families. At recruitment, all UPDF officers and men are HIV negative and therefore
almost all the infection is acquired while in service. Counseling and testing is considered to be one of the
strongest strategies of HIV infection prevention in the context of knowledge is power and because knowing
you are HIV negative motivates one to remain negative. HIV counseling and testing is also the
gateway/entry-point to all other HIV care and treatment services. With increasing access to ARVs by all
UPDF cadre serving in any corner of Uganda, CT is becoming more and more important as a means of
identifying infected military personnel and/or their infected family members and keeping them healthy to
serve their country.
With PEPFAR support, CT has been ongoing in all the military medical establishments. UPDF continues to
have challenges due to a lack of HIV test kits and other supplies, poor records keeping of the people who
receive the service, and inadequately trained personnel, especially in routine counseling and testing and
early infant diagnosis. These inadequacies are being systematically addressed via the support from the
USG, focusing on all the military hospitals. The HIV test kits and sundries are being procured for the testing
centers. On job training for doctors, nurses, counselors and clinical officers has been an area of emphasis.
Efforts are underway to improve collaborations with Ministry of Health in the area of data management and
monitoring and evaluation. HIV test registers have been secured from the MoH and other partners involved
in CT.
2. Progress to-date. In spite of the highlighted challenges, in the FY08, UPDF conducted 16,747 HIV tests,
the majority of which were male and 656 were for patients who presented with TB. These clients were
tested both at the static Health facilities and through outreaches and house to house HIV testing activities.
Awareness about the availability of the service is increasing partly because of the advocacy and
sensitization through the UPDF command structure. With the intensified community based HIV testing
activities, it is anticipated that more people will be reached. More healthcare providers will be reached and
oriented in the Uganda Ministry of Health (MOH) guidelines for routine counseling and testing and early
infant diagnosis. Introduction of community volunteers will ensure that we reach those most in need and
increase linkage to care and treatment services.
UPDF has just acquired a film van from DoD/PEPFAR, which will further strengthen the community
sensitization strategy. Messages from film shows will be re-enforced by person to person messages from
peer educators and other community volunteers. Emphasis will be put on accurate reporting to enhance
monitoring of implementation through training of health professionals in proper records management.
Advocacy meetings will be held for UPDF commanders and the healthcare professionals. The program will
also procure HIV test kits for use in the military health facilities, to supplement MoH supplies. On-job
trainings and support supervision will be conducted to support health professionals implement the routine
counseling and testing according to MoH guidelines.
Table 3.3.14:
a high-risk population. As Commander in Chief of the armed forces, the President mandated the UPDF's
AIDS Control Program to oversee and manage prevention, care and treatment programs through out the
forces. Although the exact HIV prevalence in the military are unknown, it is estimated that approximately
Additionally, the UPDF medical clinics are accessed by civilians not affiliated with the military, and there has
been a trend of increased utilization, representing up to 50% of patients in some of the clinics and sick bays.
This activity supports an HIV sero-behavioral survey of UPDF personnel, with shared variables from the
national MOH survey, in order to determine an accurate estimate of HIV sero-prevalence in the UPDF. The
existing UPDF data capturing and management system is in need of improvement. It is mainly paper based
with frequent stock-out of the relevant data capturing stationery. The personnel charged with medical data
capturing do not have the required training in Health Management Information Systems. Ultimately, after
establishing an effective hard paper system, a computer based HMIS will be developed with acquisition of
necessary hardware, software, and training of data staff necessary to support this.
In FY 2008, the HIV sero-behavioral survey was conducted. This survey targeting 3,000 randomly selected
combatants on 5 military bases across the country. A BED assay to identify newly infected individuals will
be done through collaboration with CDC. The information from this survey will assist in guiding the
Prevention and Clinical Care programs of the UPDF. .Data analysis is in its final stages. The USG
conducted site visits to UPDF Bombo Barracks Hospital and two additional clinics. Specific
recommendations were made, including training for UPDF data staff. Implementation is underway, with
development of a proper medical information system that is meets Ministry of Health national standards and
PEPFAR reporting. To improve on the data capturing reporting in the UPDF, three health facilities (Bombo,
Nakasongola and Gulu) were selected to pilot an improved HMIS. From these centers a total of 24 Nursing
Assistants were trained and equipped with skills in data collection, analysis and reporting. From these we
selected six Medical Records Clerks and 6 HMIS Focal Persons. An additional 30 health workers involved
in the generation of medical data (Medical doctors, Clinical Officers and Nursing Staff) have also attended
Ministry of Health Modular training in HMIS and Integrated Disease Surveillance. For the selected centers
relevant medical data capturing tools and related medical stationery were procured including, OPD and In-
patients registers, medical forms, clinical notes sheets, patients records files, x-ray and laboratory request
forms, laboratory registers, patient appointment cards and standard HMIS reporting forms. Internet has
been established at Bombo Barracks Hospital and Clinic.
Activities initiated in FY 2008 will continue in FY 2009. New activities will include the of completion of the
model HMIS system, and expansion of this to the other 8 ART centers, as well as extension of internet.
Continuing Activity: 16073
16073 3969.08 Department of US Department of 7336 690.08 $100,000
8387 3969.07 Department of US Department of 4821 690.07 $100,000
3969 3969.06 Department of US Department of 3156 690.06 $50,000
Table 3.3.17:
infected family members. Additionally, an increasing trend is the utilization of military clinics and hospitals by
civilians not affiliated to the military, with up to 50% of patient visits for HIV care and treatment being non-
military. Thus the demand to provide quality ARV services is continually growing. With PEPFAR support,
8 sites now provide ART and HIV care services. ARV services have been strengthened through training of
health care providers, via the Infectious Diseases Institute (IDI) based in Kampala, and a partnership with
San Diego DHAPP. A critical resource in the provision of HIV care and treatment services is the human
resource (healthcare providers). The military community is among the hard-to-reach communities and as
such, requires special consideration when planning for their health professionals. While there is
understaffing particularly with health professionals, not many providers are comfortable working in military
establishments. These inadequacies are being systematically addressed via the support from the USG,
initially in the Kampala based Bombo military hospital, and Mbuya military Hospital. A course has been
developed for nurses and clinical officers through the Infectious Diseases Institute, Kampala and for the
past 2 years this training has been used to ramp up care in HIV clinical management, to include addressing
military specific issues. A delicate balance must therefore be established between training the existing staffs
and bringing on board new ones. Most importantly, innovative ways of task-shifting to already existing
military volunteers must be explored.
2. Progress to-date.
There are currently 4,000 active duty UPDF personnel, family members and civilians followed for ART and
OIs and PMTC.
This year, an HIV/AIDS technical advisor was hired to directly provide technical support to UPDF at
strategic planning level and program monitoring and evaluation. The program will soon recruit an
administrative assistant to help track administrative issues at the embassy and in the field.
3. Planned activities for FY 2009. ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS: The
recruited staff will continue to support UPDF in planning and implementing the plans. Partnerships will be
strengthened with organizations like RTI to leverage the capacity gap. In addition in all the 8 ART sites,
volunteer expert clients will be supported to work with the medical teams to strengthen linkage from testing
to enrollment into care, follow-up patients with missed appointments and support adherence to medications.
Support will be in form of training and activity based facilitation while in the field following-up clients. Regular
meetings will be held for volunteers to air challenges in executing their work and get their input in plans to
improve care in that aspect. The laboratory staffs will be facilitated to transport blood samples to regional
laboratories for Early Infant Diagnosis.
Continuing Activity: 16074
16074 3971.08 Department of US Department of 7336 690.08 $228,000
8389 3971.07 Department of US Department of 4821 690.07 $100,000
3971 3971.06 Department of US Department of 3156 690.06 $100,000
Table 3.3.19:
