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
Activity Narrative:
This activity relates to PMTCT, VCT, sexual prevention, care and treatment (adult care and treatment,
pediatric care and treatment, TB/HIV, HIV/AIDS treatment/ARV drugs and laboratory infrastructure), Health
systems strengthening, and Strategic information.
The activity is a combination of the Uganda Program for Human and Holistic Development (UPHOLD) follow
-on and TBD District Support for Rural Access to ART in Eastern and Western Uganda. Both activities have
been approved in COP08.
The district-based program will support the national efforts to improve the quality, utilization and
sustainability of services delivered in the areas of HIV/AIDS and TB in an integrated manner at both facility
and community levels. In partnership with the Government of Uganda and other stakeholders, the district-
based HIV/AIDS/TB program will strengthen the national response to the HIV/AIDS epidemic. Within the
National Strategic Framework, the district-based HIV/AIDS/TB program will continue to work through local
governments, the private sector, other USG and non-USG implementing partners and civil society
organizations (including faith-based and community based organizations) towards improved quality of life
and increased equitable access to preventive and clinical services at both district and lower level facilities.
Key activities at the district level include technical support at the policy and technical level, systems
strengthening including quality assurance, M&E and support supervision as well as financial resources for
services delivery.
This activity will focus on increasing access to PMTCT services through support to six districts in the East
Central region of Uganda including Bugiri, Iganga, Kaliro, Kamuli, Mayuge and Namutumba at both facility
and community settings. Whereas these districts are estimated to have more than 74,000 people living
with HIV, they are among those districts underserved by USG and non-USG funded partners providing
HIV/AIDS care and treatment services. This program will expand delivery of PMTCT services in districts
without a PEPFAR implementing partner by strengthening district leadership and management, health
management information systems (HMIS), as well as improvements in human resources for health, supply
chain management systems, strategic information, infrastructure and laboratories. The primary emphasis in
districts without a PEPFAR PMTCT partner will be to directly support PMTCT programs to provide Opt-out
HIV counseling and testing, ARV prophylaxis, HAART, psychosocial support, community follow-up and
mobilization, training, adequate counselor and laboratory technician staff, upgraded laboratory facilities and
counseling rooms, management information systems and strengthened MCH/FP services. The above
Technical assistance will be provided in Districts that have PEPFAR PMTCT implementing partners
depending on the prevailing need.
The program will also work with facilities on other initiatives aimed at improving quality and efficiency of care
and treatment services within health facilities and community organizations, building of community-facility
linkages to enhance referrals as a way of improving access to, coverage of and utilization of care and
treatment services. Community programs will strengthen social mobilization in order to enhance demand
for PMTCT services. Involvement of the Private Sector and TBAs in the provision of Comprehensive
PMTCT services and strengthening of follow-up mechanisms for the Mother-baby pair will be strengthened.
During FY 2009, objectives for the PMTCT services will focus on:
1. Support the scale up of PMTCT services to reach 85% of the expected population of pregnant women in
the six districts.
2. Promote the use of more efficacious ARV regimens for PMTCT through strengthening capacity building
and logistics management.
Key Activities
The district based program will aim at contributing to the national PMTCT strategy(2006 - 2010) whose
focus is to roll out the revised PMTCT policy, support the holistic implementation of the four-year pronged
PMTCT strategy (primary prevention, family planning, provision of ARV prophylaxis, care and support). In
order to achieve the policy implementation goals, the district based program will focus on the following
areas:
- Increasing program coverage for PMTCT: Focus will be placed on the scaling up PMTCT services up to
Health Center IIIs in all districts without a USG PMTCT Implementing Partner. Outreach services will be
extended to H/C II or lower level health facilities that do not have the capacity to offer maternity services.
Strengthening quality improvement interventions at health district and health facility levels will increase
program coverage. Strengthened linkages between the community and the health facility will be enhanced
through peer educators selected from HIV positive parents (mothers and their male partners) identified
during PMTCT, trained, and assigned roles alongside professional health workers at the care and treatment
sites.
- Increase the uptake of combination ARV regimen for the maternal/infant pair. Capacity to offer the more
efficacious regimen will be developed through increased training and the streamlining of logistics
management at both national, district and health facility level. Significant improvement in access to
combined regimens for PMTCT will be through improvement of quantification of ARV requirements and use
of innovative approaches to increase access to HIV positive pregnant women. Logistical support for the
procurement and distribution of ARVs, drugs for opportunistic infections and HIV test kits will continue to be
major activity. All of eligible HIV positive pregnant women (CD4+ > 350/ml) will be started on HAART and
50% of pregnant women (CD4+ <350) will receive Combined ARV regimens.
- Continuum of care and treatment of the HIV positive mothers and their families: The provision of
treatment, care and support services to eligible individuals has been shown to improve the uptake of all
other PMTCT services. Focus will be directed at strengthening the enrollment of identified HIV-exposed
and infected infants into continuum of treatment and care programs through the scale up early infant
diagnosis of HIV and follow-ups. This program will further support to HIV infected families to adopt safe
infant feeding practices in relation to the revised infant feeding materials.
- Capacity building and mentoring: The program will reinforce the skills of health workers in the
MCH/HIV/AIDS/ART clinics by the provision of mentoring programs (from the Regional Referral hospitals)
and Continuing Medical Education (CME) in order to improve program uptake. Approximately, 150 service
providers (such as counselors, mid wives, laboratory staff and data/records management assistants) will be
Activity Narrative: trained. Individuals trained from the community will focus on encouraging community discussions in areas
such as gender power relations aimed at reducing gender-based violence, increasing male involvement and
facilitating couple dialogue. Support and supervision will be directed at enhancing the quality of PMTCT
service delivery and the development of linkages between PMTCT and other HIV/AIDS care services,
including care and treatment, and supporting the full integration of PMTCT programs into district and MOH
work plans.
- In collaboration with other stakeholders, the district based program will review, print, distribute and
disseminate new/updated information, education and communication (IEC) materials (including job aides)
that will focus on increasing uptake of PMTCT services and create positive behaviors such as supportive
male involvement, appropriate/alternative infant feeding practices, spouse disclosure, partners support,
living positively and IPT uptake.
- Integration of family planning services into HIV/AIDS/MCH/Treatment services.
- Through community mobilization, support will be provided to psychosocial support (PSS) groups for HIV+
mothers and their spouses as coping mechanism on top of accessing the care services. The PSS groups
will be supported to leverage other wrap around services such as mosquito nets from the President's
Malaria Initiative (PMI), nutrition support from World Food funded programs, etc
This activity will also support integrated support supervision conducted quarterly within each health sub
district; establish and/or maintain facility based quality improvement teams; introduction of continuous ART
quality improvement tools in coordination with HCI or HIVQUAL; support accreditation of new ART sites,
mapping community resources; and create community and facility networks.
This activity will also endeavor to scale up adult care and treatment services through community
partnerships through efficient and transparent grant mechanism and by providing technical support to civil
society organizations.
New/Continuing Activity: Continuing Activity
Continuing Activity: 21145
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
21145 21145.08 U.S. Agency for To Be Determined 9221 9221.08 TBD/District
International East Central
Development
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Increasing women's legal rights
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
* TB
Military Populations
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $100,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
This activity relates to PMTCT, care and treatment (adult care and treatment, pediatric care and treatment,
TB/HIV, HIV/AIDS treatment/ARV drugs and laboratory infrastructure), Health systems strengthening, and
Strategic information.
The USAID funded district-based HIV/AIDS/TB program will be a follow-on project to the Uganda Program
for Human and Holistic Development (UPHOLD) program ending in September 2008. The USAID funded
district-based program - East - Central will support the national efforts to improve the quality, utilization and
services delivery. The project will cover six districts of Bugiri, Iganga, Kaliro, Kamuli, Mayuge and
Namutumba.
AB
Even with the positive trends among young people regarding delayed sexual debut and increased
abstinence, secondary data HIV Sero Behavioral analysis shows that certain behaviors particularly among
adults are regressing towards those of the late 1980s when HIV prevalence was at its peak in the country:
there is an increase in casual sex,, an increase in multiplicity of partners, and a decrease in condom use
with casual partners. A secondary analysis of available faithfulness data from the Uganda HIV/AIDS Sero-
Behavioral survey 2004-05 shows that 88% of men are not lifetime faithful, compared to 56% of women,
and only 10% of couples are mutually lifetime faithful.
The district-based program will support the civil society to improve on the gains attained through the existing
abstinence programs for the 10 -19 year olds, through a combination of in-school and out-of-school
programs, media and community mobilization approaches. The in-school abstinence programs will be
complemented by other USG partners programs that focused on strengthening and scaling up of the
national Presidential Initiative for AIDS Strategy. Other abstinence activities will focus on the following:
• Promoting tailor-made talk shows on various topics aimed at creating more risk-free community
environments to address legal issues on sex abuse, harassments, value of virginity, stigma and
discrimination, care for persons affected and infected with HIV/AIDS.
• Information, Education and Communication (IEC) messages targeting out-of-school youth, couples, and
the general community. The IEC messages will focus on creating an enabling environment for sexually
active youth to abstain from early sexual activity, reduce sexual partners and to remain faithful to each
other.
• Promotion of other IEC mechanisms that may include but not limited to radio programs, civil society drama
groups to perform other targeted music, dance and drama that fosters community dialogue, addressing
issues like couple dialogue, faithfulness and non violent behaviors, gender based violence. All together, it is
estimated that 150,000 will be reached by abstinence and faithfulness messages including couples and out
of-school youth
Other Sexual Prevention:
Recent findings have shown that high risk populations, such as commercial sex workers (among whom
prevalence is thought to be as high as 50% and on the increase), long distance truck drivers, urban
motorcycles riders (commonly refereed to as ‘Boda boda in Uganda), discordant couples, fishermen and the
communities living at the landing sites, and other mobile populations remain major pockets of HIV
prevalence within generalized epidemic in Uganda.
The district-based program will use its financial and technical support to provide resources to civil society
organizations (CSOs) to reach most-at-risk populations with HIV/AIDS education, counseling and testing as
well as condom education and distribution services in collaboration with other key stakeholders such as
Ministry of Health and organizations involved in social marketing. Key activities to be supported will include
but not limited to the following:
• Condom distributions to key commercial outlets such as lodges, night clubs and bars (approximately 200
outlets)
• Supporting communities living near the landing sites for fishing with prevention interventions
• Promoting responsible behaviors such as couple counseling and mutual disclosure, consistent and correct
condom use among discordant couples and casual partners and reduction of multiple concurrent
partnership'
• Training community resources persons to undertake community based mobilization and education on
gender based violence prevention.
• Empowering couples and communities to promote societal norms that reduce the risk of HIV transmission
and promote use and access to HIV counseling and testing services.
• Encourage the use of IEC and behavior change communication (BCC) materials promoting couples testing
together, promotion of mutual disclosure and increasing awareness of discordance among couples.
Activity Narrative: • Promotion of prevention among positives through PLHA network activities that increase knowledge on the
importance of partners testing, diagnosis of sexually transmitted infections (STIs), treatment and prevention,
family planning and PMTCT.
• Promotion of STI prevention through supporting CSO's access to MOH and other partners' STI treatment
guidelines and education on Herpes Simplex type 2 virus (HSV-2).
• Supporting sexually youth who are mainly out-of-school to access youth friendly services such as
counseling and testing, treatment, information, entertainment and recreational services.
• Training at least 2500 community volunteers from CSOs and most at risk populations with different skills
related to HIV sexual prevention
* Reducing violence and coercion
Table 3.3.02:
Table 3.3.03:
This activity relates to PMTCT, VCT, sexual prevention, pediatric care and treatment, TB/HIV, ARV drugs,
laboratory infrastructure, Health systems strengthening, and Strategic information.
In FY 2009, this activity will focus on increasing rural access to HIV/AIDS care and treatment through
support to six districts in the East Central region of Uganda including Bugiri, Iganga, Kaliro, Kamuli, Mayuge
and Namutumba. Whereas these districts are estimated to have more than 74,000 people living with HIV,
they are among those districts underserved by USG and non-USG funded partners. This will expand
delivery of HIV/AIDS care and treatment services by strengthening district leadership and management,
health management information systems (HMIS), as well as improvements in human resources for health,
supply chain management systems, strategic information, infrastructure and laboratories. The primary
emphasis will to strengthen care and treatment service delivery systems at health center IV's, III's and build
community outreaches that serve to provide intermediate care and generate demand for facility based
services. The program will also work with facilities on other initiatives aimed at improving quality and
efficiency of care and treatment services within health facilities and community organizations, building of
community-facility linkages to enhance referrals as a way of improving access to, coverage of and utilization
of care and treatment services. This activity will expand to other underserved districts in subsequent years.
In addition to supporting expanding delivery of HIV/AIDS services, this activity will also support capacity of
decentralized health delivery system to improve uptake of services at lower level facilities. Support will focus
on areas of leadership, management, health management information systems (HMIS), and human
resources for health, supply chain management, strategic information, infrastructure and laboratories.
Specific adult care and treatment activities to be supported under this mechanism will include:
• Training health workers in delivery of quality care and treatment services that adhere to national and
international standards, guidelines and protocols. Specifically services shall be tailored to the existing MoH
HIV/AIDS care and treatment guidelines, treatment eligibility criteria and standard 1st and 2nd line
treatment regimens.
• Provision of comprehensive care and support including treatment and prophylaxis for OIs, psychosocial
support, as well as basic preventive care to people living with HIV/AIDS (PLHAS) in all the target districts.
• Provide support to PLHAs with a focus on strengthening/setting up of PLHA networks to serve as hubs for
community level care, adherence monitoring and referral.
• Integrating symptom, pain management, spiritual as well as culturally appropriate end of life care into
routine HIV/AIDS care.
• Ensure that patients under HIV/AIDS care and treatment receive regular laboratory tests for HIV-disease
monitoring including a CD4 cell count every six months and samples for viral load collected and transferred
to regional labs at least once a year.
• Support districts to establish functional networks within and between health facilities and communities to
improve access to and uptake of HIV/AIDS care and treatment services.
•Support districts to institutionalize infection control procedures as standard integral practices within the
services delivered both at facility and community level.
•Support best practices and proven interventions and approaches that would improve access to continuum
of HIV/AIDS services, including critical services not directly supported by PEPFAR or other activities.
•Promotion of family approach to the delivery of palliative care services through partnerships with CSOs
using the HIV+ client as an entry point into the family and community.
•Support various community based groups in the delivery of care services and referrals at community levels.
Groups to be supported will include: post-test clubs, psycho social support groups for HIV+ mothers and
spouses, religious leaders, faith-based organizations and volunteers. These groups will address legislative
issues such as stigma, discrimination and gender based violence.
•Support linkages that support leveraging other resources to benefit PLHAs in the areas of malaria, TB,
family planning and safe motherhood, nutrition and child survival support, and education
district; establish or maintain facility based quality improvement teams; introduction of continuous ART
This activity will also endeavor scaling up of adult care and treatment services through community
Moreover, the activity will explore approaches and best practices for strengthening the network model of
service delivery; innovative ways of using existing structures like village health teams, community
volunteers and family members;
Table 3.3.08:
•Integrating symptom, pain management, spiritual as well as culturally appropriate end of life care into
•Ensure that patients under HIV/AIDS care and treatment receive regular laboratory tests for HIV-disease
•Support districts to establish functional networks within and between health facilities and communities to
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.09:
This activity relates to PMTCT, VCT, sexual prevention, adult care and treatment, TB/HIV, laboratory
infrastructure, Health systems strengthening, and Strategic information.
support to nine districts in the West and South Western regions of Uganda including Bulisa, Kibaale,
Kamwenge ,Kyenjojo, Isingiro, Kanungu, Ibanda, Kisoro and Kiruhura. Whereas these districts are
estimated to have more than 77,000 people living with HIV, they are among those districts underserved by
USG and non-USG funded partners. This will expand delivery of HIV/AIDS care and treatment services by
strengthening district leadership and management, health management information systems (HMIS), as
well as improvements in human resources for health, supply chain management systems, strategic
information, infrastructure and laboratories. The primary emphasis will to strengthen care and treatment
service delivery systems at health center IV's, III's and build community outreaches that serve to provide
intermediate care and generate demand for facility based services. The program will also work with facilities
on other initiatives aimed at improving quality and efficiency of care and treatment services within health
facilities and community organizations, building of community-facility linkages to enhance referrals as a way
of improving access to, coverage of and utilization of care and treatment services. . This activity will expand
to other underserved districts in subsequent years.
Significant progress has been made in the area of pediatrics HIV/AIDS care and treatment. There are nine
laboratories nationwide have the capacity of conducting DNA-PCR for early infant diagnosis; the number of
sites providing pediatric ARV services has increased from 30 to 147 over the last 12 months and an
estimated 12,000 children are currently on ART.
Despite progress Pediatric HIV/AIDS treatment has been identified as a major gap and area of focus by the
Uganda MoH and USG. The national and PEPFAR target is that 15% of ART patients should be children.
Data from PEPFAR and MoH shows that children constitute only 11% of those on treatment.
Likewise access to pre-ART care is suboptimal and associated with high levels of drop out.
Some programs have made significant progress of increasing access of children to HIV care and treatment.
Some of the best practices include: integration of ART and PMTCT services; assessment of infants and
children for ART eligibility in every clinic visit; routine counseling adults on bring children for testing,
intensified case findings of exposed infants within immunization units, scheduling the same appointment
dates for children and parents/caretakers, and introduction of specific clinic days for children. This activity
will support districts and health facilities to implement proven innovations and practices.
The roll out of pediatric HIV/AIDS care and treatment to lower level facilities is hampered by lack of
adequate counseling and clinical skills among health workers and suboptimal access to laboratory services,
suboptimal linkage to services. This activity will build the skills of health workers on pediatric care, and
treatment through didactic and on job trainings, clinical mentoring and availing simplified tools and aides.
This activity will closely work with the JCRC follow-on and other relevant partners to support districts and
health facilities to build effective mechanism for transferring samples for DNA-PCR, CD4, viral load and
other advanced laboratory test.
mapping community resources; and create community and facility networks
Table 3.3.10:
This activity relates to PMTCT, VCT, sexual prevention, adult care and treatment, TB/HIV, ARV drugs,
Table 3.3.11:
This activity relates to PMTCT, sexual prevention, care and treatment (adult care and treatment, pediatric
care and treatment, TB/HIV, HIV/AIDS treatment/ARV drugs and laboratory infrastructure), Health systems
strengthening, and Strategic information.
This activity is a combination of the Uganda Program for Human and Holistic Development (UPHOLD)
follow-on and TBD District Support for Rural Access to ART in Eastern and Western Uganda. Both activities
have been approved in COP 08. The USAID funded district-based HIV/AIDS/TB program - East Central will
be a follow-on project to the Uganda Program for Human and Holistic Development (UPHOLD) program
ending in September 2008. The district-based program will support the national efforts to improve the
quality, utilization and sustainability of services delivered in the areas of HIV/AIDS and TB in an integrated
manner at both facility and community levels. In partnership with the Government of Uganda and other
stakeholders, the district-based HIV/AIDS/TB program will strengthen the national response to the
HIV/AIDS epidemic. Within the National Strategic Framework, the district-based HIV/AIDS/TB program will
continue to work through local governments, the private sector, other USG and non-USG implementing
partners and civil society organizations (including faith-based and community based organizations) towards
improved quality of life and increased equitable access to preventive and clinical services at both district
and lower level facilities. Key activities at the district level include technical support at the policy and
technical level, systems strengthening including quality assurance, M&E and support supervision as well as
financial resources for services delivery.
This activity that will focus on increasing rural access to HIV/AIDS Counseling and Testing (HCT) and anti-
retroviral therapy (ART) through support to 6 districts in the East Central region of the country. This region
has a low ART coverage and lies along the highway connecting Uganda to neighboring countries.
According to the 2005 Uganda national HIV/AIDS Sero-Behavioural Survey 2004-2005, 79% of HIV-
Ugandans do not know their HIV sero-status due to various reasons including limited access and utilization
of HIV counseling and testing (HCT) services. The District HIV/AIDS/TB program will increase access and
utilization of HCT services at both district hospital/lower level facilities and the community through the
following initiatives:
• Increasing HCT service access and utilization for people in the rural setting and hard-to-reach high risk
populations e.g. fishing communities, out-of-school youth, internally displace populations, etc.
• Promotion of home-to-home and family-based HCT. Routine counseling and testing (RCT) will be
supported in all district and lower level facilities with emphasis on referring all HIV+ clients into care and
treatment facilities for follow on support services such as TB. In these health facilities, HCT will be routinely
provided in the high HIV-prevalence clinics namely tuberculosis and Sexually transmitted clinics and
medical in-patient wards.
•Promotion of outreach activities in high activity areas such as landing sites for fishing communities,
communal markets, camps for internally displaced people, tertiary institutions and trading centers
• Training of health service providers such as counselors, laboratory staff, and data assistants. The training
to cover personnel from approximately 50 outlets will support the role out of routine counseling and testing,
strengthening counseling skills, logistics and records management, laboratory services, referral and general
integrated patient care. A total of 300 personnel will be trained
• Increase support for and utilization of post test services through post test clubs (PTCs). PTCs will be used
to promote awareness about disclosure, discordance and stigma.
• Promotion of couple counseling and testing coupled with referral linkages to post test services for both HIV
- and HIV- individuals
To achieve the required results, the program will support provider-initiated HCT services in 50 health
facilities. It is estimated that over 50,000 clients will receive HCT services in FY2009 and those testing HIV-
positive linked to palliative care and treatment services. The program will build capacity of Networks and
groups of People Living with HIV/AIDS (PHAs) to provide pre-test and post-test counseling to clients and
facilitate family-based HCT. PHAs will be trained to function as expert clients facilitating linkages and
referrals between community-based and facility-based care and linking all those testing HIV-positive to
palliative care and wrap around services.
Table 3.3.12:
• Promotion of outreach activities in high activity areas such as landing sites for fishing communities,
Table 3.3.14:
pediatric care and treatment, TB/HIV, ARV drugs, Health systems strengthening, and Strategic information.
In the 8 focus districts, the program will provide support to the Directorates of District Health Services
(DDHS) and over 16 primary health centers to provide laboratory services for improved laboratory testing
for diagnosis of HIV infection and other opportunistic infections and for monitoring patients during care and
treatment. Through the DDHS office, the program will support the establishment of effective laboratory
networks in the 12 focus districts. The program will build the capacity of the district hospitals to provide
laboratory support to lower health centers (HCIVs, HCIII and HCII) through referral testing and support
supervision. The program will build capacity of the district hospital to provide quality assurance and train
laboratory personnel.
Through support to the districts the program will generate support from the local government structures and
provide an environment for a sustainable long-term impact. The program will provide financial and technical
support to the District Directorate of Health Services (DDHS) to provide support supervision to health
workers in the district and monitor establishment of tiered-quality-assured laboratory networks in the
respective districts. Lab strengthening activities will be coordinated with CPHL/MOH activities.
Estimated amount of funding that is planned for Human Capacity Development $50,000
Table 3.3.16:
care and treatment, TB/HIV, HIV/AIDS treatment/ARV drugs and laboratory infrastructure), counseling and
testing, and health systems strengthening.
The FY 2009 activity will focus support to 6 districts in the Eastern region of the country. As a follow up to
previous efforts by UPHOLD, UNICEF and Uganda AIDS Control Programs (UACP), the district based
HIV/AIDS/TB program - East Central will continue focusing on activities aimed at promoting evidence-
based planning and decision making at district and lower levels. Districts for this region will include: Bugiri,
Iganga, Kaliro, Kamuli, Mayuge and Namutamba. Evidence-based planning and decision making will be
achieved through regular measurement of program performances and progress in all the districts that this
program will operate. Regular and timely feedback to the supported local governments, non-governmental
organizations ad civil service organizations will be provided through systems strengthening of district level
monitoring and reporting systems including HMIS and other civil society reporting tools developed under the
new civil society fund as well as through the annual Lot Quality Assurance Sampling (LQAS) survey. Up to
FY 2008, LQAS has been carried out in 43 UPHOLD and NUMAT districts as well as some UNICEF
districts. LQAS was previously supported through the World Bank MAP project in selected other districts.
Under the FY 2009 activity (new design), the mission will work closely with the GOU to determine the best
way to transfer ownership and management of the annual survey. From FY 2009 onwards under the three
new district-based activities, LQAS survey will be conducted annually in approximately 50 districts in order
track coverage and utilization of key indicators related to program performance. LQAS will be supported at
the national level by one of the HIV/AIDS/TB projects to provide one major source of data/information for
the USG programs. Key stakeholders such as line ministries, local government authorities, civil society
organizations and other implementing partners will be involved in the development of questionnaires of this
survey. The LQAS results will be used to inform district level work planning in order to identify intervention
areas and sub-counties on which to focus in the future. LQAS will also track indicators under the President's
Malaria Initiative (PMI).
Table 3.3.17:
testing, and Strategic information.
Since supportive policy environment is very important for the implementation of activities, the district based
HIV/AIDS/TB program - East Central will complement the efforts of the Ministry of Health (MOH), Ministry of
Gender, Labor and Social Development (MGLSD) and other national bodies like Uganda AIDS Commission
and National TB and Leprosy Programs towards the dissemination of policies that are relevant to the
activities that the program will support. The project will cover activities in 6 districts. For example, the district
based program will support the continued roll out of the revised policies of PMTCT, RCT, ART, TB and any
other policies as they get approved. This program will build on past efforts by the AIM, UPHOLD and
Uganda AIDS Control Program (UACP) to strengthen district planning (fresh support for new districts)
through continued support to the District AIDS Committees. The support will facilitate streamlining district
capacity to manage HIV/AIDS structural plan development, coordination of activities and monitoring
progress. Other activities will include:
• Once completed, the dissemination of the following policies and/or guidelines will be undertaken:
integrated TB/HIV management, management of opportunistic infections, scaling up of the utilization of co-
trimoxazole prophylaxis among people living with HIV/AIDS (PLHAs) as well as the provision of isoniazd
prophylaxis in PLHAs at high risk of acquiring tuberculosis
• Supporting the printing and distribution of policies and implementation guidelines and the re-training and
orientation of health workers to improve service delivery in HIV/AIDS management targeting private and
public health facilities. The training will benefit at least 500 persons (health workers and CSO staff).
Table 3.3.18:
