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.
Introduction
This narrative is a component of other EGPAF activities that include HIV care and treatment supported
through USG funding. EGPAF also supports treatment services at 5 sites using private funds donated
through the Abbott Fund.
EGPAF Uganda supports the Uganda National PMTCT program to prevent HIV infection among infants and
utilizes the PMTCT program as a point of identification of HIV-infected and affected individuals to provide
care and support and access to HIV treatment services for families. The Foundation directly supports
programs in 27 districts to provide HIV counseling and testing, ARV prophylaxis, HAART, psychosocial
support, community mobilization, training, adequate counselor and laboratory technician staff, upgraded
laboratory facilities and counseling rooms, management information systems and strengthened MCH/FP
services. The Foundation's staff provides technical support to the district programs and by participating in
MOH technical committees such as pediatric ART and PMTCT. The Foundation works closely with the
Uganda MOH and other PMTCT and treatment partners in Uganda to coordinate support and maximize
coverage of PMTCT and HIV treatment services. These include: the Supply Chain Management System
(SCMS) that we work with to coordinate training of district health workers, forecasting, reporting and
requisitions for HIV test kits, ARVs and drugs for opportunistic infections. The Joint Clinical Research
Centre provides laboratory services for CD4 cell counts to HIV positive pregnant women as well as
providing ARVS for PMTCT and ART. ICOBI is a recent recipient of funding to carry out community
PMTCT we hope to develop joint programming with an aim of ensuring the seamless delivery of PMTCT
services within participating districts. Other collaborating partners are Uganda Cares that provides CD4
cell testing in the districts of Masaka, Sembabule and Rakai; WHO and UNICEF for the development and
distribution of job aides, advocacy. EGPAF Uganda participates in the various technical working groups at
AIDS Control Program /Ministry of Health and works with other USG PMTCT implementing partners
including PREFA, Mild May, TASO, AIDS Information Centre, Baylor Children's Foundation Uganda,
CRS/AIDS Relief collaborate in the sharing of best practices and the coordination of district activities.
Progress and Achievements
The EGPAF Uganda program has continued to make achievements against its broad objective to prevent
HIV infection among infants and link identified HIV-positive mothers and their families to comprehensive
care and support. Since the start of USAID funding in late 2003 the number of service outlets have
increased from 37 to 363 in 27 districts (Bundibugyo, Bushenyi, Iganga, Namutumba, Hoima, Ibanda,
Iganga, Kasese, Masaka, Sembabule, Isingiro, Kiruhura, Mbarara, Kabale, Mayuge, Mukono, Kampala,
Mpigi, Lyantonde, Kamwenge, Kibaale, Kabarole, Rukungiri, Ntungamo, Kisoro, Kanungu and Rakai).
During SAPR08 156,159, women were tested for HIV, 11,410 HIV positive women received ARV
prophylaxis respectively. The use of more complex regimens for PMTCT has been scaled up within the
EGPAF supported districts as part of a strategy to integrate affordable, family-based quality HIV/AIDS care
and ART services into maternal and child health services. Building on the successful establishment of
Family Support Groups a peer educator program has been initiated to integrate People Living With
HIV/AIDS into routine HIV services. This has strengthened linkages between the community and the health
facility by involving peer educators selected from among HIV positive parents (mothers and their male
partners) identified during PMTCT and trained and assigned roles alongside professional health workers at
the care and treatment sites.
FY 2009 Activities
EGPAF will focus on three activity Objectives: 1) Support the scale up of PMTCT services to reach 85% of
the expected population of pregnant women in the districts where the Foundation works. 2) Promote the
use of more efficacious ARV regimens for PMTCT through strengthening capacity building and logistics
management. 3) Scale up Family focused HIV Care Clinics within MOH Health Centers and directly enroll
HIV-positive mothers and family members in HIV comprehensive care including treatment. 1) Increasing
program coverage for PMTCT. Current population coverage (Proportion of the expected number of
pregnant women [corrected for 2008] reached with HIV counseling] within the 27 districts stands at
approximately 60%. The EGPAF Uganda program plans to broaden PMTCT coverage from 64% to an
average of 85%. Focus will be placed on the newest 7 district programs to reduce on missed opportunities
and on the remaining Health Center IIIs in all districts. In spite of the widespread human resource
challenges EGPAF will scale up the integration of PMTCT services within maternity, post natal services
including Family Planning, and in the well child clinics where efforts to identify HIV exposed infants to offer
nutritional counseling and initiate OI prophylaxis with cotrimoxazole. Outreach services will be extended to
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: HIV
counseling, testing and logistic services will be targeted. Support for general reproductive health services
will continue in the form of supplies for infection control including plastic sheeting, gloves, disinfectants,
disinfection bins, aprons and gumboots for labor and delivery rooms. EGPAF will also replenish used up
stationery including integrated RH registers and job aides. Equipment like delivery kits will be procured on a
case-by-case basis.
2) Increase the uptake of combination ARV regimen for the maternal/infant pair. The Foundation will aim to
increase the uptake of combination PMTCT regimen (AZT and SD NVP, or AZT/3TC and Sd NVP) from the
current approximately 20% to 50% (semiannual 2291 out of 11,831), and to increase the uptake of HAART
from 5% to 10% (semiannual 560 out of 11,831)of eligible HIV positive pregnant women accessing PMTCT
services. The latter target will however be limited by the capacity of health facilities to offer ART services.
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. By improving
quantification of ARV requirements, providing repackaging material for both nevirapine (aluminum foil
pouches) and AZT (syrup bottles of a more appropriate/ smaller volume) oral solutions and improving
coordination at national level the Foundation hopes to realize a significant improvement in access to AZT,
and AZT+3TC for PMTCT. Successful training approaches on the use of the combination regimen will be
rolled out to more PMTCT sites. The Uganda program will continue to supporting the sites to improve the
collection of data related to these ARV regimens. Logistical support for the procurement and distribution of
ARVs, drugs for opportunistic infections and HIV test kits will continue to be major activity. EGPAF has
Activity Narrative: developed a system of transporting blood samples for CD4 test from health facilities to regional laboratories
run by JCRC (Kabale, Fort Portal, Mbarara, Mengo, Kakira and Mbale) and returning results to PMTCT
sites. In coordination with JCRC, this critical referral service will be scaled up to include more sites. This
same facility is used for DNA PCR testing for HIV exposed infants. 3) Longitudinal follow-up of HIV-positive
mothers within MCH including during well-child visits. HIV care and treatment services will be strengthened
through the development of mechanisms to offer continuum of care to HIV-positive mothers and their
families. The provision of care and support services to eligible individuals has been shown to improve the
uptake of all other PMTCT services. Capacity will be built to support the scale up of the program for early
infant diagnosis of HIV. Focus will be directed at strengthening the enrollment of identified HIV-exposed and
infected infants into continuum of care programs. Standardized operating protocols and job aides will be
developed as part of this effort. Following the successful involvement, PLWHA networks in the provision of
HIV care at five-health center IVs the Foundation rolled out this initiative to 41 sites. The integration of peer
mothers and fathers (drawn from the Family Support Groups) into the regular HIV/AIDS services at health
facilities will be expanded to support the follow up of the mother-baby pair in the community. The provision
of peer counseling to parents of HIV exposed infants and guiding them through the various services on offer
at the health facility has reduced loss to follow up of identified HIV exposed infants. HIV infected families will
roll out use of revised infant feeding materials to support the adoption of safe infant feeding practices.
Postnatal registers have been introduced at PMTCT sites and will enable the recording of specific data for
HIV services offered during this period. HCT has been introduced within Family Planning at regional and
some district hospitals and this will be scaled up during FY09. In a bid to reach those women and men who
do not, come to health facilities EGPAF intends to work with the new Community PMTCT partners to
develop effective linkages with the community. Joint programming will be developed to improve the delivery
of ARVs for PMTCT within the community, follow up of mother-baby pairs from PMTCT and to support
community/home-based counseling and testing for male partners. There is need to include how EGPAF will
collaborate with ICOBI and/or THETA in relation to the community PMTCT services. 4) Human resource
capacity building: The Foundation will continue to conduct IMAI/IMPAC training activities, Continuing
Medical Education (CME) approach and using the mentoring approach in order to reinforce skills
development among health facility staff with the goal of improving program uptake. The technical
development of MOH staff in the supported districts will ensure sustainable capacity for program
implementation. The Foundation will train up to 600 health workers during FY09 with the focus primarily
targeting health workers in the Maternal and Child Health departments in the remaining Health Center IIIs in
supported districts. Clinicians, nursing/midwifery and laboratory staff will be trained as integrated teams for
HIV/AIDS patient care. Training activities will reflect the expanded nature of the PMTCT program with a
strong bias towards integrating preventive and treatment aspects of HIV/AIDS. Special emphasis will be
made towards increasing the use of more efficacious (combination) regimen for PMTCT and the
repackaging of oral ARV medications for HIV exposed infants. This opportunity will be used to introduce and
disseminate any new changes to national policies and implementing guidelines. Through sub grants to the
supported districts EGPAF will continue to support full time positions for urgently needed health facility staff.
In all situations, district health services will be encouraged to absorb these individuals onto permanent
payrolls as soon as local government budgetary allocations allow. 5) Monitoring and Evaluation Plan: The
Foundation will continue to support the MOH's M&E network through the provision of evaluation reports on
key PMTCT and HIV care and treatment indicators. Field support 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. 6) Nutrition Support: The Foundation will in collaboration with the NuLife Project
initiate a therapeutic feeding program in 9 EGPAF supported districts. This will also involve the development
of resource materials like job aides, pamphlets for infant feeding (IYCF) and nutrition of pregnant women.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14190
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14190 12375.08 U.S. Agency for Elizabeth Glaser 6734 6159.08 EGPAF $3,000,000
International Pediatric AIDS
Development Foundation
12375 12375.07 U.S. Agency for Elizabeth Glaser 6159 6159.07 Plus up EGPAF $0
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
* TB
Refugees/Internally Displaced Persons
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools
and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
This narrative is a component of other EGPAF activities that include PMTCT supported through USG
funding. EGPAF also supports treatment services at 5 sites using private funds donated through the Abbott
Fund. The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Uganda supports the Uganda National
PMTCT program to prevent HIV infection among infants and utilizes the PMTCT program as a point of
identification of HIV-infected and affected individuals to provide care and support and access to HIV
treatment services for families. The Foundation directly supports programs in 27 districts to provide HIV
counseling and testing, ARV prophylaxis, HAART, psychosocial support, community mobilization, training,
adequate counselor and laboratory technician staff, upgraded laboratory facilities and counseling rooms,
management information systems and strengthened MCH/FP services. The Foundation's staff provides
technical support to the district programs and by participating in MOH technical committees such as
pediatric ART and PMTCT. The Foundation works closely with the Uganda MOH and other PMTCT and
treatment partners in Uganda including SCMS, JCRC, Uganda Cares, AIM, UPHOLD and UNICEF to
coordinate support and maximize coverage of PMTCT and HIV treatment services.
The Foundation has worked directly or in partnership with other USG implementing partners to provide
comprehensive care and treatment services within the 363 EGPAF PMTCT service outlets. Over the last 6
months, EGPAF is directly supporting care and treatment services to 17 service outlets that are not
supported by a PEPFAR Implementing partners. This development has increased access to critical
antiretroviral therapy for individuals identified through PMTCT. 1254 HIV positive clients received care and
treatment services in the 17 service outlets of which, 3.2% of were children. Peer educators have been
introduced at 41 sites to strengthen follow-up patient care by taking over less skilled tasks from the already
over burdened health workers. The Foundation's comprehensive family care model includes community
level linkages to increase identification of HIV exposed children and their families, PMTCT services, care
and treatment with an emphasis on pediatric care and an innovative psychosocial support effort that
includes children's support groups. By providing support for care and treatment, the Foundation will
continue to integrate affordable, family-based quality HIV/AIDS care and ART services into health care
facilities through ensuring that a continuum of services is available and accessible: from PMTCT, to care
and treatment, to psychosocial support via a Family Care Model.
Activity Objective: Scale up model Family focused HIV Care Clinics within MOH Health Centers and directly
enroll HIV-positive mothers and family members in HIV comprehensive care including treatment. Key
activities: 1) HIV care and treatment activities. During the past year, the Foundation initiated Care and
Treatment support to 20 health centers bringing urgently needed ARVs to the primary care level. Building
on the success of the initial roll out, the Foundation will scale up a family centered model of care and
treatment to an additional 20 health centers. The Foundation will provide training and technical support to
address logistical challenges especially quantification/forecasting and distribution of ARVs. This will develop
the services providers' capacity, and ensure regular supplies of ARVs and other needs. Quality
improvement systems will be strengthened through the standardization of operating procedures and
improvement of data management systems. As a result at least 15,000 individuals will be enrolled in HIV
comprehensive care and 3,000 will be initiated on ART by the end of FY08. HIV counseling and testing will
cover both outpatient and inpatient wards at the selected health facilities as well as the surrounding
communities. TB clinics will be specifically targeted for routine HIV counseling and testing. The possibility
of providing HIV care and treatment within the TB will also be explored. As stock outs of important
medications have unfortunately been a common occurrence, the Foundation will purchase ARVs to provide
a backup supply and avoid stock outs. A major component of expansion activities will be ensuring that
quality laboratory services are available in each center providing ART. Referral laboratory services will be
utilized for the monitoring of patients receiving HIV care and treatment. Where possible the Foundation will
explore the possibility of improving and equipping laboratory facilities (especially at district hospitals) for
optimal patient care. Each site will be assessed and needed upgrades in these areas will be developed.2)
Improve access to pediatric treatment. Capacity building activities to promote pediatric HIV/AIDS care will
continue to be addressed during FY09. The clinical mentorship program to support pediatric HIV/AIDS care
will be expanded to include a focus on pediatric nursing/counseling. The training activities will strengthen
skills of lower level facility personnel to provide pediatric ART through a training package developed with the
MOH Child Health Department, comprising of pediatric counseling, modified IMCI (HIV) and early infant HIV
diagnosis components. This is aimed at equipping service providers with knowledge and skills to identify
HIV-infected children and offer pediatric HIV/AIDS care. 3) Involving People Living with HIV/AIDS. PLWHA
networks will be supported to facilitate clinical care at 40 health facilities. The programs based on the peer
educator concept will utilize focal support group members in these activities. The scope of work will be site
specific but will include activities such as streamlining client flow, directing clients to the different
departments, health education, and registration of clients in MCH, and supplementing counseling sessions
through live testimonies. The PLWHAs will be enabled to carry out home visit activities to the PMTCT and
ART clients, community mobilization and sensitization. These activities aim to improve follow up of PMTCT
clients at the facilities. Family support groups will continue to form a critical avenue for the provision of
psychosocial support to families infected and affected by HIV/AIDS. The recently launched Ariel Clubs
guidelines have formalized approaches to providing psychosocial services to HIV infected children through
child focused support groups. 4) Longitudinal follow-up of HIV-positive mothers within MCH including during
well-child visits. HIV care and treatment services will be strengthened through the development of
mechanisms to offer continuum of care to HIV-positive mothers and their families. EGPAF will scale up
Early Infant Diagnosis by expanding access to DNA PCR testing and routine HIV counseling and testing at
key pediatric service points within the health facilities. Collaboration and coordination with partner
organizations supporting HCT will enable expanded access to routine HIV testing. Capacity building
initiatives for this activity will emphasize care for the HIV exposed infant alongside its mother and other
family members. The provision of care and support services to eligible individuals has been shown to
improve the uptake of all other PMTCT services. Capacity will be built to support the scale up of the
program for early infant diagnosis of HIV. Focus will be directed at strengthening the enrollment of identified
HIV-exposed and infected infants into continuum of care programs. Standardized operating protocols and
job aides will be developed as part of this effort. Following the successful involvement, PLWHA networks in
the provision of HIV care at five-health center IVs the Foundation rolled out this initiative to 41 sites. The
Activity Narrative: integration of peer mothers and fathers (drawn from the Family Support Groups) into the regular HIV/AIDS
services at health facilities will be expanded to support the follow up of the mother-baby pair in the
community. The provision of peer counseling to parents of HIV exposed infants and guiding them through
the various services on offer at the health facility has reduced loss to follow up of identified HIV exposed
infants. HIV infected families will roll out use of revised infant feeding materials to support the adoption of
safe infant feeding practices. 5) Training activities will reflect the integral nature of the HIV/AIDS care with a
bias towards family based care of HIV. Crucial knowledge and skills in ART compliance and adherence
monitoring will be included in the training activities. The capacity of teams at health sub
district/district/regional levels will further be built by involving all the trained trainers in supervisory roles. The
Foundation will continue to conduct Continuing Medical Education (CME) approach and using the
mentoring approach from five regional hospitals in order to reinforce skills development among health
facility staff with the goal of improving program uptake. The technical development of MOH staff in the
supported districts will ensure sustainable capacity for program implementation. Overall, the Foundation
will train up to 600 health workers during FY09 in both PMTCT and ART services with the focus primarily
repackaging of oral ARV medications for HIV exposed infants. 6) Monitoring and Evaluation Plan: The
and MOH work plans. 7)Nutrition Support: The Foundation will in collaboration with the NuLife Project
initiate a therapeutic feeding program in 20 EGPAF supported districts. This will also involve the
development of resource materials like job aides, pamphlets for infant feeding and nutrition of pregnant
women. 8)The Foundation will work to ensure that sites provide quality clinical care services. Antiretroviral
treatment will be provided in accordance with Uganda treatment guidelines and the procurement and ARV
distribution will utilize the MOH systems. Collaboration will be sought from other USAID funded programs
e.g. QAP to design quality improvement interventions of HIV care and treatment and provide ongoing
technical guidance in this critical area.
Continuing Activity: 15921
15921 15921.08 U.S. Agency for Elizabeth Glaser 6734 6159.08 EGPAF $2,039,364
Table 3.3.09:
treatment with an emphasis on pediatric care to an additional 15 health centers. The Foundation will provide
training and technical support to address logistical challenges especially quantification/forecasting and
distribution of ARVs. This will develop the services providers' capacity, and ensure regular supplies of ARVs
and other needs. Quality improvement systems will be strengthened through the standardization of
operating procedures and improvement of data management systems. As a result at least 15,000
individuals will be enrolled in HIV comprehensive care and 3,000 will be initiated on ART by the end of
FY08. HIV counseling and testing will cover both outpatient and inpatient wards at the selected health
facilities as well as the surrounding communities. TB clinics will be specifically targeted for routine HIV
counseling and testing. The possibility of providing HIV care and treatment within the TB will also be
explored. As stock outs of important medications have unfortunately been a common occurrence, the
Foundation will purchase ARVs to provide a backup supply and avoid stock outs. A major component of
expansion activities will be ensuring that quality laboratory services are available in each center providing
ART. Referral laboratory services will be utilized for the monitoring of patients receiving HIV care and
treatment. Where possible the Foundation will explore the possibility of improving and equipping laboratory
facilities (especially at district hospitals) for optimal patient care. Each site will be assessed and needed
upgrades in these areas will be developed.2) Improve access to pediatric treatment. Capacity building
activities to promote pediatric HIV/AIDS care will continue to be addressed during FY09. The clinical
mentorship program to support pediatric HIV/AIDS care will be expanded to include a focus on pediatric
nursing/counseling. The training activities will strengthen skills of lower level facility personnel to provide
pediatric ART through a training package developed with the MOH Child Health Department, comprising of
pediatric counseling, modified IMCI (HIV) and early infant HIV diagnosis components. This is aimed at
equipping service providers with knowledge and skills to identify HIV-infected children and offer pediatric
HIV/AIDS care. 3) Involving People Living with HIV/AIDS. PLWHA networks will be supported to facilitate
clinical care at 40 health facilities. The programs based on the peer educator concept will utilize focal
support group members in these activities. The scope of work will be site specific but will include activities
such as streamlining client flow, directing clients to the different departments, health education, and
registration of clients in MCH, and supplementing counseling sessions through live testimonies. The
PLWHAs will be enabled to carry out home visit activities to the PMTCT and ART clients, community
mobilization and sensitization. These activities aim to improve follow up of PMTCT clients at the facilities.
Family support groups will continue to form a critical avenue for the provision of psychosocial support to
families infected and affected by HIV/AIDS. The recently launched Ariel Clubs guidelines have formalized
approaches to providing psychosocial services to HIV infected children through child focused support
groups. 4) Longitudinal follow-up of HIV-positive mothers within MCH including during well-child visits. HIV
care and treatment services will be strengthened through the development of mechanisms to offer
continuum of care to HIV-positive mothers and their families. EGPAF will scale up Early Infant Diagnosis by
expanding access to DNA PCR testing and routine HIV counseling and testing at key pediatric service
points within the health facilities. Collaboration and coordination with partner organizations supporting HCT
will enable expanded access to routine HIV testing. Capacity building initiatives for this activity will
emphasize care for the HIV exposed infant alongside its mother and other family members. The provision of
care and support services to eligible individuals has been shown to improve the uptake of all other PMTCT
services. Capacity will be built to support the scale up of the program for early infant diagnosis of HIV.
Focus will be directed at strengthening the enrollment of identified HIV-exposed and infected infants into
continuum of care programs. Standardized operating protocols and job aides will be developed as part of
Activity Narrative: this effort. Following the successful involvement, PLWHA networks in the provision of HIV care at five-
health center IVs the Foundation rolled out this initiative to 41 sites. The integration of peer mothers and
fathers (drawn from the Family Support Groups) into the regular HIV/AIDS services at health facilities will be
expanded to support the follow up of the mother-baby pair in the community. The provision of peer
counseling to parents of HIV exposed infants and guiding them through the various services on offer at the
health facility has reduced loss to follow up of identified HIV exposed infants. HIV infected families will roll
out use of revised infant feeding materials to support the adoption of safe infant feeding practices. 5)
Training activities will reflect the integral nature of the HIV/AIDS care with a bias towards family based care
of HIV. Crucial knowledge and skills in ART compliance and adherence monitoring will be included in the
training activities. The capacity of teams at health sub district/district/regional levels will further be built by
involving all the trained trainers in supervisory roles. The Foundation will continue to conduct Continuing
Medical Education (CME) approach and using the mentoring approach from five regional hospitals in
order to reinforce skills development among health facility staff with the goal of improving program uptake.
The technical development of MOH staff in the supported districts will ensure sustainable capacity for
program implementation. Overall, the Foundation will train up to 600 health workers during FY09 in both
PMTCT and ART services with the focus primarily targeting health workers in the Maternal and Child Health
departments in the remaining Health Center IIIs in supported districts. Clinicians, nursing/midwifery and
laboratory staff will be trained as integrated teams for HIV/AIDS patient care. Training activities will reflect
the expanded nature of the PMTCT program with a strong bias towards integrating preventive and
treatment aspects of HIV/AIDS. Special emphasis will be made towards increasing the use of more
efficacious (combination) regimen for PMTCT and the repackaging of oral ARV medications for HIV
exposed infants. 6) Monitoring and Evaluation Plan: The Foundation will continue to support the MOH's
M&E network through the provision of evaluation reports on key PMTCT and HIV care and treatment
indicators. Field support 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. 7)Nutrition
Support: The Foundation will in collaboration with the NuLife Project initiate a therapeutic feeding program
in 20 EGPAF supported districts. This will also involve the development of resource materials like job aides,
pamphlets for infant feeding and nutrition of pregnant women. 8)The Foundation will work to ensure that
sites provide quality clinical care services. Antiretroviral treatment will be provided in accordance with
Uganda treatment guidelines and the procurement and ARV distribution will utilize the MOH systems.
Collaboration will be sought from other USAID funded programs e.g. QAP to design quality improvement
interventions of HIV care and treatment and provide ongoing technical guidance in this critical area.
Develop and implement SOPs and strengthen outreach to assure that (75%) of exposed infants receive
CTX prophylaxis.
Table 3.3.11:
