Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 9833
Country/Region: Uganda
Year: 2009
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $3,168,337

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $800,000

Activity Narrative

ACTIVITY UNCHANGED FROM FY 2008:

Health Communication Partnership (HCP) is a three-year USAID Associate Award for health communication

support in Uganda managed by the Johns Hopkins University Bloomberg School of Public Health's Center

for Communication Programs that was awarded in July, 2007. HCP has been working in Uganda since July,

2004, assisting the Uganda AIDS Commission to establish a national multi-channel communication

initiative for young people 15 - 24 years old called Young Empowered and Healthy (Y.E.A.H.). Y.E.A.H. is

managed by a partnership of Ugandan organizations led by Communication for Development Foundation

Uganda (CDFU), and has launched two multi-channel communication campaigns for young people—one

discouraging transactional and cross-generational sex, and the other—the Be a Man campaign--promoting

more gender equitable attitudes and behaviour among men. Both campaigns promote HIV/AIDS

prevention through abstinence, partner reduction, faithfulness, and HIV counseling and testing.

In FY 2005, Y.E.A.H. launched a weekly half-hour radio serial drama called "Rock Point 256", which won an

international award for excellence in HIV/AIDS communication in 2007, and has an estimated listenership of

59% among young 15 - 24 year olds, according to a survey conducted in 14 districts by HCP in 2008.

Y.E.A.H. is a national campaign, implemented in six major languages: Luganda, Runyoro/Rutoro,

Runyankole/Rukiga, Luo, Ateso, and English. During FY 2008, Y.E.A.H. expects to reach more than 2

million young people through mass media and 50,000 through community outreach promoting gender

equitable relationships, faithfulness and partner reduction, open and non-violent communication between

intimate partners, couple counseling and testing for HIV. Near the end of FY 2007, HCP assisted Y.E.A.H.

to design a second phase "Be a Man" campaign, which will focus on alcohol, violence against women,

multiple concurrent partners, and transactional sex. During FY 2008, Y.E.A.H. will have launched the

second phase umbrella campaign, and rolled out two sequential focused campaigns on alcohol and

violence against women as they relate to HIV. HCP will work with Y.E.A.H. and other partners to launch a

hotline with telephone counselors prepared to answer callers' questions about these issues, as well as

medical male circumcision, HIV counseling and testing, ARV treatment, family planning.

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

FY 2009 activities are a continuation of FY 2008 work and will have four components. The first component

is to execute two more focused campaigns under the Be a Man umbrella—the first on transactional sex and

the second on concurrent partners. This includes a continuation of Rock Point 256 radio serial drama and

comic books in four languages, radio spots, print materials, as well as community outreach activities. The

emphasis will be on social and individual change to create an environment where multiple sexual partners

and transactional sex are no longer associated with manhood; where young people, especially men,

recognize the association between alcohol, violence, concurrent partners and HIV; and where community

resource persons such as the police and peer educators are trained to assist young people resist alcohol

abuse and violence against women, adopt abstinence, faithfulness or condom use as HIV prevention

strategies; and avoid stigmatizing and discriminatory practices and language toward people with HIV and

AIDS. HCP will also work with the media and influential leaders at both national and community level to

ensure that they recognize concurrent partners, violence against women, alcohol abuse, and HIV/AIDS

related stigma as underlying factors to HIV infection and speak out against these practices. Additionally,

HCP will work with the media to encourage portrayals of the underlying causes of HIV (violence against

women, alcohol abuse, multiple sexual partners, transactional sex, and HIV/AIDS related stigma) in a more

serious and constructive manner. All media will continue to refer young men and women to a hotline that

will be established during FY 2008 with a Ugandan non-governmental partner for personalized information

and counseling.

The second component involves a continuation of training facilitators among men's groups and youth

groups at community level, and vocational training institutions to facilitate interactive discussions using

materials and tools produced by Y.E.A.H.. HCP will assist Y.E.A.H. to adapt successful tools and

approaches produced by various partner organizations and train facilitators to use them during community

outreach work. Community-based interpersonal approaches will be designed to raise consciousness and

stimulate changes in the ways men and women relate to one another—specifically, encouraging more

responsible drinking behavior, non-violent resolution of differences, mutual respect and equity in

relationships, faithfulness and partner reduction, and more compassionate attitudes toward people living

with HIV and AIDS. Campaign media and interpersonal approaches will be designed to reinforce one

another, leading to informal dialogue about these issues among young people and their influencers, and

changes in individual and collective practices. HCP will assist Y.E.A.H. to train 1,200 peer educators and

community resource persons, and 50 police community welfare officers to facilitate group discussions and

education sessions about alcohol abuse, concurrent partners, violence against women, transactional sex,

and HIV/AIDS related violence. These peer educators and community resource persons will each counsel

and facilitate discussions among 40 young people, for a total of 50,000 young men and women reached

through community outreach with alcohol and HIV prevention information.

The third component is to assist Y.E.A.H. to mobilize resources to support future communication initiatives

for young people. During FY 2008, Y.E.A.H. prepared three proposals for funding from non-USG sources,

and received some supplemental financial and in-kind support for the Be a Man campaign from Save the

Children and the British Council, and promises of funding through the Global Fund. Also during FY 2007,

HCP assisted Y.E.A.H. to finalize a resource mobilization and advocacy strategy, which will be fully

implemented during FY 2008 and FY 2009. The strategy focuses on leveraging private commercial

sponsorship for Rock Point 256 comic books and radio programs; raising institutional support through

private foundation funding; and applying for bilateral or multi-lateral donor funds to support future campaign

activities. During FY 2009, HCP will hire a consultant to assist Y.E.A.H. to prepare and submit at least four

proposals to private foundations and bilateral or multi-lateral donors, with the aim of obtaining funding from

at least two non-USG sources.

The fourth component is to evaluate the reach and impact of Y.E.A.H. communication through a second

household survey in the same 14 districts as were surveyed in FY 2007. Data from the 2009/10 survey will

Activity Narrative: be compared with data from the FY 2007 Y.E.A.H. survey, and will provide information about the reach and

effectiveness of various communication messages and approaches which can be used to inform the design

of future HIV/AIDS communication for young people, and particularly for young men.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Reducing violence and coercion

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $75,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $550,000

Activity Narrative

ACTIVITY UNCHANGED FROM FY 2008:

Health Communication Partnership (HCP) is a three-year USAID Associate Award for health communication

support in Uganda managed by the Johns Hopkins University Bloomberg School of Public Health's Center

for Communication Programs that was awarded in July, 2007. HCP has been working in Uganda since July,

2004, assisting the Uganda AIDS Commission to establish a national multi-channel communication

initiative for young people 15 - 24 years old called Young Empowered and Healthy (Y.E.A.H.). Y.E.A.H. is

managed by a partnership of Ugandan organizations led by Communication for Development Foundation

Uganda (CDFU), and has launched two multi-channel communication campaigns for young people—one

discouraging transactional and cross-generational sex, and the other—the Be a Man campaign--promoting

more gender equitable attitudes and behaviour among men. Both campaigns promote HIV/AIDS

prevention through abstinence, partner reduction, faithfulness, and HIV counseling and testing.

In FY 2005, Y.E.A.H. launched a weekly half-hour radio serial drama called "Rock Point 256", which won an

international award for excellence in HIV/AIDS communication in 2007, and has an estimated listenership of

59% among young 15 - 24 year olds, according to a survey conducted in 14 districts by HCP in 2008.

Y.E.A.H. is a national campaign, implemented in six major languages: Luganda, Runyoro/Rutoro,

Runyankole/Rukiga, Luo, Ateso, and English. During FY 2008, Y.E.A.H. expects to reach more than 2

million young people through mass media and 50,000 through community outreach promoting gender

equitable relationships, faithfulness and partner reduction, open and non-violent communication between

intimate partners, couple counseling and testing for HIV. Near the end of FY 2007, HCP assisted Y.E.A.H.

to design a second phase "Be a Man" campaign, which will focus on alcohol, violence against women,

multiple concurrent partners, and transactional sex. During FY 2008, Y.E.A.H. will have launched the

second phase umbrella campaign, and rolled out two sequential focused campaigns on alcohol and

violence against women as they relate to HIV. HCP will work with Y.E.A.H. and other partners to launch a

hotline with telephone counselors prepared to answer callers' questions about these issues, as well as

medical male circumcision, HIV counseling and testing, ARV treatment, family planning.

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

FY 2009 activities are a continuation of FY 2008 work and will have four components. The first component

is to execute two more focused campaigns under the Be a Man umbrella—the first on transactional sex and

the second on concurrent partners. This includes a continuation of Rock Point 256 radio serial drama and

comic books in four languages, radio spots, print materials, as well as community outreach activities. The

emphasis will be on social and individual change to create an environment where multiple sexual partners

and transactional sex are no longer associated with manhood; where young people, especially men,

recognize the association between alcohol, violence, concurrent partners and HIV; and where community

resource persons such as the police and peer educators are trained to assist young people resist alcohol

abuse and violence against women, adopt abstinence, faithfulness or condom use as HIV prevention

strategies; and avoid stigmatizing and discriminatory practices and language toward people with HIV and

AIDS. HCP will also work with the media and influential leaders at both national and community level to

ensure that they recognize concurrent partners, violence against women, alcohol abuse, and HIV/AIDS

related stigma as underlying factors to HIV infection and speak out against these practices. Additionally,

HCP will work with the media to encourage portrayals of the underlying causes of HIV (violence against

women, alcohol abuse, multiple sexual partners, transactional sex, and HIV/AIDS related stigma) in a more

serious and constructive manner. All media will continue to refer young men and women to a hotline that

will be established during FY 2008 with a Ugandan non-governmental partner for personalized information

and counseling.

The second component involves a continuation of training facilitators among men's groups and youth

groups at community level, and vocational training institutions to facilitate interactive discussions using

materials and tools produced by Y.E.A.H.. HCP will assist Y.E.A.H. to adapt successful tools and

approaches produced by various partner organizations and train facilitators to use them during community

outreach work. Community-based interpersonal approaches will be designed to raise consciousness and

stimulate changes in the ways men and women relate to one another—specifically, encouraging more

responsible drinking behavior, non-violent resolution of differences, mutual respect and equity in

relationships, faithfulness and partner reduction, and more compassionate attitudes toward people living

with HIV and AIDS. Campaign media and interpersonal approaches will be designed to reinforce one

another, leading to informal dialogue about these issues among young people and their influencers, and

changes in individual and collective practices. HCP will assist Y.E.A.H. to train 1,200 peer educators and

community resource persons, and 50 police community welfare officers to facilitate group discussions and

education sessions about alcohol abuse, concurrent partners, violence against women, transactional sex,

and HIV/AIDS related violence. These peer educators and community resource persons will each counsel

and facilitate discussions among 40 young people, for a total of 50,000 young men and women reached

through community outreach with alcohol and HIV prevention information.

The third component is to assist Y.E.A.H. to mobilize resources to support future communication initiatives

for young people. During FY 2008, Y.E.A.H. prepared three proposals for funding from non-USG sources,

and received some supplemental financial and in-kind support for the Be a Man campaign from Save the

Children and the British Council, and promises of funding through the Global Fund. Also during FY 2007,

HCP assisted Y.E.A.H. to finalize a resource mobilization and advocacy strategy, which will be fully

implemented during FY 2008 and FY 2009. The strategy focuses on leveraging private commercial

sponsorship for Rock Point 256 comic books and radio programs; raising institutional support through

private foundation funding; and applying for bilateral or multi-lateral donor funds to support future campaign

activities. During FY 2009, HCP will hire a consultant to assist Y.E.A.H. to prepare and submit at least four

proposals to private foundations and bilateral or multi-lateral donors, with the aim of obtaining funding from

at least two non-USG sources.

The fourth component is to evaluate the reach and impact of Y.E.A.H. communication through a second

household survey in the same 14 districts as were surveyed in FY 2007. Data from the 2009/10 survey will

Activity Narrative: be compared with data from the FY 2007 Y.E.A.H. survey, and will provide information about the reach and

effectiveness of various communication messages and approaches which can be used to inform the design

of future HIV/AIDS communication for young people, and particularly for young men.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Reducing violence and coercion

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $75,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $516,587

Health Communication Partnership (HCP) is a three-year USAID Associate Award for health communication

support in Uganda managed by the Johns Hopkins University Bloomberg School of Public Health Center for

Communication Programs that was awarded in July, 2007. Its purpose is to provide communication support

to the Government of Uganda, PEPFAR and USAID HIV/AIDS and health programs and to strengthen

capacity for strategic, evidence-based HIV/AIDS and health communication in Uganda.

Since November, 2007, HCP has been assisting the Ministry of Health and Uganda AIDS Commission Male

Circumcision Task Force to provide accurate and easy-to-digest information about medical male

circumcision (MMC) for HIV prevention. The purpose of this effort is to correct misinformation about MMC

and HIV prevention, to inform policymakers and health workers about MMC and HIV, and to influence policy

concerning the provision of MMC services. During FY2007, HCP, in partnership with Makerere University

School of Public Health, conducted a literature review and quantitative research on male circumcision

knowledge, attitudes, practices, and programmatic interventions in Uganda and elsewhere in the region,

assisted the MC Task Force to develop a MMC communication strategy; produced and distributed

informational materials about MMC and HIV to policy makers and health workers; conducted media

relations training for MMC providers and experts, and briefings for representatives of both print and

electronic media and parliamentarians; organized public debates and radio and television call-in talk shows

about MMC and HIV prevention; and worked with Signal FM in Bagisu region to educate community

members, leaders and traditional circumcisers about safe circumcision practices during the traditional

circumcision season. During FY2008, HCP plans to orient District Health Educators from 82 districts and

incorporate accurate information about MMC and HIV prevention into training materials for Village Health

Teams (VHTs) and other community volunteers; incorporate sessions on MMC and HIV for broadcast

during a distance learning radio series for health workers; continued community education about safe

circumcision in the Bagisu region; and plans to establish a hotline for men that offers counseling and

information about medical male circumcision and prevention of HIV acquisition, as well as male norms that

increase risk of HIV transmission, including violence against women and multiple sexual partners.

ACTIVITY UNCHANGED FROM FY 2008; ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

HCP will continue to provide technical assistance to the Makerere University School of Public Health (SPH)

to strengthen its ability to design and manage advocacy and communication programmes, specifically in

support of male circumcision for HIV prevention, incorporating results from the MMC assessment conducted

in FY2007 and planned for dissemination in the first quarter of FY2009. HCP will work with the SPH to

translate key results of the situation analysis into advocacy materials supporting the development of a MMC

policy and strategy for service delivery/scale up appropriate to Uganda's health and socio political setting.

HCP will assist SPH to evaluate male circumcision advocacy activities and approaches conducted over the

previous years, and build on successful approaches. During FY2009, HCP and SPH will work with

religious, cultural and community leaders to provide correct information about male circumcision and HIV.

HCP and SPH will also work with the MOH to provide public education about MC and its relationship to HIV

prevention, and provide client education materials and training for health workers in counseling and client

education concerning circumcision for health and HIV/AIDS prevention. Specifically, HCP and SPH will

assist the MOH to train 20 national trainers, who will in turn train 172 district and NGO trainers. These

trainers will train health workers in hospitals and HCIV, TASO and AIC clinics to educate clients and

correctly answer their questions concerning MMC and prevention of HIV acquisition, as well as male norms

and behaviors that increase risk of HIV transmission, including multiple sexual partners, and sexual

violence. Training for health workers will be integrated with health worker training being conducted by

other PEPFAR and USAID-supported projects (eg. family planning/reproductive health, malaria, HIV/AIDS,

or TB/HIV).

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

Health-related Wraparound Programs

* Family Planning

* Malaria (PMI)

* TB

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $43,164

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.07:

Funding for Treatment: Adult Treatment (HTXS): $482,500

Health Communication Partnership (HCP) is a three-year USAID Associate Award for health communication

support in Uganda managed by the Johns Hopkins University Bloomberg School of Public Health Center for

Communication Programs that was awarded in July, 2007. Its purpose is to provide communication support

to the Government of Uganda, PEPFAR and USAID HIV/AIDS and health programs and to strengthen

capacity for strategic, evidence-based HIV/AIDS and health communication in Uganda.

ACTIVITY UNCHANGED FROM FY 2008. ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

This activity is a continuation of activities implemented in FY2007 and FY2008. Health Communication

Partnership (HCP) has been providing technical assistance to the Joint Clinical Research Center (JCRC),

the Ministry of Health, and other HIV/AIDS treatment partners to improve the quality of ART client education

and adherence counseling, provide public education about ART, increase the uptake of HIV services among

children with HIV/AIDS, and reduce stigma and discrimination against people living with HIV/AIDS. In FY

2007 and 2008, HCP assisted JCRC to launch a pediatric ART campaign focused on care givers of children

at risk of HIV, HIV positive adolescents on ART, and caregivers of children on ART. The multi channel

campaign aimed at motivating care givers to take their children for HIV testing and, for those who are

positive, start them on ART and maintain adherence to medication. HCP supported JCRC to conduct out

reach counseling and testing for over 2,200 children and their care takers in Kampala, and to develop and

disseminate support materials for use by caretakers and health workers when counseling HIV positive

children. In FY 2008, HCP, JCRC, PIDC, EGPAF, and Mildmay plan to launch a communication campaign

encouraging prevention of transmission among HIV-positive adolescents, and adherence to ART among

adolescent clients. Also during FY2008, HCP will provide technical support to JCRC to develop the course

curriculum and training materials for a diploma training course for university graduates in treatment

adherence and disease management counseling.

In FY 2007 and FY 2008, HCP also worked with a group of HIV/AIDS stakeholders and groups of People

living with HIV/AIDS (PHA) to design a national cross-cutting communication strategy to reduce HIV-related

stigma. According to qualitative studies, stigma is one of the main reasons given for not getting testing for

HIV, and for ART clients to stop taking their drugs. Stigma is also a major reason given by HIV-positive

men and women, and parents of HIV-positive children for not disclosing their HIV status; it is also a major

reason why couples often do not use condoms. This activity aims to improve uptake of HIV counseling and

testing, to improve ART adherence, and to increase condom use by reducing stigma associated with

HIV/AIDS. According to Uganda's HIV/AIDS National Strategic Plan 2007/2008 - 2011/2012 (NSP), stigma

is an underlying factor that must be addressed in order to reach national goals for treatment and prevention.

During FY 2009, HCP plans to provide support to the Uganda AIDS Commission to implement a HIV/AIDS

stigma reduction strategy designed during the previous year to increase uptake and adherence to ARVs

among adults and children.

Over the past three years, HCP has worked with a variety of ART providers and PHA groups to roll out two

communication campaigns on ART literary, and paediatric ART. These partners include: JCRC, PIDC, the

Mildmay Center, Reach Out Mbuya, Young Positives, EGPAF, HIPS Project, NUMAT, and NACWOLA.

During FY2009, HCP plans to expand this network of HIV/AIDS treatment/care providers to include addition

new and existing care and treatment partners.

HCP will assist this expanded network to critically assess progress under the ART communication strategy

developed in 2006, and to identify communication needs for future focus. HCP will assist this network to

design an updated HIV/AIDS treatment communication strategy; and to implement it. It is anticipated that

this strategy will include client counseling and education approaches, provider job aides and, possibly,

training to support provision of comprehensive information for ART and PMTCT clients at clinic and

community levels. The strategy will include approaches for providing essential information for PHA,

counselors, health workers, and community volunteers about treatment, prevention of transmission and re-

infection, prevention and treatment of opportunistic infections including TB, nutrition, and stigma reduction.

Messages and materials will be developed based on a review of relevant research and feedback from

existing community volunteers and clinical providers, and with input from technical experts. The aim will be

to support clinical providers and community volunteers to provide services and information tailored to the

needs of particular clients, with an aim of empowering PHA and ART clients to take responsibility for

maintaining their own health and well being. HCP will assist with the training for trainers, will facilitate and

coordinate the development of common messages and educational materials, and will develop and

disseminate media materials that model and build the expectation for comprehensive treatment, prevention,

care, and support services among PHAs and their families.

Many partner organizations support community based volunteers and clinical providers, and have a

structure and system for training and supervision. HCP will work together with representatives of these

programs and the MOH to train the trainers and supervisors of community volunteers, including PHA

treatment support agents, and clinical providers, in interpersonal communication skills and in the use of

common materials that provide comprehensive information about prevention, treatment, positive living, and

stigma reduction. HCP anticipates training 100 trainers and supervisors of community and PHA volunteers,

who will integrate training in the use of common tools and materials into their organization's training plans.

HCP will monitor the number of trainers trained in each organization through direct counts; and will monitor

the quality of community outreach activities after training through observational visits to selected

communities. Each partner organization will monitor the numbers of outreach activities conducted using

common tools, and the estimated number of people reached through these activities through their routine

monitoring systems. HCP will monitor the quantity of print materials produced and distributed; and will

monitor radio broadcasts to ensure they are broadcast on schedule and to estimate the number of people

reached.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

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

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09:

Funding for Treatment: Pediatric Treatment (PDTX): $434,250

This activity is a continuation from the FY 2008 pediatrics training and curriculum development activity

through the Regional Center of Quality of Health Care (RCQHC). In an effort to limit the number of

management units and to effectively utilize complementary competencies of existing partners, USAID has

made a decision to implement this activity through an existing mechanism with the Johns Hopkins

University Center for Communication Programs (JHUCCP). RCQHC will be the main sub partner

responsible for providing the clinical content and implementing the clinical care and treatment aspect of the

program. The prime, JHUCCP will be responsible for developing the curriculum and for technical content for

the pediatric counseling. Both partners have credible experience in the area of curriculum, training and

education materials development which is a significant portfolio under this activity.

The program will also draw on the regional experiences of RCQHC with the Africa Network for Care and

Children with AIDS (ANECCA).The RCQHC HIV/AIDS program has access to experts in pediatric AIDS

through this Network. This includes 300 individuals of whom 29 are senior pediatricians currently involved in

providing services to children and families affected by HIV/AIDS in all regions of the country. The ANECCA

network members have extensive experience in clinical care, treatment and psychosocial support for

pediatric AIDS. The Health Communication Partnership (HCP) is a three-year USAID Associate Award for

health communication support in Uganda managed by the Johns Hopkins University Bloomberg School of

Public Health Center for Communication Programs that was awarded in July 2007. Its purpose is to provide

communication support to the Government of Uganda, PEPFAR and other USAID health programs, and to

strengthen capacity for strategic, evidence-based HIV/AIDS and health communication in Uganda. HCP has

been very successful in providing communication support across several program areas and its end date is

being extended through 2012.

HCP has been providing technical assistance to the Joint Clinical Research Center (JCRC), the Ministry of

Health, and other HIV/AIDS treatment partners to improve the quality of ART client education and

adherence counseling, provide public education about ART, increase the uptake of HIV services among

children with HIV/AIDS, and reduce stigma and discrimination against people living with HIV/AIDS. In FY

2007 and 2008, HCP assisted JCRC to launch a pediatric ART campaign focused on caregivers of children

at-risk of HIV, HIV positive adolescents on ART, and caregivers of children on ART. The multi-channel

campaign aimed at motivating caregivers to take their children for HIV testing and, for those who are

positive, start them on ART and maintain adherence to medication. HCP supported JCRC to conduct

outreach counseling and testing for over 2,200 children and their caretakers in Kampala, and to develop

and disseminate support materials for use by caretakers and health workers when counseling HIV positive

children.

This activity will address some key gaps in pediatric HIV/AIDS treatment that has been identified by the

Uganda Ministry of Health (MOH) and USG; and supports PEPFAR and National targets that at least 15%

of ART patients should be children.

Challenges related to pediatric services include: high cost of pediatric ARVs, inadequate skills, and limited

resources for diagnosis of HIV in children. The roll out of pediatric HIV/AIDS care and treatment to lower

level facilities is hampered by a lack of adequate counseling and clinical skills among health workers and

suboptimal access to laboratory services and linkages to services.

This activity will address key gaps in health workers skills by developing and/or strengthening pediatric

treatment and counseling training, curricula and practical job aides including comic books for child literacy.

The implementing partner will also support the MoH in training regional and district training of trainers

(ToTs) and resource persons; train technical staff of partners with clinical mentoring responsibilities and

also health workers delivering services in lower level facilities (HCIV level)

The proposed activity will coordinate with the MoH pediatric ART technical working group, Joint Clinical

Research Center (JCRC), Mildmay, TASO SCOT, Pediatric Infectious Disease Clinic (PIDC) and other key

players in developing such materials.

The activity has clear and well defined deliverables including:

1) Develop and disseminate policy/guidelines, training curriculum and standards on pediatric counseling,

education, care and treatment, building on existing guidelines and protocols produced by other partners;

Print and disseminate simplified job aides including ARV and CTX dose charts, counseling aides, child

counseling cards and IEC materials; 2) Develop a training curriculum for people living with HIV/AIDS,

network support agents and OVC providers on community mobilization for increased utilization of pediatric

care and treatment services; 3) Work with OVC partners to develop, print and disseminate simplified tools

and job aides for linking OVC programs with pediatric HIV/AIDS counseling, care and treatment; 4)

Dissemination of best practices and lessons learnt in Uganda and within the region through publications

(biannual news letter); 5) Support national pediatrics HIV/AIDS conference (FY 2009 and FY 2010); 6)

Develop, print and disseminate training curriculum on pediatric referral, care and treatment services

utilization and community mobilization for PHA network support agents and community volunteer; 7)

Develop education materials for children (e.g. comic books) on HIV, ART, and adherence; and 8) Build

human resource capacity by training regional and selected district teams who would be champions in

leading expansion and quality improvement in pediatric care; Over 2,000 health workers ranging from

physicians, nurses, counselors, community health workers and expert clients will be trained during FY 2009

and 2010.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Health-related Wraparound Programs

* Child Survival Activities

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.11:

Funding for Prevention: HIV Testing and Counseling (HVCT): $385,000

Health Communication Partnership (HCP) is a three-year USAID Associate Award for health communication

support in Uganda managed by the Johns Hopkins University Bloomberg School of Public Health Center for

Communication Programs that was awarded in July, 2007. Its purpose is to provide communication support

to the Government of Uganda, PEPFAR and USAID HIV/AIDS and health programs and to strengthen

capacity for strategic, evidence-based HIV/AIDS and health communication in Uganda.

According to the Uganda HIV/AIDS Sero-Behavioural Survey 2004-05 (HSBS), only 10 - 13% of men and

women have ever tested for HIV, although approximately 70% would like to test. The national HCT testing

and disclosure campaign, which was designed in FY2007 and will be launched in FY2008, targets

cohabiting couples for counseling and testing, as approximately 42% of new HIV infections occur within this

group according to the HSBS. As more than 50% of cohabiting adults who are HIV-positive have an HIV-

negative partner, and most new infections are occurring within marriage (HSBS), this intervention is aimed

at protecting uninfected partners in discordant relationships. The campaign is also designed to link HIV-

positive couples and individuals to supportive services; and help HIV-negative couples to discuss and adopt

preventive behaviour.

ACTIVITY UNCHANGED FROM FY 2008; ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

This is a continuation from FY 2008. During FY2008, HCP in partnership with the AIDS Information Center

(AIC), is working with the National HIV Counseling and Testing (HCT) Coordinating Committee (CT17) to

design and launch a communication campaign promoting counseling, testing and disclosure of HIV status

among cohabiting partners in six regions of Uganda where AIC has services: central, north central,

northwestern, eastern, southwestern and northeastern. The campaign will encourage and motivate couples

to assess their risks of HIV, test, and share their status with each other, and will direct them to all health

facilities in their areas offering HCT. Although AIC is the lead implementing agency, this initiative is a

coordinated effort with participation of various partners at various levels of implementation. HCP's role

during FY 2008 is to design the "Know and Share Your Status" communication strategy, map locations of

HCT services in the six regions, develop/adapt campaign media and materials, develop community

mobilization tools for couple testing days, monitor communication and community mobilization interventions,

and conduct a small evaluation of the campaign as it unfolds. AIC will primarily be responsible for assisting

the MOH to review and update HCT guidelines and training materials, training national trainers in the

updated training materials, organizing couple counseling and testing weeks in six districts, and collecting

and reporting on HIV counseling and testing clinical data. AIC will also provide technical input for a radio

distance learning program focusing on new guidance concerning HIV counseling and testing for health

workers; HCP will design and produce the radio series, which will also focus on other priority HIV/AIDS and

reproductive health priority areas. HCP will also provide training for AIC staff in strategic communication

and media relations. The media and mobilization campaign will be rolled out in all districts in the six

regions, and will utilize a mixture of communication approaches to attract couples for HCT, and to promote

disclosure of HIV status among cohabiting partners, including mass media, client education and information,

and community outreach. The educational campaign will culminate in couple counseling and testing days

or weeks in six districts where AIC has services, during which HCT services will be made available free of

charge to couples. AIC and the MOH will ensure that needles and other biological wastes are disposed of

according to infection prevention guidelines and protocols.

During FY2009, HCP will continue to support the national HCT and disclosure "Know and Share your

Status" campaign, and will expand its focus beyond cohabiting couples to include other high-risk

populations. During FY 2009, counseling and testing days or weeks will be expanded to more districts, and

the campaign will target most at risk populations in order to identify people who are HIV-positive and enroll

them in PHA services, and to promote HIV protective behavior among HIV-negatives. Specifically,

communication will be tailored to high risk populations such as refugees, fishermen, mobile transport

workers, transient laborers, members of uniformed services, and their spouses.

HCP will also conduct assessments of the effectiveness of HCT communication that took place during

FY2008, to inform the design of HCT communication in FY2009 and beyond. This national communication

campaign will reach a minimum of 10 million adults throughout Uganda through the mass media, and a

minimum of 1,000 men and women per district with interpersonal communication about HCT between 1

October 2009 and 30 June 2010. HCP will strive to build the capacity of AIC and other Ugandan partners,

including the Ministry of Health AIDS Control Program, to design and coordinate national HCT

communication and education campaigns. In this way, the HCT campaign will become a sustainable

activity of the Ministry of Health and its HCT partners.

AIC will report numbers of HCT clients resulting from the communication campaign.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Military Populations

Refugees/Internally Displaced Persons

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $50,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14:

Subpartners Total: $1,604,250
Communication for Development Foundation - Uganda: $1,000,000
Makerere University: $150,000
Regional Center for Quality of Health Care: $434,250
Sifisulwazi Development Organisation: $20,000
Cross Cutting Budget Categories and Known Amounts Total: $243,164
Human Resources for Health $75,000
Human Resources for Health $75,000
Human Resources for Health $43,164
Human Resources for Health $50,000