This activity will build up on the achievements of the AFFORD project.

This activity has the following four objectives:

Expanded availability of quality health products and services to prevent, control and manage diseases or conditions of major public health and or development concern;

Enhance and sustain healthy behaviors and lifestyles through innovative communication;

Enhance public-private partnerships that will develop and expand consumer markets for a broad range of health products (e.g. basic care package, condom, contraceptives, diarrhea and malaria prevention and treatment products, etc); and

Ensure sustainability of the Uganda Health Marketing Group (UHMG).

This activity will build upon the achievements of the AFFORD social marketing group and will take it to the next level by ensuring sustainability, increased diversity of public health products and services, expanded reach within the private sector and strengthened demand for services and products. The activity will also provide targeted subsidies and/or free products to vulnerable populations and non-governmental and not-for-profit organizations.

This activity will support distribution and marketing of HIV/AIDS, Family Planning (FP) and Child Survival (CHS) commodities through established distribution networks that reache the private clinics, private not-for-profit and public health facilities. This will include distribution and marketing of existing public health commodities or launching new products based on need, demand and evidence.

One of the main achievements of the AFFORD project has been the establishing of the Good Life Clinics (GLC) networks in the private sector which have been the main mechanisms for provision of quality HIV Counseling and Testing (HCT) and basic palliative care services. This activity will build on this achievement through several approaches including:

Accreditation

Certification

Expanded coverage

Continuous medical education and training

Supportive supervision

Supporting private sector self-monitoring and regulation through association of private medical practitioners.

Moreover, this activity will enhance healthy behaviors and lifestyles through innovative and proven communication approaches which will include but not be limited to:

Interpersonal communication through Popular Opinion Leaders

The Good Life Campaign: This is a highly popular TV, radio and experiential road show assisted by "the four tent model" which enables smaller groups to interact with the road show team and engage in dialogue on different intervention areas (HIV/AIDS, Family Planning, Child Survival and Malaria).

System strengthening: This activity will build on the achievements of the AFFORD project in improving efficiencies and contribution of the private sector in addressing major public health issues. This activity will establish a sound monitoring and reporting mechanism between private sector, districts and MoH to enable private sector data to be captured and integrated in the district and national HMIS. Moreover, the mechanism will ensure sustained optimal coordination and partnership between the public and private sector in implementing policies, guidelines and standard operating procedures.

Sustainability: Over the first two years, USG will phase out or significantly reduce product injection into the social marketing mechanism. USG will support a competent social marketing group to effectively market wide range HIV/AIDS, FP, malaria and child survival products to expanded network of private facilities nationwide. This will increase efficiency and cost-effectiveness.

During this period, USG will work with the social marketing group to ensure establishment of a self-sustaining mechanism for procurement and distribution of products.

Services, which will be supported through this mechanism will include:

Behavior Change Communication for prevention

HIV sexual prevention targeting couples, most at risk populations, and large workplace settings (existing-plantation and emerging-oil exploration)

HIV counseling and testing

Palliative care

Positive living

Treatment literacy and adherence (HIV and TB)

Expanded Basic Care products (cotrimoxazole, safe water, water vessel, acyclovir, condom, FP products, Long Lasting Insecticide Treated bed Nets)

Reach more than 50,000 condom outlets with consistent supply of product and appropriate communication materials

This activity will build on the achievements of the AFFORD project through scaling up of HIV care and support services through existing 600 Good Life Clinic (GLC) networks of service outlets and expanding coverage in terms of geographic distribution and number of service outlets. A total of 700 clinics in all 80 districts will be included in GLC network that provides HIV/AIDS care and support services and products including basic care package commodities (cotrimoxazole prophylaxis, condom, nutrition counseling and supplementation, water vessel and water treatment products, family planning and child survival services). At least 500 of these facilities will be supported to deliver HCT services.

The GLC clinic network will be supported to provide quality services based on standards set by the GLC network. The private providers will be supported to establish a strong association that will provide quality monitoring, mentoring, training and supportive supervision of member clinics. Qualified GLC clinics will be accredited and certified through the association of private health care providers which will allow them to access basic public health commodities through the GLC network. GLC providers will also be linked with public health facilities within their respective catchment area for referral and linkage. This will ensure continuity of care for their clients.

A major area for linkage includes access to advanced and comprehensive HIV/AIDS care and treatment services and advanced laboratory services. This activity will also procure and distribute key Opportunistic Infection (OI) and basic care products like cotrimoxazole , acyclovir, LLINs, condoms, aqua safe (water purification product), and multivitamin. This activity will continue to leverage the existence of products supported with child survival funds. This includes Aqua safe, Zinc ORS and LLINs.

This activity will build on the achievements of the AFFORD project through scaling up of HIV care and support services through existing 600 Good Life Clinic (GLC) network of service outlets and expanding coverage in terms of geographic distribution and number of service outlets. A total of 700 clinics will be included in GLC network that provides HIV/AIDS care and support services and products including basic care package commodities (cotrimoxazole prophylaxis, condom, nutrition counseling and supplementation, water vessel and water treatment products, family planning and child survival services). At least 500 of these facilities will be supported to deliver HCT services.

The GLC clinic network will also be supported to provide quality of services based on standards set by the GLC network. The private providers will be supported to establish a strong association that will provide quality monitoring, mentoring, training and supportive supervision of member clinics. Qualified GLC clinics will be accredited and certified through the association of private health care providers which will allow them to access basic public health commodities through the GLC network. GLC providers will also be linked with public health facilities within their respective catchment area for referral and linkage. This will ensure continuity of care for their clients.

This activity will use multiple communication channels, such as TV shows, radio, and road shows to increase awareness on pediatric HIV care and treatment within family context. The activity will also link private providers with public and private facilities with the DNA-PCR capacity to diagnose HIV among exposed infants. The GLC network clinics will be trained, supervised and mentored on pediatric HIV/AIDS care.

This mechanism will also address psychosocial and reproductive health issues of adolescents living with HIV/AIDS. The project will start by assessing the challenges and needs of HIV positive adolescents (in and out of schools) and develop appropriate and comprehensive interventions to address developmental, physical and psychosocial issues among this group. Moreover, this activity will socially market and distribute existing and new products in dosage and quantities suitable for HIV positive children and adolescents. Products will include co-trimoxazole and other selected OIs, zinc, multivitamins, ORS, and IEC materials.

This activity will increase HIV/AIDS risk perception, prevention behavior and safe life styles among communities, with a particular focus on men and women of reproductive age, those in multiple concurrent partnership, youth, most-at-risk populations and the general public through multiple communication channels including:

Client-centered communication at service delivery points and product outlets;

Multiple Good Life Communication (GLC) channels including, Good life TV and radio shows, street shows and interpersonal communication.

The main strategy will revolve around interactive street shows with four tents (a four-tent-model), educating on different health topics under the category of HIV/AIDS, family planning, malaria, and child survival which allows community members to get information and product through direct interaction and asking questions. This activity will be nationwide focusing on populations with high prevalence and increasing trend in HIV/AIDS incidence. Increased focus will be given to partner reduction and faithfulness, particularly amongst men.

The AB messages will be integrated in all communications through the Good Life Campaign. In addition, this activity will integrate new evidence and scientific findings as they become available. Potential sources of new evidence include the AIDS Indicator Survey which is under planning and the multiple concurrent partnership formative assessment being finalized by the Family Health International.

This activity will increase HIV/AIDS risk perception, prevention behavior and safe life styles among communities, with a particular focus on men and women of reproductive age, discordant couples who are the most at-risk populations, through multiple communication channels including:

Client-centered communication at service delivery points and product outlets;

Multiple Good Life Communication (GLC) channels including, Good life TV and radio shows, street shows and interpersonal communication.

The most at risk populations targeted through this activity include commercial sex workers and their clients, uniformed personnel, people living in fishing communities, long distance truck drivers, and workplaces with large numbers of mobile and sexually active men with disposable income.

This activity will build on the achievements of AFFORD project and enhance the following approaches for sexual prevention:

Increased condom outlets and product distribution: In a bid to make condoms even more readily accessible at high risk locations, the project will support stocking condoms in as many bars as possible in all the regions of the country and will carry out direct condom promotion in these locations. This, coupled with increasing condom availability in corner shops (dukas) will increase the condom outlets to more than 50,000.

Targeting Most At Risk Populations (MARPS): Using community outreach and interpersonal communication, the project will reach fishermen in several fishing communities, commercial sex workers in major urban areas in the country, the military, police and other private security agencies. The MARPS program will include HIV counseling and testing, STI diagnosis and treatment, family planning services, condom promotion and productive skills training as alternative means of income generation for sex workers who would like to transition to safer lifestyles.

The Good Life Campaign: Formative research revealed that Ugandans equate "wellness" with material wealth rather than physical health. This insight led to the development of the Good Life platform, designed to promote the simple things Ugandans can do everyday to keep healthy and save money, thereby improving overall quality of life. This Good Life campaign which was launched by the AFFORD project will continue to be supported for increased TV, radio and roadside shows.

Addressing Alcohol and Sexual Violence: The activity will reach out to bar and lodge owners to promote condom use at the work place, STI and HIV referral, and address sexual violence with staff and patrons. This will enhance bar and lodge owners' knowledge of the relationship between alcohol consumption, sexual violence and HIV transmission in order for them to promote and enforce key HIV/AIDS prevention practices and basic workplace polices in their establishments.

Workplace programs: The activity will continue to support workplace programs targeting major companies including mining, sugar and tea plantation workers.