The Makerere University School of Medicine (MUSOM) will provide comprehensive HIV and AIDS services in Mulago, Butabika and Mbarara national referral Hospitals and their catchment areas.

MUSOM goals are mainly to contribute to primary prevention of HIV through the expansion of Provider Initiated Testing and Counseling (PITC) and scaling up PMTCT. Persons identified through PITC will be linked into care using linkage facilitators and using the new WHO guidelines; they will be assessed for eligibility and given ARVs as detailed in the narrative. This will ensure a continuum of response and contribute towards improving the quality of care of people living with HIV, which is the second goal of the program.

The program will also strengthen health systems for HIV prevention, care and treatment.With the new pivots MUSOM will continue offering comprehensive HIV and AIDS services especially focusing on PITC as an entry point, ART using the new WHO guidelines, Option B+ using the test and treat approach and Voluntary Medical Male Circumcision (VMMC). The program will improve targeted HTC outreach activities to most at risk populations in their catchment areas: commercial sex workers, their clients, uniformed forces and incarcerated populations. Other services will include TB management, continuing ART to the existing ART clients and care to OVC.

Cost efficient strategies include; leveraging resources from the GOU and other partners for, integration, task shifting and involvement of PLHIV in tracing patients lost to follow up. Capacity building of HCWs in various program areas will be enhanced including Option B+, HMIS and logistics management in supported facilities.

In line with PEPFARs focus on supporting the Government of Uganda (GOU) to further expand access to HIV care and support with the goal to achieve universal access of 80% in care by 2015, the MUSOM program will support provision of care and support services to at least 38,136 individuals including 34,704 adults as a contribution to the overall PEPFAR target of 812,989 HIV positive individuals in care. This target was derived at using burden tables based on district HIV prevalence and treatment need. Specific attention will be given to key populations, such as, truck drivers, commercial sex workers (CSW) and men who have sex with men (MSM).

The Continuum of Response (CoR) model was also applied to ensure improved referrals and linkages. MUSOM will implement approaches to promote an effective CoR model and monitor key indicators along the continuum. The project will be implemented in two districts of Mbarara and Kampala in Uganda in Mulago, Butabika and Mbarara teaching referral hospitals and their catchment areas. MUSOM will support facilities to provide comprehensive care and support services in line with national guidelines and PEPFAR guidance including: strengthen positive health dignity and prevention (PHDP), strengthen linkages and referrals using linkage facilitators, implement quality improvement for adherence and retention, pain and symptom management and provide support to targeted community outreaches in high prevalence hard to reach and underserved areas.

The project will place focus on increasing access to six-monthly CD4 assessment among pre-ART clients for ART initiation in line with MoH guidance. This has been a major bottleneck to treatment scale up nationally. Working with the Central Public Health Laboratory and other stakeholders, CD4 coverage in the districts will be improved over the next 12 months. MUSOM will support the sample referral network in line with this national CD4 expansion plan, and will monitor and report clients access to CD4 in quarterly reports. In addition, facilities will be supported to regularly keep track and report on client waiting lists for CD4 testing.

MUSOM will liaise with PACE for provision and distribution of basic care kits to clients through PHA and VHT networks. Additionally, liaise with National Medical Stores and Medical Access Uganda Limited for other HIV commodities including cotrimoxazole and lab reagents. MUSOM will build the capacity of facility staff to accurately forecast, quantify and order commodities as well as timely reporting.

The MUSOM program will further work with USG partners such as PIN, SPRING, HEALTHQUAL, ASSIST and Hospice Africa Uganda in their related technical areas to support integration of HIV services with other health and nutritional services. Collaboration with other key stakeholders at all levels for provision of required wrap around services including family planning will occur.

The program will be aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); support and strengthen the national M&E systems including ensuring the availability of tools; and work within district health plans. MUSOM will work under the guidance of MoH/ACP and the Quality Assurance Department for trainings, mentorship and supportive supervision.

MUSOM OVC program targets children of HIV infected patients within the program supported clinics. Children receiving HIV care and treatment in the MUSOM supported clinics and HIV exposed infants are followed up within the PMTCT-EID clinics.

Effective July 2011, MUSOM expanded the scope of OVC interventions from the previous three core programming areas health, education and food and nutrition security to providing CPAs the including: health water and sanitation, child protection and legal support, legal policy and institutional mechanisms as stated in the 2011/12-2015/16 National OVC Strategic Plan. The core programming areas provided are tailored to the need of the OVC household. This modification followed experience sharing visits to OVC service implementing partners and was modelled on the Ministry of Gender, Labor and Social (MoGLS)development strategy.

MUSOM social workers worked closely with health care providers, particularly the nurse counsellors to identify OVC through the patients receiving care within the MUSOM supported clinics. Given that MUSOM cannot provide all the OVC needs, the team contacted several organizations within the catchment area and the district probation, welfare and community development officers in order to establish functional referrals and linkages. Some OVC are still supported with tuition and scholastic materials for retention in school. All the identified OVC are provided with clinical care at MUSOM supported clinics using the family care model.

In FY 2012, MUSOM will consolidate the above activities and reach 2100 OVC with the interventions. The OVC will be identified using the vulnerability index as well as the priority intervention areas. MUSOM will continue to work with the microfinance institutions to promote saving among OVC households and support more OVC households to access loans in order to start or expand income generating activities. MUSOM will train more OVC and their care takers on child protection and some of the older OVC will be attached to various facilities such as salons, motor garages and tailoring groups among others for apprentices.

Both HIV positive and HIV negative OVC will continue to receive medical services such as Immunization for those under five years, routine de-worming and treatment for common childhood infections. Identified HIV positive OVC will get comprehensive HIV care either from MUSOM supported clinics or referred to specialized paediatric HIV facilities.

MUSOM OVC activities will be aligned to the MoGLS development strategy. MUSOM social workers will continue to work closely with the structures at the supported facilities supported to build a sustainable OVC function and linkages.

The MUSOM program will focus on supporting the GOU to scale up TB/HIV integration; and specifically the PEPFAR goal to achieve TB screening of 90% (731,690) of HIV positive clients in care. In addition, initiate 24,390 HIV positive clients in care on TB treatment. The program will contribute to this target by screening 34,322 HIV positive clients for TB; and 1,144 of these will be started on TB treatment in Mbarara, Mulago and Butabika teaching referral hospitals and their catchment areas. This target was derived using burden tables based on district HIV prevalence and treatment need. The Continuum of Response (CoR) model was also applied to ensure improved referrals and linkages.

The program will strive to improve Intensified Case Findings (ICF) and the use of national ICF tool as well as improve diagnosis of TB among HIV positive smear negative clients, extra pulmonary TB and pediatric TB through the implementation of new innovative technologies- GeneXpert and fluorescent microscopy. MUSOM will support MDR-TB surveillance through sputum sample transportation to GeneXpert hubs and receipt of results at facilities.

In FY 2013, MUSOM will ensure early initiation of all HIV positive TB patients on ART through the use of linkage facilitators and/or the provision of ART in TB clinics. The MUSOM program will increase focus on adherence and completion of TB treatment, including DOTS through use of proven low cost approaches. A TB infection control focal person will be supported to enforce infection control at facilities using interventions such as: cough hygiene, cough sheds and corners, fast tracking triage including cough monitors and ensure adequate natural ventilation. MUSOM will support MOH/ACP and National TB and Leprosy Program (NTLP) to roll out provision of IPT, in line with the WHO recommendations.

MUSOM will work with USG partners such as PIN, SPRING, HEALTH QUAL, ASSIST and Hospice Africa Uganda in their related technical areas to support integration with other health and nutritional services. The program will collaborate with other key stakeholders at all levels for provision of required wrap around services.

The program will be aligned to the National Strategic Plan for HIV/AIDS and National TB Strategic Plan (2011/12-2014/15), support and strengthen the national M&E systems and work within district health plans. MUSOM will work under the guidance of MoH/ACP, NTLP and the Quality Assurance Department in trainings, TB/HIV mentorship and supportive supervision. Additionally, MUSOM will support facilities to participate in national external quality assurance for TB laboratory diagnosis.

The MUSOM program will focus on supporting the GOU to further expand pediatric HIV care and OVC with the goal to achieve universal access to care by 2015. The program will contribute at least 38,136 to the overall PEPFAR target of 812,989 HIV positive individuals in care and support services. At least 3,432 children will be provided with care and support services contributing to the national target of 73,169 children. MUSOM will support Mulago, Butabika and Mbarara national referral hospitals with their catchment areas in Kampala and Mbarara districts.

The MUSOM program will provide comprehensive child friendly care and support services in line with national guidelines and PEPFAR guidance, improve adolescent services, strengthen linkages and referrals using linkage facilitators, implement quality improvement for adherence and retention and provide support to targeted community outreaches to the key populations. EID services and focal points at facilities will be scaled up to ensure follow up and active search of exposed children in facilities and communities to enable early enrolment of children in care. A focus will be on scaling up low cost approaches, such as use of care taker support groups so as to support retention in care. MUSOM will implement community mobilization and targeted activities such as Know Your Childs status campaigns to identify more children. Focus will be placed on improved assessment of pre-ART children for ART eligibility to ensure timely initiation on treatment in line with MoH guidance.

The MUSOM program will prioritize support for retention of adolescents in care, as well as, ensure a smooth transition into adult life using expert peers and adolescent support groups. Adolescents will be provided with positive health dignity and prevention services including, sexual and RH services, and psychosocial support and life skills training. Lessons learned from the planned national adolescent service assessment will be incorporated in these activities.

A key priority will be to establish strong referrals between OVC care and support programs to ensure HIV positive children are linked to OVC services, and children provided with OVC services are screened for HIV and appropriately linked to care and support. MUSOM will also support the integration of HIV services in routine pediatric health services, including the National Child Health Days.

MUSOM will liaise with PACE for provision and distribution of basic care kits to clients. Additionally, liaise with National Medical Stores and Medical Access Uganda Limited for other HIV commodities including ARVs, cotrimoxazole and lab reagents. Capacity of facility staff will be built to accurately forecast, quantify and order commodities as well as timely reporting.

The MUSOM program will work with USG partners such as SCORE, SUNRISE, PIN, SPRING, HEALTHQual, ASSIST and Hospice Africa Uganda in their related technical areas to support integration with other health, nutrition and OVC services. The program will collaborate with other key stakeholders at all levels for provision of required wrap around services.

The program will be aligned to the National Strategic Plan for HIV/AIDS, support and strengthen the national M&E systems and work within district health plans. MUSOM will work under the guidance of MoH/ACP and the Quality Assurance Department in pediatric trainings, national pediatric mentorship framework and supportive supervision.

During FY 2013, changes will be made in PEPFAR support for laboratory program in Uganda in line with the identified pivots. The pivots will focus on a change from facility based to lab network strengthening. Building on success of Early Infant Diagnosis (EID) hubs there will be an increase in the number of hubs for from 19 to 72 thus increasing the geographical coverage and access for specimen transportation, testing and result transmission. This is aimed at ART targeted population receiving CD4 tests to increase coverage from 60% to 100% improving the quality of laboratory services, reducing stock out of reagents, laboratory supplies and commodities, reducing equipment downtime and improving data collection, transmission, analysis and utilization. To achieve this, technical staff will need to be hired and retained and where possible task shift non-technical activities to appropriately trained lay health workers.Implementation of the WHO Strengthening Laboratory Management Towards Accreditation (SLMTA) will be the mainstay for quality improvement in addition to other quality assurance activities.

The hubs are strategically located health facilities identified by the MoH to serve as coordination centers for specimen referral, testing and result transmission for a catchment area of 30 to 40km radius serving 20 to 50 facilities.

In FY 2013, MUSOM will, in collaboration with the infrastructure division at the MoH and Central Public Health Laboratory (CPHL), refurbish the Mbarara Regional Referral Hospital laboratory to the required standard and ensure installation and equipping for CD4+, clinical chemistry and hematology. In addition MUSOM will support the district in the recruitment of two laboratory technologists and three laboratory technicians for Mbarara RRH laboratory with the aim of providing quality laboratory services. Training of new and existing laboratory staff will be done using MoH approved curriculum. The program will also continue to support internal and external quality control systems and ensure the laboratory implements the WHO recommended strengthening laboratory management towards accreditation (SLMTA) process with the aim to achieve a minimum of WHO stars for that level of facility by end of 2014.

Additional efforts will be undertaken towards promoting and strengthening laboratory services at HC III and HC IVs in Mbarara. The program is setting up an electronic laboratory records system intended to improve lab records management in Mulago and Butabika hospitals. Through collaboration with CPHL, MUSOM will support coordination of partner activities. MUSOM will continue to support the health facilities to strengthen infection control and medical waste management. For EID, the program will refer samples to CPHL and advocate for an EID hub in Mbarara. The program will also continue to support internal and external quality control systems. The program will facilitate referral of EID samples to the National EID laboratory at CPHL and maintain the hospital as an EID hub in Mbarara.

The national Voluntary Medical Male Circumcision (VMMC) interventions are geared towards contributing to the Uganda National HIV/AIDS Strategic Plan goal To reduce the incidence rate of HIV by 40% by the year 2012 and also to objective 5 To promote use of new prevention technologies and approaches proven to be effective. Given the results of the USAIS (2010/2011) with alarming increase in HIV prevalence and very low circumcision prevalence (approx 25%). In March 2010, the Ministry of Health (MoH) launched the Safe Male Circumcision policy to guide the integration of VCCM services in Ugandas national health system to reduce the number of new HIV infections. PEPFAR Uganda is prioritizing VCCM as a major pivot to reduce the number of new HIV infections.VCCM is being offered in Uganda as part of a comprehensive HIV prevention package, which includes: promoting delay of sexual debut (for primary abstinence), abstinence and reduction in the number of sexual partners and be faithful; providing and promoting correct and consistent use of male condoms, providing HIV testing and counseling services and refer to appropriate care and treatment if necessary, and providing services for the treatment of sexually transmitted infections. VMMC presents a unique opportunity to engage female partners to advocate, mobilize men and involve women in seeking HTC with appropriate referrals, including ANC and PMTCT care (and treatment where necessary).

MUSOM will target Males aged 15 years and above in the catchment areas of Makerere University Hospital. It will also support Pre and in-service training in VCCM for Medical School Interns, Clinical officers and Nurses.

MUSOM will use multiple delivery approaches; dedicated VMMC teams, static and VMMC seasonal outreaches to offer services in Makerere University hospital. MUSOM will use the Model for Optimizing the Volume for Efficiency (MOVE) to optimize on efficiencies and increase the volume safely. MUSOM will pay special focus on quality assurance and quality assessments (internal and external) which will be conducted on a regular basis.

Demand creation strategies undertaken will be community mobilization through health talks and radio programs, as well as, IEC materials. These strategies will be in line with guidelines from WHO, UNAIDS and the Uganda National Communication Strategy on VCCM. The program will strengthen peer recommendation by actively encouraging already served clients to inform their peers about the service and its advantages to target men (and female partners to increase testing uptake). MUSOM will engage community mobilisers to target localities with high numbers of men like taxi parks and Boda Boda stages.

The Program will work with partners such as Walter Reed to develop a pool of trainers that will target both pre-service trainees and teams from health facilities. These teams will be supported to scale up VCCM in their facilities.MUSOM will continue to report to the VMMC National Operational Center as required by MOH.

Routine Provider Initiated Testing and Counseling (PITC) is offered to all patients in the health facilities and their family members. TB screening and prevention counseling is offered to all patients. Couples HIV Counseling and Testing (HCT) is also provided and the identified discordant couples are referred to discordant couple clubs at HIV clinics. Identified HIV persons are linked to care. The program supplements the supplies, equipment and furniture to the health units and strengthens HMIS, logistics management and laboratory quality assurance systems in the health units. The program target is to reach a minimum 64,208 with testing and counseling modalities mentioned above.

The program will increase access to and use of essential counseling and testing services for key populations. Activities will include scaling up PITC to the 13 Health Center III in Mbarara as well as connecting clients to HIV Care and Treatment and social support services, through linkage facilitators. These activities have the aim of increasing demand and accessibility for HTC, and identifying and retaining positive clients for care and treatment services.The key populations in MUSOM supported districts are mainly sex workers, their clients and partners; men who have sex with men; uniformed forces; and long distance truck drivers. In addition, there will be targeted HCT outreaches for these populations to increase awareness and accessibility of services. The MARPI clinic in Mulago Hospital, staffed with personnel specifically trained to deal with key populations, will continue to appropriately link clients to HIV and other health services at their preferred sites.

HTC program activities shall be conducted in partnership with district local governments under the stewardship of the MoH, recognizing that the scale-up of activities will require a medium-term commitment by the USG.

The program will work in partnership with the Medical Access Uganda Limited; a central procuring mechanism, to ensure a steady supply of HIV rapid test kits for HTC services to be delivered efficiently.

Additionally, in order to maximize program success, this program will work towards evidence gathering for the purpose of standardizing service delivery, to ensure consistency with World Health Organizations HTC Quality Assurance/Quality Improvement guidelines.

Routine Provider Initiated Testing and Counseling (PITC) is offered to all patients in the health facilities and their family members. TB screening and prevention counseling is offered to all patients. Couples HIV Counseling and Testing (HCT) is also provided and the identified discordant couples are referred to discordant couple clubs at HIV clinics. Identified HIV persons are linked to care. The program supplements the supplies, equipment and furniture to the health units and strengthens HMIS, logistics management and laboratory quality assurance systems in the health units. The program target is to reach a minimum 64,208 with testing and counseling modalities mentioned above.

The program will increase access to and use of essential counseling and testing services for key populations. Activities will include scaling up PITC to the 13 Health Center III in Mbarara as well as connecting clients to HIV Care and Treatment and social support services, through linkage facilitators. These activities have the aim of increasing demand and accessibility for HTC, and identifying and retaining positive clients for care and treatment services.The key populations in MUSOM supported districts are mainly sex workers, their clients and partners; men who have sex with men; uniformed forces; and long distance truck drivers. In addition, there will be targeted HCT outreaches for these populations to increase awareness and accessibility of services. The MARPI clinic in Mulago Hospital, staffed with personnel specifically trained to deal with key populations, will continue to appropriately link clients to HIV and other health services at their preferred sites.

HTC program activities shall be conducted in partnership with district local governments under the stewardship of the MoH, recognizing that the scale-up of activities will require a medium-term commitment by the USG.

The program will work in partnership with the Medical Access Uganda Limited; a central procuring mechanism, to ensure a steady supply of HIV rapid test kits for HTC services to be delivered efficiently.

Additionally, in order to maximize program success, this program will work towards evidence gathering for the purpose of standardizing service delivery, to ensure consistency with World Health Organizations HTC Quality Assurance/Quality Improvement guidelines.

In FY 2013, MUSOM will facilitate the implementation of PMTCT Option B+ activities in Mulago, Mbarara national referral hospitals and their catchment areas.

Key strategic pivots for PMTCT will focus on:

1) Improving access and utilization of eMTCT services in order to reach more HIV infected pregnant women as early as possible during pregnancy. This will be done through provision of universal HIV Testing and Counseling (HTC) services during ANC, labor/delivery and community mobilization.

2) Decentralizing Treatment and Option B+ through the accreditation of all PMTCT sites up to Health Center IIIs. Activities will include site assessments; identification of training needs; procurement of equipment, printing M&E tools, job aides, and Option B+ guidelines, training of service providers and sample referral system for CD4+ and Early Infant Diagnosis (EID). The transition to Option B+ in will be done in accordance with MOH guidance and a total of 18 sites will be accredited by end of FY 2013.

MUSOM will support the delivery Option B+ services using a Family focused model within MNCH settings. Through monthly meetings, clients will receive adherence counseling and psycho-social support, Infant and Young Child Feeding (IYCF) counseling, EID, Family Planning (FP) counseling, Couple (HTC), supported disclosure and ARV refills. Village health teams will be utilized to enhance follow-up, referral, adherence support. Male partners will receive condoms, STI screening and management, treatment for those who are eligible and linkage to Voluntary Medical Male Circumcision (VMMC) for the HIV negative men. At least 23,000 partners of pregnant women will be tested within the MNCH setting.

3) Supporting intensive M&E of activities to inform Option B+ roll out through tracking of mother-baby pairs and electronic data reporting. All sites will actively document services provided to the mother-baby pairs at both facility and community level. Using phone technology, mothers will be reminded about their appointments, EID results and ARV adherence. All sites will submit daily reports on key program elements electronically to support effective monitoring and timely management.

4) Facilitating quarterly joint support supervision and mentorships at all PMTCT/ART sites involving MOH, AIDS Development Partners, Districts, USG, and implementing partner staff in accordance with MOH guidance. Site level support will entail cohort reviews, adherence rates, retention rates, data management, availability of supplies, commodities and tools, and knowledge gaps.5) Integrating voluntary and informed FP services with PMTCT services. MUSOM will ensure FP sessions are integrated within PMTCT trainings, counseling; education, and information during ANC, labor and delivery, and postnatal periods, as well as for women in care and treatment. FP services will be based on respect, womens choices and fulfillment of their reproductive health rights. Finally MJAP will support the establishment of a Lab hub at Mbarara regional referral hospital to facilitate EID sample collection and transportation.

MUSOM will provide HIV counseling and testing to 46,465 pregnant women in 18 service outlets during FY 2013. A total of 4,707 HIV positive pregnant women will be identified, of which 4,001 will be initiated on HAART for life and 706 provided with ARV prophylaxis; 4,584 babies will receive infant ARV prophylaxis and a DNA/PCR test.

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The MUSOM program will focus on supporting the National Strategic Plan 2011/12-2014/15 objective to increase access to ART from 57% to 80% by 2015. The program will enroll at least 4,225 new adult clients on ART and support 31,314 adults and children on ART by APR 2013 including 27,243 adults, contributing to overall national and PEPFAR target of 190,804 new clients and 490,028 individuals current on treatment. This target is not a ceiling, allowing for higher achievements with continued program efficiencies. Priority will be given to enrolment of HIV positive pregnant women, TB/HIV patients, and key populations. This support will cover two districts of Mbarara and Kampala; Mbarara, Mulago and Butabika teaching referral hospitals and their catchment areas..

The MUSOM program will support the MoH roll out of Option B+ for eMTCT through the following activities: accreditation of 11 additional health facilities, training, mentorship and joint PMTCT/ART support supervision. MUSOM will also support ART/PMTCT integration at facility level piloting feasible service delivery models, such as same day integrated HIV clinics. Continum of Response (CoR) linkages and referrals will be strengthened using linkage facilitators across different service points in facilities and communities. Facilitators will also be utilized for TB/HIV integration to ensure early ART initiation for TB/HIV patients. MUSOM will support RH integration including family planning and cervical cancer screening at facility level through provision of the services or referrals. Key populations will be targeted using innovative approaches including setting up specialized services; such as moonlight services.

Facilities will be supported to implement quality improvement initiatives for the ART framework: early initiation of ART eligible clients on treatment, improve adherence and retention and monitor treatment outcomes. Use of innovative, low cost approaches for adherence, retention and follow up such as: phone calls, SMS reminders, appointment registers and alert stickers will be supported. Special focus will be placed on adherence and retention of women enrolled under Option B+. Focus will be placed on increasing access to CD4 for routine monitoring of ART clients in line with MoH guidance. The sample referral network will be supported in line with the national CD4 expansion plan; and will monitor and report clients access to CD4 in quarterly reports.

MUSOM will liaise with National Medical Stores and Medical Access Uganda Limited for ARVs and other HIV commodities including cotrimoxazole and lab reagents. MUSOM will build the capacity of facility staff to accurately, forecast, quantify and order commodities as well as timely reporting.

In addition, MUSOM will work with USG partners and other key stakeholders for provision of required wrap around services.

The program will be aligned to the National Strategic Plan for HIV/AID (2011/12-2014/15), support and strengthen the national M&E systems and work within district health plans. MUSOM will work under the guidance of MoH/ACP and the Quality Assurance Department in trainings, ART/PMTCT mentorship and supportive supervision.

The MUSOM program will focus on supporting the National Strategic Plan 2011/12-2014/15 objective to increase access to ART from 57% to 80% by 2015. This program will enroll at least 1,056 new HIV positive children and support 4,071 children on ART by APR 2013. This will contribute to overall national and PEPFAR target of 38,161 new children on ART and 63,704 children current on treatment. This support will be provided to Mbarara, Mulago and Butabika teaching referral hospitals and their catchment areas.

In FY 2013, MUSOM will support the national program scale up of pediatric treatment through strengthening the identification, follow up and treatment for all infants through early infant diagnosis focal persons, peer mothers, SMS messages, phone calls and flagging files with initiate ART immediately stickers. Facilities will be supported to strengthen test and treat for all HIV positive infants under two years in line with the national treatment guidelines.

The MUSOM program will support early initiation, adherence and retention of adolescents on treatment using expert peers and adolescent support groups. They will be provided with positive health dignity and prevention services including: sexual and reproductive health services, psychosocial support and life skills training.

A key priority will be to establish strong referrals between OVC and care and support programs to ensure children on treatment are linked to OVC services, and children provided with OVC services are screened for HIV and appropriately linked to treatment. The program will support the integration of HIV services in routine pediatric health services, including the National Child Health Days.

MUSOM will liaise with PACE for provision and distribution of basic care kits to clients. In addition MUSOM will work with National Medical Stores and Medical Access Uganda Limited for ARVs and other HIV commodities including ARVs, cotrimoxazole and lab reagents. MUSOM will endeavor to build the capacity of facility staff to accurately, forecast, quantify and order commodities as well as timely reporting.

MUSOM will work with USG partners such as SCORE, SUNRISE, PIN, SPRING, HEALTHQual, ASSIST and Hospice Africa Uganda in their related technical areas to support integration with other health, nutrition and OVC services. The program will collaborate with other key stakeholders at all levels for provision of required wrap around services.

The program will be aligned to the National Strategic Plan for HIV/AID (2011/12-2014/15), support and strengthen the national M&E systems and work within district health plans.MUSOM will work under the guidance of MoH/ACP and the Quality Assurance Department to support pediatric trainings, implementation of the national pediatric mentorship framework and support supervision.