Protecting Families Against HIV/AIDS (PREFA) is a national NGO that supports the implementation of PMTCT Services in Uganda and currently receives PEPFAR funds to support the scale up of PMTCT services in seven districts. The goal of this project is to contribute to the elimination of MTCT in seven districts and therefore contribute to the achievement of PEPFAR goals 1, 2, 3, 4, and 5, and the goals of Ugandas National Strategic plan.

The key objectives are:1) To facilitate the implementation and monitoring of PMTCT of Option B+ services within Maternal and Child Health (MNCH);2) To provide early infant HIV testing to 90% of all HIV-exposed babies below the age of 12 months;3) To strengthen the integration of Family planning within and PMTCT services seven districts.

The total population in the targeted districts is 150,270 people and this project will target specifically women of reproductive age group, pregnant women and their spouses, lactating mothers, infants and the general community. The activities of the project will be implemented by the district health workers, peer mothers as well as village health teams at community level through a district-led approach. To enhance cost effectiveness, the district based trainers will conduct trainings of service providers, as well as, post-training mentorships, and on-site support supervision. In addition, PREFA will engage volunteers to support adherence and retention as well as linkages to other HIV care services.

PREFA has procured four vehicles since the beginning of the project and will not procure any in FY 2012.

In FY 2013, PREFA will facilitate the implementation of PMTCT Option B+ activities in the seven districts of Central region in Uganda.

Key strategic pivots for this program 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 and to achieve this PREFA will ensure provision of universal HIV Testing and Counseling (HCT) services during ANC, labor and delivery and enhance community mobilization.

2) Decentralizing Treatment and Option B+ through the accreditation of all PMTCT sites at hospital, Health Center (HC) IV and HC III levels. Activities will include site assessments for accreditation, identification of training needs; procurement of equipment, printing M&E tools, job aides, Option B+ guidelines, training of service providers and sample referral system for CD4+ and Early Infant Diagnosis (EID). The transition of Option B+ in PREFA sites will be done in accordance with MOH guidance and a total of 140 out of 164 sites will be accredited by end of FY 2013.

Effective delivery of Option B+ services will be enhanced through a family focused model within MNCH settings. In this model family support groups will be formed at all PMTCT sites and will meet monthly to receive adherence counseling and psycho-social support, Infant and Young Child Feeding (IYCF) counseling, EID, family planning counseling, couples HTC; supported disclosure and ARV refills. Village health teams will also be utilized to enhance follow-up, referral, birth registration and adherence support. Through this model, male partners will receive condoms; STI screening and management, support for sero-discordant couples, treatment for those who are eligible and linkage to Voluntary Medical Male Circumcision (VMMC). At least 58,000 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 cohort 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. Each beneficiary will have a standard appointment schedule that will be aligned to the follow-up plan of each PMTCT site. Mobile phone technology will be used to remind mothers and their spouses on appointments, EID results and ARV adherence. Service providers will conduct home visits to trace client who are lost to follow-up. 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 Family Planning services with PMTCT services. PREFA 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, based on respect, womens choices, and fulfillment of their reproductive health rights.