Kalangala District Local Government received CDC/PEPFAR funds to implement a 5-year program to improve and sustain health outcomes of target fishing communities by providing public health services in the district. The program will increase demand and access to services, build capacity for laboratory services, and strengthen health systems. Key activities will include: scaling up Provider or Client Initiated Testing and Counseling (P/CITC) in two Health Center (HC) IVs and six HC IIIs and intensify the use of targeted HIV Testing and Counseling (HCT) outreach activities, care and treatment of HIV positive clients, PMTCT, OVC, screening for SGBV and child defilement, integration of MNCH/family planning/reproductive health into PMTCT settings, Post Exposure Prophylaxis (PEP), condom promotion and distribution, delivering harm reduction interventions for alcohol and drug abusers, medical transmission/injection safety and waste disposal awareness at health facilities, capacity building for laboratory services, health systems strengthening, establishing timely functional referrals and linkages, integrating malaria into ART services, identifying strategies to increase demand and access to the services, support ART adherence both for prophylaxis and ART treatment, facility and community based ART outreaches, developing adequate human resource capacity for the services and strengthening district HMIS systems. Targets for specific activities within a specific time frame will be set to monitor progress of the program through supervision and monitoring of program activities to ensure realization of outputs and assessment of the quality of services provided. The program will purchase two motor vehicles, 12 motorcycles, six boats and engines for the program to scale up services.

The Kalangala District Local Government (KDLG) program will focus on supporting the Government of Uganda (GOU) to expand access to HIV care and support with the goal to achieve universal access of 80% in care by 2015. The program will support the provision of care services to 8,500 as a contribution to the overall PEPFAR target of 812,989 HIV positive individuals in care and support services. This target was derived using burden tables based on district HIV prevalence and treatment need for Kalangala. T he Continuum of Response (CoR) model was applied to ensure improved referrals and linkages. The KDLG program will be expected to implement approaches to promote an effective CoR model and monitor key indicators along the continuum. The program will pay specific attention to key populations residing in fishing communities such as, fishermen and commercial sex workers.

This project will provide comprehensive care and support services in line with national guidelines and PEPFAR guidance including, strengthening positive health dignity and prevention, strengthening linkages and referrals using linkage facilitators within facilities and using mobile phones to track referrals across facilities, 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 focus of the program will be placed on increasing access to 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, the KDLG program will support improvement of CD4 coverage in the district over the coming year. KDLG will support the sample referral network in line with the national CD4 expansion plan; and will monitor and report clients access to CD4 in quarterly reports. To ensure that clients access CD4 testing in a timely manner, the program will regularly keep track and report on client waiting lists and document reasons.

The program will closely work with PACE for provision and distribution of basic care kits to clients as well as with National Medical Stores and Medical Access Uganda Limited for other HIV commodities including cotrimoxazole and lab reagents. The program will build the capacity of facility staff to do accurate and timely report, forecast, quantify and order commodities.

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

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; and work within district health plans. KDLG program will work under the guidance of MoH/ACP and Quality Assurance Department for trainings, mentorship and supportive supervision.

Kalangala district has a high concentration of orphans and vulnerable children (OVC) largely attributable to the districts high HIV/AIDS prevalence. The district has an estimated 7,463 OVCs representing 12% of the total population of which 1,439 are critically vulnerable, 3,458 moderately vulnerable and 2,466 generally vulnerable (Recent survey by Ministry of Gender Labor and Social Development (MoGLSD). A significant number of children and adolescents have lost one or both of their parents to HIV/AIDS and are cared for by surviving parents of which majority are widows or grandparents. The majorities of the children live in poor households and are unable to afford schooling or medical services.

In FY 2013, and given the available funding, OVCs at Health Centers (HC) and at community levels will be identified using the newly developed Vulnerability Index Guidance developed by PEPFAR OVC TWG in collaboration with MoGLSD, UNICEF and other key players. The district will identify and link critically vulnerable 1,000 OVCs (400 females and 600 males) to comprehensive OVC packages in line with the MoGLSD guidelines. The program will identify and support all the HIV positive OVC under the care of the adult clients. OVCs facility activities include counseling, care and treatment and community activities will include community mobilization and sensitization by probation/community development officers, trained HWS and volunteers at community and family level using existing structures. A family-centered care environment, enhanced community support systems, support for OVC peer groups, foster homes and paralegal support will be initiated. All HCs will establish support groups for OVCs. All the 11 HCs will have designated child friendly corners and child days on a quarterly basis whereby children will be grouped by age and age appropriate activities will be carried out. Sessions on discipline, behavior life skills, and leadership skills, identification of skills and talents will be done and identified OVCs will be linked to livelihood support programs such as vocational skills and apprenticeship. Additionally, adolescents will be trained in prevention activities, using the Value of Life Curriculum, with a focus on abstinence.

The services will include: food/ nutrition, shelter and care, protection and legal aid, health care and psychosocial support, nutritional assessment and counseling, therapeutic and supplementary feeding for malnourished children, strengthening family based care models for children, supporting child headed households, referrals and linkages to child health care including appropriate ART, growth monitoring, immunization, malaria prevention, sanitation and clean water, and personal hygiene and age appropriate prevention activities. Psychosocial services will include gender- sensitive life skills; improving links between children affected by HIV/AIDS in their communities, referral for counseling for anxiety, grief and trauma. Teenage pregnancies, SGBV, rape and PMTCT services for teenage mothers will be integrated in the OVC interventions. 100 OVC care givers will be selected from all islands that make up the district for coaching and mentoring in comprehensive OVC management while 30 in service health workers will be coached and mentored in OVC care services. Implementation, supervision and monitoring of OVC program will be done by responsible district staff.

The KDLG 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 and on TB treatment. This program will contribute to this target by screening 7,650 HIV positive clients for TB, and starting 255 on TB treatment in Kalangala district. 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 along service delivery points.

The KDLG program will work to improve Intensified Case Findings (ICF) and the use of the 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 including GeneXpert and fluorescent microscopy. The KDLG program will support MDR-TB surveillance through sputum sample transportation to GeneXpert hubs and receipt of results at facilities.

In FY 2013, the program will ensure early initiation of all HIV positive TB patients on ART through use of linkage facilitators and or the provision of ART in TB clinics. The KDLG 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 by cough monitors and ensure adequate natural ventilation.

The MOH/ACP and National TB and Leprosy Program (NTLP) will be supported to roll out provision of IPT, in line with the WHO recommendations.

In addition, the program will work with USG partners such as PIN, SPRING, HEALTHQual and Hospice Africa Uganda in their related technical areas to support integration with other health and nutritional services. KDLG 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. The KDLG program will work under the guidance of MoH AIDS Control Program, NTLP and the Quality Assurance Department in trainings, TB/HIV mentorship and support supervision. To ensure quality of TB tests, KDLG will support facilities to participate in national external quality assurance for TB laboratory diagnosis.

The Kalangala District Local Government (KDLG) 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 765 children in the district of Kalangala to the overall PEPFAR target of 812,989 HIV positive individuals in care and support services of which 74,555 are children. 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 along service delivery points.

The 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 in high prevalence hard to reach and underserved areas. Early Infant Diagnosis (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 to support retention in care. The program 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 program will support retention of adolescents in care as well as ensure a smooth transition into adult life using expert peers and adolescent support groups. They will be provided with PHDP services including, sexual and reproductive health services, and psychosocial support and life skills training. Lessons learned from the planned national adolescent service assessment will be incorporated in activities to improve adolescent care.

As part of the priority interventions the program will 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 linked to care and support. The program will also support the integration of HIV services in routine pediatric health services, including the National Child Health Days.

In continued provision of the basic care kits to clients the program will liaise with PACE for provision and distribution of the commodity. Additionally, liaise with National Medical Stores, and Medical Access Uganda Limited for other HIV commodities. KDLG will build the capacity of facility staff to accurately report, forecast, quantify and order commodities in a timely manner.

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 and work within district health plans. KDLG will work under the guidance of MoH AIDS Control Program and Quality Assurance Department in pediatric trainings, national pediatric mentorship framework and support supervision.

The new Uganda AIDS Indicator Survey 2011/12 (AIS) shows that HIV Prevalence has changed since the last survey in 2004/5; the national HIV prevalence in 2011 has significantly increased to 7.3%. There are also changes in prevalence among population sub groups and data show that for youth aged 15-19, there was an increase in prevalence by 0.5%.In Uganda, there has been over reliance on Abstinence and be faithful (AB) interventions which have proven to be less effective and PEPFAR Uganda changed the prevention portfolio by moving away from AB to increasing the investment in evidence based interventions. The AB programs have been scaled back significantly by reducing the number of AB USG partners from 27 to 11, the USG has developed partnerships and funded FBOs and other partners to promote AB programs with a focus on the youth and unmarried individuals.This is one of the programs that received PEPFAR funds for AB promotion in FY 2013. The program will reach out to approximately 5,943 (2,414 females & 3,529 males) individuals with individual or small group preventive interventions that are focused on AB only. AB messages will be disseminated through school based programs, community meetings and individual one on one meetings to reach target groups. The program will implement targeted community behavior change communication for supporting combination prevention interventions to enhance the continuum of response, by promoting AB messages aimed at stemming HIV infections with a directed focus for development of risk reduction skills for in-school youth to delay sexual activity or practice secondary abstinence, and for unmarried individuals to practice abstinence. The KDLG program will support the set-up and/or strengthening of community-based support groups and post-test clubs to assist in providing psychosocial support to AB beneficiaries.

Working closely with the District Directorate of Health Services, education department and other stakeholders in the community, the program will support establishment or adoption of social and community norms that denounce forced sexual activity among unmarried individuals and promote being faithful and also disseminate messages that encourage staying in school, delaying sex and promote life skills. USG teams will work closely with district teams to conduct quarterly support supervision and monitoring visits which will be enabled by the program management to ensure realization of outputs and assessment of the quality of services provided to the AB beneficiaries.

The goal of Kalangala HBVTC program is to contribute to the reduction of HIV infection rate and mitigate the impact of HIV in Kalangala District and the surrounding fishing communities by expanding delivery of comprehensive prevention, care and treatment services through a combination of evidence informed interventions. The program will contribute to the overall HIV Testing and Counseling (HTC) goals for PEPFAR by increasing access to and use of essential counseling and testing services for the most-at-risk populations which include fisher folks and other key populations determined by existing data on HIV prevalence in Uganda. The program will engage in scaling up Provider Initiated Testing and Counseling (PITC) in two Health Centers (HC) IVs and six HC IIIs and also intensify the use of targeted HTC outreaches. This activity proposes to reach 10,000 individuals including all pregnant mothers in the ANC clinic, eligible men who come for circumcision either in facility or in outreaches, family members of HIV positive individuals, couples and eligible children. Given the Male: Female sex ratio of 1.5:1, 6,000 males and 4,000 females will be tested for HIV. We anticipate outcomes to be: increased HTC awareness, increased HTC services uptake, 90% of targeted population to be reached with HTC, skilled and competent people to offer HTC and adequate supplies to support HTC and many stable sero-discordant couples will be identified.

This program will contribute to the continuum of response by linking clients to other health services using linkage facilitators to escort and physically link HIV positive clients to care and treatment services within public health facilities in the project areas and social support services by strengthening existing partnerships with other CBOs, NGOs (AMREF and KAFOPHAN) in the community and, with the aim of increasing demand for services and adherence for positive clients.

Program targets reflect the prioritization of districts with high HIV/AIDS prevalence and unmet need. Partner and district-level capacities were also key factors in determining the allocation of program resources. The project is a decentralized administrative entity serving highly mobile, high HIV-prevalence fishing communities in the Lake Victoria region. The District is a conglomeration of all fishing communities distributed in 84 islands on Lake Victoria who from time to time cross between the several fishing communities and are served by 11 local government health facilities. The target populations identified in this district for priority focus to receive HTC will be residents of fishing communities.

Currently, PEPFAR contributes to more than half of the MoHs HTC targets. Recognizing the important role of GOU, HTC program activities shall be conducted in partnership with district local governments under 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 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.

For FY 2013, prevention pivots for Other Prevention (OP) includes addressing prevention needs for older population and youth, addressing condom distribution bottlenecks to increase accessibility and promotion, establishing specific intense prevention programs to target key populations in high burden districts and hot spots, sero-discordant couples and multiple partnerships in rural/urban populations and those residing in hard to reach areas to access core elements of combination prevention.

The National Prevention Strategy (NSP) defines MARPS as: sex workers and their partners, fisher folk, uniformed personnel, long distance truckers and men having sex with men (MSM). Uganda has provided for MSM programming in the NSP and PEPFAR Uganda has addressed this in FY 2013. Size estimation for MSM is underway and tailored programs for LGBTs (including MSM) will be implemented within a legally constrained environment.

For the purpose of this program, and taking male: female ratio of 1.5:1, 5,600 MARPS (3,360 males and 2,240 females) will be reached with focused high impact risk reduction interventions. These include: 600 Commercial Sex Worker (CSW), 200 truckers and 4,800 fisher folk. Identification and mapping of hot spots for MARPS to access the core elements of combination prevention (HTC, SMC, ART, PMTCT) services will be undertaken by the program in inhabited island areas.

The program will identify sero-discordant couples (SDCs) through HTC and support establishment of comprehensive risk reduction programs for both HIV negative and HIV positive persons, care (with more emphasis on strengthening the integration of positive health dignity prevention interventions and Post Exposure Prophylaxis (PEP) in clinical and community settings) and treatment services. Strengthening linkages of target populations to combination prevention interventions will also be a priority for this program from HCT/VMMC service points. Strategies for supporting couples to test together include: using influencing Village Health Teams (VHT) and community leaders to help promote couple's counseling and testing and educate couples about HIV and also use VHTs to educate and increase awareness among SDCs about the availability of PEP services and support referrals to HCs for those in need of PEP.

Condom service outlets will be established and increased from 49 to 400 at several sites as an effort to support and improve accessibility and promotion of both male and female condoms, and ensuring efficient distribution systems at facilities, in landing sites and island communities with a focus on high prevalent areas within the district. This will be realized through engagement of VHTs, hospitality industry, bars and hotels at landing sites. The program will also undertake advocacy to de-stigmatize condoms through engagement of other stakeholders as well as religious and political leaders. All the 11 HCs will be supported to provide PEP services.

In FY 2013, Kalangala District Local Government (KDLG) will facilitate the implementation of PMTCT Option B+ activities in eight PMTCT sites in Kalangala district.

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 by ensuring provision of universal HIV Testing and Counseling (HTC) services during ANC, labor and delivery, and community mobilization.

2) Decentralizing treatment and Option B+ through the accreditation of all PMTCT sites at and Health Center (HC) IVs and six 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 KDLG sites will be done in accordance with MoH guidance and a total of eight sites will be accredited by end of FY 2013. KDLG will support the delivery of Option B+ services using a family focused model within MNCH settings in which, family support groups will be formed at all PMTCT sites; 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 (VHT) 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 VMMC.

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 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 clients who are lost to follow-up.

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 (FP) services with PMTCT service to 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.

KDLG will provide HIV counseling and testing to 2,623 pregnant women in 11 service outlets during FY 2013. A total of 525 HIV positive pregnant women will be identified, of whom 425 will be initiated on HAART for life (Option B+) and 75 will be provided with ARV prophylaxis (Option A); in addition, 485 exposed babies will receive ARV prophylaxis and DNA/PCR tests.

The KDLG 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 1,741 new adult clients on ART & support 4,598 adults and children on ART by APR 2013, contributing to overall national and PEPFAR target of 190,804 new clients & 490,028 individuals current on treatment. 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 & linkages along service delivery points. 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, & key populations in Kalangala district, Uganda.The program will support MoH roll out of Option B+ for eMTCT through the following activities; accreditation of six additional health facilities; training, mentorship and joint PMTCT/ART support supervision; and also support ART/PMTCT integration at facility level piloting feasible service delivery models, such as same day integrated HIV clinics. Continuum 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. KDLG program will support reproductive health integration including family planning and cervical cancer screening at facility level through provision of the services or referrals.Targeted community outreaches in high prevalence hard to reach & underserved areas for example Kasekulo, Senero, Bugoma Lujaabwa, Butulume, Keserwa, Nkose, Kachanga, Misonzi and BIDCO main camp will be conducted. KDLG will also target key populations using innovative approaches including setting up specialized services such as moonlight services.The program will implement quality improvement initiatives for the ART framework: early initiation of ART eligible clients on treatment, improve adherence & retention, and monitor treatment outcomes. Use of innovative, low cost approaches for adherence, retention & follow up such as: phone calls, SMS reminders, appointment registers, alert stickers will be supported. Special focus will be placed on adherence & retention of women enrolled under Option B+ and increasing access to CD4 for routine monitoring of ART clients in line with MoH guidance. The program will support the sample referral network in line with this national CD4 expansion plan; monitor & report clients access to CD4 in quarterly reports.The program will liaise with PACE for provision and distribution of basic care kits to clients and also liaise with National Medical Stores and Medical Access Uganda Limited for ARVs and other HIV commodities. Building the capacity of facility staff to accurately and timely report, forecast, quantify and order commodities will be done.The program will work with USG partners & other key stakeholders for provision of required wrap around services. Being aligned to the National Strategic Plan for HIV/AID (2011/12-2014/15), the program will support and strengthen the national M&E systems and work within district health plans. The program will work under the guidance of MoH/ACP & the Quality Assurance Department in trainings, ART/PMTCT mentorship & supportive supervision.

The KDLG program will support efforts of the GOU in the National Strategic Plan 2011/12-2014/15, objective to increase access to ART from 57% to 80% by 2015. KDLG program will enroll at least 113 new HIV positive children and support 589 children on ART by APR 2013 in Kalangala district. 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 along service delivery points. This will contribute to overall national and PEPFAR target of 39,799 new children on ART and 64,072 children current on treatment.

The KDLG program will prioritize support to the national program scale up of pediatric treatment through strengthening the identification, follow up and treatment for all infants through Early Infant Diagnosis (EID) focal persons, peer mothers, SMS messages or phone calls and flagging files with initiate ART immediately stickers. Test and treat for all HIV positive children under two years will be strengthened in all facilities in line with the national treatment guidelines.

The program will support early initiation, adherence and retention of adolescents on treatment using expert peers, adolescent support groups and training of health care providers. In line with quality service delivery, they will be provided with positive health dignity and prevention services including; sexual and reproductive health services, psychosocial support and life skills training.

To provide other key services KDLG will 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. Furthermore the program will support the integration of HIV services in routine pediatric health services, including the National Child Health Days.

The KDLG program will closely work with PACE for provision and distribution of basic care kits to clients. Also liaise with National Medical Stores and Medical Access Uganda Limited for ARVs and other HIV commodities including cotrimoxazole and lab reagents. KDLG program will build the capacity of facility staff to accurately and timely reports, forecast, quantify and order commodities.

In addition, KDLG 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. KDLG will collaborate with other key stakeholders at all levels for provision of required wrap around services.

The KDLG 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. This program 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.