Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014

Details for Mechanism ID: 9300
Country/Region: Uganda
Year: 2012
Main Partner: Mulago-Mbarara Teaching Hospitals' Joint AIDS Program
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: USAID
Total Funding: $558,718

The REACH-U program aims to support Ministry of Health (MOH) efforts of increasing access to quality HIV Testing and Counseling (HTC) services to most-at-risk and underserved populations. Program objectives are to enhance early identification of HIV infected individuals, linking them to care and treatment, and ultimately reducing new infections. The program also seeks to strengthen national and district systems to improve quality and efficiency of HTC services. REACH-U covers ten rural districts of Abim, Kotido, Kaabong, Nakapiripirit, Moroto, Mukono, Napak, Wakiso, Rakai and Lyantonde and will target most at risk populations and focus on couples, commercial sex workers and partners, truckers, fisher folk, uniformed and incarcerated populations and other MARPS identified.The program will also strengthen systems for effective HCT logistics management and strengthen MOH leadership in delivery of HCT services at facility level. This will be implemented in collaboration with District Health Teams and government health workers. Hands-on learning, mentoring and coaching are emphasised to ensure skills transfer for sustainabilty. REACH-U will use MOH tools for data collection/reporting, documents and disseminates results periodically. Data Quality Assessments are periodically performed to ensure quality and validity of data reported to PEPFAR and the national system. The program will leverage resources and minimize overlap through collaboration and coordination with other partners and the districts, and address wrap around health issues such as malaria, reproductive health, tuberculosis and sexually transmitted infections which impact HIV/AIDS.

Funding for Testing: HIV Testing and Counseling (HVCT): $558,718

REACH-U program operates in 90 primary health care facilities and neighboring communities in the districts of Abim, Kotido, Kaabong, Nakapiripirit, Moroto, Napak, Mukono, Wakiso, Rakai and Lyantonde districts. The first six districts constitute Karamoja, the most neglected and underserved region in Uganda. With the primary goal of early identification of HIV-infected individuals, the program will target about 103,000 individuals in the general and specific populations including couples, sex workers, truckers, uniformed forces, and other migrant populations in urban and peri-urban settings.REACH-U will deliver its HTC services using two prongs, namely Provider-Initiated Counseling and Testing (PICT) and Client Initiated Testing and Counseling with varying levels of intervention depending on district-level data. General HTC services will be delivered through targeted community outreaches while PICT will be delivered at Health Centre IIIs targeted at units with high client volumes such as STI and TB clinics, general outpatient departments, in-patient wards, as well as antenatal clinics. Moonlight clinics in nightclubs and truck park yards, scheduled home visits and outreaches at fish landing sites, where we expect to target roughly 11,000 individuals alone, will also be used to reach specific populations at risk. Existing community structures such as Village Health Teams (VHT), clan and religious leaders as well as PLHA networks, will be harnessed for mobilization and coordination of activities. Facility and community services will be linked through community structures to ensure appropriate referral and support of both HIV positive and negative individuals and couples, using the linkage facilitators both at facility and community level.REACH-U uses a holistic approach to HTC and strives to maximize opportunities for addressing other health challenges. HTC messages integrate family planning education, STI assessment, condom promotion, education on and referral for SMC for HIV-negative males, identification of HIV-exposed infants and linking them to EID services, as well as information on adult and childhood nutrition. All HIV positive individuals including pregnant women will be linked to PMTCT, care and treatment programs and referrals will be traced to recipient facilities using mobile phones and physical visits. HIV-negative individuals shall be linked to prevention programs, particularly safe male circumcision for eligible men.REACH-U is aligned with the National HIV/AIDS Strategic Plan and contributes to its objective of scaling up HCT services to facilitate universal access. Services are also delivered in accordance with the national protocols and guidelines. REACH-U will also continue to build the capacity of the health workers both at facilities and in the community in pursuance of sustainability. This will be accomplished through in-service training and joint on-job support supervision and mentoring with MOH and DHT. All activities of HCT implementation involve partnership with district and community level players such as VHTs and PHAs so that there is considerable amount of learning by doing. This will empower them with skills to successfully manage the services as well as ensuring ownership and sustainability beyond the project period.

Subpartners Total: $0
AIDS Information Center: NA
Makerere University: NA
Mayanja Memorial Hospital Foundation: NA
The AIDS Support Organization: NA
Cross Cutting Budget Categories and Known Amounts Total: $172,000
Human Resources for Health $172,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
enumerations.Impact/End-of-Program Evaluation
Military Populations
Mobile Populations
Tuberculosis
Family Planning