The goal of the project is to improve HIV/AIDS prevention, care and support services through community based approaches. Specific objectives include: 1) improve quality of life of HIV positive individuals and families; 2) increase access of Orphans and Vulnerable Children (OVC) to services; and 3) build capacity of indigenous organizations. In order reduce duplication, FY 2012 funding to TASO through USAID will be in prevention and OVC services, while CDC support will focus on HCT, care and treatment. The geographic coverage of the program will be through TASOs 11 national centers; the catchment area of each center is a 75 km radius.

To ensure smooth execution of the project and monitor progress, TASO will ensure systematic analysis of project results and reports, regular support supervision, and use participatory monitoring mechanisms. TASO is currently transitioning the outreach approach in some sites with the aim of system strengthening to ensure that facilities that used to host TASO are capable of providing quality HIV/AIDS services as part of their routine operation.

Efficiencies built in the program include merging the role of field officers and counseling offices, and integration of drama activities with the overall prevention approach, which has enabled the program to reach more individuals that are mobilized through educational drama entertainment. The counselors follow this up with individual and group sessions. The group therapy approach enables counseling service delivery to a larger population. In addition TASO conducts joint support supervision visits with district, MOH and development partner teams, involving the VHTs in service delivery and community mobilization. TASO programming in FY 2012 will emphasize combination HIV prevention.

The key goal of this project is to enhance access to comprehensive services by Orphans and Other Vulnerable Children (OVC) in line with the National Strategic Program Plan for Intervention (NSPPI) for OVC. TASO will reach 20,000 OVC, who are HIV positive or have lost a parent to AIDS or are living in HIV/AIDS affected households and are vulnerable to HIV infection or its socio-economic consequences.

The strategies include provision of a comprehensive care package of services that include socio-economic empowerment, psychosocial services, medical care, child protection, education support and food security and nutrition support based on household assessments. Psychosocial and medical support will be provided routinely to children living with HIV/AIDS. These services will be provided through child care centers and psycho-social support will be provided by specialized child counseling experts. Therapeutic and supplementary feeding will be given to moderately or severely malnourished children. Caregivers of chronically ill household members will be counseled about alternative food security practices and trained in appropriate nutrition. Educational support will be given to children living in extreme poverty to enable them benefit from universal primary or secondary education while subsequently their households will be targeted for economic strengthening interventions to enable caregivers to eventually take over their primary responsibilities. Community structures like PLHIV networks, peer mother and youth will be used to mobilize OVC households for outreach services. Those identified as positives will be immediately linked to care and treatment services. All children will benefit from child protection services and HIV prevention services. OVC households in need of services not offered under the TASO OVC program such as food security will be assessed and referred to other agencies within the community network model for additional support.

In addition, TASO will continue to build capacity of families to meet the needs of OVC, train caregivers to support OVC at home and in schools, ensure OVCs consistently attend school and complete education (up to the tertiary level), and support OVC to acquire vocational skills and become self-sustaining. TASO will also ensure that OVCs access quality comprehensive services in three or more core program areas.

The efforts that TASO have taken to improve OVC service delivery are through building partnerships and collaborations with other service providers and local authorities for OVC services. TASO works with respective district offices to identify target sub counties for the OVC programs. Since resources are inadequate to meet all core program areas, OVC are linked to other service providers especially in nutrition and socio economic support including government poverty alleviation programs, as well as raising supplementary resources for the socioeconomic empowerment of households, especially child-headed-households.

High poverty levels have constrained the program and some caregivers are unable to meet their obligations leading to poor academic performance of OVC. Limited vital registration makes it difficult to obtain legal documents (i.e. birth certificates, death certificates and marriage certificates) that can be used to establish and protect civil rights of the OVC and for obtaining key vital statistics.

In the revised COP 12, the key pivots for other prevention activities aim to ensure a balanced portfolio that addresses the prevention needs for the older population as well as the youth as the primary target groups and supports high impact interventions. TASO will focus on increasing accessibility, availability and acceptability of condoms among the target populations in the 11 services centers of Entebbe, Gulu, Jinja, Masaka, Masindi, Mbale, Mbarara, Mulago, Rukungiri, Soroti and Tororo and will target 80,000 individuals with prevention interventions.

Deliberate efforts will be made to promote condom use among TASOs clients including sero-discordant couples, those with multiple partnerships and youth out of school. TASO will increase the number of distribution outlets at community level to 149 outlets using community volunteers. It will also engage with community leaders to empower them to promote condom use and to promote faithfulness in marriage. TASO will adopt various approaches to target the different groups using appropriate channels of communication including print and electronic mass media, drama and linkage facilitators: the village health team and counselors, to provide comprehensive risk reduction information. Information will include: promotion of delayed sexual debut (for primary abstinence), abstinence and reduction in the number of sexual partners and being faithful; providing and promoting correct and consistent use of male condoms. TASO will target 15,000 CSW and long distance truckers with specific interventions that focus on increasing perception of risks associated with sex work, and scale up of evidence based behavioral interventions with supportive behavior change communication and to create demand for services. The PHDP interventions will aim at increasing knowledge of HIV status among PHLA and their partners, reducing the risk of HIV transmission and reducing HIV acquisition among persons at high risk for infection. TASO will support community campaigns to create acceptance and demand for condoms by targeting 95,000 individuals. The goal is to increase utilization and demand for condoms amongst the older population and youth including the MARPS and PDHP. Program monitoring and evaluation activities will be supported within this budget to strengthen the collection of data through national HMIS tools and to improve the technical quality of data through periodic data quality assessments.