Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 699
Country/Region: Uganda
Year: 2008
Main Partner: Population Services International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $4,442,718

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $60,000

Population Services International (PSI) is a private non-profit organization with a mission to improve the

health of low income people worldwide through social marketing. PSI Uganda is an affiliate of PSI with

operations in Uganda since 1998. It aims at measurably improving the health of vulnerable Ugandans using

evidence based social marketing and other proven techniques that promote sustained positive behavior

change with added emphasis on rural populations. It is committed to effective collaboration in support of

the Ministry of Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health

and reproductive health.

Young women in Uganda, as is the case in all sub-Saharan countries are at much higher rates of HIV

prevalence than their male peers. Seminal research studies have linked this disparity in prevalence to

sexual relationships with older men a practice known as cross generational sex (CGS)—defined as a sexual

relationship between a young girl and an older man 10 or more years her senior in exchange for material

gains. Of girls aged 15 - 19, 10% report having had sex with men 10 or more years their senior in the past

12 months (National Survey of Adolescents - Uganda 2006) Another study reveals that among university-

going sexually active girls 19 - 24 years, 20% had been in a cross generational relationship, and 36%

believe it is normal to engage in such relationships (PSI Uganda Tracking Survey 2005). The Uganda

HIV/AIDS Sero-Behavioural Survey 2004/05 showed that the HIV prevalence peaks and is highest among

the 30 - 44 year olds among the men and yet cross generation sex is on the increase (PSI Tracking Survey

2005/06). As many men in this age bracket continue to have sexual relationships with young girls aged 15-

24 years; who are easily swayed with material things as little as a mobile phone (PSI Tracking Survey

2005/06), it is critical to address this CGS problem.

In FY2007 PSI/Uganda is implementing a dynamic, multifaceted intervention to address Cross Generational

Sex. The program focuses on the reduction of cross generational sex, along side delay of sexual activity,

secondary abstinence among girls 15 -24 and fidelity among men 30 -49 years. The intervention is in 10

universities and 50 secondary schools in the districts of Kampala, Mukono, Wakiso, Luwero, Mbarara, Gulu,

Masaka, and Mpigi. The program targets 3 main audiences; young women; older men engaged in the

practice and the general population. Among the program's components is the establishment of peer and

social support groups for young women dubbed the "Go-Getters." In FY 2008 in partnership with Straight

Talk Foundation, PSI will extend the "Go-Getters" to secondary schools. Through these clubs, young

women receive peer education and counseling about the risks involved in cross generational sex

relationships, guidance on planning for their dreams and mapping out a path to success in their future

careers. Go-Getters club members are also empowered with the life skills that will enable them to make

good, sound decisions and judgments when faced with choices that will ultimately either save or end their

lives. The aim of the campaign is to empower the girls 15 -24 to reject cross generational sex and abstain

from sexual activity, while encouraging fidelity among the men involved in the CGS practice. Besides the

"go-getters" interpersonal communications, the program has a multi-channel mass media campaign and

mobile HIV counseling and testing at universities. Those who test positive are linked up with care and

support centers nearest to their universities especially AIC sites; one of PSI's partners in the CGS program.

Free HIV Counseling and Testing has been included as an additional component in the universities

program, in response to data that showed that only 15% of women aged 20-24 have ever tested for HIV

(Uganda HIV/AIDS Sero Behavioural Survey 2004/05).

Current gaps: The current campaign has a strong emphasis on mass media and has generated a lot of

discussion in the media, but this needs to be integrated with an equally strong emphasis on interpersonal

communications. With the current program we are not able to obtain immediate feedback from the target

audience which would be valuable in crafting messages to address their concerns and underlying beliefs

and causes of CGS, early sexual activity and infidelity. The behaviors being addressed are individual in

nature and require a strong personal counseling and reflection. While the mass media campaign will lead to

increased awareness and education about the healthy behaviours promoted, these are insufficient bases for

personal action. The gap between knowing what to do and carrying it out is notorious. With funding from

CDC, PSI will develop a strong interpersonal communications campaign that allows for careful listening to

the target groups concerns and address them. Through this feedback mechanism PSI will be able to

develop a cost-benefit analysis of the promoted behaviors from the target groups' perspective. The activities

(explained below) will include community outreach events to the 50 secondary schools and 10 universities

and a short messaging service (SMS) media promotion targeting university students and married couples.

The SMS media campaign will target the 20 -24 year olds in university as SMS media is fashionable to this

category but will not target the 15 -19 year olds as they are unlikely to access mobile phones. Feedback

from the 15- 19 year olds will be obtained from school teachers and at the community outreach events.

In FY 2008 PSI will conduct the following activities to bridge the above gap.

1.Expand the interpersonal communications (IPC) to the 50 secondary schools and surrounding

communities, targeting the 15-19 year olds (male and female) with abstinence messages and messages

encouraging the rejection of cross generation sex. The IPC activities will include the screening of a new

cross generation video drama "the honorable" that is followed by discussions on the problem of CGS and

what young people can do to reject CGS. PSI will continue to partner with FBOs such as CHAIN

Foundation and Power Fm to lead the discussions after the film dramas. Through the IPC, PSI plans to

reach 50,000 male and female 15 -19 year olds in the schools and their surrounding communities with key

messages on abstinence, and cross generational sex.

2.The discussions held with a vicarious-interaction style, will be recorded, edited and aired weekly on Power

Fm for greater reach, especially to young people out of school. 200,000 male and female 15 -24 are

expected to be reached through the mass media campaign.

3.Another activity for the FY2008 will be the addition of a short messaging services (SMS) media promotion

to support the already existing mass media campaign. Through this promotion dubbed "One million reasons

to reject cross generational sex" PSI will engage the young girls 20 -24 years to send SMS messages with

their top reasons for rejecting CGS—an excise that will get them to deeply think about the benefits of

abstinence and rejecting CGS. A similar campaign targeting the men dubbed "One million reasons to

remain faithful" will engage the men in fidelity messages. This interactive element to the ongoing "No to

Sugar Daddies, No to HIV" media campaign will provide PSI with feedback directly from the target

audience, promote interaction with the target audience, enable real time access to the public through SMS,

and provide PSI with an accurate database of phone numbers of the target audience through incoming

SMS. The promotion will feature incentives such as One million shillings worth of tuition fees per semester

as a grand prize for the girls 20 -24 years and a one million worth of holiday/vacation grand draw prize for

Activity Narrative: the fidelity campaign. Other incentives will include T-shirts, caps, airtime among others. 100,000 people are

expected to be reached through the SMS media campaign.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $300,000

Population Services International (PSI) is a private non-profit organization with a mission to improve the

health of low income people worldwide through social marketing. PSI Uganda is an affiliate of PSI with

operations in Uganda since 1998. It aims at measurably improving the health of vulnerable Ugandans using

evidence based social marketing and other proven techniques that promote sustained behavior change with

added emphasis on rural populations. It is committed to effective collaboration in support of the Ministry of

Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health and reproductive

health.

Over 900,000 people die of HIV related illnesses each year in Uganda despite sufficient evidence to show

that with simple yet comprehensive interventions, these illnesses can be avoided. Standardized, evidence-

based and innovative recommendations on HIV prevention have been put together as the HIV basic

preventive care package (BCP) to allow for provision of effective care to millions of people living with HIV

(PHA) who currently have limited access to HIV related services and health products. The BCP is a 5 year

program (September 2004 - March 2010) targeting 200,000 PHA in Uganda. The program goal is to help

reduce morbidity and mortality caused by opportunistic infections (OIs) in PHA and to reduce HIV

transmission. Currently, the BCP components include; identification of PHA through family based

counseling and testing; prolonging and improving the quality of their lives by preventing OIs; and prevention

with positives interventions (PWP). The PWP aim to avert HIV transmission to sexual partners and unborn

children through: screening and management of sexually transmitted infections, family planning, partner

testing and supported disclosure, partner discordance counseling, prevention of mother to child

transmission of HIV (PMTCT), and safer sex practices including abstinence, and fidelity with correct and

consistent use of condoms. The PWP are in harmony with the overall PEPFAR other prevention strategy. In

addition, BCP combines key informational messages, training and provision of affordable health

commodities. The health commodities include free distribution of a starter kit with two long lasting

insecticide treated bed nets, household water treatment chlorine solution, a filter cloth, and water vessel,

condoms and important health information to prevent HIV transmission.

The BCP program is implemented through HIV/AIDS prevention, care and support organizations across the

country and serves to increase the production, access and utilization of BCP health products and services

among PHA. Program implementation is supported by a multi-channeled communications campaign that

educates PHAs on how to prevent OIs, live longer and healthier lives through cotrimoxazole prophylaxis,

prevention of diarrheal diseases using household water treatment and safe storage, use of ITN for malaria

prevention, family planning and the prevention of HIV transmission to sexual partners and unborn children.

The campaign includes development and production of information, education and communication (IEC)

materials for PHA, health care providers and counselors. These materials include posters, brochures,

positive living client guides and stickers in eight local languages. In partnership with MOH and Straight Talk

Foundation (STF), PSI is producing spots and ‘parent talk' programs on radio. Service providers, peer

educators and drama groups are trained and are implementing activities that reinforce these messages. PSI

manages the procurement, packaging and distribution of all health commodities to ensure consistent supply

of the kits and re-supply.

The output of the condom and other prevention activity is to ensure regular and constant availability of

condoms to eligible PHA in Uganda. This will be achieved through the distribution of the complete starter kit

and annual replenishment of 60 condom pieces per adult client. Free condoms for the program are sourced

from the MOH stock. A buffer stock of 6,300,000 condom pieces has been procured using US $250,000

allocated to PSI by PEPFAR in FY 2007. Supply from MOH has remained irregular as was the case in FY

2006 were supplies were erratic and fell short of the national requirements and resulted in disruption of the

assembly and supply of starter kits. In FY 2008, US $250,000 has been allocated to the procurement,

shipping, handling, post shipment testing and packaging of a condom buffer stock to ensure continued

access by PHA.

In FY 2007, PSI has partnered with 60 HIV/AIDS care and support organizations in 33 districts. Fifty- three

of these distribute condoms to their adult clients. Between April and June 2007, PSI has distributed 2,730

starter kits, containing 163,800 pieces of condoms and 653,500 condoms re-supplied for adult PHA. 234

health service providers and 29 peer educators have been trained to promote HIV/AIDS prevention beyond

abstinence and/or being faithful including correct and consistent use of condoms. PHA have been actively

involved in interpersonal communication activities (IPC) at partner sites including health talks and

community sensitization on HIV/AIDS prevention. They have conducted 3,182 peer education sessions

reaching an estimated 164,456 people. 399,000 IEC materials including posters, client guides, brochures

and stickers have been distributed. To support the IEC campaign, STF has developed and aired 2,574 radio

messages in eight local languages on 18 radio stations countrywide and 60 parent talk programs in four

local languages on eight radio stations in the east, west, central and northern regions of Uganda. The radio

program is aimed at providing information to the general population and PHA in particular, on the benefits of

the basic care components and PWP. 1,287 messages that focus on PWP have been aired. Since program

inception, 97,308 adult PHAs have received starter kits containing 5,838,480 condom pieces. 2,666 health

service providers and 1,043 peer educators have been trained on BCP with focus on HIV/AIDS prevention

beyond abstinence and/or being faithful. Over 670,000 people have been reached with IPC activities.

Expansion of the BCP activities across USG partners has been initiated with the Plus-Up funding. This will

include the addition of 20 new HIV/AIDS care and support organizations. PSI has partnered with EGPAF

and NUMAT so as to scale up BCP implementation through the district health system. PSI is currently

carrying out a mapping exercise to clearly understand the coverage of all the partner sites and therefore

unmet need for BCP. Through this exercise efforts will be made to suggest strategies to avoid client overlap

by the sites.

In FY 2008, PHA in rural and hard - to - reach areas for example islands and conflict areas served by USG

partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps, State IMC, State IRC, MUWRP,

DOD/UPDF, Alliance, JCRC) who newly initiated BCP activities or do not have the full range of preventive

care activities will be prioritized. 97,308 adult clients who have received starter kits containing condoms will

each have a replenishment of 60 condom pieces. Other planned activities in FY 2008 include; 1) Continue

to implement the BCP program at current sites. 40,000 new clients will receive BCP starter kits in FY 2008.

2) Continue to make available on the market all the elements of the BCP package to enhance their

availability to all PHA. This will also help minimize stigma for the BCP commodities and services. 3) On

going distribution of IEC materials to PHA and health service providers. 4) On going peer education to

Activity Narrative: support uptake and utilization of BCP components including condoms. 5) PSI will continue to coordinate

implementation of palliative care activities as part of the BCP at HIV/AIDS support sites, and not as a

parallel activity. 6) Refresher training and training for new health service providers and peer educators in

preventive care and prevention with positives initiatives. 7) On going monitoring activities to track program

implementation.

Additional activities that the program will cover in FY 2008 will include; 1) Support and strengthen PWP

activities at partner sites through: regular support supervision of partner sites, partnership with SCOT to

train and mentor health service providers and assist in establishment of linkages to PWP services among

BCP partners and other service providers; 2) Improve demand for refill commodities and replenishment of

insecticide treated bed nets; 3) Work with MOH, CDC, and stakeholders to expand components of BCP to

address emerging needs of PHA e.g. TB, nutrition, HSV2; 4) Establish implementing partner regional

network system and facilitate study trips across partner sites targeting unit heads and staff involved in BCP

activities so as to learn from each others best practices as well as improve integration of BCP activities; 5)

Meaningful involvement of PHA. PSI in partnership with Alliance, NUMAT and EGPAF in selected districts

shall pilot building capacity of PHA networks in preventive care. These will be supported to follow up and

support fellow PHA on BCP adherence; 6) Increase program staff to cope with program expansion. One

person is required to oversee the implementation of PWP component of BCP and 4 assistants to support

regional activities; 7) Procure vehicles to maintain standards of supervision and commodity supply at

current and new sites; 8) Support sites to step up community component of their programs to improve on

client follow up.

Plans for program sustainability include; PSI to continue working with local manufactures to produce BCP

health commodities, partnership with MOH, and scaling up of BCP activities through district health

structures.

Funding for Care: Adult Care and Support (HBHC): $3,496,718

Population Services International (PSI) is a private non-profit organization with a mission to improve the

health of low income people worldwide through social marketing. PSI Uganda is an affiliate of PSI with

operations in Uganda since 1998. It aims at measurably improving the health of vulnerable Ugandans using

evidence based social marketing and other proven techniques that promote sustained behavior change with

added emphasis on rural populations. It is committed to effective collaboration in support of the Ministry of

Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health and reproductive

health

Over 900,000 people die of HIV related illnesses each year in Uganda despite sufficient evidence to show

that with simple yet comprehensive interventions, these illnesses can be avoided. Standardized, evidence-

based and innovative recommendations on HIV prevention have been put together as the HIV basic

preventive care package (BCP) to allow for provision of effective care to millions of people living with HIV

(PHA) who currently have limited access to HIV related services and health products. The BCP is a 5 year

program (September 2004 - March 2010) targeting 200,000 PHA including children in Uganda. The

program goal is to help reduce morbidity and mortality caused by opportunistic infections (OIs) in PHA

including children and to reduce HIV transmission to unborn children and sexual partners. Currently, the

BCP components include; identification of PHA through family based counseling and testing; prolonging and

improving the quality of their lives by preventing OIs; and prevention with positives interventions (PWP). The

PWP aim to avert HIV transmission to sexual partners and unborn children through: screening and

management of sexually transmitted infections, family planning, partner testing and supported disclosure,

partner discordance counseling, prevention of mother to child transmission of HIV (PMTCT), and safer sex

practices including abstinence, and fidelity with correct and consistent use of condoms. In addition, BCP

combines key informational messages, training and provision of affordable health commodities. The health

commodities include free distribution of a starter kit with two long lasting insecticide treated bed nets,

household water treatment chlorine solution, a filter cloth, and water vessel, condoms and important health

information on how to prevent HIV transmission.

The BCP program is implemented through HIV/AIDS care and support organizations including those

offering pediatric care and PMTCT services across the country. Program implementation is supported by a

multi-channeled communications campaign that educates PHA on how to prevent OIs, live longer and

healthier lives through cotrimoxazole prophylaxis, prevention of diarrheal diseases using household water

treatment and safe storage, use of ITN for malaria prevention, and PWP interventions. The campaign

includes development and production of information, education and communication (IEC) materials for PHA,

health care providers and counselors. These materials include posters, brochures, positive living client

guides and stickers in eight local languages. In partnership with MOH and Straight Talk Foundation (STF),

PSI is producing spots and ‘parent talk' programs on radio. Service providers, peer educators and drama

groups are trained and are implementing activities that reinforce these messages. PSI manages the

procurement, packaging and distribution of all health commodities to ensure consistent supply of the kits

and re-supply.

In FY 2007, PSI has partnered with 60 HIV/AIDS care and support organizations in 33 districts. Between

April and June 2007, PSI has distributed 3,400 starter kits and, 20,902 bottles of chlorine solution for water

treatment and 653,500 condom pieces as refills for adult PHA. 234 health service providers and 29 peer

educators have been trained to promote use of BCP components. PHA have been actively involved in

interpersonal communication (IPC) activities at partner sites including health talks and community

sensitization on HIV/AIDS prevention. They have conducted 3,182 peer education sessions reaching an

estimated 164,456 people. 399,000 IEC materials including posters, client guides, brochures and stickers

have been distributed. To support the IEC campaign, STF has developed and aired of 2,574 radio

messages in eight local languages on 18 radio stations countrywide and 60 parent talk programs in four

local languages on eight radio stations in the eastern, western, central and northern regions of Uganda. The

radio program is aimed at providing information to the general population and PHA in particular, on the

benefits of the basic care components. In partnership with Hospice Africa, a symptom and pain

management curriculum is under development for the BCP training manual, and will be included in the BCP

staff and peer educator trainings. Since program inception, 116,591 PHA have received starter kits. 2,722

health service providers and 1,151 peer educators have been trained on BCP. Over 670,000 people have

been reached with the IPC activities.

Expansion of the BCP activities across USG partners has been initiated with the Plus-Up funding. This will

include the addition of 20 new HIV/AIDS care and support organizations. PSI has partnered with EGPAF

and NUMAT so as to scale up BCP implementation through the district health system. PSI is currently

carrying out a mapping exercise to clearly understand the coverage of all the partner sites and therefore the

unmet need for BCP. Through this exercise efforts will be made to suggest strategies to avoid client overlap

by the sites.

There is overwhelming evidence attesting to the effectiveness of HIV/AIDS preventive care, including

chemoprophylaxis, use of bed nets and safe water in delaying HIV disease progression and consequently

improving the quality of life for PHA. However, access to these commodities remains low in Uganda. This

activity is aimed at expanding access to cotrimoxazole prophylaxis, long lasting treated bed nets, condoms

as well as safe water systems. In FY 2008, PHA particularly in rural and hard - to - reach areas for example

islands and conflict areas served by USG partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps,

State IMC, State IRC, MUWRP, DOD/UPDF, Alliance, JCRC) who have newly initiated BCP activities or do

not have the full range of preventive care activities will be prioritized. 36,000 PHA who received the BCP

starter kits in FY 2005 will have their bed nets replaced following wear and tear due to consistent use. Other

planned activities in FY 2008 include; 1) Continue to implement the BCP program at current implementing

partner sites. Expansion of BCP distribution through the PEPFAR care and treatment implementation

partners will make the BCP components available to over 200,000 PHA through out Uganda by the end of

FY 2008. 40,000 new clients will receive BCP starter kits in FY 2008. 2) Continue to make available on the

market all the elements of the BCP package to enhance their availability to all PHA. This will also help

minimize stigma for the BCP commodities and services especially the safe water vessel. 3) On going

distribution of IEC materials to PHA and health service providers. 4) On going peer education to support

uptake and utilization of BCP components. 5) Continued support for palliative care activities, together with

Hospice Africa by production of palliative care IEC and advocacy materials, and BCC focusing on pain and

symptom management, psychological, and social support. PSI will continue to coordinate implementation of

palliative care activities as part of the BCP at HIV/AIDS support sites, and not as parallel activity. 6)

Activity Narrative: Refresher training and training for new health service providers and peer educators in preventive care and

prevention with positives initiatives. 7) On going monitoring activities to track program implementation.

Additional activities that the program will cover in FY 2008 will include; 1) Support and strengthen PWP

activities at partner sites through: regular support supervision of partner sites, partnership with SCOT to

train and mentor health service providers and assist in establishment of linkages to PWP services among

BCP partners and other service providers; 2) Improve demand for refill commodities and replenishment of

insecticide treated bed nets; 3) Work with MOH, CDC, and stakeholders to expand components of BCP to

address emerging needs of PHA e.g. TB, nutrition, HSV2; 4) Establish implementing partner regional

network system and facilitate study trips across partner sites targeting unit heads and staff involved in BCP

activities so as to learn from each others best practices as well as improve integration of BCP activities; 5)

Meaningful involvement of PHA. PSI in partnership with Alliance, NUMAT and EGPAF in selected districts

shall pilot building capacity of PHA networks in preventive care. These will be supported to follow up and

support fellow PHA on BCP adherence; 6) Increase program staff to cope with program expansion. One

person is required to oversee the implementation of PWP component of BCP and 4 assistants to support

regional activities; 7) Procure vehicles to maintain standards of supervision and commodity supply at

current and new sites; 8) Support sites to step up community component of their programs to improve on

client follow up.

Plans for program sustainability include; PSI to continue working with local manufactures to produce BCP

health commodities and scaling up of BCP activities through district health structures.

Funding for Care: Orphans and Vulnerable Children (HKID): $586,000

Population Services International (PSI) is a private non-profit organization with a mission to improve the

health of low income people worldwide through social marketing. PSI Uganda is an affiliate of PSI with

operations in Uganda since 1998. It aims at measurably improving the health of vulnerable Ugandans using

evidence based social marketing and other proven techniques that promote sustained behavior change with

added emphasis on rural populations. It is committed to effective collaboration in support of the Ministry of

Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health and reproductive

health

Over 900,000 people die of HIV related illnesses each year in Uganda despite sufficient evidence to show

that with simple yet comprehensive interventions, these illnesses can be avoided. Standardized, evidence-

based and innovative recommendations on HIV prevention have been put together as the HIV basic

preventive care package (BCP) to allow for provision of effective care to millions of people living with HIV

(PHA) who currently have limited access to HIV related services and health products. The BCP is a 5 year

program (September 2004 - March 2010) targeting 200,000 PHA including children in Uganda. The

program goal is to help reduce morbidity and mortality caused by opportunistic infections (OIs) in PHA

including children and to reduce HIV transmission to unborn children and sexual partners. Currently, the

BCP components include; identification of PHA through family based counseling and testing; prolonging and

improving the quality of their lives by preventing OIs; and prevention with positives interventions (PWP). The

PWP aim to avert HIV transmission to sexual partners and unborn children through: screening and

management of sexually transmitted infections, family planning, partner testing and supported disclosure,

partner discordance counseling, prevention of mother to child transmission of HIV (PMTCT), and safer sex

practices including abstinence, and fidelity with correct and consistent use of condoms. In addition, BCP

combines key informational messages, training and provision of affordable health commodities. The health

commodities include free distribution of a starter kit with two long lasting insecticide treated bed nets,

household water treatment chlorine solution, a filter cloth, and water vessel, condoms and important health

information on how to prevent HIV transmission.

The BCP program is implemented through HIV/AIDS care and support organizations including those

offering pediatric care and PMTCT services across the country. Program implementation is supported by a

multi-channeled communications campaign that educates PHA on how to prevent OIs, live longer and

healthier lives through cotrimoxazole prophylaxis, prevention of diarrheal diseases using household water

treatment and safe storage, use of ITN for malaria prevention, and PWP interventions. The campaign

includes development and production of information, education and communication (IEC) materials for PHA,

health care providers and counselors. These materials include posters, brochures, positive living client

guides and stickers in eight local languages. In partnership with MOH and Straight Talk Foundation (STF),

PSI is producing spots and ‘parent talk' programs on radio. Service providers, peer educators and drama

groups are trained and are implementing activities that reinforce these messages. PSI manages the

procurement, packaging and distribution of all health commodities to ensure consistent supply of the kits

and re-supply.

Through the OVC activity, there is increased knowledge, access and utilization of BCP products and

services among children affected and infected with HIV/AIDS, their families and children vulnerable to

HIV/AIDS. Training sessions with focus on the unique needs of the OVC have expanded awareness among

health service providers on the benefits of the BCP. In FY 2007, PSI has partnered with 60 HIV/AIDS care

and support organizations in 33 districts. Sixteen of these offer PMTCT services to pregnant women while

two offer specialized pediatric care to children living with HIV/AIDS. Between April and June 2007, PSI has

distributed 307 starter kits to children living with HIV/AIDS and their families. PHA including parents and

care takers of the OVC have been actively involved in interpersonal communication (IPC) activities at

partner sites including health talks and community sensitization on HIV/AIDS prevention and care. They

have conducted 416 peer education sessions reaching an estimated 22,000 children. 89,000 IEC materials

including posters, client guides, brochures and stickers have been distributed to PMTCT and pediatric

centers. To support the IEC campaign, STF has developed and aired 2,574 radio messages in eight local

languages on 18 radio stations countrywide and 60 parent talk programs in four local languages on eight

radio stations in the eastern, western, central and northern regions of Uganda. The radio program is aimed

at providing information to the general population and PHA and their care takers in particular, on the

benefits of the basic care components. In partnership with Hospice Africa, a symptom and pain

management curriculum is under development for the BCP training manual, and will be included in the BCP

staff and peer educator trainings. Since program inception, 8,814 starter kits have been distributed to OVC.

109 health service providers and 76 peer educators have been trained on BCP with focus on the unique

needs of the OVC. Over 147,000 children have been reached with IPC activities on BCP.

Expansion of the BCP activities across USG partners has been initiated with the Plus-Up funding. This will

include the addition of 20 new HIV/AIDS care and support organizations. PSI has partnered with EGPAF

and NUMAT so as to scale up BCP implementation through the district health system. PSI is currently

carrying out a mapping exercise to clearly understand the coverage of all the partner sites and therefore the

unmet need for BCP. Through this exercise efforts will be made to suggest strategies to avoid client overlap

by the sites.

In FY 2008, OVC particularly in rural and hard - to - reach areas for example islands and conflict areas

served by USG partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps, State IMC, State IRC,

MUWRP, DOD/UPDF, Alliance, JCRC) who have newly initiated BCP activities or do not have the full range

of preventive care activities will be prioritized. 4,465 children who received starter kits in FY 2005 will have

their bed nets replaced. Other planned activities include; 1) Continue to implement the BCP program at

current sites. Expansion of BCP distribution through the PEPFAR care and treatment implementation

partners will make the BCP components available to over 200,000 PHA including 18,800 OVC throughout

Uganda by the end of FY 2008. 40,000 new PHA including 3,760 OVC will receive BCP starter kits in FY

2008. 2) Continue to make available on the market all the elements of the BCP package to enhance their

availability to all PHA. This will also help minimize stigma for the BCP commodities and services especially

the safe water vessel. 3) Development of OVC specific IEC and on going distribution of current IEC

materials to OVC and health service providers. 4) On going peer education to support uptake and utilization

of BCP components. 5) Continued support for palliative care activities, together with Hospice Africa by

production of palliative care IEC and advocacy materials, and BCC focusing on pain and symptom

management, psychological, and social support. PSI will continue to coordinate implementation of palliative

care activities as part of the BCP at HIV/AIDS support sites, and not as parallel activity. 6) Refresher

Activity Narrative: training and training for new health service providers and peer educators in preventive care and prevention

with positives initiatives. 7) On going monitoring activities to track program implementation.

Additional activities that the program will cover in FY 2008 will include; 1) Support and strengthen PWP

activities at partner sites through: regular support supervision of partner sites, partnership with SCOT to

train and mentor health service providers and assist in establishment of linkages to PWP services among

BCP partners and other service providers; 2) Improve demand for refill commodities and replenishment of

insecticide treated bed nets; 3) Work with MOH, CDC, and stakeholders to expand components of BCP to

address emerging needs of PHA e.g. TB, nutrition, HSV2; 4) Establish implementing partner regional

network system and facilitate study trips across partner sites targeting unit heads and staff involved in BCP

activities so as to learn from each others best practices as well as improve integration of BCP activities; 5)

Meaningful involvement of PHA. PSI in partnership with Alliance, NUMAT and EGPAF in selected districts

shall pilot building capacity of PHA networks in preventive care. These will be supported to follow up and

support fellow PHA on BCP adherence; 6) Increase program staff to cope with program expansion. One

person is required to oversee the implementation of PWP component of BCP and 4 assistants to support

regional activities; 7) Procure vehicles to maintain standards of supervision and commodity supply at

current and new sites; 8) Support sites to step up community component of their programs to improve on

client follow up.

Plans for program sustainability include; PSI to continue working with local manufactures to produce BCP

health commodities and scaling up of BCP activities through district health structures including PMTCT

sites.

Subpartners Total: $200,000
Straight Talk Foundation: $200,000