PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
The Uganda Ministry of Health (MOH) AIDS Control Program (ACP) conducts activities to achieve the
objectives of the Second National Health-Sector Strategic Plan, (HSSP II) 2006-2010, and the National
HIV/AIDS Strategic Plan (NSP) 2007-2012, aimed at expanding access to quality HIV prevention, care, and
treatment services to HIV infected/affected persons and their families. PEPFAR is currently supporting MOH
to undertake the following five initiatives: i) HIV Prevention, Palliative Care, Treatment and Support to
improve the quality and scale-up of HIV/AIDS programs including: coordination of local and international
partners to increase access to confidential counseling and testing, PMTCT, palliative care and treatment
services; improved integration of HIV prevention, care and treatment into comprehensive primary health
care; and, support for countrywide access to confidential HIV counseling and testing through provider-
initiated and home-based testing approaches; ii) TB/HIV integration to strengthen integrated prevention and
clinical management of HIV and TB and increase access to confidential HIV testing for TB patients and TB
diagnosis and treatment for HIV-infected individuals; iii) Policy and Systems Strengthening to identify gaps
and develop, revise and update Uganda national policies and technical guidelines for HIV/AIDS related
health services and to develop and implement policies and technical guidelines to improve the management
of TB/HIV co-infection; iv) Laboratory Infrastructure to support the national central public health laboratory to
develop policies, standard operating procedures and quality assurance and quality control process; to
conduct training and support supervision to peripheral, district and, regional laboratories; to improve access
to early infant HIV diagnosis; and, to develop the capacity for related diagnosis of HIV, TB and OI in health
center IVs and IIIs laboratories; v) Strategic Information to implement HIV/TB/STI surveillance activities and
support national and decentralized monitoring and evaluation of HIV/TB/STI programs and population-
based studies.
The PMTCT program area of the MOH includes central level activities of the national PMTCT program. The
current PMTCT policy (2006-2010) focuses on supporting the holistic implementation of the four-pronged
PMTCT strategy (primary prevention; family planning; provision of ARV prophylaxis; care and support) and
includes the consolidation of services to increase uptake, male involvement, strengthening of family
planning services, improvement of comprehensive care for HIV positive women, their spouses and their
exposed children through early HIV diagnosis and linkages to care. The program coordination and scale up
is guided by a National Advisory Committee (formerly National PMTCT Technical committee), which meets
quarterly to oversee, discuss and advise on the roll out of the program in the country. This advisory
committee has 5 sub committees (Capacity building, IEC/BCC, Community mobilization, M & E and logistics
and laboratory sub committees) with clear terms of reference related to the various technical issues
pertaining to each sub-committee. All the major donors supporting the PMTCT program
such as PEPFAR, UNICEF, WHO, USAID, UAC, UGFATM and major implementing partners (EGPAF,
PREFA and JSI/SCMS) are represented in the National advisory committee and it's subcommittees. Other
implementing partners on subcommittees include IRC, AVSI, GTZ, MSF-France, AMREF, ISS-ROME and
PLAN-Uganda. The research partners include MU-JHU and MRC that conduct informative research to
guide policy formulation and review as well as program implementation. MOH/ACP performs the overall
function of ensuring coordination of the many partners, equitable distribution of PMTCT services in the
country, ensuring the implementation of the decisions taken by the National Advisory Committee, reviews
and updates the policy, implementation guidelines and training package as need arises. MOH also
supports capacity building at national and regional level and supports the districts in development of their
work plans to priorities HIV/AIDS activities. Regarding the logistics and supplies for the PMTCT program,
the STD/ACP with technical support from JSI/SCMS/DELIVER handles the Procurement Supply chain
Management (PSM) plan that includes product selection, forecasting, procurement, planning, inventory
management and rational use of medicines. MOH is also mandated to ensuring quality of the PMTCT
services provided and this is usually achieved through technical support supervision to the districts as well
as through inter-district coordination meetings. The MOH is also supposed to conduct operations research
to inform program implementation, monitoring and evaluation.
During FY2008, MOH PMTCT program was involved in the dissemination of the revised PMTCT policy
guidelines and provision of technical support supervision to the districts and together with the implementing
partners provided oversight during the intra-district scale up of PMTCT services. By June 2008 a total of
596(51%) of health facilities up to HC III were providing PMTCT services (99% of Hosp, 94% of HC IV, 31%
of HC III and 3.2% of HC II) with support from USG and other partners. The National Program now
prioritizes scaling the services to all HC III by 2010 and to improve the quality of PMTCT data being
collected. The PMTCT program was also evaluated this year and the report is available. The program
intends to implement most of the recommendations from this report as well as the recommendations from
The joint review of the PMTCT and Pediatric HIV/AIDS program in the FY2009 and FY2010.
During FY 2009, MOH aims at strengthening capacity for delivery of PMTCT services in line with the HSSP
II and revised PMTCT policy guidelines 2006-2010. Overall national targets are to reach 80% of HC III in
financial year 2009/2010; provide counseling and testing to 80% of pregnant women through routine opt out
approach; reach 100% prophylaxis coverage for mothers and 60% for babies; improve uptake of
combination regimens from 20% to 50%; increase HAART coverage for eligible pregnant women from the
current 7% to 15% by 2010. Intra-partum single-dose Nevirapine (SD-NVP) prophylaxis will also be
implemented as stipulated in the revised PMTCT policy. The specific activities for FY 2009 are: i) continue
to disseminate the current revised PMTCT policy guidelines as well as the revised implementation
guidelines to the district health workers at the PMTCT sites. ii) Initiate the process of revising the current
PMTCT policy guidelines to incorporate new developments including new CD-4 T cell counts cut off points
for ART initiation among pregnant women and Pediatric ART treatment guidelines. iii) In 2007, UNICEF
supported revision of infant feeding policy guidelines and their dissemination will continue this year. iv)
strengthen the Monitoring and Evaluation components of the program by reviewing/updating, printing and
dissemination of M & E tools, protocols and job aids for overall PMTCT implementation. This includes the
integrated RH/PMTCT registers and program monitoring and reporting tools. Data management, reporting
and utilization at sub national levels will be strengthened and supported, v) strengthen regional and district
supervision teams through regular or targeted technical supervisions to the districts as well as through
revision, updating and dissemination of the integrated RH/HIV/AIDS supervision tool. vi) WHO supported
the program to update the PMTCT Training package in line IMAI/IMPAC WHO training curriculum. The
latest version is ready for field testing and finalization and in FY 2009 we shall conduct refresher training for
trainers on the revised materials as part of the expansion of services to HC IIIs. vii) The early infant
diagnosis program (EID) which began in FY 2006 will be strengthened and expanded with the goal to reach
80% of the HIV exposed infants in 2009/2010. The MOH will provide supervision and monitoring to ensure
Activity Narrative: that HIV infected children are linked to Pediatric AIDS care, treatment and support services within the health
facilities. Viii) Strengthen integration of PMTCT into care and treatment programs through harmonization
and collaboration with RH and ART programs to support linkages, ix) strengthen supply chain management
for PMTCT commodities through supporting PSM plan including support for the storage and distribution of
donated products, ix) Hold regular coordination and collaborative meetings with the donors and
implementing partners. x) Print and disseminate the revised and updated Family/Psychosocial support
strategy as part of innovations to improve male involvement and uptake of PMTCT services in general. xi)
review, update, print and disseminate the communication strategy for PMTCT. xii) Review and update the
existing VHT guidelines to include PMTCT. xii) Peer support groups for PMTCT clients will be established
through the involvement of NGOs, CBOs, FBOs and the private sector. This will also include support to HIV
negative pregnant women and their spouses to remain HIV negative. MOH will provide overall
programmatic oversight on these activities xiii) Strengthening the linkage between health facilities and
communities including streamlining referrals and guideline for linkage. xv) Support the national officers to
participate in conferences and short courses to update their skills.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13293
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13293 4402.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $350,000
Disease Control & Uganda National
Prevention HIV/AIDS/STD/T
B Prevention,
Care,
Treatment,
Laboratory
Services,
Strategic
Information and
Policy
Development
8341 4402.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $299,897
4402 4402.06 HHS/Centers for Ministry of Health, 3342 1259.06 $94,914
Disease Control & Uganda
Prevention
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $120,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
The Uganda Ministry of Health (MOH) AIDS Control Programme (ACP) conducts activities to achieve the
HIV/AIDS Strategic Plan (NSP) 2007-2012, which are aimed at expanding access to quality HIV prevention,
care, and treatment to HIV infected persons and their families. This cooperative agreement specifically
supports the MoH to undertake the following five initiatives: 1) HIV Prevention, Palliative Care, Treatment
and Support initiatives to improve the quality and scale-up of HIV/AIDS programs including: coordination of
local and international partners to increase access to confidential counseling and testing; PMTCT, palliative
care and treatment services; improved integration of HIV prevention; care and treatment into
comprehensive primary health care; and, support for countrywide access to confidential HIV counseling and
testing through provider-initiated and home-based testing approaches; 2) TB/HIV integration initiative
strengthens the prevention and clinical management of both illnesses; while increasing access to
confidential HIV testing for TB patients,and provides TB diagnosis and treatment for HIV-infected
individuals; 3) Policy and Systems Strengthening initiatives are used to identify gaps and assist in
developing, revising and updating the Ugandan national policies and technical guidelines for HIV/AIDS
related health services; creating improved management of TB/HIV co-infection and other Opportunisitic
infections; 4) Laboratory Infrastructure initiative supports the national central public health laboratory
(CPHL) to develop policies, standard operating procedures, quality assurance and quality control process.
The CPHL is able to conduct training and provide supervision to peripheral, district and, regional
laboratories; improving access to early infant HIV diagnosis (EID). Simliarly, this intative supports
strengthening capacity of health center IVs and IIIs laboratories to diagnose HIV related HIV, TB infection.
5) Strategic Information initiative supports the HIV/TB/STI surveillance activities, monitoring and evaluation
of national and decentralised HIV/TB/STI programs and population-based studies, and support to the
resource centre.
Under previous support, the national Information, Education and Communication/Behavior Change
Communication (IEC/BCC) strategy has been critical in facilitation of the behavior change process. Many
activities are done in collaboration with other MoH partners; UNICEF, WHO, GLIA, UNFPA, the Global Fund
and with the Distirct DHTs. The IEC/BBC plays a significant role in promoting the uptake and utilization of
existing services; increasing over time and in scope and variety. The program creates awareness,
influencing attitudes and beliefs, as well as promoting skills.
In FY 2008, 20,000 people received HIV/AIDS information through IEC/BCC and 1,500 were referred for
services; In support of behavior change interventions through media, MoH provided capacity building
activities for IEC partners in 20 local media outlets.
The MoH also accomplished advocacy meetings on male medical circumcision (MMC) in the Eastern and
Northern regions. MMC educational sessions were held for 120 district leaders (cultural, political,
administrative, technical (DHT), local surgeons (traditional circumcisers) to promote In addition, MoH
conducted 20 community film shows in 4 strategic fishing locations along Lake Victoria and at long-distance
truck drivers parking sites in Katuna (south western Uganda), Naluwerere (eastern Uganda), and Mbuya,
(central region).
The IEC/BCC unit procured and distributed ABC promotion materials (2,000 bags for community condom
distributors and penile models to 240 community condom distributors in 6 districts and provided technical
supervision to interventions conducted in 10 districts.
The STI unit trained a district STD trainers from ten districts; held orientation meeting for MCH, antenatal
and family planning providers in syphilis screening and syndromic STD case management in 8 districts,
and supported on 52 radio sessions on two radio stations to educate the community about STI .
The challenges in FY2008 were bureaucratic delays in procurement of both goods and services. More
activities were planned but could not be carried out as scheduled. Mass production of IEC materials was not
made, and no logo condoms procured with support from UNFPA and USAID were not popular among
users.
In FY 2009 the activities will continue. Sexual prevention will cover IEC/BCC, condom promotion and the
management of Sexually Transmitted Infections (STIs). The implementation these project interventions, will
be consistent with the country's efforts in scaling up a comprehensive integrated approach to HIV
prevention. The focus of the IEC/BCC during this period will address the key emerging issues including:
medical male circumcision, HIV discordance, high prevalence of Herpes Simplex type II infection, multiple
concurrent partnerships, cross-generational sex, transactional sex and gender based violence. Similarly,
IEC/BCC and condom promotion continue to play critical roles in ensuring the adaptation of risk reduction
behaviors and in the promotion of the utilization of HIV and AIDS services. Consistent with the MoH
mandate, the activities will focus on capacity building, development and dissemination of guidelines. These
activities will include: production and distribution of print IEC/BCC materials including condom promotional
materials; training of district focal persons on IEC/BCC; advocacy meetings on safe male medical
circumcision; training of condom focal persons and promoters in districts; holding interactive radio talk
shows, dissemination of guidelines through the life planning handbook and peer-educators handbook;
development of HIV/AIDS mobilization guide for village health teams; producing educational films, and
providing technical support supervision.
The management of sexually transmitted infections (STI) in health facilities is another important area in
sexual prevention. STI syndromic case management remains the main stay of approach in Uganda. MoH
will support building STI case management capacity at the district level via the following strategies: training
of trainers programs, providing STI prevention education and information at the community level, and
improve the STI drug supply. The training of STI trainers at district level, will reach more districts and
supporting integrated HIV and reproductive health services -
UNICEF & WHO will specifically support the revision of comprehensive HIV/AIDS communication strategy,
medical male circumcision advocacy strategy, and IEC/BCC promotion materials for male circumcision.
GLIA, Global Fund MJAP/CDC /PEPFAR and UNFPA will focus their attention on the most at risk
populations such as, sex workers and truck drivers to promote healthier sexual behaviors. The District will
implement the activities.
New/Continuing Activity: New Activity
Continuing Activity:
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Military Populations
Refugees/Internally Displaced Persons
Table 3.3.03:
supports the MOH to undertake the following five initiatives: 1) HIV Prevention, Palliative Care, Treatment
The main role of the Infection Control Unit of the MOH is to prevent medical transmission of HIV/AIDS;
where injection safety is a key component. The infection control program targets all health care settings but
needs to begin addressing medical transmission of HIV in the community; given the expansion of home-
based care services for AIDS patients.
In FY 2008, MOH, with additional support from WHO and the Making Medical Injection Safe (MMIS) Project,
continued to build the capacity at the district level to initiate and implement Infection Prevention Programs.
Post Exposure Prophylaxis (PEP) policy guidelines were printed and distributed to all hospitals and Health
Centre IVs and PEP implementation guidelines are ready for dissemination. A review of the infection
prevention and control audit tool based on National standards was completed. Work on the development
of TB/HIV co infection assessment tool is progressing. Thus far, 856 health providers from 10 districts
were trained, to use the new injection devices; technical support and supervision has been offered to 8
district hospitals. The main challenges in FY2008 was delay in getting funds for the acctivites, lack of
understanding if nosicomial infections and lack of awareness of infection prevention among communities.
In FY 2009, a number of activities that started in FY 2008 are expected to continue. Training of trainers in
comprehensive infection prevention will continue; 80 health workers on infection control committees will be
trained to support and educate other health providers on this topic in their facilities. Approximatley 20
hospitals will be assessed on their capacity to perform HIV/TB collaborative activities, and adhere to
Standard Precautions in relation to TB infection prevention. Through this initiative, two TB/HIV co-infection
awareness workshops will be conducted; 200 hospital managers and 80 health workers will be targeted and
trained in TB/HIV co infection prevention and management.
Continuing Activity: 13295
13295 4405.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $200,000
8344 4405.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $200,000
4405 4405.06 HHS/Centers for Ministry of Health, 3342 1259.06 $65,466
Health-related Wraparound Programs
* TB
Table 3.3.05:
Under previous support, the Ministry of Health has trained health workers from district health facilities in
comprehensive HIV/AIDS care and management of ART. Health workers trained included medical officers,
clinical officers, nurses, counselors and nursing assistants who provide direct HIV care and treatment.
Todate over 3000 health workers have been trained in ART provision. In addition, longitudinal data
management has been supported, updating, production and dissemination of ART data management tools,
mentoring of staff in ART data management, supporting supervision to all accredited health facilities
providing ART services including their management of longitudinal data. The MOH also led the national
treatment workgroup in the review and updating of the national ART policy, treatment guidelines and
training materials that have been completed. The next step will be updating of ART data management tools
and reporting forms and strengthening the data management and treatment outcome system. The Care and
support program has obtained support from WHO, USG, GFATM and UNICEF. In FY2008, health facilities
accredited to offer ART increased from 305 to 358. 100 District TB/HIV managers from 10 districts and 60
health workers from 10 problem districts were trained in the IMCI/HIV complementary course. In addition,
24 health workers from sites with low enrolment of children into HIV care were attached to PIDC and
Mildmay and post-training supervision will be carried out in 12 districts that were trained in the IMCI/HIV
Complementary course. A total of 160 people comprising HMIS officers, ART district coordinators and
health workers will be trained in data management and cohort analysis. In addition, data quality audits for
ART will be carried out in 20 health facilities and 40 sign language instructors trained in comprehensive HIV
prevention and care and sites with weak history of ART data management and reporting will be supported.
Under the HIVQUAL and HCI program, the MoH had established HIV Quality of Care activities in 226 sites.
The program developed an HIV Counseling and Testing module which will be piloted in ten health facilities.
The HIVQUAL program initiated 20 more facilities into quality improvement, assessed and built quality
management infrastructure in 130 health facilities from 40 districts, conducted 600 coaching and mentoring
sessions, 10 continuous quality improvement trainings in 4 regions for total of 180 of health workers, 8 data
management trainings in 4 regions for 120 data management staff , 4 regional learning network meetings,
trained 120 trainers of trainees, sensitized 40 districts and 70 national stakeholders, supported data
collection and reporting tools at 130 health facilities, supported 40 districts to monitor the implementation of
quality improvement activities. The final draft ART treatment guidelines were produced and should be ready
for dissemination .
In FY 2009, activities under this program shall continue. New and selected districts affected by staff attrition
and transfers will be supported to conduct comprehensive HIV care training including ART and the IMCI
Complementary HIV course. Post-training support supervisions for health facility staff from 20 districts
trained in HIV care, ART and data management will be carried out two weeks after each district-level
training. These support supervision visits will also contribute to the process of accreditation of newly trained
facilities as ART sites. An additional 40 new health facilities will be accredited to provide ART services. An
additional 40 ART sites will be involved in monitoring and evaluation including ART cohort tracking and data
analysis. New sites will be trained in data management for enrolled cohorts using standardized tools.
Mentoring and support supervision of existing ART sites will be carried out as part of quality improvement
coaching activities. Data quality audits will be carried out as part of mentoring activities. Districts with health
facilities that have low enrollment of children into HIV care will be supported to provide placements for some
of their staff in Mildmay Center and the Pediatric Infectious Disease clinics. A total of 30 health facilities will
be supported to improve pediatric HIV care and treatment. The program aims at strengthening districts and
regional level systems to support and sustain quality improvement activities. District health teams supported
by central HIVQUAL staff shall provide 600 coaching and mentoring sessions. Central HIVQUAL teams
shall conduct 12 sessions of QI training for 320 health workers and train 120 additional workers in data
management. The program will roll out quality improvement activities to an additional 20 facilities providing
HIV care with Anti retroviral treatment. The revised ART treatment guidelines will be also be disseminated
to all health workers at the ART sites. In collaboration with stakeholders, the program will review quality of
care indicators including HIV Counselling and testing indicators. The program will continue to implement
regional learning networks to promote peer learning and sharing, coaching and mentoring, districts and
regional facilities.
Continuing Activity: 13296
13296 4404.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $331,625
8343 4404.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $331,625
4404 4404.06 HHS/Centers for Ministry of Health, 3342 1259.06 $276,354
Table 3.3.08:
This is not new activity but a continuation of Activity Number 4407.08
laboratories; improving access to early infant HIV diagnosis (EID). Similarly, this initiative supports
clinical officers, nurses, counselors and nursing assistants who provide direct HIV care and treatment. To-
date over 3000 health workers have been trained in ART provision. In addition, longitudinal data
support program has obtained support from WHO, USG,GFATM and UNICEF. In FY2008, health facilities
to all health workers at the ART sites.. In collaboration with stakeholders, the program will review quality of
care indicators including HIV Counseling and testing indicators. The program will continue to implement
Table 3.3.09:
for dissemination.
Table 3.3.10:
This is not a new activity, but a continuation of Activity Number 4407.08
and reporting forms and strengthening the data management and treatment outcome
system. The Care and support program has obtained support from WHO, USG,GFATM and UNICEF. In
FY2008, health facilities accredited to offer ART increased from 305 to 358. 100 District TB/HIV managers
from 10 districts and 60 health workers from 10 problem districts were trained in the IMCI/HIV
complementary course. In addition, 24 health workers from sites with low enrolment of children into HIV
care were attached to PIDC and Mildmay and post-training supervision will be carried out in 12 districts that
were trained in the IMCI/HIV Complementary course. A total of 160 people comprising HMIS officers, ART
district coordinators and health workers will be trained in data management and cohort analysis. In addition,
data quality audits for ART will be carried out in 20 health facilities and 40 sign language instructors trained
in comprehensive HIV prevention and care and sites with weak history of ART data management and
reporting will be supported. Under the HIVQUAL and HCI program, the MoH had established HIV Quality of
Care activities in 226 sites. The program developed an HIV Counseling and Testing module which will be
piloted in ten health facilities. The HIVQUAL program initiated 20 more facilities into quality improvement,
assessed and built quality management infrastructure in 130 health facilities from 40 districts, conducted
600 coaching and mentoring sessions, 10 continuous quality improvement trainings in 4 regions for total of
180 of health workers, 8 data management trainings in 4 regions for 120 data management staff , 4 regional
learning network meetings, trained 120 trainers of trainees, sensitized 40 districts and 70 national
stakeholders, supported data collection and reporting tools at 130 health facilities, supported 40 districts to
monitor the implementation of quality improvement activities. The final draft ART treatment guidelines were
produced and should be ready for dissemination .
Table 3.3.11:
HCT remains the cornerstone for HIV prevention, control, care and support interventions. HCT is a
prerequisite for all core medical interventions such as ART, PMTCT, and Prophylaxis. The HSSP II and
NSP recommend an increase in identification of infections for early diagnosis, treatment and positive
prevention to reduce transmission. To maximize benefits of HCT it is necessary to increase coverage and
access to these services delivered based on national and international standards.The demand for HIV
testing is high and access to HCT has increased from 12% in 2004/2005 to 25% in 2006(UDHS 2006).
Previous support under this activity, all HCT approaches and practices in service planning, development
and implementation have been standardized albeit the challenges . These include Stand alone VCT,
Provider initiated couselling and testing and home based HCT . However because of evolution of events
and experiences there is needed to update these standards. In 2005 , a revised HIV National Counseling
and Testing policy which adopted key HCT approaches: routine provider-initiated opt-out; home-based and
client-initiated VCT; post-exposure prophylaxis and, considerations for testing children under 18 years of
age was developed and disseminated.
With rapid expansion of HCT over 600 sites (including all hospitals and HC IV, and 40% of HC III), HCT
data was integrated into the in the national HMIS data collection systems. The national HCT coordination
committee (CT17) was expanded from 17 members to over 30 stakeholders. They meet and identify
successes and challenges in the CT implementation and help in standardization of HCT approaches in
Uganda. MOH supported the launch of several counseling and testing and prevention curricula through the
TASO/SCOT project. MOH and MJAP supported training and roll out of PITC at five regional hospitals.
Some of the challenges faced in FY 2008 were lack of human resouces, lack of HIV test kits, and delayed
disbursement of funds.
In FY 2009 the thrust at national level will be responsive to accelerating HCT to facilitate universal access to
care and treatment. The policy guidelines last reviewed in 2005 will be updated in line with HSSP indicators
and other coverage indicators e.g. ART and PMTCT access and country demand for HIV testing. Several
coordination/planning meetings will be major activities. The technical coordination committees shall review
and update the national approved testing algorithms.. To sustain data collection in the HMIS, tools will be
produced and distributed to all service points. Given that only 40% of HC III currently provide HCT services
and yet the HSSP 2 target is 100% HC II, this activity will support the expansion of HCT to about 50% of HC
IIIs by 2010. Support under this activity directly relates to all other activities supported by the USG through
PEPFAR as well as other HCT and other activities supported by other bilateral and multilateral development
partners in the country. In response to the need to target couples and MARPS with HIV prevention and CT
services, MOH in collaboration with Health Communication Partnerships (HCP), AIDS Information Centre
(AIC) and other stakeholders will provide oversight to the ‘Know your HIV status' campaign targeting
couples and MARPS. MOH will also provide oversight for HCT training using the training standards that
were launched in FY2008.
Continuing Activity: 13297
13297 4403.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $60,000
8342 4403.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $60,000
4403 4403.06 HHS/Centers for Ministry of Health, 3342 1259.06 $49,154
Table 3.3.14:
ACTIVITY UNCHANGED FROM FY 2008
treatment to HIV infected/affected persons and their families. Specifically this cooperative agreement
supports the MOH to undertake the following five initiatives: i) HIV Prevention, Palliative Care, Treatment
and Support to improve the quality and scale-up of HIV/AIDS programs including: coordination of local and
international partners to increase access to confidential counseling and testing, PMTCT, palliative care and
treatment services; improved integration of HIV prevention, care and treatment into comprehensive primary
health care; and, support for countrywide access to confidential HIV counseling and testing through provider
-initiated and home-based testing approaches; ii) TB/HIV integration to strengthen integrated prevention
and clinical management of HIV and TB and increase access to confidential HIV testing for TB patients and
TB diagnosis and treatment for HIV-infected individuals; iii) Policy and Systems Strengthening to identify
gaps and develop, revise and update Uganda national policies and technical guidelines for HIV/AIDS-
related health services and to develop and implement policies and technical guidelines to improve the
management of TB/HIV co-infection; iv) Laboratory Infrastructure to support the Central Public Health
Laboratory (CPHL) to develop policies, standard operating procedures and quality assurance and quality
control processes; to conduct training and support supervision to peripheral, district and, regional
laboratories; to improve access to early infant HIV diagnosis; and, to develop the capacity for related
diagnosis of HIV, TB and OI in health center IV and III laboratories; v) Strategic Information to implement
HIV/TB/STI surveillance activities and support national and decentralized monitoring and evaluation of
HIV/TB/STI programs and population-based studies.
Since FY06, with support under this activity, the MOH has been carrying out activities to strengthen
laboratory services in Uganda. The main areas of focus have been: strengthening the capacity of the CPHL
to coordinate health laboratory services, early diagnosis of HIV infection among infants (EID), external
quality assessment schemes (support supervision/proficiency testing), in-service training in HIV rapid
testing, T.B microscopy, and laboratory management; and Laboratory information management systems
(LIMS). As part of the support, CPHL has been able to rent office and laboratory premises and has procured
reagents, supplies and equipment. In addition, the technical and administrative capacity at CPHL has been
strengthened by hiring a Project officer (Laboratories), as a Technical Advisor, Training Coordinator, 2
laboratory assistants, 2 technologists and 10 support staff. The intractable problem of laboratory space will
soon be solved by construction of a new CPHL building using a USD 1.5M PEPFAR award. Construction is
expected to commence during 08/09. In collaboration with the FIND project, the development of the
national health laboratories policy that started in FY06 will be finalized during FY08/09. EID now reaches
150 health facilities and under this program, 15,000 babies have been tested. The program will expand to
220 facilities allowing 28,000 babies to be tested by the end of FY 2008. Support supervision is now
conducted regularly in collaboration with district personnel with each of 1002 government and NGO labs
visited quarterly. Currently, 120 labs participate in the CPHL administered proficiency testing scheme for
HIV testing and for tests for diagnosis of opportunistic infections; the number is expected to rise to 250 by
the end of FY 2008. In collaboration with CDC, a proficiency testing scheme is being run for 64
laboratories for CD4+ counting and automated chemistry/haematological tests for HIV monitoring. In FY
2008/09, CPHL will support a maintenance contract for the automated chemistry/haematology equipment in
government facilities. To support data collection, an electronic database (LIMS) has been established at
CPHL. The system is fed by computers and PDAs installed at districts and by the end of FY 2008/09 a total
50 districts will be covered Several documents including an HIV rapid testing manual, laboratory SOPs,
safety guidelines, a T.B smear microscopy training manual, a laboratory management training manual and
laboratory quality assurance guidelines have been developed or customized for use in Uganda. In-service
training has been conducted for trainers and service providers. To date, 1264 have been trained in HIV
rapid testing with support from this activity and funding from other partners), 105 in laboratory
management/quality assurance and 60 in T.B smear microscopy. CPHL will embark on a scheme to
promote the capacity of regional laboratories to diagnose opportunistic infections particularly
bacterial/fungal cultures through procurement of equipment and supplies, and mentoring of the labs; one
regional laboratory is targeted for FY 2008/09. The CPHL has continued to support activities of the National
Health Laboratories Advisory and Technical (LTC) sub-committees to advise the ministry on effective
management of laboratory services in the country.
During FY 2009, under this activity, the focus of laboratory services and quality improvement activities will
be to strengthen EID, LIMS, EQA, in-service training and overall coordination of laboratory activities.
Central coordination of national laboratory activities will require funds for renting of premises, utilities, staff
costs, transport and communication. The LTC subcommittee will be supported to advise MOH on technical
and policy issues of laboratory services. A functional EID program is critical in ensuring timely care for
infected babies; it will be scaled up to cover 220 facilities nationwide and reach 28,000 babies during FY
2009. This requires training of facility personnel, courier services and coordination meetings. Supplemental
support shall come from the Clinton Foundation and UNICEF. LIMS data is critical for forecasting of
laboratory supplies including HIV test kits, reagents for ART monitoring and diagnosis of opportunistic
infections. During FY09/10, the number of districts on the electronic data collection and delivery system
(PDAs and computers) shall be scaled up to 80. The LIMS database should be integrated in the HMIS.
Technical laboratory support supervision shall continue both at district and central level using the network of
District Laboratory Focal Persons and personnel from CPHL and other national institutions. A total of 1002
labs nationwide shall be targeted, focusing on HIV testing, logistics management and EID in addition to
routine laboratory activities. In collaboration with UVRI, the proficiency scheme for HIV testing and
opportunistic infections tests shall be scaled up to cover 400 of the 1002 government and NGO laboratories
nationwide. To ensure continuous functioning of automated equipment for HIV monitoring, an equipment
maintenance contract and supplies shall be procured for 25 government facilities. CPHL will continue to roll-
out HIV rapid testing with 340 service providers trained as we work towards the goal of 3,500 nationwide.
Other areas of training shall include T.B smear microscopy (200 personnel) and laboratory management
using the ‘Job Task Based Approach' (60 personnel), EID (200 personnel). Training shall be done in
collaboration with a number of PEPFAR-supported partners including Uganda Health Marketing Group,
Activity Narrative: AMREF and the National T.B Reference Laboratory. Regional laboratories shall be strengthened and a
laboratory referral network developed that would facilitate supervision and coordination of national
laboratory activities; during FY09/10, an additional 2 regional laboratories (Mbale and Gulu hospitals) shall
be equipped and mentored for this purpose. Support under this activity directly relates to all other activities
supported by the USG through PEPFAR as well as other HIV/AIDS activities supported by other bilateral
and multilateral development partners in the country.
Continuing Activity: 13299
13299 4408.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $2,025,000
8347 4408.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $1,875,000
4408 4408.06 HHS/Centers for Ministry of Health, 3342 1259.06 $855,000
Estimated amount of funding that is planned for Human Capacity Development $467,000
Table 3.3.16:
The MOH SI activity provides accurate data to inform both the strategic planning and monitoring and
evaluation (M&E) for HIV prevention, care and treatment, as well as broaden integrated health sector
programs. The MOH SI activity also support elements of STI surveillance, behavioral surveillance, and
AIDS case surveillance as part of monitoring of the ART program. STI surveillance and STI case reporting
is done through the national universal reporting system (HMIS). The PEPFARsupport has improved the
implementation of second generation HIV surveillance, M&E, and public health evaluation. A strengthened
surveillance system is particularly important in light of the current trends of HIV prevalence. The surveillance
sites use enhanced methods to continually observe HIV trends, as well as estimate the overall burden of
HIV/AIDS in Uganda thorough mathematical modeling; which supports setting of potential targets and
impacts of prevention and care programs.
In FY2008, The MOH HIV surveillance system was expanded from 25 to 30 sentinel surveillance sites in
several districts. The 2007 sentinel survey round was successfully implemented and samples collected and
shipped for central laboratory testing. A protocol for a behavioral surveillance survey among fishermen was
written and submitted to CDC Atlanta for review. Policy briefs from recommendations of he 2004-2005
serobehavioral survey were finalized and disseminated to key stakeholders. Working papers and some
manuscripts were completed and published . The M&E system was evaluated with support from GFATM. A
technical working group on HIV drug resistance (HIVDR) was appointed and data on HIVDR early warning
indicators from 4 sites were presented to stakeholders. The initial discussions and planning for the 2009
AIDS and Malaria indicator survey were held.
The national Health Information Management System(HIMS) is being supported through a two pronged
approach: 1) the training of sentinel, district, and sub-district surveillance staff, and 2) through the collection,
analysis and dissemination of data, as well as direct support to the Resource Centre.
HIV sero-prevalence surveys have been started amongst selected high risk groups such as sex workers,
fishermen, and truckers. These surveys will assist in updating relevant surveillance protocols and obtaining
institutional ethical approvals for continued surveillance. Support under this activity directly relates to all
other activities supported by the USG through PEPFAR as well as other HIV/AIDS activities supported by
other bilateral and multilateral development partners in the country.
During FY 2009, this activity will continue to improve the second generation HIV surveillance program,
M&E, and the HMIS. Sero-prevalence data from ancillary sources including: programmatic data, HIV
Counseling and Testing (HCT), PMTCT and blood transfusion services and secondary data will be
collected. The MOH has the lead role in the Uganda Malaria and AIDS indicator survey and hope to initiate
fieldwork this year. The HIV and STI antenatal surveillance will be strengthened including training of sentinel
site staff from 30 ANC sentinel sites, collection of biological samples and data, procurement of test kits,
laboratory testing and quality assurance, data management and analysis as well as dissemination of the
surveillance reports.
The HMIS will be strengthened to support STI and AIDS case reporting through training of sentinel, district,
sub-district based, and resource centre staff in collection, analysis and dissemination of data. The activity
will regularly collect HIMS data and integrate M&E from health sector HIV programs including: STI,
PMTCT, ART, HCT, condom promotion, ABC programs and AIDS treatment data. The HIMS data
integration project, will strengthen the country's monitoring and surveillance system During FY 2009, efforts
to implement activities in the national strategy for HIVDR surveillance will be supported. Technical support
to districts and other organizations will continue to be provided, in order to improve competence for local
M&E teams; with emphasis on output and process monitoring. Program indicators for output, process,
outcome, and impact monitoring will be reviewed and updated; particularly taking into account emerging
program areas such as ART, cotrimoxazole prophylaxis, and TB/HIV collaborative activities. Utilization of
M&E and surveillance data will continue to be strengthened through appropriate training of users and
enhanced dissemination of M&E findings. Data collection and management of ART longitudinal data (from
client follow-ups), including cohort analysis to provide data on treatment outcomes will be done. MOH will
assist with facility level data collection, compilation, analysis and reporting of ART data; as it is reported
regularly to districts and sub-district levels MOH will be able to provide support supervision and technical
assistance to service delivery sites. Futhermore, this activity will improve data management for the
Activity Narrative: STD/ACP data unit and Resource centre including procurement of relevant hardware and software,
supporting internet connectivity and incorporating geo-referencing in surveillance and programme
monitoring activities.
The training component will create continuity in quality improvement of integrated HIV prevention care and
support programs. Support under this activity directly relates to all other activities supported by the USG
through PEPFAR as well as other HIV/AIDS activities.
additional narrative to existing text
The HMIS of the Ministry of Health largely depends on data sent forward by districts. Districts, under the
decentralization process are required to collect data from individual health facilities, aggregate it and
forward it to the Ministry of Health. They are also expected to analyze the data at district level and make
interventions, if necessary.
The activities to be carried out require infrastructure and human resources, such as computers, electronic
HMIS systems and training. In general, districts are under funded to perform all required HMIS activities,
and some districts are being supported through district-based programs, such as NUMAT. Other districts
receive support directed at health clinics within the district, but may not be directly supported to carry out
their HMIS activities. Focused support activities are necessary to build a functional HMIS. Sharing of
experiences may be undertaken across districts that receive support through district based programs and
those under the currently proposed support in a bid to create unified USG approaches to HMIS support.
This activity proposes to provide some support, as described below, to build capacity within districts that do
not directly benefit from a district-based program. Furthermore, this activity is expected to further strengthen
the Resource Centre to carry out the activities mentioned below.
Tasks
The following tasks are proposed as part of the activity:
§ Improve district capacity in the analysis and use of district-based HMIS and program data
§ Supplement district HMIS budgets in districts with Non USG supported programs.
§ Provide training to national and district-based HMIS focal person in the use of HMIS and the available
electronic HMIS system supporting software
§ Install an electronic HMIS system in districts with computers without any software, and repair/restore
electronic HMIS systems in districts where a system was installed, but are no longer working
§ Facilitate support supervision by national level to districts and districts to service sites to improve point-of-
care data collection
§ Provide guidance and leadership to districts served by district-based programs (such as NUMAT) in order
to improve HMIS capacity
§ Support and facilitate the revision of tools as part of HSSPIII development process, and the national
information strategy (Vision 2012)
Indicators
§ Number of data use workshops carried out and number of people in attendance; § Number of district
supplemented with HMIS funds and amounts provided; § Number of districts reporting electronically to the
national level after 6 and 12 months; § Number of district-based and HQ people trained in HMIS activities; §
Number of support supervision activities carried out; Further outputs; § Quarterly progress reports; §
Monthly national HMIS summaries shared from the district data
Continuing Activity: 13300
13300 4406.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $740,000
8345 4406.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $739,862
4406 4406.06 HHS/Centers for Ministry of Health, 3342 1259.06 $672,602
Program Budget Code: 18 - OHSS Health Systems Strengthening
Total Planned Funding for Program Budget Code: $7,884,091
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The USG is working collaboratively with the UN systems, bilateral, and multilateral partners in supporting the Uganda AIDS
Commission (UAC) on the implementation of the three ones (i.e., one national plan - the National Strategic Plan, one national
M&E system and one coordinating authority) in the response to HIV/AIDS in Uganda. Support is also being extended to key line
ministries for policy development and program implementation, human resource capacity development, institutional capacity
enhancement for indigenous organizations, and supporting democracy and governance programming, especially for decentralized
HIV/AIDS response.
A. National leadership and coordination
The USG continues to engage with the UAC in spear heading mobilization of resources for HIV/AIDS programs. In 2008, with
USG support the UAC started the operationalization of the five-year National Strategic Plan as well as the development of a
Performance Monitoring and Management Plan. These are key guiding instruments against which progress can be measured and
future strategies developed. In collaboration with UNAIDS and other AIDS development partners, the USG will continue to provide
support to strengthen the capacity of the UAC to effectively lead the national response.
USG will continue to support the Government of Uganda to reorganize governance structures and implementation arrangements
for the management of the Global Fund resources. Work is in progress to support UAC to ensure that GFATM funds for HIV/AIDS
activities for government and non-governmental partners are channeled through the Civil Society Fund (CSF) that will be
managed by UAC-Partnership Committee. USG/PEPFAR is contributing financial and technical management support on behalf of
the development partners. The resource envelop for the CSF is expected to grow larger due to the three recently approved
proposals. Proper management of these resources will position the CSF as a reliable and effective structure for channeling
resources to civil society organizations.
B. Policy development and implementation
USG provides technical and financial support to MOH to meet its mandate of developing policies, standards and technical
guidelines for the provision of quality health services. All PEPFAR working groups are represented on all MOH's technical
committees that develop, review and update policies and technical guidelines. Some of the technical policies and guidelines so far
developed include: the National Policy documents for ART, HCT, PMTCT, Nutrition in HIV/AIDS and Home-based Care, HIV/TB
Collaboration, Cotrimoxazole Prophylaxis for People with HIV/AIDS, Post Exposure Prophylaxis, Infant Feeding guidelines,
Communication Strategy for ART and TB/HIV Collaboration, the National ART Scale up Plan, and the National Condom Use and
Distribution Guidelines among others. These policies and guiding instruments directly support service delivery and uptake of HCT,
ART, HBC, PMTCT, and TB management.
In FY09, USG will continue to support MOH to complete unfinished policies and technical guidelines as well as to develop, update
and disseminate these instruments in all regions. Priority will be given to developing new policies and guidelines for: Medical Male
circumcision, Isoniazid prophylaxis, Positive Prevention, and HSV2 management. With the availability of new information and
rapid development of new technologies, the MOH has plans to review and disseminate the following policies: the revised national
HCT policies and related guidelines, ART implementation guidelines, STI treatment guidelines and in-service training manuals,
and PMTCT implementation guidelines.
The Ministry of Gender Labor and Social Development has recently developed an HIV/AIDS in the workplace policy that is
currently under review by Cabinet. The new follow-on private sector initiative will support the GOU to roll-out and implement the
HIV/AIDS workplace policy through the private sector. Building on previous successes, this activity will continue to assist mid to
large size employers to establish and or improve workplace policies, with a particular focus on supporting the delivery of
prevention programs and improving access to critical care and treatment programs for employees, their families and respective
communities.
C. Human Resources for Health
HRH policy and planning. To ensure an adequate health workforce for integrated HIV/AIDS and health services, the Capacity
Project (CP) will continue to support the central and district levels to strengthen systems for effective performance-based health
workforce development and management practices for improved performance and retention. The MOH's HRH Strategic Plan
2005-2020 has been strengthened and a Health Sector Master Plan for 2008 -2015 developed. Almost all (78) districts have
developed district specific HRH Action Plans in line with national HRH Policy and Strategy. Using results from an MOH study on
high staff turnover, comprehensive strategies for improved retention and motivation, and policy and guidelines for workplace
safety and health, are being developed. The MOH has introduced a Performance Improvement (PI) program, including a
Technical Resource Team to provide assistance at the central and district levels. HRH databases have been established in four
Professional Councils and linked to the MOH and two pilot districts to improve recruitment and placement of health workers. In
FY09 support will continue to complete the development of Human Resource Information System linking it to MOH Planning
department and districts.
Leadership and management. Key training programs for HIV program managers and service providers will be expanded to
support the development of quality high- and mid-level national leaders who will be charged with sustaining the national response
over the long-term. Makerere University School of Public Health (MUSPH) started an HIV leadership training program in 2002 with
USG support. This two-year apprenticeship training program graduated over 45 professionals who are occupying senior
management positions in leading HIV/AIDS organization in Uganda and abroad. The HIV leadership fellowship was the first on the
African continent and its model is being replicated in a number of African countries with similar human resource challenges. The
program was evaluated in 2007 and modified and additional funding was obtained for another five years. In phase two, the
program introduced short to medium term fellowships of 4-6 months and technical placements in addition to longer-term
fellowships.
Internship Program. The USG team will continue to support the project that identifies and places Ugandan interns and trainees as
technical support staff or advisors in civil society organizations, implementing partner organizations, and host country
organizations that are implementing HIV prevention and treatment programs. This new activity will identify and provide support to
academic public health, medical and/or social science training institutions to increase students' practical experience in HIV/AIDS
service delivery and prevention areas. The ultimate goal of this project is to strengthen and diversify the pool of Ugandan skills
and expertise needed to address the multifaceted challenges posed by the HIV/AIDS epidemic, and mobilize national resources in
the national response to the epidemic.
Skills development. PEPFAR supports a number of capacity building and training programs. HIV/AIDS care and management
programs are offered through central and regional centers by the Mildmay Center, Joint Clinical Research Center (JCRC), The
Aids Support Organization (TASO) and Infectious Diseases Institute (IDI). Laboratory leadership training programs are offered by
Central Public Health Laboratories (CPHL), AMREF and JCRC. The USG funded project for Strengthening Counselor Training in
Uganda (SCOT) has supported the national program to standardize curricula for different cadres of counselors and roll out
trainings in the districts. In January 2008, five curricula developed through the SCOT partnership were launched by the MOH as
national standards for training counselor in the areas of: Provider Initiated Counseling and Testing in health care settings (PICT),
Home Based HIV counseling and testing (HB HCT), Basic HIV Counseling and testing (HCT) and HIV Counseling Supervision. In
addition, the SCOT provides institutional support to the Uganda Counseling Association (UCA). The USG has also supported
Health Professional Councils and Associations in developing standards for accreditation of in-service training and continuing
professional development (CPD).
In FY09, the SCOT program will continue to support the national program to develop, review and update materials for training of
counselors, work hand with MOH and partners to develop a common certification framework for the different cadres of counselors
and most importantly advocate to establishment of the cadre of counselors in the Public service
Task shifting. The USG participates in the national committee on task shifting, which was created following discussions with
WHO/Geneva. The committee is comprised of MOH, UNAIDS, WHO/Uganda and USG. Guidelines are expected to be finalized
and posted in November. USG/Uganda will follow the guidance outlined and work in partnership with other development partners
to identify the most appropriate ways to support the GOU to address recommendations
D. Capacity enhancement for indigenous organizations
USG will also continue to provide organizational systems strengthening to national indigenous organizations playing key roles in
the national response and decentralized local governments. Given Uganda's decentralized system of financing and governance,
and the increasing number of new districts (from 56 in 2001 to 82 in 2008), USG efforts will continue to support improved
HIV/AIDS planning, management, implementation and monitoring at district level through key political and technical HIV/AIDS
structures. A key outcome will be integration of HIV/AIDS into District Development Plans, budgeting for HIV/AIDS services
beyond basic commodities and improved coordination of resources and service delivery at the district and sub-county level.
In addition, the ongoing peace process in Northern Uganda has resulted in approximately 95% of people in the Lango region
returning to their homes and 45% of people in the Acholi region moving to transit camps or their homes. A key focus in the North
will be to improve service equity for vulnerable populations including internally displaced individuals, women and children. This will
continue to require significant systems strengthening of key political and technical HIV/AIDS systems and structures to ensure
well-planned, implemented and monitored HIV/AIDS activities after an 18-year civil war that decimated livelihood, education and
health structures.
E. Democracy and governance
For democracy and governance programming, the USG will support the work of accountability committees and issues-based
caucuses in Parliament focusing on the conflict in the North, women and children impacted by conflict, corruption, health and
HIV/AIDS. These efforts are intended on increasing accountability and transparency between national level leaders and their
constituents as well as creating increased demand at the local level for services and accountability. PEPFAR resources will
leverage USAID's democracy and governance activities.
Table 3.3.18:
Under previous support under this activity, The MOH's has been able to meet its mandate of developing
policies, standards and technical guidelines for the provision of quality health services. This support has
enabled the review, revision, development, and dissemination of updated HIV/AIDS-related technical
policies to guide national and district health services and frontline service providers in providing
comprehensive and effective prevention, care and treatment services. Some technical policies and
guidelines developed with support under this activity include; National Strategic Framework for HIV/AIDS
activities in Uganda, the National Strategic Framework for the Expansion of HIV/AIDS Care and Support in
Uganda, National Policy documents for ART, HCT, PMTCT, Nutrition in HIV/AIDS and HBC, HIV/TB
Collaboration Policy, National Policy Guidelines for Cotrimoxazole Prophylaxis for People with HIV/AIDS,
Post Exposure Prophylaxis (PEP) Policy, Training guidelines for Counseling, HCT, PMTCT, ART, Home
Based Care/Palliative Care, and Infant Feeding, Communication Strategy for ART and TB/HIV
Collaboration, the National ART Scale up Plan and the National Condom use and Distribution Guidelines.
Other agencies that support policy development this activity include DFID, UNICEF, GTATM and PSI. In FY
2008 MOH reviewed the Communication strategy for ABC + promotion, printed and distributed the PEP
policy and implenetation guidelines; initiated policy discussion on Male circumcision, initiated development
of child counseling guidelines. MOH revised the ART treatment guidelines and started adaptation of
protocols for monitoring HIV drug resistance.
In FY 2009 this activity will develop, review, and update technical policies and guidelines, ensuring that all
relevant policies and guidelines are evidence based, relevant, appropriate and responsive to meet the
demands for appropriate services to address the current epidemic in Uganda and to ensure the
achievement of the program goals. During policy development, the MOH will conduct wide consultation with
national and international experts and local stakeholders, service providers, nongovernmental
organizations, community based organizations, other sectors whose activities impact on the program and
most importantly with the intended users of the services, persons infected with HIV and their families. The
MOH in FY 2009 will review and disseminate the following policies: the revised national HCT policies and
related guidelines, regional dissemination of ART implementation guidelines, develop STD management
implementation guidelines, update STI treatment guidelines and in-service training manuals, review and
update the PMTCT implementation guidelines., adopt the Family Support Groups' guidelines for PMTCT,
dissemination of national HBC policy guidelines, develop policy framework on nutrition in HIV/AIDS,
disseminate policy guidelines for laboratory services. In addition, the activity will support the development of
new policies for the implementation of male circumcision, isoniazid prophylaxis, prevention with positives
and HSV-2 management. The MOH's human resources department will be supported to implement the new
Human Resource policy to create the position of HIV counselors in public health facilities and address task-
shifting concerns. Finally, the MOH will ensure the completion of unfinished policies and guidelines and will
undertake activities to evaluate existing policies with a view to identifying gaps.
Continuing Activity: 13301
13301 4502.08 HHS/Centers for Ministry of Health, 6434 1259.08 Support for $800,000
8348 4502.07 HHS/Centers for Ministry of Health, 4809 1259.07 Support for $250,000
4502 4502.06 HHS/Centers for Ministry of Health, 3342 1259.06 $150,000
Workplace Programs
Estimated amount of funding that is planned for Human Capacity Development $100,000
