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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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: 2010
STAR-EC covers 6 districts in the East Central region including Bugiri, Iganga, Kaliro, Kamuli, Mayuge and Namutumba. The main goal of the program is to increase access to, coverage of, and utilization of quality comprehensive HIV&AIDS and TB prevention, care and treatment services within district health facilities and their respective communities. This goal is in line with the national priorities articulated in the National HIV&AIDS Strategic Plan 2007/08 -2011/12. Other specific objectives include:
1. Strengthening decentralized HIV&AIDS and TB service delivery systems with emphasis on health centers (HCs) IV and III and community outreach;
2. Improving quality and efficiency of HIV&AIDS and TB service delivery
3. Strengthening networks and referrals systems
4. Intensifying demand for HIV&AIDS and TB prevention, care and treatment services.
The target population includes the most at risk populations such as commercial sex workers, fisher-folk, migrant workers, boda boda cyclists and long distance truck drivers. Other target populations include pregnant women, HIV positive pregnant women, People living with HIV&AIDS, HIV positive infants, orphans and other vulnerable children, HIV/AIDS affected families, TB patients, adults, outof-school youth, students in institutions of higher learning and People With Disabilities, With regard to strengthening health systems, STAR-EC provide technical and financial support to District HIV&AIDS Committees, District HIV&AIDS Task forces and other district leadership/management. District performance review meetings will be conducted quarterly. District and CSO personnel will also be trained to improve their monitoring and evaluation skills. An additional 10 new CSOs will be provided with funding through a competitive granting mechanism. STAR-EC will procure supplies including HIV test kits, condoms, Co-trimoxazole, and some laboratory equipment. Ten laboratories will be refurbished.
With regard to human resources for health, STAR-EC will encourage the task shifting for tasks such as community-based client follow-up to ensure adherence, psychosocial support to PLHIV using lay providers such as 'expert patients' and 'mentor mothers. Quality Improvement teams will be trained and established at supported health units. Additionally, pre-service and in-service training will be given to different district and CSO staff across all the technical areas. As regards nutrition, the program will partner with NuLife project to train service providers in nutritional supplementation with ready-to-use therapeutic feeds. Clean and safe water will be provided as part of a Basic Care Package to PLHIV. Health workers in 80 heath facilities will be provided with training, onsite technical support and mentoring on TB/HIV integration and their competence increased in TB/HIV diagnosis and management including pediatric TB/HIV, internal and external referrals for support counseling and ART for eligible individuals, logistics planning and TB/HIV reporting. Screening of all TB patients for HIV and the vice versa will be supported. 10 laboratories will be renovated including portioning available rooms to create space for examining and counseling patients.
Education as one of the cross cutting areas will be promoted through working with institutions of higher learning (since UNITY works with primary and secondary schools) to carry out HIV prevention campaigns and behavior change interventions. Prevention of gender based violence will be supported by training and conducting support supervision of the partner CSOs to conduct action oriented community discourses on issues of gender power relations.
Child survival will be addressed through training 25 health workers in Pediatric care using the Integrated Management of Childhood Illnesses approach. STAR-EC will also support Early Infant Diagnosis of HIV infection through facilitating transportation of dry blood spot samples to referral laboratories. Safe mother hood will be supported through prevention of malaria in pregnancy (IPTp) and. providing safe delivery kits (maama kits), Gender issues will be addressed through CSOs conducting community mobilization activities to promote positive behaviors such as: gender equity; couple dialogue; partner counseling and testing and disclosure. As alluded to above, mobile populations and the workplace (as for the fisher-folk) are targeted with interventions.
STAR-EC will pool together the required items and carry out bulk purchases in order to increase its bargaining power. Procurement will be done through competitive bidding. Partners like Uganda Health Marketing Group and Program for Accessible Health Communication and Education (PACE) will assist STAR-EC to obtain items like condoms and the basic HIV preventive care package from respectively. The program will order ARVs through SURE project and utilize Joint Medical Stores.
Monitoring and evaluation plans include developing a comprehensive electronic data base, up-dating the Performance Monitoring Plan (PMP) in line with the new generation PEPFAR indicators, sharing baseline survey findings with the districts, CSOs and the MoH. We plan to conduct organisational capacity assessments, strengthen data collection at district level through the use of HMIS and improve data quality. The program will conduct the annual Lot Quality Assurance Survey to enable results to be incorporated into Local Government annual planning.
STAR-EC will support health facility-based counselors to provide risk assessments to HIV positive clients and their household members (affected by HIV). HIV clinics are co-located with routine HIV test points, and so early identification of HIV-positive persons will occur followed by their enrollment into chronic care clinics. 7,000 people living with HIV (PLHIV) are targeted for clinical assessments using WHO clinical staging and diagnosing opportunistic infections.
90 health workers shall be trained on management of opportunistic infections and sexually transmitted infections (STIs). Also 40 clinicians will train on palliative care medicine pain and symptom control in collaboration with Hospice Africa. Clinic workers will be oriented on prevention with positives to enable them to offer family planning/dual protection, treatment of STIs, and behavioral counseling on reduction of sexual partners, disclosure of HIV status plus partner testing.
Care services shall scale up to 80 facilities with support towards ordering medicines for treatment of opportunistic infections and oral morphine from the National Medical Stores. STAR-EC will support access to co-trimoxazole for use during national stock outs often experienced in public facilities. In collaboration with the Program for Accessible Health Communication and Education, the program will provide HIV preventive basic care package kit (BCP) that contains an insecticide treated net, a safe water system, condoms and a guide to positive living.
STAR - EC will conduct bi-monthly support supervision visits to provide technical assistance. The program will use existing data collection and reporting tools to strengthen the existing national monitoring and evaluation system.
Community-based care and support shall be provided by our civil society organizations mainly targeting MARPs. Through outreaches, CSOs will offer co-trimoxazole prophylaxis, home-based care kits, prevention with positives counseling, peer adherence support and psychosocial support. CSO shall train home care givers as trainers on home-based care to emphasize their role in basic nursing care, patient hygiene and nutrition. Network support agents will be responsible for linkages and referrals from community to health facilities and NGOs.
Coverage of antiretroviral therapy (ART) services shall be scaled up from 15 to 19 health facilities targeting provision of treatment to 1,500 new individuals (adults and children). About 100 health workers shall be trained on comprehensive HIV/AIDS treatment including ART. The training aims at expanding the prescriber base and targets workers in the HIV clinic, medical and maternity wards.
To address under-staffing at four hospitals (higher patient volume), the project will facilitate hired labor for extra duties in order to reduce patient waiting time and thus increase utilization of ART. To reduce drop-out and loss to follow-up rates, the project will facilitate hospitals to conduct outreach satellite ART clinics to lower level facilities thus eliminating potential barriers to ART access.
STAR-EC shall facilitate the transportation of blood specimens from 19 ART sites to JCRC laboratory at Kakira for CD4 cell count testing and also pay the test fees. This immunological monitoring shall boost decision making to initiate ART as well as help track clinical outcomes. Various adherence activities such as adherence counseling, pill counting, medication boxes, adherence calendars, and home follow-up when appointments are missed, shall be supported and their outcomes closely monitored.
Health workers will receive on-the-job mentorship on antiretroviral (ARV) logistics management system. We will also facilitate postage of ARV bi-monthly order forms to the district health offices and National Medical Stores and support the distribution of ARV supplies from district stores down to ART sites.
AIDS Control Program will assess four sites, recommend areas that STAR-EC can support to get accredited to provide ART services. Clinics shall be renovated and equipped with furniture to handle bigger client loads. We will support site clinical teams to regularly meet and review clinical care to maintain quality. Further, site captains shall have exchange visits to other ART sites to share challenges and observe best practices.
STAR-EC will provide technical assistance on ART service delivery through regular support supervision visits. Facilities will hold regular continuing medical education sessions to update their knowledge and skills.
STAR-EC will employ the 'know your epidemic, know your response' analogy in scaling up HIV testing and counseling (HTC) to increase knowledge of one's own and partner HIV status. The program will emphasize taking HTC services to institutions of higher learning where cross-generational sex is experienced, road-side truck-stops where multiple concurrent relationships are rampant, and to couples in view of their high vulnerability to HIV infection. Working with the public and civil society, the program will strengthen delivery of HTC services by introducing and supporting Provider Initiated HTC (PITC) at 80 health units. Other innovative community models such as home-to-home HTC, family-based HTC, index-client-based HTC, community camping, mobile HTC and moonlight HTC will be supported. Emphasis will be placed on couple HTC using 'counselor assisted mutual disclosure' to strengthen knowledge of partner HIV. STAR-EC will support HTC during commemoration of World AIDS day and World TB day.
STAR-EC will train 50 health workers in pediatric counseling and testing and 150 health workers and lay providers in rapid HIV testing techniques to provide both static and outreach HTC services. 30 health facilities will be supported to conduct regular outreaches to communities and lower level health units; CSOs will access funds to conduct additional outreaches in hard-to-reach areas. Bicycles will be procured for service providers to reach difficult terrains inaccessible by vehicles. STAR-EC will support training of 'model couples' and facilitate them to conduct couple dialogue sessions to increase couple uptake of HTC.
STAR-EC will procure buffer stocks of HIV test kits and consumables to cover stock out periods often experienced in most of the public health facilities. The project will support community mobilization for HTC services through community-staged music, dance and drama shows and messages through the media especially radio. The quality and progress of HTC services will be regularly monitored through quarterly review meetings and district onsite support supervision visits. The project will also support the reproduction and dissemination of MoH data collection tools such as HTC client cards and registers. Health facilities will be supported to transport samples to reference laboratories for quality control.
STAR-EC will support the early infant diagnosis of HIV infection using the polymerase chain reaction test. In particular, the project will equip facilities to transport dry blood spot samples to Joint Clinical Research Centre laboratory at Kakira regional centre of excellence. Test results shall be collected at the time of next sample delivery and those infants and children found to be HIV infected shall be enrolled into HIV clinics and initiated on co-trimoxazole therapy (CPT).
CPT shall also be provided to all babies above 6 weeks of age who are HIV exposed (i.e. born to HIV positive mothers) to reduce the risk of developing opportunistic infections and dying prior to their first birth day. Therefore STAR-EC shall procure syrup co-trimoxazole for these babies since government facilities often lack syrup formulations.
Pediatric counseling and support shall be provided by trained pediatric counselors on a routine basis at 40 facilities.
STAR-EC will train 50 health workers on the integrated management of childhood illnesses to build their capacity in providing pediatric care. As part of the training on comprehensive HIV&AIDS treatment including ART, five days shall be dedicated to pediatric ART (theory and practicum) to increase the capacity of health workers to treat HIV&AIDS in children.
The project shall implement the new policy of ministry of health which guides that all infants confirmed to be HIV positive must be initiated on ART immediately irrespective of their CD4 cell count or their clinical staging. This policy shall be disseminated and discussed with health workers to ensure compliance. STAR - EC targets treating at least 280 children while scaling up pediatric ART from 4 hospitals to 19 sites.
A similar laboratory mechanism as for adults shall be employed to provide regular CD4 monitoring of children on anti-retroviral therapy. In addition, health workers shall monitor growth and development, assess nutritional status, provide infant feeding counseling, treat opportunistic infections, and link and refer children to other service centres.
STAR-EC staff shall provide regular monitoring and support supervision in collaboration with the regional hospital Pediatrician.
In order to promote evidence based planning, this activity will support the Government of Uganda to institutionalize the use of the Lots Quality Assurance Sampling (LQAS) and ensure that the data generated is used. The activity will also support the key national HIV/AIDS data use (including reporting) processes and activities taking place at the district in order to build sustainability. These activities will be implemented in 9 districts in the Eastern region of the country, namely: Bugiri, Iganga, Kaliro, Kamuli, Mayuge and Namutamba. Evidence-based planning and decision making will be achieved through regular measurement of program performance and progress at the districts and lower levels. Regular and timely feedback to the supported local governments, non-governmental organizations ad civil service organizations will be provided through systems strengthening of district-level monitoring and reporting systems including HMIS and PMMP. While the LQAS results will be used to inform district-level work planning in order to identify intervention areas and sub-counties on which to focus in the future, this USG investment goes beyond this and achieves two other objectives. First, the support is intended to build the capacity of the central level GOU to design, plan, manage, coordinate, and institutionalize the use of the LQAS. The other objective of this USG support is to ensure that these district-based programs support the existing national data collection, collation, use, and reporting systems at the district and lower levels for purposes of building sustainability. Increased capacity will improve performance monitoring of service delivery and overall district planning. Coordination at the district also includes ensuring that the existing supply of, and demand for, ICT (information, communication, and technology) and human capital resources are optimized.
Qualitative key informant interviews will be conducted during the first quarter so as to establish gaps in the functionality of District AIDS Committes (DACs), District AIDS Teams (DATs), Health Sub Districts (HSDs) and other district leadership/management structures related to HIV&AIDS and TB. On a quarterly basis, district performance review meetings will be conducted involving different District Health and Management teams as well as CSOs. Action plans will be developed in relation to the reviewed program outputs and outcomes.
STAR-EC's baseline survey information will be used to ascertain the level at which different health facilities possess the capacity to manage HIV&AIDS and TB-related logistics and thereafter develop targeted solutions. Additionally, targeted solutions will be executed through collaboration with the MoH and the SURE project including the training of health facility staff, technical support, on-the-job mentoring and coaching in logistics and supply chain management per district. Facilities will be supported in preparing and delivering their requisitions for ARVs, other drugs and supplies, HIV test kits and laboratory reagents to the SURE project. A similar arrangement will be made with JMS on proper storage and transportation to the sites.
STAR-EC will issue Request for Applications (RFAs) to CSOs working within East Central districts. Ten new CSO's will be selected to supplement the existing four. A comprehensive organisational capacity assessment for the existing four CSOs and new CSOs will be conducted once they are on board in order to identify gaps and the level of required support. During CSO quarterly finance compliance and technical review meetings, onsite support will be given. District and CSO personnel will also be trained in different M&E applications that will promote data quality and reporting timeliness. A performance-based CSO grants financing mechanism will be adopted.
STAR-EC will promote and support the introduction of MMC as one of the biomedical prevention approaches that have been proven to be effective when combined with other approaches.
STAR - EC preliminary activities will involve holding consultative meetings with MOH on the policy guidelines. The program will receive technical support from partners with the requisite experience in providing MMC services such as the Rakai Health Sciences Project. The technical support will give STAR - EC guidance on initiation of MMC as part of our comprehensive package of HIV prevention. Since MMC does not provide complete protection against HIV, STAR - EC will encourage MMC along with messages promoting the delay of onset of sex, abstinence, mutual faithfulness, reduction in the number of sexual partners, consistent condom use, HIV counseling and testing, and treatment of other sexually transmitted infections.
STAR-EC will support MoH to produce BCC/IEC materials for dissemination and community mobilization for MMC. The program will conduct a site visit to the nearby Kayunga Hospital Project in Kayunga district to learn from their experience with the recently- introduced MMC services.
WHO/UNAIDS recommended MC as part of a comprehensive HIV prevention package in 2007.Uganda endorsed this recommendation and started MMC policy development in 2009. the policy has recently been approved and USG through the Health Communication Partnership, will work with MOH to have a national and dissemination workshops. MMC is however being done in some Public and private health facilities and the demand is increasing. PEPFAR supported pilot MMC projects namely: SPH-Rakai, Walter Reed Kayunga, UPDF and HIPs.
With additional resources, PEPFAR is going to scale up provision of Safe Male Circumcision (SMC). This will be contributing to the NSP goal of reducing HIV incidence rate by 40% by 2012.
The key target groups for Safe Male Circumcision are: HIV negative males including older adolescents and sexually active men; older men at particularly high risk (truck drivers, uniformed services, STI patients, and uninfected men in HIV discordant couples and in the long term, Neonatal male circumcision.
With the additional funding, both HIPS and STAR- EC will undertake HU assessments to determine the human resource and infrastructure needs. The needed personnel will be trained by either Rakai or Walter reed training centers. Both projects will, working hand in hand with HCP, will undertake IEC and BCC activities with the aim of creating demand but also increasing correct and appropriate knowledge about SMC in particular and HIV prevention in general. HIPS will extend to 10 new health units while STAR EC will be in 8 health units at both level IV and III .
The Key activities will include :
Developing a plan to provide Voluntary Safe Male Circumcision services as a minimum package alongside other known HIV prevention interventions
Supporting the rapid scale up of facility based VMMC services in Government, Private, FBO and community based health facilities
Supporting the provision of outreach (temporary or mobile) Voluntary Safe Male Circumcision services to increase access, particularly in remote areas.
Undertaking advocacy, community sensitization/mobilization, and education to create informed demand for VMMC services,
Undertaking in-service training of service providers in public, Private, Faith based and community health facilities. At least 3 training centers will be supported
Long-term sustainable and integrated VMMC capacity in health facilities including capacity for provision of neo-natal and pediatric MC services
Facilitate referrals and linkages of VMMC services to other HIV/AIDS prevention, care and treatment services
STAR-EC will support "Highly Active HIV Prevention" with a multiple of interventions including: behavioral, biomedical, treatment and structural prevention. STAR-EC will tailor the project HIV prevention response to the locally known drivers of the epidemic. Our interventions will promote abstinence, including delay of sexual activity or secondary abstinence, fidelity, reducing multiple and concurrent partners, and related social and community norms that impact these behaviors.
STAR-EC will adopt 'Value for Life' training program commonly used by our partner Youth Alive, to train Abstinence and Be-faithful promoters. Behavior Change Communication Programs (BCPs) will be supported to equip youth with knowledge and skills to enable them appreciate causes of HIV&AIDS; assess personal risk; set personal goals and plans of achieving them. We will support positive peer group/club formation and equip them with play-kits for 'edutainment' as a sustainability strategy for positive behavior amongst peers with activities including 'peer-to-peer' education; sports outreaches; games; and small group discussions.
STAR-EC will support CSOs to train individuals and married couples in 'Couples-on-the Way' and 'Couples United' programs who will train and support their peers and conduct door-to-door activities. STAR - EC will support community drama, 'Faithful House' seminars and group discussions on parent-child dialogue sessions. STAR - EC will train peers to address gender issues pertaining to HIV infection.
STAR-EC will train CSOs in the 'men and HIV&AIDS curriculum', the sexual network game, alcohol and how to use some trigger videos in community settings. STAR-EC will support religious leaders as AB promotional outlets to offer premarital and marital counseling. They will support Young Marrieds, Fathers and Mothers and Unions against the tide of HIV acquisition. STAR-EC will support 'be faithful' radio talk shows and radio spots in the main local languages. We will orient radio presenters on communicating concepts and benefits of being faithful, prevention of stigma and discrimination.
STAR - EC estimates to train 400 individuals and reach 76,000 individuals with HIV preventive interventions focused on abstinence and/or being faithful.
STAR-EC will accelerate the prevention of sexual transmission of HIV through targeted interventions focused on most-at-risk populations (MARPs); one of the notable drivers of the HIV epidemic in the region. The MARPs will include; migrant workers, distance truck drivers, 'boda boda' cyclists, transactional sex workers, bar and lodge attendants, fisherfolk and persons in multiple or concurrent sex partnerships.
STAR-EC will support CSOs to map "hot spots" of underserved and/or hard-to-reach areas and areas likely to put people at high risk of HIV transmission like bars and lodges as well as local video halls commonly known as 'bibandas' and prioritize these sites for HIV prevention interventions. STAR-EC will support beach management units (locally known as 'Gabungas') to mobilize residents to attend outreach services.
STAR - EC will target an estimated 50,000 MARPs to be reached with individual and/or small group level HIV preventive interventions mainly through peer-to-peer interactions and community outreach programs. STAR-EC in collaboration with targeted audiences, will identify peers to be trained and oriented in basic counseling skills on correct condom use, recording and reporting. STAR-EC will facilitate peer educators to deliver other HIV prevention messages and distribute of condoms.
STAR-EC will support condom education and distribution at HTC, PMTCT, ART and palliative care sites and ensure that counsellors provide prevention education to all clients. Partner CSOs will also be mapped as targeted condom outlets. STAR-EC will support mapping of other community distribution points by community members and CSOs. PTCs will be used to promote prevention messages with a focus on correct and consistent use of condoms by the targeted audiences. STAR-EC will collaborate with MoH and social marketing organizations like UHMG to procure and distribute condoms to targeted vulnerable populations including MARPs.
STAR-EC will support the Ministry of Health to produce context specific IEC materials on ABC including posters, cue cards, calendars and leaflets to reinforce messages in the radio programmes and information passed on by the community volunteers.
STAR-EC will support 34 public health units in Bugiri, Iganga, Kamuli, Kaliro, Mayuge, and Namutumba districts to provide PMTCT services. The target population includes pregnant women and their spouses, HIV positive pregnant women, infants of HIV positive women, and heath workers providing PMTCT services. An estimated 900 HIV positive pregnant women will receive prophylactic ARV regimens. 100 health workers will be trained to provide ARV prophylactic regimen according to the Ministry of Health (MoH) PMTCT guidelines. Experienced teams from hospitals and HCIVs will be facilitated to conduct PMTCT outreaches to lower health units. Additional 40 'mentor mothers'- mothers who are already utilizing PMTCT services and have gone ahead to give public testimonies about their experience- and 20 family support groups will be trained to counsel mothers, trace defaulters; to ensure adherence to therapy and the chosen method of Infant and Young Child Feeding.
Routine Testing and Counseling will be promoted in maternal and child health clinics, maternity and postnatal wards. Family planning and prevention of malaria in pregnancy will be integrated in PMTCT through routine delivery of goal oriented antenatal care. Safe delivery kits will be distributed to ensure a clean delivery environment. The program will obtain long lasting insecticide treated nets from President's Malaria Initiative and distribute them to pregnant mothers. Laboratory personnel will receive funds to physically transport blood samples to referral laboratories at Kakira, Buluba and Kamuli Mission hospitals for CD4 testing. PMTCT mothers will be provided with cotrimoxazole preventive therapy and TB screening and management. Eligible clients (i.e.: CD4 count of <350) will be counseled and enrolled into the HIV clinics to initiate Highly Active Anti-retroviral Therapy. Through home visits, mothers will be utilized as index clients to extend family centred care. Pre-packaged regimen for babies will be accessed to facilities through working with the National PMTCT program. The program shall link mothers and babies to nutrition programs at community level through the networks and the NuLife project. Support supervisory visits will enhance quality assurance.
STAR-EC is targeting to have 25% of facilities with functional, accredited laboratories for key tests by the end of the first year of implementation. Support to laboratories will involve training laboratory personnel at two levels. The first level will be an in-service training of laboratory assistants and microscopists on sputum ZN staining and microscopy, then followed by training on laboratory principles practices plus diagnostic methods for other diseases. The second level will be a pre-service training of existing microscopists to upgrade to laboratory assistants' cadre by undertaking a certificate course in medical laboratory technology offered at Jinja Laboratory Training School. As part of improvements to the health work force in the East Central region, STAR-EC will fully sponsor six microscopists selected by the District Laboratory Focal Persons to undertake this course.
The project will procure laboratory equipment ranging from 20 microscopes to 2 Flow Cytometers (CD4 machines) in consultation with the Central Public Health Laboratory (CPHL) and the National Tuberculosis Reference Laboratory (NTRL). Laboratory reagents for the above equipments will also be procured. STAR-EC will support refurbishment of laboratories at 10 facilities (HCIV and HCIII level) to create a safe working environment. The refurbishment will be undertaken in collaboration with Health Infrastructure Department of the Ministry of Health, Distrcit Health Office (DHOs) and Chief Administrative Office (CAOs).
District Laboratory Focal Persons (DLFPs) will be facilitated by STAR-EC to provide regular technical assistance and support supervision together with STAR-EC's Laboratory Services Advisor. The project intends to strengthen the HIV proficiency testing and External Quality Assurance (EQA) by reference laboratories (such as NTRL, Uganda Virus Research Institute (UVRI), JCRC) on a wide range of tests including HTC, sputum ZN staining, DNA-PCR, CD4, rapid protein reagent (RPR) and blood smears.
STAR-EC will facilitate district and health sub-district level joint TB and HIV&AIDS coordination and review meetings, district planning workshops, and fund M&E activities related to TB/HIV.
The project target is to identify and treat 400 PLHIV for TB disease. Health workers will be trained on TB/HIV collaborative activities, and will receive on-job mentorship on conducting routine screening for TB among PLHIV using intensified case finding tools. The program will facilitate home visits to actively trace contacts of index TB cases.
The Tuberculosis Control Assistance Program (TB CAP) will assist the project to conduct risk assessments for TB infection control in facility departments and to institute administrative and environmental control measures in clinics e.g.: patient triage and separate waiting areas. The project refurbish laboratories, TB clinic & HIV clinic rooms in order to improve air flow.
STAR-EC will facilitate the testing of 600 TB patients for HIV infection and appropriately treat those co-infected. Test points shall be set up in TB clinics to provide diagnostic HTC on-site by procuring additional furniture, HIV test kits and related supplies. Health workers will be trained to use the provider-initiated HTC approach. On job mentorship will be provided on data recording and reporting for co-trimoxazole preventive therapy (CPT), and on how to expedite the enrollment of TB/HIV patients into HIV clinics to access CD4 testing, ARVs and nutritional supplements.
The National TB and Leprosy program (NTLP), and Buluba Hospital shall be supported to train nurses on TB diagnosis, treatment and case management, to train laboratory personnel on sputum staining and microscopy, and to train sub-county health workers (SCHW) on CB DOTS strategy.
STAR-EC shall procure 12 motorcycles and 65 bicycles for SCHW, 2 X-ray machines for Iganga and Bugiri hospitals, and 18 microscopes for HCIIIs. In addition, we will contribute towards repairs and maintenance of existing equipments.
STAR - EC will support the NTLP structures such as Zonal TB and Leprosy Supervisors (ZTLS), District TB and Leprosy Supervisors (DTLS), and SCHW to function as supervisors through providing activity specific funds for technical support supervision and program monitoring.