Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015

Details for Mechanism ID: 13944
Country/Region: Uganda
Year: 2012
Main Partner: Uganda Health Marketing Group
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $884,019

USAID/Uganda recently awarded a three-year program to UHMG and its partners, Integrated Community-Based Initiatives (ICOBI) and Johns Hopkins Bloomberg School of Public Health Center for Communications Programs (JHU/CCP), to clearly identify and sustainably address the behavioral and structural obstacles to reducing the incidence of HIV in five divisions of Kampala City. The proposed integrated HIV Counseling and Testing project can be distinguished from other USG-supported activities in that its focus is on private sector health delivery. The objectives of the program are: 1) increase demand for HCT services as an entry point to prevention and care services; 2) increase access to and utilization of HCT services among most-at-risk populations; 3) strengthen networks, referral systems and linkages to other HIV/AIDS, TB, Reproductive Health, Maternal and Child Health services and; 4) build capacity for sustainability of services initiated by the program.

The program will work with the Kampala Capital City Authority throughout the five divisions of the city, and also over 100 private facilities in the city, to counsel and test over 130,000 clients and link them to other services. The program will use mass communications and media to relay messages on HIV and other health services including risk reduction behaviors, as well as information on prevention counseling and referrals.

The program will purchase three vehicles in year one. One vehicle will be for administrative purposes while the other two will be used for mobile counseling and testing outreaches.

Funding for Testing: HIV Testing and Counseling (HVCT): $744,019

The Uganda AIDS Indicator Survey (AIS) 2011 revealed that Kampala residents have considerably high knowledge of HIV testing and benefits yet only 44% of the residents have ever been tested, and nationally 43 percent of new HIV infections occurred in mutually monogamous heterosexual couples. Late identification of HIV status also impacts early mortality on or before initiation of treatment. In this context, HCT, especially for high-risk populations, is a critical entry point for other HIV and health services. In this context, HCT, especially for high-risk populations remains a key variable in the broader national HIV/AIDS response equation. Through this project, nearly 2,000,000 individuals will access HCT services and be linked to HIV care and treatment services.

This new activity will endeavor to increase access to HCT services through the private sector in Kampala district with the aim of promoting early knowledge of HIV status, reducing the risk of transmitting and/or acquiring HIV and likewise improve timely access to care. The program will target Most-at-Risk Populations (MARPs), including couples and other sexual partners, mobile populations, commercial sex workers, uniformed personnel, as well as incarcerated populations. A baseline study will enable the project to better understand barriers to access for other at-risk-populations, including the LGBT community, in Kampala specifically, as well as the role of private sector in increasing health seeking behaviors.Given the mobility of Kampala residents as well as the influx of individuals from outside of Kampala throughout the day, the program will employ activities that will reach individuals with a range of HIV outreaches and in their workplace communities.

In order to complement other PEPFAR-supported efforts, the program will work with private sector facilities and at the community level to provide referrals for VMMC, PMTCT and EID, as well as HIV/AIDS care and treatment. The programs communication campaign will highlight the benefits of HCT, partner disclosure, and highlight the populations most at risk in Kampala by increasing mobile technology platforms and use of social network mediums for populations that are tech-savvy.

The project will benefit clients that are seeking health services by providing HCT as a complementary offering. This approach positions the project to increase PICT and post-test health service support.

The project is aligned with the National HIV/AIDS Strategic Plan and contributes to its objective of scaling up HCT services to facilitate universal access. Services will also be delivered in accordance with the national HCT protocols and guidelines.

Activities will be implemented in partnership with Village Health Teams and other community volunteers so that there is considerable linkage and referral for clinical care and treatment. This will empower them with skills to successfully manage the services as well as ensuring ownership and sustainability beyond the project period.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $140,000

In alignment with the key COP12 pivots, Kampala HTC activities will address the prevention needs of the general population as well as specific populations in Kampala City with unique needs such as discordant couples, youth, commercial sex workers, motorcyclists, and upper income and working class professionals. Program activities will be carried out through the implementation of high impact interventions in a variety of settings relevant to Kampalas population, including private clinics, outreach campaigns, bars and clubs frequented by commercial sex workers, and various work place locations.

UHMG has a solid track record of using social marketing to mobilize communities and influence their health-related behavior. It has demonstrated success in influencing groups most-at-risk of HIV to consistently use condoms. To increase demand and utilization of condoms among these key populations, Kampala HTC will work through JHU, its communications partner, to develop an advocacy strategy aimed at de-stigmatizing condoms. Community promotional campaigns will be implemented in all facilities and outreaches through peer-to-peer strategy for interpersonal communication; use of linkage facilitators to mobilize men; community mobilization; and use of appropriate channels of communication including print and mobile mass media. The program will also provide condoms to support its PHDP activities.

The program will engage a call-in center as part of the communication campaign and referral system to ensure that individuals can access information and counseling on HIV and STD prevention, including benefits and necessity of, and the location of health facilities and services in the Kampala area. The projects baseline study will determine additional barriers to access and utilization that can be addressed by the call-in center as well.

Amongst the MARPS, the interventions will focus on increasing perception of HIV risk associated with sex work, strengthening couples counseling for HIV and other health services at facility and community levels, and scale up of support for counselors that will be placed at the private sector facilities, the call-in center, and at community outreaches to provide information on sexual and reproductive health.

Program monitoring and evaluation activities will strengthen the collection of data to support national Health Management Information Systems tools and to improve the technical quality of data through periodic data quality assessments. The program will engage in a secondary analysis of the UDHS to better understand how and when to target Kampalas key populations, as well as the interventions most effective for each unique community. The call-in center will also provide data for program design and implementation purposes.

Subpartners Total: $0
Integrated Community Based Initiatives: NA
Johns Hopkins University: NA
Key Issues Identified in Mechanism
Addressing male norms and behaviors
enumerations.Impact/End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services
enumerations.Malaria (PMI)
Child Survival Activities
Military Populations
Mobile Populations
Safe Motherhood
Workplace Programs
Family Planning