Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 9236
Country/Region: Uganda
Year: 2012
Main Partner: Integrated Community Based Initiatives
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $357,332

Since 2008 ICOBI received PEPFAR funds to implement Full Access Home Based HIV Counseling and Testing (HBHCT) and basic care services project in six districts. Activities focus on HBHCT, sexual prevention, adult/pediatric care and support, and TB/HIV with the goal to contribute to the reduction of HIV infection and mitigating its impact of in the districts of Wakiso, Luwero, Mubende, Mityana, Nakasongola and Nakaseke. There are two specific objectives:

1) To offer HBHCT to 100,000 persons > 14 years of age and HIV exposed children below five years.2) To offer HCT to 15,000 couples.

The project provides HBHCT services to all adults and at risk children, including couples, and link HIV + to post test care services in the communities and health facilities. HBCT was not considered a strategic pivot in the revised COP 2012 and in FY 2013, the project will offer HCT to 50,000 individuals including 30,000 couples, identify 5,000 HIV+ individuals and link them to care and support services through targeted key population groups and HCT approaches in the communities.

To improve cost effectiveness ICOBI will collaborate with Mildmay, PREFA, AMREF and PACE to ensure effective referral linkages for HIV infected clients identified through HCT services; and community systems strengthening to prevent Gender Based Violence. The project also provides services to sex workers and truck drivers along the Kampala-Gulu-Sudan highway and the fishing communities around Lake Kyoga.

ICOBI has procured four vehicles since 2008 and in FY 2013 no vehicle will be procured.

Funding for Testing: HIV Testing and Counseling (HVCT): $207,332

The initial goal of this project was to implement Full Access Home Based HIV Counseling and Testing (HBHCT) and basic care services in six districts of Central Uganda: Wakiso, Luwero, Mubende, Mityana, Nakasongola and Nakaseke.

In the revised COP 12, the approved the strategic pivots for HIV Testing and Counseling (HCT) include: scaling up Provider Initiated Testing and Counseling (PITC), rolling out more targeted community HCT for key populations and improving linkages from HCT to Voluntary Medical Male Circumcision (VMMC), PMTCT, Care and treatment. The scale up of HBCT is not a focus.

In the final months of the award, which closes in March 2013, ICOBI will provide targeted community HCT for key population groups. These include: fishermen around lakes Kioga, Victoria, and Wamala, truckers along the Kampala-Gulu-Sudan highway, commercial sex workers, street kids, prisoners, uniformed men and women and boda-boda drivers.

The project will offer HCT services to 50,000 individuals using counseling and testing outreach teams and HIV testing will be conducted in line with the national testing algorithm as prescribed by the MoH standards. ICOBI will work with resident parish mobilizers to link 5,000 HIV positive clients to ongoing care and treatment services at the health facilities supported byMildmay while HIV negative individuals will be linked to VMMC services provided by AMREF at the Health facilities and community outreach activities. Activities to strengthen successful referrals and linkages will include utilization of village health teams and local councils to track and follow-up HIV-positive individuals not enrolled in care or treatment services.

Finally, the project will support quality assurance of both testing and counseling, and monitoring and evaluation of HCT, including incorporation of couples HCT indicator and other new PEPFAR and WHO recommendations. Counselors and laboratory supervisors will use check lists and guidelines during supportive supervision visits to Counseling and Testing (CT) teams to ensure quality of CT. The project and district laboratory supervisors will support CT teams to observe SOPS as they do HIV testing in homes, as well as, ensuring proper waste management. Dry Blood Spots (DBS) for External Quality Assurance will be shipped for retesting at UVRI/HRL Entebbe Lab. Proficiency assessments will entail use of DTS to assess the quality of HIV testing by the field CT teams will be done during joint supportive supervision with the district laboratory supervisors. All HIV+ clients tested from CT outreach activities will be recorded at referral health centers in the MoH HCT register.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $150,000

FY 2013 prevention pivots for other prevention (OP) activities includes addressing prevention needs for the older population and youth, addressing condom distribution bottlenecks to increase accessibility and promotion, establishing specific intense prevention programs to target key populations in high burden districts and hot spots, sero-discordant couples and multiple partnerships in rural/urban populations and those residing in hard to reach areas to access core elements of combination prevention.

The National Prevention Strategy (NSP) defines MARPS as: commercial sex workers (CSW) and their partners, fisher folk, uniformed personnel, long distance truckers and men who have sex with men (MSM).

In the Central region districts ICOBI will provide HIV prevention services to key population groups and has mapped these groups in the project districts that include fishermen around lake Kioga, Lake Victoria and Lake Wamala, truckers along the highways, commercial sex workers, street kids, prisoners, uniformed men and women, and boda-boda riders among others.

In FY 2013, ICOBI will focus high impact risk reduction interventions to reach 100 CSWs, 30 truckers and 2,300 fisher folk. In addition, the program has identified over 1,000 sero-discordant couples through HCT and will support the establishment of comprehensive risk reduction programs for both HIV negative and HIV positive persons, care (with more emphasis on strengthening the integration of positive health dignity and prevention interventions in clinical and community settings) and treatment services. Strengthening linkages of target populations to combination prevention interventions will also be a priority for this program from HCT and VMMC service points.

ICOBI will increase distribution outlets for both male and female condoms at facilities, community level, landing sites and hard to reach areas and undertake advocacy to de-stigmatize condom use through engagement of other stakeholders, as well as, religious and political leaders. 335 condom service outlets will be established at several points in an effort to support and improve accessibility and promotion of both male and female condoms, and ensuring efficient distribution systems in the six districts. This will be realized through engagement of village health teams, hospitality industry, bars and hotels at landing sites around Lake Kyoga and Lake Victoria.

Cross Cutting Budget Categories and Known Amounts Total: $104,000
Gender: Reducing Violence and Coercion $70,000
Human Resources for Health $34,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Increasing women's legal rights and protection
Child Survival Activities
Military Populations
Mobile Populations
Tuberculosis
Family Planning