NUMAT: Northern Uganda

Malaria, AIDS, and TB Programme

NUMAT P. O Box 946 Gulu, Uganda

Phone: (256) 041 221 581, 0312 264 976/7

info@numatuganda.org

NUMAT Partners: JSI Research and Training Institute, Inc.

AIDS Information Center

World Vision

Geographic Targets: Sub regions of Acholi and Lango. Districts of Gulu, Amuru, Kitgum, Pader, Lira, Amolatar, Dokolo, Apac and Oyam.

With NUMAT support, some health facilities started providing complex regimens following clinical staging and CD4+ tests. By September 2007, 427 pregnant women were diagnosed HIV positive in 8 ART accredited hospitals and health centers IVs in Northern Uganda. Out of these, 15% received complex ARV regimens while 48% received single dose Nevirapine for PMTCT. Thirty-seven percent did not receive any ARV prophylaxis. HIV diagnosis remains the biggest challenge for infants and young children, below 18 months in particular, to access a continuum of HIV/AIDS services including treatment. NUMAT is support-ing Early Infant Diagnosis (EID) of HIV in post conflict Northern Uganda. As of December 2007, 5 Health facilities in Northern Uganda were imple-menting EID, and 228 children below 18 months had been tested for HIV. Out of these, 32 (14%) were found HIV-positive.

Ten PMTCT sites were supported to launch fam-ily support groups (FSGs), developed according to MOH guidelines, to enable HIV positive women to access wrap-around services.

The process of establishment of FSGs involved some stages: • Sensitization of 105 civic, religious, political and cultural leaders on the concept of psychosocial sup-port for mothers in the PMTCT programme. • 36 district and health facility-level FSG focal per-sons were trained in the implementation of the groups. • 126 women and 34 male partners actively partici-pated in the PMTCT meetings conducted and facili-tated by the focal persons. • The PMTCT clients were also linked to care and ART services as were the PHA groups.

BACKGROUND Northern Uganda Malaria AIDS and Tuberculosis Program (NUMAT) is a five-year USAID-funded program based in Gulu that is collaborating with the Ministry of Health and working through existing health structures in Northern Uganda to improve access to TB, HIV and malaria services. Every year, 25,000 children acquire HIV from their mothers through Mother to child Transmission in Uganda. Without any intervention for PMTCT of HIV, up to 35% of women living with HIV would pass the virus to their babies in Uganda. With single dose Nevirapine based interventions, the risk of transmission is reduced by at least half. The revised national PMTCT policy made provision for use of more efficacious and combined ARV regimens, in-cluding HAART, for HIV positive pregnant women in addition to use of single dose Nevirapine. After a program needs assessment to identify critical service delivery gaps, NUMAT conducted technical support supervision and mentoring at 46 PMTCT sites across the nine Northern Uganda districts, which were conducted in collaboration with the MOH and district partners. Integrated PMTCT and HCT technical support supervision training included:

• PMTCT counseling skills; • establishment of family support groups; • distribution of revised policy guidelines • distribution of IEC materials, data and logis-

tic management tools; • provision of HIV test kits to sites that ex-

perienced shortages. A total of 308 health workers (168 females and 140 males) were oriented on the revised PMTCT and HCT policy guidelines, including the provision of HAART to eligible HIV-positive pregnant women, use of combination regimens for PMTCT and early infant HIV diagnosis.