may 20, 2015 uganda std/acp, moh 1 geoffrey taasi, std/acp, ministry of health, uganda
TRANSCRIPT
April 18, 2023 Uganda STD/ACP, MOH 3
• Of the 146,000 children living with HIV, 76,750 urgently need ART
• Only 24% had access to ART by 2009. Without ART, 75% die by age five.
• In 2009 the Uganda National coverage was at 33%.• Early diagnosis & treatment can prevent these deaths• Coverage remain low at 68% and 58% at hospital
and HC IV• 100% and 82% adult ART respectively• Most health workers lack the skills to manage
paediatric HIV.
April 18, 2023 Uganda STD/ACP, MOH 4
• Between 2009 and 2011, the MOH implemented the Pediatric HIV training and communication project
• To strengthen capacity of care providers to identify and test children at risk of HIV,
• To provide quality pediatric and adolescent HIV and AIDS care
April 18, 2023 Uganda STD/ACP, MOH 5
• A harmonized National curriculum • A five day training and a two day mentorship• Job aids, mentorship guides and an M&E system
were developed. • Retrospective data collection and analysis of
service statistics -early 2012.• Client exit interviews -10 sites in 2011, 40 care
givers of children (35F, 5M) and 10 adolescents were interviewed and data analyzed
April 18, 2023 Uganda STD/ACP, MOH 6
• Coverage increased to 68% in 2012 up from 33% in 2009
• 36.6% on ART by March 2012 from 24% in 2009
• 462 health trained on pediatric psychosocial support and
• 1,082 trained on clinical care
• 202 mentors (regional and National)
April 18, 2023 Uganda STD/ACP, MOH 7
• Mean period between eligibility and initiation on ART reduced from six to one month.
• Care providers can provide quality pediatric ART services.
• 100% of the care givers interviewed knew correct dosing and frequency of medication
• 95% knew their appointment dates and 80% kept them
In 2011 – only 49% of Infants were initiated on
ART
In 2012 – 56% of Infants were initiated on ART
Have we made any progress?
April 18, 2023Uganda STD/ACP, MOH
10
• Delay in consensus building
• Late identification of children,
• late initiation, losses to follow up,
• Poor adherence, Paed formulations
• Strengthened central coordination by MOH,
• Role distribution among partners, improved supply chain, mentorship, use of job aids
April 18, 2023Uganda STD/ACP, MOH
11
• Proper needs assessment ensures demand driven CB,
• ownership, sustainability and SS• Ownership of interventions by stakeholders
requires interventions by them, for them and to them and not at them.
• Scaling up of pediatric HIV is best done simultaneously with the Adult ART.
April 18, 2023Uganda STD/ACP, MOH
12
• The model can be replicated to effectively save costs and develop capacity without much disruption of other services
• Pediatric HIV care does not require separate clinics and long training but harmonized, standardized curricula & mentorship
• Country ownership is possible when efforts are coordinated by government and implementation provided for by a public framework
April 18, 2023 Uganda STD/ACP, MOH13
• STD/ACP, Uganda Ministry of Health• USAID• Health Communications Partnership (HCP)• Regional Centre for Quality of health care,
Miserere University• All HIV USAID partners in Uganda (STARs,
Baylor, SUSTAIN, RTI,,,,)