The Ugandan Ministry of Health (MOH) promotes a comprehensive package of services for people living with HIV/AIDS (PLHA) implemented across the continuum of care. The package includes clinical services, nursing care, counseling, social support, palliative care and home-based care. As a growing number of PLHA require long-term care, the community plays a critical role in complimenting the health sector’s efforts to deliver an effective response to the epidemic. The community participates in the delivery of quality HIV services--through counseling and psychosocial support, adherence support, referrals and dissemination of information--which reduces the burden of care on the already-constrained healthcare system.
In order to support the MOH’s efforts to build a strong community linkages component in the health system, USAID/SUSTAIN working with ICOBI (Integrated Community Based Initiatives) has developed functional linkages between healthcare facilities and surrounding communities.
Through the use of hospital-based community linkages coordinators that work with the facility community health departments and quarterly inter-facility meetings (between hospitals, lower health units and key stake holders), follow-up and transfer of clients has been streamlined while keeping documentation up-to-date.
Community linkages activities include follow-up of HIV-positive clients receiving antiretroviral treatment and pre-antiretroviral therapy care, tuberculosis (TB) and multi-drug resistant TB treatment, clients on nutrition rehabilitation, prevention of mother-to-child transmission and early infant diagnosis care services who missed appointments.
- Monthly inter-facility meetings and client home visits are conducted at 12 supported facilities.
- Through improved referrals and follow up, linkage to care for clients newly identified as HIV-positive has improved from 62.3% in March 2014 to 85.5% in March 2016.
- Through client home visits, 30% of clients lost to care have returned to care within a month of follow-up.