The USAID-funded Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project began in 2010 to support the Ministry of Health (MOH) in implementing and delivering selected HIV prevention interventions and care and treatment services. The project currently supports 11 public healthcare facilities (10 regional referral hospitals and one general hospital) to deliver quality HIV care and treatment services to the population. The project targets to enroll up to 56,000 clients—adults, children and adolescents—on antiretroviral therapy (ART). By March 2016, 51,610 clients were already enrolled on ART.
To ensure the continuity of care and treatment for patients currently in supported hospitals, SUSTAIN aims to strengthen the health system and equip healthcare providers with the skills to provide quality care and treatment services for the services listed below:
- Antiretroviral therapy: Determine eligibility for initiation of ART for people living with HIV, increase service provider skills in the provision of ART services according to national guidelines and ensure a constant supply of antiretroviral drugs (ARVs) by strengthening supply chain management systems.
- Community-facility linkages: Develop functional linkages between hospitals and surrounding communities by strengthening hospital-based community health departments, developing systems for client follow-up and supporting psychosocial support through the facilitation of peer support groups and linkages with community-based resources.
- Prevention of mother-to-child transmission of HIV (PMTCT): Strengthen health worker skills and hospital systems to provide PMTCT services in support of MOH efforts to eliminate mother-to-child transmission of HIV in Uganda. In 2012, the MOH initiated efforts to roll out Option B+ (initiation of full ART for pregnant mothers) in several project-supported hospitals. More recently, mother-baby care points have been established to improve retention of mother-baby pairs in HIV care.
- HIV counseling and testing (HCT): Scale-up quality HCT services using various approaches, including couples counselling and provider-initiated testing and counseling. In 2015, efforts shifted to provide targeted HTC services in areas which identify more HIV-positive persons, like in in-patient wards as opposed to out-patient wards.
- Adolescent-friendly health services (AFHS): Establish functional AFHS model centres at six regional referral hospitals (RRH) in collaboration with the MOH. The centres are at Jinja, Mbale, Gulu, Lira, Moroto and Kabale RRH. The facilities have set aside care spaces for adolescents and have been equipped with recreational and information education and communication materials to attend to the specific needs of adolescents.
- Laboratory services: Improve supported laboratories’ capacity for HIV-related testing and develop an effective referral system for transferring samples and results of viral load monitoring and DNA-PCR tests for early infant diagnosis. Supported laboratories are also enrolled on select laboratory accreditation programs.
- Nutritional assessment and counseling support (NACS): Integrate NACS into the care of people living with HIV/AIDS (PLHA) by strengthening service provider skills in NACS and infant and young child feeding (IYCF), implementing malnutrition prevention activities, facilitating linkages with other implementing partners and advocating for the provision of ready-to-use therapeutic food (RUTF).
- Pediatric HIV care and treatment: Improve diagnosis, care and treatment, referral and follow-up services for HIV-exposed and infected infants and children.
- Psychological support and counseling for PLHA: Integrate psychological support into the routine HIV care and treatment package and equip health workers with the skills to provide ongoing and quality psychological support and counseling to PLHA.
- Tuberculosis (TB) and HIV co-infection: Support facilities to implement joint TB-HIV care in line with MOH policy by establishing TB-HIV coordination structures, improving access to HIV testing and prevention services for TB patients and routine TB assessment for HIV patients and establishing effective linkages to treatment.
- Safe male circumcision (also known as voluntary medical male circumcision – VMMC) is a scientifically proven biomedical intervention for prevention of female-to-male transmission of HIV.
- Key population services: Support facilities to provide services for key populations by equipping healthcare providers with knowledge and skills to integrate and offer routine care for key populations (also know as most at-risk populations).