HIV in Uganda

Uganda has made tremendous gains in reducing HIV prevalence from 30% to 6.4% in the last two decades. Currently, there are about 1,100,000 people living with HIV/AIDS (PLHA), of whom, 110,000 are below 15 years of age. Without ART, 66% of children living with HIV (CLWH) will die before 2 years of age, and 75% will die before their 5th birth day. About 50,000 CLWH are in need of ART but only 13,000 (26%) are getting it. Until recently, only 174 out of 324 ART active sites were providing paediatric ART. These have increased to 222 within the past year resulting in over 60% enrollment of adults in need of ART compared to about 10% for children. This glaring disparity can be attributed to;

Inadequate knowledge and technical skills of service providers in management of HIV/AIDS in children
Difficulty treating children with adult ARV formulations, due to lack of paediatric formulations
Inadequate and inappropriate health infra-structure

National and international efforts are, however being made to rectify the situation through several strategic interventions. It is on the basis of such interventions that Baylor-Uganda, in October 2007, was awarded a 5-year grant by Centers for Disease Control (CDC) to expand access to high quality pediatric HIV/AIDS care and treatment services nationwide.

By 2012, Baylor-Uganda should have supported 133 health facilities in the country to integrate paediatric HIV/AIDS care and treatment services into their existing service delivery systems. Since its inception, the program has helped change the lives of many people, young and old, infected and affected by HIV/AIDS.

Each year, 32 health facilities, in several rural Ugandan districts are enrolled. The aim of the program is to support these districts, and therefore health facilities, to integrate paediatric and Adolescent HIV/AIDS care and treatment into their service delivery systems.

Support to the facilities is done through;

Training of health care workers in care and treatment, paediatric HIV management, records and data management, pediatric HIV/AIDS counseling etc.
Logistics e.g. ARVs, medicines for Opportunistic Infections, laboratory supplies

Local Council #1 Local Council #2
A Local Council Chairman in Kagadi, handing over bicycles to community volunteers on behalf of Baylor-Uganda.

Building strategic partnerships for complimentary services
Developing and strengthening (where existent) links with community based service providers.
Media awareness campaigns i.e. sponsoring and participating in talk shows and infomercials on local radio stations.

volunteers #1 volunteers #2
Community volunteers undergoing training in the basics of Paeditric HIV/AIDS. (The Volunteers help to follow up clients after enrollment to ensure that they are retained in care)

The program uses the family care model; where the child is the index client that links the rest of the family to care. In the first year of implementation (2007/2008), 32 health facilities in 29 districts were enrolled onto the program. 9357 clients have been enrolled into care. 1129 of these are children, 249 of whom are on HAART. 8228 are adults, with 2033 of these on HAART. In all, there are 2282 clients on HAART (Highly Active Antiretroviral Therapy).

The graphs below show the impact of the program in terms of numbers of adults and children enrolled between March 2008 and December 2008.

Figure 1: Shows children in care.
Figure 2: Shows adults in care.

Figure 1.

Figure 2

Year 2 of implementation is already underway. 35 health facilities have been assessed. Come March 2009, pediatric HIV/AIDS care and treatment services will have been extended to yet more people, in need, all over the country.