Strengthening Civil Society for Improved HIV & AIDS and Orphans and Vulnerable Children service delivery in Uganda (SCIPHA)

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Strengthening Civil Society for Improved HIV & AIDS and Orphans and Vulnerable Children (OVC) service delivery in Uganda (SCIPHA) was an 18 months project which Commenced early 2011, and was being implemented by a consortium comprising of the JCRC and Uganda Health Marketing Group (UHMG) in 5 regions of Uganda (West Nile, North, Central, Mid-west, and Eastern) with a total of 19 districts. However JCRC received extensions II and III of SCIPHA operation that saw it last 5 years.

JCRC served as the prime, with the responsibility of coordinating the implementation of the project. In the implementation of the project, the consortium complements each other based on the unique competencies, niche and experiences of each organization in the provision of quality HIV prevention, Care, treatment and support services. Particularly, UHMG led on HIV prevention by creating demand and uptake of HIV service & products while JCRC led on Care, Treatment, and quality assurance at all levels.

The consortium adopted a lead agency model that involved working through existing district and community structures such as the Civil Society Organizations (CSOs), private sector health providers, Village health teams, and AIDS coordination committees focusing on the Most at Risk Populations (MARPs) such as Truckers, Fisher-folk, Commercial Sex workers, as well as the OVC and People Living with HIV& AIDS.

To enhance effective participation of the stakeholders, the consortium operates through district coordination structures in the targeted districts. Although the consortium worked in collaboration in the implementation of the project, UHMG oversees the operations in the two regions of central and West Nile comprising of 8 districts of Moyo, Koboko, Arua, Nebbi, Kalangala, Mpigi, Mityana, Kiboga, while JCRC oversaw and coordinated the activities in the Northern, Mid-western and Eastern regions comprising of 11 districts of Gulu, Lira, Amolatar, Katakwi, Soroti, Tororo, Kabarole, Bundibugyo, Kasese, Hoima, Masindi.

This arrangement aimed at leveraging resources and was based on the partnerships and presence of each consortium members in the targeted districts.

The project served to increase access and utilization of HIV/AIDS prevention, care, treatment and support services; strengthen quality of HIV prevention, care and treatment services; establish effective referrals, linkages and partnerships for comprehensive HIV services; and enhanced the capacity of ten CSF-funded organizations to deliver quality HIV prevention, care and treatment services. The expected outputs of the project included:

  • Ten Civil society Organisations (CSOs) supported to implement comprehensive HIV prevention, Care, treatment and support services.
  • Thirty eight Sub-county Health facilities supported to provide HIV prevention, care, and treatment and support services.
  • Community Structures supported to increase demand and uptake of HIV products and services.
  • Nineteen district institutions oriented to national standards, policies, tools for delivery of quality HIV services.
  • Quality Assurance systems of Nineteen CSOs strengthened.
  • 21 SCIPHA SUB grantees and 6 Civil Society Fund (CSF) Funded CSOs are supported to establish collaborative partnerships, referral and linkages in the provision of comprehensive HIV and AIDS services.
  • Capacity of six CSF organizations built to deliver quality HIV services.

To achieve the goal of the program, the project pursued four specific result areas:

  • Objective 1: To increase access and utilization of HIV/AIDS prevention, care, treatment and support services in the 19 focus districts by the end of May 2012
  • Objective 2: To strengthen quality of HIV prevention, care and treatment services offered by at least 10 CSOs in the 19 districts by June 2012
  • Objective 3: To establish effective referrals, linkages and partnerships for comprehensive HIV services within the 19 selected districts by 2012
  • Objective 4: Build capacity of CSOs of CSF funded organizations to deliver quality HIV prevention, care and treatment services
  • Objective 5: Address the underlying socio-cultural, gender based and other structural drivers of the HIV epidemic in the 19 SCIPHA districts

Joint Clinical Research centre (JCRC) received an 11 months extension from Feb to Dec 2015 Strengthening Civil Society for Improved HIV/AIDS and Orphans and Vulnerable Children (OVC) Service Delivery in Uganda (SCIPHA). It was implemented in 5 regions solely by JCRC targeting 19 districts of Uganda namely; Kabarole, Hoima, Masindi, Kasese, Bundibugyo, Mpigi, Kiboga, Kalangala, Mityana, Lira, Amolatar, Agago, Soroti, Katakwi, Tororo, Arua, Nebbi, Koboko and Moyo covering 75 sub counties. SCIPHA worked with existing structures including 19 district officials, 20 CSOs, 525 VHTS,75 community owned resource persons, networks of PLHIVs and health facilities in 75 sub counties, to provide HIV care and HIV prevention services including HCT, BCC, condom and IEC distribution, STI screening SRH to Key Populations comprising the Commercial Sex Workers, Truckers, Fisher Folk, Men and women in Uniform, incarcerated populations, Bodaboda riders, People living with disabilities, youth out of school, pregnant women, discordant couples as well as People Living with HIV as well as HIV care services e.g. psychosocial support, STI, OI, TB screening, Septrin prophylaxis EID, SRH, social support to children, adolescents and adults living with HIV at community level.

The main objectives were:

Objective I: To increase access and utilization of HIV prevention services in the 17 focus districts by the end of December 2014.

Objective II: To increase access and utilization of HIV/AIDS care, treatment and support services to adults, adolescents and children living with HIV/AIDS in targeted communities by the end of December 2014.

Objective III: To establish effective referrals, linkages and partnerships for comprehensive HIV services within the 19 selected districts by December 2014.

Objective IV: To build capacity of 9 CSF funded CSOs and 20 SCIPHA sub grantee CSOs to deliver Quality HIV Prevention, care and treatment services by the end of December 2014.

Objective V: To address the underlying socio-cultural, gender based and other structural drivers of the HIV epidemic in the 19 SCIPHA districts

SCIPHA supported formation of mama clubs for purposes of EMTCT mentorship and sensitisation of women and their partners for Antenatal care, HCT, FP and other health services as well as Baba clubs to increase male involvement in HIV and other health seeking activities. Youth out of school clubs, People with disability and children living with HIV clubs were formed for peer sensitisation and psychosocial support. The project shared its achievements and reports with district officials and other HIV stake holders during district review meetings in the 19 districts.

SCIPHA implemented a combination HIV prevention, treatment, and care and support services in 19 districts. In order to address the structural drivers in the HIV combination strategy SCIPHA did needs assessment of these drivers in the 19 districts by conducting mini assessments among opinion leaders in order to design meaningful, relevant and appropriate interventions.

SCPHA disseminated findings of the mini assessments done among different opinion leaders including district, sub county, religious, political, cultural, technical, key population leaders in each of the 19 districts to determine the harmful social cultural and other structural drivers of the HIV epidemic in 19 districts and has continued to hold dialogues with communities on how to mitigate these drivers.

The project continued to hold interactive sessions like mentorship and coaching with CSF funded CSOs and SCIPHA sub grantees into build their capacity in management, finance and administration, human resource, data management, quality improvement and other technical areas to enable them deliver quality HIV services to communities served.

SCIPHA generally achieved its target of empowering individuals of the key populations, to demand and access HIV prevention services including messages of adoption of safer sexual behaviours and HCT. This was largely attributed to mobilization of the key populations through their coordinators as well as other opinion leaders, VHTs and employing strategies e.g. targeted outreaches for bodaboda cyclists, safe sailing boat initiative and moon light camps.