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JSI successfully implemented the Uganda AIDS/HIV Integrated Model District Programme for the U.S. Agency for International Development from 2001 to 2006. Further information about Uganda AIM activities can be obtained from jsinfo@jsi.com

Key Aspects of the Programme

The AIM Programme exists to strengthen and support organisations and individuals to participate in district-level decision making which will result in broader access to quality HIV/AIDS prevention, care and support services. AIM's approach is driven by the needs of local government agencies, non-governmental organisations (NGOs), community-based organisations (CBOs) and the private sector working in selected districts. The community and those affected by HIV will also have a vital role in the design of the programme. Through the provision of technical assistance and involvement of grassroots-level stakeholders, AIM will support the establishment and management of integrated services for those heavily impacted and burdened by HIV. This involves integrating other development areas including tuberculosis (TB), malaria, food security, micro-nutrients, water and sanitation, income generating projects, gender issues, and orphan care. The Ministry of Health and the Uganda AIDS Commission have welcomed AIM, and are enjoying a close and successful working relationship.

AIM's approach is comprised of:

  • District-based and community driven, owned and managed services
  • Comprehensive, integrated and multi-sectoral services
  • Effective monitoring and evaluation at all levels
  • 'Twinning' or linking of districts
  • Simultaneous phasing of all districts
  • Sub granting through districts and directly to NGOs and CBOs
  • Capacity building through training and information, education, and communication (IEC)

The main areas of intervention include: primary prevention of HIV, HIV/AIDS care and support for men, women and children, and capacity building. Specific focus will be on voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT), orphans and vulnerable children (OVC), young people and community care.

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AIM's Programme Mission

To establish effective and replicable models that successfully contribute to the decrease in HIV prevalence and incidence in Ugandan adults and children, and that play a significant role in increasing the level of care and support to all those in Uganda affected by AIDS.

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AIM's Goal

The overall goal of AIM is for men, women, and children in selected districts in Uganda to access and utilise appropriate, affordable and quality HIV/AIDS prevention, care and support services.

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AIM's Objectives

The primary objectives of the programme are to:

  1. Strengthen the capacity of government, NGOs, CBOs, faith-based organizations (FBOs), and the private sector to plan, implement, manage and provide services at the national, district and sub-district levels.

  2. Increase the level and quality of integration of HIV/AIDS prevention, care and support services at the district and sub-district levels.

  3. Increase access to and utilisation of quality HIV prevention services in selected districts and sub-districts.

  4. Increase access to and utilisation of quality HIV/AIDS clinical, community and home-based care in selected districts and sub-districts.

  5. Increase access to and utilisation of quality social support services for people infected and affected by HIV/AIDS, including orphans, vulnerable children, and adolescents in selected districts and sub-districts.

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AIM's Strategy

The integrated approach AIM has adopted is designed to be driven by the needs of the community and includes a comprehensive plan with key interventions:

  1. Simultaneous roll out of selected districts with phased implementation.

  2. Linking of selected districts.

  3. Networking through partner collaboration.

  4. Comprehensive, integrated and multi-sectoral services.

  5. District-based and community driven, owned and managed services.

  6. Capacity building through training and IEC.

  7. Sub-granting through districts and directly to NGOs and CBOs.

  8. Effective monitoring and evaluation at all levels.

A participatory tool, the joint institutional assessment (JIA), will be used in the process of assessing the capacity of each NGO in order to strengthen the planning, management, and implementation of support services nationally and at sub-district levels.

A JIA has been completed with each NGO; consensus was gained on priority areas of strength and areas that need improvement. The AIM staff rated each category to help identify capacity gaps. Findings were then discussed with individual institutions and together they decided upon a list of priorities for capacity building. Assistance will be in the form of training, customized technical assistance or other agreed upon mechanisms. A partnership agreement will then be signed by the NGO and AIM to carry out the agreed activities over a specified time-frame.

A half- day workshop was organized on 6th June to gain feedback from the institutions about the JIA process and suggestions on how this could be improved. In addition, AIM shared the crosscutting issues arising from the assessments:

  • Strategic planning
  • Advocacy and networking
  • Monitoring and evaluation
  • Resource acquisition skills
  • Financial management
  • Strengthen district support
  • Human resources/Leadership skills
  • MIS/Report writing/Data analysis

While these similarities were quickly apparent, it is also understood that the institutions assessed have unique differences and comparative strengths and weaknesses. Capacity building can occur at the individual, organisational or institutional level. At institutional level, some customized technical assistance is required for specific NGO's (e.g. establishing an accounting system and an accompanying accounting package). NGOs like the Straight Talk Foundation (STF) do not operate through established district branches and programme staff are in direct contact with their target audiences. Those institutions with weak district branches expressed willingness to replicate capacity building in these branches.

While ten JIAs were conducted by the end of PY1, the JIA process will continue over the life of the project, with AIM monitoring and evaluating the areas of improvement with each NGO to set up a continual feedback loop to improve services.

The two main areas of intervention will be HIV primary prevention and AIDS care and support for men, women and children. Specific attention is given to VCT, PMTCT, OVC, and young people and community care. AIM regional personnel will coordinate these activities at the district level, supported by the Kampala team.

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AIM's Core Activities

Following is a list of prioritized core activities that each district will plan for and implement during the programme period. These core activities have been agreed upon by stakeholders and each district. If all activities are available in a district, then a comprehensive service is available. AIM's task is to assist with the process.

The core activities are:

  • VCT
  • Targeted prevention efforts for high risk population, especially youth
  • Clinical care, including prevention and treatment of OIs
  • Clinical care, including prevention and treatment of TB
  • Community and home-based care
  • Laboratory capacity
  • PMTCT
  • STI management
  • Skills building and education intervention for orphans, vulnerable children and adolescents (OVCA)
  • Infection control

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AIM's 'Comprehensive AIDS Service Centre'

One of AIM's goals will be to launch comprehensive service centers in selected districts so people will have access to high-quality services all located in an easy to access center.

Role of the Centre
  • Provides comprehensive HIV/AIDS care and prevention services to all members of the public through direct intervention and referrals to partner/integrated facilities.
  • Provides training and technical supervision of lower service delivery points in the district
  • Coordinates with existing community activities/facilities/services
  • Schedules adolescent friendly services (mainly STI management, VCT, condom education) through a 'youth-friendly corner' type approach

It may not be possible to provide all services in one location or centre. For this reason an effective referral system will ensure a multi-centre approach providing the public with a comprehensive range of accessible HIV/AIDS services.

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AIM's Key Achievements to Date

  • Fifty-two Ugandan staff recruited (for health services, training capacity building and management, and administration)
  • Six editions of SCOPE newsletter produced and distributed
  • Districts selected (16 in all) following key meetings and district assessments
  • Established programme office base and logistical support
  • Regional coordination centres and personnel established
  • TB priorities identified
  • Core activities identified and agreed to
  • Over half a million dollars provided to 138 NGOs to enable them to scale up activities at national level
  • Technical assistance provided to PMTCT video production
  • Technical assistance provided to VCT materials revisions in collaboration with key stakeholders
  • Finalised Joint Institutional Assessment process with AIM partner NGOs
  • Fostered a strong working relationship with MOH and UAC
  • Established AIM Steering Committee
  • Established AIM Advisory Group
  • Held AIM Launch for all 16 AIM Districts
  • Conducted reconnaissance visits to all Phase I and Phase II districts
  • Sensitised DHACs in all selected Phase I and Phase II districts
  • Conducted District Assessment visits
  • Conducted Health Facility and Infection Prevention surveys with the
    DELIVER Project
  • Completed Situational Analysis and Needs Assessment of districts
  • Collaborated with UAC on district HIV/AIDS co-ordination guidelines
  • Prepared one-stop HIV/AIDS service guidelines
  • Established AIM Resource Centre
  • Conducted in-service staff training in reproductive health for AIM staff
    (Fortnightly training programme)
  • Presented on district selection process and on VCT manual development at
    Barcelona XIV International AIDS Conference
  • Supported NACWOLA to attend and present at International AIDS
    Conference
  • Produced five-year Monitoring and Evaluation Plan
  • Produced Strategic Plan and five-year Work Plan
  • Established and piloted AIM Programme M&E Database

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View a map of the districts that AIM will be working in.


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