International Development

International Health Projects: Uganda

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Project		Indoor Residual Spraying (IRS) to Control Malaria

Timeline		2005-2007

Funding Agency		United States Agency for International Development

Background		The Kabale district, located in the highlands region of southwestern Uganda, is one of the most malaria-prone districts in the nation. Significant epidemics occurred in February 2002, November 2003, and June–July 2005, and an estimated ninety-three percent of the population is at risk for contracting malaria.

Purpose		To conduct a well-targeted IRS project that can be used to develop an IRS system for scaling up activities to other parts of the country.

Activities and Results		RTI has been supporting the Uganda Ministry of Health National Malaria Control Program (MOH/NMCP) to implement the IRS program, covering a population of about 500,000. A malaria situation analysis and needs assessment conducted in November 2005 helped determine the technical, financial, human capacity, and logistical needs required to implement the IRS activity in the district. Beginning in April 2006, RTI helped organize and train 379 spray operators, team leaders, supervisors and other health officials for the spraying activities conducted between June and August 2006. The team also conducted 139 district-, subcounty-, and community-level sensitization and mobilization meetings about IRS, employing a variety of educational methods such as film shows, radio talks, daily radio spots, and posters. Additional activities included conducting entomological surveys to determine indoor and outdoor vector densities prior to spraying, and a baseline survey on environmental and human health monitoring. Post-IRS surveys are being conducted in October-November 2006 to evaluate the persistence of the sprayed insecticide on treated surfaces; to determine the impact, if any, of IRS on the environment; and to assess the spray operators' health after the spraying.

More Information		Malaria in Africa (516 kB PDF)

Project		Malaria Prevention and Control

Timeline		2005-2007

Funding Agency		U.S. Centers for Disease Control and Prevention

Background		Malaria is endemic in 95% of Uganda and is one of the leading causes of morbidity and mortality there. The Ugandan Ministry of Health (MOH) policy guidelines for preventing and managing malaria emphasize the following interventions: Improving case management of malaria illnesses in health facilities and at home Promoting the use of ITNs, especially among vulnerable groups such as pregnant women and children Promoting vector control through indoor residual spraying Improving epidemic preparedness and response

Purpose		Promote the use of insecticide-treated nets (ITNs) for preventing and managing malaria.

Activities and Results		RTI is working to increase the effective use of long-lasting ITNs among 38,200 residents of Ogur and Abia camps for internally displaced persons in Lira District. The project is being implemented in partnership with the Uganda Ministry of Health-Lira District Directorate of Health Services and the Christian Children's Fund. Under this project, RTI hopes to develop mechanisms that address the critical barriers to utilization of ITNs among camp residents, mechanisms which can also be replicated elsewhere. Using information generated from various local stakeholders on factors that influence effective ITN utilization, the team is developing a malaria health education and free ITN distribution strategy to promote and facilitate the proper use of nets in the camps. Lessons learned from this project will be valuable to upcoming ITN distribution programs in other parts of the country and continent where there is also high incidence of the disease. RTI is also implementing a similar project in Kabale District, southwestern Uganda, funded by USAID under the Integrated Vector Management task order. Between June and August 2006, the project sprayed a total of 103,329 houses, resulting in more than 488,502 residents being protected from malaria, including 82,275 children.

More Information		Malaria in Africa (516 kB PDF)

Project		Expansion of Routine HIV Counseling and Testing and the Provision of Basic Care in Clinics and Hospitals in the Republic of Uganda

Timeline		2004-2010

Funding Agency		U.S. Centers for Disease Control and Prevention (CDC), Global AIDS Program National Center for HIV, STD, and TB Prevention (NCHSTP)

Background		One of the key interventions that the fight against AIDS has been lacking has been the absence of an incentive for people to get tested. Currently, the majority of patients who are seen by health workers and who show signs of HIV/AIDS are not tested, because examiners typically have not been properly trained to recognize the symptoms. This project aims to change this by educating communities about the benefits of testing, in particular the incentives of better health and improved quality of life. Trained health workers will be better able to offer or refer patients for testing, counseling, and treatment services. Better-educated patients, health care workers, and communities will provide an opportunity to avoid sickness and early death, and good prospects to deliver a higher quality of life in communities strongly affected by HIV/AIDS.

Purpose		The purpose of this project is to introduce routine HIV counseling and testing (RCT) to all patients presenting themselves at district hospitals and clinics in Uganda and provision of basic health care services to those testing HIV positive. The goal is to provide an integrated, sustainable HIV infection prevention and AIDS treatment and care service that breaks down individual and institutional barriers to HIV testing and establishes the conditions necessary to foster positive health-seeking and maintaining behaviors.

Activities and Results		RTI conducted training courses and a technical assistance needs assessment to assess current clinical resources, practices, and referral systems in each district relating to routine HIV counseling and testing, preventive, care, and treatment. RTI partnered with a local nongovernmental organization (NGO), AIDS Information Center, and with the Ugandan AIDS Healthcare Foundation, Uganda AIDS Commission, Ministry of Health, District health authorities, and other stakeholders. Local experts from these organizations help to empower communities to continue to campaign for these initiatives through awareness building and direct health services. Through workshops and seminars, 200 doctors, nurses, clinical officers, laboratory workers, and pharmaceutical technicians will be trained during the first year. In the following four years, over 1,000 will be trained.

More Information		HIV Counseling, Testing, and Care in Rural Uganda (333 kB PDF)

Project		Combating HIV/AIDS in Ugandan Workplaces Through Community/Faith-Based Organizations

Timeline		2003-2007

Funding Agency		U.S. Department of Labor

Background		While many successful HIV/AIDS intervention initiatives have taken place in Uganda over the past 15 years, little has been done to reach the informal sector workplace. Yet, a sizable proportion of Ugandan workers are employed in the informal sector, which comprises various occupations such as market vending, fishing, local transportation, auto mechanics, carpentry, and many other sources of livelihood. Through a cooperative agreement funded by the U.S. Department of Labor, RTI will seek to stem HIV infections in Ugandan workplaces in collaboration with the Ugandan government, local faith-based organizations (FBOs), and community-based organizations (CBOs).

Purpose		The purpose of this project is to support Ugandan community and faith-based organizations to plan, implement and monitor HIV/AIDS prevention programs in the informal sector and surrounding communities in four districts.

Activities and Results		The project undertook a rapid assessment of HIV/AIDS issues in informal sector workplaces in the proposed districts. The findings of the rapid assessment led toward the development of a behavior change strategy that will be utilized with the target groups. RTI's approach focuses on creating mechanisms necessary to disseminate HIV prevention messages to workers, based on each workplace's culture. The program also provides relevant information about HIV/AIDS with the aim of fostering a dialogue among workers and the surrounding communities. The goal is to change attitudes and behaviors that influence the spread of HIV and that perpetuate stigma and discrimination of people infected or affected by HIV/AIDS. The project will also develop linkages between HIV/AIDS services (including treatment and care) and services related to HIV prevention, counseling and testing, early detection of potential mother to child transmission, STI treatment, home based care support and providing information to workers on how they and their partners/relatives can assess such services. RTI will work to address the most critical areas of need of local organizations, including better skills to scale up their existing activities, improved program management and evaluation, enhanced financial and administrative systems, and strengthened partnerships between the informal sector and the government. Activities such as training in peer education, counseling, basic accounting, human resources management, proposal development, report writing, fundraising, planning and budgeting, and network strengthening will improve the efficiency of the organizations as well as enabling them to obtain more funding to continue carrying out HIV/AIDS awareness and prevention programs.

More Information		Uganda Workplace HIV/AIDS Prevention Project (WAPP) (360 kB PDF)

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