Background: 

The IDI Kibaale Kiboga Project attempts to build the capacity of the health sectors in these two districts by working within the existing structures to increase community access to care and treatment services for HIV/AIDS, sexually transmitted diseases, TB and malaria. More than 21 health units have been identified for renovation and capacity building in these two districts.

Approaches Used and Key Accomplishments:

Scaling up HIV/AIDS Services: 

The project has established a mechanism for the procurement of test kits at short notice and has created logistical links with MOH for supplies. So far more than 50,000 people in the two districts have been counseled and tested for HIV.

Development of Innovative Approaches:  In order to increase the effectiveness of the project, a camping strategy to get in touch with hard to reach areas, like the landing sites along the shores of Lake Albert, has been developed and implemented.

Community Mobilization:

 In partnership with The AIDS Support Organization (TASO), the project has trained over 100 AIDS Community Volunteers to support testing and to enhance community support.

Continuous Medical Education:

The IDI Training Programme has targeted health workers in Kiboga and Kibaale, and has enabled them to acquire additional medical training in data management, TB management and HIV management—among other things.

Laboratory Support:

Free CD4 testing has been initiated at partner facilities. A total of 1,695 samples have been collected. Using public means, these samples are transported from Kiboga and Kibaale Districts to the MU-JHU Core Lab at IDI, or to neighboring districts that have CD4 machines, for testing.

Addressing Staff Shortages:

The project has supported advertising, short listing and interviewing for recruitment of health care workers in Kiboga (six clinical officers and four lab techs have been hired through project-supported processes). Two mobile teams made up of physicians, clinical officers, counselors, lab assistants and medical records clerks have also been recruited to support the districts’ health services.  

Addressing Health Worker Motivation: 

Motivation schemes have been put in place to encourage health workers in the two districts. A group motivation package is given to each district hospital and each lower level health unit. The money is shared by all staff in a manner that they determine. All members of staff associated with the HIV/AIDS clinic, including cleaners and tea girls, are also included in this scheme.

Partner Coordination:

The project has been actively involved in strengthening coordination among health providers working in the two districts. It has supported the district in holding key stakeholder meetings such as District AIDS Committee meetings. The project has also initiated partner meetings in Kampala, in a bid to help coordinate efforts, which will increase the impact of all organizations’ activities.

Challenges and Opportunities: 

This year the project will focus on scaling up HIV/AIDS, TB and Malaria programmes in Kibaale and Kiboga.  In addition, the project will be expanded to three other underserved districts:   Hoima, Masindi and Bulisa. Some of the other challenges that the project will focus on this year include: 

• How to streamline the process of  drug procurement by the districts, in order to reduce drug stock outs
  
• How to quickly increase the number of skilled health care workers at the district level, through on-site and off-site Continuous Medical Education
  
• How to improve service delivery through infrastructural development of health facilities at the at the very lowest levels