Maternal Child HIV/AIDS Component
The maternal child HIV/AIDS component of SIHCI promotes health development through creation of and strengthening systems for health care around mothers and their children as these are considered vulnerable. The vulnerable groups here include expectant mothers and children, Adolescent girls who are a reproductive age group with a wide range of reproductive health challenges.
These are linked in a systematic manner to existing MCH services through promoting sustainable and effective access and availability of services.
Comprehensive packages of care are provided through utilisation of existing MCH services at both the peripheral Health service delivery points.
HIV/AIDS Prevention, Care, Treatment and Support
People’s ability to protect themselves against HIV infection has proven inadequate. SIHCI therefore provides people with evidence based information within an enabling environment to help them reduce HIV susceptibility and vulnerability. This gives them opportunity to change their behavior based on knowledge gained through information dissemination.
SIHCI, augments general awareness-raising activities to provide information and counter negative reactions among the population at large; focused persuasive action to meet the needs of specially vulnerable groups
HCT: SIHCI provides counselling and testing in a variety of settings, where clients may seek services. Community gazetted canters, places of work, health facilities or other settings, or they may receive this service as a routine part of services at primary health facilities, antenatal clinics, STI clinics, or maternal and child health (MCH) clinics.
The HCT setting is tailored to available resources, cultural context, and the health priorities and needs of clients in particular communities.
Positive Prevention for (PHAs)
• Support for consistent condom use and safer sex.
• Support for disclosure and partner testing
• Discordant and Risk reduction counseling
• Reproductive choice counseling and family planning
• Provision of PMTCT interventions
• Interventions against inter-generational sex
Intervention to prevent other infections (insecticide-treated bed-nets, safe water, nutritional support; care including cotrimoxazole, INH and
fluconazole prophylaxis, early case detection and management of cryptococcal meningitis and other OIs; etc)
Care and Treatment for PHAs
Once HCT has been done, clients who test positive are immediately subjected to CD4 count tests to ascertain their eligibility for ART. The clients are also provided with cotrimoxazole prohylaxis and are screened for TB, STIs as well as urinary tract and skin infections. When found positive they are treated or referred for further management. All this is done in liaison with existing public health structures. This approach is critical in strengthening the Health service delivery system and sustainability.
Adequate supply of medicines, diagnostics and other commodities for STI is integrated within the supply system with ART, OI, other drugs and diagnostics.
Nutritional needs: Focusing on helping families improve their gardens, teaching about nutritional foods and preparation, ensuring safe drinking water, providing food.
Social needs: Including helping people overcome fear of visiting and supporting PLWHIV.
Capacity needs: Creating supportive systems helping PLWHIV and their families and caregivers make their own decisions and run their own programs.
Supportive Care and Support Interventions
Home Based Care
• Train caregivers in the basic home health care of PLWHIV.
• Provide counselling services to PHAs and their caregivers at home.
• Train clinic or hospital medical staff to meet the medical needs of PLWHIV
in their homes.
• Establish, train and support PHA networks and peer support groups through
mentoring and coaching.
SIHCI meets adolescents requirements (both male and female), comprising integrated reproductive health (RH) education and services that include abstinence promotion as
well as dissemination of family planning information, counselling services for sexually active adolescents; sex education and information for prevention of STD and HIV/AIDS; counselling on gender relations, violence and sexual abuse against adolescents.
SIHCI also prides in creating sustainable systems for community involvement in programme and intervention development, building upon the will of groups and individuals: greater integration between prevention and care to reduce costs and levels of discrimination and stigmatization and action to build societal resistance to HIV transmission and reduce the systematic vulnerability among adolescents and women of reproductive age.
Orphans and Vulnerable Children (OVC) Interventions
Care and support services for OVC are implemented to build their capacity to enable them address comprehensively the needs of OVC. Besides supporting OVC, care givers are supported with necessary skills so that they can meet their own long tern needs. Partnership building, networking, collaboration and referral are major factors enabling communities to provide services.
Improvement of OVC care and support is done at three interventional levels namely; the Child level to ensure provision of a comprehensive package; the caregiver/ family level where continuous follow up and mentoring of caregivers is used to enhance their ability to care for OVC and at their level; and community level where capacity of partners is built through information sharing dissemination workshops and regular support supervision.
Partners utilize existing referral networks in their communities through collaboration to access specialized services such as palliative care services and paediatric care. To intensify awareness in OVC care and support, drama clubs are used to conduct
community magnet theatres to raise awareness on HIV/AIDS as well as OVC care and support. Child protection continues to be an important ingredient in realizing OVC’s socioeconomic welfare. Partners through their routine home visits emphasize issues on child protection to reduce incidences of child abuse with capacity and courage to refer cases of child abuse for further support through established collaboration and partnership networks. Community awareness programs to ensure increased OVC support are promoted through information, education and communication activities at community level.
At family level, OVC households with guidance from partners strive to improve nutritional supplementation activities through value addition, agricultural diversification and food storage. Caregivers have been trained in improved farming methods, demonstration farms visited and nutritional skills for OVC households improved. This has been achieved largely through referral and established networks with the district authorities.
Best Practices and Innovations for HIV prevention targeting MARPs
Roads II Project Kinawataka Nakawa Division Kampala in collaboration with Family
SIHCI has piloted a new approach in HIV/AIDS prevention targeting Most at Risk populations (MARPs). The specific MARPs in this project are Commercial Sex Workers (CSWs) and Long distance truck drivers. This project was implemented in partnership with Family Health International (FHI). SIHCI was instrumental in mobilizing the truck drivers and community members who included CSWs for HIV prevention and HCT. Through this process SIHCI disseminated HIV prevention and positive living messages and other appropriate practices. CSWs and truck drivers were then separated from the rest of the community through their structural heads and group discussions conducted to enable them open up and for our facilitators to have a deeper understanding of any prevailing issues with regard to HIV prevention and control.
Our approach involves community partners to integrate discussion of broader health services into their ongoing HIV activities. SIHCI implemented a “cluster model approach” and initiated two community clusters: a) Low-income Women Cluster and b)
Youth Cluster in Kinawataka – a Kampala suburb. Clusters are composed of groups involved in the full range of indigenous volunteer groups.SIHCI implemented HIV/AIDS and other health programs through community clusters, which capitalize on routine interpersonal communication through trusted networks. With technical support from SIHCI clusters identify needs, plan and collectively implement activities, drawing on many of their own resources (e.g. thousands of hours of volunteer time and community facilities), using SIHCI support as a catalyst. Transport workers are part and parcel of these discussions as Kinawataka is a hub of long truck drivers.
Through community mobilization and outreach (peer education and counseling) these volunteers have generated significant uptake of HIV services especially HCT and referral for support services. SIHCI trained peer educators who serve as an excellent platform to extend health messages and promote the full menu of services among difficult-to-reach and vulnerable audiences.
Occupational Health and Safety (OHS)
Workers in Uganda are protected by Occupational Safety and Health (OSH) Act of 2006, Employment Act of 1977, The Public Health Act and the Workers’ Compensation Act of 2000. Anyone working full-time or part-time, or has a permanent, temporary or casual job, is covered. These legislations are designed to protect people by establishing safe systems of work to eliminate or minimise the risks to health, safety and welfare. Employers, employees and others, such as manufacturers and suppliers of machinery or substances used at work, all have an important role to play.
SIHCI therefore ensures employees’ reasonable health and safety measures are undertaken through risk assessment of the workplace, training, quality assurance and regular monitoring and inspection. At road construction sites Traffic control and management is also pertinent in provision of OSH services. SIHCI works closely with other law enforcement agencies like police and Labour offices to ensure workers safety is enhanced by the employer.