HUMANITARIAN CARE UGANDA (HCU)

Project Title: Fighting AIDS In The Home (FAITH)

Project

KABALE DISTRICT QUARTERLY REPORT

October 2012 December 2012

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

Acronyms

AIDS CAO CHCT DHO FAITH GLCs HCU HIV PHAs PMTCT RDC SMC STI UHMG USAID

Acquired Immunodeficiency Syndrome District Chief Administrative Officers Couple HIV Counseling and Testing District Health Officers Fighting AIDS In The Home Project Good Life Clinics (UHMG supported private health facilities) Humanitarian Care Uganda Human Immunodeficiency Virus People living with HIV/AIDS Prevention of Mother to Child Transmission of HIV Resident District Commissioner Safe Male Circumcision Sexually Transmitted Infections Uganda Health Marketing Group United States Agency for International Development

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

1.0 Introduction
This report is a product of a number of FAITH project activities in Kabale district. It therefore accounts what took place in the district in relation to implementation of FAITH project. FAITH an acronym for Fighting AIDS In The Home project supports HIV prevention among couples and partners in long term sexual relationships integrated in broader maternal and child health services. Objectively, the project looks forward to contribute tothe reduction of new HIV infections among people in long term/stable unions and increasing awareness and utilization of services for a good life. As an implementing agency, Humanitarian Care Uganda received funding from USAID through UHMG to implement the FAITH project in Kabale and other 8 districts of Kanungu, Mbale, Kabarole, Lira, Wakiso, Kamuli, Mukono and Kyenjojo. Working through fidelity couple support groups popularly known as fidelity clubs, has enabled the project to increase couples and general communitys access to HIV prevention, care and social support services; as a way of empowering them in their long term sexual relationships harmoniously.

2.0 Quarterly Activity Performance Matrix No. Activity Description

1. Promotion and orientation of HERO couples on a variety of modern FP methods Community education and mobilization for promotion of faithfulness

Performance Indicators
No. of couples oriented

Target
16couples

Output
32persons

%age Comments clarification

100%

/Performance

Accomplished. Thanks to the effective mobilization and interest in the project by HERO couples Ongoing. Affected by the limited club meetings for review of progress and gaps in the monitoring and support supervision of project activities. Ongoing. Affected by shortages of test kits and the number of outreaches per month which need to
2

2.

No. of people in long 11765 term sexual adults relationships educated and mobilized

8,410 adult 71% individuals

3.

Linkages for CHCT No. of couples 2304 among people in long mobilized for CHCT couples term sexual and receiving their

314 couples

14%

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

relationships 4. Mobilization for Maternal Health Services Mobilization for Child Health Services

results 940 mothers 1567 children 356mothers 38%

5.

6.

7.

8.

No. of mothers accessing Maternal Health services No. of Children accessing Child Health services Mobilization and No. of adult males referral for Safe Male embracing SMC for Circumcision HIV prevention Marital Counseling No. of individuals counseled on marital issues to promote family harmony Support supervision and No. of visits conducted monitoring visits

be increased due to the demand for this service. Ongoing.

552 children

35%

Ongoing.

2131 adult 165adult males males 1241

8%

Ongoing

Ongoing. Thanks to club meetings and outreaches.

8 visits

8 visits

100%

Accomplished

3.0 Activity Implementation

3.1 Promote and orient couples on a variety of modern family planning methods

Upon promotion of good life, HCU through the FAITH project procured a number of family planning products which included among others Injectaplans, Implants, IUDs, NewFem, Softsure, Pilplanplus, O-condoms and protector condoms to help couples to have small and manageable families. These were distributed to 3 Good Life Clinics (as shown in table 1 below). Meanwhile to ensure that couples adopt their use, a sample of 32couples (2 couples from the 16 clubs) subscribing to the fidelity clubs were oriented by medical person officers from UHMG supported GLCs through discussions and demonstrations on how to use these products and later mobilize and refer other members of the community to such clinics where the products had been stocked. During the delivery moments, chair persons of fidelity clubs were invited and witnessed the process.

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

Table 1: List of family planning methods distributed in Kabale district S/N ITEM Quantity supplied to Good Life Clinics NYAKASHARARA HC III RUGARAMA HOSPITAL 1 2 3 4 5 6 7 8 9 Injectaplans Implants IUDS New Fem Soft Sure Pilplans plus O-condoms Protector condoms Aqua Safe 1 Carton Carton 1 Carton 1 Carton 2 cartons 2 Cartons 2 Cartons 2 Cartons 1 Carton 2 Cartons 8 Small boxes 2 Cartons box KIHEFO CLINIC 2 Cartons 1 Carton 50 Pieces 1 Carton 1 Carton 1 Carton 6 packets 2 Cartons 10 packs

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

Fig 1

Fig 1: A medical officer noting down the type and quantities of family planning products being delivered as an HCU staff (in a cream T-shirt) looks on
3.2 Community Education and Mobilization

Members of the Fidelity Clubsengaged community members through peer to peer education and community outreach visits. Issues which may increase their vulnerability to HIV infection like sero discordant, PMTCT, family planning, STI management and care, positive prevention, gender based violenceamong others were integrated into these community discussions. This was done to enable couples explore the available options and opportunities and make informed decisions based on what to apply in a given situation In total, 8410of which 3984 were men and 4426 women were reached by the HERO couples through interpersonal communication approaches and small group discussions as presented in table 2 and 3 below.

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

Table 2: Individuals reached by HERO couples during the ongoing couple communication & education on fidelity

District Kabale Sub-county Buhara Bukinda Maziba Bubaare Kyanamira Kabale S Div Kaharo Kamuganguzi Kitumba Kabale N Div Hamurwa Rwamucucu Muko Kabale C Div Total

OCT 241 272 217 274 275 158 233 111 80 148 182 122 223 163 2699

NOV 241 319 243 308 291 163 251 133 79 173 198 123 264 160 2946

DEC 229 258 253 292 266 144 265 120 73 164 185 112 246 158 2765

Total 711 849 713 874 832 465 749 364 232 485 565 357 733 481 8410

Table 3: Summary of individuals reached by HERO couples by gender and age

Months

District 15-24 years 25 years & above Total M F M F 2088 2350 8410 October - December 2012 Kabale 1896 2076

3.3 Linkages for Couples HIV Counseling and Testing among couples

As a result of continued community outreaches aimed at mobilizing couples for HCT, HCU through the FAITH project and with medical assistance from Good Life Clinicstested and supported284 couples to know their HIV statuses, and later on facilitate and
6

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

promote disclosure and plan for their future in relation to care and treatment amongst couples. On top of that several couples were referred for other couple services including family planning, STI management and other couple services during this quarter. The table below shows the results of the tested couples in Kabale district during Oct-Dec 2012 quarter.
Table 4: Summary of Couple HIV Counseling and Testing results

Number of couples tested and received results Discordant 12 couples 628individuals

3.4 Mobilization for Maternal Health Services

Positive 18 couples

Negative 284 couples

As part of the package of services under the families prosper strategy of the FAITH project, Humanitarian Care Uganda together with HERO couples to mobilized, sensitized couples in various communities on increased uptake of maternal and child health services. In addition severalpeer referrals and follow-ups especially among pregnant mothers living with HIV/AIDS for PMTCT and family planning through peer to peer interventions. Community mobilization outreaches for maternal health services were conducted with reference to GLCs and government health facilities for the services. This was meant to promote safe motherhood, child survival and care especially during pregnancy. Consequently a total number of 356mothers in Kabale District were mobilized and referred for maternal health services uptake during the quarter in review.
3.5 Mobilization for Child Health Services

During the same quarter, HCU together with HERO couples subscribing to all fidelity clubs in KabaleDistrict mobilized, referred and followed up 552 children for children health servicesthrough community outreaches.
3.6 Safe Male Circumcision

Through Peer to peer education and conducting of community outreach visits,HCU working with HERO couples engaged adult males in their respective communities and encouraged them to embrace Safe Male Circumcision as one of the many alternatives for HIV prevention. In total, 165 adult males were supported to undergo SMC in the districts during the quarter.

FAITH Project Quarterly Report October December 2012 3.7Marital Counseling

KABALE DISTRICT

As a way to strengthen harmony and stability within families, Humanitarian Care Uganda through members of the Fidelity Clubs in Kabale District mobilized and provided counseling sessions to community members on issues like promotion of faithfulness in families, family planning, gender based violence, positive prevention and discordance among other issues. During the quarter, a total of 1241 couples in benefited from a number ofcommunity and individual counseling sessions. Put a table

4.0 Best practice

Working with HERO couples recruited from the local communities during community outreaches and mobilization of community members is a very good practice. Community members and peers are free with them as they usually go to them for counseling, referrals and sometimes are invited as guest speakers during community gatherings.

5.0 Lessons Learnt

1. During monitoring visits, we learnt that fidelity clubs involved in activities aimed at improving the livelihoods of families like poverty eradication activities through income generation and rotational loans are performing far better and stand a chance of staying united for long. 2. We also learnt that with the increasing numbers of couples knowing their statutes and cases of behaviour change at community level led by fidelity club members, stigma decreases, uptake of couple services and demand for the FAITH project increases.

6.0 Challenges
1. Clubs kept together by other activities other than those of the FAITH project risk being swayed from the original purpose of the very existence. 2. The unprecedented demand for FAITH project activities is not reciprocated by adequate resources to have the project scaled up. 3. Whereas demand for modern family planning services in high among couples, access to the modern family planning services for couples is still a challenge. Most family decisions hinge on men most of whom are not ready to embrace FP. 4. The negative reactions and negligence of Catholic founded health facilities to some methods of family planning.

FAITH Project Quarterly Report October December 2012

KABALE DISTRICT

7.0 Planned activities for the next quarter

During the next quarter, HCU through the FAITH project shall Support linkages to Couple HIV counseling and Testing services among couples in long term stable unions in the project districts Support HERO couples to reach out to other members for couple services. Monitor, evaluate and provide support supervision to the FAITH Project Conduct quarterly review meetings with stakeholders