The IDI capacity building project, strengthening HIV care and treatment at Regional Referral Hospitals (RRHs) in Uganda was established in 2010 with support from the Civil Society Fund (CSF) to prolong the survival and quality of life for those living with HIV in targeted areas. 

The project operates in eight Regional Referral Hospitals:  Masaka, Mubende, Hoima, Fort Portal, Moroto, Lira, Gulu, China Uganda Friendship Hospital -Naguru, one Private-Not-For-Profit (PNFP) health provider (Kibuli Muslim Hospital) and one HCIV (Kasangati HCIV).

IDI has also established specialized services for special populations at the RRHs, targeting young adults and adolescents, discordant couples, commercial sex workers and those on second line Antiretroviral Therapy (ART), with the aim of encouraging sero-disclosure, condom use, Sexual Reproductive Health (SRH), adherence and elimination of Mother-to-Child Transmission (eMTCT).

At the inception of the project, poor linkages between HIV testing and care were identified. Health care workers also lacked knowledge on HIV management and both the general and key populations were reluctant to access services at RRHs owing to the poor perception of HIV services at the RRHs, and the fear of being stigmatized. The project set out to address these challenges and from January 2011 to December 2014 has registered notable achievements which include: provision of comprehensive care services to 45,035 PLHIV (114% achievement); building the capacity of laboratories to address supply chain management; screening 44,086 people (98% achievement) for TB;  provision of treatment to 432 people who tested positive for TB (99.5% achievement) in addition to screening 10,907 ART eligible PLHIV for cryptococcal meningitis (94% achievement). 

IDI has also built the skills and knowledge of health workers, through Continuing Medical Education (CMEs), to manage patients being initiated on ART, with particular emphasis on patients with low CD4 counts and those who need intensified screening for cryptococcal meningitis and TB. IDI has also embarked on developing filing systems, and has trained M&E staff to manage electronic records using the open medical record system. 

“You can see the changes as people apply what they have learned from the CMEs. Furthermore, these good practices are integrated within the system which means that they will be easy to sustain”, says Dr. Pancras Odongo, the Head of Medicine at Hoima Regional Referral Hospital.  

“Nurses have learned the importance of CD4 counts in determining the appropriate treatment regimen for the mothers they serve in the antenatal care unit”, says Sister Masika, Senior Nursing Officer at Hoima RRH. She attributes the establishment of the Early Infant Diagnostic (EID) care point to good practices learned in the CME training. “Babies now born to HIV positive mothers receive adequate care and follow up in order to avoid mother-to- child transmission of the virus”, she adds. 

Overall, the project has played a vital role in establishing a linkage with the RRHs and developing the professional capacity of health care workers. “We consequently receive referrals from all over the country at the IDI clinic as a result of this linkage. We have also developed new training courses such as Sexual Reproductive Health (SRH) training for the IDI-RRH project, which can be offered to health care workers from other organizations”, states Diana Asiimwe-Bena, the Project Manager of the IDI/CSF RRH Capacity Building Project.