HTS (HIV TESTING SERVICES)
HIV testing services (HTS) is the entry point into care and treatment. It involves early identification of persons living with HIV and getting them on treatment. This is done through screening for HIV eligibility testing at different entry points like outpatient department (OPD inpatient, TB clinic and STI clinic. Some of the approaches that MUWRP employs under HTS include; provider-initiated HIV testing and counselling (PITC) which refers to counselling and testing recommended by health providers and Voluntary counselling and testing (VCT) which is an initiative by an individual to undergo HIV AIDS counselling and testing. In both scenarios, counselling is offered to help the clients make an informed decision before testing for HIV.
The other forms of HIV testing modalities include; Index client testing (ICT) to reach spouses and biological children of people living with HIV, Assisted Partner Notification (APN) to reach sexual partners of people living with HIV , social network strategy (SNS) to reach social contacts of HIV positive and high-risk HIV-negative individuals), highly targeted risk-based facility testing (TB, STI, malnutrition) & targeted community testing subject to screening for HIV test eligibility (Hotspot & workplace) and HIV self-testing for the hard to reach populations.
This is aligned to the National HTS priorities of optimized HTS models like targeted PITC at facility & community, focus on 5Cs (Confidentiality, counselling, consent, correct result, connection to care), HIV eligibility screening & testing; focus on linkage to care – to enhance test and treat, innovations such as HIVST, partner services, improved coordination, strengthening strategic information for HTS and improving the quality of HIV rapid Testing
The MUWRP HTS program supports district comprehensive HIV/AIDS services; Capacity building, training and mentorship, work plan development and implementation, infrastructure renovations and remodelling, Human resources for health, technical assistance through integrated support supervision, monitoring and evaluation to ensure meaningful implementation of the PEPFAR and national HTS priorities and modalities.
MUWRP PEPFAR Laboratory support focuses on lab hub capacity improvement in infrastructure development, efficient sample referral through the hub system, equipment and human resource support and implementation of quality management systems at the lab hubs and lower facilities. The 4 MUWRP- supported lab hubs include Kayunga Regional Referral Hospital, Mukono General Hospital, Kawolo General hospital and Buvuma HC IV. A total of 113 facilities (both ART and PMTCT sites) are served by the 4 lab hubs (with 09 hub bikes that support sample referral through the hub system.
Lab Infrastructure improvement support has been provided through renovation and expansion of laboratory spaces since the inception of the program in all the supported lab Hubs, with Buvuma Hub being the most recently renovated Hub.
Lab Hub support involves; procurement and replacement of worn out hub bikes, fuelling, routine maintenance and repair, salaries, medical insurance and protective riding gear for hub riders among others. Human Resource support is provided at the 4 lab hubs to ensure efficient running of hub
activities and a total of over 20 lab and non-lab personnel are supported.
Implementation of Laboratory Quality Management Systems (LQMS) is supported both at the lab hubs and lower facilities through the Strengthening Laboratory Management Towards Accreditation process (SLMTA) and LQMS respectively. Kayunga Regional referral hospital has been supported to attain and maintain international accreditation by the South African National Accreditation System (SANAS) and Kawolo General hospital is also being prepared for international accreditation.
Lab personnel are routinely supported to attend LQMS, SLMTA and accreditation related training and follow-on mentorship and coaching sessions are conducted.
To ensure effective implementation of lab quality management systems, facilities are supported to participate in EQA/PT testing by facilitating EQA/PT panel distribution through the Lab hub system and Slide Sampling for blinded rechecking and site mentorship for TB microscopy Blinded rechecking. Performance of onsite corrective actions for any failed EQA/PT results is also supported
Lab Logistics Management
Efficient lab logistics management is supported through implementation of the lab SPARS. All District Lab Supervision, performance assessment and recognition strategy (SPARS) supervisors are trained and quarterly lab SPARS Support supervision is facilitated.
Laboratory Equipment through procurement of automated equipment for continued functionality.
In Collaboration with CPHL, Biomedical engineers have supported the maintenance of auxiliary equipment at lab hubs and lower facilities and replacement of non-functional essential equipment like microscopes and centrifuges at lab hubs and lower facilities
Implementation of Biosafety measures is supported through Provision and maintenance of biosafety equipment and supplies. Three of the lab hubs were supplied with biosafety cabinets maintained by the CPHL team.
Biannual biosafety/biosecurity training is facilitated to ensure effective implementation of biosafety measures at facility level and Biosafety audits are routinely facilitated to identify implementation gaps and institute remedial actions.
SI (STRATEGIC INFORMATION)
Strategic Information (SI) provides programmatic information to support planning, decision making and budgeting in the implementation of the MUWRP-PEPFAR program. The SI teams at the 88 health facilities that MUWRP supports are responsible for the availability and utilization of the Health Management Information System tools and support the day today data collection, monitoring, evaluation and reporting.
The teams work with Biostatisticians, IT officers and Health workers to quantify tools used in HIV programming in the four districts of Kayunga, Mukono, Buikwe and Buvuma where the PEPFAR program is implemented.
SI work is guided by the principles of data quality and this is done closely in partnership with the Ministry of Health that is mandated to ensure timely reporting at a weekly, monthly, Bi-monthly, quarterly, semi-annually and annual basis.
Medical Logistics Management
Medical Logistics Management supports public and Private Not for Profit (PNFPs) facilities submit bimonthly orders to National Medical Stores (NMS) and Joint Medical Stores. All orders are submitted electronically through NMS+CSSP and ELMIS for Public and PNFPs facilities respectively
The Medical Logistics management team supports ordering of 3rd line drugs through Kayunga Regional Referral Hospital and distributes to facilities with 3rd line clients the team further supports with last mile delivery of ARVs, TB and HIV testing kits to island facilities in Koome and Buvuma islands. Medicines Logistics supports receipt from warehouses and distribution to health facilities of other commodities like STI drugs, PREP ARV drugs, VMMC, and Cervical Cancer commodities. Accountability of these commodities is done through the Dispensing logs, and Prescription books.
Medicine Management /LAB supervisors are District Health care workers who are trained to conduct facility-based training and mentorship. They are facilitated to conduct quarterly mentorship and supervision in ART and Lab supervision.