Uganda

Having gone through dictatorship and civil war in the 1970s and 1980s, Uganda seems to be on the path of social and economic recovery. In September 2006, news of peace agreements between the government and the leader of the infamous Lord’s Resistance Army rebel group operating in Northern Uganda confirmed this optimism.

Uganda’s population is estimated at 28,816,000, 40% of whom are less than 15 years old. More than 80% of the population lives in rural areas.

The first clinical case of AIDS in Uganda was reported in 1982. In the 1990s, Uganda was one of the countries most affected by the HIV epidemic in sub-Saharan Africa and in the world, with a prevalence rate of 30% among 15-49 year olds in 1999. Since then, HIV prevalence has halved and is now reported to be 6.7%. HIV prevalence among high risk groups is also reported to have fallen, from 35% in 1999 to 12-15% in 2003.

Despite these reassuring trends, a resurgence of the HIV epidemic cannot be ruled out. Increases in HIV incidence have recently been reported by the Uganda AIDS Commission, up from 70,000 cases in 2003 to 130,000 cases in 2005. Reductions in HIV prevalence have also levelled off among pregnant women, remaining at 6.5% since 2000. Transmission rates are shifting from youth to adults aged 30 to 40, with HIV prevalence currently at 6.4% within the latter age group.

Over 1,000,000 Ugandans are estimated to be living with HIV, out of whom 520,000 are women and 110,000 are children. The number of children orphaned by the HIV epidemic is estimated at 1,000,000. And 20,000 HIV positive infants are born every year to HIV positive mothers.

HIV prevalence in Uganda is higher in urban areas, alongside major transport routes, in some lakeside fishing communities as well as in Northern Uganda’s refugee camps. Most affected populations include women and girls, internally displaced people, fishing communities, child soldiers, army officers and victims of rape and sexual abuse in Northern Uganda.

Primary modes of transmission of HIV include unprotected heterosexual sex; mother-to-child transmission of HIV; sero-discordance among married and unmarried couples; transactional sex; cross-generational sex; and internal mobility and displacement.

What we do

Expanding the role of networks of people living with HIV

In Uganda, the Alliance leads on a USAID-Uganda funded project which aims to expand the role of networks of people living with HIV in the delivery of prevention, treatment and care services, in collaboration with the National Forum for People living with HIV/AIDS in Uganda, NAFOPHANU.

At sub-district level, the Alliance and NAFOPHANU are strengthening, through small grants and technical support, the capacity of groups and community based service providers to better participate in the delivery of HIV prevention, AIDS treatment, as well as care and support services. This includes psycho-social support, nutritional support and economic strengthening. At this level, the project will aim to link providers of these various types of services with people living with HIV and their families by training and using Network Support Agents. The mission of these Network Support Agents is to ensure that people living with HIV and their families enter and remain as long as they wish in this network of prevention, treatment and care and support services.

At district level, the project’s objective is to support and strengthen NAFOPHANU’s district forums. These act as a technical and organisational resource for groups of people living with HIV at the sub-district level.

At the national level, the project will develop the advocacy capacity of the NAFOPHANU, to increase the involvement of people living with HIV in the Ugandan response to the epidemic.

Building government and civil society capacity to respond to the orphan crisis

In Uganda, the Alliance is also part of a consortium project called the Communities Responding to AIDS Initiative or CORE Initiative Uganda. Led by CARE International in Uganda, the project aims to expand targeted services for orphans and other vulnerable children by strengthening partnerships between the government of Uganda and civil society, faith-based and community-based organisations. To achieve this, the project has the following objectives:

  • strengthen the capacity of the Ministry of Gender, Labour and Social Development (MGLSD) to provide strategic direction, coordination, and monitoring of the overall responses to orphans and other vulnerable children, which includes strengthening links to Districts and civil society responses
  • establish granting mechanisms through which MGLSD will partner with civil society organisations
  • increase the availability and quality of orphans and other vulnerable children services under the National Strategic Programme Plan of Interventions for Orphans and Other Vulnerable Children
  • strengthen the support for abstinence and faithfulness initiatives among youth and couples as part of the national HIV response
  • provide capacity-building and technical support to improve orphans and other vulnerable children and HIV prevention programme quality, and scaling-up youth prevention and care and support activities for orphans and vulnerable children.

In order to achieve these objectives, the Alliance is responsible for the following within the consortium:

  • Organisational and institutional capacity-building of the MGLSD, including its district representatives, so that it can truly lead on the implementation of the National OVC Policy and the National Strategic Program Plan of Interventions.
  • Technical leadership on the development of minimum standards for orphans and other vulnerable children programming, in line with the National OVC Policy and National Strategic Program Plan of Interventions.
  • Technical capacity-building of NGO grantees in orphans and other vulnerable children programming; technical capacity-building of NGO grantees in HIV prevention with youth; organisational capacity-building of NGO grantees.

What we will achieve

Through the CORE Initiative, the Alliance plans to have delivered the following by the end of 2008:

  • a comprehensive package of training to at least ten central level Ministry staff and five Community-Based Services Departments staff in each of Uganda’s 80 districts in the areas of multi-sectoral, planning, project management, staff performance appraisal, support supervision, orphans and other vulnerable children programming and HIV prevention programming.
  • quality standards in orphans and other vulnerable children programming that have been disseminated to each Community-Based Services Department at district level, as well as key civil society organisations delivering services to children. The Alliance also expects to have put in place mechanisms to increase understanding of the quality standards and compliance with these standards.
  • a significant contribution, as a technical support provider to the Ministry, to the operationalisation of the National Implementation Unit for the implementation of the National OVC Policy within the Ministry. This will include workplanning and definition of roles within the unit.
  • a significant contribution, again as a technical support provider to the Ministry, to the re-enacting of the National OVC Steering Committee, which spearheaded the development of the National OVC Policy and the National Strategic Program Plan of Interventions. This will involve a redefinition of mission and workplanning.
  • transfer of skills and competencies in orphans and other vulnerable children programming, HIV prevention, and organisational and institutional development to at least 60 civil society organisations.