Updates of PrEP Program Implementation in Uganda by Dr. Herbert Kadama
Uganda has been proactive in implementing oral PrEP as a key biomedical prevention intervention since December 2016. Dr. Herbert Kadama, on June 18, 2019, provided updates on the progress of the PrEP program in Uganda. The country has developed a comprehensive road map for PrEP implementation, covering the formation of task forces, policy guidelines, training curriculum development, and phased roll-out in various healthcare facilities. The program has evolved over time, with milestones achieved in supervision, site accreditation, and expansion to new facilities. Continuous monitoring and evaluation have been key in guiding decision-making for further expansion and improvement of the PrEP program.
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Updates of PrEP Program Implementation in Uganda Dr Herbert Kadama 18/6/2019 MUJHU
Introduction Uganda is one of the countries that provided global evidence for the efficacy of oral PrEP Prompted by the findings from these studies and WHO recommendations Uganda adopted and introduced PrEP as one the Biomedical prevention interventions in the Combination HIV Prevention in Dec 2016 Currently PrEP is being rolled out in a phased and funded approach The country has adopted a road map for the roll out of PrEP Implementation
Road map for PrEP Implementation Activity Timeli ne Progress to date/comments Formation of the PREP Task force. Oct 2016 A 15 members task force Development of the technical policy guidelines December 2016 Finalised Developed the training curriculum June 2016 Finalized M&E tools June 2016 Finalized Commence the initial phased roll out in six facilities by PEPFAR & MOH Jul to Sep 2017 Started in mid 2017.. (MARPI Mulago, Kansensero HCIII, Rubare HCIV, Kamuganguzi HCIV , Rushoka HCII and Mbarara RRH
Road map for PrEP Implementation Activity Time line Oct 2017 Completed Progress to date/comments Conduct support supervision to the initial phased sites Developed the PrEP site accreditation tools Roll out to additional sites (MUG, RHITES SW, E,) Oct 2017 The accreditation tool is available Oct 2017 17 sites came on board PrEP supervision and mentorship guide Conduct PrEP modelling to guide target setting and selection of facilities for next roll out Oct 2017 Completed Dec2017 Completed
Road map for PrEP Implementation Activity Time line Feb 2018 Progress to date/comments Completed Conduct a situational analysis for PrEP to document early lessons learnt Set up Whatsapp group for TWG and Key stakeholders (CSOs/CBOs implementing KP/PP programs Developed the KP/PP and PrEP dash board March 2018 Operational Sept 2018 We are now using this to trucker progress and compile reports 90 sites providing PrEP Roll to more 73 new PrEP sites Oct 2018
Road map for PrEP Implementation Activity Time line Progress to date/comments Adoption of PrEP Indicators in HMIS Tools Dec 2018 Accomplished Partnership for Development the PrEP app Development of the PrEP communication Plan Jan 2019 Process on going Jan 2019 A plan is available awaiting printing and dissemination Awaiting approval and dissemination Development of PrEP communication messages Feb 2019
What we do We hold quarterly IP coordination meetings We hold quarterly TWGs We hold bi-annual support supervision and mentorship to PrEP implementing site We conduct capacity building for health workers in PrEP implementing site We compile and share updates on PrEP with stakeholders We conduct sensitization meeting about PrEP with CSO,NGO and beneficiaries We pattern with institutions to conduct PrEP research in Uganda
Ongoing researches on PrEP Institution MUJHU IDI MUWRP MRC/UVRI
Models Models of of PrEP Delivery PrEP Delivery Facility Static Drop in Centres Community Mobile Outreaches Moon light
Coverage Coverage of of PrEP Implementation PrEP Implementation Less !2 regions Karamoja and Busoga 35 districts 90 Facilities Details of Facilities on the PrEP app
Coverage of Coverage of PrEP Implementation PrEP Implementation # REGION/PARTNER DISTRICTS FACILITIES 1 RHITES ACHOLI 1 2 2 RHITES LANGO 1 1 3 RHITES- E 1 2 4 RHITES SW (Mbarara & Kabale) 12 39 5 MUWRP 4 12 6 RHSP 4 5 7 Baylor Uganda 3 7 8 IDI (West Nile, Hoima & Kampala) 6 11 9 Mildmay 1 1
PrEP: Progressive performance since FY18 Q1; Achieved 73% of FY18 Target Quarterly PrEP Achievements through FY18 11,757 Best Practices Worked with KP-CSOs to enhance demand creation for PrEP services Used PrEP tracker Dashboard to enhance real time PrEP monitoring 12,000 8,527 10,000 PrEP #s 8,000 73.7% 24.8% 6,000 29.1% 3,562 4,000 2,050 1,643 1,272 2,000 0 FY18 Achievem ent FY18 annual target FY18Q3 FY18Q4 FY18Q1 FY18Q2 15
Clients tested HIV negative, eligible for , accepted Clients tested HIV negative, eligible for , accepted and initiated on PrEP July 2017 and initiated on PrEP July 2017 March 2019 March 2019 Tested HIV negative Eligible for PrEP 373 156 1774 810 1375 341 Accepted PrEP Initiated on PrEP 290 113 1696 707 673 301 Population Sub type AGYW Boda Boda Serodiscordant Couples Fishing Community MSM Migrant Workers Non Injecting Drug Users Other PIP PWID SW TG TKR UF Overall total 388 160 1799 805 1496 342 316 125 1760 785 709 322 4 4 4 4 1726 10 232 8416 41 703 62 16184 1567 10 225 8145 31 695 55 15561 1336 8 196 6041 28 685 36 12351 1289 8 143 5707 27 668 31 11657
Challenges/Emerging Issues Challenges/Emerging Issues Few health workers have been trained on the use the PrEP dash board Retention of clients on PrEP at 3 and 6 months Laboratory screening tests for PrEP Creating demand for PrEP in the catchment areas Dispelling myths and misconceptions about PrEP Packaging of PrEP in Containers similar to ART
Moving forward Moving forward Continue Capacity Building of Health Workers in PrEP Scale up PrEP under COP 19 Target 30,000 Develop PrEP Peers Training Curriculum Mid term review of the PrEP Policy Dissemination and Operationalization of the PrEP Communication Plan Develop a comprehensive PrEP Directory Finalize the hosting of the PrEP dash board at MoH Finalize the PrEP app
End Thank you for listening
