Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN)
Funded by: US Agency for International Development (USAID)
Project Duration: 2010 to present
Partners: The AIDS Support Organization (TASO), Integrated Community Based Initiatives (ICOBI), Health Research Inc. (HRI), and Initiatives Inc.
URC is working with the Ugandan Ministry of Health (MoH) to
ensure continued provision and sustainable scale-up of comprehensive HIV and
AIDS services for people living with HIV and AIDS (PLHA) at 10 regional
referral and six general hospitals across the country. Such services include a basic care package
for PLHA, antiretroviral therapy, the prevention of mother-to-child
transmission of HIV, management of TB and HIV co-infection, laboratory services,
HIV counseling and testing, and safe medical male circumcision. In addition to the
16 hospitals receiving support for these services, SUSTAIN supports selected
services at two regional referral hospitals and laboratory services at four
health care facilities in the Karamoja region. The project aims to strengthen
the public health system to ensure the delivery of quality services that meet clients’
the delivery of HIV prevention, care, and treatment services at 22 health care
laboratory services in the public sector by improving physical infrastructure,
providing equipment for HIV-related laboratory and general health care tests
(e.g., CD4 and complete blood counts, liver and renal function tests, and HIV
and TB diagnosis, etc.), strengthening laboratory staff skills, and improving
systems and processes to ensure timely and accurate laboratory test results;
- Institutionalize quality improvement
(QI) approaches in routine service delivery, guided by the Uganda MoH National
- Improve service provider skills for the management
of HIV and AIDS through training, routine mentorship, and supportive
the MoH to provide fully integrated and sustainable quality care and treatment
for people living with HIV and AIDS.
- From June
2010 to March 2013, over 367,000 clients received tests for HIV infection, their
results, and referrals to appropriate care and prevention services.
- Over 158,000
pregnant women seeking antenatal care were tested during the same period for
HIV infection; those who were HIV positive (about 14,000) received care to
prevent mother-to-child transmission of HIV (PMTCT).
- As of
March 2013, over 37,000 clients were receiving antiretroviral treatment at the
16 SUSTAIN-supported hospitals.
project renovated and equipped nine hospital laboratories and trained and supported
their personnel to provide quality laboratory services. This support has given the public health
sector the capacity to conduct CD4, hematology, and chemistry tests at all 18
project-supported public hospitals in the country.
project helped computerize data on all HIV clients at 16 hospitals using the Open
Medical Records System, a newly developed MoH electronic patient data
project also helped strengthen supply chain management systems for drugs and
supplies: the average overall order submission rate for HIV-related medical
commodities, including antiretrovirals, PMTCT supplies, HIV test kits, and
other related commodities, at the SUSTAIN-supported hospitals improved from about
35% in December 2010. to over 84% in March 2012. This higher rate has resulted
in increased availability of HIV-related commodities at the hospitals.
project helped equip hospital management teams with the skills and knowledge
required for managing health care resources and improving the quality of
- The project launched its website: www.sustainuganda.org/ in March 2013.
Knowledge sharing between SUSTAIN-supported hospitals has been challenging,
with traditionally limited communication across health care facilities in
Uganda. The new website enables the
hospitals to share the results of their work and learn what other hospitals are
doing. Each hospital has its own webpage
with practical tools for documenting, analyzing, and sharing results, such as
how many new clients were tested for HIV and how many of those tested accepted
treatment. The site also offers a range of electronic technical resources and
hosts an interactive blog. Beside health care providers, website users include
the general public and SUSTAIN partners.
Quality Improvement; Health Systems Strengthening