Fewer HIV infections, more children receiving medication - Results from Towards an AIDS-Free Generation in Uganda program

October 16, 2017

In Uganda, 1017 HIV-positive children are now receiving treatment thanks to the first phase of Towards an AIDS-Free Generation in Uganda (TAFU). The TAFU programme is unique in its ambition and approach. It aims to reduce HIV infection rates among infants in rural Uganda and increase the number of HIV-positive children receiving treatment there. TAFU links rural communities to healthcare facilities and empowers families living with HIV. What did we achieve and learn in Napak, Moroto, Serere, Mityana and Mubende districts?

TAFU's approach: The story of Kizza

The TAFU programme aims to ensure all HIV-positive children receive the medication they need. The most important factor is building stronger ties between communities and the available healthcare facilities. But TAFU does more. It empowers families socially and economically. It encourages communities to address barriers to testing, treatment and adherence. And the programme makes it easier to trace HIV-positive children, refer them to basic healthcare services and follow up their treatment.

'Before the start of the TAFU programme, we did not even know that these HIV-positive children were out there. Now, more children are accessing HIV care thanks to community mobilisation and education.' -Member of Network of People living with HIV Mityana District, Uganda 

Linking everyone involved

TAFU links all parties involved in the HIV response in rural Uganda, including community resource people and healthcare facilities at all levels. The programme focuses on families to ensure children go for testing and adhere to treatment. As well as 1017 children, it has enrolled and retained 1355 women in HIV treatment. Moreover, 1008 women and caregivers of children living with HIV have joined village loan and savings associations. These enable families to cover health-related costs, such as transportation and food expenses. Unfortunately, stigma is still a barrier to accessing healthcare for women and children living with HIV. However, in Uganda we see a promising trend of more people going public about their HIV status, even in rural areas where this has not been common practice owing to the continued sensitisation, peer support groups and support from expert clients and community resource persons.

Areas for improvement

The first two-year phase of the TAFU programme has demonstrated that improving links between communities and health services is achievable. Research conducted at the end of the first phase mid-2017 revealed some areas where TAFU could be improved. The research indicated that there is a need to encourage more communication, build more self-help groups for affected families, including children, and progress meetings with community resource persons to motivate them. Also, a longer follow-up phase is essential for communities to ensure the TAFU initiatives are sustainable.

'We don't always have enough food at home. Sometimes it felt like the medicine was burning my stomach. So, when there is no food, I don't take my pills.' - A child living with HIV in Uganda 

Nutritional support for families

In addition, there is a clear need for more nutritional support for families of children who take HIV medication. Malnutrition is more serious for children living with HIV as their medication should not be taken on an empty stomach. We hope to reduce the risk of malnutrition by promoting food security and the preparation of nutritious meals, for instance by supporting and demonstrating families how to grow their own food including establishing vegetable gardens. For more lessons learnt, read the full evaluation report.

The recommendations in the evaluation report are being incorporated in the programme's second phase, which is now being rolled out in another three districts in Uganda. 

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