The Republic of Uganda

Ministry of Health

EMTCT Communication Plan to Support the Roll Out of Option B+ for EMTCT in Uganda December 2012

Acknowledgements The STD/AIDS Control Program, Ministry of Health wishes to thank the members of the Technical Working Group for the relentless effort put in the review process which culminated in the production of the EMTCT Communication strategic roll out plan. Special appreciation goes to all EMTCT stakeholders’ including development and implementing partners for the financial, technical inputs extended and sharing their vast experiences which made this review process successful. It would be an omission therefore not to thank them abundantly. These partners include the, USAID, CDC, HCP, AFFORD, and UHMG.

Dr.Joshua Musinguzi Programme Manager STD/AIDS Control Program Ministry of Health

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Contents Acknowledgements................................................................................................................................. 2 List of Abbreviations ............................................................................................................................... 4 Background ............................................................................................................................................. 5 Operational Plan for Communication Support to the National EMTCT Roll Out .................................... 8 Communication Plans for Specific Audiences ....................................................................................... 11 EMTCT Communication Plan for Leaders ......................................................................................... 12 EMTCT Communication Plan for Clinical Health Workers ................................................................ 14 EMTCT Communication Plan for Village Health Teams .................................................................... 16 EMTCT Communication Plan for Men and Women of Reproductive Age ........................................ 17 EMTCT Communication Plan for Pregnant and Post-partum Women ............................................. 19 EMTCT Communication Plan for HIV-positive Pregnant and Post-Partum Women ......................... 21 EMTCT Communication Plan for Partners of HIV-positive Pregnant and Post-partum Women ...... 25 Appendix A: Participants of EMTCT Materials Review and Campaign Planning Workshop ................ 27 Appendix B: Summary of EMTCT Communication Plan to Support the Roll Out of Services .............. 30

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List of Abbreviations: ABC+

HIV risk reduction practices: abstinence, faithfulness, condom use, male circumcision, knowing your HIV status, preventing and treating STIs

AIDS

Auto-immune disease syndrome

ANC

Antenatal care

ART

Antiretroviral therapy (or treatment)

ARV

AntiRetrovirals

CBO

Community based Organisation

CHCT

Couple HIV Counselling and testing

DNA/PCR

A test for HIV in the blood

EMTCT

Elimination of Mother to Child HIV Transmission

HC IV

Health Centre IV

HC III

Health Centre III

HC II

Health Centre II

HCT

HIV Counselling and testing

HIV

Human immune-deficiency virus

MCH

Maternal and child health

MOH

Ministry of Health

MTCT

Mother to child HIV transmission

NGO

Non-governmental Organisation

PLHIV

People living with HIV

PMTCT

Prevention of mother to child HIV transmission

PNC

Postnatal care

SMC

Safe Male Circumcision

UHMG

Uganda Health Marketing Group

VHT

Village Health Team

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Background The Ministry of Health with support from Development Partners initiated the program for prevention of mother to child transmission of HIV in 2000 and scaled it up to all districts in the country by 2005. As of June 2011, PMTCT services were available from about 1,596 health facilities up to health centre II level out of a total of 4,441 (35.9% coverage). The detailed breakdown is as follows: 110 out of 131 functional hospitals (84% coverage); 178 out of 178 health centre IV (HC IV) facilities (100% coverage); 969 out of 1114 health centre III (HC III) facilities (87% coverage). In addition, there were about 339 Health Centers II (HC II) (11.2%) facilities providing the complete package of PMTCT services, out of the estimated 3018 facilities at this level. There are currently about 124 health facilities under construction. Uganda is one of the countries that have responded to the global call for virtual elimination of mother-to-child transmission of HIV (EMTCT). The Ministry of Health, with support from partners, adopted Option B+ for all pregnant women once they test HIV positive. Under this option, all HIV-positive pregnant women receive lifelong ART. Option B+ services are new in Uganda and so the MOH has designed a Roll out Plan to train and equip health workers in government and private sector health facilities countrywide to offer this service. In order for this strategy to succeed, there is a need to educate and mobilize pregnant women and their partners to access these services, as most pregnant women and their partners have very little knowledge about it. In summary, the Elimination of MTCT Roll out Plan has the following goal and objectives: Goal:  To eliminate new paediatric HIV infections and improve maternal, newborn and child health and survival in the context of HIV Broad Objective:  Reduce the number of new infections in children by 90% and reduce HIVassociated maternal deaths by 50% by 2015. Strategic Objectives:  Prong 1: Primary prevention of HIV infection among women of reproductive age  Prong 1 Target: 50% reduction in HIV incidence (new infections) in reproductive age women (15-49 yrs).  Prong 2: Prevent unwanted pregnancies among women living with HIV  Prong 2 Target: Reduce unmet family planning need to 10% among all women (regardless of HIV status)

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 Prong 3: Prevent HIV transmission from women living with HIV to their infants  Prong 3 Target: Reduce the overall transmission rate to less than 5% at population level, and  90% of women living with HIV and their exposed infants receive ARVs for prophylaxis according to the national guidelines during pregnancy and breast feeding.  Prong 4: Provide appropriate treatment, care, and support to mothers living with HIV and their children and families o Prong 4 Target: 90% of HIV positive pregnant women in need of ART for their own health are put on lifelong treatment

Programmatic targets by 2015:  All (100%) of health facilities offering ANC services also offer PMTCT services (HIV testing and ARVs) and all of them offering early infant diagnosis either onsite or through referrals.  80% of registered health facilities in the private sector implement the essential package of EMTCT services by 2015.  98% of pregnant women tested for HIV and received results.  90% of pregnant women identified HIV positive receive ARVs for EMTCT.90% of infants born to HIV positive women receive ARVs at birth for EMTCT.  90% of HIV positive women deliver under skilled care up from current 59%.  80% of infected pregnant women and exposed infants receive co-trimoxazole prophylaxis.  80% of infants born to HIV positive women receive a virological HIV test by 2 months of age.  50% of male partners whose spouses have received EMTCT services are counselled and tested for HIV and given their results. 