Coordinating AIDS Treatment Provision in Kampala Technical Working Group of the AIDS Treatment Providers (ATP) Initiative J Rwomushana (UAC), E Namagala (MOH), D Masiira (JCRC), A Kambugu (IDI), S Allamo-Talisuna (Reach out), D Mwesigire (MJAP), E Mushabe (UAC), L Thayer (IDI), P Iutung (Uganda Cares), L Makanga (KCC) Satellite meeting of the 4 th National HIV/AIDS Partnership Meeting, 30th January 2006

Challenges facing HIV treatment providers in Kampala Demand Outstripping Capacity Demand Outstripping Capacity -High HIV prevalence (12%) -Increase in testing capacity -High rate of influx of temporary upcountry patients seeking care Highly dynamic patient population within city Highly dynamic patient population within city -Difficult to keep track of patients

Challenges, Cont. HIV treatment providers have no formal channel for communication HIV treatment providers have no formal channel for communication End results: End results: -Duplication of services -Multiple registration of patients at different health units -Mismatch of demand for ART and available “slots” in different health units

Provider Identified Key Needs Mechanisms for communication Mechanisms for communication Delineation of specialization among facilities Delineation of specialization among facilities Organized referral system Organized referral system Renewed focus on adherence Renewed focus on adherence Improved capacity of providers and facilities Improved capacity of providers and facilities Harmony in service provision Harmony in service provision

The Forum of AIDS Treatment Providers (FATREP) Goal: To serve as a coordination platform for organizations providing ART in Kampala

Specific Objective #1: Information Exchange Creating accessible sources of information Creating accessible sources of information Linking treatment providers with training opportunities Linking treatment providers with training opportunities Highlighting challenges and identifying solutions Highlighting challenges and identifying solutions

Specific Objective #2: Development of Linkages Making recommendations on communication and coordination mechanisms Making recommendations on communication and coordination mechanisms Developing standardized referral systems including the design and utilization of a standard referral tool Developing standardized referral systems including the design and utilization of a standard referral tool Encouraging renewed focus on adherence Encouraging renewed focus on adherence

Specific Objective #3: Advocacy Infrastructure to providers that need it Infrastructure to providers that need it Resources for providers that need them Resources for providers that need them Funding arrangements to provide for costs of test, personnel, training and management Funding arrangements to provide for costs of test, personnel, training and management Working closely with PHA forums for better conditions for PHAs Working closely with PHA forums for better conditions for PHAs

Conclusion Disharmony in care provision was identified in the 2005 Health Sector Review--the Kampala example is serious and urgent Well coordinated services prevent inadequate access and poor adherence FATREP contributes to overall coordination FATREP pledges to enhance and sustain ART coordination together with other providers AIDS Partnership is requested to support this effort