Linkage Facilitators Boost Couple Testing and HIV Care in Lamwo.

4631 Views Lamwo, Uganda

In short
Francis Okumu, the Lamwo HIV Focal Person says data collected from 23 health care facilities last year shows that among others 67 percent of the more than 134,000 people living in Lamwo now turn up at health centers to test as couples in Lamwo district against the national average of 50 percent.

More than three thousand people living positively with Human Immunodeficiency Virus (HIV), the virus that causes AIDS have been enrolled onto care and support in Lamwo district last year alone.

The district health department says the figure was realized with the help of community linkage facilitators, a group of positive living campaigners trained to create awareness and encourage access to HIV/AIDS services including voluntary counseling and testing among others.

Francis Okumu, the Lamwo District HIV/AIDS Focal Person says the district with 8.3 prevalence rate of HIV has 350 clients on pre-Anti-Retro viral Treatment Therapy (ART) and more than 3,370 clients on Anti-Retro viral Treatment.  He says the district conducts nutrition assessment for young infants in care to enable better response to treatment.

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Okumu says the number has been projected to surge to 7,530 clients this year, as they continue to implement the strategy that began last year. To better coordinate the efforts and achieve the most, the district has also set up HIV/AIDS coordination structures at district and sub-county levels to supervise monitor and coordinate the activities of the community linkage facilitators who also coordinate their activities with Village Health Teams (VHTs).

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Before the program implementation started last year, few people had embraced Voluntary Counseling and HIV as couples in the district. But the story is different today. 

Okumu says data collected from 23 health care facilities last year shows that "67 percent of the more than 134,000 people living in Lamwo now turn up at health centers to test as couples in Lamwo district against the national average of 50 percent".

Although uptake of condoms remains low in some communities, at least 6,370 clients have been circumcised to reduce their chances of getting infected during unprotected sex by 60 percent.

Influence of Modern Laboratory.

Madi Opei is one of the nine sub counties struggling with high burdens of HIV among communities. Here, the services of linkage facilitators are paying dividends in peer counseling, enrolment of expectant mothers in programs targeted at Prevention and elimination of mothers to child Transmission of HIV (eMTCT).

Luckily, the sub county host an ultra-modern laboratory hub equipped with some of the latest automated medical technologies in the country. For example, it has a solar powered automatic FACC CD4 Count Machine that is now able to conduct mass tests on samples within a short period of time.

The machine has boosted the number of clients turning up to the laboratory from 100 to 150 every month, some from as far places as South Sudan, neighbouring Mucwini, Orom and Palabek sub counties.

Ochan Kilama, one of the five linkage facilitators in Madi Opei Sub County told Uganda Radio Network that the presence of the laboratory has ensured a holistic approach to management and treatment of HIV, Tuberculosis, Malaria and others.

Kilama says the biggest challenge in tackling HIV burden is ensuring that the right communication consistently reach most at risk groups of population including adolescent youth in need of preventive measures, expectant mothers and those living in isolated farming communities.

"So, we reach them door to door if they don't turn up in health centers or community meetings. Those missing their appointments (lost to follow up) are either contacted on phone or physically in their homesteads", he explained.

External Support.

In addition to ensuring that the right HIV/AIDS messages reach different communities, government of Uganda has remarkably improved on making voluntary HIV counseling and testing services available and accessible to different communities.  

In Lamwo district alone, nine Anti-Retro viral Treatment Clinics have been accredited and made functional. Two other lower health facilities in Ngom Oromo and Potika have also been accredited to offer option B+ to mothers living in areas with poor health care coverage.

Dr. Charles Oyoo Akiya, the Lamwo district Health Officer says, integrated with other measures, the linkage facilitators have supported the district to realize 84 percent enrollment of expectant mothers to Prevention of Mothers To Child Transmission of HIV (PMTCT) services. "Compared to the national average of 95 percent enrollment, Lamwo district deserves a pat on the back", he said.

According to Dr. Oyoo, many of the successes are also attributed to support of donors. For example, the defunct Northern Uganda Health Integration To Enhance Services (NUHITES) funded by United States Agency for International Development (USAID) supported the district to rehabilitate and equip the more than 160 Million shillings ultra-modern laboratory hub in Madi Opei sub county.

Uganda Radio Network learned from the laboratory that the number of people seeking various tests has doubled in the laboratory since the 2013 when it was upgraded in to a hub to serve the district and its neighbours.

Francis Okumu, the HIV Focal Person says ASSIST, another USAID funded project is helping the district by supporting the community linkage facilitators with logistics they require for their operations.

Dr. Herbert Turyagenda is a Board Member of Uganda Health Care Federation and Global Fund's Country Coordinating Mechanism. He commended the efforts of the district and said despite the recorded achievements, more work remains to address driving factors to HIV infection in the district including alcoholism, low uptake of condoms, low level of education, poverty and loss to follow up of clients on care.

Dr. Turyagenda also advised the district to enroll more children below 15 years on Anti-Retroviral Treatment from the current 8.9 percent and also increase the low number of general population living positively with HIV on ART treatment beyond the national average to achieve a model status in HIV care and treatment.


About the author

Peter Labeja
Peter Labeja has been a practicing journalist for the last 13 years during which he has covered part of the brutal conflict which bedeviled Northern Uganda as well as the painful transition to Peace thereafter. Emerging post conflict issues such as land rights of under privileged widows and orphans, challenges of access to social services in the immediate aftermath of Lord’s Resistance Army conflict in Northern Uganda.

Labeja is now the Northern Uganda Bureau chief in Acholi Sub Region since 2014 - Gulu, Amuru, Nwoya and Omoro districts as well as South Sudan falls within his areas of jurisdiction. He previously worked with The Vision Group for four years.

Labeja’s major career interests are in Climate Change; Agriculture and Environment - natural resources such as Water, Oil and Gas; Transitional Justice; Human Rights, Democracy and Governance as well as South Sudan’s humanitarian crisis. In 2013, Labeja was awarded a prestigious Pan African Journalism Award for excellence in journalism at United Nation’s UNEP headquarters in Nairobi, Kenya for Climate Change and Health Reporting.