In March 2013, SPRING/Uganda began supporting Uganda’s implementation of the Partnership for HIV-Free Survival (PHFS). PHFS is an initiative conceived by the World Health Organization (WHO) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to accelerate the adoption and implementation of the 2010 WHO guidelines for the prevention of mother-to-child transmission (MTCT) of HIV.1 Uganda is one of six countries piloting the PHFS program.
The PHFS activities in Uganda were launched in August 2013, five months after the global PHFS launch in South Africa. The initiative’s goal in Uganda is to “contribute to the elimination of MTCT through targeted interventions during the postpartum period for the first 1,000 days.”
SPRING/Uganda is supporting implementation of PHFS activities in Kisoro, Ntungamo, and Namutumba, three of six districts selected to participate in the initial phase. In 2013, SPRING/Uganda worked closely with USAID, the Ugandan Ministry of Health, and other implementing partners to develop a national work plan, performance indicators, and terms of reference for different partners and committees. They then identified Phase I facilities, and began the implementation of the plan in these facilities. SPRING/Uganda is implementing PHFS activities in collaboration with the USAID-funded Strengthening TB and AIDS Responses in East Central (STAR-EC) and South West (STAR-SW) projects and health facility-level partners in Namutumba, Kisoro, and Ntungamo.
Since its launch, PHFS has implemented activities both at the facility and community level. These include training health facility staff on the nutrition assessment, counseling, and support (NACS) framework; the elimination of MTCT; infant and young child feeding (IYCF) practices; creating demand for NACS services at all maternal and child health points; following up on lost mother-baby pairs; and supporting health workers to ensure that infants in their care obtain all possible services.
In the facilities, PHFS looks at key areas that include retention of all identified mother-baby pairs, while also ensuring that each individual pair receives a comprehensive care package. PHFS has also implemented activities designed to strengthen the NACS framework within HIV care.
In Namutumba district, PHFS was initiated in four prototype health facilities that included three level-III facilities (Namutumba, Magada, and Ivukula) and one level-IV facility (Nsinze). Since the initiation, hundreds of pregnant and lactating women have received nutrition counseling and assessment and, by strengthening the community-facility linkage, hundreds of mother-baby pairs have been identified and retained in care.
The prototype facilities provided valuable insights and led to an improvement in the key PHFS indicators; both the quantity and the quality of services improved. The activities implemented in these sites are currently being scaled up to include Phase II health facilities. Improvements have also been introduced, such as the pairing of mother and baby cards, ensuring that the pair receives services from one care point on the same date, and reviewing the cards at the end of each clinic day to ensure accuracy and completeness.
As the global push to eliminate MTCT of HIV continues, the PHFS initiative remains one of the best strategies to achieve a well-nourished and healthy HIV-free generation.