Uganda

Action for Community Development

Although Uganda has been fighting HIV since the pandemic first surfaced in the early 1980s, stigma and discrimination remains high. As a result, people’s basic human rights and dignity are at stake, especially when compounded by issues of ill-health, poverty, violence against women, the effects of civil war, and threats to safe motherhood. 

Action for Community Development responds to these challenges holistically. It counters discrimination and abuse through advocacy and education, voluntary HIV counselling and testing (VCT), a nutritional support programme to the area’s most vulnerable people living with HIV and AIDS (including children), limited medical support, and various income-generating activities. These include the promotion of high-yield “kitchen gardens,” a small-scale savings-and-loan program, and a vocational sewing programme for fifteen young people. Training is regularly provided on HIV, good parenting practice, coping with loss, and “how to run a small-scale business.” With SLF support in three sub-counties, Action for Community Development also helps 200 orphans to stay in school. In doing so, they give priority to children living with HIV, child-headed households, and orphans who are being cared for by elderly grandparents.

Apoolo Na Angor (ANA, Development of Women)

Apoolo Na Angor (meaning “development of women”) began as a self-help group and was founded in 2003 by two persons affected by HIV/AIDS to help motivate and empower community members to improve their health and wellbeing. Ninety percent of ANA’s beneficiaries are marginalized rural women infected or affected by HIV/AIDS who are supported with community-based health care, household agricultural training and inputs and continuing education. Dedicated staff and community volunteers train on sustainable farming, human rights, gender, land rights, children’s rights and responsibilities and income-generation skills. SLF is funding ANA’s scale up programme to improve the quality of life of orphans and vulnerable children and their families in Bukedea District including primary education support for more than 300 children and vocational support for 50 young adults. The children’s caregivers receive training on basic health and disease prevention and are helped with referrals for necessary services. They receive ten heifers for a revolving milk nutrition scheme. ANA provides transportation support to clinics for people living with HIV/AIDS in the community both for medical care and to participate in support groups. SLF also supports some administrative and salary costs.

Busoga Integrated Development and Care Foundation (BIDCAF)

BIDCAF is a Christian community organization that works to improve the lives of vulnerable and marginalized people in rural and urban communities affected by HIV/AIDS. Without bias on any cultural, tribal or social basis, BIDCAF uses participatory and partnership approaches to sustainable socio-economic development. SLF funds the organization’s agricultural and education support project for children orphaned by AIDS and women-headed households.  The project supports 100 vulnerable women (including 43 widows, 14 aunts/caregivers and 42 grandmothers) through training workshops in counselling, nutrition, modern farming, soil fertility and harvest management, food processing and establishing gardens and plots. Two Agricultural Field Assistants work with the women and supply agricultural inputs such as seeds. BIDCAF provides school fees and material resource support to 100 children (including 57 girls) in primary school and does life-skill, sexual reproductive health and HIV/AIDS awareness training with youth in and out of school. The organization conducts community leader awareness training on nutrition, community psychosocial support and coping mechanisms and building community based cooperative care groups for vulnerable children and families. BIDCAF also leads exercises to map and address community identified needs. SLF also supports administrative costs including a Coordinator Child Welfare Manager and Accounts Assistant.

Katalemwa Cheshire Home for Rehabilitation Services (KCH)

Katalemwa Cheshire Home for Rehabilitation Services (KCH) started over forty years ago in order to provide a family-home environment for people who were chronically ill or suffered from severe physical disabilities. Currently, KCH focuses on the short-term community-based rehabilitation of sick and disabled children, including support to their family members. Working with community stakeholders, they also promote children's rights, help access a quality education for children with disabilities, and offer livelihood training to enable children with disabilities and their families live as independently as possible. Nutritional assistance, skills training and recreational opportunities have been added in recent years, and have become important elements of KCH's programme.

SLF support focuses on children whose disabilities are caused by HIV or augmented because HIV has directly affected their relatives. Most beneficiaries live with grandparents who are ill or frail. KCH responds by providing access to medical care and/or home-based therapy, nutritional support and seedlings, and educational support for the children to attend school. Children with disabilities who need intensive therapeutic assistance may be admitted with a caregiver to KCH’s residential Centre for a period of rehabilitation and/or to receive a specially tailored assistive device for sitting, standing, feeding or walking. As part of KCH’s own Action, Learning and Planning process, the SLF also helps KCH ensure good monitoring, evaluation and communication systems.

Kawempe Youth Development Association (KYDA)

KYDA was formed ten Makerere University graduates who wanted to help improve the welfare of vulnerable children and youth, including children living with HIV/AIDS and teenage mothers. The organization works in 3 districts throughout central Uganda to engage community groups and local leaders in child and youth care and peer education, provide vocational training and direct support services to orphaned and vulnerable children, as well as children living with HIV. KYDA works with local health centres to identify children requiring support and then visits their homes to determine the specific needs of the families and caregivers.

With SLF support, KYDA is working to scale up their care and support services to reach 1,000 young people in need. Currently, twenty-five children receive vocational training and those that graduate receive start-up kits. The Project also funds the instructor’s salary and student materials. Over 500 young adults receive counselling on HIV/AIDS awareness, adolescent sexual reproductive health, positive living, food and nutrition and behaviour change and access to voluntary HIV testing and counselling. Twenty HIV-positive children receive monthly food support, school fees and materials and their caregivers receive grants to support income-generating activities of their choice.

Keep a Child Alive — Alive Medical Services

Keep a Child Alive works to prevent the spread of HIV and mitigate its negative effects through education, home-based care, counselling and treatment. It is headquartered in the United States with projects in Africa and India. In Uganda’s capital of Kampala, Keep a Child Alive serves the city’s poorest and most densely populated areas. Their clinic provides free HIV treatment services to approximately 2,000 patients, while over 5,500 await treatment. The organization estimates that 70% of people they reach have been internally displaced from the border conflicts in northern Uganda.

HIV treatment and good nutrition are closely linked. Hence, the Stephen Lewis Foundation helps Keep a Child Alive by providing the clinic’s neediest patients with supplemental food packets once a month. The organization monitors all their patients regularly to ensure that they adhere to their medical regimens. While adherence had presented a big problem in the past because the treatment increased the patients’ hunger pains, now that nutritious food is provided it is expected that adherence rates will increase significantly. Sufficient food is provided so that all members of the household will benefit.

Kitovu Mobile AIDS Organization (formerly MAHCOP)

Kitovu Mobile aims to build the capacity of local families and communities through programmes that emphasise prevention, care, treatment and support services, economic stability and emotional coping skills. Support from the Stephen Lewis Foundation is directed to orphans and vulnerable children and the grandmothers who care for them. Over three hundred grandmothers and about the same number of orphans have benefited, to date.  Kitovu Mobile uses a three-step approach:

Phase one: Grandmothers receive psychosocial support, training and capacity building from staff and volunteers who have “graduated” from Kitovu’s Granny Programme in the past.

Phase two: Grandmothers form solidarity groups, receive bereavement counselling and start saving schemes. They are also given farm inputs and register formally as a Community Based Organization, which allows them to benefit from government assistance from programmes such as the National Agricultural Advisory Service. Each group starts an income-generating project such as a piggery or poultry production. Members use their common savings fund to support transport costs needed for hospital trips.

Phase three: Grannies receive refresher training and begin to play a leadership role in their community, including support to new granny groups that are getting started. 

Additional services for needy grandmothers include house repairs, the installation of pit latrines, and home-based care. At the same time, orphans in greatest need are supported with school fees, examination costs, and educational materials. To maximize their chance of success, the children participate in Kids’ Clubs, receive medical care and HIV-prevention training, and liaise with Kitovu Mobile staff and volunteers on a regular basis. The SLF also supports Kitovu Mobile by paying for staff meetings and training.

Kyetume Community Based Health Care Programme

Kyetume Community Based Health Programme is a community-based health care organization that was founded in 1994 by an ecumenical coalition of the Christian Churches in Uganda’s Mukono District. With a General Assembly of 225 persons and an Executive Board of 11, the Programme maintains a small administrative and medical staff and works with almost 200 volunteers. Their services related to HIV/AIDS include HIV prevention education and support, counselling and testing, prevention of vertical transmission of HIV (to babies), anti-retroviral therapy, TB testing and treatment, home-based care, and transportation to the health centre for needy patients.

Kyetume’s programme also provides care and support to some of the area’s many orphans, with SLF support. Twenty-three community-based artisans have been selected and equipped as mentors for orphans in vocational subjects such as tailoring, hairdressing, motor vehicle maintenance, welding and metal fabrication, and carpentry. Of the almost 130 orphans they have trained, many are now self-sufficient. Others have become involved in a heifer and organic farming programme. School dropouts are helped to return to school with the support of scholastic materials and fees. Through the use of 25 trained Child Care Outreach workers who offer home-based counselling and advocacy on child rights, the organization has noted a reduction in stigma and in exploitative or abusive practices, as well as a reduction in teenage pregnancies. SLF funding also provides bicycles for the Child Care Outreach workers, supplemental medical care for orphans and their caregivers, a new goat-project, administrative support, and the promotion of child protection committees within local village councils.

Literacy Action and Development Agency

Literacy Action and Development Agency (LADA) was started in 2003 by a group of women and men in Rukingiri District of Uganda who had lost many of their children, husbands, and wives to AIDS. In their Family and HIV/AIDS Support Project, which the SLF supports, LADA takes a three-fold approach that addresses health issues for HIV-affected families, education for orphans and vulnerable children and life-skills for all.

Currently, sixty children — one third of whom are HIV-positive — are provided with school fees, a uniform, scholastic materials, and toiletries.  They receive counselling and are visited regularly in their schools and at home in order to encourage their success. In addition, family members and community leaders learn how to provide psychosocial support to orphans and vulnerable children, and all members of the child’s family receive assistance to access medical care, as needed. Special care is given to encourage adherence to HIV treatment protocols, with the hope of keeping at least one parent alive for each child for as long as possible. HIV-positive children also receive special care and monitoring. Health education and life-skills are provided through radio programmes, small group sessions, and drama or music sensitization in villages and urban centres.

Nsambya Home Care Department Nsambya Hospital

Nsambya Home Care (NHC) Department first started at Nsambya Hospital in 1987 in order to deal with the rising number of HIV/AIDS cases that were overwhelming the hospital wards. While NHC continues to provide community-based medical and psychosocial services to people living with or affected by HIV andAIDS, in recent years the needs of orphans and vulnerable children and their granny caregivers emerged as one of NHC’s most pressing concerns.

The SLF supports NHC’s overall programme with a special focus on providing a better quality of life for the children in care of elderly grandmothers. In particular, NHC’s granny and child-support programme identifies the area’s neediest households and provides school fees for children attending primary school, plus both school fees and start-up kits for older children attending vocational training. Regular home-care visits are intended to provide household members with encouragement and “nip in the bud” any other problem — e.g. health, emotional, etc — that may arise. In addition, the children’s grandmothers are divided into two groups. Where the grannies are physically able, they are helped with small-scale income-generating activities, such as buying-and-selling, poultry and piggeries, and the production of straw sleeping mats. By contrast, grannies who are too weak or unable to participate in these activities receive direct food support. The SLF also helps pay for several key staff positions at NHC, as well as some administrative costs.

Nyimbwa Multi-Purpose Organization of PLWHA

Nyimbwa Multi-Purpose Organization of PLWHA is a self-help organization in rural Uganda that works holistically with local orphans and vulnerable children, care-giving grandmothers and people living with HIV and AIDS (PLWHA). With support from the SLF, the organization’s volunteers receive trainingon HIV/AIDS, psychosocial support, and sustainable livelihood planning. The volunteers then conduct outreach sessions in the community and undertake regular home visits to approximately one hundred HIV-affected households in their catchment area.

With additional help from these volunteers, they select beneficiaries who could benefit from  the organization’s support. Once chosen, all beneficiaries are visited regularly for counselling and encouragement, and provided with material assistance in the form of washing soap, sugar and maize-meal. Some guardians are also given two piglets each as income-generating work. After the pigs grow up and give birth, some of the offspring will remain with the original household and the remainder are to be shared with other beneficiaries in the community. Additional beneficiaries receive micro-credit loans to expand small businesses that they already have, such as food-kiosks, handicrafts, brick-making, and tailoring. Nyimbwa also provides a small number of girls with educational support to attend secondary school, and helps repair the homes of grandmothers in need. The SLF also provides  the organization with funding to cover  office expenses and some staffing costs.

Reach Out Mbuya Parish HIV/AIDS Initiative

Reach Out Mbuya Parish HIV/AIDS Initiative offers an integrated approach to HIV care and treatment. They explain, “Medicine is useless without food; food is of no consequence when patients are devoid of a future; and the future is bleak when it lacks hope”. 

Reach Out’s services include an accredited health centre, which allows them to implement both treatment and HIV prevention programmes to thousands of beneficiaries annually.  In addition, orphans and vulnerable children receive educational support, food packages, and psychosocial assistance. Reach Out also conducts many training programmes to other organizations with the goal that similar independent, community-owned programmes will proliferate successfully.  Most of the organization’s “staff” are volunteers who have been — or still are — patients.

At the core of Reach Out, lies its home-based care programme. Home-based care fills the gap between centre-based treatment and support at the individual, family and community levels. With SLF assistance, Reach Out offers training, incentives, supplies and supportive supervision to approximately 60 community home health workers. Additional capacity-building in outlying areas includes peer-to-peer exchange visits and training sessions to ensure local buy-in and sustainability. Patients-in-need receive legal assistance, nutritional training, food supplements and counselling. They are further invited to join support groups and attend adherence workshops. With SLF assistance, Reach Out is also able to provide clean-water and malaria-prevention services (e.g. health-education, water-guard tablets and mosquito nets), economic empowerment training (focusing on food production), and regular feedback to local community networks and village leaders in order to generate local support and break down stigma and discrimination.

St. Francis Health Care Services

St. Francis Health Care Services is located near the source of the Nile River in Uganda and serves a catchment area of approximately 2.5 million people. It responds to the HIV/AIDS epidemic through the provision of medical care and psychosocial supports to people living with HIV and AIDS and their family members. Despite very modest beginnings, St. Francis Health Care Services now conducts extensive community outreach activities and serves approximately 10,000 patients, more than 300 granny-caregivers and over 1,500 orphans.

SLF support focuses on the organization’s community-based programmes. There are two emphases: In the first, the SLF helps St Francis support granny-caregivers and the children for whom they are responsible. Activities include income-generating activities, village saving and loan schemes, medical support and visits by grandmothers to model farms where they learn new farming techniques. Orphaned children in greatest need receive school fees and scholastic materials. Where appropriate, these children also attend sessions at the Health Centre where they receive psychosocial support, health-education, supplemental nutrition and encouragement from specially trained mentors. The grandmothers explain that the best part about all these programmes is that, increasingly, their families are now able to sustain themselves and look positively towards the future, rather than just sit and wait and rely on hand-outs. 

Second, the SLF’s helps underwrite St. Francis’ home-based care programme. Trained community health volunteers visit programme beneficiaries to provide counselling referral, and encouragement. They promote HIV-testing and treatment adherence, strengthen family communication, provide palliative care, distribute supplemental food-packets, and offer one-on-one health-education. Additionally, home-based care volunteers assist project nurses in the distribution of life-savings drugs. SLF funding pays for some staffing and administrative costs and also helps St Francis facilitate a support group for about 50 ‘Young Positives’, age 10-24.

Wells of Hope Ministries

The HIV prevalence rate in the Uganda's prisons stands at 17%, which is far greater than the national average of just below 7%. Working with people of all faiths, Wells of Hope Ministries offers hope and support to HIV-positive prisoners and their family members in Kampala and several nearby districts. For example, with SLF support Wells of Hope Ministries provides high-protein food supplements to HIV-positive prisoners in order to strengthen their immune systems and improve their health status. This includes 72 women prisoners with HIV and 30 babies being cared-for in prison. They conduct training on HIV prevention and care in several prisons and encourage peer counselling between their trainees and other inmates. They also offer HIV counselling and testing to both prisoners and family members.

SLF funding ensures that grandmothers who care for grandchildren due to a parent’s imprisonment are assisted withincome-generating activities  in order to better provide for their grandchildren’s needs. In critical situations, children also benefit directly via the provision of school fees and educational materials. The organization provides an important linkage between the prisoners and their families by facilitating communication and three meetings a year between the prisoners and their family members. Wells of Hope Ministries conducts psychosocial support sessions with affected families and their staff helps all parties prepare for a prisoner’s release and reintegration into society. The SLF also pays for some staff salaries and expenses, and for costs related to monitoring and evaluation.

• Project descriptions last updated April 2011