Community- facility linkages and referral
The community health facility framework was introduced to leverage and strengthen the capacity of communities in achieving 90-90-90 targets and ensuring delivery of quality health and psychosocial services along a continuum of response. The core package of community based services focuses on evidence-based interventions that complement and/or extend facility based services. They are organized around the 90-90-90 and combination prevention frameworks, and are informed by the need for 1) identifying more HIV-positive individuals through improved contact tracing and highly targeted community based testing, 2) the differentiated service delivery approach recommended in the WHO Consolidated Guidelines on the use of ARVs for Prevention and Treatment of HIV (2015), 3) the importance of addressing social and community factors affecting adherence and retention, 4) the benefits of case management, and 5) leveraging the OVC platform. The package also draws on opportunities in leveraging the OVC platform. Strengthened two-way linkages between facility and community structures is paramount for improving access to and ensuring the quality of care, treatment and prevention services.
HIV counseling and testing (HCT),
This icludes both pre- and post-test counseling, confidentially conducted by trained health workers.
Including counseling, social work, and community home-based care. These programs promote behavior change (such as partner reduction, abstinence, and correct and consistent condom use), drug adherence, and disclosure. Psychosocial support is offered in many settings beyond the clinic, including educational camps, peer support groups, men’s access clubs, home visits, play therapy, and programs specific to orphans and vulnerable children (such as child protection, education support, and income generation activities). The psychosocial unit also proactively identifies HIV-positive children and their family members through targeted voluntary counseling and testing campaigns, HIV screenings in orphanages and child centers, and Know Your Child’s Status campaigns.
Including ante- and post-natal care. HELP links community systems with health facilities to increase
facility-based delivery and reduce maternal and neonatal mortality
Safe male circumcision (SMC)
As an HIV prevention strategy,SMC has proven to reduce the risk of infection in men by approximately 60%, making it one of the simplest and most effective tools for reducing the spread of HIV. Still, only 23.6% of Ugandan men aged 15-49 have been circumcised.