The ART services supported by MJAP include screening for ART eligibility, provision of ARV drugs, laboratory and clinical monitoring of ART and training of health care providers in ART services.
In order to reduce losses to follow up, we have a patient tracking and adherence program for patients on ART whereby patients who miss their clinic appointments are actively followed up through phone calls and home visits.
As a result, we have had good retention on ART year on year, CD4 assessment for all clients in care is routinely done every six (6) months. Satisfactory immunological outcomes among patients on ART were registered across all the MJAP supported clinics. In Mbarara, the program facilitates transportation of blood samples from lower level facilities to MbararaMunicipal Clinic Laboratory for CD4 testing. MJAP also supports transportation of the dry blood samples to the Central Public Health Laboratory (CPHL) for DNA PCR. This mechanism has reduced the turnaround time for the CD4 and DNA PCR test results and increased access to ART for both adults and children.
We also support health units to access drugs from National Medical Stores (NMS) and procured some ARVs to cover gaps. ARVs for Post Exposure Prophylaxis (PEP) to survivors of SGBV, as well as to health workers exposed to HIV at work were also provided.
The increase in number of eligible clients for enrollment on ART brought about by the implementation of the new MOH recommended CD4+ cells cut off for ART initiation of <350 cells/ ml led to straining of the available human, logistical and infrastructural resources. The Nurse and Pharmacy only visits whereby patients who are stable on ART are given long appointment schedules have helped to reduce on patient waiting time in some clinics.