Tana Wuliji, Senior Improvement Advisor, Health Workforce Development Unit Lead, USAID Applying Science to Strengthen and Improve Systems Project (ASSIST), University Research Co., LLC (URC)
Since the rapid roll-out of ART across Uganda in 2005, the Ministry of Health and its partners have seen increasing numbers of eligible HIV+ patients being enrolled in care with over 290,971 on ART in 2011 compared to 105,000 in late 2006 (Global AIDS Response Progress Report, Uganda AIDS Commission, 2012). At the same time, gaps have also been observed in patient’s adherence to ART, completion of TB treatment courses, and availability of drugs for opportunistic infections. The absence of drugs in the right quantities, right dosages and right combinations at the health facilities has at times been stated as the reason for eligible patients not being enrolled onto HIV care, those enrolled not being retained in care and those in care not clinically improving. A rapid situational analysis conducted in April 2012 had identified gaps such as stock outs of HIV testing kits and HIV care medicines, 40% of clients not being able to explain how to take their medicines upon leaving the pharmacy window, delays in ordering, ordering not based on actual needs, lack of communication between clinical and pharmacy staff, and lack of adherence to dispensing standards. These gaps potentially compromise client outcomes by affecting adherence and clinical outcomes.