Improving Systems to Empower Communities
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HIV and AIDS


An Enugu woman (left) receives an HIV test from a
laboratory advisor through URC’s HIV and AIDS
Comprehensive Care Initiative in Nigeria and
Women for Women International. Photo by
Dr. Ikechukwu Ezekpeazu, URC
URC supports 25 countries in Africa, Asia, Eastern Europe, and Latin and North America to develop HIV programs that focus on creating better health outcomes for underserved and vulnerable populations. We apply methods that are locally adapted and country led to improve health care systems. Working with local health care providers, community leaders, patient advocates, and government officials, we identify gaps in service delivery processes, then develop and scale up best practices to achieve sustainable improvements. Our programs are designed to advance the US Global Health Initiative objective of creating an AIDS-free generation and encompass the areas described below. You can find more information about these areas in our technical brief.

Prevention

URC’s efforts to prevent HIV transmission include be­havioral, medical, and environmental components: preventing transmission of infections, reducing risky behaviors, increasing counseling and testing, and fostering an environment free of discrimination and stigma. We assist health systems in strength­ening the continuum of care for the prevention of mother-to-child transmission of HIV. That continuum is a comprehensive, interconnected array of services that includes prevention, treatment, and care for pregnant women and their infants during pregnancy, labor, delivery, and beyond.

We work closely with facilities to empower health care providers to provide high-quality, patient-specific, and comprehensive HIV counseling combined with accurate and reliable testing. We help health systems create and/or strengthen links between HIV and other health services for provider-initiated counseling and testing. We also work with community groups to reach individuals for voluntary counseling and testing.

Care and Treatment

URC works with treatment centers to reach, retain, and achieve better outcomes for people living with HIV. For example, our Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project supports 17 Ugandan hospitals that have provided comprehensive HIV services to more than 45,000 HIV-positive adults and children. The project helped the hospitals reach and retain nearly 34,000 patients on antiretroviral therapy (ART) and link them to preventive services. In the first three months of 2012, the hospitals prescribed preventive medicines to 93% of these patients.

We also work to integrate prevention, counseling and testing, and care and treatment services of HIV and TB. For example, within two years, our TB South Africa project increased TB screening among HIV-positive patients from about 75% to nearly 97%, and it increased HIV counseling and testing among TB patients from 76% to 92%. (These data cover project-supported facilities in 18 high-burden districts.) We strive to quickly initiate TB/HIV co-infected patients into appropriate treatment; in Swaziland, our HIV project increased ART for co-infected TB patients from near zero in 2008 to 60% in 2011 (see figure).


Community-based Care and Support

URC engages communities to provide ongoing care and support for people living with HIV and AIDS. We are working in Mozambique and Tanzania to develop national standards for home-based care. Through the HIV and AIDS Comprehensive Care Initiative (HACCI), we partnered with a local organization, Women for Women International, to reach women in rural Nigeria. HACCI discussed issues surrounding HIV/AIDS with and offered voluntary counseling and testing services for groups of women who meet regularly through Women for Women. Three outreach campaigns have reached more than 400 women in one community in Enugu.

Vulnerable Children and Families

Due to the long-term effects of HIV/AIDS and poverty, many countries, particularly in Africa, are home to large numbers of children living either without the support of a caring family or in a family struggling to meet his/her needs. These children are considered vulnerable—they are more likely to be exposed to conditions of violence, exploitation, abuse, and neglect—and subsequently are at greater risk of poor health, including HIV/AIDS infection. URC is working to improve the well-being of vulnerable children and families in nine countries.

Health Workforce Development

High-quality HIV services depend on having a competent, efficient health workforce. However, countries with a high HIV burden often lack the health workforce required to provide basic health care. Many health workers experience tremendous strain due a multitude of factors that vary in different contexts, including a high volume of patients and frustrations related to working in a weak health system. These factors can result in low morale, absenteeism, poor retention, and high staff turnover. URC supports research and improvement activities to strengthen health worker engagement, productivity, retention, and performance in seven countries.

Laboratory Strengthening

In low-resource settings, inaccessible or unreliable laboratory support and infrastructure diminish the quality of many health services. URC seeks to build and improve health systems’ capacity to provide laboratory support through accreditation; facility renovations; and on-site training in bio-safety, documenting standard operating procedures, and equipment maintenance. We also facilitate in-country training among national and regional labs and lower level facilities. We have helped strengthen laboratories in seven countries.

Health Management Information Systems

Organized, well-maintained records are critical in providing efficient and informed care as well as for developing and testing changes to improve care. Our activities frequently begin with a focus on improving doc­umentation and data collection practices. We often imple­ment activities focused on improving medical records man­agement to strengthen the continuity of care for HIV patients.

Download our technical brief to learn more about our HIV/AIDS work.

Current Projects

Building Human Resource Capacity to Support Prevention, Care, and Treatment: Strategic Information and Other HIV/AIDS Programs
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2008 to present

Strengthening TB Case Detection and Treatment and TB-HIV Coordinated Activities
Funded By: URC
Project Duration: 2007 to present

TB Program South Africa
Funded By: US Agency for International Development
Project Duration: 2009 to present

HIV/AIDS and Tuberculosis Laboratory Support
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2009 to present

USAID Health Care Improvement Project (HCI) | Global
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Nicaragua
Funded By: United States Agency for International Development
Project Duration: 2007 to present

Lesotho Health Sector (LHS) Project
Funded By: Millennium Challenge Corporation
Project Duration: 2009 to present

Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN)
Funded By: US Agency for International Development (USAID)
Project Duration: 2010 to present

PrevenSIDA
Funded By: United States Agency for International Development
Project Duration: 2010-present

Strengthening the Response to TB, HIV and STIs in Central America and Panama Region
Funded By: Centers for Disease Control and Prevention (CDC)
Project Duration: 2010 to present

TB CARE II
Funded By: United States Agency for International Development (USAID)
Project Duration: 2010 to present

Improving TB Detection and TB-HIV Services Integration
Funded By: URC
Project Duration: 2011 to present

USAID Health Care Improvement Project (HCI) | Zambia
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2011 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Global
Funded By: US Agency for International Development (USAID) through the USAID Bureau for Global Health, Office of Health Systems
Project Duration: 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Burundi
Funded By: US Agency for International Development (USAID) through USAID/Burundi
Project Duration: January 2013 to present


USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Cote d’Ivoire
Funded By: US Agency for International Development (USAID) through USAID/Cote d’Ivoire
Project Duration: April 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | South Africa
Funded By: US Agency for International Development (USAID) through USAID/South Africa
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Swaziland
Funded By: US Agency for International Development (USAID) through USAID/Swaziland
Project Duration: 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Tanzania
Funded By: US Agency for International Development (USAID) through USAID/Tanzania and USAID Bureau for Global Health, Office of HIV and AIDS
Project Duration: October 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Uganda
Funded By: US Agency for International Development (USAID) through USAID/Uganda and the Bureau for Global Health, Office of HIV and AIDS and the Office of Health Systems
Project Duration: 2012 to present

HIV Innovate and Evaluate Project
Funded By: US Agency for International Development (USAID)
Project Duration: August 2013 to present

Quality Health Services for Haiti (Services de Santé de Qualité pour Haïti – SSQH) North Project
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Lesotho
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Mozambique
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Nicaragua
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Zambia
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Pakistan
Funded By: US Agency for International Development (USAID)
Project Duration: 2012 to present

Cooperative Biological Engagement Program (CBEP)
Funded By: Defense Threat Reduction Agency, US Department of Defense
Project Duration: 2013 to present

Social Health Protection Project
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

Laboratory Development and Set-Up
Funded By: Defense Threat Reduction Agency, US Department of Defense
Project Duration: 2014 to present

HIV Co-Infection Surveillance Strategies for Program Planning in the Central America Region
Funded By: CDC
Project Duration: 2014 to present

TASC 4 Africa - Population, Health and Nutrition IDIQ
Funded By: US Agency for International Development (USAID)
Project Duration: 2014 to present

Past Projects

HIV and AIDS Comprehensive Care Initiative (HACCI)
Funded By: US Centers for Disease Control and Prevention through the President's Emergency Plan for AIDS Relief
Project Duration: 2008-2013

Better Health Services (BHS)
Funded By: US Agency for International Development (USAID)
Project Duration: 2009-2013

Data Quality Audit (DQA) Framework
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2008-2010

USAID's Health Promotion and Communication Project (HealthPRO)
Funded By: US Agency for International Development (USAID)
Project Duration: 2007–2012

Increasing Access to HIV Testing and Counseling
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2006-2012

Global Fund Consulting Services
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2007 to 2012

Technical Assistance and Support Contract 3: Global Health (TASC3 Global Health)
Funded By: United States Agency for International Development
Project Duration: 2007-2013

USAID Health Care Improvement Project (HCI) | Ethiopia
Funded By: US Agency for International Development
Project Duration: 2007–2012

USAID Health Care Improvement Project (HCI) | Cote d’Ivoire
Funded By: United States Agency for International Development
Project Duration: 2008-2013

USAID Health Care Improvement Project (HCI) | Kenya
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2009-2013

USAID Health Care Improvement Project (HCI) | Mozambique
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2009-2013

USAID Health Care Improvement Project (HCI) | Namibia
Funded By: US Agency for International Development
Project Duration: 2008-2011

USAID Health Care Improvement Project (HCI) | Russia
Funded By: US Agency for International Development (USAID)
Project Duration: 2007-2012

USAID Health Care Improvement Project (HCI) | South Africa
Funded By: US Agency for International Development (USAID)
Project Duration: 2007-2013

USAID Health Care Improvement Project (HCI) | Swaziland
Funded By: US Agency for International Development
Project Duration: 2007-2013

USAID Health Care Improvement Project (HCI) | Tanzania
Funded By: US Agency for International Development
Project Duration: 2007-2012

USAID Health Care Improvement Project (HCI) | Uganda
Funded By: US Agency for International Development
Project Duration: 2007-2012

USAID Health Care Improvement Project (HCI) | Vietnam
Funded By: US Agency for International Development
Project Duration: 2007 to March 2011

Integrated Infectious Disease Capacity Building Evaluation (IDCAP)
Funded By: Accordia Global Health Foundation
Project Duration: 2008-2012

Food and Nutrition Interventions (NuLife)
Funded By: US Agency for International Development through the President’s Emergency Plan for AIDS Relief
Project Duration: 2008-2011

Improving Primary Health Care in Albania I and II (Pro Shëndetit)
Funded By: US Agency for International Development
Project Duration: 2003–2009

Multi-Sector Alliance Program (Alianzas II)
Funded By: US Agency for International Development through RTI International
Project Duration: 2010 to 2012

Nongovernmental Organization Service Delivery Program in Bangladesh
Funded By: US Agency for International Development/Bangladesh
Project Duration: 2002-2006

Benin Integrated Family Health Project (PROSAF)
Funded By: US Agency for International Development/Benin
Project Duration: 1999-2006

Health Systems Strengthening (HSS)
Funded By: US Agency for International Development/Cambodia
Project Duration: 2002-2008

Central America Health Consultancies
Funded By: The World Bank
Project Duration: 1990-1995

El Salvador Strengthening Health Project Technical Assistance and Support Contract 2 (TASC2)
Funded By: US Agency for International Development
Project Duration: 2006–2009

Diagnostic Test Cost Analysis for the Developing World
Funded By: The Bill and Melinda Gates Foundation
Project Duration: 2007–2009

Health Planning and Health Delivery Systems
Funded By: US Agency for International Development
Project Duration: 1983-1990

Primary Health Care Management Advancement Program
Funded By: The Aga Khan Foundation
Project Duration: 1991-1993

Partnerships for Health Reform Project and Partners for Health Reformplus
Funded By: US Agency for International Development
Project Duration: 1995–2005

Primary Health Care Operations Research Project (PRICOR) I and II
Funded By: US Agency for International Development
Project Duration: 1981–1991

Water and Sanitation for Health
Funded By: US Agency for International Development
Project Duration: 1988–1994

WHO/Global Programme on AIDS Senior Managers’ Training Course
Funded By: World Health Organization
Project Duration: 1990-1993

Multi-Sector Alliance Program (Alianzas I)
Funded By: US Agency for International Development (USAID) through Research Triangle Institute (RTI)
Project Duration: 2006–2009

Jamaica Adolescent Healthy Lifestyles (JA-STYLE)
Funded By: US Agency for International Development/Jamaica
Project Duration: 2005-2008

Malawi Support to AIDS and Family Health Project
Funded By: US Agency for International Development
Project Duration: 1994-1998

Project for Regional Management of Health Services
Funded By: US Agency for International Development/Morocco
Project Duration: 1994-2003

Improving Medical Injection Safety in Namibia Project
Funded By: President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development
Project Duration: 2004-2009

Peru Strengthening Health Institutions Project, MaxSalud Component
Funded By: US Agency for International Development/Peru
Project Duration: 1994-1999

Quality Assurance Project (QAP) I, II, and III
Funded By: US Agency for International Development
Project Duration: 1990-2008

PreventAIDS
Funded By: US Agency for International Development
Project Duration: 2005-2008

TASC II Tuberculosis/South Africa
Funded By: US Agency for International Development/South Africa
Project Duration: 2004-2009

Integrated Technical Assistance Project
Funded By: US Agency for International Development/South Africa
Project Duration: 2004-2008

Development of Harmonized Minimum Standards for the Prevention, Treatment and Management of Tuberculosis in the SADC Region
Funded By: Southern African Development Community
Project Duration: 2009-2010

Feasibility and Pilot Efficacy of Flash-Heated Breast Milk for Reduction of Maternal-to-Child Transmission of HIV in Tanzania
Funded By: The Thrasher Foundation and the National Institutes for Health
Project Duration: 2007-2009

Uganda: REDUCE II
Funded By: Academy for Educational Development
Project Duration: 2000-2001

UNICEF Malawi and New York
Funded By: UNICEF
Project Duration: 2008-2010

Technical Assistance and Support Contract 2 (TASC2): Global Health
Funded By: United States Agency for International Development
Project Duration: 2004–2009

Strengthening Community Safety Nets (SCSN)
Funded By: United States Agency for International Development
Project Duration: 2008-2011

Food and Technical Assistance (FANTA) II
Funded By: United States Agency for International Development
Project Duration: 2010 to 2011

USAID Health Care Improvement Project (HCI) | Malawi
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2011-2013

USAID Health Care Improvement Project (HCI) | Nigeria
Funded By: US Agency for International Development (USAID)
Project Duration: 2011-2012

Technical Support to Develop a Quality-of-Care Framework for a Hospital Health Care Improvement Project in Liberia
Funded By: The World Bank Group
Project Duration: 2013



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