Strengthening TB and HIV & AIDS Responses - Eastern Region
USAID’s Strengthening TB and HIV & AIDS Responses in Eastern Uganda (STAR-E) project was funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) and implemented by an MSH-led consortium of international and Ugandan organizations.
STAR-E empowered districts, health facilities, and communities in eastern Uganda to effectively respond to the HIV and tuberculosis (TB) epidemics by preventing new infections, treating and caring for those infected, and mitigating the diseases’ health and social impact.
The project had four key objectives: To strengthen district management of the decentralized health system, improve the quality of HIV and TB services provided by health facilities, to strengthen the continuum of care of services between health facilities and their served communities, and to increase demand for HIV and TB prevention, care, and treatment services among communities.
STAR-E worked closely with Uganda’s ministry of health to develop guidelines and standards of care and to oversee their implementation.
To strengthen district health management, STAR-E provided technical and other assistance to health management teams in 12 districts with a combined population of 2.7 million people. To improve the quality of HIV and TB services provided by health facilities, the project provided training and onsite mentoring for health care providers.
To strengthen a continuum of care between the health facilities and the communities they serve, STAR-E partnered with local nongovernmental organizations, community-based civil society organizations, religious leaders, and peer educators from key and priority populations.
STAR-E scaled up support to 154 health facilities to offer integrated HIV and TB services, up from one supported facility in 2009. By 2015, more than 400,000 people were being tested for HIV per year, up from fewer than 30,000 in 2009. The TB case detection rate improved from 29 percent in 2009 to over 40 percent, and the TB treatment success rate went from 50 percent in 2009 to 87 percent in 2015.
A component of the STAR-E project was Lot Quality Assurance Sampling (LQAS), a community-based random sampling survey tool. LQAS ascertains household knowledge, reported behavior, and coverage of essential services, which provides districts with a deeper understanding of their communities for evidence-based planning and action.