HIV/AIDS previous to the year 2000 had not been much felt in Moroto District and Karamoja region as a whole, but the situation has changed now because of increased awareness that has seen more people reporting to Health Units and Community based service providers in search of assistance both medical and material. The 2005 National Serobehavioural prevalence study put the prevalence of HIV/AIDS at 3.5% in Moroto District. This represents a 300% increase in prevalence from 1998 where prevalence was at 0.9% at sentinel surveillance sites.
According to the 2001 Baseline study report conducted by UNICEFCP in the four Sub Counties of Lotome, Ngoleriet, Nadunget and Lopeei the level, HIV/AIDS awareness among the population was reported to be at 90%, which is significantly important given the national rate of 100%. The impacts of this rising trend has been the increase in the dependency ratio, which is already considerably high due to the tribal conflicts there by placing excessive burden on individuals particularly the women. Since households will tend to devote more time and resources to offer medical care to sick relatives at the expense of productive activities, assets and subsequently general productivity is being Lost from time to time.
In terms of Gender and age, there are increased number of households headed by Grandparents, Widows, Youth and Orphans. Commonly these categories of people are not suitably placed to competently handle such responsibilities given their lack of resourcefulness and inexperience with family matters. Matany and Moroto hospitals with support from UNICEF and AIC are currently offering Prevention of Mother to Child Transmission of HIV/AIDS and Voluntary Counselling and Testing services (PMTCT/VCT) The counseling and testing services have been extended to three of the HCIIIs (Rupa, Iriiri and Kangole). The WFP currently provides support to the hospitals in feeding PWHAs.
The data on HIV/AIDS has been very scanty due to lack of comprehensive system of capturing and tracking the situation at household level and health units. The district has in addition adopted Multisectoral approach to Mainstream HIV/AIDS in Development Programmes under support from the World Health Organization. A working group for HIV/AIDS has been formed to coordinate the activities of individual players. This is in consonant with the National framework in the fight against HIV/AIDS.
In 2006, the number of people counseled and tested for HIV increased mainly due to the increased availability of services. The figure below shows the number of people tested and trends over the last nine years. The sentinel surveillance data also revealed that 4.5% of pregnant mothers tested HIV positive. It is important to note that this is only the number of cases reporting to health facilities for treatment.
The main focus on HIV/AIDS services in the district is now on the areas listed below,
• Scaling up counseling and testing.
• Provision of Ante retroviral therapy (ART)
• Establish home based care services
• Reduce stigma
• Provision of PMTCT services.
• Coordination of activities by partners including NGOs, CBOs and UN agencies.
There are still challenges even in carrying out interventions and designing projects. HIV/AIDS continues to be one of the biggest obstacles to reducing poverty and attaining the PEAP goals. The capacity to respond at all levels depends on strong leadership, allocation of adequate resources, coordination of Planning and promoting a best practice approach. The key challenges include sustaining (and increasing) the levels of resources allocated to HIV/AIDS activities, maintaining workplace coherence and coordination across all levels of support; building capacity to respond and promoting best practice and lesson learning.
Although prevention should encompass multiple integrated elements, including links to expanded treatment access changing or maintaining of behaviour aimed at risk avoidance and risk reduction must remain the cornerstone of HIV prevention. The identification and direct involvement of most at risk and marginalized population is critical because they account for a Long proportion of infected programme designed specifically for people living with HIV.AIDS. Another challenge is that there is still poor response by men towards VCT and PMTCT services. Programmes should be designed to bring men on board otherwise the LG efforts to avert the pandemic might bare less fruits.
HIV / AIDS Services in the district
Currently a total of six health facilities are offering VCT services in the district, Moroto and Matany Hospitals. Iriir, Kangole, Tapac and Nadunget HC IIIs. PMTCT services are offered in these centres. In all these centres, treatment of opportunistic infections is provided. However, only Moroto and Matany Hospitals are currently providing Antiretroviral therapy. With support from partners, VCT services are provided on outreach basis to communities where the services are not available.
NGOs/CBOs main collaborating agencies in HIV /AIDS services Provision
Type of Services offered
Non state actors are mainly limited to community initiatives like mobilization, sensitizing of communities. The service delivery is by and large still limited to the formal health care system in both NGOs and Government facilities.
Community Led HIV/AIDS Initiatives
Community led initiatives on HIV/AIDS activities are still very limited in scope in Moroto district. This is largely due to the severely undefended organisations with limited capacity in mobilisation of resources. HIV/AIDS was also previously not viewed as a serious health challenge for the people of Moroto District and Karamoja at large.
HIV/AIDS & Construction
Issues of HIV/AIDS are integrated during the planning, design preparation of contract documents, mobilization and sensitization, contract procurement and training. Sensitization and awareness is conducted by both the supervision staff before and during the implementation of works. The district has adopted the use of labour with light equipment support for the construction of district roads. As part of the sensitization programmes, HIV/AIDS awareness campaigns are organized for workers with and including the distribution of condoms and information/education message cards.
