Uganda is one of the 10 countries that, together, account for 81% of the estimated 24.7 million people living with HIV (PLWH) in Sub-Saharan Africa (SSA). The most recent surveillance data (2016) show an HIV prevalence of 6.5% in the general population in Uganda (1.4 million PLHIV), and this burden is disproportionately born by women (7.6% seroprevalence) vs. adult men (4.7%). Although HIV prevalence in rural Uganda is somewhat lower (5.8%), this is where 80% of the population resides; yet, 71% of doctors and 41% nurses and midwives serve urban areas. Thus, although the majority of PLWH are in rural areas, these communities are underserved ? often with widely scattered healthcare facilities ? and need strategic approaches to attract and retain a well-trained workforce to confront the healthcare and prevention challenges of the epidemic. The Ugandan National HIV/AIDS Strategic Plan 2016-2020 prioritizes human resources for delivery of health, prevention, and community-based HIV/AIDS services in both public and non-public sectors. To address the health-professional training that will be critical to lessening the HIV/AIDS burden ? particularly in rural Uganda ? the Mbarara University of Science and Technology (MUST) in rural southwest Uganda and its partner institutions in rural Uganda (Bishop Stuart, Busitema and Lira Universities) and the US (Massachusetts General Hospital) propose the HEPI-TUITAH (Transforming Ugandan Institutions Training Against HIV/AIDS) program. This inter-professional HIV/AIDS service-improvement training program will build on our successes in the MEPI-MESAU consortium and our current Mbarara University Research Training Initiative (MURTI; D43TW010128, PI: Obua) and Mbarara University Research Ethics Education Program (MUREEP; R25TW010507, PI: Kiwanuka) to address the following specific aims: (1) To increase the competency of undergraduate medical, nursing, midwifery, and allied health professional students in the management of HIV/AIDS through the low dose, high frequency training model for quality clinical education, patient care, and HIV prevention services in Uganda; (2) To enhance the capacity of primary health care providers to provide comprehensive HIV services and strengthen bidirectional linkages between health facilities and communities in rural Uganda; (3) To develop the capacity of undergraduate health professional students in rural Uganda to conduct locally relevant biomedical, behavioral, clinical, and operations research in HIV and its co-morbidities; and (4) To strengthen a network of health professional training institutions (HPTIs) by building a community of practice and leveraging local resources and expertise to mitigate the national HIV/AIDS burden. At the completion of the TUITAH, we expect to have trained 2,368 health professionals students and up to 240 Primary Care Providers in HIV/AIDS prevention, care, and research, thus contributing significantly to the cadre of health professionals serving rural Uganda. The TUITAH program has the potential to be a model for health provider training throughout SSA.
Education in HIV/AIDS care and service delivery at MUST and its partner training institutions will provide undergraduate health professional students and primary healthcare providers with clinical skills and research capacity that will contribute to reduction of HIV/AIDS burden in Uganda. The program is significant in its focus on increasing health services delivery and research in rural Uganda and inclusion of nurses and midwives, given the disproportionate burden of HIV/AIDS borne by women in Sub-Saharan Africa.
