ART in Uganda Catholic Church health facilities: opportunities and challenges

Uganda Government plans to scale up access to antiretroviral therapy (ART) through the involvement of all stakeholders including public, private, Non-governmental organizations, Private-not-for-profit providers etc. based on the use of the existing institutional framework. Like other stakeholders, health facilities of the Catholic Church stand some opportunities to participate in this process. However, it is already clear that the rollout process is overstretching both the implementing health facilities and the Ministry of Health. The human and infrastructure resource demand is fast proving overwhelming. This is worse for the private-not-for-profit facilities. Salary enhancement for government staff alone will further weaken the PNFP partners from contributing effectively in the rollout. Integration of the ART programme into the comprehensive function of the hospitals faces difficulty from its "project" or vertical nature. There is concern over the visible drain of resources from other activities of health facilities providing ART and possible weakening of these facilities. The future sustainability is progressively being questioned. It is proposed that government assists the Church and other implementing partners in strengthening the existing framework as a composite part of the rollout package. It is also suggested that strengthening of the Public Health approach that Uganda is already partially practicing could offer some relief. Strengthening of the community-based approach is particularly advocated for.