U Care Inc

USING ENHANCED PEER GROUP STRATEGIES TO SUPPORT OPTION B+ IN UGANDA

IMPLEMENTATION SCIENCE TO UNDERSTAND AND DESIGN STAKEHOLDER INFORMED INNOVATIVE INTERVENTIONS TO IMPROVE ADOLESCENT AND YOUTH HIV PREVENTION AND CARE CONTINUUMS IN RURAL AND URBAN UGANDA - PROJECT SUMMARY: ADOLESCENTS AND YOUNG ADULTS (AYA) HAVE A HIGH HIV INCIDENCE AND POOR OUTCOMES ALONG THE ENTIRE HIV PREVENTION AND CARE CASCADES COMPARED TO ADULTS. DESPITE THE HIGH HIV BURDEN, BOTH UPTAKE OF ORAL PREP (HIV NEGATIVES) AND ACHIEVING VIRAL SUPPRESSION (HIV POSITIVES) ARE SUB-OPTIMAL AMONG YOUTH IN SUB-SAHARAN AFRICA. AMONG YOUTH IN UGANDA, UPTAKE AND PERSISTENCE ON ORAL PREP IS LOW, WITH REASONS FOR DISCONTINUATION INCLUDING: PILL BURDEN, LOW PERCEIVED SEVERITY OF HIV, NEED FOR PARTNER OR PARENTAL APPROVAL, HIV- RELATED STIGMA, FEAR OF SIDE-EFFECTS AND HEALTH FACILITY BARRIERS. CABOTEGRAVIR, A IS NEW LONG-ACTING ANTIRETROVIRAL (CAB-LA) AND HIGHLY EFFICACIOUS PREP CHOICE THAT CAN MITIGATE BARRIERS TO USE OF DAILY ORAL PREP. WE PROPOSE TO EVALUATE EVIDENCE-BASED HIV PREVENTION AND CARE INTERVENTIONS TO IMPROVE IMPLEMENTATION OUTCOMES AMONG HIGH-RISK AYA (15-24 YEARS) IN UGANDA. THE STUDY COVERS THE CONTINUUM OF CARE, WILL USE NOVEL SCREENING METHODS FOR HIV RISK, WILL INVOLVE TEAMS THAT ARE HIGHLY EXPERIENCED IN YOUTH-FOCUSED CLINICAL TRIALS AND IMPLEMENTATION SCIENCE (IMS), WILL IMPLEMENT MOH APPROVED COMMUNITY DIFFERENTIATED SERVICE DELIVERY MODELS FOR DELIVERY CAB-LA, WILL EVALUATE THE IMPLEMENTATION OF THE SEARCH-YOUTH (SY), A MULTI-COMPONENT INTERVENTION COMPRISING OF LIFE-STAGE BASED ASSESSMENT AND SUPPORT TO INCREASE VIRAL SUPPRESSION IN HIGH-RISK AYA WITH HIV, AND WILL USE HYBRID EFFECTIVENESS IMPLEMENTATION DESIGNS TO ASSESS THESE EVIDENCE-BASED INTERVENTIONS. OUR AIMS INCLUDE: AIM 1: USING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR), WE WILL IDENTIFY DETERMINANTS OF POTENTIAL IMPLEMENTATION SUCCESS OF TWO INNOVATIONS: CAB-LA AND SY IMPLEMENTATION AT THE COMMUNITY, CLINIC, PROVIDER, AND PATIENT LEVELS IN 5 GEOGRAPHICALLY DISTINCT SITES IN UGANDA. AIM 2A: USING A HYBRID EFFECTIVENESS IMPLEMENTATION TYPE II DESIGN, WE WILL ASSESS THE UPTAKE AND PERSISTENCE OF CAB-LA. WE WILL CONDUCT A RANDOMIZED PROSPECTIVE STUDY TO ASSESS EFFECTIVENESS FOR THE PROVISION OF CAB- LA AMONG HIGH RISK AYA. EFFECTIVENESS OUTCOME WILL BE PROPORTION OF STUDY SUBJECTS WHO HAVE INITIATED CAB-LA AND PERSISTED AT 18 MONTHS OF FOLLOW-UP COMPARING FACILITY AND COMMUNITY DELIVERY OPTIONS. IMPLEMENTATION OUTCOMES WILL BE FEASIBILITY, ACCEPTABILITY, ADOPTION AND MAINTENANCE USING RE-AIM. AIM 2B: USING A HYBRID EFFECTIVENESS IMPLEMENTATION TYPE III DESIGN WE WILL ASSESS IMPLEMENTATION (FEASIBILITY, ADOPTION, FIDELITY, AND SUSTAINMENT) AND EFFECTIVENESS OF THE SY INTERVENTION IN INCREASING LONG-TERM VIROLOGIC SUPPRESSION (<200 C/ML) AT 18 MONTHS OF FOLLOW-UP IN 5 CRPS USING RE-AIM. AIM 3: WE WILL USE PLATFORMS IN AIMS 1 AND 2 TO STRENGTHEN CAPACITY OF IMS AND TO TRANSLATE FINDINGS INTO POLICY AND GUIDELINES. OUR STUDY INVOLVES SOLID COMMUNITY AND INSTITUTIONAL PARTNERSHIPS AND BUILDS ON A STRONG MULTI-DISCIPLINARY TEAM HIGHLY EXPERIENCED IN INNOVATIVE METHODS AND IMPLEMENTATION SCIENCE IN SUB-SAHARAN AFRICA. THE PROJECT, BUILDING ON PATC3H AND AHISA, IS RESPONSIVE TO WHO’S, UGANDA’S MOH PRIORITIES REGARDING THE GAP IN HIV SERVICES FOR HIGHLY VULNERABLE AYA. IT WILL TEST A NOVEL, SCALABLE AND INTEGRATED APPROACH TO INITIATE AND SUSTAIN SUPPORT FOR HIGH-RISK AYA IN LMIC.

HOSPITAL-BASED BIRTH DEFECTS SURVEILLANCE IN KAMPALA, UGANDA

HOSPITAL BASED BIRTH DEFECTS SURVEILLANCE IN KAMPALA - COMPREHENSIVE RELIABLE DATA ON THE BASELINE PREVALENCE AND RISK OF BIRTH DEFECTS IN RESOURCE-LIMITED COUNTRIES IS RARE OR NON-EXISTENT. CONCERNS HAVE BEEN RAISED ABOUT THE POSSIBILITY OF HIV ANTIRETROVIRAL THERAPY (ART) AT CONCEPTION OR EARLY PREGNANCY HAVING AN INCREASED RISK OF ADVERSE BIRTH OUTCOMES, INCLUDING BIRTH DEFECTS. HOWEVER, INTRODUCTION OF NEW DRUGS TO MANAGE HIV AND OTHER DISEASES DURING PREGNANCY CONTINUES. WITHOUT A SURVEILLANCE SYSTEM, IT IS DIFFICULT TO HAVE AN EFFECTIVE MEANS TO EVALUATE THE ASSOCIATION OF THESE NEW MEDICATIONS AND ADVERSE BIRTH OUTCOMES. THE PURPOSE OF THIS BIRTH DEFECT SURVEILLANCE SYSTEM IS TO CONTINUE TO PROVIDE BACKGROUND PREVALENCE RATES OF MAJOR EXTERNAL BIRTH DEFECT AND PROVIDE A MECHANISM TO DETERMINE IF THE MATERNAL USE OF DOLUTEGRAVIR, COTRIMOXAZOLE, AND OTHER MEDICATIONS IN EARLY PREGNANCY ARE ASSOCIATED WITH A HIGHER RISK OF BIRTH DEFECTS IN NEWBORNS AND OTHER ADVERSE PREGNANCY OUTCOMES; ESPECIALLY AS THEY TRANSITION TO DOLUTEGRAVIR AS THE PREFERRED ART REGIMEN INCREASES, TO PREVENT MOTHER TO CHILD TRANSMISSION OF HIV. THIS SURVEILLANCE PROJECT ALSO PROVIDES A UNIQUE OPPORTUNITY TO IMPROVE THE SURVIVAL OF NEWBORNS WITH BIRTH DEFECTS THROUGH STRENGTHENING REFERRAL LINKAGES AND MAKING PARTNERSHIPS WITH HEALTH FACILITIES/ORGANIZATIONS THAT PROVIDE CARE AND SUPPORT FOR AFFECTED CHILDREN AND THEIR FAMILIES. OVER THE FIVE-YEAR PERIOD OF THIS PROJECT, THE SURVEILLANCE TEAM WILL WORK IN COLLABORATION WITH UGANDA MINISTRY OF HEALTH (MOH) AND KEY STAKEHOLDERS TO EXPAND THE SURVEILLANCE TO OTHER REGIONS IN THE COUNTRY AND INCORPORATE BIRTH DEFECT SURVEILLANCE INTO THE NATIONAL SYSTEM TO ENSURE SUSTAINABILITY AFTER THE END OF THE PROJECT. THE LONG-TERM OUTCOMES OF THIS PROJECT INCLUDE A SUSTAINABLE BIRTH DEFECT SURVEILLANCE SYSTEM INTEGRATED WITHIN UGANDA?S PUBLIC HEALTH SYSTEM; EVIDENCE OF CURRENT BIRTH DEFECT PREVALENCE AND COMMON RISK FACTORS, WHICH WILL GUIDE POLICY ON BIRTH DEFECT PREVENTION AND IMPROVE CARE FOR NEWBORNS WITH BIRTH DEFECTS. FURTHERMORE, FINDINGS FROM THIS PROJECT WILL INFORM MOH, WHO, AND PEPFAR ON USE OF SPECIFIC HIV, TB, AND OTHER MEDICATIONS DURING PREGNANCY.

BONE MINERAL DENSITY IN A COHORT OF YOUNG WOMEN USING DEPO-PROVERA AND TENOFOVIR

STRENGTHENING CAPACITY OF RESEARCHERS IN UGANDA TO CONDUCT HIV TREATMENT AND PREVENTION CLINICAL TRIALS IN PERINATAL, PAEDIATRIC, ADOLESCENT, AND AT RISK POPULATIONS INCLUDING WOMEN AND THEIR PARTNERS - PROJECT SUMMARY: THERE HAS BEEN STEADY PROGRESS OVER THE PAST 3 DECADES IN BOTH HIV TREATMENT AND PREVENTION BASED ON CLINICAL TRIALS LEADING TO MAJOR BREAKTHROUGHS IN PEDIATRIC AND MATERNAL HIV TREATMENT; AND HIV PREVENTION AMONG AT-RISK WOMEN AND ADOLESCENT FEMALES. THESE INCLUDE NEW INTERVENTIONS WITH LONG ACTING ARVS FOR BOTH TREATMENT AND PREVENTION. HOWEVER, THERE ARE UNIQUE ASPECTS TO THE CONDUCT OF HIV CLINICAL TRIALS IN PERINATAL, PEDIATRIC, ADOLESCENT AND AT RISK POPULATIONS INCLUDING REGULATORY/ETHICAL CONSIDERATIONS; COUNSELING APPROACHES; ASSESSING SAFETY, DOSE FINDING AND PHARMACOKINETICS OF NEW HIV THERAPEUTICS IN THESE POPULATIONS; WHICH REQUIRE SPECIFIC TRAINING AND PRACTICUM EXPERIENCES. THE MU-JHU RESEARCH COLLABORATION/MU-JHU CARE HAS OVER 30 YEARS’ EXPERIENCE CONDUCTING HIV PERINATAL AND PEDIATRIC TREATMENT TRIALS; AND MORE RECENTLY, HIV PREVENTION TRIALS AMONG AT-RISK ADOLESCENT AND YOUNG WOMEN. THUS MU-JHU IS WELL POSITIONED TO BE A CENTRE OF EXCELLENCE TO TRAIN OTHER UGANDAN RESEARCHERS/RESEARCH TEAMS TO CARRY OUT HIV CLINICAL TRIALS IN THESE POPULATIONS; AND TO FURTHER STRENGTHEN ITS OWN RESEARCH CAPACITY, WITH DOCTORAL LEVEL BEHAVIORAL AND BIOSTATISTICS EXPERTISE. TOWARD THE GOALS OF TRAINING OTHER UGANDAN RESEARCHES/RESEARCH TEAMS IN CONDUCTING PERINATAL, PEDIATRIC AND ADOLESCENT HIV TREATMENT AND PREVENTION TRIALS; AND OF INCREASING MU-JHU’S BIOSTATISTICS AND BEHAVIORAL RESEARCH CAPACITY, MU-JHU PROPOSES WITH THIS D43 APPLICATION TRAINING PROGRAM TO SERVE AS A TRAINING CENTER TO OFFER SHORT TERM, AND MEDIUM TERM DIDACTIC AND PRACTICUM TRAININGS; AND SUPPORT LONG TERM TRAINING ADDRESSING THE UNIQUE ASPECTS OF CONDUCTING HIV PERINATAL, PEDIATRIC, ADOLESCENT AND ADULT TREATMENT/PREVENTION CLINICAL TRIALS. THE SPECIFIC AIMS OF THIS D43 APPLICATION ARE: 1) OFFER SHORT TERM (<3 MONTHS) TRAINING TO MU-JHU AND OTHER UGANDAN RESEARCH TEAMS ON THE UNIQUE ASPECTS OF CONDUCTING HIV CLINICAL TRIALS AMONG PREGNANT WOMEN, PEDIATRIC/ ADOLESCENTS, AT RISK WOMEN AND PARTNERS INCLUDING ETHIC ISSUES, PHARMACOKINETICS/ SAFETY AND TRIAL DESIGN. 2) PROVIDE CORE DIDACTIC AND PRACTICUM MEDIUM TERM 3-6MONTH) TRAINING FOR MU-JHU AND OTHER UGANDAN RESEARCHERS ON CONDUCTING HIV RELATED CLINICAL TRIALS-- EMPHASIZING THE UNIQUE ASPECTS OF IMPLEMENTING TRIALS IN THESE POPULATIONS. 3) SUPPORT LONG TERM TRAINING FOR DOCTORAL DEGREES IN BIOSTATISTICS, PHARMACOLOGY AND BEHAVIORAL TOPICS RELEVANT TO PERINATAL, PEDIATRIC, AND ADOLESCENT HIV PREVENTION AND TREATMENT TRIALS. 4) PROVIDE POSTDOCTORAL FELLOWSHIP RESEARCH SUPPORT TO EARLY CAREER UGANDAN INVESTIGATORS FOR RESEARCH SUPPORTING HIV TREATMENT AND PREVENTION STUDIES AMONG PREGNANT WOMEN, CHILDREN, ADOLESCENTS AND AT-RISK WOMEN AND THEIR PARTNERS.

FEASIBILITY AND COST OF WHO PMTCT OPTION A VS. B IN RURAL AND URBAN UGANDA

MU-JHU RESEARCH COLLABORATION OFFICE OF RESEARCH DEVELOPMENT TRAINING PROGRAM

STRENGTHENING RESEARCH COMPLIANCE AND INTEGRITY (RCI) OFFICE CAPACITY FOR RIGOROUS OVERSIGHT OF HIV CLINICAL TRIALS AT THE MAKERERE UNIVERSITY-JOHNS HOPKINS UNIVERSITY RESEARCH COLLABORATION. - PROJECT SUMMARY UGANDA IS ONE OF THE LARGEST RECIPIENTS OF NIH FUNDING IN AFRICA, SOME OF WHICH PROVIDES OPPORTUNITIES FOR CAPACITY BUILDING. HOWEVER, THE BULK OF THESE OPPORTUNITIES ARE SKEWED TOWARDS SCIENTISTS TO THE DISADVANTAGE OF ADMINISTRATORS IN COMPLIANCE AND REGULATORY WHOSE ROLE IN THE CONDUCT OF CLINICAL TRIALS CANNOT BE OVERSTATED. IN RECENT YEARS, THE COMPLIANCE LANDSCAPE HAS MOVED AT AN UNPRECEDENTED PACE, CHALLENGING OUR RESEARCH ENTERPRISE, ITS STRUCTURE, AND OUR ABILITY TO ADJUST TO NEW REQUIREMENTS AND REGULATIONS. IN ORDER TO INCREASE INSTITUTIONAL CAPACITY TO REVIEW AND MONITOR RIGOROUSLY THE CONDUCT OF CLINICAL TRIALS, IT IS IMPERATIVE THAT THE RESEARCH COMPLIANCE AND INTEGRITY (RCI) TEAMS ARE EQUIPPED WITH THE RIGHT KNOWLEDGE AND SKILLS FOR EFFECTIVE AND EFFICIENT COMPLIANCE REVIEW OF CLINICAL TRIALS, AS WELL AS ESTABLISHED POLICIES AND PROCEDURES. IT IS AGAINST THIS BACKGROUND THAT THIS PROPOSAL HAS BEEN DEVELOPED. THE OVERALL GOAL OF THE PROPOSED PROJECT IS TO FURTHER STRENGTHEN RCI TEAM MEMBERS’ CAPACITY AT THE MAKERERE UNIVERSITY- JOHNS HOPKINS UNIVERSITY (MU-JHU) RESEARCH COLLABORATION AND OTHER INSTITUTIONS IN UGANDA TO MANAGE RESEARCH COMPLIANCE AND INTEGRITY-RELATED ACTIVITIES. TO THIS END, WE PROPOSE TO OFFER THE RCI’S LEAD STAFF ADVANCED TRAINING IN RESEARCH COMPLIANCE AND INTEGRITY MANAGEMENT AND EXPOSURE TO US UNIVERSITY RESEARCH COMPLIANCE PRACTICES. THE RCI LEAD WILL RECEIVE TRAINING FROM (1) OUR PARTNER INSTITUTION, THE JOHNS HOPKINS UNIVERSITY (JHU) COMPLIANCE OFFICE, (2) ATTENDING RESEARCH INTEGRITY OFFICER (RIO) BOOT CAMPS AT THE HHS OFFICE OF RESEARCH INTEGRITY IN WASHINGTON DC TO OBTAIN TRAINING ON HANDLING ALLEGATIONS OF RESEARCH MISCONDUCT, AND (3) ENROLLING IN AN ACCREDITED COMPLIANCE MANAGEMENT DEGREE PROGRAM ORGANIZED BY THE AFRICA INSTITUTE FOR REGULATORY AFFAIRS (AIFRA). THE LESSONS LEARNED BY THE RCI LEAD WILL BE CASCADED TO THE CO-LEAD AND OTHERS IN UGANDA. IN ADDITION, THE RCI CO-LEAD AND REGULATORY AFFAIRS COORDINATORS AT MU-JHU AND SISTER INSTITUTION, BAYLOR FOUNDATION UGANDA, WILL ATTEND THE POST-DIPLOMA DEGREE PROGRAM ON REGULATORY COMPLIANCE AT THE AIFRA. WE WILL ALSO RUN SEMINARS AND CREATE A FORUM THROUGH WHICH CONSULTATION ON RESEARCH COMPLIANCE AND INTEGRITY POLICIES, INNOVATIONS, CHALLENGES, AND OPPORTUNITIES IN RESEARCH COMPLIANCE ARE SHARED. THE CAPACITY OF OTHER RESEARCH COMPLIANCE STAFF IN UGANDA WILL BE STRENGTHENED BY PROVIDING LOW-COST TRAINING AND MENTORSHIP THROUGH A HYBRID COMPLIANCE AND INTEGRITY SUPPORT HUB AT MU-JHU, TO BE ESTABLISHED AS PART OF THE PROJECT. THE ESTABLISHMENT OF THIS HUB WILL ALLOW US TO PROVIDE INEXPENSIVE SUPPORT TO OTHER UGANDAN RESEARCH STAFF INVOLVED IN REGULATORY AND COMPLIANCE THEREBY BUILDING THEIR CAPACITY FOR MANAGING THEIR CLINICAL TRIALS. THIS INTERVENTION WILL ALSO CREATE A POOL OF EXPERTS THAT FUNDERS CAN WORK WITH WITHIN THE REGION TO TRAIN OTHER FUTURE STAFF. BY THE END OF THE THREE-YEAR PROJECT PERIOD, WE WILL HAVE CREATED AN INSTITUTIONAL COMPLIANCE AND INTEGRITY LEADER, TRAINED AND MENTORED COMPLIANCE TEAM MEMBERS, REGULATORY ADMINISTRATORS, RESEARCH SCIENTISTS, AND IMPROVED CLINICAL TRIAL COMPLIANCE PRACTICES THROUGH THE IMPLEMENTATION OF RIGOROUS SYSTEMS AT THE INSTITUTIONAL LEVEL.

A NOVEL VIDEO-BASED INTERVENTION TO ENHANCE OPTIMAL UPTAKE OF MALARIA PREVENTIVE THERAPY: A PILOT STUDY OF A HEALTH EDUCATIONAL APPROACH TO MALARIA PREVENTION DURING PREGNANCY - PROJECT SUMMARY: MALARIA IN PREGNANCY REMAINS A MAJOR PUBLIC HEALTH CONCERN THAT IS ASSOCIATED WITH MATERNAL AND FETAL ADVERSE EVENTS AND IS THE LEADING CAUSE OF PREVENTABLE MATERNAL DEATHS IN SUB-SAHARAN AFRICA. DESPITE THE PROVEN EFFICACY OF SULPHADOXINE-PYRIMETHAMINE (INTERMITTENT PROPHYLAXIS TREATMENT OF MALARIA_ IPTP_SP) AND COTRIMOXAZOLE AS PROPHYLAXIS TREATMENT OF MALARIA IN HIV NEGATIVE AND HIV POSITIVE PREGNANT WOMEN RESPECTIVELY, ADHERENCE TO THESE MEDICATIONS REMAINS UNACCEPTABLE IN UGANDA ESPECIALLY IN KAMPALA. SUB-OPTIMAL ADHERENCE TO MALARIA PREVENTIVE THERAPY IS REPORTED TO BE DUE TO LACK OF EDUCATION OR IGNORANCE ABOUT THESE INTERVENTIONS AMONG PREGNANT WOMEN, AND THE LACK OF EXPOSURE TO MALARIA PREVENTION MESSAGES TO STIMULATE BEHAVIORAL CHANGE. ADDITIONALLY, DUE TO OVERPOPULATION IN KAMPALA AND THE PERSISTENT SHORTAGE OF HEALTH WORKERS LIKE IN MANY OTHER LOW RESOURCE SETTINGS, HEALTH WORKERS OFTEN DON’T HAVE ADEQUATE TIME TO SUFFICIENTLY EDUCATE PREGNANT WOMEN ABOUT ALL ANTENATAL CARE PROCEDURES INCLUDING THE IPTP-SP DOSING SCHEDULE FOR HIV NEGATIVE PREGNANT WOMEN AND RE INITIATION TO COTRIMOXAZOLE FOR HIV POSITIVE PREGNANT WOMEN. TO ADDRESS THIS CRITICAL KNOWLEDGE GAP ON ADEQUATE MALARIA PREVENTIVE THERAPY UTILIZATION AMONG PREGNANT WOMEN, WE PROPOSE A COMBINED IMPLEMENTATION AND DISSEMINATION INTERVENTIONAL APPROACH. THIS WILL PRIMARILY INVOLVE THE DEVELOPMENT OF THE INTERVENTION NAMED “PREVENT” (PREVENTION OF MALARIA IN PREGNANCY USING VIDEO-BASED EDUCATION TO ENHANCE OPTIMAL MALARIA PREVENTIVE THERAPY KNOWLEDGE AND UPTAKE). IN THIS R03, WE WILL DEVELOP, TAILOR, AND REFINE THE VIDEO TO ADDRESS MALARIA PREVENTIVE THERAPY KNOWLEDGE DEFICITS IN A CLIENT-CENTERED MANNER. THE PREVENT INTERVENTION WILL INVOLVE A 10 MIN VIDEO TO EDUCATE PREGNANT WOMEN ABOUT CURRENT IPTP-SP AND COTRIMOXAZOLE RECOMMENDATIONS DURING ANC FOLLOWED BY A 5 MIN QUESTION AND ANSWER SESSION WITH A HEALTH WORKER. WE WILL QUALITATIVELY ASSESS THE PREVENT INTERVENTION FOR FEASIBILITY, ACCEPTABILITY, AND APPROPRIATENESS USING A PILOT STUDY IN AN URBAN PUBLIC HEALTH FACILITY. THE OBTAINED DATA WILL BE USED TO PREPARE FOR AN R21 GRANT IN WHICH WE WILL RIGOROUSLY EVALUATE THE EFFECTIVENESS OF THE INTERVENTION IN INCREASING OPTIMAL IPTP-SP AND COTRIMOXAZOLE UPTAKE. ULTIMATELY, THIS AND PROGRESSIVE STUDIES WILL RESULT IN THE DEVELOPMENT OF A COST-EFFECTIVE, EVIDENCE-BASED, AND SCALABLE INTERVENTION THAT WILL EVENTUALLY REDUCE MALARIA- RELATED MATERNAL AND NEONATAL ADVERSE OUTCOMES.

"THE INTERFACE OF HIV, NUTRITIONAL SUPPLEMENTATION AND BREASTFEEDING AMONG HIV EX

DEVELOPING SUSTAINABLE HIV CLINICAL TRIALS RESEARCH CAPACITY IN UGANDA

MU-JHU RESEARCH COLLABORATION - INCREASED COMMUNITY PARTICIPATION IN RESEARCH PLA

THIS GRANT WILL FUND A DISCLOSURE CAMP FOR CHILDREN, AS WELL AS ONE SUPPORT CAMP FOR PARENTS, HOME BASED CARE AND HEALTH MANAGEMENT TRAINING.

THIS GRANT WILL FUND NINE BI-MONTHLY ADHERENCE CLUBS TO REACH 270 PEOPLE OVER 12 MONTHS.

MUJHU WILL INSTALL AN IRRIGATION SYSTEM IN A COLLECTIVE FARM RUN BY PHA TO INCREASE SCALE OF GARDENING FOR IGA AND BOOST NUTRITIONAL LEVELS OF FAMIL