Integrated Community Based Initiatives (ICOBI)

Article Index

Project Background:

The ICOBI Community PMTCT is a CDC funded five (5) year project, that covers ten districts of South Western Uganda (Bushenyi, Sheema Mitooma, Rubirizi, Buhweju, Ntungamo, Mbarara, Ibanda, Kiruhura and Isingiro) with estimated 2,776,188 (F: 1,434,577, M: 1,341,611) beneficiaries. The project area covers 5,727 villages, 641 parishes and 132 sub-counties in the ten districts of Ankole Region. This project aims at expanding uptake for interventions to prevent the transmission of HIV from mothers to their children by using community based strategies under the PEPFAR.

Edutainment. Community PMTCT has educated masses using drama shows

Program Coverage:

The program covers the districts of Bushenyi, Ntugamo, Isingiro, Ibanda, Kiruhuura and Mbarara. By the end of 2012, the program is expected to have reached a population of 2.8 million people.

Target population:

  • Primary : Approximately 120,000 pregnant women and their spouses.
  • Secondary : Members of households affected by HIV/AIDS
  • Tertiary : Community, district and national leaders

Project Goals:

The overarching goal is to contribute towards the improvement of child survival through increasing the uptake of prevention of mother to child HIV transmission services and providing care and support to infected parents and children using home based community strategies.

Project Objectives:

The overall objective of this project is to contribute towards the improvement of child survival through increased uptake of Prevention of mother to child HIV transmission (PMTCT) services and providing care and support to infected parents and their families using community based and family centered strategies.

The following are the strategic project objectives:

  1. To promote innovative community based primary prevention of HIV through mobilization and referral of pregnant women and their spouses for counseling and testing at the health facilities.
  2. To prevent un-intended pregnancies among women living with HIV by promoting use of modern contraceptives and other family planning strategies.
  3. To reduce HIV transmission from pregnant or lactating women living with HIV to their babies by referring them for appropriate ART prophylaxis for PMTCT as well as other strategies.
  4. To mobilize women living with HIV and their families for Care, Treatment and Support.
  5. To enhance advocacy, capacity building and behavior change communication for community PMTCT services.


Routinely outreach teams each composed of a counsellor and laboratory assistant based in each sub county are assisted by VHTs, local council officials, peers and village health teams or local council officials. The CT teams move systematically from door to door in respective villages/communities offering HIV/AIDS health education, HCT to consenting eligible household members found at home, referring identified HIV infected individuals and couples to health units and other support groups/organisations in their villages, parishes, sub counties and districts. Data for each individual client is collected by filling a HCT card/client profile. All field staff are supported by the project supervisors.


Program Activities:

  • Building the capacity of Resident Parish Mobilizers (RPMs) and Community PMTCT Officers (CPOs) through training workshops.
  • Carrying out community awareness using various channels; community drama, weekly radio shows, sporting events and film shows.
  • Carrying out home visits by RPMs to do counseling, referrals, client follow-ups, distribution of IEC materials and other family planning commodities.
  • Building partnerships with People Living with HIV/AIDS, Village Health Teams (VHTs), government departments, districts, hospitals, health units, and other service and media organizations.
  • Carrying out PMTCT advocacy among all leaders at national, district and community levels.
  • Production and distribution of appropriate Information Education and Communication (IEC) materials
  • HIV Counseling and Testing of couples in communities
  • Identification and referral for early infant diagnosis


  • Has held 13,485 sensitization meetings
  • Distributed 436,895 condoms in the community
  • Counseled and referred 10,881 HIV positive women for modern FP methods. 6,096 of these have been offered modern contraceptives/FP methods
  • Distributed condoms to 7,272 persons in discordant relationships/PLWHA
  • Identified and registered 105,065 pregnant women in the community
  • Referred 84,930 pregnant women from the community for ANC attendance
  • 39,281 pregnant women from the community have been counseled, tested, and received results by the project. 33,810 disclosed their results to their partners/family members.
  • 13,317 spouses of pregnant women counseled tested and received results in the community
  • 13,266 couples tested in the community


Ministry of Health, District Local Government, MPs, EGPAF, and PACE. More partners expected on board include; TASO, AIC, JCRC, MJAP, UPHOLD, CRS, Children Aids Fund, District Health Departments, Private and public hospitals and health units, among others. ICOBI also works with health promotion programs like the YEAH Campaign and Straight Talk Foundation. The aim is to maximize benefits of wrap-around initiatives to achieve the goal and objectives of this project.

Lessons Learnt/Best Practices:

  • Conducting integrated community outreaches increases more clients accessing PMTCT services more especially male partners.
  • Strengthened teamwork and relationship between health workers, political leaders and community structures like VHTs and community psychosocial support groups increase acceptability and utilisation of services.
  • Involving the district leadership, LCs, religious leaders, health service providers and community members in VHT selection, monitoring and coordination of their activities at all levels promotes ownership and sustainability of VHT strategy.
  • A continuous actively supported psycho-social group reduces stigma and discrimination in communities with continuous awareness campaign for behavioural change.
  • Engaging community structures in all activities at sub-county level motivates them, build their confidence and trust among the community members.
  • Involving and integrating Health assistants and CDOs at sub-county level improve coordination, supervision, monitoring and mentoring of community structures and thus improve their performanc.e
  • Good working relationship between health workers and community structures like VHTs and psycho-social support groups increases acceptability of PMTCT services.
  • Advocacy meetings with the district leadership, relegoius leaders and local LCs have led to increased support to the health services and more so the community structures in creating demand.