HIV is one of the leading causes of mortality and morbidity in Uganda. According to the World Health Organization (WHO), there are 1.4 million people living with HIV (PLHIV) in the country. Over the past decade, there has been significant progress made towards the goal of ending HIV/AIDS by 2030, but Uganda still has one of the highest infection rates globally.
The AIDS Information Centre (AIC) was established in 1990 to respond to the increasing rates of HIV infection and to meet HIV testing needs. Over the years, AIC has expanded its services to provide counselling, care, support, and treatment to PLHIV. It has also strengthened the capacity of health workers through training and advocates for HIV prevention through research and evidence.
Between 2015-2018, Commonwealth Alumnus Minsi Monja worked at the AIC as the Business Development and Communications Manager and rejoined the organisation in 2023 as the Director of Business Development.
As the Director of Business Development, Minsi’s responsibilities include diversifying revenue and funding by strengthening donor relations and delivering income generation exercises. He is also involved in policy development and stakeholder and community engagement.
Securing funding to advocate for HIV
Minsi joined AIC in 2015 following the completion of his Master’s in Development Management from The Open University. Looking back on his scholarship, he reflects on the skills and knowledge he gained during his studies which have been integral to his roles at AIC.
The organisation relies on external funding to run its programmes and as such grant and proposal writing is key to its success and financial security. During his Master’s, Minsi developed skills in writing compelling grants and proposals which he has subsequently applied to his work at AIC to secure competitive funding opportunities from international aid agencies, such as USAID, and Global Fund for HIV, TB and Malaria.
Through his contributions, AIC has increased its budget by 40%, enabling them to deliver effective programmes addressing HIV/AIDs, sexual and reproductive health (SRHR), and gender-based violence (GBV). Additional funding has also enabled AIC to extend its services and carry out patient flow assessments in a number of health facilities across eight districts.
Patient flow is the movement of patients through a healthcare facility. It involves the medical care, physical resources, and internal systems needed to get patients from the point of entry to admission and finally discharge, while maintaining quality service and patient/provider satisfaction. To optimise patient flow, providers seek to successfully match the appropriate amount of resources to each of their admissions.
Based on data gathered through patient flow assessments, AIC has disseminated reports which have been used by Ministry of Health, Uganda AIDS Commission and Ministry of Gender, Labour and Social Development to inform policies including, the National Health Policy, National Gender Policy and National HIV/AIDS Strategic Plans to address HIV/SRHR/GBV integration gaps.
“Through grant writing skills, I was able to increase AIC’s budget from donors including USAID/CDC, UNFPA, SIDA, and EGPAF. This helped in carrying out systems capacity and patient flow assessments in health centres which contributed to the development of future work.”
Widening outreach through peer mobilisers
In Uganda, new cases of HIV infections are highest amongst marginalised groups such as LGBTQ+ people, sex workers, adolescent girls and young women. Stringent national laws and policies against LGBTQ+ people have created significant challenges to AIC’s work in delivering HIV services to this marginalised group.
“In 2023, Uganda approved the Anti-Homosexuality Act because of which we are unable to provide services to marginalised groups such as the LGBT community.”
In addition to this law, cultural and religious beliefs have increased the vulnerability of LGTBQ+ people to persecution and imprisonment. As such, the LGBTQ+ community has become a hidden population in Uganda, increasing the likelihood that those at risk of and living with HIV/AIDS do not access treatment and health services.
To address this challenge, Minsi and his team developed a peer-led approach to create awareness on HIV and promote access to health services. Through training and mobilisation, his team supported LGBTQ+ people, sex workers, and members of fishing communities to act as peer leaders, encouraging others to access HIV testing and screening to improve early detection. Monja trained over 1,756 key populations including LGBTQ+, sex workers and members of fishing community.
Minsi shares one of the key successes of this approach was the ability of the peer leaders to reach over 13,000 people his team could not.
“Through the peer-led model, we trained individuals from LGBT groups, sex workers, and fishing community to mobilise their peers. This ensures that people can access the required health services without any inhibitions.”
HIV related stigma is another challenge faced by PLHIV who avoid disclosing their HIV status while accessing health services for fear of being discriminated against by health workers. Stigma and misinformation about HIV are deeply ingrained in Uganda and Minsi shares that health workers are often unable to overcome their personal bias while responding to the health needs of vulnerable groups especially LGBTQ+, sex workers and adolescent girls and young women.
“In Uganda, people think HIV is still a disease of people who are cursed. PLHIV are often disowned by their families because they think they are cursed.”
To address this, Minsi utilised his skills to create advocacy materials for AIC such as the Directive to provide healthcare services without discrimination, which was supported by the Ministry of Health. The materials included guidelines for health care workers on HIV awareness and best practice in responding to the healthcare needs of vulnerable groups and PLHIV.
Using these materials and an accompanying training programme, AIC has trained over 1,560 health workers nationally on how to provide HIV related health services without discrimination. These trainings have resulted in enhanced quality and efficiency of healthcare delivery and improved diagnosing, treating, and educating of patients by health workers. It also contributed to restoring trust in the healthcare system by the community, leading to increased utilisation of health services. As such, health workers feel empowered to engage with local populations, address misconceptions, and promote preventive healthcare measures, further encouraging people to seek timely medical attention at health facilities.
Increasing allyship to combat HIV
Cultural norms play an important role in influencing behaviours in Uganda and can increase people’s risk of contracting HIV. Restricting the use of condoms or HIV medication, for example, has led to an increase in the spread of HIV and high mortality rates among some cultural groups.
Addressing these cultural practices is a sensitive issue. To successfully manage this, Minsi utilised his networking and stakeholder management skills to reach out to leaders in cultural institutions, NGOs, and religious and community leaders to discuss HIV prevention and raise awareness of the needs of PLHIV.
Working with these leaders and PLHIV, Minsi has improved general awareness of HIV and the importance of supporting PLHIV to access health facilities in their communities. He has also built relationships between AIC and local leaders, some of whom now support AIC’s work by sharing ideas on ways to advocate for HIV awareness and prevention.
As a result of this work, cultural institutions including the Buganda Kingdom, Busoga Kingdom, Tooro Kingdom, and Bunyoro Kingdom have committed to mobilise funds towards HIV programmes. For Minsi, this is a significant outcome of his outreach and community engagement.
“The cultural institutions have committed to mobilise resources, conduct research on HIV, and promote awareness in order to bring a change in people’s behaviour towards HIV.”
Drawing further on his community engagement, Minsi believes that mobilising young people and young PLHIV will be crucial in reducing new HIV infections and holding the government to account for ending HIV/AIDS by 2030.
As the lead writer for the Uganda AIDS Commission, Minsi led the establishment of the Uganda Multisectoral Action and Accountability Framework 2019-2030. The framework was developed to optimise HIV prevention interventions to reach zero new infections amongst adolescents and young people (AYP). To raise awareness of the framework amongst AYP, Minsi worked with youth groups across the country to promote key messages and HIV prevention strategies. Through this work and the inclusion of youth groups, Minsi is pleased to share there was a 4% increase in the uptake of HIV testing services amongst AYP.
Influencing national policies
Through his work experience at AIC and the skills gained during his Master’s studies, Minsi is now a sought-after consultant for business development, HIV programmes, GBV programmes, SRHR programmes, and youth programmes in Uganda.
He has lent his technical expertise and skills in writing bids and proposals to national committees, organizations and contributed to national policy briefs. He has also provided technical support to the government of Uganda on the development of national proposals to the Global Fund to access financial support for programmes tackling HIV, TB, and malaria.
Reflecting on the impact of his work at the local and national level, Minsi is proud to be contributing to the global goal of ending HIV by 2030 and using his skills in business development to make a positive change.
“I have become a Business Development/Resource Mobilisation Specialist in Uganda. There are very few people with these skills set and I’m very grateful that my MSc in Development Management gave me this experience and technical skills to support national policies. Credit goes to the Commonwealth for the financial support.”
Minsi Monja is a 2012 Commonwealth Distance Learning Scholar from Uganda. He completed his MSc in Development Management from The Open University.
