THE IMPACT OF TASO ACTIVITIES TOWARDS THE WELFARE OF THE PERSONS

INFECTED WITH HIV/AIDS IN GULU MUNICIPALITY A CASE STUDY OF IN LAROO

DIVISION

BY

ADONG SUSAN

12/U/892/DES/PS

A RESEARCH PROPOSAL SUBMITTED TO THE FACULTY OF BUSINESS AND

DEVELOPMENT STUDIES IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
THE AWARD OF DEGREE OF DEVELOPMENT STUDIES OF GULU UNIVERSITY

JUNE 2015
 DECLARATION

I, Adong Susan hereby declare that this research proposal entitled “the impact of TASO
activities towards the welfare of the persons infected with HIV/AIDS in Gulu Municipality, a
case study of Laroo division”” is my own original work and has never been submitted to any
other university for the award of bachelor’s degree in development studies.

Sign…….…………………………………… Date…………………………………………

ADONG SUSAN

(12/U/892/DES/PS)

i
 APPROVAL

This is to certify that this research proposal entitled “the impact of TASO activities towards the
welfare of the persons infected with HIV/AIDS in Gulu Municipality, a case study of Laroo
division” has been submitted to Gulu University with my approval.

Signed: ……………………………… Date………………………………….…

Mr. OWOT GODFREY

(SUPERVISOR)

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 LIST OF ACRONYMS AND ABBREVIATIONS

AIDS Acquired Immune Deficiency Syndrome

AMREF African Medical and Research Foundation

CASA Community ART Support Agents

CBOs Community Based Organizations

CDOs Community Development Officers

HIV Human Immune Virus

ILO International Labour Organization

LRA Lord’s Resistance Army

NGOS Non-Governmental Organization

UAC Uganda AIDS Commission

PEPFAR President's Emergency Plan for AIDS Relief

PIASCY Presidential Initiative on Aids Strategy to Communication to the Youth

PLWA Persons Living With HIV/AIDs

PMTCT Prevention of Mother to Child Transmission

UNAIDS Joint United Nations Programme on HIV/AIDS

USAID United States Aid for International Development

UNICEF United Nations Child Education Fund

VCT Voluntary Counseling and Testing

WHO World Health Organization

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 TABLE OF CONTENTS

DECLARATION...............................................................................................................................................i
APPROVAL....................................................................................................................................................ii
LIST OF ACRONYMS AND ABBREVIATIONS..................................................................................................iii
TABLE OF CONTENTS...................................................................................................................................iv
CHAPTER ONE..............................................................................................................................................1
GENERAL INTRODUCTION...........................................................................................................................1
1.0 Introduction...........................................................................................................................................1

1.1 Background to the Study.......................................................................................................................1

1.2 Problem Statement.................................................................................................................................5

1.3 General Objective of the Study..............................................................................................................6

1.4. Specific Objectives of the Study...........................................................................................................6

Research Questions.....................................................................................................................................6

1.6 Scope of the Study.................................................................................................................................6

1.6.1 Geographical Scope............................................................................................................................6

1.6.2 Subject Scope.....................................................................................................................................7

1.6.3 Time Scope.........................................................................................................................................7

1.7 Significance of the Study.......................................................................................................................7

1.8: Limitations and delimitations of the Study...........................................................................................8

CHAPTER TWO.............................................................................................................................................9
LITERATURE REVIEW....................................................................................................................................9
2.0 Introduction...........................................................................................................................................9

2.1 Various activities carried out by TASO and other Organizations...........................................................9

2.3 Challenges faced by TASO and other organizations when improving the welfare of PLWAs..............12

2.4. Impact of the activities of TASO and other various organizations on the welfare of PLWAs.............14

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CHAPTER THREE........................................................................................................................................17
RESEARCH METHODOLOGY.......................................................................................................................17
3.0: Introduction........................................................................................................................................17

3.1: Research Design.................................................................................................................................17

3.2: Study population.................................................................................................................................17

3.3: Sample Size and Selection..................................................................................................................17

3.4 Sources of Data Collection..................................................................................................................18

3.4.1 Primary Data.....................................................................................................................................18

3.4.2 Secondary data..................................................................................................................................18

3.5 Tools of Data collection.......................................................................................................................19

3.5.1 Interviews.........................................................................................................................................19

3.5.2 Questionnaire....................................................................................................................................19

3.5.3 Documentary reviews.......................................................................................................................20

3.6 Data Management and Analysis...........................................................................................................20

3.7 Ethical Consideration..........................................................................................................................20

REFERENCES..............................................................................................................................................21
African clan revisited, AIDS care, 5-22.......................................................................................................21
Asingwire, N (2010) Towards the development of AIDS policy in Uganda, [MA dissertation]. Hamilton,
ON, Canada, McMaster University.............................................................................................................21
Piot, P. Walker, N., &Schwartlander, B. (2005). The global impact of HIV/AIDS, insight review articles 968-
971.............................................................................................................................................................21
Rwabukwali, C (2002) HIV transmission among adolescents in Uganda, Kampala, Makerere University,
Sociology Department...............................................................................................................................21
The AIDS Support Organization (TASO) Uganda,August 2005, with Peter Aggleton and Paul Tyrer Thomas
Coram Research Unit Institute of Education, University of London, United Kingdom...............................21
The AIDS Support Organization (TASO),(2006),Annual Report,Kampala,Uganda.......................................21
The Ritchies in Uganda, September 2012, HIV/AIDS and Uganda's children.............................................22

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 CHAPTER ONE

GENERAL INTRODUCTION

1.0 Introduction.
This research chapter provides an overview of impact of TASO activities towards the welfare of
the persons infected with HIV/AIDS in Gulu Municipality a case study of Laroo Division, a
topic which will guide the study undertakings. Therefore the key areas in the chapter include the
background to the study, statement of the problem, overall objective, specific objectives, research
questions, significance of the study, scope of the study and the underlying assumptions.

1.1 Background to the Study

AIDs is simply an abbreviation that stands for, Acquired Immune Deficiency Syndrome; which
is a collection of symptoms and infections resulting from the specific damage to the immune
system caused by the Human Immunodeficiency Virus (HIV). AIDS is a chronic; potentially life-
threatening damaging our immune system, HIV interferes with our body's ability to fight the
organisms that cause the disease. (Pepin, 2011)

AIDS is caused by the human immunodeficiency virus (HIV), which originated in non-human
primates in Sub-Saharan Africa. While various sub-groups of the virus acquired human
infectivity at different times, the global pandemic had its origins in the emergence of one specific
strain – HIV-1 subgroup M in Léopoldville in the Belgian Congo (Democratic Republic of the
Congo) in the 1920s.Since the beginning of the epidemic, almost 75 million people have been
infected with the HIV virus and about 36 million people have died of HIV. Globally, 35.3 million
(32.2–38.8 million) people were living with HIV at the end of 2012. An estimated 0.8% of adults
aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues
to vary considerably between countries and regions.

According to a study conducted by scientists, it concluded that HIV/AIDs was transmitted from
the chimpanzees to humans probably during the late 19th or early 20th century, a time of rapid
urbanization and colonization in equatorial Africa. It then started to spread in the human
population in the early 20th century, probably between 1915 and 1941. A study published in

1
2008, analyzing viral sequences recovered from a recently discovered biopsy made in Kinshasa,
in 1960, along with previously known sequences, suggested a common ancestor between 1873
and 1933 (with central estimates varying between 1902 and 1921) In 2014, a study conducted by
scientists from the University of Oxford and the University of Leuven, in Belgium, revealed that
because approximately one million people every year would flow through the prominent city of
Kinshasa, which served as the origin of the first known HIV cases in the 1920s,passengers riding
on the region's Belgian railway trains were able to spread the virus to larger areas. The study also
attributed a roaring sex trade, rapid population growth and unsterilized needles used in health
clinics as other factors which contributed to the emergence of the Africa HIV epidemic.
(Gallagher,2014).

According to ILO, (October 2005) HIV/AIDS has become one of the most complex development
challenges the world has faced. Current statistics starkly demonstrate the severity of the
pandemic by the end of 2003 an estimated 38 million adults and children were living with HIV.
Sub-Saharan Africa is the region most affected with 25 million persons living with HIV (two-
thirds of the global estimate) by the end of 2003, the total number of deaths attributed to AIDS
since the first cases were identified was about 20 million, with 3 million estimated deaths in Sub-
Saharan Africa for 2003 alone over 13,800 people become infected worldwide each day, and
8,000 of them live in Sub-Saharan Africa at the end of 2003, 15 million children were estimated
to have been orphaned as a result of HIV/AIDS, and 80 per cent of them (12.1 million) live in
Sub-Saharan Africa. 57 per cent of adults living with HIV in Sub-Saharan Africa are women.
Although many actions have been undertaken to halt the progression of the pandemic, it is still
expanding, in terms of deepening impact as well as new infections. To better address the
epidemic and implement targeted programmes and strategies, it is crucial that policy-makers
understand the severity of the national situation. HIV/AIDS impact assessments can be important
analytical tools for advocacy and improving the welfare of the persons infected with HIV/AIDs
all over the world.

United States Agency for International Development (USAID) in its studies in 2004 stated that,
HIV/AIDS is the leading cause of death worldwide for people of between 15 to 49 years of age,
leaving many orphans in the care of relatives. In 2003 alone it is estimated that 2.9 million
people were infected with HIV/AIDS through sexual relations. Over 40 million worldwide

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diseases, AIDS have orphaned a generation of children and are not relenting. The most affected
is sub-Saharan Africa.

Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults living with
HIV and accounting for 71% of the people living with HIV worldwide. (WHO Report, 2000)
The prevalence of HIV among urban women from 21 countries studied in Sub-Saharan Africa is
1.5 times higher than among urban men, and 1.8 times higher than among rural women. Low
socioeconomic status seems to further compound the problem for urban women. In 71% of
countries considered for this analysis, the poorest 40% of urban women had a higher HIV
prevalence than other women, who are relatively wealthier; among men, this income-based
inequality was found in only 48% of the studied countries.

In Uganda, the AIDS epidemic began to spread during the mid-1970s (World bank, 1995) and it
was first identified in 1982 in a fishing village on the western shores of Lake Victoria. Since then
the epidemic has had devastating effect on the demographic, economic and governance structures
of the economy (Tumushabe, 2006). It is generally argued that HIV and AIDS epidemic are
likely to have devastating consequences on the overall economic development of Uganda and
that those consequences are likely to be felt in the future due to the impact of skill losses (Piot
2005)
Presently, about 2.3 million people in Uganda are living with HIV/AIDS, an increase from 1.8
million in 2005. Rates of infection vary across the country. They are worse among people living
in towns and cities - a rate of 11% for urban women compared with 8% for their rural cousins.
HIV infection rates are worse for women than for men. In 2012 only, more than one million
women tested HIV positive. Women represent 57% of all infections. The overall infection rate
for women has risen from 7.5% to 8.3% compared with a rise for men from 5% to 6.1% (The
Uganda AIDS Indicator Survey, 2012). Recent estimates by the Joint United Nations Programme
on HIV/AIDS (UNAIDS) indicate that about 130,000 children aged 0 to 14 years are living with
HIV in Uganda. However though all the above has been occurring in the country the government
of Uganda has not been reluctant to curb down the spread of the epidemic and in this way
various intervention measures have been carried out for example in the year 1996, the Uganda
AIDS Commission (UAC) was set up with the mandate of overseeing, planning and coordinating
AIDS prevention and control activities throughout Uganda. From that period the government has

3
established various strategies related to AIDs like in primary schools there is PIASCY, male
circumcision, voluntary counseling and testing and many others.

The decline in HIV and AIDS prevalence in Uganda is attributed partly to Multi-sectoral
approach and involvement of various partners including civil society, Non-governmental
Organizations (NGOs), media, religious leaders, youth groups, traditional leaders, people living
with HIV and AIDS (PHA), high political commitment spearheaded by the president of Uganda,
openness in society in discussing matters of sexuality and reproductive health, psycho-social
learning skills especially by adolescents and strong institutional framework (UN, 2001),
international and local donors (AMREF & UAC, 2001). For example by 1997, over 1200
agencies were implementing HIV and AIDS related activities in the country (UAC, 2002). These
organizations have increased HIV and AIDS awareness and have also provided PHA with
counseling, food, shelter, clothing, school fees, basic training and income generating schemes
(Tumushabe, 2006). The government position on control of the epidemic and favorable policy
environment on HIV and AIDS has made it conducive for other stakeholders to respond to the
challenge presented by the epidemic. Partner organizations and institutions are encouraged to
identify and focus on areas where they can create most impact (Kamya, 2003).

Though many Non-governmental Organisations and other international agencies like World
Health Organisation (WHO), United States Agency for International Development (USAID),
UNICEF, World Vision, Good Samaritan, Caritas Counseling centre Gulu, Teenager care center
in Laroo and Marie Stopeshave been fundamental in fighting the HIV/AIDS epidemic geared
towards improving the welfare, TASO has been on the forefront in improving the welfare of
those infected with HIV/AIDs. However though all efforts have been carried out and the work of
all those involved in HIV issues in Uganda, it was evident in the early to mid-1990s that
discrimination and stigmatization were still very serious problems in the country. Particular
negative effects have been identified in “culturally defined out groups” (Barnett &Blaikie, 2000),
among whom HIV and AIDS-related stigma has led to many of those infected and affected
withdrawing from social contact with others altogether (Asingwire, 2010). Such people almost
inevitably had more difficulty accessing health-promotion activities, the result being poorer
mental and physical health for those affected (Rwabukwali, 2002). Other researchers (like.
Asingwire,2010; Ankrah et al.,2009) therefore underscored the need to address questions of

4
psycho-social support for people with HIV/AIDS, and the concomitant need to address issues of
stigmatization and Discrimination in all settings where it might be expected to occur.

Gulu Municipality is one the areas located in Northern Uganda devastated by a 20-year old
conflict which caused a massive displacement, involving at present about 90% of the civil
population. The dimension of the conflict has caused severe vulnerability in the population,
lacking basic services and exposed to brutal disruption of the economic and social fabric of
communities and the families. And because of this, the spread HIV/AIDS has been high
alongside stigmatization mostly the formerly abducted children and women. Furthermore, in the
recent studies carried out among universities in Uganda, it was fond out that HIV/AIDs had the
highest cases of the disease. This could be attributed to the high rates of prostitution, poverty
which has made young girls to engage themselves in sexual acts all these exacerbating the virus
(Ritches Northern Uganda, 2012)

Therefore, with the above stated background to the study and with existing problems in the
background, the researcher therefore had to examine the impacts of TASO activities towards the
welfare of the persons infected with HIV/AIDS in Gulu Municipality, a case study of Laroo
Division

1.2 Problem Statement

In a study carried out by Asingwire 2010, it was found out that community members sometimes
could not provide adequate care and social support to people with AIDS because of fears
associated with HIV transmission, the stigma and other judgmental attitudes. HIV/AIDS was
seen to have adverse effects on the welfare of those mainly infected with the epidemic especially
during and after the LRA rebel group insurgency. TASO Uganda together with other Non-
governmental Organisations were established to work with PLWAs so as to improve on their
wellbeing through counseling, social support information capacity building, medical services
like information related to condom use, provision of drugs and preventing the spread of the
syndrome from one person to another. However, though all these have been carried out the
epidemic has still claimed the lives of many people in Laroo Division thus more efforts are
needed to make PLWAs happy like other persons. (TASO Uganda Annual Report, 2006)

5
Therefore this study will be conducted in order to examine the impact of TASO activities
towards the welfare of the persons infected with HIV/AIDS in Gulu Municipality, as no one has
done research on this before especially in this particular field.

1.3 General Objective of the Study

To establish the impact of TASO activities towards the welfare of the persons infected with
HIV/AIDS in Gulu Municipality, a case study of Laroo Division

1.4. Specific Objectives of the Study

1. To analyze the various activities carried out by TASO and other organizations to improve the
welfare of the persons infected with HIV/AIDS in Gulu municipality.
2. To ascertain the impact of TASO activities on the welfare of the persons infected with
HIV/AIDS in Gulu municipality.
3. To identify some of the challenges faced by TASO and other organizations when improving
the welfare of the persons infected with HIV/AIDS in Gulu municipality.

Research Questions
In order to address the research objectives, the following questions will guide the study.

1. What are the various activities carried out by TASO and other organizations in improving the
welfare of the persons infected with HIV/AIDS in Gulu municipality?
2. What are some of the challenges faced by TASO and other organizations when improving
the welfare of the persons infected with HIV/AIDS in Gulu municipality?
3. How have the activities of TASO and other organizations impacted on the welfare of the
persons infected with HIV/AIDS in Gulu municipality?

1.6 Scope of the Study

1.6.1 Geographical Scope

The study will be carried out in Laroo Division in Gulu municipality which is situated
approximately 330 kilometers North of Uganda’s Kampala city. Laroo Division has both peri
urban and urban settlements with a good tropical climate. It covers approximately 5km square of

6
land. Both the District and the municipal headquarters are located in this division.
Administratively Laroo Division is at local council three (LC3) levels. It is divided into four
parishes namely; Queens, Pece prison, Agwee and Iriaga all of which are at LC2 level. It has 14
sub wards at LC1. Laroo Division is bordered by Pece Division in the South, Bardege Division
in the West, and Layibi Division in the North. According to Uganda population and housing
census conducted in September to November 2002 by the Uganda bureau of statistics the
population of Laroo division stood at 21,214 out of which 10,380 were male and 10,834 were
female. The researcher selected Laroo Division because this area has had the highest cases of
HIV/AIDs, its where the TASO offices are located and above all even most of the respondents
especially those infected with the syndrome are located in this area.

1.6.2 Subject Scope

The study will cover the contributions of numerous organizations towards the welfare of the
persons infected with HIV/AIDS in Gulu Municipality a case study of Laroo Division.

1.6.3 Time Scope

The time scope of this study will be three years from 2014 to 2016 and the information that will
be gathered within this time frame will be accounted for and held responsibly by the researcher.
Thus the information that will be got beyond this time frame will be considered inapplicable in
accordance to the research.

1.7 Significance of the Study

The government and other stake holders can use the information of this study to design efficient
and effective HIV/AIDS policies to reduce the associated impact of HIV/AIDS in accordance to
wellbeing of PLWAs in Laroo division.

Researchers and academics would find this study very instrumental in terms of readily available
dependable literature (secondary data source).

The researcher will also improve on her knowledge base out of the study that will involve data
collection and report writing and further lead to the award of a bachelor degree upon completion
of the exercise.

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1.8: Limitations and delimitations of the Study
The following are the limitations which might hinder the effectiveness of the research

The study might be greatly affected by poor responses from respondents since most respondents
might consider students’ questionnaires and interviews as time consuming yet yield no tangible
benefits thus this might hinder some respondents to spare time and answer the questions which
will be asked by the researcher. The problem of poor response will be handled through
convincing the respondents that the findings of the study shall be vital as far as TASO activities
is concerned in order to improve the welfare of PLWAs.

The study will also be faced with the problem of inadequate transport facilitation since the data
for study will be collected from all the zones of Laroo Division. Transport problem will then be
solved by using the available cheap and affordable means of transport like boda bodas.

The study will also be faced with inadequate finance to support the research process since it will
involve a lot of photocopying, typing, phone calls and other related expenses. This might limit
the researcher from reaching all the planned areas of coverage. Financial constraints will be
solved by spending cautiously to avoid such financial dilemma.

During the study, the researcher anticipates to encounter difficulties in data collection especially
finding the right persons in the field who would be willing to give the relevant information. The
researcher will convince the respondents on confidentiality of the information given and the
purpose of the study.

Considering the nature of the study, the researcher extracted data from already published
materials related to the HIV/AIDS. However, the required materials are few and scattered given
even few public libraries which contain such documents. This will be reduced by the help of the
internet, journals, articles and newspapers.

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 CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction
This chapter comprehends the aspects of different scholarly views pertaining the topic of the
study. It also includes the actual literature review which focuses on the specific objectives of the
study to be undertaken. This is to address each objective while ensuring that enough literature is
provided to substantiate arguments.

2.1 Various activities carried out by TASO and other Organizations

TASO was initially founded in 1989 by Noeline Kaleeba and other 15 colleagues. Its foundation
was based with the ambition that people especially those in the developing countries were
unified by common experiences faced encountering HIV/AIDS at the time of stigma, ignorance,
discrimination and improving the wellbeing of those with HIV/AIDs. Today TASO is one of
largest indigenous NGOs that have been vital in humanizing the well-being of the persons
infected with HIV/AIDs. (TASO Annual Report, 2005)

The organization operates in an area were there has been war and civil strife for the last 20 years.
It also operates in an area where people used to move from one place to the other especially
those who used to go back to homes from their places of refuge now that peace is being realized.
The organization is located in a place linking southern Sudan to Uganda which has attracted
business people, urbanization and high population rates, and this means that people being
worked on may not readily be available on the stated appointment dates because of the cross
boarder movements. The organisation operates in a place where there are very many NGOs both
national and international, carrying out various interventions and rehabilitation. In its effort to
improve on the welfare of the persons infected with HIV/AIDs, TASO has involved its self in
numerous activities as they have been discussed below; (TASO Newsletter, 2010)

The organization has participated in counseling through education and sensitization in the form
of Music Dance and Drama (MDD), Pre and post-test counseling for new clients, and for clients
on CD4 test, Adherence counseling for clients on ART, Couple counseling (both Discordant and

9
Concordant), Child Counseling, Adolescent counseling, Family counseling, bereavement
counseling. This has been carried out during sessions of individuals or groups. The organization
also carries out demand driven VCT in conjunction with other partners.

Medical treatment is also another activity carried out by the organization. Since TASO’s
inception in Gulu in 2004 it has always been providing medical services to those infected with
HIV/AIDs with septrin prophylaxis on immediate enrollment with TASO. By end of the year, a
total of 48,034 clients (34,732 female and 13,302 males) were on Septrin. The organization treats
all forms of opportunistic infections during the clinic and outreach days. TASO rolled out
Antiretroviral Therapy in 2005. This has led to the improvement of PMTCT, Condom education
and distribution, Family planning, Home care, Aromatherapy and reflexology, Tuberculosis
Management and Laboratory services. With support from the community, the organization has
established CDDPs where clients are able to meet and collect their medicine instead of travelling
all the way to the organization. TASO has also identified community based volunteers called
Community ART Support Agents (CASA). These are expert clients who monitor adherence
levels as well as home visits to the clients. They give reports to TASO on the progress of clients
on ART in the community. Home based HIV Counseling and Testing is done to household
members of the TASO index clients and relevant HIV/AIDS prevention treatment and care
information extended to the family members thereby enhancing the clients’ wellbeing at home.
(TASO Annual Report, 2005)

TASO has encouraged clients to form groups and with support from partners resulting into the
formation of Income Generating Activities (IGAs). There are currently over 20 client groups in
northern Uganda carrying out activities like maize milling, Groundnut paste milling, and
tailoring, small business entrepreneurship among others. Nutrition supplementation in
conjunction with partners is ongoing especially for clients who are most vulnerable and are on
ART. Therapeutic feeding for children less than 14 years is being conducted by the organization
to improve on the health of HIV positive children and boost their immunity. Over 30 students in
presence of their parents/guardians received start up kits after successful completion of their
vocational education in Gulu. The students, mostly OVCs, have been supported by CSF, through
Gulu district local government and TASO Gulu. These children were drawn from TASO needy
client’s households through the TASO OVC support selection criteria, and were trained in the

10
fields of catering, metal works, hair dressing, carpentry, brick laying and tailoring. Equipment
worth 30 million comprising of sewing machines, hair cutters, fabricating machines, hair
treatment chemicals, chairs, source pans, cooking stoves, carpentry tools among others were
handed to them by the TASO Uganda Board of Trustees chairperson, Reverend Willy Olango.

Advocacy and Networking is also promoted where by PLWAs have been trained and their
capacity been empowered so as to respond to the complexity paused by HIV and build their
aptitude in providing accurate up to date information on HIV/AIDS. Referral and receipt of new
clients is conducted on every clinic and outreach day to respond to the movement of clients from
one place to the other. TASO in a bid to respond to the pressing needs of its clients, conducts
networking collaboration and partnership building. In this, the organization has created coalitions
with other service providers to deliver some services that it cannot offer to clients. TASO is
therefore a member of the district HIV/AIDS task force, Gulu network of HIV/AIDS service
organizations and the District AIDS committee. As part of its advocacy role, TASO continued to
produce and distribute periodical advocacy materials. These materials carry messages on the
rights and responsibilities of the infected. They also aim at influencing attitudes of all the people
in decision making positions to contribute positively to the well-being of the infected and
affected by the epidemic. Over the year, TASO continued distribution of IEC materials. TASO
distributed 1,051 Annual Report for 2003; 2004 Newsletters (3,178); TASO Information booklets
(3,375); TASO brochures (10,518); ART brochures (832) Memory books (706), TASO
philosophy / Movement brochures (1,911); TASO values (217); TASO 2003-7 strategic plan
(108) and Mission Statements (229). They were distributed to different organizations that include
MOH, Donors, Districts, Partner NGOs, Mini-TASO, CBOs including TASO key visitors (TASO
Annual Report, 2005)

Conclusively, TASO’s mandate of addressing HIV/AIDS prevention has been done through
sensitization of the community to be aware of the virus, PMTCT Services, Condom education
and distribution, Prevention for most risk groups, Prevention with positives, community capacity
building for HIV prevention, care and support thus all these have been geared to ensure that the
wellbeing of the PLWAs is satisfactory.

11
2.3 Challenges faced by TASO and other organizations when improving the welfare of
PLWAs
According to 2012 TASO Annual Report, it indicated that despite the above activities geared
towards improving the welfare of the persons infected with HIV/AIDs, TASO encounters a
number of programmatic challenges. The major challenges faced during the year were;

Difficulty in tracing some clients who were enrolled while in camps but have now gone back to
their villages because there is peace in the region. This has greatly stressed their activities as it
has become impossible to identify the location of their clients who were on treatment and have
never bothered to come back for ART, counseling or any other service from TASO.

There is still high risk of infection especially in the urban centres where there are numerous
activities that can easily make people to be infected with the virus for example prostitution
making young girls to be engaged in sexual activities because of the need to get money as they
see commercial sex the best survival strategy.

According to the situational analysis for pediatric HIV/AIDS carried out in Ethiopia also
indicates that the majorities of the counselors are not trained in pediatric HIV/AIDS care and
hence lack the confidence and skills to handle PLWAs. Qaziet al also cite the limited number of
trained staff in HIV and integrated management of childhood illnesses as a challenge to scaling
up ART for their clients. The professional expertise in paediatrics is in short supply in many
African countries and few African or developing world.

According to Oloka, (2000), NGOs in Uganda of which TASO is among them are more
developed in urban areas as compared to rural areas. The backwardness and ignorance of the
rural people and lack of enthusiasm among social workers to the absence of availability of
minimum comforts are the two important reasons for the backwardness of the NGOs in rural
areas. This has limited local participation yet most of those infected with HIV/AIDs are in the
rural areas yet their wellbeing is not all that appropriate.

There are also challenges faced in implementation of the PMTCT program as the resettlement
exercise has been hampered by inadequate follow up and monitoring of a bulk of the mothers

12
and babies delivered. Infant feeding options are limited for the mothers, thus the continued
exposure of the infants to HIV post-partum.

Some of the challenges faced under the nutritional assistance project include difficulties to
implement the exit strategy. Most clients do not want to leave the food programme and look at
the food aid as the only source of life. In addition, clients weaned off need some startup capital to
begin businesses, which TASO cannot provide adequately.

One of the principal challenges faced by TASO is having difficulties in recruiting and retaining
some teams of staff mainly staff Medical Doctors. This is particularly so in new centres of Gulu,
Masindi, Rukungiri and Soroti. This has happened as a result of limited funds provided to them
by the donors which limited them from employing the required staff members. The low salaries
provided to them also makes the medical doctors and other trained counselors to look for other
organizations which can pay them highly.

Beneficiaries who were affected by suspension of activities (child support) in 2004 resulting
from financial deficit continued to amount pressure on TASO in 2005. The suspension of Global
fund in 2005 also attracted further pressure especially from Mini-TASOs and Community Based
Organization who were primary beneficiaries of these funds. The effects of such incidences have
the potential of compromising the credibility and image of the organization.

While there is overwhelming demand across centres particularly at centres where ART
programme is running, the situation is bad in new centres of Masindi, Gulu, Soroti and Rukungiri
where a full package of TASO services is not provided. Services not provided include: support to
community; social support services and ART services except in Gulu.

Although TASO continued to improve its infrastructure; there is still a challenge of space at all
Centres all over the country. This situation sometimes compromises quality of services. The
study carried by Rujumba (2010) also revealed that there is limited space to provide quality and
child-friendly services. Some of the study sites lacked space to provide child-friendly services,
including room for play, and more often, services for adults and children were combined. This

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has caused a lot of congestion at all the centres as more clients flood to get medical services from
TASO.

According to the descriptive study conducted by Rujumba in 2010 on the challenges faced by
health workers in Uganda, many caretakers have a negative attitude towards educating HIV-
positive persons compared to HIV-negative persons. Although ARVs for PLWAs are now
becoming more available in developing countries, many people still think it is a waste of money
to educate HIV-positive who will die soon anyway.

According to the UNAIDs report of 2008, it was observed that some caretakers prefer to keep the
child's HIV status private due to fear of unforeseen consequences on the child and the family.
Indeed, in some cases, this fear by parents resulted in delayed HIV testing for children with
resultant delays in care even when care was available. Similarly, Rwemisisi and colleagues, in a
qualitative study of 10 clients of The AIDS Support Organization (TASO), note that some
parents were regularly worried that their children might be infected, but preferred to wait for the
emergence of symptoms before considering HIV tests for fear of the child's emotional reaction,
lack of perceived benefits from knowing the HIV status and stigma.

2.4. Impact of the activities of TASO and other various organizations on the welfare of
PLWAs

Despite the above challenges, there have been successes and promising signs mounted to address
the epidemic, particularly in the last decade. Prevention has helped to reduce HIV prevalence
rates in a small but growing number of countries and new HIV infections are believed to be on
the decline. In addition, the number of people with HIV receiving treatment in resource-poor
countries has dramatically increased in the past decade.

According to WHO, at the end of 2013, 12.9 million people living with HIV were receiving
antiretroviral therapy (ART) globally, of which 11.7 million were receiving ART in low- and
middle-income countries. About 740,000 of those were children. This is a 5.6 million increase in
the number of people receiving ART since 2010. Antiretroviral therapy helps people who are
infected with HIV to live longer, healthier lives. Although AIDS remains an epidemic in many
parts of the world, the death rate from the disease has fallen drastically in the United States and

14
other industrialized nations where people have access to affordable antiretroviral drugs.
Antiretrovirals, when taken in the right combination and according to schedule, can result in
immune reconstitution, restore health, and prevent the development of AIDS and AIDS-related
conditions.

Progress has also been made in preventing mother-to-child transmission of HIV and keeping
mothers alive. According to WHO, in 2013, 67% of pregnant women living with HIV in low-
and middle-income countries (970,000 women) received ART to avoid transmission of HIV to
their children. This is up from 47% in 2010.

These organizations have carried out Capacity building for Community based organizations like
the TASO experiential attachment to combat HIV/AIDS program. Since the inception of TEACH
in 2005, 76 people from over 12 countries in sub-Saharan Africa have been trained through
hands on experience. The organization has also supported and is open for capacity building for
visitors, local and international students on placement or internship. The organization has
conducted collaborative and operational research in conjunction with partners for example IFPRI
and PATA.

The United States is proud to be supporting Uganda as they take a leadership role in their fight
against HIV/AIDS. Progress achieved in Uganda through direct PEPFAR support during fiscal
year (FY) 2011 showed that 257,000 individuals received antiretroviral treatment,834,700 HIV-
positive individuals who received care and support (including TB/HIV) 282,300 orphans and
vulnerable children (OVCs) received support1,136,900 pregnant women with known HIV status
receiving services 55,400 HIV-positive pregnant women receiving antiretroviral prophylaxis for
PMTCT4,361,900 individuals received counseling and testing 16,742 estimated infant HIV
infections averted through PEPFAR. On top of that Uganda received $896.8 million to support
comprehensive HIV/AIDS prevention, treatment and care programs from FY 2009 to Financial
Year 2011 from the USAID. (USAID Report, 2012)

WHO together with its Ministers of Health on Programmes for AIDS prevention held in London
in January 1988 proclaimed 1 December as Worlds AIDS Day. Their focus was related for
worldwide efforts against AIDS. That same year, WHO established a Global Commission on

15
AIDS to provide the Director General with broad policy and scientific guidance from eminent
experts representing a wide variety of disciplines. Today in every country first December is
celebrated so as to come up with new strategies which can eliminate the HIV/AIDS epidemic in
the world.

TASO together with other organizations have also provided social support to the infected persons
of AIDs by encouraging their clients to get involved in Sustainable livelihood activities. For
example women have been engaged in kitchen gardening, backyard agriculture, bee keeping,
animal and crop husbandry. Since women have been the most vulnerable persons to the
syndrome and lack economic independence with such activities, they have been able to get
sustainable incomes which can enable them to access other basic needs. Child support activities
include basic education and provision of scholastic materials. With support from Civil Society
Fund (CSF), some of these organizations are currently supporting over 2000 children in both
primary and secondary schools. TASO only has facilitated the formation of AIDS Challenge
Youth Clubs (ACYC) in schools. Adolescent community drama groups for HIV/AIDS
prevention have also been established to sensitize young people about HIV.

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 CHAPTER THREE

RESEARCH METHODOLOGY

3.0: Introduction
This chapter entails the description of how the study will be conducted. It presents the research
design, study population, sample size, sample techniques, data collection instruments, data
analysis and interpretation tools and ethical consideration.

3.1: Research Design

The research design will be descriptive in nature. This is because it is an effective and easiest
form of research presentation. The research study will also involve qualitative and quantitative
approaches. The use of qualitative methods tries to neutralize bias that could arise from the use
of such methods and it is necessary because of the wide range of information required before an
informed conclusion is reached at. The qualitative approach will involve the use of interviews
when generating data and the quantitative approach will be based on the use of questionnaires
and documentary analysis.

3.2: Study population

The study population will be 60. The respondents to be selected will include 5 Local Council, 30
Beneficiaries, 10 Youth, 5 CDOs and 10 TASO staff. The target will be based in Laroo Division,
Gulu Municipality.

3.3: Sample Size and Selection.

The researcher will apply purposive sampling techniques where the respondents will be selected
on the basis of judgment that they are in position of providing relevant information needed
within the study. This kind of sampling will enable the researcher to deliberately select only
those individuals who are capable of providing adequate information. These will be sampled
from four wards of Laroo Division. Such respondents sampled will act as a representation of the
study population and this will be cost effective and credible for a good report.

17
Table 1- Showing the proposed Sample Size

S/No Category of the Respondents Number of the respondents(x) Percentages (%)

01 Beneficiaries of TASO 30 50

02 Staff members of TASO 10 16.6

03 Youths 10 16.6

04 CDOs 5 8.3

05 Local council 1(LC1) 5 8.3

Total 60 people 100%

Source: Primary Data, 2015

3.4 Sources of Data Collection

The researcher will use both primary and secondary data

3.4.1 Primary Data

This will be gathered exclusively from the persons who are infected with AIDs as they come to
seek for assistance from TASO, medical practitioners at TASO offices, counselors in the
hospitals like Gulu Regional Referral Hospital, local council elders all from the four wards of
Laroo division. Questionnaires will also be administered by the researcher. This investigation
will guide the researcher to come up with a clear conclusion of the research problems basing on
the facts got from the respondents.

3.4.2 Secondary data

Secondary data will include evaluation reports and other published reports of TASO and other
organizations related to HIV/AIDs from libraries, Government Journals, Newspapers, research
papers and government publications. More information will be generated from numerous text
books, internet sources and magazines relevant to the study.

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3.5 Tools of Data collection

During the course of carrying out the study, the following instruments will be used to ensure
efficiency and accuracy in obtaining data while observing how the epidemic has been reduced in
Gulu Municipality. These will include the following:

3.5.1 Interviews
An interview guide will be designed with questions related to the topic of research will be asked
and the interviewees are expected to give their responses as demanded by the questions. This will
be used to get information from people who might not use questionnaires (illiterates) and those
who might fear to put evidence on paper. This method also will enable the respondents to speak
out of their minds and feelings about the situation on the ground and above all helping the
researcher to get first-hand information from respondents.

The interview will involve both respondents and the interviewer. It will be adopted because of its
flexibility, adaptability and cost effectiveness as well as time saving. Using this tool the
researcher will use a rapport talk that will enable her to obtain all the required data from the
respondents.

3.5.2 Questionnaire

Questionnaires can be classified in terms of nature such as closed and open ended. For this study,
both closed and open ended questionnaires are to be used. Written statements and questions to
which respondents are expected to answer will be used. Both structured and semi structured
questionnaires are to be used to provide information regarding household demographics,
HIV/AIDS status if any, various activities carried out by TASO, the challenges they do face and
where it is necessary the respondents would be instructed on how to fill the questionnaires.

With this tool a set of structured and formalized questions will be administered by the researcher
to the targeted respondents and where possible answers are to be provided either in writing. This
kind of tool will be employed mostly to elite respondents like the PLWAs, staff members of
TASO and local council leaders among others.

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3.5.3 Documentary reviews
This will involve looking at already recorded reports from hospitals like Gulu Regional referral
hospital and Lacor hospital and also written reports especially those concerned with HIV/AIDs
by Non-Governmental organizations operating in the municipality.

3.6 Data Management and Analysis

After collecting data, it will be edited and coded to ensure completeness of questionnaires and
discover any misunderstanding of the question. As editing and coding will be done, frequency
tables will be drawn. Coding will be used in assigning numbers towards respondents which will
be used to derive statistical meaning of the data to present in the frequency table, showing
frequencies and percentages since the data will be both qualitative and quantitative.

The findings from the study will then be quantified and interpreted in line with the objectives of
the study and the literature review. Quantitative data will be analyzed using quantitative means
of data analysis through questionnaires while qualitative data analysis will be used in value
judgment. Data will be presented in frequencies, percentages, tables, graphs, charts and analyzed
using percentage score method.

3.7 Ethical Consideration.

The researcher will conduct the study following the professional codes of conduct to ensure
validity and accuracy. An introduction letter will be obtained from Department of Development
Studies Gulu University which will provide information about the researcher where ever the
research will be conducted and the researcher therefore will use this letter to seek for permission
from the authority in Laroo Division. The researcher also will inform the respondents about the
overall purpose of the study and will be able to encourage voluntary participation; confidentiality
of the information given will be of utmost importance such that information could not leak
anyhow to unauthorized people. Time will also be very important; as it will enable me to come
up with productive research by working on appointments, going to the respondent’s at the most
appropriate time when most of these people are not so busy with their work.

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REFERENCES

Ankrah, E. M., (2009). The impact of AIDS on family and other significant relationships, the

African clan revisited, AIDS care, 5-22.

Asingwire, N (2010) Towards the development of AIDS policy in Uganda, [MA dissertation].
Hamilton, ON, Canada, McMaster University

AMREF & UAC, (2001).Inventory of agencies with HIV/AIDS activities and HIV/AIDS

interventions in Uganda.

David L. Kitara, AnetNakitto Judith K. Aloyo, Amos D. Mwaka Pacific Journal of Medical
Sciences: Vol. 12, No. 1. December 2013 HIV/AIDS among youths in Gulu: A post-conflict
northern Uganda

Joint United Nations Programme on HIV/AIDS, Together We Will End AIDS (2012)
UNAIDS, (2008).Report on Global HIV and AIDS epidemic

Oloka-Onyango Joe, (2000), Foreign Political Aid, Democratization, and Civil Society in the
1990s/Africa. Working Paper No. 53. Ghana, Centre for Basic Research.

Piot, P. Walker, N., &Schwartlander, B. (2005). The global impact of HIV/AIDS, insight review
articles 968-971

Rwabukwali, C (2002) HIV transmission among adolescents in Uganda, Kampala, Makerere

University, Sociology Department

The AIDS Support Organization (TASO) Uganda,August 2005, with Peter Aggleton and Paul
Tyrer Thomas Coram Research Unit Institute of Education, University of London, United
Kingdom

The AIDS Support Organization (TASO),(2006),Annual Report,Kampala,Uganda

21
The Ritchies in Uganda, September 2012, HIV/AIDS and Uganda's children

Tumushabe, J. (2006). The politics of HIV/AIDS in Uganda: Social policy and development

programme paper Number 28.

UNAIDS, (2012).Report on Global HIV and AIDS epidemic

Uganda AIDS Commission (UAC).Accelerated HIV prevention, a roadmap towards universal

access to HIV prevention in Uganda.GoU/MoH/ACP report 2006. Kampala, Uganda. 2006. 18.

UNAIDS. UNGASS country progress report: Uganda'. GoU/UNAIDS report 2010. Kampala,
Uganda. GoU/UNAIDS. 2010. 19.

UNAIDS. Global AIDS pandemic: UNAIDS report. Geneva, Switzerland. 2008. 20

UN, (2001).Country presentation for Uganda, (2001). Third United Nations conference on the

Least Developed countries Brussels (14-20 May), 45

Uganda AIDs Commission,(UAC), (2002), HIV and AIDS in Uganda, The epidemic and
response.
Uganda AIDs Commission,(UAC),2005 Annual report, UAC Secretariat, Kampala.

World Health Organization, Joint United Nations Programme on HIV/AIDS, United Nations
Children’s Funds, Towards Universal Access: Scaling up priority HIV/AIDS Interventions in
the Health sector. Progress report (2011)

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