The country is operating through a Decentralized system of governance and as a result of this policy, a lot of efforts have been channeled to this level, which also harbors the community where service delivery takes place.
The Decentralization Policy provides a legal framework for managing HIV/AIDS in Local Governments. The policy mandates Local Governments to directly manage and monitor delivery of services, including those for HIV/AIDS within their areas of jurisdiction.
The local communities in Uganda shoulder the biggest burden of the epidemic, yet they still face limited capacities to enable them respond to the grave impact of HIV/AIDS.
The Government is convinced that working through Local Governments which are closer to the people, is one strategy to ensure a sustainable response to the pandemic.
The mission of the MoLG is to coordinate, support and advocate for Local Governments (LG) for sustainable, efficient and effective service delivery in the decentralized system of governance.
The Ministry's mandate and mission is drawn from the Constitution, Article 176 and Sections 95 to 110 of the Local Governments Act (CAP 243).
Provision of HIV/AIDS services at the Local Government level
HIV response in the local government sector is not new. The sector put up one of the initial small and spontaneous self-help community initiatives in the country, which later transformed into a structured response.
The AIDS Control Programme in the sector was established in 1995 and has since been the reference point for coordination & management of HIV/AIDS activities in the Sector.
It also links other Self-Coordinating Entities under the AIDS Partnership coordination arrangement. The Ministry has also successfully led the Decentralized Response Self-coordinating Entity of the AIDS Partnership.
The Local Government sector has benefited from a wide range of development initiatives which have contributed to the improvement of lives of our people. The Sector's capacity to coordinate, and implement HIV/AIDS interventions, has been strengthened in different aspects.
Over the last year, the Ministry of Local Government has continued to offer technical guidance and overall policy direction in the fight against HIV/AIDS in the Local Government Sector as the Chair of the Decentralized Response Self Coordinating Entity under the AIDS Partnership Coordination arrangement.
Specifically, whilst working with Uganda Aids Commission, UNAIDS, USAID, UNDP, AMICALL and other partners, the Ministry boasts of among others the following interventions;
i) The Ministry has developed a comprehensive Local Government Sector HIV/AIDS Prevention Strategy 2011/12 - 2015/16. This strategy outlines a broad range of strategic interventions that will be implemented through a multi-sectoral approach to ensure wide participation of the different stakeholders in the sector.
ii) The Ministry developed the HIV/AIDS Workplace Policy for use as a guide and benchmark for coordinating and monitoring of the quality of HIV/AIDS services offered to Local Government Sector employees at the Ministry Headquarters and Local Governments in general.
iii) There is established an HIV/AIDS Committee at the Ministry headquarters and there are also established District Aids Committees and District Aids Task Forces in all the 111 Districts of Uganda.
These committees have been strengthened to undertake local based HIV/AIDS planning, resource mobilization and monitoring of all AIDS related interventions in the districts. They however require continuous financial and technical support.
iv) The Ministry has created and trained a pool of resource persons to carry out capacity building of focal persons and other implementers at the district level. However, such a team requires continuous refresher trainings.
v) The Ministry recently organized in-district HIV/AIDS partners meetings in 55 selected Local Governments. These meetings were instrumental in bringing together all HIV/AIDS partners in those districts to share experiences and forge the way forward.
vi) The Ministry has partnered with USAID through the Strengthening Decentralization for Sustainability (SDS) Programme to improve delivery of quality HIV/AIDS health services in 35 districts.
USAID SDS Program has supported districts to develop the District Management Improvement Plan which has greatly enhanced coordination of activities at district and sub-county level and will improve district management of resources and programs in support of HIV/AIDS interventions.
Despite its centrality in service delivery, the local government sector remains constrained to respond to the pandemic due to the following challenges;
a) There are still a lot of myths and misconceptions about HIV/AIDS in our communities; an example is whether Circumcision fully prevents acquisition of HIV. We need massive sensitization on particularly new initiatives to reduce confusion and improve our people's knowledge and ability to seek for services.
b) Local Governments are faced with limited human and financial resources to facilitate service delivery. Whereas some projects exist, the Ministry is aware of the inequitable distribution of resources in the districts.
The tendency for some projects to deal directly with their beneficiary communities weakens Local Governments' mandate. The Limited revenue base in Local Governments makes it difficult for LGs to meaningfully prioritize HIV/AIDS in their local budgets.
c) The HIV/AIDS Coordination function in local governments continues to perform below average making it difficult for local governments to effectively lead the AIDS response.
The HIV focal office status as an assignment both at the Ministry and the districts also poses challenges. We need to devise mechanisms of improving the functionality of this important office.
d) Though leaders are expected to be role-models and massively mobilize their communities, we have noted much decline in the interest and commitment of our local leadership to the AIDS response in their localities which is in turn affecting communities seriously. We need to get back to our earlier days and support leaders' engagement with communities/electorate so that they can competently and strongly advocate for important HIV/AIDS issues.
Over time, we have learnt lessons that have pointed to what really works if we are to have a better response as a country. Among these is the critical need to strengthen district competencies, re-engage leadership at all levels, document good initiatives and also promote sharing of these initiatives across the different districts both within the country and with other countries if resources allow.
The NRM Government and indeed the Ministry of Local Government are committed to using the Local Government service delivery systems and structures created under the Decentralization Policy to ensure that services reach our people in the communities.
In this regard, the Ministry therefore calls upon all Local political and technical leaders, especially the District Chairpersons and Chief Administrative Officers, to take full mantle of the fight against the pandemic by ensuring that the AIDS Taskforces and Committees and those of the Lower Local Governments in their respective areas are fully functional.
This is one way in which we will mobilize our people to sustainably respond to the challenge of HIV/ AIDS in our communities.
Ministry of Local Government Kampala