Common use of Challenges Clause in Contracts

Challenges.  The inability or unwillingness of NMS to routinely share vital shipment data made it very difficult to accurately update supply plans for HIV, TB, and malaria commodities  Limited availability of and inaccurate logistics and health service data for forecasting and quantification In Year 2, the UHSC staff members seconded to the AIDS Control Program continued to strengthen the national web-based ARV ordering and reporting system (WAOS) to ensure the availability of quality ART data on logistics and patients for program planning, monitoring and sharing. Our ongoing work focused on maintaining the high WAOS facility reporting rate (currently >90%), disseminating bimonthly WAOS reports, and training of health workers and supervisors to improve the accuracy and completeness of ARV ordering and reporting. A highlight was that the UHSC team conducted the first assessment of WAOS data quality, including a desk review of six months of data and a field study carried out between June and October, 2015. The findings and recommendations led the MoH to undertake three important actions that will improve facility ARV management as well as the accuracy of WAOS reporting—  The ART facility accreditation guidelines and site assessment tool were updated to include, among other things, standards to assess a facility’s logistics management capacity. To date, 1,600 of the 2,000 active and inactive ART sites have been reassessed.  The MoH Resource Center has cleaned up the master ART site list (last updated in December 2014) by removing more than 170 inactive sites and adding 42 new sites that have been recently accredited. WAOS reporting indicators will now be more accurate.  Revisions were also made to the WAOS form and job aid to improve the accuracy of orders and patient information. During the year, our team worked closely with the AIDS Control Program M&E team to produce the official national ART patient numbers by validating and triangulating WAOS patient data with the District Health Information System version 2 (DHIS2) patient numbers. These numbers are the basis for forecasting and quantifying national HIV commodity requirements and are key performance indicators for PEPFAR and the Global Fund. Toward the end of the year, we also participated in the MoH stakeholder workshop for drafting the Consolidated Guidelines for Preventing and Treating HIV Infection in Uganda based on the 2015 WHO ART guidelines. We ensured that supply chain considerations were appropriately factored into the guidelines and that future implementation of new formulations and other changes involve supply chain planning.

Challenges.  Strike action embarked upon during the quarter by staff of Federal Medical Centre Yenagoa which commenced since August 2016 and is still ongoing, affected project implementation in the facility. SIDHAS team continued to leverage on volunteers and adhoc staff to facilitate service provision pending when the strike action is called off. • Restricted movement to riverine areas due to insecurity limited access to facilities in those locations. The inability or unwillingness SIDHAS team will continue to be guided by security advisory from the Country Office security team In Edo State, SIDHAS prioritized capacity building of NMS healthcare workers as a strategy towards improving quality HIV service provision in supported facilities. As part of this strategy, the team conducted Joint Supportive Supervisory Visits (JSSVs) to routinely share vital shipment data made it very difficult to accurately update supply plans for HIVsupported facilities (GHs Iruekpen, TBAgenebode, Igarra, Usen, Iguobazuwa, CH Auchi, and malaria commodities  Limited PHCs Ikhueniro and Okugbo) during which the ▇▇▇▇ checklist was applied as a quality assessment tool. Some of the identified gaps, such poor documentation, were immediately addressed; performance improvement plans were developed to address other areas requiring attention such as VL service uptake, client retention in care, improving PMTCT service delivery with emphasis on the 18-month outcome, and closing EID/ART prophylaxis gaps. Folder audits were also conducted and various registers reviewed to address gaps such as incomplete documentation in the care cards, routine CD4 and VL monitoring, EID testing for babies, early update of inventory tools, and daily update of worksheets. The aim was to ascertain availability of complete and inaccurate logistics valid data across the thematic areas. Series of capacity building initiatives were conducted during the quarter in line with SIDHAS focus on improving skills and health service data for forecasting knowledge of healthcare workers in supported facilities. To this end, SIDHAS supported a 4-day Roche system analyst training on CAP/CTM (COBAS Ampliprep)/COBAS TaqMan PCR machine November 9 – 12, 2016 in University of Benin Teaching Hospital (UBTH) PCR suite. Four (2M; 2F) medical laboratory scientists were trained on operating, maintaining, and quantification In Year 2troubleshooting of the Roche COBAS TaqMan PCR machine. This has increased the pool of facility laboratory personnel trained on PCR technology from 5 to 9. Similarly, four (3M; 1F) UBTH PCR laboratory staff and the UHSC SIDHAS lab staff members seconded to the AIDS Control Program continued to strengthen the national web-based ARV ordering and reporting system (WAOS) to ensure the availability of quality ART data participated in a training on logistics management of HIV/AIDS (PCR) commodities for facility PCR laboratory staff. The training was conducted by USAID Global Health Supply Chain Program Procurement and patients for program planningSupply Management (GHSP-PSM) in Lagos from November 14 – 16, monitoring and sharing2016. Our ongoing work focused on maintaining the high WAOS facility reporting rate Four facilities (currently >90%UBTH, Faith Mediplex (FMH), disseminating bimonthly WAOS reports, Central Hospitals (CHs) Auchi and training of health workers Uromi) registered for NHLS CD4 EQA program and supervisors to improve the accuracy and completeness of ARV ordering and reporting. A highlight was that the UHSC team conducted the first assessment of WAOS data quality, including a desk review of six months of data and a field study carried out between June and October, 2015. The findings and recommendations led the MoH to undertake three important actions that will improve facility ARV management as well as the accuracy of WAOS reporting—  The ART facility accreditation guidelines and site assessment tool were updated to include, among other things, standards to assess a facility’s logistics management capacity. To date, 1,600 of the 2,000 active and inactive ART sites have been reassessed.  The MoH Resource Center has cleaned up the master ART site list (last updated in December 2014) by removing more than 170 inactive sites and adding 42 new sites that have been recently accredited. WAOS reporting indicators will now be more accurate.  Revisions were also made to the WAOS form and job aid to improve the accuracy of orders and patient information. During the year, our team worked closely with the AIDS Control Program M&E team to produce the official national ART patient numbers by validating and triangulating WAOS patient data with the District Health Information System version 2 (DHIS2) patient numbers. These numbers are the basis for forecasting and quantifying national HIV commodity requirements and are key performance indicators for PEPFAR and the Global Fund. Toward the end of the year, we also participated in the MoH stakeholder workshop Survey 4 Trial 40 and 41 (October and December 2016 surveys). In addition, reports of Trial 39 were received with all facilities scoring 100%; these were duly reviewed and filed at the facilities. Similarly, EQA PT samples for drafting HIV serology and CD4 received from OASYS for the Consolidated Guidelines seven registered facilities (UBTH, Irrua Specialist Teaching Hospital (ISTH), FMH, Saint Camillus Catholic Hospital (SCCH), ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Hospital (SOH), CHs Auchi and Uromi) were analysed, and results uploaded to the OASYS website by the sites’ personnel. The team, in collaboration with FMOH, HIV/AIDS Division and Nigerian Alliance for Preventing Health System Strengthening (NAHSS), conducted a 2-day training/learning meeting on national quality improvement project for SIDHAS supported health care facilities in the state. A total of 26 (23M; 3F) participants drawn from 19 NIGQual supported health facilities participated. The learning meeting focused on service quality improvement for HIV clients and Treating documentation. The participants developed a quality improvement plan which the facility CQI team will monitor over a 6-month period. The SIDHAS team facilitated a Micro Enterprise Fundamentals (MEF) step-down training for caregivers/support group members and older OVC (51M; 243F) across Benin, Oben, Auchi and Igarra. Participants had their capacities built on fundamentals of business development and income generating activities. This is expected to provide an economic platform as a Launchpad to self-sustenance. As part of SIDHAS’ engagement with the state government, the team participated in a road walk to celebrate WAD 2016. The walk, led by the deputy speaker of House of Assembly, ▇▇▇ ▇▇▇▇▇▇, ended with a town hall meeting with stakeholders in the HIV/AIDS response in the state. The town hall meeting featured a stakeholders’ interactive session with panel members from the Network of Persons Living with HIV Infection and AIDS in Uganda based Nigeria (NEPWHAN), and the Edo State Agency for the Control of AIDS (EDOSACA). The event was graced by the Deputy Governor of the state, EDOSACA, SMOH, Civil Society for HIV/AIDS in Nigeria (CiSHAN), Local Government and Chieftaincy Affairs (LGA), and IPs represented by Achieving Health Nigeria Initiative (AHNi). The discussion centred on challenges of the 2015 WHO ART guidelinesstate HIV response and recommendations for the response going forward. We ensured that supply chain considerations were appropriately factored into A communique was drafted with resolutions reached for onward transmission to the guidelines and that future implementation of new formulations and other changes involve supply chain planningGovernor through his Deputy who was present at the event for necessary action.

Challenges.  The inability or unwillingness increased and continuous transfer of NMS facility staff already trained by SIDHAS on ART client management. In accordance with USAID directives and the facility transition plan, eight SIDHAS supported health facilities (one ART and seven PMTCT sites) were transited to routinely share vital shipment data made it very difficult the Bauchi State Government this quarter. Clients from the transited sites were transferred to accurately update supply other SIDHAS supported sites based on their preference. However, Al-Ameen clinic, a private-for-profit ART site, retained its clients on ART and continued to provide services at no cost to the client. The SIDHAS team continued to support provision of quality HIV/AIDS services using the QMAP approach. The team supported healthcare workers with the conduct of folder audits and review of pre-ART registers in selected facilities (General Hospital (GH) Toro, IDH Bayara, State Specialist Hospital, ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Balewa University Teaching Hospital (ATBUTH), Urban Maternity, and Pahlycon clinic. This activity resulted in identified and eligible positives being placed on ART. This quarter, 23 ART clients were identified to have evidence of immunologic failure (▇▇ ▇▇▇▇ – 4, ATBUTH – 7, IDH Bayara – 12). Mechanisms have been put in place to track and reassess adherence of the clients for a possible regimen switch. Furthermore, clinicians in the above stated facilities were mentored on management of treatment failure. SIDHAS continued to support DBS sample transfer to PCR laboratories. As a result of this, the average turnaround time improved from 4 weeks to 2 weeks. Efforts aimed at increasing INH uptake continued this quarter through sensitization of clinicians in SIDHAS supported sites on the need for IPT prescription. In view of this, efforts focused on capacity development activities targeting triage units, clinicians and pharmacist in IDH Bayara, ATBUTH, Urban Maternity, GHs Tafawa Balewa and Dass. Pharmacy focal persons in the above stated sites were assigned to review client documentation to ensure all eligible clients commenced INH. The SIDHAS OVC program within the state continued efforts of graduating older OVC. A list of older OVC compiled was used as an advocacy tool to relevant government (state and local) and community stakeholders. Advocacy efforts paid off as the Bauchi Emirate Council has expressed interest to continue providing support to the graduated OVC within Bauchi community. As part of efforts aimed at improving the provision of quality HIV services and the integration of services in SIDHAS supported facilities, SIDHAS conducted capacity building activities for select service providers. An interactive session on challenges that hinder effective reproductive health/HIV integration was held with 18 female healthcare workers drawn from 17 supported facilities. The session equipped the healthcare workers with knowledge required to support effective service integration in their facilities. In addition, 20 laboratory scientists and technicians (M:15, F:5) were trained on sample logging for TB analysis using GeneXpert equipment. Similarly, 16 laboratory scientists and technicians (M:10, F:6) were trained on the One World Accuracy System (OASYS) Proficiency Testing Program and sample logging for VL. These trainings are expected to contribute to improved quality of laboratory services within these facilities. ATBUTH, one of two supported blood safety sites in the state, was provided with on-the-job mentoring to improve the quality of blood transfusion services. SIDHAS supported the Federal Medical Centre (FMC) Azare, IDH Bayara and ATBUTH to conduct DTC meetings during the reporting period. The meetings were aimed at addressing cases of treatment failure, ADR reporting, medication error, and patient adherence to medication. The meeting also followed up on recommendations from the previous meeting. Pharmacy staff in the 17 supported ART sites were mentored on inventory management of ARV/OIs during the transition period of SCMS. BACATMA/SASCP was supported to conduct a 5-day training for 30 healthcare workers from 10 PHCs who had never been trained on PMTCT service provision. It is expected that the trained staff will provide quality PMTCT services during ANC and refer positive clients for care. In a drive for increased ownership and sustainability, as well as promoting collaborative efforts with the Bauchi State Government, the state team supported the state Ministry of Health to validate, finalize and cost the Health Sector Development Strategic Plan 2016-2020. This has ensured incorporation of quality HIV care provision into the strategic plan. Furthermore, continuous engagement with the state government has resulted in the recruitment and posting of pharmacists and record officers to some SIDHAS supported sites to close HR gaps. As part of efforts towards ensuring quality HIV service provision, the state team continued with its QMAP approach to supported facilities. The team conducted a workshop on household economic strengthening for caregivers and 22 (M:21, F:1) older OVC. This workshop is expected to enhance participants’ knowledge on developing care plans for HIVhouseholds. SIDHAS continued in its collaborative efforts with the state government at all levels in ensuring the provision of quality HIV services. One of such collaborations was the active participation of the team in the “Safe Home” committee meetings and HIV screening of wives and children of insurgents that have been rescued. The team provided technical assistance to the government as well as referrals of beneficiaries to available services (HTS, TBSTI screening etc.). The SIDHAS team also continued to host various coordination meetings and participation in meetings organized by other IPs providing humanitarian services in Borno State. These included meetings with UN agencies such as UNICEF, UNHCR, UNFPA, WHO, UNOCHA, Save the Children UK, Medicine San Frontiers (MSF), and malaria commodities  Limited availability Action and Against Hunger. In view of and inaccurate logistics and health service data for forecasting and quantification In Year 2SIDHAS intervention efforts in the state, the UHSC staff members seconded team participated in the Protection Sector Working Group (PSWG), Health Sector Working Group, SGBV sub-sector working group, and IPs/SEMA/NEMA coordination meetings. The team also supported the state government in providing HTS and ART services to Internally Displaced Persons (IDPs) and host communities in the state. In line with project objectives, the state team supported the University of Maiduguri Teaching Hospital (UMTH) to develop its HIV/AIDS Control Program continued to strengthen the national websustainability roadmap during a 2-based ARV ordering and reporting system (WAOS) day workshop. Technical support was provided to ensure the availability alignment of developed strategies with global strategies as well as budget development for the plans. During the quarter, the SIDHAS team provided technical assistance to health facilities, CBOs, and relevant state agencies, to maintain access to quality HIV services in the state. Supportive supervision, orientation and mentoring was provided to facilities on documentation, adherence counselling, triaging, TB/HIV, PMTCT, and EID. Efforts aimed at achieving pharmacy service integration continued through mentoring of pharmacists and pharmacist specialists in four supported facilities (GH Damagum, GH Fika, GH Gashua and GH Potiskum). ▇▇▇▇▇▇ also supported repairs of laboratory equipment, fixing of faulty ACs and an inverter in the GeneXpert laboratory at FMC Nguru, for continued provision of quality ART data on logistics and patients laboratory services. FMC Nguru was also supported to develop a costed sustainability roadmap 2016 -2018. During the period under review, a SIDHAS supported CBO was provided TA by the state team to conduct household economic strengthening training for program planning, monitoring and sharing. Our ongoing work focused on maintaining the high WAOS facility reporting rate (currently >90%), disseminating bimonthly WAOS reports, and training of health workers and supervisors older OVC to improve the accuracy and completeness of ARV ordering and reporting. A highlight was that the UHSC team conducted the first assessment of WAOS data quality, including a desk review of six months of data and a field study carried out between June and October, 2015prepare them for graduation. The findings team continued in its engagement with key stakeholders in the state through advocacy visits, joint facility supportive supervisory visits and recommendations led provision of monthly summary progress reports. These efforts have resulted in the MoH to undertake three important actions that will improve facility ARV management development of a sexual and SGBV SOP, as well as the accuracy finalization and dissemination of WAOS reporting—  The ART facility accreditation guidelines a task-shifting policy on human resources for health for the state. In line with the SIDHAS transition plan, two supported health facilities (GHs Buniyadi and site assessment tool Gashua) were updated to include, among other things, standards to assess a facility’s logistics management capacity. To date, 1,600 of the 2,000 active and inactive ART sites have been reassessed.  The MoH Resource Center has cleaned up the master ART site list (last updated in December 2014) by removing more than 170 inactive sites and adding 42 new sites that have been recently accredited. WAOS reporting indicators will now be more accurate.  Revisions were also made transitioned to the WAOS form state government. The Government, through SACA, expressed commitment to funding sample transfer, maintenance of laboratory equipment, and job aid supply of RTKs to improve the accuracy facilities. Through participation in TWG and monthly M&E meetings, the state team maintained collaboration with stakeholders and built capacity of orders SACA and patient informationother SMT members on data validation, data use, and drug and commodity logistics. During the year, our The team worked closely with the AIDS Control Program M&E team to produce the official national ART patient numbers by validating and triangulating WAOS patient data with the District Health Information System version 2 (DHIS2) patient numbers. These numbers are the basis for forecasting and quantifying national HIV commodity requirements and are key performance indicators for PEPFAR and the Global Fund. Toward the end of the year, we also participated in special events such as World Blood donor day which held during the MoH stakeholder workshop quarter. This improved relationships and collaboration with stakeholders, increased USAID and SIDHAS visibility, and provided avenues for drafting the Consolidated Guidelines for Preventing more advocacy messages to stakeholders on ownership and Treating sustainability of donor funded HIV Infection in Uganda based on the 2015 WHO ART guidelines. We ensured that supply chain considerations were appropriately factored into the guidelines and that future implementation of new formulations and other changes involve supply chain planningservices.

Challenges.  The inability or unwillingness Non availability of NMS VL reagents to routinely share vital shipment data made it very difficult PCR laboratory in Jalingo limited the number of VL tests and analysis thus, affecting quality of care provided to accurately update supply plans for the clients SIDHAS teams continued to support the Borno State Government to provide quality comprehensive HIV/AIDS services across seven supported facilities and 10 Internally Displaced Persons’ (IDP) camps. Comprehensive ART and PMTCT services were provided through the mobile ART teams. HTS were also provided to IDPs and identified positives were enrolled into care at the camps by the mobile teams; clients current on treatment on the other hand were provided with drug refills. Other packages of care provided to PLHIV in the camps included OI drugs refill, TBpharmaceutical care, and malaria commodities  Limited availability clinical pharmacovigilance. A two-day onsite skills update session was conducted for two focal laboratory technicians at ▇▇ ▇▇▇▇▇ on sample preparation (CD4 absolute and CD4 %), incubation, initializing, loading, count check beads QC testing, sample testing and cleaning, decontamination, and machine shut down procedures. The session was integrated into one of the routine planned preventive maintenance (PPM) exercises carried out for the facility. The SIDHAS team continued the North East (NE) TB emergency response initiative with TB screening of all clients in supported sites and inaccurate logistics initiation of eligible clients on IPT. A 2-day onsite multidisciplinary orientation was conducted for healthcare workers in ▇▇ ▇▇▇▇▇▇ (3F, 4M) and health service data for forecasting ▇▇ ▇▇▇▇▇ (1F, 4M) on IPT eligibility screening, initiation and quantification In Year 2refilling, counselling, documentation, and inventory management. The triaging strategy used under the UHSC staff members seconded to the AIDS Control Program continued to strengthen the national web-based ARV ordering NE TB emergency response initiative, and reporting system (WAOS) to ensure the availability of quality ART data INH stock in all supported facilities, resulted in increased IPT uptake in the affected facilities. ▇▇▇▇▇▇ also supported the state with the installation of GeneXpert machines (supplied by NACA) at State Specialist Hospital, ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Memorial Hospital, and General Hospital Biu. The team also provided technical assistance through a presentation on logistics and patients PMTCT at the WHO-organized training for program planningnewly recruited healthcare workers for hard-to-reach areas in the newly liberated LGAs in Borno. This quarter, monitoring and sharing. Our ongoing work focused on maintaining ▇▇▇▇▇▇ provided technical assistance to the high WAOS facility reporting rate Borno State Agency for the Control of AIDS (currently >90%BOSACA), disseminating bimonthly WAOS reportsSASCP and SMoH to commemorate the 2016 WAD on December 1, 2016 themed “Hands up for HIV Prevention”. As part of the WAD 2016 activities, the management of BOSACA, the State AIDS Program Coordinator (SAPC), and training SIDHAS team, paid an advocacy visit to the management of health workers Borno Radio and supervisors to improve the accuracy and completeness of ARV ordering and reporting. A highlight was that the UHSC team conducted the first assessment of WAOS data quality, including a desk review of six months of data and a field study carried out between June and October, 2015Television (BRTv). The findings team sensitized BRTv management on the HIV/AIDS situation in the state and recommendations led solicited its support to create awareness about the MoH epidemic. The BRTV General Manager, ▇▇▇▇ ▇▇▇▇, committed to undertake three important actions that will improve facility ARV management use its radio and TV stations to sensitize and educate the people of Borno State on HIV/AIDS prevention, treatment, care and support. In addition, the team participated in a group discussion with PLHIV organized by BOSACA and SASCP as well part of the activities to commemorate the WAD2016 celebration in the state. National Emergency Management Agency (NEMA) also supported the celebration by providing household materials such as children clothing and milk supplements, plastic buckets, toilet soap, detergents and slippers to 103 PLHIV. ▇▇▇▇▇▇ also actively participated in various humanitarian coordination meetings such as the accuracy Protection Sector Working Group (PSWG), health sector working group, SGBV sub-sector working group, food security working group, and IPs/SEMA/NEMA coordination meetings. Participation of WAOS reporting—  The ART facility accreditation guidelines SIDHAS in these coordination meetings enhanced project visibility and site assessment tool were updated to include, among other things, standards to assess a facility’s logistics management capacity. To date, 1,600 of the 2,000 active and inactive ART sites have been reassessed.  The MoH Resource Center has cleaned up the master ART site list (last updated in December 2014) by removing more than 170 inactive sites and adding 42 new sites that have been recently accredited. WAOS reporting indicators will now be more accurate.  Revisions were also made to the WAOS form and job aid to improve the accuracy of orders and patient information. During the year, our team worked closely strengthened collaboration with the AIDS Control Program M&E team to produce the official national ART patient numbers by validating and triangulating WAOS patient data with the District Health Information System version 2 (DHIS2) patient numbers. These numbers are the basis for forecasting and quantifying national HIV commodity requirements and are key performance indicators for PEPFAR and the Global Fund. Toward the end of the year, we also participated stakeholders in the MoH stakeholder workshop state for drafting the Consolidated Guidelines for Preventing and Treating HIV Infection in Uganda based on the 2015 WHO ART guidelines. We ensured that supply chain considerations were appropriately factored into the guidelines and that future implementation of new formulations and other changes involve supply chain planningmore effective programming.

Challenges.  Inadequate supply of commodities during the last supply circle to some sites; Cotrimoxazole for CH Auchi and CD4 Cyflow reagent for UBTH, SCCH, SOH and FMH resulting in constant redistribution between sites. SIDHAS, in collaboration with the state government, continued the delivery of quality HIV/AIDS and TB services across eight ART and eight PMTCT supported sites in the state. HTS was provided to clients based on clinical symptomology or when requested by the client, identified HIV positives individual were placed on ART while positive pregnant women were placed on prophylaxis to reduce the risk of mother to child transmission of HIV. In order to sustain and improve quality of care for clients currently on ART, clinical assessment of clients was conducted using WHO staging, CD4 count, and VL assessment across supported facilities. Access to quality TB services for PLHIV was prioritized by screening for TB symptoms during clinical visit, and identified positives started on TB treatment. During the quarter, the team intensified efforts to increase access to ART services for pediatrics through client tracking and follow up on DBS testing for EID. DBS samples were collected from HEIs from six supported sites comprising five ART and one PMTCT sites and sent for EID analysis at the Aminu Kano Teaching Hospital, Kano. During the quarter, the state team sensitized and mentored supported facilities on the revised LMIS reporting templates to enable them compile and produce quality bimonthly LMIS reports. The inability or unwillingness team facilitated commodity logistics during the quarter by redistributing ARVs and laboratory commodities from health facilities with excess commodities to sites with low stock. This was done to ensure uninterrupted service delivery whilst also preventing expiries. To this end, 136 units of NMS TDF/3TC/EFV 300/300/600mg were resupplied to routinely share vital shipment data made it very difficult GH Birnin-Kudu and 100 Rohren tubes transferred to accurately update supply plans GH Dutse to close stock gaps. SIDHAS carried out series of capacity building activities for healthcare workers this quarter. This was geared towards quality improvement in services provided to PLHIV in supported facilities. Healthcare workers from all eight SIDHAS supported ART sites were trained in three clusters on the VL platform from October 25 to December 30, 2016 in Birnin Kudu, Dutse and Ringim. A total of 34 (5F; 29M) benefited from the training which covered the current PEPFAR policy direction for HIV/AIDS, TBas well as best practices and approach to handling VL test results among PLHIV. In addition, a one-day onsite orientation on Pharmacy Best Practice (PBP) was organized for pharmacy personnel at FMC Birnin Kudu on October 26, 2016. The orientation updated skills of the staff on pharmacy documentation, client monitoring, drug counselling and dispensing, service linkages, client retention, and malaria commodities  Limited availability intervention on drug therapy problems. A total of and inaccurate logistics and health service data for forecasting and quantification In Year 2, 11 (9M; 2F) pharmacy personnel participated in the UHSC staff members seconded to orientation. ▇▇▇▇▇▇ supported the AIDS Control Program continued to strengthen the national web-based ARV ordering and reporting system (WAOS) to ensure the availability installation of quality ART data on logistics and patients for program planning, monitoring and sharing. Our ongoing work focused on maintaining the high WAOS facility reporting rate (currently >90%), disseminating bimonthly WAOS reports, a GeneXpert machine provided by NACA and training of health workers medical laboratory personnel on its operation and supervisors to improve maintenance at the accuracy GHs Jahun and completeness of ARV ordering and reporting. A highlight was that Kazaure during the UHSC team conducted the first assessment of WAOS data quality, including a desk review of six months of data and a field study carried out between June and October, 2015quarter. The findings training had in attendance 16 laboratory technicians and recommendations led scientist (▇▇ ▇▇▇▇▇ (5 M; 3F); GH Kazaure (7M; 1F)). Understanding of the MoH laboratory staff was enhanced in the use of GeneXpert equipment for early detection of TB cases and quality treatment to undertake three important actions that will improve facility ARV management clients. Following development and finalization of the state sustainability roadmap for HIV/AIDS in FY16, the Jigawa State Government signed the narrative document for both the State government and the Federal Medical Center Birnin Kudu. The document is expected to serve as a guide to the state government for future strategic direction towards coordinating and ensuring an effective HIV/AIDS state response. ▇▇▇▇▇▇ also supported the state government to convene its first post GBV care response committee meeting. The committee membership is drawn from law enforcement agencies, Ministry of Women Affairs, female lawyers’ association, medical women association and civil society organizations in the state. The committee is charged with the responsibility of facilitating shared understanding of gender issues among all stakeholders, as well as the accuracy of WAOS reporting—  coordinating an effective response to gender issues at facility and community levels. The ART facility accreditation guidelines and site assessment tool were updated to include, among other things, standards to assess a facility’s logistics management capacity. To date, 1,600 of the 2,000 active and inactive ART sites have been reassessed.  The MoH Resource Center has cleaned up the master ART site list inaugural meeting had in attendance eight (last updated in December 20144M; 4F) by removing more than 170 inactive sites and adding 42 new sites that have been recently accredited. WAOS reporting indicators will now be more accurate.  Revisions were also made to the WAOS form and job aid to improve the accuracy of orders and patient information. During the year, our team worked closely with the AIDS Control Program M&E team to produce the official national ART patient numbers by validating and triangulating WAOS patient data with the District Health Information System version 2 (DHIS2) patient numbers. These numbers are the basis for forecasting and quantifying national HIV commodity requirements and are key performance indicators for PEPFAR and the Global Fund. Toward the end of the year, we also participated in the MoH stakeholder workshop for drafting the Consolidated Guidelines for Preventing and Treating HIV Infection in Uganda based on the 2015 WHO ART guidelines. We ensured that supply chain considerations were appropriately factored into the guidelines and that future implementation of new formulations and other changes involve supply chain planningparticipants.