What MARPI Clinic Do.

MARPI is a national NGO implementing programs in over 22 districts across the country. It is a multifaceted organization providing a wide range of programs and interventions including behavioral, biomedical and structural interventions. The focus is majorly on high risk, marginalized and vulnerable populations who are commonly underserved because of one reason or another. Some of the programs include:

1.  Sexual Reproductive Health and rights program:

   • Focused on provision of information, products and services, we do family planning education offer choices and referrals. Annually we reach over 10000 clients with services. We deliberately provide information on prevention of unsafe abortion practices and referral for Prevention of Mother to Child Transmission -PMTCT. The four prongs as pillars of PMTCT are closely and critically adhered to as we provide services to our clients and a number of children of sex workers found positive have been enrolled into care using the family centered approach.

2.  Cervical Cancer Screening and proctology Program:

   • This program focuses on delivering cervical cancer screening for females and proctologic examination for anal lesions and pathologies. The program serves over 2000 clients annually at the clinic

3.  STI screening and treatment program.

   • Focused on screening, treatment and health education promoting early care seeking behaviors, STI prevention and control. We reach over 20000 clients with STI services annually

4.  TB screening and treatment program.

   • Focused on screening for TB, health education promoting early symptom recognition, and referral for TB identified cases. Major focus has been the HIV positive clients and over 2100 clients are reached annually

5.  Condom Program:

   • This program promotes 100% condom use for our target populations. Under this program we distribute 3-5 million condoms annually to target populations including both male and female condoms. We have set up over 250 condom outlets in hot spots and installed over 100 condom dispensers.

6.  HIV testing Services program:

   • We ran a key populations and other vulnerable populations clinic with a sex workers’ cohort of over 5000 sex workers attending the clinic annually and tested for HIV; with an (HIV prevalence of 35%). We test over 15000 persons annually. We ran a Drop in center at the facility serving Most at risk, Key and vulnerable populations that is linked to the clinic and provides all services including Testing services. We employ a number of innovative strategies in HTS including assisted partner notification, Snowballing, Social Network testing, among others.

7.  Prevention with Positives activities:

   • We have Strengthened referral linkages and collaboration with our partners to ensure that all identified positive clients in our program are linked to care and continue to be supported through our positive health dignity and prevention programs

8.  HIV care and treatment:

   • We ran an ART clinic with about 2100 adults (about 1800 are KPs) and 35 children accessing care and ART treatment from the clinic

9.  Communication for social and individual behavioral change:

   • We deliver behavior change programs including messaging, small group targeted community dialogues and one to one (individual dialogues). Annually we reach over 12000 individuals with risk reduction and other health related messages.

10.  Learning site program:

    • As a learning site we innovate, pilot and replicate intervention for national level scale up. We have innovated and piloted successfully a MARPI key population’s friendly clinic model which is being scaled in the entire country for MARPs. And as such we ran a “Training and Capacity building program” targeting; Health workers, community resource persons, peer educators, Community Based Organizations-CBOs and other civil society organizations. In that regard we have trained over 300 peer educators for MARPI – STRATEGIC PLAN 2021 – 2025 for sex workers, MSMs and general community, 250 community condom distributors including an FC2 module as part of the training. We have built capacity of health care providers on targeted interventions for MSMs, Sex-workers, Injecting Drug Users, and other vulnerable populations for various partners including IDI, MUJHU, TASO, Baylor, KCCA, Entebbe Grade B, Naguru Teenage Centre, Mbuya Outreach, Kitebi HCIII, Mukono HCIV, Bwaise Health Clinic and Lusaka Life Care among others. We also ran a joint leadership training program for sex workers with FAHAMU under the-Sex Workers Leadership Institute (SWLI) initiated by Fahamu, 1 with a purpose of developing the leadership of the SW organizations. The SWLI pilot program targets Uganda, Kenya, Tanzania, Zimbabwe and Namibia. We have trained over 1000 health care providers from various health facilities in Gender and sexual diversity.

11.  Centre of Excellence clinic: 

    • We have established a model “Drop in Centre” -DIC at MARPI clinic-Mulago which serves key populations and young people at the National referral hospital. This is one of its type in the country and it is a model that the Ministry is using to scale up friendly services in other facilities. Has been scaled up in Regional Referral Hospitals

12. Regional referral Hospitals Key Populations Drop in Centers and Hubs Program:

    • We ran Drop in Centers for Key and vulnerable populations in over 23 facilities majorly regional referral hospitals and some facilities strategically placed in high volume areas for Key and vulnerable populations. This is a Ministry of Health program aimed at scaling up friendly key populations interventions in regional referral hospital supported by Global fund through TASO. We are currently expanding the program to reach 40 facilities by 2025.

13. PrEP:

    • We are implementing a Pre-Exposure Prophylaxis Program- PrEP and we were among the first of the 6 selected sites in the country that provided PrEP service up to now. Program started in 2018 July and to date we have enrolled over 2000 clients making MARPI a site that contributes to over 70% of the total number of clients on PrEP in the country.

14. School program:

    • Working with POPARC-Positive Parenting and Responsible Childhood- a local NGO, we have reached over 10,000 children in school with sexuality education, sensitized over 500 teachers and held dialogue meetings with over 200 parents.

15. Needle exchange Program for People Who Inject Drugs- PWID:

    • We have piloted a needle Syringe Program supported by Global fund through KANCO-Uganda Harm Reduction Network and findings are going to inform further programing for PWID.

16. HIV self-testing Program:

    • Started in September 2018 with PATH as our implementing partner, we targeted to distribute 9142 self-testing kits to high risk men. The aim to reach the deeply hidden populations with HIV testing services and over 35000 kits have been distributed in the last three (3) years and the program continues

17. Gonococcal Antimicrobial Resistance surveillance: 

    • We are one of the sites supported by Makerere University – Infectious Disease Institute (IDI) to implementing the Gonococcal Antimicrobial Resistance Surveillance Program (GASP) under WHO Antimicrobial Global Security Program.