1. Organizational Strengthening

       i.        Sustaining legal status and registration as a Non-Government Organization: The organization is legally registered as a Non-Governmental organization in Uganda.

      ii.        Compliance with statutory requirements: SUI is fully compliant with regulatory requirements for tax compliance which comprises clearance of Pay As You Earn (PAYE) taxes for full-time staff and making a legal contribution of 10% to the National Social Security Fund (NSSF) for paid staff. These developments make SUI an attractive employer and strengthen its ability to operate as a legal entity in Uganda.

     iii.        Strengthening governance: The organization has also invested in policy development to ensure transparency and accountability. For instance, human resources, finance, safeguarding, and anti-fraud, among other policies, have since been developed with support from relevant subject matter experts. Furthermore, the organization has a fully functional board of directors that sits twice a year and provides guidance on the organization's strategic direction and reviews and approves the developed policies. Members of the Board have since played a significant role in providing the required technical assistance to management whenever called upon.

2. Direct Provision of HIV Services

      i.  Creating of drop-in centers: Today, SUI office premises also serve as a drop-in center (DIC) which extends various HIV services, including client intake and referral, distribution of health related materials. Additionally, the organizations run two additional centers in Kabarole and Soroti, operated by focal coordinators who oversee their day to day functioning. The establishment of additional DICs has enhanced access to HIV services by vulnerable Key populations in rural areas and subsequently increased SUI's reach.

      ii. Enrollment of peer educators. In its bid to reach out to its target beneficiaries, SUI adopted the use of community peer educators across the country, who would identify beneficiaries in need of services and provide them with the needed assistance to access those services. Today, the organization boasts forty (40) peer educators operating in twenty-three (23) districts across the country. Internal data shows that each peer educator handles at least five (5) support requests per month, implying a monthly coverage of almost five thousand (5,000) applications per month across the country.

     iii. Setting up a toll-free helpline: SUI established a toll-free helpline in September 2016 to scale up coverage  and ease the process through which beneficiaries could access the organization's services and provide linkages and referrals. Today, an average of 30 – 40 calls are registered monthly with common cases ranging from HTS, PrEP/PEP, need for consumables, legal support and other emergencies, need for STI screening and treatment, Psycho social support, IEC Materials, Hepatitis B screening and vaccination, SMC, GBV/IPV and General Information. The mechanism had become popular within the target communities. When the government announced COVID-19 lock down measures, the number of callers on the helpline increased by almost 300% per month – mainly requests for food support.

    iv. Establishment and sustainability of adherence clubs: SUI successfully operationalised more than ten (10) adherence clubs with 121 members across the country. The formation of these clubs was based on the hypothesis that HIV positive members could be encouraged to effectively adhere to their treatment through regular peer interaction and engagement. Today, 99 HIV positive club members had their viral loads suppressed within the first six months of enrolling on ART – accounting for almost 82% viral load suppression. The success of this model recently received international acclaim. "Leaving no one behind: Assessing the impact of community-based adherence clubs on retention and viral load suppression in Uganda", an abstract authored by Spectrum Uganda, won a global award at the AIDS 2020 conference. Furthermore, the clubs have enhanced regular nutritional support to members in various districts across the country.

     v. Mapping hot-spots for Key populations and vulnerable communities at risk. SUI successfully identified areas where Key populations are concentrated and at risk. Subsequently, the organization has been able to conduct various outreaches in the identified hot-spots, which – according to reports, has increased uptake of the organization's services, including access to HIV testing, counseling, and referrals for ART.  

3. Advocacy and Stakeholder Engagement

      i. Outreach to national and district level health officials. SUI has established and maintained regular communication and participation with the ministry of health officials and the Uganda Aids Commission. This relationship has been cultivated over the years with a continuing commitment to ensure that the relationship stays remains solid. Such engagements have contributed to achieving progressive results ( for instance, the National HIV Strategic Plan inclusive of Key populations issues and the National MARPs Action Plan) and have enhanced collaboration and information sharing. Analysis of internal data indicates that SUI engages with an average of 305 health workers through training and other outreach activities per year. For instance, the organization has reached 382 health workers on a single project supported by Amplify Change. These engagements have been credited to have enhanced the shift of most health workers toward a positive attitude to Key population related health issues.

      ii Furthermore, SUI has actively engaged district Chief Administrative Officers (CAOs) and District Health Officers (DHOs) to create a positive relationship with a shared understanding of the organization's work and its role in extending the much-needed services in the latter's respective jurisdictions. SUI has reached more than 18 DHOs, out of 23 districts where the organization operates. Furthermore, through its networks, the organization has attended several meetings targeting different stake holders . Through these meetings, the organization reports that they have been able to demystify several misconceptions regarding vulnerable people in Uganda.

     iii Representation of Key Populations on Key National Health Financing Platforms. Recognizing the role of Spectrum Uganda as a leading provider of HIV/AIDS services to Key population communities in Uganda, the organization's programs director was subsequently voted and elected to represent key populations on the Global Fund's Country Coordinating Mechanism (CCM).

    iv. Membership with Uganda Network of Aids Service Organizations (UNASO). For more than five years, SUI has been a proud member of other human rights network that has created more visibility for the organization and enhanced recognition of SUI at a national and international level.

      v. Participation at Regional and International Levels: Members of the management team at SUI have participated in more than ten advocacy interventions at a regional level – African Commission on Human and Peoples' Rights sessions in Banjul; and UN Human Rights Committee convening in Geneva. They have also been part of the team that has actively lobbied local diplomatic missions regarding the plight of the Key populations community in Uganda.

4.  Economic Environment

There have been drastic reductions in poverty levels in Uganda over the past 30 years. The country surpassed the first target of the Millennium Development Goal of halving the proportion of people living in extreme poverty by 2015. Ugandan economy grew at an average of 5.25% between 2016 and 2020. However, the Uganda National Household Survey 2016/17 shows that the poverty levels have increased from 19.7% to 21.7% between 2012/13 to 2016/17. Similarly, the labor force employed in 2017/18 reduced to 56.8% from 75.4% in 2012/13 (Source: UBOS Statistical Abstract 2018).

However, unemployment rates for Key populations in Uganda remain high. This is mainly because of inadequate skills, and even where skills exist, discriminatory practices and other intersecting vulnerabilities further limit their economic prospects. Expectations from our beneficiaries for solutions are high, yet potential funding sources for Income Generating Activities are not consistent. Besides, The COVID-19 pandemic has aggravated the employment situation and increased poverty levels. A study by Economic Policy Research Center highlighted an estimated 3.8 million people lost their jobs by December 2020 due to the COVID-19 pandemic. Unemployment and poverty tend to exacerbate the crime rate, which increases the incidences of violence.