Uganda - AIDS Indicator Survey 2004-2005, HIV/AIDS Sero-Behavioural Survey (UHSBS)

Start	End	Cycle
2004-08	2005-01	N/A

Face-to-face [f2f]
TRAINING
The training of field staff for the UHSBS was held from 21 July to 6 August 2004. A total of 140 candidates for supervisors and interviewers were trained at the Hotel Africana in Kampala, while 46 laboratory technicians were trained at Tal Cottages in Kampala. Trainers were senior staff from the UHSBS project, assisted by staff from the Uganda Bureau of Statistics, UVRI, Ministry of Health, Makerere University, and ORC Macro.

Because of their large number, trainees for team supervisors and interviewers were divided into three groups, each with two assigned trainers. Training consisted of an overview of the survey and its objectives, techniques of interviewing, field procedures, a detailed description of all sections of the household and individual questionnaires, mock interviews between pairs of trainees, and three tests. During the second week, trainees were divided into language groups to review the questionnaires in their local languages. That week was also taken up with three days of practice in three sites close to Kampala, interspersed with discussions of the experience. A few days before the end of training, project staff identified individuals to be appointed as regional and team supervisors and these individuals were provided a half-day of special training.

The laboratory technicians were trained on blood draw procedures (for both venous and capillary blood), specimen processing in the field lab, storage and transportation of specimens, syphilis testing, lab safety procedures, labeling of samples, and consent administration. The training included a visit to the Acute Care Division of Mulago Hospital for further practice on infants and children. The laboratory technicians joined the interviewer and supervisor trainees for two days of field practice during the last few days of training. The nurse-interviewers were also trained on how to administer syphilis treatment.

An average of two training sessions were held in each of the nine designated regions for the counsellors and lab persons on the VCT teams. Training consisted of a general introduction to the survey, understanding the survey protocols, and how to use rapid HIV kits.

MOBILISATION AND FIELDWORK
Prior to the start of fieldwork, UHSBS staff arranged for numerous activities designed to promote awareness of the survey and encourage participation. Posters and brochures were printed and distributed to local officials in the areas that fell within the sample. TV and radio spots and talk shows were conducted to raise awareness of the general public to the survey. Teams from the survey office visited local officials immediately before the commencement of the survey to alert them to the survey. Advocacy and mobilisation activities continued throughout the survey period to encourage participation. The purpose of the survey, its design, implementation, utilisation of survey data, and the need for community participation were discussed, as well as issues of confidentiality and reasons for anonymity of HIV testing. Finally, when the survey was launched, UHSBS staff arranged for a press briefing and ‘flagging off’ of the teams by the Minister of Health and other senior MOH officials. The ceremony was covered by the news media, which also helped to advocate for the survey.

Eighteen teams carried out data collection for the survey. Each team consisted of one supervisor, two female interviewers, two male interviewers, two laboratory technicians and one driver. UHSBS staff coordinated and supervised fieldwork activities, assisted by occasional visits by staff from ORC Macro. Data collection took place over a five-month period, from 14 August 2004 to the end of January 2005.

Two questionnaires were used in the survey, a Household Questionnaire and an Individual Questionnaire for women and men aged 15-59. The contents of these questionnaires were based on the model AIDS Indicator Survey questionnaires developed by the MEASURE DHS programme.

In consultation with a spectrum of government agencies and local and international organisations, the MOH and MEASURE DHS adapted the model questionnaires to reflect issues in HIV/AIDS relevant to Uganda. These questionnaires were then translated from English into six local languages—Ateso- Karamajong, Luganda, Lugbara, Luo, Runyankole-Rukiga, and Runyoro-Rutoro. The questionnaires were further refined after the pretest and training of the field staff.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, relationship to the head of the household, and orphanhood among children under age 18 years. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership of mosquito nets. Information was also collected on whether the household had received specific types of care and support in the preceding 12 months for any chronically ill adults, any household members who died, and any orphans and vulnerable children. The Household Questionnaire was also used to record respondents’ consent to volunteer to give blood samples. The blood collection and testing procedures are described in the next section.

The Individual Questionnaire was used to collect information from all women and men aged 15-59 and it covered the following topics:
• Background characteristics (e.g., education, media exposure, occupation, religion)
• Reproduction
• Marriage and sexual activity
• Husband’s background (for women)
• Knowledge and attitudes towards HIV/AIDS
• Knowledge and prevalence of other sexually transmitted infections (STIs)

All aspects of the UHSBS data collection were pretested in June 2004. For this, five teams were formed, each with 1 supervisor, 2 female interviewers, 2 male interviewers and 2 laboratory technicians. Team members were trained for ten days and then proceeded to conduct the survey in the various districts in which their native language was spoken. In total, 300 individual interviews were completed in the pretest. The lessons learnt from the pretest were used to finalise the survey instruments and logistical arrangements for the survey.