Male Action Groups: Bringing HIV and TB Case-Finding Services Closer to Men in Uganda

By Ndungu Robert, TB Contact Tracing Officer, CEHURD

Men continue to experience lower uptake of HIV and tuberculosis (TB) services, partly due to delayed health-seeking, competing work commitments, and limited access to health facilities. To address these barriers, the Centre for Health, Human Rights and Development (CEHURD), in partnership with The AIDS Support Organization (TASO) through the Global Fund initiative, introduced the Male Action Groups (MAGs) strategy, a community-led approach designed to bring integrated HIV and TB services closer to men.

The strategy is currently being piloted in three cities: Gulu, Lira, and Arua.

CEHURD began implementation with district microplanning meetings involving City Health Teams, including the City Health Officer, City TB and Leprosy Supervisor, city laboratory personnel and biostatisticians, as well as health facilities and implementing partners. These meetings helped identify priority hotspots, map available resources, and coordinate implementation across the three cities.

Community dialogue meetings followed, bringing together local leaders, employers, and community members to discuss the barriers that prevent men from seeking health services and identify practical solutions. These engagements also helped strengthen local ownership of the intervention.

To strengthen community mobilisation, 69 Male Champions were identified, trained, and equipped with knowledge and skills to provide peer education, mobilise fellow men to seek health services, and facilitate referrals.

“Before I was trained as a Male Champion, many men in my community were reluctant to visit a health facility or even talk about HIV and TB. After the training, I began visiting ghettos, washing bays, and other places where men gather to provide accurate information, encourage men to get screened, and link those who needed further care. During our first outreach, men felt free to come and access services, making this initiative more community-owned.”
Robert Ricky Oyoo, Male Champion, Aywe HC III, Gulu City

Working alongside health workers, Male Champions led integrated outreach activities in places where men spend much of their time, including boda boda stages, markets, construction and welding sites, workplaces, and landing sites.

The outreach services were supported by Mobile TB Van Clinics provided by regional referral hospitals. Equipped with digital chest X-ray technology and HIV counselling and testing services, the mobile clinics brought screening and diagnostic services closer to communities, making it easier for men to access services without having to leave their workplaces or daily activities for extended periods.

One of the beneficiaries diagnosed with TB during an outreach in Lira shared:

“I never thought I had TB because I only had a mild cough, which I treated with local remedies for some time, but it did not go away. When the Male Action Groups and health workers came to our community, they encouraged me to get screened. The X-ray showed that I might have TB, so I was asked to produce sputum for confirmation. The test confirmed that I had TB. I am thankful that they brought the services closer to us because I would not have gone to the facility on my own.”

Early results

Since the rollout of the strategy in February 2026, the intervention has reached 4,228 individuals with integrated HIV, TB, and malaria prevention, screening, and referral services across the three cities. Of these, 3,004 (71.0%) were male and 1,224 (29.0%) were female, demonstrating strong engagement of men through the community-based approach.

TB screening through symptom assessment and digital chest X-ray identified 1,429 (33.8%) individuals as presumptive TB cases, comprising 1,132 males and 297 females. Samples were obtained and delivered for testing from 1,333 (93.3%) of the presumptive cases, while 1,326 (99.5%) of the samples were analysed.

Of the samples analysed, 125 (9.4%) tested positive for TB, including 100 males and 25 females. All 125 confirmed TB cases were successfully linked to care.

For HIV, 19 clients tested positive, including 16 males and three females, using the national HIV testing algorithm. All were linked to HIV care and treatment.

For malaria, 452 individuals presenting with fever were tested, of whom 125 (27.7%) tested positive using malaria rapid diagnostic tests (mRDTs). All 125 clients received artemisinin-based combination therapy (ACT).

These early results point to strong male engagement and effective linkage to care across the integrated HIV, TB, and malaria services.

Taking services to where men are

The experience of the Male Action Groups shows that reaching men requires more than making services available at health facilities. It requires taking services to the places where men live, work, and socialise, while using trusted community members to encourage them to seek care.

The combination of district-led planning, community dialogue, Male Champions, mobile outreach, and digital diagnostic technologies has helped address some of the practical and social barriers that limit men’s access to HIV and TB services.

The early results are encouraging. By supporting earlier case detection, increasing access to screening, strengthening referrals, and linking clients to treatment, the MAG model offers a promising approach for reaching underserved men and strengthening Uganda’s HIV and TB response.

Looking ahead

The potential for scaling up the Male Action Groups model will depend on sustained community engagement, reliable referral and treatment systems, continued access to mobile diagnostic equipment, and regular monitoring of outcomes across different settings.

As implementation continues, documenting lessons from Gulu, Lira, and Arua will be important in understanding what works, what needs to change, and how the model can be adapted to reach more men with timely HIV, TB, and other essential health services.

Aug 19, 2026Aug 20, 2026 Article, Featured

Rural Uganda’s Forensic Evidence Gap is Undermining Justice for Survivors of Sexual Violence

By Judith Nakalembe

For many survivors of sexual violence in rural Uganda, the journey to justice is often obstructed not only by the trauma of the violation itself, but also by gaps in the systems meant to support them. One of the most significant challenges is the limited availability of forensic services, particularly the collection and testing of sexual assault swabs. These services are critical to gathering scientific evidence that can strengthen investigations and prosecutions.

The absence of accessible forensic services in many rural districts can weaken cases that might otherwise result in successful prosecutions. When crucial evidence cannot be collected, preserved or analysed within the required timeframe, investigations may be left without the scientific evidence needed to corroborate a survivor’s account or connect a suspect to an offence.

A case involving a 14-year-old girl from Mayuge District illustrates the challenges faced by survivors in rural communities. The girl was defiled while on her way to school. Although she could not identify the perpetrator by sight, she was able to remember his voice. Importantly, semen was found on her clothing, potentially providing valuable forensic evidence to support the case.

The suspect was arrested, giving the survivor and her family hope that justice would be achieved. However, the investigation faced a major obstacle: the need to conduct a sexual assault swab test to obtain corroborative forensic evidence. The police were informed that the required testing could only be conducted at the Wandegeya laboratory in Kampala, despite the offence having occurred in Mayuge District.

This requirement created additional barriers within the justice process. Transporting a police officer and evidence to Kampala requires financial resources that many rural police stations do not have. For survivors and their families, many of whom live in economically vulnerable communities, meeting these costs can be impossible.

As a result, some families eventually withdraw from pursuing cases, not because they do not want justice, but because the process becomes too expensive, prolonged and emotionally exhausting. When cases are abandoned for these reasons, perpetrators of sexual violence may escape accountability, while survivors’ confidence in the justice system is further undermined.

The challenge also affects police officers responsible for investigating sexual offences. Even where investigators are committed to pursuing cases, the lack of nearby forensic facilities limits their ability to build strong cases. Delays in accessing evidence collection and testing services can compromise investigations and reduce the likelihood of successful prosecution.

Civil society organisations have played an important role in addressing some of these barriers. Organisations such as the Center for Health, Human Rights and Development (CEHURD) have supported survivors to reduce some of the costs associated with pursuing justice. However, such interventions cannot reach every survivor or cover every district across the country. Access to justice should not depend on whether a civil society organisation is available to provide financial assistance.

The responsibility to provide accessible and effective forensic services rests with the government. Sexual violence occurs in both urban and rural communities, and survivors should not face unequal chances of obtaining justice simply because of where they live.

The government must take urgent steps to decentralise sexual violence evidence collection services and ensure that survivors can access timely forensic support closer to home. Health Centre III and Health Centre IV facilities should be appropriately equipped and supported to collect, preserve and refer evidence in accordance with professional standards. Health workers, police officers, prosecutors and other justice actors should also receive regular, specialised training in survivor-centred care and evidence handling.

Improving access to forensic services at local level would reduce delays, lower costs for survivors and investigators, and increase the chances of successful prosecution. It would also help prevent the loss or deterioration of time-sensitive evidence and demonstrate a commitment to ensuring that every survivor has equal protection under the law.

Justice should not depend on a family member or police officer being able to travel hundreds of kilometres to access a service that is essential to proving a crime. A survivor in Mayuge deserves the same opportunity for justice as a survivor in Kampala or anywhere else in Uganda.

The government must act to ensure that sexual violence evidence collection services are accessible throughout Uganda. Without these reforms, many survivors will continue to face a second injustice: the failure of the very systems meant to protect them and hold perpetrators accountable.

The author is a lawyer at the Center for Health, Human Rights and Development (CEHURD).

Aug 15, 2026Aug 15, 2026 Featured, News

13th Annual CEHURD Moot Court Competition: Moot Problem and Instructions Now Available

The Centre for Health, Human Rights and Development (CEHURD) is pleased to announce that the Moot Problem and accompanying Instructions for the 13th Annual National Inter-University Constitutional Law Moot Court Competition are now available.

This year’s competition is themed:

“Reproductive and Gender Justice in Uganda: Navigating Constitutional Rights, Public Interest and Social Values.”

The competition provides an opportunity for law students from participating universities to engage with critical constitutional questions at the intersection of reproductive and gender justice, constitutional rights, public interest and social values in Uganda.

CEHURD appreciates all universities that have registered to participate in this year’s competition and looks forward to the thoughtful legal analysis, advocacy and debate that the competition will bring.

We wish all participating universities and students the very best as they prepare for the competition.

The Moot Problem and Instructions are available here –

PROBLEM FOR THE 13TH ANNUAL NATIONAL INTER-UNIVERSITY CONSTITUTIONAL LAW MOOT COURT COMPETITION Download

INSTRUCTIONS FOR THE CEHURD 13TH ANNUAL MOOT COMPETITION 2026 Download

#13thCEHURDMoot2026

Aug 10, 2026Aug 15, 2026 Article

The Clarion Call: How we can end Hepatitis B as an ecosystem focusing on prevention

By Kizito Khalid Ssekabembe

According to World Health Organization, “Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most transmitted from mother to child during birth and delivery, in early childhood, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments. The WHO estimates that 240 million people were living with chronic hepatitis B infection in 2024, with 0.9 million new infections each year. In 2024, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).

In Uganda, approximately 1.845 million Ugandans are chronically infected with the virus and liver cancer caused by HBV contribute 5.1% of all cancer deaths.

According to the 2016 Uganda Population based HIV Impact assessment survey, prevalence of Hepatitis B infection among adults stands 4,3% (5,6% among men and 3.1% among women). The survey indicates that Hepatitis B prevalence is highest in Northern region with 4.6% in mid North ,4.4% in Northeast and 3.8% in West Nile. Hepatitis B infection was lower in the rest of the country with a range of 0.8% in the Southwest region to 2.7% in East Central region.

Laws and Policies on Right to Health and Hepatitis B in Uganda and gaps that need to be addressed.

Although the constitution is not so clear on the right to health, there are laws and policies that have been put in place: Uganda guidelines for prevention, testing, care and treatment of hepatitis B and C virus 2024, Public Health act 2023, National immunization Strategy (2024-2028), immunization act 2017, public health rules 2014.

Gaps that need to be addressed

Financial gaps: financial disparity needs to be given attention because financial allocations are more given to HIV than Hepatitis B; Hepatitis B remains underfunded despite its high disease burden. Financing structures must be reevaluated for purposes of equity and fairness.

Implementation and sensitization: there is an urgent need to bridge the persistent and sensitization gaps in Uganda’s public health response to Hepatitis B. While the Uganda guidelines for prevention, testing, Care and treatment of Hepatitis B 2024 offer a robust framework, a disconnect between these clinical standards and public understanding. The government must effectively engage the public by educating high risk groups such expectant mothers and sex workers on Hepatitis B prevention and procedures.

Human rights and stigma protection on Hepatitis B patients: government policy must protect the rights of Hepatitis B patients and one of the ways should be guaranteed confidentiality by strictly enforcing medical confidentiality laws, workplace equality like banning mandatory screening at places of work to prevent unfair termination or exclusion.

The battlefield as an eco-system our focus being prevention

Since hepatitis B is incurable, we can work on control and prevention as our mode of fighting, one of the ways we can do this to make sure we do regular checkups.

Diagnosis: This involves the steps that your health care professional takes to find out if you have hepatitis B. Your healthcare professional gives you a physical exam and looks for symptoms of liver damage. These symptoms can include yellow skin and stomach pain. Tests that can help diagnose hepatitis B or its complications are Blood tests that can detect the hepatitis B virus in your body. They can also tell your health care professional if the infection is acute or chronic. A simple blood test also can find out if you are immune to the condition this is according www.mayoclinic.com

Vaccination: hepatitis B is preventable with a vaccine. All babies should receive hepatitis B as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. Hepatitis B can be passed from mother to child. this can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine shortly after birth. The pentavalent vaccine to infants at 6,10 and 14 weeks. Adult vaccination may also be offered as long as there is no evidence of chronic infection. This vaccine should be given at 0,1and 6-month intervals.

Public campaigns and addresses especially among the Youth on Hepatitis B prevention, especially on regular condom use: To effectively eliminate the spread of Hepatitis B, we must promote safe sex practices such as consistent condom use. The phrase of ‘’eating a sweet in polyethene bag ‘’ is a commonly slang term used by young people to express that using condoms reduces sexual pleasure and intimacy during sex. Public health campaigns frequently fail to address this mindset because they heavily focus on clinical facts rather than addressing consistent use of condoms.

Currently public health awareness is overwhelmingly focused on HIV but it’s high time we also intentionally focus on Hepatitis B. Targeted intervention is urgent in transit and the areas around Busega and Nateete are well known hubs for nighttime, trade, transport and informal businesses which correlate with high levels of commercial sex. Introducing focused Hepatitis B awareness and its prevention is essential in these communities and many other communities.

According to the world health organization we should also avoid sharing needles or any equipment used for injecting drugs, piercing or tattooing, wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces and get a hepatitis B vaccine if working in a health care setting.

Conclusion

The World Health Assembly called for governments and populations to take action to prevent diagnosis and treat viral hepatitis. Globally, 90% of people living with viral Hepatitis B and C do not know they have it, leading to an average of 3000 deaths every day. It is important to remember that the fight against Hepatitis B cannot be won in isolation, we must recognize that eliminating this disease requires a fully integrated ecosystem rather than leaving the government to carry the burden alone.

The Author is a Lawyer and an Intern as Center for Health, Human Rights and Development (CEHURD).

Jun 29, 2026Jul 1, 2026 General News

BID NOTICE: Invitation to Bid for Installation, Commissioning & Training of the Center For Health Human Rights and Development Enterprise Resource Planning System

Download the bid notice for the Installation, Commissioning & Training of the CEHURD Enterprise Resource Planning (ERP) System, including submission requirements, timelines, and bidding instructions.

BID NOTICE. ERP qrt Download

NON-CONSULTANCY SERVICES BID DOCUMENT 2026 Download

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