The critical challenges of MADIPHA
  1. The government and the international HIV/AIDS  policy formulation  agencies,  within the United nations, research  and funding agencies  has adamantly failed  to formally recognize  people with disabilities  among the  so-called “most At Risk Populations”.    As a result, limited  strategic efforts  have been  undertaken by international, national and local  health service systems to promote  the right  to  equitable  access  to HIV/AIDS services and people with disabilities  continue to have  their  rights    violated in terms of  Lack of information in accessible formats.
  2. Lack of National disaggregated data on prevalence of HIV&AIDS among PWDs and to make it worse some ones disability is not considered in HIV in HIV service centres. Policies which would promote equitable access to HIV/AIDS services by PWDs are not known to decision-makers, little has been done to develop strategies that specifically aim at mainstreaming disability in HIV and AIDS services regarding to accessibility and utilization.
  3. PWDs living with HIV are not represented on any of the HIV&AIDS service decision making committees established under decentralization from health service providing facilities, Sub County to district level, Districts HIV and AIDS strategic plans do not adequately include disability issues, nor do health facility work plans. Health service facilities have no provisions for ensuring PWD accessibility to services in their work plans.
  4. Limited efforts to make follow up on the critical issues like, sexual and gender based violence (SGBV) cases against PWDs more especially by the relatives. This challenge has left the culprits to continue violating the rights of girls and women with disabilities and puts them on increased high risks of HIV infection. In order to address this MADIPHA tried to seek support from women led organization to cause campaign against such violations although have not been successful.
  5. Inadequate trained PWDs peer-counselors and facilitation to provide counseling support and linkages on HIV information and services to PWDs of different types within their community.
  6. Unmet growing needs for PWDs living with HIV: Although MADIPHA and partners have been able to meet some of the needs of people living with HIV like follow up, more needs are still unmet. Like providing PWDLHIV with income generating activities, as many PWDs who were followed wished if MADIPHA could economically empower them, some of the IGAs mentioned include local poultry keeping, piggery, Kitchen gardening and other small scale businesses.
  7. Stigma affects and denial on decision of the HIV positive PWDs to seek care from the health centers. Stigma still rampant among PWDs, most of them referred do not access the services from the nearby Health units they are referred to for example clients in Kitanda sub county are referred to Kitanda Health centre III but preferred to go Villa Maria Hospital about 20 km away which is costly in terms of transport for them which affects their adherence on treatment in the long run.