An operational package for Integrated Management of HIV/AIDS prevention, treatment and care ICASA - Abuja, Nigeria 5 December 2005.

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Presentation transcript:

An operational package for Integrated Management of HIV/AIDS prevention, treatment and care ICASA - Abuja, Nigeria 5 December 2005

ART service delivery points, and patients on ART. Malawi,

Type of service delivery points Malawi, Mid central hospitals (tertiary) 22 district hospitals (out of 24) 20 mission hospitals 3 military (barracks) hospitals & 1 police 1 paediatric hospital 7 (private) clinics 1 rural hospital and 2 health centres

Number of people started ART, Malawi,

Challenges (1) : Rapidly Scaling-up comprehensive HIV/AIDS services Coordinating actions of many stakeholders Strengthening weak health systems Operating in an emergency mode

Challenges (2) : Systems for service delivery Policy-based –Human rights/Equity –Community Ownership/Responsibility –Health systems adjustments/decentralization –Task shifts Evidence-based –Best International Standards –Convincing leaders, service providers and users –Documenting and adapting knowledge to different settings

Challenges (3) : Monitoring progress and quality At point of service delivery –Pre ART/ART Registers At district level - Indicators for district and national reporting and planning At national level – Summary indicators for national planning and reporting

Levels of care for ART

General Community Support Home Care Patient and Treatment supporter Clinical Team COMMUNITY PREPAREDNESS - Support Groups, Advocacy Groups, - Education & destigmatisation - Normalisation of HIV - Scale up Testing & Counselling HOME PREPAREDNESS *Family members and visiting carers prepared for supportive and palliative care, nutritional support, adherence support INDIVIDUAL PREPAREDNESS - Patient/client self-management -Treatment supporters for one-on-one support - Psycho-social support - Other adherence support ADVANCED INDIVIDUAL CAPACITY * Expert patients as trainers * ART aid Help with facility management *Weigh, triage for self-limited illness & side effects Community Intervention in HIV/AIDS Services

Strategies (1) Build on existing ART initiatives Development of normative tools and guidelines Strengthening regional capacity and partnerships Support strengthening of health systems

Countries with ART Scale-up Plans,

Number of countries with 3 by 5 Officers

Implementation of IMAI in the African Region

M & E systems and Patient Monitoring Systems ART Scale-up M&E Patient monitoring systems

Norms and Standards (1) Framework for planning for 3 by 5 Regional Guidelines and training manuals on VCT for health and non-health workers Strategy and modules for STI prevention/control Clinical guidelines for care and treatment including Community and Home-based Care Training materials on Injection Safety/IPC HIV Rapid Testing Training Package Guidelines for health sector based HIV prevention

Partnerships for Country support (3) USAID/PEPFAR/JSI/SIGN for Infection Prevention and Control/Injection safety UNICEF, CDC & USAID for PMTCT &paediatric HIV UNECA, World Bank for TAP GLIA, OCEAC, ECOWAS, SADC, and other regional bodies intensifies & harmonized response

Allocation of CIDA Funds

Implementation Rate for CIDA Funds

Lessons learned ART scale–up challenges health systems Country wide implementation of ART is feasible Linking treatment and prevention produce synergy to mitigate HIV/AIDS impacts Cost-recovery policies a barrier to access Decentralized & operational services critical Efficient Systems to monitor adherence & outcomes/quality of services

Way Forward Implementing interventions to strengthen health system Focus on prevention with links to treatment with community participation Essential package as a core commitment to universal access to prevention and care