Treatment Working Group

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Strengths Adults . ART Roll out Guidelines in placeHealth workers trainedM

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Treatment Working Group

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1. Treatment Working Group PEPFAR 17th June 2008 Retreat

2. Strengths Adults ART Roll out Guidelines in place Health workers trained M&E in place Medicines Adults adhere better Political IMAAI Laboratory Procurement and supply systems in place The increasing collaboration between TB/HIV Medicine availability

3. Weakness Infrastructure Outreach program Some groups not reached by treatment services eg correctional facilities, NDF, … Training inadequate for non-medical staff especially for developments in treatment Inadequate communication of treatment literacy issues Inadequate Namibia specific Adherence information No/minimal linkage between facility and community interventions Language barrier Women coming for treatment more than men Inadequate identification/collation of adverse medicine effects

4. Opportunities Donor support Political will HIVQUAL Adherence

5. Threats Cost of transport etc to facilities Nutrition Lack of qualified staff Language barriers Long distances to treatment facilities

6. Recommendations Emphasis on Treatment literacy communication/strategy Emphasis on targeting Males for treatment Increased linkages between facilities and community Speed-up roll out of IMAAI and roll out to rural communities Holistic approach to strenghtening health systems Bursaries and support for health training programs (local and international)

7. Pediatric strengths Training Roll out children FDCs EID

8. Weaknesses FDCs not widely available Lack of follow up mechanisms for children Disclosure issues inadequately covered Counseling for children High workload Children on treatment not significantly increasing Nadequate focus on children with disability

9. Opportunity Lifeline childlike services Lironga Eparu IBIS IMCI New more efficacious regimen

10. Threats Caregivers not committed to OVCs IMAAI does not include children Hidden costs for clients to access to treatment Food insecurity Disclosure in institutional settings Prescription responsibilities of Nurses

11. Recommendations Strengthen PMTCT Get children to Rx early Improve PMTCT follow up Treatment literacy targeting children and guardians Training and staff retention Stigma reduction Application of new WHO guidelines for Rx of children Implementing the child counseling program Ensurring linkages

12. Laboratory Strengths Good infrastructure Ability to do most tests Funding available

13. Weaknesses Slow roll out of RT Limited RT algorithms Weak data sharing between laboratory and programs Long turn-around time Limited access Lack of resistance testing/monitoring Limited capacity Limted space in the district labs

14. Threats Cost and sustsainability

15. Recommendations Speed up RT roll out Use of POC techniques Improve lab infrastructure Improve data systems between the lab and programs Policy review to allow resistance testing Improve lab logistics SOPs for specimen collecting proceudres

16. Attendance list

17. Attendance list

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