Building the Capacity of the Health and Social Care System in Case Management

1. “HELP” HIV/AIDS Education in Lithuania Program Building the Capacity of the Health and Social Care System in Case Management J. Csiszar MD. MSc. MBA IAS Conference July 2010

2. Content • Introduction of Project HOPE • Background • The Problem • Goal and Objectives • The Uniqueness of our approach • Results • Conclusion

3. Introduction of Project HOPE Since 1958 • Improving health via education training,targeted humanitarian assistance, health policyresearch • Present in 5 continents, 37 countries • Core strengths: • Health Professional Education • Health of Mother and Children • Health Systems & FacilitiesDevelopment • Infectious Diseases • Non -Communicable Diseases

4. Background • Turbulent political social and economic environment for transitional countries • Loss of safe employment, social security and disintegration of safety nets in the society • Ethnic minorities and other marginalized groups are even more dramatically affected than the mainstream population • Transparent borders, availability of cheap drugs result in a surge of HIV/AIDS among marginalized groups (ethnic minorities, prisoners, IDU) • Existing health and social systems cannot successfully cope with the epidemic due to fragmentation and lack of coordination between their services • Long term commitment to CEE countries in transition • Several years of successful collaboration with Lithuanian partners on Health Care Management program • Successful experience with multi professional team training and network development

5. The Epidemics in Lithuania

6. The problem • Doctor centered care • Complex, fragmented services- difficult to navigate by the patient • Limited awareness in the health and social sector of the needs of PWLHA, risk groups, and people with special needs • Lack of multidisciplinary team culture • Communications, coordination, continuity across services is poor

7. Goal: To place the patient in the centre of prevention and care efforts and design a program that addresses his/her unique - health and social- needs in a comprehensive , holistic fashion.

8. Objectives Policy level • Integrated case management model • Regulatory framework • System for supervision, follow up , quality management Institutional level • Create a network of collaborating institutions • Develop Institutional framework for continuing training (CPD) and supervision • Create a pool of Master Trainers affiliated with the National AIDS Institute • Reduce Stigma in health institutions • Build mechanism for monitoring and follow up of implementation Provider level • Improve KASP • Reduce stigma and discrimination • Improve multidisciplinary teamwork and coordination • Develop organization, communication and management skills • Facilitate the development of team projects • Improve cost effectiveness of the services by avoiding duplication and waste

9. The uniqueness of the approach • Multidisciplinary team training (introductory course) • Selection of candidates for ToT • Training of trainers • Cascading the training throughout the country • Shadow faculty, mentoring • Locally owned program

10. Results Coverage

11. Results • 231 participants trained • 153 organizations represented • 268522 clients reached annually

12. Results- 39 team projects developed

13. Results

14. Conclusions • The culture of multidisciplinary teamwork, communication, collaboration and continuity of care is essential to the delivery of value to patients • Building local training capacity was key to scaling up the effect of our program • Residential, multidisciplinary team setting to promote the culture of collaboration and networking has proven successful • Countries with similar background may benefit from replicating this model

15. Thank you!