An operational package for integrated management of hiv aids prevention treatment and care
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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, 2002-2005. Type of service delivery points Malawi, Mid 2005. 4 central hospitals (tertiary)

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An operational package for integrated management of hiv aids prevention treatment and care

An operational package for Integrated Management of HIV/AIDS prevention, treatment and care

ICASA - Abuja, Nigeria

5 December 2005



Type of service delivery points malawi mid 2005
Type of service delivery points 2002-2005 Malawi, Mid 2005

  • 4 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 2004 2005
Number of people started ART, 2002-2005Malawi, 2004-2005


Challenges 1 rapidly scaling up comprehensive hiv aids services
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
Challenges (2) : Systems for service delivery services

  • 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
Challenges (3) : Monitoring progress and quality services

  • 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



An operational package for integrated management of hiv

Community Intervention in HIV/AIDS Services services

ADVANCED INDIVIDUAL CAPACITY

* Expert patients as trainers* ART aid

Help with facility management*Weigh, triage for self-limited illness & side effects

Clinical

Team

INDIVIDUAL PREPAREDNESS-Patient/client self-management

-Treatment supporters for one-on-one support

- Psycho-social support- Other adherence support

Patient and Treatment supporter

HOME PREPAREDNESS *Family members and visiting carers prepared for supportive and palliative care, nutritional support, adherence support

Home Care

COMMUNITY PREPAREDNESS- Support Groups, Advocacy Groups, - Education & destigmatisation

- Normalisation of HIV- Scale up Testing & Counselling

General Community Support


Strategies 1
Strategies (1) services

  • 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 2003 2005
Countries with ART servicesScale-up Plans, 2003-2005

2003

2004

2005




M e systems and patient monitoring systems
M & E systems and Patient Monitoring Systems services

Patient monitoring

systems

ART Scale-up M&E


Norms and standards 1
Norms and Standards (1) services

  • 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
Partnerships for Country support (3) services

  • 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




Lessons learned
Lessons learned services

  • 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
Way Forward services

  • 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