increasing access to and uptake of hiv testing, counseling ......management sciences for health 1...
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1 Management Sciences for Health
Increasing Access to and Uptake of HIV Testing, Counseling and
PMTCT Services among Women in Purdah in Resource-Limited Settings of North East Nigeria
2 Management Sciences for Health
Introduction
• Women in purdah – the seclusion of women from
public observation by using a veil and limiting
movement.
• They are segregated physically from men and only
participate in limited activities outside their home.
• More than 75% of women who don’t access
HIV/AIDS services are in purdah or have husbands
who restrict their movement.
3 Management Sciences for Health
• Facility data audit-baseline assessment of
women and men who access facility for
HTC.
• Community mobilization and Sensitization.
• Use of Voucher and Escort Services.
• Daily service registers and referrals.
• Monthly and yearly monitoring systems.
Methods
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Methods-contd
5 Management Sciences for Health
Methods-contd
Advocacy Visit to Local Government Chairman in Michika LGA, Adamawa State,
Nigeria
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Methods-contd
Advocacy visit to some religious leaders in two Local Government of Adamawa
State, Nigeria
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Outcome of Intervention
Some women in Purdah attending Health talks and ANC at the Facility in
Adamawa State
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• Five (5) couples averagely accessed facilities monthly before intervention.
• Post intervention figures after third and twelve months increased uptake to 32 and 77 couples respectively.
• In the two facilities, more couples accessed services in May, August and December due to increased sexual activity during festivals and holidays.
• GH Michika has higher uptake.
• At the end of year two, more than 1000 intending or married couples had accessed both HTC and PMTCT services.
Results
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Results-contd
Jan Feb March April May June July Aug Sept Oct Nov Dec
4 6
20
12
36
12
26 26
12 14
29
118
23
49
38
48 47
38
47
52
24
29 31
117
8 5
12 10
28
15
7
28
23
16 18
34
25 28
43 41
32
22 24
13
4
9 11 11
GH Michika 2010 Michika2011 GH Garkida 2010 Garkida 2011
Number of Couples who assessed HTC at four facilities between
2010 and 2011 in Adamawa State, Nigeria
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Challenges
• Request for written documents on test
results from religious leaders.
• Inadequate staff for follow-up services with
community and religious leaders.
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Ways to Overcome the
Challenges • Continuous advocacy to community and
religious leaders on confidentiality issues
surrounding HIV/AIDS in Nigeria
• Task shifting and multitasking of
volunteers in the community, churches and
mosques
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• Advocacy and community mobilization are
important tools in HTC.
• They increase knowledge of and access to
PMTCT services among women in purdah
when supported by men.
• To increase PMTCT uptake, government,
donors and NGOs should expand efforts in
advocacy and community mobilization and
engage more men.
Conclusion
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• To the USAID for funding the PROACT
Project.
• The PROACT Project in Nigeria
• The State Team of PROACT Adamawa
State
• The Community Leaders in Adamawa
State especially, Michika, Song, Gombi
and Fufore LGAs
• The facility staff, LACA and MSH
community volunteers
Appreciation
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Thank you
Olukunle Omotoso MPH Community HIV/AIDS Services Specialist