pascal niamba , cecil beloume
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Experience under the TAP: ART scale up and health systems related bottlenecks in Burkina Faso Treatment Acceleration Program Learning from the experiences gained and the challenges ahead November 30, 2006, Washington DC. Pascal Niamba , Cecil Beloume. Outline. Introduction - PowerPoint PPT PresentationTRANSCRIPT
Pascal Niamba, Cecil Beloume
Experience under the TAP: ART scale up and health systems
related bottlenecks in Burkina Faso
Treatment Acceleration ProgramLearning from the experiences gained and the
challenges ahead November 30, 2006, Washington DC
Introduction1.Situation analysis: Country Data
2 Interventions
3 Results
4. Key issues & challengesConclusion
Outline
Background & Background & ContextContext
Burkina Faso274 200 km² 12 802 282 inhabitants: 2005< 15 years: 55%52% WomenPNB 268 USD
12802282
-46 % of the population is below the poverty line
-IDH=0,303 ( 2000)
Situation Analysis
Epidemilogical Data:Sentinel site surveillance (2004):
Prevalence rate 2.4%.
Urban sites: 3.4%
Rural areas: 1.5%
Estimates for 2005 (UNAIDS)Adults living with HIV/AIDS: 135 120
HIV/AIDS prevalence rates in adults (15- 49): 2%
CARE SYSTEMIN BURKINA FASO
C.H.R
C.S.P.S
C.H.U
C.M.A
3rd Level
2nd Level
1st Level
Front line health facility level:
55 Districts
Mid-level health care system: 13 Regions
Central Level
Package of interventions: ART context
Package of interventions: ART context
1. VCT and regular support to PLWHI
2. Treatment ART and OI
3. Parent To Child Transmission P.T.C.T
4. Nutritional support
5. Psycho-social and economic support
6. Capacity building for different actors
ResultsResults
VCT and regular support to PLWHIV
2005 Achievements in VCT in networks settings
4863
32587
37689
0
5000
10000
15000
20000
25000
30000
35000
40000
NGO AIDSITI and CICDoc)
2004 2005 2006
1.RECAP OF ACHIEVED RESULTS IN VCT CENTER
15001666
1500
3203
1500
3733
15001642
1500
3110
1500
771
0
500
1000
1500
2000
2500
3000
3500
4000
AFAFSI AJPO BERGERIE SOS SIDA URBLS CICDép2
Tests prévus Tests réalisés
TESTED POSITIVE IN VCT CENTER
20
5047
107
15
60
28
66
26
159 9
0
20
40
60
80
100
120
AFAFSI AJPO BERGERIE SOS SIDA URBLS CICDép2
Hommes Femmes
Treatment ART and OI
COVERAGE IN TREATMENT (ART)
49629
1116
27000
3867
133
27000
8136
1124
27000
9536
5515
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2003 2004 2005 2006
Goal ART
Patients on ART
ART /ONG
COVERAGE on ART
2,5
10,13
24,56
0
5
10
15
20
25
2003 2004 2005
ART coverage
Status of patients under ART(TAP)
5901
3019
775 562
2693
1463
3532
43653 35
0
1000
2000
3000
4000
5000
6000
DS/Hôp St Cam AIDSETI CICDOC Priv(Suka)
File Active ARV-T1-2006
News patients under ART (in 2006)
34
29
53
40126
12
95
80
17
34
0
20
40
60
80
100
120
140
160
180
AFAFSI AJPO BERGERIE SOS SIDA URBLS
Patients ARV 05 Patients ARV 06 nouveaux
873 patients under ART now S2
Proportion of news patients under ART S1 2006
53,42%
43,10%
8,60%
45,70%
66,60%
0,00% 10,00% 20,00% 30,00% 40,00% 50,00% 60,00% 70,00%
AFAFSI
AJPO
BERGERIE
SOS SIDA
URBLS
Nouveaux patients S1- 2006
Is an increase of 38,67 % of the patients under ART
Active file and patients under ART (TAP)
5901
3019
7828
2966
0
1000
2000
3000
4000
5000
6000
7000
8000
G structure (hospital ) NGO(AIDSITI,CICDoc,St Camille Suka)
File Active ARV-T1-2006
PTCT
General recap of key results in PTCTIndicator S1-2005 S2-2005 T1-2006
women seen at ANC 28772 13595 21.813
women seen at ANC and tested 11495 13528 15.831
pregnant women tested positive and have actually given birth
463 523 472
Number of newborns from positive mothers who have taken NVP
348 508 398
newborns tested positive at 18 month
11/102 6/91 8/48
Psycho-social and economic support
Participation for auto-support meetings
53
635
656
501
200
0 100 200 300 400 500 600 700
AFAFSI
AJPO
BERGERIE
SOS SIDA
URBLS
Participants
A total of 2045
Visites à domicile au bénéfice des patients
65308
361158 1033
1815
265
77
62192
0 500 1000 1500 2000
AFAFSI
AJPO
BERGERIE
SOS SIDA
URBLS
Bénéficiaires VAD réalisées
2550 VAD ont donc permis d’apporter un soutien à 1786 PVVIH
Psychosocial and nutritional support 2005
(CICDOC)
0
2281
0 12
5542
2062
0
1000
2000
3000
4000
5000
6000
1er Semestre 2ème semestre
Education nutrition Soutien Psycho-social Soutien alimentaire
Psychosocial and nutritional support 2005
AIDSETI
33546
2932210
15297
5531
0
5000
10000
15000
20000
1er Semestre 2ème Semestre
Séances Educat Nutri Soutien Psycho-social Soutien alimentaire
General overview of VCT, PTCT and PECM facilities from 2003 to T1-06
0
20
40
60
80
100
120
140
160
180
200
Fin 2003 Fin 2004 Fin 2005 T1-2006
Nombre de centre de PECM/ARV Nombre de centres de CDV Nombre de centre PTME
324
46 5112
29
63
152
176
56
93 95
Positive aspect of ART(1) Success1 NGOs involment has contributed to the improving the access to ARVs for PLWHI.
2. Collaboration between care and support NGOs network members and public health facilities is feasible;
3. The integration of care achieved from health centers and community centers to the referral hospitals.
2. Positive aspect of ART(1) Success
4. Capacity building of the different stakeholders has contributed to the improvement of the care and support of PLWHIV
5. With ART a strong demand for care has been established .
Key issues and challenges for scaling up
At NGO level
Make available human resources
data base harmonized and reliable for Patients
Social and economic impact
Documentation of lessons learned and operational research on
adherence
resistance
social and economic impact
Key issues and challenges for scalling up
At management structure level
-Make available resources in time VCT
Treatment OI
Infrastructures
Equity in service offers satellite (in the rural area )
To harmonize cost
General questions related to treatment
What will become of the 7000 patients under ARV after 2007?
Capacity building for ART stakeholders?
Reinforcing access to community for PLWHIV?
Supporting the involvement of NGOs?
Reinforcing the integration of voluntary testing in public health facilities!!!
Promotion of operational research!!!
Follow up on compliance surveillance
CONCLUSION
TAP has contributed at the national level to the greater involvement of PLWHI elegible for ARV treatment.
TAP has increase an honest collaboration between public health facilities and NGOs.
There is a need to be cautious while implementing resistance sentinel sites of HIV/AIDS and ART.
ART is a essential in Burkina Faso and needs to be continued.
AcknowledgementsAcknowledgements