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Pascal Niamba , Cecil Beloume

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

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Pascal Niamba , Cecil Beloume

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  1. 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

  2. Outline • Introduction • 1.Situation analysis: Country Data • 2 Interventions • 3 Results • 4. Key issues & challenges • Conclusion

  3. Background & Context

  4. Burkina Faso • 274 200 km² • 12 802 282 inhabitants: 2005 • < 15 years: 55% • 52% Women • PNB 268 USD • 46 % of the population is below the poverty line • IDH=0,303 ( 2000)

  5. 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%

  6. CARE SYSTEMIN BURKINA FASO C.H.U Central Level 3rd Level C.H.R 2nd Level Mid-level health care system: 13 Regions C.M.A 1st Level Front line health facility level: 55 Districts C.S.P.S

  7. Package of interventions: ART context

  8. 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

  9. Results

  10. VCT and regular support to PLWHIV

  11. 2005 Achievements in VCT in networks settings

  12. 1.RECAP OF ACHIEVED RESULTS IN VCT CENTER

  13. TESTED POSITIVE IN VCT CENTER

  14. Treatment ART and OI

  15. COVERAGE IN TREATMENT (ART)

  16. COVERAGE on ART

  17. Status of patients under ART(TAP)

  18. News patients under ART (in 2006) 873 patients under ART now S2

  19. Proportion of news patients under ART S1 2006 Is an increase of 38,67 % of the patients under ART

  20. Active file and patients under ART (TAP)

  21. PTCT

  22. General recap of key results in PTCT

  23. Psycho-social and economic support

  24. Participation for auto-support meetings A total of 2045

  25. Visites à domicile au bénéfice des patients 2550 VAD ont donc permis d’apporter un soutien à 1786 PVVIH

  26. Psychosocial and nutritional support 2005 (CICDOC)

  27. Psychosocial and nutritional support 2005 AIDSETI

  28. General overview of VCT, PTCT and PECM facilities from 2003 to T1-06 176 152 95 93 63 56 29 46 51 12 24 3

  29. Positive aspect of ART(1) Success • 1 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.

  30. 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 .

  31. 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

  32. 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

  33. 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

  34. 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.

  35. Acknowledgements

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