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MOAE0102. Family Health Days: An innovative approach to providing integrated health services for HIV and non-communicable diseases among adults and children in hard-to-reach areas of Lesotho.
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MOAE0102 • Family Health Days:An innovative approach to providing integrated health services for HIV and non-communicable diseases among adults and children in hard-to-reach areas of Lesotho A. Tiam, J. Khonyana, O. Oyebanji, A. Ahimbisibwe, R. Pakela, A. Isavwa, L. Buhendwa, M. Mokone, M. Putsoane, M. Foso, M. Tsoeu, M. Nyabela.
Background • In Lesotho, considerable resources have been allocated to the HIV/AIDS response, while resource allocation for non-communicable diseases has lagged. • Due to geographic location and weak transportation and infrastructure, a number of clients find access to health care facilities challenging. • The Family Health Day (FHD) campaign is a national mobile health program, which brings integrated health services to communities and families.
Goals and Objectives FHD aims to make integrated health services accessible to communities in Lesotho through use of mobile clinics, and use of multi-disciplinary teams and family-centered approaches Objectives: • Test all HIV-exposed children • Increase early infant diagnosis of HIV and timely enrollment into care and treatment • Increase adult access to HIV care and treatment services • Increase screening for hypertension, diabetes, malnutrition, and TB • Increase access to integrated family services
Methods • EGPAF supported Lesotho’s Ministry of Health (MOH) to assemble a multidisciplinary team, composed of medical doctors, nurses, and nutritionists, pharmacists, mental health officers, social workers, counsellors. • EGPAF provided logistics support to the MOH, technical support for the monitoring and evaluation component, and worked with other service delivery partners to strengthen the campaign.
Services Provided at FHD Table 2: Services
Results • Between October 17 and November 25, 2011, 10 rounds of FHDs were carried out in the 10 districts of Lesotho. • Of the 8,396 adults tested for HIV, 7% were positive. • Of HIV-positive individuals, 68.5% received CD4 testing and 36.6% were enrolled into HIV care • 324 defaulters were linked back to care • 990 children were immunized • Of the 4,454 adults screened for hypertension, 24.2% had elevated blood pressure* • 3.1% of 3.045 adults had elevated blood sugar, and all were linked to care** *JNC7 report. See table 3 for details. ** hypertension.ADA. I. Classification and Diagnosis. Diabetes Care 2011;34 (suppl 1):S13. Table 2. defined as random plasma glucose ≥200 mg/dl (11.1 mmol/l) according to national guidelines
Discussion • HIV screening • Non-communicable diseases HIV prevalence was quite low compared to national prevalence High number of treatment defaulters identified; this provided an opportunity to link defaulters back to HIV care and treatment services Enthusiasm about knowing HIV status FHD gave first opportunity in Lesotho to carry out hypertension screening in hard-to-reach communities The mean blood pressure seemed to be quite high; selection bias is one hypothesis