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ESTHER PARTNERSHIPS: A KEY INSTRUMENT FOR DECENTRALISATION OF HIV CARE AND HSS IN CAMEROON . Jules Motto, ESTHER coordinator in Cameroon Caroline Comiti, program manager. Content. CONTEXT & JUSTIFICATION ESTHER LOGIC OF INTERVENTION SOME KEY RESULTS CONCLUSION & RECOMMENDATIONS.
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ESTHER PARTNERSHIPS: A KEY INSTRUMENT FOR DECENTRALISATION OF HIV CARE AND HSS IN CAMEROON Jules Motto, ESTHER coordinator in Cameroon Caroline Comiti, program manager
Content CONTEXT & JUSTIFICATION ESTHER LOGIC OF INTERVENTION SOME KEY RESULTS CONCLUSION & RECOMMENDATIONS
1 - Context & Justification • Cameroon : ≈ 20 M inhabitants (projections census 2007) • 4,3 % seroprevalence HIV (HDS 2011) • Nb de PLHIV: 560 306 (8,5% are children) • Need of ART : 260 000 PLHIV • Coverage of global ART: ≈ 106 000 (with 49% are followed within sites supported by ESTHER) • 24 National / Regional Hospitals (ATC, 13 are tutors) & 178 HD
LEVEL OF INTERVENTION OF ESTHER IN CAMEROON MOH DLM, DPM, DROST Reg Lev RHD, CAPR ATC Partnership HCU/DH DH HCU PLWHIV CBO’S A wayforward to InstitutionnalTwinningPartnerships
2 - ESTHER logic of intervention • Access to care and treatment (Paediatric, STI, OI, E-MTCT, ...) • Health system strengthening (training of HRH and equipments ) • Monitoring and evaluation (support to Health information System : ESOPE) • Strategic support and project management : central and intermediate level of the MoH (DDC,RHD) • Support to key populations
C2D/ESTHER: DECENTRALIZATION THROUGH THE TUTORING ESTHER traditionaltwinning 1st generation Tutoring 2ndgeneration tutoring Other ANC EPI units CRN/CTN counsellor/ Community National / regionalHospital Health District Hospital Northern Hospital
IMPLEMENTATION ESTHER TWINNING IN CAMEROON TOGO Since 2002 Expertise recognized by MoH Today the whole country is covered : central, regional et peripheral levels • 13 tutor hospitals (national/regional: ATC in the 10 regions • 10 northern hospitals (8 in France & 2 in Germany)
3 - KEY RESULTS Scaling up of Decentralization through tutoring of care of HIV/AIDS project
DISTRIBUTION OF TRAINED HR WITHIN ESTHER SITES The whole package
THE WAY FOWARD … UNIVERSAL ACCESS 4 - Conclusion & recommendations A. ART Coverage through ATC & tutored HD (49%) B. ART Coverage through ATC & tutored HD & tutored health units (80%) DEMAND OF THE MOH DH/CU Cov 49% DH/CU Cov 49% MC Cov 10% HC Cov 5% ATC twinning NorthernHospital HC Cov 3% HC Cov 16%
THANKS SO MUCH to You and to our partners & donors The hospitals partners MINSANTE CBO’s inCameroon