ICAP Mozambique

1
ICAP Mozambique
International Center for AIDS Care and Treatment
Programs Annual Meeting, March 2006 Dar Es
Salaam, Tanzania

• Session I Reaching Enrollment Goals
• Josué Lima
• March 6, 2006

2
Mozambique Strategic Plan for HIV/Aids2004 - 2008
3
Mozambique ART Growth in 2005
Number of HIV Patients in Treatment by Month
At the end of 2005, Mozambique reported 18,675
patients in treatment.
Source CMAM
4
HIV Prevalence National Mozambique 2004
9.3 (North HIV Prevalence)
Nacional HIV Prevalence 16.2
20.4 (Center HIV Prevalence)
18.1 (South HIV Prevalence)
5
ICAP/MZ Sites
6
ICAP/MZ Sites and the HIV Prevalence
9.3 (North HIV Prevalence)
?
?
?
?
?
?
Nacional HIV Prevalence 16.2
20.4 (Center HIV Prevalence)
?
?
?
?
18.1 (South HIV Prevalence)
?
?
?
?
?
7
ICAP/MZ Sites by Month Services Began
8
Main Obstacles to Achieving Targets
9
Personnel for ICAP Mozambique Team

• Rapid recruitment of personnel
• Pro-active search and recruitment of specialized
  and experienced staff
• Short term consultancies as needed
• Original team members with multiple areas of
  expertise

10
Human Resources for ICAP/MZ Supported Sites

• Short term contracts and complementary personnel
  for Day Hospital teams
• Training for entire care and treatment team
• Specialized training for individual team members
• Contracting ex-patriot MDs experienced in
  HIV/AIDS and fluent in native language
  (Portuguese) able to begin immediately in
  provinces
• South/South Collaboration Fellowship Program

11
Infrastructure for Mozambican Day Hospitals

• Rapid procurement of readily available space
• Use of areas not providing afternoon services
• Renting new space or enlarging existing space
• Use of space made available by other NGO
• Parallel planning for renovations and use of
  easily adapted, temporary spaces while waiting
  for permanent space
• Use of mixed and complementary structures

12
Prefabricated Rooms
13
Prefabricated Room with Complementary Permanent
Structures
14
Strategies for Reaching Patients (1)

• Counseling and testing
• Linkages with VCT
• Counseling and testing for all hospitalized
  patients
• Specialized cross-consulting for patients who may
  be HIV or have AIDS

15
Strategies for Reaching Patients (2)

• Tuberculosis
• HIV counseling and testing training for TB
  clinics
• PMTCT
• Linkages and referrals from PMTCT services
• Linkages and collaboration with PMTCT Model
  Centers

16
Strategies for Reaching Patients (3)

• Strengthen and support expansion of ARV for
  children
• Include new, unplanned sites which show great
  potential for reaching patients
• Include strategic sites which already provide
  services but have no NGO partners
• Active participation in training medical
  technicians (allowing them to prescribe ART)
• Increase availability of CD4 testing
• Offer daily snacks at clinic to increase patient
  adherence and satisfaction, as nutrition is seen
  as part of total treatment package
• Subagreements with other NGOs to create linkages
  with community outreach and psycho-social support
  
• Implement ART in specialized adolescent and youth
  health services as satellites of ICAP/MZ Day
  Hospitals
• ICAP/MZ Staff Workshop November/2005 Aimed at
  defining ways to achieve project Goals

17
ICAP/MZ Internal Workshop Nov/2005Achieving
our Goals
18
COMO ALCANÇAR NOSSAS METAS ATÉ MARÇO DE
2006 PLANO DE ACÇÃO
19
Success?

• Successful Strategies
• Adapting infrastructure under adverse conditions
• Rapid creation of a strong team able to provide
  both technical and site support
• Quick and creative solutions to overcome large
  lack of human resources
• Less Successful Strategies
• Ease in establishing rural sites
• Establishing linkages and referrals to
  Tuberculosis