Transcript 1.1 Setting the Scene - Global Plan

CHAZ Partnering in the National
Response to PMTCT
Dr. Dhally Menda
MD, MPH, MBA
Director of Health Programmes
UNAIDS Conference
Cresta Golf View Hotel, Lusaka
28th February 2013
www.chazhealth.zm.org
Churches Health Association of Zambia
Content
1. CHAZ Background
2. Current Situation of the Mother Baby
Pair
3. CHAZ Partnership in National PMTCT
Response
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
CHAZ Background Information
Formation & Membership
• Formed in 1970 ( Catholic and Protestant Medical Committees)
• Interdenominational (Catholic and Protestant) umbrella organisation for 147 CHIS in
10 Provinces :
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36 Hospitals & 81 RHCs & 9 Training Schools
29 CBOs: 20 Community Based Programmes & 9 Catholic Dioceses
Health Services Coverage
• CHAZ is the second largest provider of health services in Zambia.
• MoU with the MoH: 75% Grant- Staff Secondment – Essential Drugs
Principal Recipient Status
• PR for the Global Fund Mechanism in Zambia for all the 3 disease components:
HIV/AIDS (including ART), Malaria & TB.
• PR for the PEPFAR –CDC HIV Prevention and Treatment Grant.
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
You failed
her…
Grandmother in Kanyanga RHC 2008
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She lived 10 Km
away from the Clinic
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She attended
only 1 ANC Visit…
19%: ANC in 1st Trimester
All data: ZDHS 2007
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She tested HIV +
16% HIV Prevalence in Women
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She delivered
at home
Rural: 67.2% Deliver at Home
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She bled to death
in the oxcart…
on our way to the clinic
Hemorrhage: 25% of Maternal Mortality
MMR: 591/10,000 – 42% during child birth
Life Expectancy: 52 years in 2010
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
She left me a gift…
An HIV infected baby…
U5M: 119/1,000
Post Natal Mortality: 36/1,000
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Her last words…
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
“Mum,
tell the people listening
to this presentation:
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
“No HIV+ Woman should Die…
No Child should be infected
with HIV…”
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
You failed
me…
my daughter…
my grand daughter….
Delay no more… Act Now!
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
SUPPLY
Left Out
Drop Outs
Adherence
QUALITY
DEMAND
CHAZ Partnership in National
PMTCT Response
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
They called me:
“HIV Exposed baby”
I was born at
Mpongwe Mission
Hospital…
Now I have a Name …
I am HIV negative
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Why me?
CHAZ, help me answer
this question…
You are not the only one!
92% of your friends on the CHAZ
Programme are also negative
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Supply of PMTCT Services
We provide integrated comprehensive PMTCT
Services (Static & Mobile) in hard to reach Place…
63 PMTCT Sites - The 4 Prongs of PMTCT
We strengthen Health Facilities and Communities System
We offer Holistic Family Centered Services
CHAZ AIDS Programme Started
In Churches: HBC-OVC Support
At CHAZ: Advocacy-HBC-OVC
DCA –DANIDA CACPP
1993-2004: 11 Years
STI-OVC-IGA-Nutrition – Prevention +Condoms
EU -LCCB
2003-2006: 3Years
GF – HIV Prevention
2003-2008: 5 Years
1984
1986
1st HIV Case
2005
1993
2007
2010
2011
2003
DCA/DANIDA - FCCT
2005-2006: 2Years
GF – ART
2005- to date
JFA
DCA-EKN-IA-C- Denmark– HIV Prevention
2007 to date
GF – HIV Prevention
2010- to date
27 years in complementing Government’s efforts
in HIV & AIDS Programming
Funded by several Partners
PEPFAR-CDCPrevention - ART
2011- to date
CHAZ PMTCT Services
No. Women receiving ARV Prophylaxis
No. Babies Receiving ARVs Prophylaxis
4138
3849
3179
1910
1749
1024
448
Y 2007
1801
904
618
Y 2008
Y 2009
• Sensitize Chiefs & Champions
• Maternity Waiting Homes
• Performance Based Financing
Y 2010
Y 2011
• Mothers’ Support Groups
• ASWs : defaulter Tracing
• Men Taking Action: ANC,
Couple Counseling
CHAZ Database
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
PMTCT Services Demand Creation
My Mother underwent
a traditional Marriage
Counseling with an
improved Curriculum
including PMTCT
We Create demand for PMTCT Services
at all levels, using Opinion Leaders, HWs and CBHWs
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
PMTCT Services Quality
My sister and I were born at
Mpongwe Mission Hospital,
from an HIV positive mother…
We are HIV Negative…
We participate (TWGs) in the:
National Policies, Standards, Guidelines and Regulations
Development & Implementation
At Mpongwe Mission
Hospital they cared for me
with compassion and
accompanied me through
out my pregnancy
We Advocate, Mobilize Resources and Allocate Finance
We ensure good Leadership & Governance
I exclusively breastfeed
and our child is HIV
negative.
A Safe Motherhood
Action Group Member is
visiting us every day
We encourage Task Shifting for HWs & CBHWs
We advocate for paid CBHWs
My twins’ tested
negative with the PCR
Test…
We never experienced
any stock out of ARVs .
We supplement the National Supply
Chain Operations for Medical & Non
Medical Products
My husband and I are
strong members of the
Village “Post Test Club”
and explain to couples to
benefits of PMTCT Services
We Strengthen Communities Capacity,
Networks and Support Groups
To increase their PMTCT Services ownership
We provide:
Technical Support, M&E and Mentoring
- Joint Annual Reviews, etc…
I am a Trans Out
and my records are
properly kept
at the hospital
We develop Data Collection Tools and Reporting
format for Health Facilities and Communities,
in line with the National System
Acknowledgement
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Community Members and Leaders
MoH
MoCDMCH
Cooperating Partners
CHAZ Board
CHAZ Management
CHAZ Staff
Stakeholders
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
We Thank You
Let your Yes be Yes
God Bless You
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2