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How can HIV professionals around the World contribute to sustainable E2 work ?

How can HIV professionals around the World contribute to sustainable E2 work ?. IAS members’ point-of-view as captured in the E2 country consultation meeting held in Uganda Nov 27-28 th 2011 Dr. Mudiope Peter. Need for sustainable E2 work.

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How can HIV professionals around the World contribute to sustainable E2 work ?

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  1. How can HIV professionals around the World contribute to sustainable E2 work? IAS members’ point-of-view as captured in the E2 country consultation meeting held in Uganda Nov 27-28th 2011 Dr. Mudiope Peter

  2. Need for sustainable E2 work • Effectiveness and Efficiency (E2) in country programmes is vital to global efforts to continue to attract funding and leverage that funding to effectively respond to HIV/AIDS epidemic

  3. Why do IAS professionals need to be involved in E2 work • On going discussion on E2 • HIV professionals are often left out • Front line HIV services providers

  4. Multimethod approach 1. Focus Group discussions with HIV professionals at IAS 2011 in Rome 3. Country pilot consultation in Uganda 2. IAS member survey on E2

  5. Where do we gain efficiency? • Greatest efficiency still lies in preventing HIV/AIDS (all 1o , 2o & 3o prevention) (Dr.Alex Coutinho, Executive Director, IDI)

  6. Where do we lose E2 • Regular stock-out of medicines including ART • High rates of attrition from care • Low provider client ratio • Non affordability of laboratory monitoring of patients in care

  7. Where do we lose E2 cont’ • Low staff remuneration Vs work load leads to de-motivation of staff • Challenges of ownership- poor coordination of services provision • Poor or lack of evidence based decisions

  8. Results –Online survey Why lack of E2 in HIV programmes? • Functionality of health systems, • Weak collaboration and engagement of partners, • Wrong priorities • Lack of resources • Others; stigma, laws/policies, loss to follow up & poor adherence

  9. Results –Online survey Consultation by National programme • 50% of members had ever been consulted • Concern of the contribution not being taken seriously • Only 17% of members consulted had their input translated into concrete national plans

  10. Results–Suggestions to improve E2 • Strengthen national health systems • Govt ownership • Team work • Evidence based implementation strategies-M&E • Increased funding • Transparency and accountability

  11. Results –Country Pilot: suggested ways to achieve E2 @ inter/national • Country ownership • Equitable resource distribution • Strengthening of health systems Others -Mutual accountability - Efficient & HRD logistical systems, -Sustainable funding

  12. Results –Country Pilot: suggested ways to achieve E2 @ District • Prevention of new infections • Minimization of loss to follow up on ART • Better staff remuneration and motivation, • Task shifting • Operational research • Integration of services

  13. Results –FGD: Suggestions for E2 improvement • 5 key themes; • Structural and Systemic Issues • Governance, leadership and strategic process • Administrative Process • Technical Processes • Client factors • HIV professionals & other stakeholders are joint participants in defining, problem solving and implementing the E2 activities

  14. Suggested way forward at health facility level • Rationalization of clinic appointments • Task shifting • Collaboration with other vertical programmes • Rationalizing ART monitoring and holding decision support meetings that minimizes the reliance on the unaffordable viral load

  15. Suggested way forward at health facility level • Reducing loss to follow up • Training health workers ?on job verses offsite • Continued coordinated engagement and strengthening of all stakeholders( health professionals, NGOs, MARPS, patients, media & communities)

  16. Suggested way forward- inter/national level • HIV professional should be engaged to share best experiences • Offer TA in relevant field of expertise to inform national HIV care programmes • Research and Knowledge translation for evidence based policy

  17. Suggested way forward- inter/ national level cont’ • Continued coordinated engagement of all stakeholders( govts, HIV professionals, Donors, MARPS, patients, media & communities) • Media support, for accurate evidence reporting to the public

  18. Thank you for listening Discussion!

  19. Recently posted articles in one of the dairies in Uganda • ‘HIV/Aids response faltering’ (21/10/11) • ‘Inadequate services a threat to Aids fight’ (10/10/ 11) • New Aids cases increase by 60,000 this year – research (1/10/11) • More than half of HIV patients lack ARVs (29/10/11)  • ARVs fuel HIV spread, works minister says (30/11/11)

  20. Recently posted articles in one of the dairies in Uganda • Complacency, ignorance, vulnerability driving fresh HIV infections among women(31/3/12) • Cost of HIV/Aids treatment to increase by Shs2b(24/3/12)  • Circumcision and HIV: are we being fed on half-truths?(22/3/12 ) • Circumcision is a very dangerous distraction in the fight against HIV (11/03/12) • Medics criticize report against male circumcision(7/3/12) • Punitive laws blocking Uganda’s successful HIV/Aids responses(02/12/11) 

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