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Overview of ESTHER model: Status and perspectives. Dr Gilles Raguin Director www.esther.fr . ESTHER is a public operator . Ministry of Health in Partner countries. Capacity building Training Lab support PSM M and E Psycho -social support. PARTNERSHIPS. HOSPITALS AND
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Overview of ESTHER model:Status and perspectives Dr Gilles Raguin Director www.esther.fr IAS, july 2012
ESTHER is a public operator Ministry of Health in Partner countries • Capacity building • Training • Lab support • PSM • M and E • Psycho -social support PARTNERSHIPS HOSPITALS AND CBOS IN PARTNER COUNTRIES FRENCH HOSPITALS IAS, july 2012
19 partner countries 15 in Africa Bénin Burkina Faso Burundi Cameroun Côte d’Ivoire Gabon Ghana Libéria Maroc Mali Niger RCA Sénégal Tchad Togo 3 in Asia Cambodge Laos Vietnam 1 in the Carribean : Haïti IAS, july 2012
173 sites supported by ESTHER in 2011 IAS, july 2012
RESULTS 2011 (1): 158.000 PVVIH on ART IAS, july 2012
RESULTS 2010 (2) for 113 367 pts(2011 results pending) 143 sites in 17 countries assessed Response rate: 79% IAS, july 2012
RESULTS (3) IAS, july 2012
Training: a priority in order to mitigate the HealthHumanresourcescrisis En 2011, 4400 health providers trained IAS, july 2012
Psychosocial support: a know how and a priority for ESTHER 855 counselors and community health workers trained 132 partner CBOs IAS, july 2012
Main mode of intervention: hospitalpartnerships • 46 french hospitalsinvolved 2011 : French caribean hospitals IAS, july 2012
Types of expertise mobilized Doctors (77%) Nurses, midwives and labtechs (15%) IAS, july 2012
HospitalTwinnings in 2012: limits and perspectives • Capacities limited by financial crisis and health reforms • New modes of intervention linked to external funding (UNITAID/AFD/GF) w specific TORs (52%) • New strategies and objectives: Health system strengthening, MCH (MDGs 4 and 5), patient safety, more operational research IAS, july 2012
FOCUS 1 : Mother and child 2010 35 reference maternities in 12 countries • 12 000 pregnant women with PMTCT • 4 000 neonates with early infant diagnosis
FOCUS 2 : Laboratorystrengthening In 2010, 88laboratoriessupported by ESTHER In 17 countries ? -Imrproveaccess to innovative technologies for VLT: OPPERA project (UNITAID) -Strengthenlab networks IAS, july 2012
FOCUS 3 : Key populations Prisoners in Côte d’Ivoire IDUs in Dakar ? MSM in CAR -Discrimination still major -MSM and IDUs in Africa: the hiddenepidemic IAS, july 2012
Conclusion • Hospital partnerships is the backbone of ESTHER programs (solidarity and expertise) • However, evolutions are ongoing to adapt to new constraints and new fundings • Strategy 2012-2014 • 1/ Move from a site approach to a national approach, aligned on national strategies and a bilateral-multiteral approach • 2/ Move from a vertical, disease based approach, to a more transversal approach: health system strenthening IAS, july 2012
aknowledgements • To the 28 ESTHER staff members at the headquarters and 73 local staff in countries • To all hospital and CBOs partners in french hospitals and partner countries • To the technical and financial partners IAS, july 2012