Aurélie BONFILS ESTHERAID Project Manager

ESTHERAID: a Sub regional PSM Program mobilizing hospital partnerships

2

GOAL

Initiated by ESTHER, funded by UNITAID, implemented in full cooperation with each country Ministry of Health

Extend the number of patients accessing pediatric and 2nd line ARV in selected TC by strengthening the supply chain and building the health system capacity

gaps identified :• Management of the ART supply-chains not yet proven

efficient• Weak lab and TCC capacity to diagnose (infants, failure),

treat and monitor patients in need of pediatric or 2nd line treatment

• Lack of reliable data to ensure accurate ARV quantifications and forecasts

The reasons behind the project

Low and irrational demand and consumption of pediatrics and 2nd line ARV=> Stock out and expired drugs

% of patients on pediatric ARV

Rational % of patients switched

to 2L

Stock out

Access to early diagnosis & monitoring of viral load and CD4

Rational use + compliance

Accuracy of quantification & ART forecast

OBJECTIVES / STRATEGY

• Reinforce the supply chain

• Optimize the quality of diagnosis, treatment and monitoring of patients

• Improve data collection and analysis

2 TYPES OF EXPERTISE

Hospital expertisemulti-disciplinary teams of experts

Capacity building at treatment center level

ESTHERHQ/ coordinations

Additional consultancyinternational, national consultants

in collaboration with KOLs

Technical workshop (SOPs, guidelines, norms) and

recommendations at central level

National key institutions, MoH & decision makers

Steering Committee

Complementary approach Synergy Sustainability

Hospital Partnership in ESTHERAID● In the North: 14 Hospitals involved in the project.● In the South: 57 health facilities as

partners + each country National Reference Lab.

5 partner countries57 treatment centers

Range of hospital partnership

• Capacity building : on site and workshop trainings, tutoring, seminars (HIV care, therapeutic failure, pediatric,..)

• Internships in hospital• Technical training in

laboratories

• Therapeutic committee• National guidelines • Supervision• Treatment education,

dispensing

Objective: Improve healthcare provision by optimizing the quality of diagnosis, therapy and patients monitoring

Activities

Hospital partners interventions since 2011

Hospital partners profile:Doctors - Infectiologists - Paediatricians - GynecologistsBiologists - Virologists – Laboratory technicians -Pharmacists - Nurses

BENIN CAR BURKINA FASO

•Support to PMTCT •HIV PCR development •Paediatric Seminars •Trainings on management of virological failures

•Laboratory strengthening •Companionship for paediatric care

•Organization of collection and transport of VLT samples•Training through tutoring• Management of Treatment Committees

CONCLUSION

• Hospital expertise and additional technical assistance can be mobilized in a complementary way

• hospital to hospital & on overall health system • capacity building at hospital level + strategy and

recommendations at central level• ITA provides a comparative and brings resourceful “south” public

health expertise • Hospital expertise brings legitimacy, trust and continuance with

long lasting partnership

• Limitations: articulation between types of expertise, limited communication and availability of hospital partners between field missions

Acknowledgements to ESTHERAID teams

• Focal point Pharmacy: P. Doo-Kingué• Focal point M&E: C. Barberousse, B. Bassirou• Focal point PSS: M. Dieng, M. Touré, M. Dossou-Yvo• Focal point trainings: A. Beugny• Focal point UNITAID & Project coordinator: A.

Bonfils

Bénin Burkina Faso Mali Cameroon CAR

A. LaurentS. OgouL. PourteauM. NintoungbeC. Leger

O. TerzoloG. OuedraogoA. TraoreI. SondeA. Masali

D. FofanaI. MaigaH.OuedraogoL. Gressier

C. ComitiJ. MottoC. MimbangC. Leger

S. PerrotA. NaissemA. BackoX. Gillette