ICAP News - August 2007

HIV/AIDS Programs Reach Rural Tanzania
Fast-Track Initiative Brings Services to Those in Urgent Need

After only two months, the Chalinze Health Center in Tanzania’s Pwani Region has already enrolled 117 patients in HIV care and initiated 41 patients on antiretroviral treatment. The effort is part of a decentralization initiative supported by the Tanzania Ministry of Health and Social Welfare to provide HIV/AIDS services at rural healthcare facilities.

Using a “fast-track approach,” ICAP works directly with staff at health centers to help them identify their needs for the initiation of HIV/AIDS programs. Based on this assessment, ICAP provides rapid and intensive support, including clinical training and mentorship, renovating facilities, procuring equipment and supplies, and establishing systems to support laboratory services and data collection.

“The introduction of antiretroviral treatment services at our centre–thanks to ICAP’s support–has made life easier for our people,” says Dr. Waziri Mkuwiri, a doctor at Chalinze Health Center. “We have seen more people coming for HIV testing and services. Now, we can assure them that they will receive care and treatment, should they found to be HIV positive.”

Before Chalinze Health Center began providing HIV/AIDS services, Dr. Mkuwiri referred his patients to Tumbi Hospital at a distance of more than 60 km. from the health center. Approximately 300,000 people live in the seven villages around Chalinze Health Center. The area has one of Tanzania’s highest HIV seroprevalence rates at 28 percent.

Decentralization of HIV/AIDS services is an important priority for ICAP in its work in Africa. Similar efforts are taking place in Rwanda, Mozambique, South Africa, and Kenya, among other countries

Photo caption: ICAP data manager Clement Marcel (left) and ICAP Program Officer Dr. Goodluck Mwakitosha (right) consult with Chalinze Health Center Nurse Midwifes-Prevention of Mother-to-Child Transmission of HIV Amida Luamba (center) and Beata Mchopa (seated).
For more about ICAP Tanzania , visit here.

Pilot Program for HIV Care and Treatment of Prisoners Initiated in Rwanda
ICAP has joined with the National Treatment and Research AIDS Center (TRAC) in its efforts to pilot multidisciplinary HIV/AIDS care and treatment programs at Gisenyi and Kigali Central Prisons. The pilot program, launched on April 17 by Dr. Agnes Binagwaho, Executive Secretary of Tanzania's National AIDS Commission, is part of a national initiative to establish HIV/AIDS services at all 12 Rwandan central prisons, which house an estimated 52,000 people.

The prison initiative assists prison clinical staff in building needed services. The approach emphasizes a holistic approach to care and treatment delivered by multidisciplinary teams of providers, including social workers, physicians, nurses, laboratory technicians, and monitoring and evaluation officers.

Results and lessons learned from the pilot programs at Gisenyi and Kigali Central Prisons are expected to inform the scale up of HIV/AIDS care and treatment programs at other prisons throughout Rwanda.

Photo caption: At the April 17 launch of HIV/AIDS services at Kigali Central Prison, Dr. Agnes Binagwaho, Executive Secretary of the National AIDS Commission, provides a prisoner with antiretroviral therapy.
For more about ICAP Rwanda , visit here.

Unified Reporting System to Inform Program Design and Quality Improvement
A new web-based unified reporting system (URS) has been launched by ICAP’s Monitoring, Evaluation, and Research Unit. The system, which provides comprehensive information about ICAP-supported sites, integrates reporting data from a variety of sources, including patient enrollment, clinical staffing levels, and funding sources, among others. Data can also be layered on interactive maps, indicating the precise locations of sites and enabling the generation of needed reports.

The URS will enable both ICAP and site-level staff to use data regularly for monitoring their progress, informing programmatic design, and enhancing the quality of services provided. It will also enable the correlation of site-level characteristics with patient outcomes. ICAP developed the URS in collaboration with the Center for International Earth Science Information at the Columbia University Earth Institute. For more information about the system, email mt781@columbia.edu.

Ministry of Health Official Praises ICAP for its Support of Care and Treatment Services in Rural Tanzania
At a July 5 ceremony to mark the opening of ICAP’s new offices in Dar es Salaam, Dr. Bwijo Bwijo, head of the Treatment and Care Unit of Tanzania’s Ministry of Health and Social Welfare (MOHSW) National AIDS Control Programme (NACP), praised ICAP for its support of expansion of HIV/AIDS programs in Tanzania, particularly in the country’s rural regions.

“You have expanded your services in a short period of existence, going farther to those areas [in Kagera and Kigoma] hosting refugees,” said Dr. Bwijo. “This, I must say, has earned you credits to the government.”

Since 2004, ICAP has collaborated with the MOHSW to build broad capacity at
national and site levels in support of the government’s HIV/AIDS care and treatment plan. Among many activities, ICAP is supporting the decentralization of HIV/AIDS services to rural healthcare facilities (see related story) as well as the government’s initiative to get four million Tanzanians tested for HIV. ICAP also plans to expand its activities to 28 districts in four Tanzania regions.

At the opening ceremony, ICAP Country Director Amy Cunningham credited ICAP’s success to strong partnerships with the government and other organizations.

Photo caption: ICAP Director Wafaa El-Sadr (left) greets Dr. Bwijo Bwijo. At center is ICAP-Tanzania Country Director Amy Cunningham.
For more about ICAP Tanzania , visit here.

Volunteers Assist in Bringing Defaulted Patients Back to Care and Treatment Programs in Nigeria
Transportation is an impediment for many patients enrolled in HIV/AIDS care and treatment programs. Distances to these programs combined with transportation costs make it different for some patients to regularly attend their clinic appointments and may even lead them to abandon their care.
Recently, ICAP Nigeria initiated an innovative program in Ogoja, Cross River State, that recruits and trains volunteers from community-based organizations to escort these patients back to their service sites. To date, 11 volunteers have escorted 50 patients back into care and treatment. ICAP plans to support similar programs at other ICAP-supported site in Nigeria.

For more about ICAP Nigeria , visit here.

Lesotho Training Focuses on Addressing Challenges to Implementation of MTCT-Plus Services
In July, ICAP Lesotho supported the first comprehensive MTCT-Plus training for 35 multidisciplinary teams of healthcare providers at Mafeteng Hospital and its four health centers. The training, which ICAP facilitated in collaboration with the Elizabeth Glaser Pediatric AIDS Foundation, addressed challenges to the smooth implementation of prevention of mother-to-child transmission (PMTCT) of HIV services. ICAP will continue to work with the providers to build their capacity for delivering MTCT-Plus and HIV/AIDS services.

Photo caption: Healthcare providers from Mafeteng Hospital participate in the MTCT-Plus training workshop.
For more about ICAP Lesotho , visit here.

El-Sadr Honored by National Medical Association, Named Ambassador for the Paul G. Rogers Society
On Aug. 4, the National Medical Association (NMA) honored ICAP Director Wafaa El-Sadr, MD, MPH, with the Scroll of Merit Award at its 2007 Annual Convention and Scientific Assembly. The NMA award recognizes individuals or groups for their contributions to improving health care in the United States, particularly for African Americans. El-Sadr was recognized for her decades of work in the Harlem community and, more recently, in Africa.

El-Sadr was also recently named one of 23 new ambassadors for the Paul G. Rogers Society. Among the nation’s global health experts, Society Ambassadors aim to promote United States investment in global health research.
is professor of clinical medicine and epidemiology at the Columbia University Mailman School of Public Health and chief of the Division of Infectious Diseases at Harlem Hospital Center.