[fusion_builder_container hundred_percent=”no” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” overlay_color=”” video_preview_image=”” border_size=”” border_color=”” border_style=”solid” padding_top=”” padding_bottom=”” padding_left=”” padding_right=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” border_position=”all” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” center_content=”no” last=”no” min_height=”” hover_type=”none” link=””][fusion_title margin_top=”” margin_bottom=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” size=”4″ content_align=”left” style_type=”none” sep_color=””]
A Progress Report on the ACTION Plus Up Project in Ondo and Ekiti States
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EHAI, is a sub-awardee to the Institute of Human Virology, Nigeria (IHVN) on the PEPFAR funded Centre for Disease Control and Prevention (CDC) 5 year (2012 – 2017) grant award GGH000925. The grant is targeted at implementing IHVN’s AIDS Care and Treatment in Nigeria Plus Up (ACTION Plus Up) project in Ondo and Ekiti States, Southwest Nigeria. The project entails supporting the State Ministries of Health, the State Agencies for the Control of AIDS (SACA) as well as the State Primary Health Care Development Agency with the provision of sustainable high quality and free HIV prevention care and treatment as well as health system strengthening services in every local government area covering primary, secondary, tertiary as well as faith based and private health facilities.On the project in Ondo and Ekiti States, Equitable Health Access Initiative (EHAI)presentlysupports sixty-eight (68) health facilities (30 sites in Ekiti and 38 sites in Ondo). All 68-health facilities provide comprehensive PMTCT programs, while 31 of them provide Adult and Paediatric ART services.
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Targeting total elimination: Prevention of Mother-To-Child Transmission (PMTCT) of HIV
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With an estimated 230,000 HIV-positive pregnant women in Nigeria who are at risk of infecting their babies in the absence of adequate care, providing support for national public health programming therefore has become very pertinent. The Government of Nigeria (GoN), in collaboration with a range of partners including the CDC, is coordinating an aggressive response by scaling up prevention of maternal-to-child transmission (PMTCT) programmes. Since it is a known fact that transmission from mother to child can occur at pregnancy, during labour and during breastfeeding, it is important to pay attention to these stages. Of every 100 infants born to HIV-infected women who breastfeed, without any interventions; between 25% and 40% get infected with HIV. There are however four (4) comprehensive approaches or elements to prevent HIVinfection in infants and young adults;
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Element 1: Primary prevention of HIV infection
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Element 2: Prevention of unintended pregnanciesamong women infected with HIV
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Element 3: Prevention of HIV transmission from women infected with HIV to their infants
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Element 4: Provision of treatment, care, and supportto women infected with HIV, their infantsand their families
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EHAI has been able to ensure PMTCT services are available in all of the 16 and 18 LGAs in Ekiti and Ondo States respectively. The 3 year data (2012 – 2015) of it is in the drive towards eliminating MTCT of HIV can be found in the Table 1 below:
[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_2″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_imageframe image_id=”13660″ style_type=”none” stylecolor=”” hover_type=”none” bordersize=”” bordercolor=”” borderradius=”” align=”none” lightbox=”no” gallery_id=”” lightbox_image=”” alt=”” link=”” linktarget=”_self” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]https://www.ehainigeria.org/wp-content/uploads/2017/11/inching-ever-closer-to-Zero.jpg[/fusion_imageframe][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_2″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container hundred_percent=”no” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”” padding_right=”” padding_bottom=”” padding_left=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_text]
Closing the gap through Early Infant Diagnosis (EID)
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More than half of all infants born to HIV+ mothers in Nigeria may die before they reach age two (2) if not treated early. For these children, early infant diagnosis (EID) and immediate treatment with appropriate antiretroviral therapy (ART) are very important. The World Health Organisation (WHO) reports that despite a dramatic eight-fold increase in early infant diagnosis across sub-Saharan Africa since 2006, the 2009 Children and AIDS: Fourth Stock Taking Report showed that almost 50% of infants tested for HIV never receive their test results.
During this period (October 2012 – September 2015), EHAI has successfully achieved up to 93.4% (on the average) EID coverage for exposed babies getting tested and receiving their results at the end of this period from the 63% previously achieved. This is keeping in line with the 2010-2015 rapid expansion plan for Nigeria that at least 90% of all exposed babies must have EID done and must also receive their results. The Percentage of HIV+ infants placed on appropriate ARV has remained 100%. The gaps noted between exposed infants and those who get tested have continued to reduce. Many of the figures reported have been attributed to loss-to-follow-up or mothers not returning to access care at the facility. EHAI has also been able to drastically and progressively reduce the rate of vertical transmission on the program to less than 6%. This is expected to progressively reduce to 0% over the next few years based on the current strategic interventions aimed at challenging the status quo and improving quality and efficiency of service delivery at the supported health facilities.
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Reaching the Unreached: HIV counseling and Testing (HCT)
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With the rising numbers of HIV+ individuals, the Provider Initiated Testing and Counseling (PITC) was introduced with strict compliance to confidentiality of the individuals. The outcome: many individuals who test positive to HIV are promptly provided with care starting with appropriate referral. In Ekiti State, for the period October 2012 – September 2015, a total of 186,920 persons were screened either at the facilities or at special outreaches to communities. Of this figure, 3,783 tested positive constituting 2.02% of all those tested. In Ondo States, during the same period, a total of 242,544 were screened and 9,598 tested positive making 3.96% of all screened. Of the entire numbers screened for both states, percent of those who tested positive averaged 3.12%.
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Innovating for Healthier Lives: Pediatric and Adult ART
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The cascade of HIV care, treatment and prevention servicesis integrated with provision of antiretroviral drugs used for treating people living with HIV as well as for preventing HIV transmission. Despite national commitment to achieve universal access to HIV/AIDS services by 2010, coverage for ART is estimated to be 23% for adults and 10% for children in 2009, with wide variability in access and quality across the country, EHAI has been able to achieve 100% coverage for ART services in all 16 LGAs in Ekiti State and 18 LGAs in Ondo State.
ART services are delivered within the chronic care model, which puts increased emphasis on the role of communities and individuals in improving health outcomes.
An outcome oriented Continuous Quality Improvement (CQI) strategy is put in place to ensure the continued provision of quality HIV intervention services in all EHAI supported primary, secondary and tertiary facilities. EHAI staff work in collaboration with health care providers and managers at all levels of the health system (including leadership / governance level) to build capacity base on the CQI assessment and interventions. A family-centred approach to care is adopted at all sites to ensure mothers (and their partners) who test positive bring their children for testing, care and treatment as the case may be.
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Human Resources for Health (HRH) Intervention – Capacity Building for High Quality and Sustainable Services
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Over these years of operation, EHAI has continued to support the Government of Nigeria (GoN) in her states of implementation to reduce the burden of HIV/AIDS by building sustainable capacity among health care workers in Ekiti and Ondo States to deliver high-quality and sustainable comprehensive HIVprevention, care, treatment, and related services.
[/fusion_text][fusion_imageframe image_id=”13663″ style_type=”none” stylecolor=”” hover_type=”none” bordersize=”” bordercolor=”” borderradius=”” align=”none” lightbox=”no” gallery_id=”” lightbox_image=”” alt=”” link=”” linktarget=”_self” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]https://www.ehainigeria.org/wp-content/uploads/2017/11/inching-ever-closer-to-Zero4.jpg[/fusion_imageframe][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_2″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_button link=”https://www.ehainigeria.org/wp-content/uploads/2017/11/Inching-ever-closer-to-Zero.pdf” title=”” target=”_blank” link_attributes=”” alignment=”center” modal=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” color=”custom” button_gradient_top_color=”#f41000″ button_gradient_bottom_color=”#f41000″ button_gradient_top_color_hover=”#f41000″ button_gradient_bottom_color_hover=”#f41000″ accent_color=”” accent_hover_color=”” type=”3d” bevel_color=”#f41000″ border_width=”” size=”” stretch=”default” shape=”pill” icon=”fa-download” icon_position=”left” icon_divider=”no” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]DOWNLOAD PDF[/fusion_button][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
