Prevention Organizational Systems AIDS Care and Treatment (ProACT)

 {Photo credit: MSH staff.}MSH staff at IAS2015 included: Dr. Ndulue Nwokedi, Deputy Project Director, Pro-ACT; Dr. Ginika Egesimba, Senior Clinical Advisor, TB/HIV, Pro-ACT; Emmanuel Nfor, Principal Technical Advisor, SIAPS; Dr. Andrew Etsetowaghan, Clinical Advisor, PMTCT, Pro-ACT.Photo credit: MSH staff.

Management Sciences for Health (MSH) presented seven abstracts at the 8th International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) in Vancouver, Canada, July 19-22, 2015.

{Photo credit: Maeghan Orton/Medic Mobile}Photo credit: Maeghan Orton/Medic Mobile

For more than a decade, health teams in over 40 countries have improved their performance using MSH’s Leadership Development Program (LDP) and the latest version, Leadership Development Program Plus (LDP+), which improves public health impact and scale-up. During the same period, there has been a tremendous expansion of information and communication technologies (ICTs) in health and mHealth interventions, particularly using mobile devices. This past year, two MSH-led projects—the Prevention Organizational Systems AIDS Care and Treatment (Pro-ACT) project in Nigeria and The Leadership, Management & Governance (LMG) Project—collaborated with LMG partner Medic Mobile to pair the LDP+ with a mobile application to systematically capture, collate, and report LDP+ results in near-real-time.

Rabi giving a public awareness lecture on HIV in her locality. {Photo credit: MSH, Nigeria.}Photo credit: MSH, Nigeria.

Rabi gives a public awareness lecture on HIV. (Photo credit: MSH, Nigeria)

Forty-year old Rabi Suleiman lives in Koko Besse area in Kebbi state, Nigeria. She is married without children. Rabi, who now lives with her third husband, recalls that her ordeal with illness and social ostracism began in 2009. Rabi’s three marriages were the result of her inability to conceive, and a continuous search for a partner with whom she could successfully bear children. In the course of her marriages she contracted HIV.

Weakened by continuous infections and emaciated beyond recognition, Rabi recalls that she was abandoned, equated to animal status and locked up in a hut meant for cattle in her family home. Her meals were pushed to her through a door opening by relations who refused to look her in the face.

Today, Rabi has a new story to tell. With the assistance of the Prevention Organizational Systems AIDS Care and Treatment (ProACT) project outreach team, Rabi was enrolled with the USAID-supported ProACT antiretroviral therapy (ART) program in the General Hospital, Koko, late in 2009.

Yambayoh Magaji (right), a student laboratory technician, works with Garkida General Hospital's HIV Laboratory Focal Person Dahiru Sabo. {Photo credit: MSH.}Photo credit: MSH.

The USAID-supported Prevention Organizational Systems AIDS Care and Treatment (ProACT) project provides HIV & AIDS services to five sites in Adamawa State, Nigeria.

The greatest challenge for ProACT Adamawa has been the fragile health system, particularly in terms of human resources for health (HRH), one of the six building blocks of the health system. The inadequate health workforce in the laboratory affects other components of the health systems, such as: 1) medicines, vaccines and technology, 2) information, 3) governance and leadership, 4) health financing, and 5) service delivery.

The situation in Adamawa was such that one or two laboratory staff members did all the work in the laboratory, including phlebotomy, chemistry, hematology, immunology, malaria and tuberculosis (TB) microscopy. On average, there was a patient/staff ratio of 40:1 on clinic days. This situation applied to all the sites with regard to health workforce in the laboratories.

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