Saving Lives and Achieving the President’s Emergency Plan for AIDS Relief Goals in Ethiopia
The accomplishments of the HIV/AIDS Care and Support Program (HCSP) in Ethiopia have greatly exceeded expectations. Considering the program’s goal of reaching 260,000 people with prevention services after reaching more than three and a half times that many in one year and the program’s successful expansion of treatment, it has already surpassed its major objectives. More than 1,400 outreach workers have been trained in community and household HIV prevention, care, and treatment, contributing to the nearly 1 million individuals who have been counseled and tested for HIV in the past year. Nearly 400 health centers and more than 1,400 health providers offer comprehensive HIV and tuberculosis counseling and testing services. More than 250 woreda (district health offices) are supported with an HIV/AIDS service plan. Ethiopia has long struggled with poverty, disease, and illness. In 2003, more than 1.5 million people were living with AIDS, and few had sufficient access to proper care. Five years later, however, HIV prevalence in the nation has decreased dramatically. Nearly 250 health centers now offer antiretroviral (ART) treatment, and thousands more health workers are trained in HIV/AIDS prevention, care, and treatment. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), USAID has invested millions of dollars in the largest national expansion of HIV/AIDS services at the health center level in Africa, and MSH has helped Ethiopia achieve notable successes. PEPFAR, MSH, and the Government of Ethiopia created HCSP in 2007 to work with public and private partners in the region to avert morbidity and mortality of people affected by HIV/AIDS and improve their quality of life. In five regions—Amhara; Addis Ababa; Oromiya; Tigray; and Southern Nations, Nationalities, and People’s Region—the project is:
- providing comprehensive, high-quality, and integrated HIV/AIDS prevention, care, and treatment services at health centers;
- deploying community outreach workers to support family-focused prevention, care, and treatment;
- training case managers to support care and to strengthen referrals and the ART therapy network among health centers, hospitals, and community services;
- implementing HIV/AIDS prevention activities, using best practices that address issues of stigma, discrimination, and gender;
- increasing the capacity of organizations—nongovernmental, community based, and faith based—to provide care and support services to those infected and affected by HIV/AIDS.
To carry out a multifaceted, multisectoral approach to achieving PEPFAR’s goals in the region, MSH and the Government of Ethiopia developed three strategies. First, a results-oriented strategic framework includes scaling up prevention, expanding access to services at the facility and community levels, and strengthening health systems and the ART network. The second strategy puts the family at the center of all activities. Families are supported by community- and faith-based organizations and coordinated by outreach workers who refer patients to services at health posts, health centers, or hospitals. These facilities are supported by a network of public and private institutions. The third strategy, performance-based contracting, involves a variety of private and public institutions at all levels throughout the country in the rapid scale-up of services.