Ethiopia: Case Management and Community Networking Increase Adherence to ART

Seid Eshetu, 38, is a father of two children aged 7 and 10, living in Tehuledere Woreda of Amhara, Ethiopia. Seid visited Haik Health Center a year ago because of regular coughing and general weakness. His community-based health extension workers advised him to be tested for HIV.

Seid was shocked to learn that he was HIV positive. However he was comforted when he received posttest counseling and was escorted to the health center’s antiretroviral treatment (ART) clinic, where he was enrolled in chronic care and started ART.

The case manager at Haik Health Center, Ahmed Eshetu, advised Seid to come to the facility with his wife and two children for HIV testing and counseling as well. Seid was filled with mixed feelings when he learned that his wife is HIV positive, too, but greatly relieved to find that his children were negative.

Ahmed Eshetu is a case manager, under the US President’s Emergency Plan for AIDS Relief (PEPFAR) funded USAID program, the Ethiopia Network for HIV/AIDS Treatment, Care and Support (ENHAT-CS), led by Management Sciences for Health (MSH).

When Ahmed was listing patients who had stopped coming for ART, he discovered that Seid had dropped out of care and stopped taking his medications. Ahmed discussed Seid’s case with the health center’s community mobilizer, who tried without success tracing Seid through emergency telephone contacts. The community mobilizer then met with the community based health extension workers and a community outreach volunteer, who found Seid at his home suffering a lower respiratory tract infection and unable to work and support his family. Seid told the community volunteer, “I was healthy. After I stopped ART treatment I became frequently ill and was unable to work.’’

The community mobilizer then contacted Seid and convinced him to return to the health center, where the case manager counseled him on adherence to treatment and convinced him to restart treatment. As a result, Seid regained good health and was able to return to work. Now, Seid stresses that “ART treatment interruption can lead to becoming bedridden, and unable to work and participate in social activities”. He added that “the case manager and community mobilizer are health messengers and our path to a bright future”.

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