1 esther partnerships: a key instrument for decentralisation of hiv care and hss in cameroon jules...
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ESTHER PARTNERSHIPS:A KEY INSTRUMENT FOR
DECENTRALISATION OF HIV CARE AND HSS
IN CAMEROON Jules Motto, ESTHER coordinator in CameroonCaroline Comiti, program manager
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ContentContent
1. CONTEXT & JUSTIFICATION
2. ESTHER LOGIC OF INTERVENTION
3. SOME KEY RESULTS
4. CONCLUSION & RECOMMENDATIONS
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1 - Context & Justification1 - Context & Justification
• Cameroon : ≈ 20 M inhabitants (projections census 2007)
• 4,3 % seroprevalence HIV (HDS 2011)
• Nb de PLHIV: 560 306 (8,5% are children)
• Need of ART : 260 000 PLHIV
• Coverage of global ART: ≈ 106 000 (with 49% are followed within sites supported by ESTHER)
• 24 National / Regional Hospitals (ATC, 13 are tutors) & 178 HD3
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LEVEL OF INTERVENTION OF ESTHER IN CAMEROON
A way forward to Institutionnal Twinning Partnerships
Partnership
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2 - 2 - ESTHER logic of interventionESTHER logic of intervention
1. Access to care and treatment (Paediatric, STI, OI, E-MTCT, ...)
2. Health system strengthening (training of HRH and equipments )
3. Monitoring and evaluation (support to Health information System : ESOPE)
4. Strategic support and project management : central and intermediate level of the MoH (DDC,RHD)
5. Support to key populations5
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C2D/ESTHER: DECENTRALIZATION THROUGH THE TUTORING
2nd generation tutoring
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Other ANC
EPI units CRN/CTN counsellor/Community
ESTHER traditional twinning
National / regional Hospital
Health District Hospital
1st generation Tutoring
Northern Hospital
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IMPLEMENTATION
Since 2002Expertise recognized by MoHToday the whole country is
covered : central, regional et peripheral
levels- 13 tutor hospitals
(national/regional: ATC in the 10 regions
- 10 northern hospitals (8 in France & 2 in Germany)
TOGO
ESTHER TWINNING IN CAMEROONESTHER TWINNING IN CAMEROON
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3 - KEY RESULTS3 - KEY RESULTS
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Scaling up of Scaling up of Decentralization Decentralization through tutoring of care of through tutoring of care of
HIV/AIDS project HIV/AIDS project
Scaling up of Scaling up of Decentralization Decentralization through tutoring of care of through tutoring of care of
HIV/AIDS project HIV/AIDS project
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DISTRIBUTION OF TRAINED HR WITHIN ESTHER SITES
The whole package
The whole package
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4 - Conclusion & recommendations
A. ART Coverage through ATC & tutored HD (49%)
DH/CUCov 49%
DH/CUCov 49%Cov 49%
MCMCCov 10%Cov 10%
HCHCCov Cov
3%3%10
ATCATC twinningtwinningNorthern Hospital Northern Hospital
DEMAND OF THE MOH DEMAND OF THE MOH
HCHCCov 5%Cov 5%
HCHCCov Cov 16%
16%
B. ART Coverage through ATC & tutored HD & tutored
health units (80%)
THE WAY FOWARD … UNIVERSAL ACCESS
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THANKS SO MUCH to You and to our partners & donors
CBO’s inCameroonCBO’s inCameroon
MINSANTEMINSANTECAMEROUN FRANCE
Région de l’Adamaoua : HR NgaoundéréRégion du Centre HCY- HGY -CH ESSOSRégion de l’Est : HR BertouaRégion de l’Extrême Nord : HR MarouaRégion Littoral : H G. DoualaRégion Littoral : H Laquintinie DoualaRégion Nord : HR GarouaRégion Ouest : HR BafoussamRégion Sud : HR Ebolowa
Hospices civils de LyonCHU Montpellier + TrousseauCHU CreilCHU DijonAPHP TenonHU StrasbourgCHU NancyCHIC CréteilHU Strasbourg
CAMEROUN ALLEMAGNERégion Sud Ouest : HR Limbe
Région Nord Ouest : HR Bamenda
HU RostockESTHER AllemagneHU HambourgESTHER Allemagne
The hospitals partners