Community Perspectives on

HIV Control in Rwanda

Kigali INTEREST Workshop, May 2018

Geraldine UmutesiDeputy Director GeneralImbuto Foundation

Rwanda Health System Pyramid to support community service delivery

RBC, IHDPC Report, 2011

ART sites (98%)

VCT sites (98%)

PMTCT sites (98%)

Community access to HIV services in Rwanda

HIV services coverage in Rwanda, 2018

Community Based Interventions

Ministry of Health & Gov. institutions

Define National Policy & Guidelines

Coordinate National Program Implementation

Partners in HIV Response

Provide technical & Financial support

Contribute to the development of thenational guidelines & Strategies

Civil Society

Support Community HIV Programimplementation

Contribute to the development of thenational guidelines & Strategies

Associations of PLHIV

Provide Peer Adherence Support

Contribute to the development of thenational guidelines & Strategies

HIV Response

Working with Civil Society Organizations and Non-health Sector Institutions

RRP+ Package & Reach

Positive living with

HIV

Prevention

Care & Treatment

Social impact

Advocacy

• More than 120.000 members of which 68% are females and 32% are males. 89% of all members is HIV+. 11% is affected by HIV. (Source: RRP+ annual report 2017)

• The members are grouped according to their level of registration from sector level to national level (associations, cooperatives and NGOs), active in all districts across the country.

• PLHIV are mobilized to actively participate in the HIV response and encouraged to form cooperatives to support their livelihoods.

Community Health Workers

Drivers of Universal coverage

• Established in 1995

• There are 3 CHWs per village

• Roles:

➢ increasing uptake of essential maternal

and child clinical services

➢ follow up and linkages to health services

➢ Encourage pregnant women to attend

the 4 ANC visits,

➢ Encouraging them to test for HIV and

closely following up on drop out cases.

➢ Bringing to health facility presumptive TB cases

This has contributed to 50% decline of new HIV

infections in Rwanda.

Community Health Workers

Imbuto Foundation

E3 : Engage, Educate, Empower

Background

• Established as Protection and Care of Families against HIV/AIDS (PACFA) to respond to

the severe epidemic affecting the Rwandan society.

• In 2007 PACFA had embraced more programmes and changed its name to Imbuto

Foundation.

• Implements over 16 projects in health, education, youth and economic empowerment in

all 5 Provinces of the country.

• Over the past years, close to 400,000 young people were sensitized to be voluntarily

tested for HIV.

• Over 6,000 peer educators were trained in disseminating adolescent sexual reproductive

health, prevention and treatment of HIV&AIDS, treatment and positive living.

• Our Family Package Project supported to PPMTCT national Program using Peer

educators and male engagement

ICON PROJECT

ASRH

Family Package

Mountain Movers HIV prevention among young people (15-24)

12 +

CYRWA

Mentorship

RWANDA Speaks

YFS

i-Accelerator

ICON PROJECT

Yale Young African Scholars Program (YYAS)

Early Childhood Development / (ECD&F)

Edified Generation

Kacyiru Community Knowledge Centre

Promotion of Girls Education Campaign

Promotion of Reading Culture

Twige Neza Dutsinde

IMALI

Community Commitments

Mother to Child Transmission decreased from 10.9% to 1.5% ( 2000-2018)

Community Commitment to #EndAdolescentAIDS

HE The First Lady awarding 5 districts That had no child born HIV-positive from their infected mothersIn the last 5 years

Innovative Community HIV awareness Campaigns

HIV Sensitization campaigns on

HIV prevention and treatment

services involving all partners in

HIV response:

• Ministry of Health leadership

• Partners in HIV response

• People living with HIV

• Youth

• Local leaders

• CSO

• NGOs

• Media

• By increasing access to ART in Rwanda, substantial gains in life expectancy among HIV positive individuals was observed.

• Life expectancy gains for patients’ enrollment into HIV care and ART was demonstrated by improved life expectancy on ART.

• Life expectancy in Rwanda at age 20 gained an additional 45 years, a 35% gain in just ten years

• This nation-wide analysis confirms that ART expansion has population-level health gains

Impact of HIV services to the community

Contribute to HIV case findings towards achieving global targets 90-90-90:

• Uptake of HIV testing services including HIV self testing

• Index testing and partner notification

• Sustain Involvement of all levels in HIV response:

- Local leaders - Development Partners - Media - Partners - Civil Society - NGOs

To #Build the Rwanda We want

Murakoze!