CHAZ Partnering in the National Response to PMTCT

CHAZ Partnering in the National Response to PMTCT Dr. Dhally Menda MD, MPH, MBA Director of Health Programmes UNAIDS Conference Cresta Golf View Hotel, Lusaka 28 th February 2013 www. chazhealth. zm. org Churches Health Association of Zambia

Content 1. CHAZ Background 2. Current Situation of the Mother Baby Pair 3. CHAZ Partnership in National PMTCT Response “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

CHAZ Background Information Formation & Membership • Formed in 1970 ( Catholic and Protestant Medical Committees) • Interdenominational (Catholic and Protestant) umbrella organisation for 147 CHIS in 10 Provinces : • • 36 Hospitals & 81 RHCs & 9 Training Schools 29 CBOs: 20 Community Based Programmes & 9 Catholic Dioceses Health Services Coverage • CHAZ is the second largest provider of health services in Zambia. • Mo. U with the Mo. H: 75% Grant- Staff Secondment – Essential Drugs Principal Recipient Status • PR for the Global Fund Mechanism in Zambia for all the 3 disease components: HIV/AIDS (including ART), Malaria & TB. • PR for the PEPFAR –CDC HIV Prevention and Treatment Grant. “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

You failed her… Grandmother in Kanyanga RHC 2008 “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She lived 10 Km away from the Clinic “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She attended only 1 ANC Visit… 19%: ANC in 1 st Trimester All data: ZDHS 2007 “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She tested HIV + 16% HIV Prevalence in Women “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She delivered at home Rural: 67. 2% Deliver at Home “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She bled to death in the oxcart… on our way to the clinic Hemorrhage: 25% of Maternal Mortality MMR: 591/10, 000 – 42% during child birth Life Expectancy: 52 years in 2010 “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

She left me a gift… An HIV infected baby… U 5 M: 119/1, 000 Post Natal Mortality: 36/1, 000 “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

Her last words… “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

“Mum, tell the people listening to this presentation: “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

“No HIV+ Woman should Die… No Child should be infected with HIV…” “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

You failed me… my daughter… my grand daughter…. Delay no more… Act Now! “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

SUPPLY Left Out Drop Outs Adherence QUALITY DEMAND CHAZ Partnership in National PMTCT Response “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

They called me: “HIV Exposed baby” I was born at Mpongwe Mission Hospital… Now I have a Name … I am HIV negative “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

Why me? CHAZ, help me answer this question… You are not the only one! 92% of your friends on the CHAZ Programme are also negative “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

Supply of PMTCT Services We provide integrated comprehensive PMTCT Services (Static & Mobile) in hard to reach Place… 63 PMTCT Sites - The 4 Prongs of PMTCT

We strengthen Health Facilities and Communities System We offer Holistic Family Centered Services

CHAZ AIDS Programme Started In Churches: HBC-OVC Support At CHAZ: Advocacy-HBC-OVC DCA –DANIDA CACPP 1993 -2004: 11 Years STI-OVC-IGA-Nutrition – Prevention +Condoms EU -LCCB 2003 -2006: 3 Years GF – HIV Prevention 2003 -2008: 5 Years 1984 1986 1 st HIV Case 2005 1993 2007 2010 2011 2003 DCA/DANIDA - FCCT 2005 -2006: 2 Years GF – ART 2005 - to date JFA DCA-EKN-IA-C- Denmark– HIV Prevention 2007 to date GF – HIV Prevention 2010 - to date 27 years in complementing Government’s efforts in HIV & AIDS Programming Funded by several Partners PEPFAR-CDCPrevention - ART 2011 - to date

CHAZ PMTCT Services No. Women receiving ARV Prophylaxis No. Babies Receiving ARVs Prophylaxis 4138 3849 3179 1910 1749 1024 448 Y 2007 1801 904 618 Y 2009 • Sensitize Chiefs & Champions • Maternity Waiting Homes • Performance Based Financing Y 2010 Y 2011 • Mothers’ Support Groups • ASWs : defaulter Tracing • Men Taking Action: ANC, Couple Counseling CHAZ Database “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

PMTCT Services Demand Creation My Mother underwent a traditional Marriage Counseling with an improved Curriculum including PMTCT We Create demand for PMTCT Services at all levels, using Opinion Leaders, HWs and CBHWs “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

PMTCT Services Quality My sister and I were born at Mpongwe Mission Hospital, from an HIV positive mother… We are HIV Negative… We participate (TWGs) in the: National Policies, Standards, Guidelines and Regulations Development & Implementation

At Mpongwe Mission Hospital they cared for me with compassion and accompanied me through out my pregnancy We Advocate, Mobilize Resources and Allocate Finance We ensure good Leadership & Governance

I exclusively breastfeed and our child is HIV negative. A Safe Motherhood Action Group Member is visiting us every day We encourage Task Shifting for HWs & CBHWs We advocate for paid CBHWs

My twins’ tested negative with the PCR Test… We never experienced any stock out of ARVs. We supplement the National Supply Chain Operations for Medical & Non Medical Products

My husband I are strong members of the Village “Post Test Club” and explain to couples to benefits of PMTCT Services We Strengthen Communities Capacity, Networks and Support Groups To increase their PMTCT Services ownership

We provide: Technical Support, M&E and Mentoring - Joint Annual Reviews, etc…

I am a Trans Out and my records are properly kept at the hospital We develop Data Collection Tools and Reporting format for Health Facilities and Communities, in line with the National System

Acknowledgement • • Community Members and Leaders Mo. H Mo. CDMCH Cooperating Partners CHAZ Board CHAZ Management CHAZ Staff Stakeholders “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2

We Thank You Let your Yes be Yes God Bless You “He sent them to preach the Kingdom of God and heal the sick” Luke 9: 2