HIV Free Southwest and Northwest Project, Cameroon
In 2011, the Cameroon Baptist Convention Health Board (CBCHB), following a successful project proposal, began receiving funds from the U.S President’s Emergency Plan For AIDS Relief (PEPFAR) through Centre for Diseases Control and Prevention (CDC) in Atlanta to implement and support Prevention of Mother To Child Transmission (PMTCT) services of HIV in two of Cameroon’s ten regions-Southwest (SW) and Northwest (NW) for a five-year period. Not only this is the first PEPFAR grant ever made in Cameroon, the CBCHB also happens to be the first Faith based healthcare organization to receive a PEPFAR funding award.
To effectively implement this major grant, CBCHB is working in a consortium with the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the Clinton Health Access Initiative (CHAI) who are both global technical leaders in PMTCT and in PMTCT commodity supply chain management respectively.
The HIV-Free Project seeks to “Expand the coverage and improve the quality of facility and community-based PMTCT services of HIV” and has seven objectives.
The strategy adopted by CBCHB and partners align well with PEPFAR’s focus on prevention of mother to child HIV transmission (PMTCT) and linkages to care and treatment as well as with the national PMTCT program.
The project is helping Cameroon’s MOH through the CBCHB to build capacities of service providers to initiate and strengthen the delivery of PMTCT, Care and Treatment, Pediatric care and other essential services. Evidence based as well as innovative approaches and strategies are being implemented to improve access, uptake and adherence to critical services and improve treatment outcomes. The grant is revolutionizing our Drug Transport and Sample transport Systems and the Southwest EID Laboratory thus enhancing treatment for both adult and children.
AREAS OF INTERVENTION
PMTCT of HIV is the main focus of this project. We emphasize and promote early uptake of antenatal care clinic by pregnant women as a major entry point to PMTCT. We are equally rolling out a series of training programs to further improve the knowledge and skill set of various healthcare providers including in the area of documentation and reporting. As we improve testing and treatment uptake and adherence for HIV positive pregnant women and their exposed partners, similar efforts are also made to improve early infant diagnosis and treatment for infants. Together with MOH, we are ensuring that drugs and other essential commodities are readily available in the Regional Drug stores and at sites. The project is also intensifying advocacy and partnership building at all levels to strengthen the health system
PMTCT Option B+ pilot
In 2013, the CBCHB conducted a PMTCT option B+ pilot as a subsidiary component of the HIV-Free SW and NW project. The successful implementation of this pilot then led to the government of Cameroon’s adoption of this more efficacious WHO PMTCT protocol for implementation in the country following CBCHB findings.
The B+ Pilot conducted by the CBCHB was conducted in 22 sites (12 in the Bamenda Health District and 10 in Kumba Health Districts). The following sites constitute the first ever Option B+ sites in Cameroon: Azire IHC, CMA Mankon, CMA Nkwen, CNPS Clinic, Foundation Clinic, Nkwen Baptist HC, Nkwen Rural HC, Presbyterian HC Ntamulung, Regional Hospital Bamenda, St Francis Hospital, St. Blasse Clinic, St. Mary Solidade in Bamenda and BangaBakundu Apostolic, Baptist Health Centre Kumba, Catholic Health Center Fiango, District Hospital Kumba, EkombeBonji HC, Hope Clinic, Kumba Urban Health Centre, Mukonje CDC, Ntam Health Centre, Presbyterian Hospital in Kumba.
In October 2014, the Government of Cameroon began scaling up Option B+ across the national territory following a “phase” approach.
Local Capacity Initiative
The Local Capacity Initiative (LCI) is born from the desire to put in place a robust system of health care that is fully owned by the community. It is also a strategic approach that aims at boosting the uptake of ANC and PMTCT services in the various health districts. As such, the LCI is implemented as an activity under objective 7 of the HIV-Free SW and NW project.
The LCI enables the CBCHB to create and strengthen support structures, otherwise called dialogue structures in 10 districts (5 in each of the two regions) to take an active part in leading, supporting, co-financing and co-managing health care programs. With this project, we mobilize, engage and strengthen stakeholders namely; District Medical Officers, district management teams, local councils and traditional authorities to own and take the lead in defining their own quality healthcare and working towards achieving it with resources they have mobilized. The Health Districts where the LCI activities are being implemented include: Ako, Benakuma, Mbengwi, Tubah, Bafut all in the NWR and Eyumojock, Konye, Wabane, Ekondo Titi and Bangem in the SWR. LCI Districts were selected because of low ANC uptake.
This strategy aligns well with PEPFAR’s focus on community engagement to enhance and optimize health service uptake and the sustainability of health programs in resource limited countries such as Cameroon. This approach to health care also fits well with the current drive towards decentralization of services to local councils in Cameroon.
The umbrella organization of the HivF project is the Ministry of Public Health. Project reports are sent to the Ministry of Health. Other partners are the Elizabeth Glazer Pediatric AIDS Foundation (EGPAF) and the Clinton Health Access Initiative (CHAI). The EGPAF has been subcontracted by the project for technical Assistance and training. The CHAI is involved in Early Infant Diagnosis (EID) and also assists in other activities. The CBC Health Board works with these Organizations to reduce the weight on them as an organization. These partners collaboration ensure the success of the project.
The HIV-Free Northwest and Southwest project is sponsored by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centres for Disease Control and Prevention (CDC). This sponsorship that started in 2011 ends in 2016.
Management and Coordination