USAID COOPERATIVE AGREEMENT NO. AID-660-A-17-00001

INTEGRATED HIV/AIDS PROJECT HAUT KATANGA/LUALABA

Fiscal Year 2017 Quarter 3 Report

April 1–June 30, 2017 Submitted: August 15, 2017

Table of Contents

This document was produced by the Integrated HIV/AIDS Project in Haut Katanga and Lualaba consortium through support provided by the United States Agency for International Development. The opinions herein are those of the author(s) and do not necessarily reflect the views of the United States Agency for International Development or the United States government

Table of Contents

Acronyms and Abbreviations ...... 4 Executive Summary ...... 6 Quantitative impact ...... 6 Testing ...... 6 Care and treatment ...... 6 Viral suppression ...... 8 Qualitative impact ...... 8 Next quarter’s work plan ...... 8 Key Achievements and Program Progress ...... 13 Objective One: Continuum of care for HIV/AIDS services ensured ...... 13 Sub-objective 1.1: Increased availability of comprehensive HIV prevention services...... 13 Sub-objective 1.2: Expanded comprehensive HIV/AIDS care and treatment services...... 21 Sub-objective 1.3: Improved integration of HIV/TB services...... 25 Sub-objective 1.4: Expanded network and referral systems for other health and social services...... 28 Objective Two: Use of integrated HIV/AIDS services increased at both facility- and community-based levels ...... 30 Sub-objective 2.1: Improved community environment to support healthy behaviors...... 30 Sub-objective 2.2: Optimized service delivery models...... 31 Objective Three: Health systems strengthened to improve access to services and improve outcomes of PLHIV ...... 37 Sub-objective 3.1: Essential commodities are available and effectively managed at all appropriate levels...... 37 Sub-objective 3.2: Improved use of reliable data to continuously improve service delivery quality and effectiveness...... 38 Sub-objective 3.3: Effective, operational laboratory systems ensured...... 43 Project Administration ...... 45 Annex One: Monitoring and Evaluation Table ...... 47 Annex Two: Success Story ...... 50 Annex Three: Trainings and Site Visits ...... 51

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 3 Acronyms and Abbreviations

ACCELERE! Accelerating Equitable Access to School, Reading, Student Retention, and Accountability AIDS Acquired Immune Deficiency Virus ANC antenatal care ART antiretroviral therapy ARV antiretroviral medication ASSIST Applying Science to Strengthen and Improve Systems C-Change Communication for Change CIELS Comité Inter Entreprise de Lutte Contre le VIH/SIDA (Inter-company Committee for the Fight Against HIV/AIDS) CSDT Centre de Santé de Diagnostic et Traitement de la Tuberculose (tuberculosis diagnostic and treatment center) DBS dried blood spot DHIS 2 District Health Information System 2 DIVAS Division Provinciale des Affaires Sociales (Provincial Division of Social Affairs) DPS Division Provincial de la Santé (Provincial Health Division) DRC Democratic Republic of the Congo EAGLE Empowering Adolescent Girls to Lead through Education EID early infant diagnosis ELIKIA Enhancing Services and Linkages for Children Affected by HIV and AIDS FY Fiscal Year HEI HIV-exposed infant HIV human immunodeficiency virus HIV/TB HIV and tuberculosis co-infection HRH human resources for health HSS health system strengthening HTS HIV testing services HZ health zone HZMT health zone management team IHAP-HK/L Integrated HIV/AIDS Project in Haut Katanga and Lualaba iHRIS integrated human resources information system IPT isoniazid preventive therapy LINKAGES Linkages across the Continuum of HIV Services for Key Populations Affected by HIV M&E monitoring and evaluation MER Monitoring, Evaluation, and Reporting MOH Ministry of Health NGO nongovernmental organization OPQ Optimizing Performance and Quality OVC orphans and vulnerable children PEPFAR United States President’s Emergency Plan for AIDS Relief PITC provider-initiated HIV testing and counseling PLHIV people living with HIV/AIDS PNLS Programme Nationale de Lutte Contre le SIDA (National HIV/AIDS Program) PNMLS Programme National Multisectoriel de Lutte contre le Sida (National Multisectoral Program for the Fight against AIDS) PNSA Programme National de Sante d’Adolescents (National Youth Health Program) PoDi community antiretroviral therapy distribution point

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 4 ProVICplus Projet Intégré de VIH/SIDA au Congo (Integrated HIV/AIDS Project Plus) ProSANIplus Projet Intégré de Santé (Integrated Health Project Plus) QA quality assurance QI quality improvement QIC Quality Improvement Collaborative RACOJ Network of Congolese Youth Associations Against AIDS ReCos relais communautaire RNOAC Réseau National des Organisations d’Assises Communautaires (National Network of Community Organizations) SIAPS Systems for Improved Access to Pharmaceuticals and Services SIMS Site Improvement through Monitoring System SMS short message service SOP standard operating procedure STI sexually transmitted infection TB tuberculosis TBIC tuberculosis infection prevention and control TOR terms of reference TWG technical working group USAID United States Agency for International Development VCT voluntary HIV counseling and testing

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 5 Executive Summary

PATH and its consortium partners, ICAP at Columbia University and IntraHealth International, are pleased to share the report for Quarter 3 (Q3) of Fiscal Year 2017 (FY17) for the Integrated HIV/AIDS Project in Haut Katanga and Lualaba (IHAP-HK/L), covering the period April 1 through June 30, 2017.

Quantitative impact

A total of 106 facilities in Haut Katanga and 46 facilities in Lualaba provided a comprehensive package of HIV testing, care, and treatment services from April through June 2017.

Testing In Q3, 50,098 individuals were provided with HIV testing services (HTS) and received their results (Figure 1). Of those tested, 2,061 individuals were HIV positive—a seropositivity rate of 4.1 percent.

Figure 1. HIV testing services and yield by province, April–June 2017.

35,585

14,513

3.8% 5.0% 1,339 722

Haut Katanga Lualaba

Tested Tested positive

Among the 25,052 pregnant women received at antenatal care clinics, 19,890 (79 percent) knew their status (i.e., were either tested for HIV and informed of their results or knew their status at entry). Among them, 324 were HIV positive (1.6 percent), of whom 91 percent were placed on antiretroviral therapy (ART). A total of 222 infants received a virologic HIV test within 12 months of birth; 16 were found to be HIV positive (7.2 percent).

Care and treatment

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 6 In all, 21,087 people living with HIV/AIDS (PLHIV) were enrolled in IHAP-HK/L’s treatment and care cohort as of the end of June 2017. A total of 1,845 adults and children were newly enrolled on ART this quarter, which represents 90 percent of HIV-positive individuals newly identified within the reporting period (Figure 2). Figure 3 shows the percentage of HIV-positive adults and children linked to treatment in each health zone (HZ) in Q3.

Figure 2. HIV-positive individuals newly enrolled on treatment, April–June 2017.

1,339 87.4% 1,170

93.5% 722 675

Haut Katanga Lualaba

Newly identified HIV-positive individuals HIV-positive individuals linked to treatment

Figure 3. Percentage of HIV-positive adults and children linked to treatment, April–June 2017.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 7 In the reporting period, 864 of 1,077 patients with tuberculosis (TB) were tested for HIV; of these, 55 were HIV positive (6.4 percent seropositivity) and 45 (81.8 percent) were placed on ART.

Viral suppression Out of 4,919 patients from whom viral load samples were collected, 3,799 (77 percent) received their results; 3,528 (93 percent) of those that received results had an undetectable viral load.

Qualitative impact

Key activities conducted in Q3 FY17 focused on training facility-based service providers and health zone management teams (HZMTs), conducting routine monitoring visits to all IHAP- HK/L supported facilities, and conducting a viral load sample collection campaign in Haut Katanga. Further highlights from Q3 are summarized below, and details on training and site visits are noted in Annex Three.  Five staff members from provincial PNLS (Programme Nationale de Lutte Contre le SIDA, National HIV/AIDS Program) in Haut Katanga and 16 members of the eight HZMTs in Haut Katanga were trained as trainers by national PNLS facilitators in April/May 2017. The training focused on the updated integrated HIV/AIDS care guidelines, which reflect “test- and-treat” and other strategies for testing, retention, and monitoring, in support of the United Nations Programme on HIV/AIDS 90-90-90 goals.  A master training session was conducted in Lualaba from May to June 2017 for 19 members from 11 HZMTs1, one staff member from the Provincial Health Division (Division Provincial de la Santé, DPS), and four provincial PNLS staff on the updated national guidelines for integrated HIV/AIDS care, training modules, and tools.  IHAP-HK/L conducted visits in 74 sites across the five HZs around Lubumbashi to brief service providers on the use of existing TB screening and tracking tools to monitor uptake and retention of PLHIV on isoniazid preventive therapy (IPT).  IHAP-HK/L held a campaign in June to collect viral load samples from facilities and transport them to the provincial PNLS reference laboratory in Lubumbashi and Clinique Universitaire for analysis.  IHAP-HK/L provided technical assistance to facilities in Haut Katanga and Lualaba to develop and implement a personalized monitoring plan for each PLHIV in the project’s treatment cohort with a detectable viral load.

Next quarter’s work plan

IHAP-HK/L plans to implement the following key activities from July to August 2017. Sub-objective 1.1: Increased availability of comprehensive HIV prevention services.

1 Includes one participant each from three HZs not supported by IHAP-HK/L (Kalamba, Kasaji, and Dilolo).

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 8  Train facility-based service providers from 32 facilities in Panda, Kapolowe, and Sakania HZs and from 47 facilities in Lualaba on the new national guidelines for integrated HIV/AIDS prevention, care, and treatment.  Coach service providers at eight high-volume facilities in Lubumbashi and two facilities in Kolwezi on implementation of partner notification services.  Mentor facilities on use of the family tree form for PLHIV to track index case testing.  Train service providers from three high-volume sites in Manika and Dilala to provide adolescent-friendly HIV, sexually transmitted infection (STI), and family planning services.  Brief workers at community antiretroviral therapy distribution point (PoDi+) sites in Kenya and Lubumbashi to offer home-based testing as an option for testing partners and family members of PLHIV.  Coordinate through CIELS (Comité Inter Entreprise de Lutte Contre le VIH/SIDA, Inter- company Committee for the Fight Against HIV/AIDS) and with IHAP-HK/L supported facilities in Rwashi HZ to offer workplace testing at Ruashi Mining and Chemaf in Haut Katanga.  Develop standard operating procedures (SOPs) for offering HIV self-testing in conjunction with provincial PNLS.  Support facilities in generating weekly reports using Tier.Net data on missed appointments and share the list with Mentor Mothers for defaulter-tracing.

Sub-objective 1.2: Expanded comprehensive HIV/AIDS care and treatment services.  Provide technical assistance during regular site visits to facilities to implement test-and-treat and advance same-day treatment initiation.  Mentor facilities to establish a personalized monitoring plan for each patient in the project’s treatment cohort with a detectable viral load.  Conduct onsite training and mentoring of facility-based service providers on patient treatment literacy.  Orient service providers at Clinique Universitaire to implement the one-stop shop model of care.

Sub-objective 1.3: Improved integration of HIV/TB services.  Continue onsite mentoring of facility-based service providers on use of TB screening and tracking tools.  Establish tuberculosis infection prevention and control (TBIC) committees at ten facilities in Lualaba and provide technical support to develop infection prevention and control plans for all sites.

Sub-objective 1.4: Expanded network and referral systems for other health and social services.  Support monthly meetings of referral subgroups in each province with a focus on planning for referral assessments and mapping.

Sub-objective 2.1: Improved community environment to support healthy behaviors.  Train 20 peer educators from Manika and Dilala HZs to provide HIV sensitization and prevention services to adolescents.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 9  Issue a request for applications to identify local nongovernmental organizations (NGOs) to conduct community prevention and outreach activities across all IHAP-HK/L HZs.  Coordinate with the Empowering Adolescent Girls to Lead through Education (EAGLE) project to jointly train 30 youth and adolescent peer educators to provide HIV sensitization services.  Brief 40 peer educators to provide sensitization services and referrals for HIV testing to partners and family members of stable PLHIV receiving care and treatment services at Kenya and Lubumbashi PoDi+ sites.  Hold stakeholder workshops in Haut Katanga and Lualaba to determine dissemination methods and targeted messaging for each priority population targeted by IHAP-HK/L.

Sub-objective 2.2: Optimized service delivery models.  Coordinate with the National Network of Community Organizations (Réseau National des Organisations d’Assises Communautaires, RNOAC) to establish two additional PoDi+ sites, one in Rwashi HZ and one in Dilala HZ.  Work with World Production and Bak Congo to introduce antiretroviral medication (ARV) distribution at ten additional self-help groups.  Introduce a fast-track ARV pick-up circuit in two additional facilities in Haut Katanga and three facilities in Lualaba.  Conduct a needs assessment of the first four HZMTs selected for the Optimizing Performance and Quality (OPQ) approach to understand current capacity and gaps in management performance.  Train ten quality improvement (QI) coaches to provide quality assurance (QA)/QI training for potential members of QI teams in five new facilities in Haut Katanga and Lualaba.  Conduct collaborative learning sessions every two months (one in each province) with 50 participants from facility-based QI teams and QI coaches from HZs.

Sub-objective 3.1: Essential commodities are available and effectively managed at all appropriate levels.  Conduct needs assessments in HZs and high-volume facilities to determine quantities of data reporting tools and forms.  Participate in monthly commodity management technical working group (TWG) meetings in Haut Katanga.

Sub-objective 3.2: Improved use of reliable data to continuously improve service delivery quality and effectiveness.  Establish an automated human resources information system (using iHRIS) in the two provinces for improved management, distribution, and motivation of health workers.  Conduct needs assessments in all 16 HZs to determine gaps in HZ staffing, equipment, and materials for full deployment of iHRIS.  Hold microplanning workshops in seven HZs in Haut Katanga and eight HZs in Lualaba to develop microplans.  Provide onsite coaching to facilities that received red ratings during Site Improvement through Monitoring System (SIMS) visits in Q3 to implement their remediation plans.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 10  Complete initial District Health Information System 2 (DHIS 2) database development and train the IHAP-HK/L monitoring and evaluation (M&E) team on the DHIS 2 database.  Train 20 facilities in Haut Katanga and ten facilities in Lualaba on Tier.Net, including data entry and cohort analysis.

Sub-objective 3.3: Effective, operational laboratory systems ensured.  Develop data collection tools for laboratory services and distribute to facilities.  Provide technical support to develop plans for biomedical waste management for supported facilities.  Support facilities to participate in HIV proficiency testing, including developing and distributing SOPs for participating in quarterly testing.

Table 1 outlines changes to activities from what was approved in IHAP-HK/L’s FY17 implementation plan as well as the reasons for these changes.

Table 1. Changes to FY17 implementation plan.

Planned activities Status Explanation for change 1.1.6: Pilot HIV self-testing In process; preliminary Based on discussions with provincial-level in Kenya and Lubumbashi discussions with the PNLS and the steps that need to be taken in health zones in Haut PNLS began in Q3 but close collaboration with the PNLS prior to Katanga. the timeline for starting pilots, it was determined that introduction of self- additional time is needed to carry out all testing has been delayed preparatory activities before HIV self-testing to Q1/Q2 FY18. can be offered. 1.1.3: Introduce mobile Canceled. Following discussions with USAID and the voluntary HIV counseling Linkages across the Continuum of HIV and testing along the Services for Key Populations Affected by HIV transportation corridor (LINKAGES) project, IHAP-HK/L is between Kasumbalesa and proposing not to offer mobile testing along the Kolwezi. transportation corridor, in part due to difficulties with ensuring linkages to facilities for enrollment in care and treatment services. IHAP-HK/L will instead focus on rolling out home-based testing, workplace testing, and targeted mobile testing sessions in hotspots identified through the HZ microplanning process. Brief 40 peer educators to New activity. Given the offering of HIV testing services at provide HIV sensitization Kenya and Lubumbashi PoDi+ sites, IHAP- services and referrals for HK/L added this new activity to increase index HIV testing for partners case testing at the community level. and family members of PLHIV receiving services at PoDi+ sites. Train 30 youth and New activity. IHAP-HK/L recently added this activity adolescent peer educators, following discussions with the EAGLE project in conjunction with the

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 11 EAGLE project and the to improve outreach among youth and National Youth Health adolescents. Program (Programme National de Sante d’Adolescents), to provide HIV sensitization services.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 12 Key Achievements and Program Progress

Objective One: Continuum of care for HIV/AIDS services ensured

Sub-objective 1.1: Increased availability of comprehensive HIV prevention services. IHAP-HK/L focused efforts in Q3 on conducting trainings on the new guidelines for integrated HIV/AIDS services, including evidence-based strategies to optimize yield in the provision of provider-initiated HIV testing and counseling (PITC) for HZMTs and facilities in Haut Katanga and Lualaba. These trainings followed a cascade model, with staff from provincial-level PNLS and HZMTs trained as “master trainers,” and HZMTs training all project-supported facilities in Haut Katanga and Lualaba. These trainings included critical information on national guidelines and new World Health Organization recommendations in support of achieving the 90-90-90 goals: targeted testing of priority populations; test-and-treat; strategies for retention in care and treatment services; viral load monitoring; differentiated service delivery models; pre-exposure prophylaxis; and one-stop shop delivery for HIV/TB and isoniazid chemoprophylaxis.

Master trainings were conducted in Haut Katanga (May) and Lualaba (June) on new guidelines for integrated HIV/AIDS care and treatment. Sessions focused extensively on how to improve the integration of health services, and how to reorganize health facilities to ensure that patients benefit from all needed services at the same point of delivery.

In total, 45 individuals (HZ medical chiefs, HZ data managers, medical directors of health reference centers, staff from Training of trainers for Haut Katanga in April 2017. provincial PNLS and DPS) were trained as trainers. 21 participants were from Haut Katanga (16 members of the province’s eight HZMTs and five staff members from provincial PNLS), and 24 participants were from Lualaba (including 19 members of the province’s eight HZMTs, one staff member from DPS, and four staff from provincial PNLS). These newly trained master trainers conducted the first of the three training sessions on the new national guidelines for integrated HIV/AIDS care in May for 243 facility-based service providers from 74 facilities in Kenya, Rwashi, Kampemba, Kamalondo, and Lubumbashi HZs.

50,098 individuals were provided with HTS in the reporting period, among whom 2,061 (4.1 percent) tested HIV positive. Figure 4 below shows the seropositivity rate for each HZ. HZs with the highest seropositivity rates were Manika, Lualaba, and Fungurume in Lualaba, which have greater concentrations of priority populations of miners, and Lubumbashi, Kamalondo, and Kenya HZs in Lubumbashi. IHAP-HK/L plans to take steps to maximize outreach and HTS in these higher-prevalence areas in Q4, including the introduction of workplace testing in Rwashi HZ.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 13 Figure 4. Seropositivity by health zone, April–June 2017.

Figure 5 depicts seropositivity by service delivery point. Entry points with the highest seropositivity rates were facility-based voluntary HIV counseling and testing (14.1%), facility- based index case testing (5.6 percent), other PITC (4.4 percent), and PITC at TB wards (4.4 percent). More than 79 percent of individuals tested for HIV were reached through the antenatal care service entry point or other PITC, but the yield at these entry points were low, at 1.3% percent and 4.4% percent respectively. Next quarter, IHAP-HK/L will coach facility-based service providers to intensify HIV testing at high-yield entry points, particularly inpatient and TB wards, and will continue mentoring service providers to use the family tree form to follow up with and test family members and partners of PLHIV to improve facility-based index case testing. The project also plans to introduce community-based index case testing by training PoDi+ staff to offer HIV testing services at PoDi+ sites and taking steps to offer home-based testing for family members and partners of PLHIV who are not able to access testing services through other methods.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 14 Figure 5. Seropositivity by service delivery point and province, April–June 2017.

14.1%

5.6% 4.4% 4.4% 4.3%

2.0% 1.3%

VCT facility Index testing PITC (other) PITC TB clinics PITC malnutrition PITC pediatrics PITC PMTCT (ANC facility services services only) services

ANC, antenatal care; PITC, provider-initiated treatment and counseling; PMTCT, prevention of mother-to-child transmission of HIV; TB, tuberculosis; VCT, voluntary HIV counseling and testing.

Figure 6 depicts seropositivity by age and province. As observed in the figure, seropositivity was higher in Lualaba than Haut Katanga across all age groups except individuals older than 50 years of age. The number of infants below the age of one tested in Haut Katanga was small (10 infants), so the single case of HIV in this group makes the seropositivity rate appear high. In Lualaba, 570 children aged 1-9 were tested, and 45 (7.9 percent) tested HIV-positive. As further explained in Activity 2 below, IHAP-HK/L plans to intensify HIV testing and outreach among youth and adolescents in Q4 by training additional facilities in Lualaba to provide adolescent- friendly services and support training for youth and adolescent peer educators in collaboration with the National Youth Health Program (Programme National de Sante d’Adolescents, PNSA).

Figure 6. Seropositivity by age and province, April–June 2017.

Seropositivity rate by province and age

10.0% Haut Katanga Lualaba 7.5% 7.9% 6.5% 5.1% 5.4% 5.5%

2.0% 2.2% 1.9% 1.9% 2.0% 1.2% 1.0% 1.4% 1.2%

<1 <5 1-9 10-14 15-19 20-24 25-49 50+ <1 <5 1-9 10-14 15-19 20-24 25-49 50+ Age (years)

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 15

In the five facilities trained to provide adolescent-friendly HIV services under ProVICplus, 644 adolescents between 15 and 19 years of age were tested for HIV and informed of their results, among whom four were HIV positive.

As depicted in Figure 7, 19,890 pregnant women were aware of their HIV status, of whom 324 were HIV positive (1.6 percent). A total of 294 HIV-positive pregnant women (91 percent) were initiated on ART.

Figure 7. Cascade of HIV services provided to pregnant women, April–June 2017.

Haut Katanga Lualaba

16,934 86.8% 14,706

8,118 63.9% 5,184

1.4% 89.7% 2.3% 92.6% 203 182 121 112

New ANC ANC clients HIV-positive HIV-positive New ANC ANC clients HIV-positive HIV-positive clients who know ANC clients ANC clients clients who know ANC clients ANC clients their HIV on treatment their HIV on treatment status status

ANC, antenatal care.

In the reporting period, 222 infants had a virologic HIV test within 12 months of birth, of whom 16 were HIV infected (7.2 positivity; Figure 8).

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 16 Figure 8. Percentage of infants who tested HIV positive within 12 months of birth, April–June 2017.

150

72

7.3% 6.9% 11 5

Haut Katanga Lualaba

Infants tested Infants tested positive

Activity 1: Offer provider-initiated HIV testing and counseling at all entry points in 153 supported facilities in Lualaba and Haut Katanga. As an initial step to provide coaching on partner notification services to increase index case testing, IHAP-HK/L identified eight high-volume sites in Haut Katanga and two high-volume sites in Lualaba for intensive mentoring and technical assistance in this area. The sites selected in Haut Katanga were Sendwe Center of Excellence, Clinique Universitaire, Kenya General Reference Hospital, Kamalondo General Reference Hospital, Hakika General Reference Hospital, Kampemba General Reference Hospital, Kasumbalesa Reference Health Center, and Panda General Reference Hospital. Mwangeji Reference Health Center and Kolwezi Personnel Hospital were the two sites in Lualaba selected for partner notification coaching. During regular site visits in Q4, IHAP-HK/L will coach providers in these ten facilities on implementation of partner notification services, through client referral, contact referral, or provider referral.

The IHAP-HK/L clinical care team developed SOPs for index case management, including through partner notification, using the family tree form. The SOPs outline how to complete and use the family tree form to monitor uptake of HIV testing by family members of index clients. Facilities provide written invitation cards for HIV testing services for PLHIV to share with their partners. The SOPs also describe how service providers should record in index case registers (provided by IHAP-HK/L), partners and family members of PLHIV who were tested, and steps to immediately enroll those who test HIV positive in care and treatment services. Service providers will be coached by IHAP-HK/L to provide counseling to partners and family members who test HIV negative on how to remain negative.

The project held meetings with communication and information officers at DPS Haut Katanga to review and identify relais communautaire (ReCos) and community agents for training on testing family members of index cases. The training will be held in Q4.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 17 SOPs on index case management will be printed and distributed to all sites during regular coaching visits in Q4. Site support coordinators and technical officers will review SOPs with facility-based service providers as these are distributed, and mentor service providers on providing counseling to PLHIV on use of invitation cards to encourage partner testing. Site support coordinators and technical officers will continue mentoring facility- and community- based service providers on following up with partners and family members of PLHIV, through SMS, phone calls, and home visits, to ensure they are tested for HIV.

Activity 2: Offer targeted HIV testing services for adolescents and youth. Five facilities in Lubumbashi, including Bakita Health Center (Kenya HZ), Dominique Savio Health Center (Kampemba HZ), Crisem Health Center (Lubumbashi HZ), Hakika General Reference Hospital (Rwashi HZ), and Kamalondo General Reference Hospital (Kamalondo HZ), were previously trained by Projet Intégré de VIH/SIDA au Congo (Integrated HIV/AIDS Project Plus, ProVICplus) to provide adolescent-friendly services, including HIV prevention, care, and treatment services; family planning; and prevention and treatment of STIs other than HIV.

IHAP-HK/L visited each site in Q3 to observe quality of services provided to adolescents by these facilities. IHAP-HK/L will provide complementary coaching to these five facilities in Q4 on elements from ICAP’s adolescent care model, which includes adolescent-friendly sexual and reproductive health, family planning, and mental health screening, to strengthen provision of adolescent-friendly services in these facilities, in alignment with the PNSA’s minimum package of services for adolescents and youth.

IHAP-HK/L held discussions with Network of Congolese Youth Associations Against AIDS (RACOJ) to explore offering HIV outreach services at their youth centers in Haut Katanga. As part of a mapping exercise of RACOJ outlets, IHAP-HK/L’s Community Care and Support Officer conducted an assessment of Lubumbashi Youth Center (supported by RACOJ), which revealed low attendance rates. This finding locally validates global evidence that youth centers are generally not a best practice for reaching adolescents with health services.

IHAP-HK/L began discussions with the PNSA to determine mechanisms to use for sensitizing adolescents and youth in IHAP-HK/L supported HZs and ensure referrals to facilities for HTS. In coordination with the PNSA, IHAP-HK/L will train youth and adolescent peer educators in Q4 at the facilities offering adolescent-friendly services.

In addition, in July and August, IHAP-HK/L will develop SOPs on adolescent-friendly HIV care and treatment, family planning, and STI services. Based on these SOPs, IHAP/HK-L’s site support coordinators will review existing educational materials (e.g., tools, job aids) for both service providers and adolescents and update these accordingly, based on messages to be developed during IHAP-HK/L’s communication and outreach strategy workshops.

IHAP-HK/L site support coordinators and technical officers will continue to coach service providers during regular site visits on facilitating discussions with adolescents on sexual and reproductive health, PMTCT, partner involvement, infant feeding, and disclosure of status. Service providers will be mentored on counseling adolescents to encourage partners to be tested for HIV and on condom negotiation and safer sex practices. Additionally, IHAP-HK/L will

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 18 select three high-volume sites in Manika and Dilala in Q4 and train three service providers from each site, along with staff from Manika and Dilala HZMTs, to provide adolescent-friendly HIV, STI, and family planning services.

IHAP-HK/L participated in a meeting organized by the United States Agency for International Development (USAID)-funded Monitoring, Evaluation, and Coordination Contract, during which all interventions conducted by implementing partners in Haut Katanga were mapped so that partners could find additional opportunities for synergy between all USAID-funded projects operating in Haut Katanga.

Following this meeting, IHAP-HK/L met with the Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) project to map major truck stops along the Kasumbalesa-Kolwezi transportation corridor and identify locations where LINKAGES offers mobile testing services. IHAP-HK/L also met with the Enhancing Services and Linkages for Children Affected by HIV and AIDS (ELIKIA) project in May and identified 74 IHAP-HK/L facilities in Lubumbashi where ELIKIA could refer orphans and vulnerable children (OVC) for HIV testing and care services. ELIKIA held a four-day training session for 30 home case managers on the referral system for OVC to IHAP-HK/L facilities.

IHAP-HK/L identified several possibilities for collaboration with the EAGLE and ACCELERE! (Accelerating Equitable Access to School, Reading, Student Retention, and Accountability) projects to identify and sensitize adolescents and youth and refer them to IHAP-HK/L facilities for HIV and STI screening services. IHAP-HK/L intends to organize specific meetings with EAGLE and ACCELERE! next quarter to map their services and determine how to better collaborate and link services to reach youth and adolescents.

IHAP-HK/L plans to release a request for application to identify NGOs to conduct community- level outreach and prevention among priority population groups, including adolescents and youth.

Activity 4: Pilot home-based testing for families or partners of index case patients who cannot be tested through another method in two health zones of Haut Katanga. In Q3, the IHAP-HK/L team held discussions with HZMTs in Lubumbashi and Kenya HZs to determine the feasibility of offering home-based testing for family members and partners of the 648 stable PLHIV receiving services from the two PoDi+ sites in these HZs, and to PLHIV supported by facilities in these HZs.

In Q4, RNOAC will begin offering home-based testing as an option for testing partners and family members of PLHIV receiving care and treatment services at the two PoDi+ sites in Kenya and Lubumbashi. IHAP-HK/L will develop guidelines and SOPs for home-based testing and organize a briefing for PoDi+ staff to explain these guidelines. The project can also leverage existing connections between RNOAC, which manages the Kenya and Lubumbashi PoDi+ sites, and their peer educators with facilities to more quickly roll out home-based testing in these two HZs.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 19 Activity 5: Introduce workplace testing in four high-burden health zones in Haut Katanga and Lualaba. IHAP-HK/L identified four HZs for introduction of workplace testing—Rwashi and Lubumbashi in Haut Katanga and Manika and Dilala in Lualaba. The project coordinated with CIELS to map affiliated businesses where workplace testing can be offered, and noted several businesses in IHAP-HK/L supported HZs that had previously worked through local NGOs to offer HIV sensitization and testing sessions in their workplaces. Following this mapping, IHAP-HK/L identified two mining enterprises located in Rwashi HZ—Ruashi Mining and Chemaf—for introduction of workplace testing next quarter.

In Q4, IHAP-HK/L will identify project-supported facilities in Rwashi HZ located near these two mining companies and work closely with facility-based service providers from these facilities to organize workplace testing. IHAP-HK/L, in collaboration with the PNLS, will develop an SOP and brief staff from these facilities on procedures for workplace testing. The project will also work closely with CIELS, HZMTs, and the National Multisectoral Program for the Fight against AIDS (Programme National Multisectoriel de Lutte contre le Sida, PNMLS) to obtain all administrative authorizations and sensitize staff in these two mining companies before starting workplace testing sessions. All individuals who test HIV positive during workplace testing sessions will be accompanied to the facility linked to the company for enrollment in treatment.

Activity 6: Pilot HIV self-testing in Kenya and Lubumbashi health zones in Haut Katanga. IHAP-HK/L held consultation meetings with provincial-level PNLS in Q3 to discuss an HIV self-testing pilot in Kenya and Lubumbashi HZs. While provincial PNLS noted that self-testing has not yet been implemented in the Democratic Republic of the Congo (DRC; although national policy allows self-testing), they did endorse this as a strategy to boost rates of HIV testing among hard-to-reach population groups. Per discussions with provincial PNLS, IHAP-HK/L decided to begin preparations for HIV self-testing pilots in Q4 by developing SOPs for HIV self-testing with provincial PNLS and identifying manufacturers for provision of self-test kits.

Activity 8: Improve the follow-up of mother-baby pairs in all project-supported structures. In June, IHAP-HK/L developed guidelines on the use of mother-baby pair registers to ensure regular recording of infant serostatus. In July, IHAP-HK/L will begin an assessment of services offered to mother-baby pairs to inform development of a coaching plan to guide technical assistance provided during monthly site visits. The assessment will evaluate how mother-infant pairs are tracked through the final determination of infant serostatus and enrollment in pediatric care and treatment (if confirmed HIV positive), as well as identify gaps in the availability and quality of services offered to mother-infant pairs. To ensure continued early infant diagnosis (EID) coverage among HIV-exposed infants (HEIs) and track mother-infant pairs through final determination, IHAP-HK/L will distribute guidelines on the use of the mother-baby pair register during site visits in Q4 and provide onsite coaching to service providers on completing mother- baby pair registers. Service providers will also be coached on using mother-baby pair registers to generate HEI cohort analysis reports that facility staff and Mentor Mothers can use to follow up with mother-baby pairs.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 20 Activity 9: Improve the provision of early infant diagnosis for HIV-exposed infants in Haut Katanga and Lualaba. IHAP-HK/P developed SOPs for laboratory technicians on collecting dried blood spot (DBS) samples, transporting them to HZMTs on a weekly basis, and collecting EID results from the provincial laboratory. Implementation of these SOPs began in Lualaba and Haut Katanga in Q3. To facilitate faster return of results, the IHAP-HK/L Laboratory Officer visited the provincial laboratory to collect and send EID results back to originating facilities. Facilities that had samples with HIV-positive results were contacted by telephone so that service providers could more quickly contact mothers to obtain another DBS sample for confirmatory testing and initiate infants on ART.

Beginning in July 2017, IHAP-HK/L technical officers will work with facility-based service providers to generate weekly lists of missing appointments among HEIs to share with Mentor Mothers to follow up with pregnant women.

Activity 10: Introduce use of GeneXpert machines to provide polymerase chain reaction analysis for early infant diagnosis and viral load analysis. IHAP-HK/L identified and contacted stakeholders in the DRC currently using GeneXpert® machines for TB diagnosis (Kenya General Reference Hospital, Kasumbalesa Health Reference Center, and the National TB Program central laboratory) to obtain additional information on the costs and challenges related to GeneXpert use. Challenges include the need for uninterrupted supply of consumables and cartridges, maintenance, electricity supply, and management of biomedical waste. Additionally, GeneXpert machines currently generate infectious waste that necessitates the establishment of a partnership with companies with high-powered equipment to manage and eliminate the waste at high pressure and temperature.

In consultation with USAID, IHAP-HK/L will identify high-volume sites in Haut Katanga and Lualaba in July where GeneXpert machines can be placed to improve the offering of EID, TB diagnostic, and viral load analytical services. IHAP-HK/L will seek concurrence from USAID prior to procuring the GeneXpert machines, and will seek to mitigate the above-described challenges as part of procurement and implementation planned.

Sub-objective 1.2: Expanded comprehensive HIV/AIDS care and treatment services. IHAP-HK/L supported facilities enrolled 1,845 PLHIV on ART from April through June, which represents 90 percent of newly identified PLHIV in Q3. The project’s treatment cohort at the end of June was 21,087 adults and children (4,836 in Lualaba and 16,251 in Haut Katanga)—this represents an achievement of 77 percent against the project’s target for this indicator. The percentage of HIV-positive patients linked to treatment is depicted in Figure 9. Intensive coaching will be provided to facilities in low-performing HZs—Panda and Kapolowe in Haut Katanga and Lualaba, Bunkeya, Lubudi, and Kanzenze in Lualaba—to reinforce test and treat and same-day initiation on treatment.

GeneXpert is a registered trademark of Cepheid.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 21 Figure 9. Percentage of HIV-positive patients linked to treatment.

118.2% Haut Katanga 112.7% Lualaba 102.6%100.0% 93.7% 90.1% 90.2% 85.7% 83.3% 83.0% 76.9% 73.5% 76.5% 76.5% 73.2% 61.0%

Figure 10 shows the IHAP-HK/L treatment cohort as of the end of June 2017 by health zone. As depicted in the figure, almost 30 percent of the project’s cohort is in Lubumbashi HZ, followed by Kenya (12 percent) and Sakania (9 percent). Manika and Dilala HZs have the highest concentration of PLHIV in Lualaba. IHAP-HK/L is expanding differentiated service delivery models in these high-volume HZs to reinforce retention of PLHIV on treatment and intensifying coaching for facility-based service providers and PoDi+ staff to carefully monitor PLHIV attendance at scheduled appointments and self-help group meetings to more quickly identify those in danger of being lost to follow-up.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 22 Figure 10. Treatment cohort by health zone.

IHAP-HK/L held a viral load campaign in May and June to increase collection of viral load samples from eligible PLHIV. Out of 4,919 samples collected, 3,799 (77 percent) were analyzed and recorded in patients’ medical records. In all, 3,528 PLHIV (93 percent) had undetectable viral loads—2,915 in Haut Katanga and 613 in Lualaba (Figure 11). IHAP-HK/L developed and distributed SOPs to all facilities to inform the development of monitoring plans for all PLHIV with detectable viral loads, including the 271 identified in Q3.

Figure 11. Viral load cascade, April–June 2017.

4,201

3,091 2,915

718 708 613

Samples collected Results returned Suppression

Haut Katanga Lualaba

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 23 Activity 1: Ensure PLHIV are enrolled and retained in HIV treatment. In Q3, IHAP-HK/L focused on rolling out trainings to HZMTs and facilities on the updated national guidelines for integrated HIV/AIDS care, which included guidelines on implementation of test-and-treat. IHAP-HK/L also worked through NGOs, ReCos, and Mentor Mothers to provide care, treatment, and monitoring support to PLHIV at the community level, primarily through self-help groups, PoDi+ sites, and follow-up visits to PLHIV.

Following the rollout of trainings on the updated national guidelines for integrated HIV/AIDS care to all project-supported facilities in July, IHAP-HK/L will closely monitor the implementation of guidelines during site visits and provide technical assistance to address observed weaknesses. Emphasis will be placed on ensuring that all HIV-positive individuals are enrolled in treatment and improving same-day treatment initiation for newly identified PLHIV. The IHAP-HK/L team will continue to mentor facilities to implement the patient tracking system used by ProVICplus, which used phone calls, SMS, and/or home-based visits to identify patients at risk of becoming lost to follow-up.

IHAP-HK/L will also train and mentor facility-based service providers on patient treatment literacy to further support increased adherence, retention, and viral suppression among PLHIV. IHAP-HK/L will provide technical and logistical support to community health workers to provide additional post-test counseling and accompany patients to care and treatment units to ensure effective linkage to treatment. Self-help group facilitators will be briefed on holding ART literacy sessions during group meetings to further support patients to comply with and adhere to care and treatment during self-help group support meetings.

Activity 2: Provide psychosocial support for PLHIV on treatment via self-help groups. IHAP-HK/L worked through Bak Congo and World Production to provide community-based care, adherence, and psychosocial support for PLHIV on treatment by holding monthly meetings of 70 self-help groups in Haut Katanga. Bak Congo supported 40 self-help groups across Sakania and Lubumbashi HZs, and World Production supported 30 groups in Kenya, Kamalondo, Kampemba, Rwashi, and Panda HZs.

By the end of Q3, 1,083 PLHIV were enrolled in self-help groups, with an average membership of 16 people per group. Table 2 shows the number of self-help groups and patients by HZ.

Table 2. Self-help groups and patients in Haut Katanga by health zone, April–June 2017.

Health zone Self-help groups Self-help group members Lubumbashi 21 276 Sakania 16 170 Rwashi 10 180 Kenya 10 191 Kampemba 3 52 Kamalondo 4 85 Panda 6 129 TOTAL 70 1,083

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 24 In addition to adherence counseling, general support, and facilitating discussions on living positively with HIV, nutrition assessments and TB screenings were offered to all self-help group members during meetings. In Q3, all PLHIV were screened for TB and provided with a nutrition assessment. A total of 95 PLHIV screened positive for presumptive TB and were referred to a tuberculosis diagnostic and treatment center (Centre de Santé de Diagnostic et Traitement de la Tuberculose, CSDT). In all, 30 PLHIV were moderately malnourished and six were overweight; all were provided with nutrition counseling.

In Q4, IHAP-HK/L will issue a solicitation to identify two NGOs in Haut Katanga and one in Lualaba to continue provision of community-based psychosocial and care services by continuing and expanding PLHIV self-help groups in the two provinces. IHAP-HK/L’s Community Prevention and Treatment team will conduct monitoring visits to self-help group meetings in Haut Katanga and provide technical assistance to self-help group facilitators to improve provision of services during group meetings. IHAP-HK/L will also coach self-help group facilitators on strategies for tracking PLHIV who miss multiple group meetings to ensure they are not lost to follow-up and remain in the care continuum.

Activity 3: Pilot the one-stop shop model to offer an integrated package of services at Clinique Universite. In Q4, IHAP-HK/L will orient facility-based service providers onsite to implement the one-stop shop model of care predicated on integrated, streamlined services for minimal referrals and optimal uptake of HIV-related services. IHAP-HK/L will orient facility-based providers to complete routine clinical assessments, which include clinical staging; blood sample collection; ART initiation; STI screening/treatment; TB screening/treatment; opportunistic infection prophylaxis/treatment; family planning; Positive Health, Dignity, and Prevention services; malaria prevention; nutrition assessment; and counseling. IHAP-HK/L will also integrate pediatric HIV services with family services to ensure access to general pediatric services (e.g., immunizations), HIV testing, and follow-up care for HEI and pediatric ART at a single point of service.

Sub-objective 1.3: Improved integration of HIV/TB services. From April to June, IHAP-HK/L continued to provide technical assistance to supported facilities to strengthen provision of HIV testing, care, and treatment services to TB patients, and screen PLHIV for TB. As depicted in Figure 12, of the 1,077 new and relapsed TB cases identified in IHAP-HK/L facilities, 864 were tested for HIV, among whom 55 were HIV positive (6.4 percent). A total of 45 of the 55 HIV-positive TB patients (82 percent) were also receiving HIV treatment.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 25 Figure 12. HIV cascade among TB patients, April-June.

1077 80.2% 864

6.4% 81.8% 55 45

New and relapsed TB cases New and relapsed TB cases Registered TB cases with TB cases with documented identified during the with documented HIV status documented HIV-positive HIV-positive status who reporting period during the reporting period status during the reporting started or continued ART period during the reporting period

IHAP-HK/L continued to coach facility-based service providers, self-help group facilitators, and community health workers at PoDi+ sites to offer TB screening for PLHIV at each touchpoint, and ensure PLHIV who screen negative for TB are provided with IPT. The IHAP-HK/L technical team provided health workers with onsite mentoring to cross-reference TB patient screening forms with IPT logbooks to confirm that all PLHIV who screen negative are provided with IPT. In all, 4,274 PLHIV completed a course of IPT within the reporting period. Figure 13 depicts PLHIV who received IPT, disaggregated by sex and age.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 26 Figure 13. PLHIV who received isoniazid preventive therapy in Q3, disaggregated by sex and age.

Activity 1: Strengthen the capacity of health care providers to provide tuberculosis screening and isoniazid preventive therapy. In June, IHAP-HK/L collected existing TB screening and tracking tools, updated them to align with national guidelines, and distributed them to all 153 project-supported sites. IHAP-HK/L’s Clinical HIV/TB Officer conducted at least one visit to each of the 47 facilities in Lubumbashi to mentor facility-based providers on use of the TB screening form, IPT logbooks, and adherence to IPT. Main challenges observed during site visits were service providers’ poor understanding of some parameters for TB screening, such as duration of cough.

In July, IHAP-HK/L technical officers and site support coordinators will continue onsite monitoring of facility-based providers’ use of TB screening and tracking tools and will provide technical assistance to improve TB screening and tracking.

Activity 3: Implement TB infection prevention and control services in IHAP-HK/L supported facilities. To reduce TB transmission within health facilities, IHAP-HK/L started site visits in May to orient facility-based providers and administrators on TBIC measures and develop infection prevention and control plans at 27 IHAP-HK/L facilities in Lubumbashi that also serve as CSDTs. IHAP-HK/L also worked with HZMTs in the five HZs in Lubumbashi to ensure compliance with infection prevention and control measures, such as triage of coughing patients,

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 27 cough hygiene, and adequate ventilation. IHAP-HK/L helped to establish a TBIC committee at each of the 27 facilities visited in Q3. These committees are charged with overseeing the implementation of TB infection prevention and control plans developed for each site in Q3. IHAP-HK/L plans to establish a TBIC committee at each of ten facilities in Lualaba and provide technical support to develop an infection prevention and control plan for each site.

Sub-objective 1.4: Expanded network and referral systems for other health and social services. IHAP-HK/L accomplished several foundational activities during this reporting period that pave the way for moving referral activities forward. Specifically, the IHAP-HK/L Referral System Advisor liaised with nine other project and government partners working on HIV referral systems to understand their approaches and consider opportunities for collaboration going forward. He successfully advocated with DPS Haut Katanga and DPS Lualaba for the development of TWGs, led by the DPS, to focus efforts on strengthening the HIV referral system; focal points and TWG members have been named, and monthly meetings will begin in July.

Activity 1: Coordinate with other projects/partners to build on the existing referral system work. In June, IHAP-HK/L project staff initiated coordination efforts around the HIV referral system through meetings and visits to the following United States government projects and government and NGO partners working in HIV services in IHAP-HK/L supported HZs: ELIKIA, Projet Intégré de Santé (Integrated Health Project Plus), United States Centers for Disease Control and Prevention/ICAP project, DPS and the Provincial Division of Social Affairs (Division Provinciale des Affaires Sociales, DIVAS) in Haut Katanga and Lualaba, Union Congolaise des Organisations des Personnes Vivantes avec VIH (Congolese Union of Organizations of People Lviing with HIV), and RNOAC. The majority of these organizations have committed to participating in a provincial-level TWG focused on improving the HIV referral system. In addition, partners have agreed to share information that will feed into referral maps that IHAP- HK/L plans to develop. For example, ELIKIA has already collected information on HIV-related services for OVC. This information will be integrated into IHAP-HK/L’s mapping exercise (see Activity 2).

Activity 2: Strengthen the referral TWG in Haut Katanga under the leadership of the DPS/Chef de Bureau. IHAP-HK/L found that there was not an active referral TWG in place in Haut Katanga, and advocated with both DPS Haut Katanga and DPS Lualaba for the need for a strengthened HIV referral system to ensure that DRC meets its 90-90-90 goals and for DPS-based TWGs to lead such efforts, with IHAP-HK/L offering technical assistance and support. Both DPS agreed to create a referral system subgroup under their existing service delivery TWGs. Focal points and membership for these subgroups have been named, and the first monthly meetings will take place in July. Each of the subgroups is led by the head of the Technical Support Office at DPS, with DIVAS serving as the subgroup’s vice chair. Each subgroup’s secretariat comprises a PNLS representative, a local community-based organization, and IHAP-HK/L. IHAP-HK/L drafted preliminary terms of reference (TOR) for the subgroups, focused on mapping, assessing, and

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 28 strengthening the referral system going forward. The TOR will be reviewed, enriched, and ultimately adopted by the subgroups in Q4.

Activity 3: Establish a referral TWG in Lualaba under leadership of the DPS/Chef de Bureau. As described above, DPS Lualaba has established a referral system subgroup to lead efforts to strengthen HIV referrals in HZs with technical assistance and support from IHAP-HK/L. As the IHAP-HK/L Referral System Advisor is based in Lubumbashi, the project developed a scope of work for a part-time consultant to work on a regular basis with the Lualaba subgroup to ensure continuous momentum in improving the referral system in Lualaba as in Haut Katanga. The consultant will be jointly selected by IHAP-HK/L and DPS and will start working with the project next quarter.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 29 Objective Two: Use of integrated HIV/AIDS services increased at both facility- and community-based levels

Sub-objective 2.1: Improved community environment to support healthy behaviors. In Q3, IHAP-HK/L took preparatory measures for the start of community prevention and outreach activities in Q4. The project organized exchanges and orientation sessions with provincial authorities in Haut Katanga, including DPS, the PNLS, PNMLS, and PNSA, and the National Communication Program, as well as introductory meetings with the five HZMTs in Lubumbashi. IHAP-HK/L will move forward with stakeholder workshops in Q4 to develop communication and outreach strategies for each priority population, which will guide the project’s prevention and outreach activities.

Activity 1: Provide information to community members of patients on treatment to increase uptake of testing and prevention services, and support retention on treatment. IHAP-HK/L held meetings with key provincial-level programs in the Ministry of Health (MOH), including the PNLS, PNSA, and PNMLS, and the DPS communication unit in Haut Katanga to discuss community mobilization and outreach. All parties agreed that community actors, such as peer educators and ReCos, can be supported through NGOs implementing community-based services and facilitating connections with facility-based service providers.

In Q4, IHAP-HK/L will hold a similar exchange meeting with provincial PNLS, PNSA, PNMLS, and DPS Lualaba to discuss IHAP-HK/L community outreach interventions for priority populations, as well as exchange sessions with HZMTs in Sakania, Kapolowe, and Panda to present IHAP-HK/L community interventions. IHAP-HK/L will also issue a solicitation to seek applications from local NGOs to conduct community prevention and outreach activities across all 16 IHAP-HK/L HZs. In coordination with the PNSA, IHAP-HK/L will train 20 peer educators in Manika and Dilala HZs to provide HIV sensitization and prevention services to adolescents and encourage them to be tested for HIV.

In Q3, IHAP-HK/L identified and reviewed communications materials (e.g., job aids, pamphlets) created by the Communication for Change (C-Change) project and used by peer educators and ReCos in community outreach with youth and adolescents. In Q4, IHAP-HK/L plans to reproduce and distribute a limited quantity of these materials for peer educators to use in outreach with youth and adolescents, while IHAP-HK/L develops updated communications materials, based on communication and outreach strategies to be developed in Q4 (see Activity 3 below).

As noted in Activity 2 of Sub-objective 1.1, IHAP-HK/L will coordinate with the EAGLE and ACCELERE! projects to provide youth and adolescents with HIV testing services. In Q4, IHAP- HK/L will work with EAGLE to develop a joint strategy for educating youth and adolescents on HIV prevention and informing them of available outlets for HIV/AIDS services, focusing on Kenya, Kampemba, and Rwashi HZs in Haut Katanga. IHAP-HK/L plans to jointly train 30 youth and adolescent peer educators, in conjunction with EAGLE and the PNSA, across 22

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 30 schools in Lubumbashi—17 schools in Kenya HZ, four schools in Kampemba HZ, and three schools in Rwashi HZ.

IHAP-HK/L will also work with RNOAC to educate partners and family members of PLHIV in the project’s treatment cohort on HIV prevention, the importance of knowing their HIV status, and supporting their partners/families to remain adherent to their HIV treatment. IHAP-HK/L will brief 40 peer educators on providing sensitization services and referrals for HIV testing to partners and family members of stable PLHIV receiving care and treatment services from the Kenya and Lubumbashi PoDi+ sites (operated by RNOAC).

Activity 3: Develop a communication and outreach strategy for targeted population groups to increase uptake of HIV prevention, testing, and care and support services. As noted above, IHAP-HK/L obtained and reviewed communications materials developed by the C-Change project in Q3, and is in the process of documenting existing materials created for priority populations.

In Q4, IHAP-HK/L will hold two stakeholder workshops (one in each province) for stakeholders from priority population groups and local organizations working with these populations. These workshops will focus on determining dissemination methods and channels to be used to reach each priority population group with HIV messaging and developing messaging to be used with each group. Communication and outreach strategies will be developed based on these workshops and used to inform future community outreach activities implemented by IHAP-HK/L. The project will also start adapting existing communications materials, as needed, to reflect messages developed during these workshops.

Sub-objective 2.2: Optimized service delivery models. In Q3, 1,296 stable patients in IHAP-HK/L’s treatment cohort received care and treatment services from differentiated service delivery models: PoDi+ sites; treatment distribution at self- help group meetings; and fast-track pick-up circuits at facilities.

IHAP-HK/L also introduced the OPQ approach to DPS, HZ, PNLS, and PNMLS representatives as a first step in applying the approach to improve the performance of HZMTs. Two HZMTs per province were selected for the first round of OPQ implementation.

Finally, the project conducted initial quality and environmental rapid assessments at five high- volume facilities (Sendwe Center of Excellence, Cliniques Universitaire, and Hakika, Kamalondo, and Dipeta General Reference Hospitals). Gaps have been identified that will be addressed through the Quality Improvement Collaborative (QIC) methodology.

Activity 1: Strengthen community-based PoDi+ sites to improve retention of stable PLHIV on treatment. In Q3, RNOAC continued to operate PoDi+ sites in Kenya and Lubumbashi HZs with financial and technical support from IHAP-HK/L. The project organized meetings with Kenya and Lubumbashi HZMTs and the medical directors of Kenya General Reference Hospital and

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 31 Sendwe Center of Excellence to increase the number of stable PLHIV enrolled to receive treatment at PoDi+ sites.

As shown in Figure 14, From April through June, 145 new stable patients were transferred to PoDi+ sites—68 at the Kenya PoDi+ site and 77 at the Lubumbashi PoDi+ site—for a total of 648 stable PLHIV receiving care and treatment services through PoDi+ sites.

Figure 14. Growth of cohorts supported by PoDi+ sites in Haut Katanga, October 2016–June 2017.

207 189 167 130 Number 61 of 9 patients

125 212 286 315 343 375 401 421 441

October November December January February March April May June

Kenya PODI+ Lubumbashi PODI+

At the end of June 2017, 1,296 stable patients (8 percent of the project’s treatment cohort in Haut Katanga) had received care and treatment services through a differentiated service delivery model. Figure 15 below shows the distribution of stable patients across the three differentiated service delivery models offered by IHAP-HK/L. As depicted in the figure, 50 percent (648) of stable patients preferred to receive services at PoDi+ sites, due to flexibility of pick-up times and ability to access services in a less stigmatizing environment. A total of 24 percent (314) preferred to receive their treatment at self-help group meetings and 26 percent (334) preferred the fast-track pick-up circuits at health facilities.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 32 Figure 15. Enrollment by differentiated service delivery model, June 2017.

648

334 314

PoDI+ Fast-track circuit Distribution at self-help groups

All stable PLHIV who came to pick up their medication during the April through June period— 118 at the Kenya PoDi+ and 49 at the Lubumbashi PoDi+—were provided with TB screening and nutrition assessments. Additionally, index case testing for partners and family members of stable PLHIV was introduced at the Kenya PoDi+. A total of 21 individuals were tested for HIV, of whom three tested HIV positive and were referred to Kenya General Reference Hospital for treatment (14 percent yield).

In preparation for the establishment of a third PoDi+ site in Haut Katanga and a PoDi+ site in Lualaba Province, IHAP-HK/L’s Community Care and Treatment Officers started assessments in Rwashi, Manika, and Dilala HZs to identify stable PLHIV eligible for transfer to PoDi+. In Q4, IHAP-HK/L will work with RNOAC to establish a third PoDi+ site in Rwashi HZ, linked to Hakiki General Reference Hospital, and one PoDi+ site in Dilala HZ, which will be linked to Dilala General Reference Hospital. IHAP-HK/L will brief PoDi+ staff in Kenya and Lubumbashi HZs to actively follow up with stable PLHIV who miss their pick-up days through phone calls, SMS, or home visits. IHAP-HK/L will also work with service providers and PoDi+ staff in Kenya and Lubumbashi to identify additional stable PLHIV to transfer to these two sites.

Activity 2: Expand distribution of antiretroviral medication in self-help groups and adherence clubs to improve PLHIV retention in treatment. In Q3, IHAP-HK/L provided technical and financial support to World Production and Bak Congo to continue provision of ARVs to the 314 stable PLHIV receiving their treatment at self- help group meetings. Self-help group facilitators continued to identify stable patients in their groups to enroll in treatment distribution during meetings. As a result, 90 additional stable patients were enrolled in treatment distribution during this reporting period.

Of the 70 self-help groups supported by IHAP-HK/L, 21 groups across five HZs provided treatment to PLHIV at self-help group meetings. Figure 16 below compares the number of

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 33 PLHIV self-help group members by HZ and stable PLHIV members of these groups enrolled to receive their treatment at self-help group meetings. Currently, 36 percent of self-help group members receive their treatment at meetings.

Figure 16. Antiretroviral medication distribution at self-help group meetings in Haut Katanga, June 2017.

276

191 180

129

96 85 85 73

32 28

Lubumbashi Kenya Rwashi Panda Kamalondo

PLHIV in self-help groups Stable PLHIV receiving ARVs during meetings

Next quarter, World Production and Bak Congo will continue to support treatment distribution at self-help group meetings for stable PLHIV. IHAP-HK/L will also support World Production and Bak Congo in integrating treatment distribution to stable PLHIV at ten additional self-help groups, to increase the total number of groups offering treatment distribution from 21 to 31 groups.

Activity 3: Expand the fast-track antiretroviral medication pick-up system model in high-volume sites in Haut Katanga. IHAP-HK/L continued to provide technical assistance to implement a fast-track ARV pick-up system in four facilities across three HZs in Haut Katanga—Hakika General Reference Hospital, Kenya General Reference Hospital, Faveur de Dieu Health Center, and Dominique Savio Health Center. At the end of June, 334 stable patients used the fast-track circuit to pick up their ARVs. The majority of patients using this circuit were in Kenya General Reference Hospital (64 percent).

In Q4, IHAP-HK/L will introduce a fast-track circuit in two additional facilities in Haut Katanga—Kamalondo General Reference Hospital and Panda General Reference Hospital—and three facilities in Lualaba—Dilala General Reference Hospital, Fungurume General Reference Hospital, and Manika General Reference Hospital. In collaboration with provincial PNLS,

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 34 IHAP-HK/L will also brief service providers in the nine facilities with a fast-track pick-up circuit on identifying and transferring stable PLHIV to using the rapid pick-up circuit for treatment pick-up. IHAP-HK/L will work with the PNLS to finalize SOPs and guidelines on implementing the rapid pick-up system.

Activity 4: Strengthen health zone management teams for improved management and oversight of high-quality HIV/AIDS services. OPQ is a participatory performance improvement approach that IHAP-HK/L will use to build the capacity of HZMTs to improve management and oversight of HIV service delivery. IHAP- HK/L’s Capacity-Building and Quality Advisor met with DPS, PNLS, PNMLS, and HZ representatives in Q3 in both Haut Katanga and Lualaba to provide an orientation on OPQ and how IHAP-HK/L can help them to apply the approach to improve performance gaps. Based on these discussions, a focal point was identified in each agency for long-term collaboration with IHAP-HK/L on OPQ and capacity-building efforts with HZs. DPS selected a representative from its Technical Support Office, PNLS selected its STI coordinator, and PNMLS selected its provincial executive secretary to serve as focal points. Using two key selection criteria (high number of HIV patients and weak treatment retention rates, where known), two HZs in each province were selected for first-round OPQ applications (Table 3).

Table 3. Criteria for selection of initial OPQ sites.

Province Health zone ART patients (Q2 FY17) Retention Lubumbashi 5,940 78 percent Haut Katanga Kenya 2,968 74 percent Dilala 1,560 Not documented Lualaba Manika 1,478 Not documented

The OPQ process will begin with a baseline assessment to identify gaps in each HZ related to management of HIV services. IHAP-HK/L developed a protocol and tools for the assessment phase, which will launch next quarter. The assessment will focus on management aspects of HIV services, such as supervision, commodities management, and M&E. Based on the evaluation, capacity-building activities will be selected for each HZ. In addition, the project developed scopes of work and advertised for the recruitment of OPQ Mentors (consultants) to work closely with HZs under the leadership of IHAP-HK/L’s Capacity-Building and Quality Advisor. OPQ mentors will be contracted next quarter.

Activity 5: Implement and scale up Quality Improvement Collaboratives in 26 facilities and communities. The QIC approach is a QI methodology in which a network of health facilities works together to address one focus area (quality challenge) over a specified period of time, often 12 to 18 months. IHAP-HK/L will use this methodology to foster QI and diffusion of innovations across the HIV care continuum at project-supported health facilities in Haut Katanga and Lualaba. In Q3, IHAP- HK/L provided technical and financial assistance to the MOH to conduct initial quality and environmental rapid assessments at three high-volume facilities (Sendwe Center of Excellence, Cliniques Universitaire, and Hakika General Reference Hospital) to identify potential gaps that can be addressed through the QIC methodology. As part of the rapid assessments, baseline

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 35 quality data (e.g., ART on-time pick-up, retention, and viral load suppression at six months) were collected to assess the quality of service delivery and environmental mitigation practices.

To facilitate the rapid assessments, the IHAP-HK/L informed key stakeholders at the MOH of the implementation of the QIC approach in Sendwe Center of Excellence, Clinique Universitaire, and Hakika General Reference Hospital and the establishment of a QI team in each site. IHAP- HK/L also developed tools for the MOH to collect baseline data on quality of service delivery and environmental practices and met with the MOH to explain the tools. Throughout the assessment process, IHAP-HK/L conducted site visits and provided logistical support. The following gaps were revealed during the rapid assessment: incomplete tools and patient registers (poor documentation); low testing of index cases; patients lost to follow-up; long turnaround time for viral load tests and results return; and unavailability of data for patients eligible for viral load testing.

To address these gaps, IHAP-HK/L will support the QIC teams in facilities to do the following.  Use Tier.Net to create monthly tracking lists of patients eligible for viral load tests.  Schedule ARV pick-up and viral load sample collection on the same day.  Implement a patient tracking system (e.g., phone calls, SMS reminders, and home visits).  Institute daily reviews of patients’ follow-up appointments for viral load sample collection.

IHAP-HK/L conducted joint visits with MOH staff to assess the functionality of and revitalize 21 facility-based QI teams (18 in Haut Katanga and three in Lualaba) in Q3. These facilities had previously implemented the QIC approach with support from the Applying Science to Strengthen and Improve Systems (ASSIST) project. IHAP-HK/L provided logistical support to coordinate visits and financial support to reimburse accompanying MOH staff. Assessments were completed in the 18 sites in Haut Katanga; assessments will be completed in the three sites in Lualaba in Q4.

IHAP-HK/L collected baseline data evaluating QI team functionality at ten high-volume facilities in Lubumbashi, Kenya, Rwashi, and Kampemba HZs. The evaluations indicated that none of the facilities continued to have functional QI projects after the withdrawal of ASSIST support.

As a next step, in July, IHAP-HK/L will retrain the QI teams at ten of the facilities that had previously implemented the QIC approach and will conduct refresher training for ten QI coaches from the HZs where these facilities are located in Haut Katanga and Lualaba.

As part of the QIC methodology, IHAP-HK/L will also organize collaborative learning sessions every six months to review data, share learning, and document successes for scale-up.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 36 Objective Three: Health systems strengthened to improve access to services and improve outcomes of PLHIV

Sub-objective 3.1: Essential commodities are available and effectively managed at all appropriate levels. In Q3, IHAP-HK/L coordinated with HZMTs and supply chain projects to provide all health facilities in Haut Katanga and Lualaba with rapid HIV test kits, DBS sampling kits, IPT, ARVs, and cotrimoxazole. The project also procured and delivered consumables and medical supplies to deliver high-quality HIV/AIDS services to all 153 project-supported facilities. In addition, IHAP-HK/L provided the 47 facilities in Lualaba with supplies to ensure correct and safe disposal of medical waste.

Activity 1: Supply all 153 project-supported sites with needed medical supplies and consumables to offer HIV-related care and treatment services. IHAP-HK/L coordinated with the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program to supply all 153 supported facilities with commodities to support HIV service delivery. Project-supported facilities sent orders to HZMTs, who discussed the orders with IHAP-HK/L’s Supply Chain team before sending the final orders to SIAPS. SIAPS delivered commodities directly to all IHAP-HK/L facilities in Lubumbashi, while IHAP-HK/L was responsible for delivering commodities to the 32 facilities in Panda, Sakania, and Kapolowe, and the 47 facilities in Lualaba.

Activity 2: Strengthen the capacity of health zone management teams and facilities for commodity management and storage, including commodity quantification, forecasting, and ordering. The IHAP-HK/L team conducted assessments in five HZ offices around Lubumbashi to assess stocks of HIV commodities available at HZ commodity storage depots. This survey revealed stockouts of Determine™ and Uni-Gold™ rapid test kits; antiretroviral medication was also in danger of being stocked out. IHAP-HK/L requested that SIAPS quickly re-supply these products at HZ commodity storage depots, which prevented a stockout of ARVs and decreased the length of time that test kits were unavailable.

Assessments of HZ commodity storage depots also revealed that most HZs were not storing commodities correctly and in accordance with standards and best practices. In many cases, HZ commodity storage depots have limited storage space; lack fans, air conditioners, and refrigerators; medicine cabinets or shelves; and high-quality pallets.

Following these visits to commodity depots, IHAP-HK/L recommended the following actions to improve commodity management and storage:  Establish an early warning system, under which monthly commodity consumption reports will be submitted by health facilities and compiled into an electronic dashboard at the

Determine is a trademark of Alere. Uni-Gold is a trademark of Trinity Biotech.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 37 provincial level. This recommendation will be discussed with the commodity management TWG to determine feasibility and next steps, including projects that will support this initiative.  Identify one facility in each HZ that stores commodities in accordance with best practices and national standards.

IHAP-HK/L also participated in monthly commodity management TWG meetings in Haut Katanga.

In Q4, IHAP-HK/L will continue participating in the monthly commodity management TWG meeting in Haut Katanga and ensure regular coaching for site providers on commodity management. IHAP-HK/L will also advocate with HZMTs for Community Health Committees to help with quantifying and maintaining inventories of family planning commodities, including condoms, for better stock management. The project will conduct a needs assessment in the HZs and high-volume health facilities to determine quantities of data reporting tools and forms that may need to be ordered for facilities.

Sub-objective 3.2: Improved use of reliable data to continuously improve service delivery quality and effectiveness. This past quarter, the IHAP-HK/L M&E team led a briefing in Lualaba on the project’s M&E system for HZMT members (data managers and HIV supervisor nurses), IHAP-HK/L staff, the PNLS, and DPS. The M&E team also conducted three routine data quality assessment visits in Lubumbashi, at two sites in Kampemba HZ and one site in Rwashi.

IHAP-HK/L began the customized development of DHIS 2, an open-source health management information system, to capture HIV-related project data for reporting, monitoring, and evaluation. The project continued to use the Tier.Net database to help sites manage their cohorts. A total of 11 data clerks in Haut Katanga entered updates directly into the Tier.Net database.

IHAP-HK/L staff quickly established contacts with DPS in Haut Katanga and joined the human resources for health (HRH) TWG, under which open-source human resources information system (iHRIS) work will be accomplished. Initial meetings with the HRH TWG focused on planning for a rapid assessment of existing and needed staffing, equipment, and materials for iHRIS deployment.

Finally, IHAP-HK/L actively participated in the SIMS visits conducted by USAID in 20 facilities and developed improvement plans, which are being implemented to address weaknesses identified in each site.

Activity 1: Collect targeted data from 47 facilities in Lualaba for comprehensive baseline data. Baseline data were collected in 17 out of 47 sites (36 percent) across two HZs in Lualaba in Q3. IHAP-HK/L retained a consultant to help refine baseline data collection tools and analyze collected data.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 38 Activity 2: Coach 153 IHAP-HK/L supported sites on monthly data collection and reporting to ensure high-quality data reporting. The M&E team held two briefings on the project M&E system, including data flow, indicators (both United States President’s Emergency Plan for AIDS Relief [PEPFAR] Monitoring, Evaluation, and Reporting [MER] Indicators and non-MER Indicators), data collection, and data analysis and reporting tools. In Lualaba, 15 HZMT members (eight data managers and seven HIV supervisor nurses), 11 IHAP-HK/L staff (nine data clerks and two site support coordinators), and three staff from DPS in Lualaba were briefed on the project M&E system. In Haut Katanga, 19 IHAP-HK/L staff were briefed on the project system.

IHAP-HK/L also developed the following two tools for internal data analysis: 1. Monthly cross-verification tool used by IHAP-HK/L technical officers and site support coordinators to verify consistency and accuracy of the data before IHAP-HK/L data clerks enter data into the database. 2. IHAP-HK/L monthly 90-90-90 tracker, which will be used to share monthly data with USAID. IHAP-HK/L shared this tool with USAID for inputs before finalization of the tool.

The M&E team also conducted three routine data quality assessment visits at two facilities in Kampemba HZ and one facility in Rwashi. Data quality presentations were postponed to Q4 due to time restrictions.

While IHAP-HK/L facilities reported monthly data using the canevas unique, IHAP-HK/L also used annexes to the canevas unique to collect additional Briefing held in Lualaba for HZ data managers and supervisors on IHAP-HK/L’s M&E system. disaggregated data required by PEPFAR from facilities. For example, the canevas unique does not include all HIV/TB and TB/HIV cascade indicators required by PEPFAR to ensure that PLHIV who screen positive for TB are referred for confirmation of diagnosis and enrollment in TB treatment (and vice versa for TB patients who screen positive for HIV). To prepare for PEPFAR reporting, the project developed an additional template to collect these data. In August, IHAP-HK/L will train facilities in Lualaba on data reporting tools used by IHAP-HK/L, including the canevas unique and associated annexes.

The project continued to provide technical support to facilities in use of the Tier.Net database to manage treatment cohorts. In all, 11 IHAP-HK/L data clerks in Haut Katanga worked with 101 facilities to update patient information in the Tier.Net database. Four facilities in Haut Katanga (Kenya General Reference Hospital, Kampemba General Reference Hospital, Sendwe Center of Excellence, and Clinique Universitaire) made updates to Tier.Net directly, with support from IHAP-HK/L data clerks, as needed. One facility in Haut Katanga, which is being shifted to

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 39 Lualaba since it is located in Fungurume HZ, has not yet been trained on Tier.Net, but will be trained along with the other IHAP-HK/L facilities in Lualaba in the future. Eight sites in Lualaba are able to input data directly into Tier.Net; IHAP-HK/L data clerks visit these eight sites to provide support to facility data managers on Tier.Net, as needed.

In Q4, the project will expand the number of sites able to directly input data into Tier.Net and strengthen the capacity of those already using Tier.Net to conduct simple cohort analyses. IHAP- HK/L will select 20 high- or medium-volume sites for this training. In Lualaba, four sites used Tier.Net version 1.8 for a previous project. The PNLS recommended that these four sites use Tier.Net version 1.10, which includes HIV/TB data, to ensure compatibility with IHAP-HK/L systems. The PNLS agreed to support setup of the Tier.Net upgrade, and IHAP-HK/L will provide a refresher briefing for data managers in these four sites. In addition, IHAP-HK/L will train ten new sites in Lualaba on the Tier.Net system, data entry, and use of the system for cohort analysis. To facilitate facility transition to electronic data reporting, IHAP-HK/L procured a laptop and printer for all 47 facilities in Lualaba, which will be distributed to sites in Q4.

Activity 3: Conduct health zone microplanning for 15 health zones in Haut Katanga and Lualaba. The IHAP-HK/L team met with provincial management teams (the PNLS and DPS) and HZMTs from the four HZs around Lubumbashi to discuss plans for HZ microplanning, specifically how to identify priority populations within each HZ and map populations targeted for HIV testing.

Starting in Q4, IHAP-HK/L will move forward with organizing microplanning workshops for seven HZs in Lualaba (Kampemba HZ created their microplan under ProVICplus) and all eight HZs in Lualaba to develop their microplans and map priority populations in their HZs to better guide HIV prevention and testing efforts.

Activity 5: Kick off use of District Health Information System 2 for data analysis, reporting, and visualization for the project. PATH began the customized development of DHIS 2 to capture HIV-related project data for reporting, monitoring, and evaluation. A team of developers met virtually in Q3 to facilitate the back-end development of DHIS 2 using project data elements identified by the IHAP-HK/L M&E team. In addition, the team discussed how DHIS 2 will be used for data analysis and the different types of data visualizations (including Tableau dashboards) that will be integrated into the project. Finally, a server was established to host the test instance for DHIS 2. The instance will be migrated to a server hosted by BAO Systems, common for DHIS 2 deployment, after development and testing have been completed, early in FY18.

DHIS 2 development is scheduled to be completed by July, and a DHIS 2 training is planned for the IHAP-HK/L M&E team in August. PATH is also exploring the integration of Tier.Net data into DHIS 2.

Activity 6: Establish an automated human resources information system (using iHRIS) in the two provinces for improved management, distribution, and motivation of health workers.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 40 The IHAP-HK/L HRH/Health Systems Strengthening (HSS) Senior Advisor and Health Information Systems Developer spent a week in Kinshasa with IntraHealth staff working on the United Kingdom Department for International Development Access to Primary Health Care Project for on-the-job training in iHRIS. They learned about the successes in Kasai and Kasai Central and the powerful impact iHRIS can have on availability of services in IHAP-HK/L HZs once DPS and HZMTs establish iHRIS. New staff learned how to use iHRIS data for human resources management (rational deployment) and elimination of ghost workers from the public payroll in order to reallocate salaries and primes to actual health workers not currently being remunerated.

Upon arrival in Lubumbashi, project HRH/HSS staff held preliminary meetings with DPS in Haut Katanga and Lualaba to introduce the project’s planned support in the area of HRH to improve the availability and quality of HIV services. Both DPS in Haut Katanga and in Lualaba are enthusiastic about this support, as no other partner to date in the two regions has focused on HRH. The DPS Chief assigned his HRH focal points (the Human Resources Bureau Chief and Data Manager) to work with the IHAP-HK/L team. Following this meeting, IHAP-HK/L and the HRH focal points convened a first working session to begin planning for iHRIS rollout, during which it was agreed that iHRIS work will be managed under the existing HRH TWG in Haut Katanga. IHAP-HK/L will join the TWG, participating in all meetings and providing technical support. In Q4, IHAP-HK/L will conduct a needs assessment to determine gaps in DPS/HZ staffing, equipment, and materials for full deployment of iHRIS.

Activity 7: Conduct Site Improvement through Monitoring System visits for 68 project-supported facilities in Lualaba and Haut Katanga. SIMS joint visits were conducted by USAID in May and June at 20 IHAP-HK/L supported sites in Haut Katanga—ten facilities in Panda and Kapolowe HZs in May and ten facilities in Sakania, Kenya, Lubumbashi, Kampemba, and Kamalondo HZs in June. These SIMS visits focused on assessing service delivery at pharmacies and TB entry points, provision of adolescent and youth- friendly services, and index case testing for family members of PLHIV. IHAP-HK/L staff participated in these SIMS assessments, and provided clarification to health facility staff on questions posed by assessors during the assessments.

Once the assessments were completed, IHAP-HK/L worked with facility staff to identify strategies for improving weaknesses, addressing findings, and integrating recommendations provided by the assessors. Table 4 provides a summary of findings from SIMS visits for health facilities that received a red rating. An action plan was developed for each facility to address SIMS findings by the end of September, and IHAP-HK/L will monitor progress against these actions plans during site visits in Q4.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 41 Table 4. Summary findings from USAID Site Improvement through Monitoring System visits in Q3 FY17.

Activity domains Comments/Challenges Corrective action Pharmacy  Stockouts of pediatric ARV  Ensure availability of pediatric ARVs and drugs. other HIV consumables by notifying supply  Lack of registers and protocols chain projects when ARVs are in danger of for dispensing medicines in being stocked out and work with projects to each care and treatment unit. make spot orders to prevent stockouts.  Distribute registers and protocols for dispensing medicines to PLHIV.  Coach pharmacists in laboratories to update stock cards after each transaction. Tuberculosis  Lack of referral slips proving  Improve links between HIV care and referral to a CSDT for PLHIV treatment wards and CSDTs; ensure the with presumptive TB. return of results for PLHIV who screen  Absence of registers for PLHIV positive for TB; and refer these PLHIV to a with presumptive TB. CSDT for diagnosis and treatment.  Distribute registers in each care and treatment unit to record PLHIV with presumptive TB. Adolescent  Absence of HIV prevention,  Train facility-based staff to provide services care, and treatment activities adolescent-friendly HIV counseling, testing, and support for adolescents. care, and treatment services. Index case  Very low rates of HIV  Emphasize routine screening of children of testing screening of children of PLHIV in supported health facilities by PLHIV. using the Mentor Mother approach. Follow-up of  Poor follow-up of HIV-exposed  Provide coaching on using the algorithm for HIV-exposed children. follow-up of exposed children. children  Ensure the results of polymerase chain reaction/DNA tests are returned to facilities by coaching laboratory staff to monitor sample results being returned and follow up on missing results. Pediatric care  Poor follow-up of pediatric  Mentor facilities to follow the algorithm for and treatment ART. pediatric treatment and documenting patient updates in registers. Management/  Lack of QA plans in facilities.  Revitalize QA activities and update QI Quality action plans to respond to challenges improvement identified at supported sites. Injection  Lack of adequate medical  Supply facilities with consumables (e.g., safety consumables to protect facility gloves and medical gowns) to protect workers, such as medical gowns providers during injections and blood tests. and gloves.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 42 Activity 9: Support the leadership role of provincial PNLS and DPS in coordinating HIV/AIDS activities in Haut Katanga and Lualaba. IHAP-HK/L provided financial assistance to support the participation of representatives from provincial PNLS in Haut Katanga and Lualaba for the annual review meeting of the PNLS, held May 16–20 in Kisangani. IHAP-HK/L also supported joint quarterly supervision visits of the PNLS in Haut Katanga to Kenya and Kampemba HZs and PNLS Lualaba to Manika and Dilala HZs. Challenges observed during these joint site visits included:  Low number of PLHIV with viral load results in their records due to low availability of facilities with the capability to conduct analyses and slow return of results.  Passive monitoring of PLHIV with detectable viral loads; service providers wait until their next appointment instead of calling them.  Low rates of index case testing of partners and children of PLHIV on treatment due to PLHIV not disclosing their status to partners and children or weak follow-up with partners/family members.  Low rate of early diagnosis of HIV-exposed children.  Lack of infrastructure in certain health facilities to aid in correct disposal practices for biomedical waste management.

IHAP-HK/L will coordinate with HZMTs and the PNLS to identify strategies to address the above challenges. IHAP-HK/L also provided DPS in Haut Katanga with fuel to support supervision visits to facilities in Sakania HZ—the Division Chief was satisfied with the provision of HIV services in facilities and did not note any areas that need improvement. Sub-objective 3.3: Effective, operational laboratory systems ensured. During monitoring visits in Q3, IHAP-HK/L staff checked logbooks containing patient data and QA registers to ensure that tools/registers were being completed regularly and accurately by laboratory technicians. They provided technical assistance, including mentorship, to technicians to address issues observed during visits. In Q4, IHAP-HK/L’s Laboratory Advisor will assess the laboratory sample transportation system and propose a plan to improve the system to address weaknesses, in an effort to boost laboratory services for HIV diagnostics and monitoring provided to patients in IHAP-HK/L HZs. The IHAP-HK/L team will also work closely with facilities to develop plans for disposal of biomedical waste management.

Activity 1: Strengthen laboratory networks in Lualaba through standardization and decentralization of laboratory services and the improvement of the sample transportation system to provide improved HIV diagnostic and analytical services. In July, IHAP-HK/L’s Laboratory Advisor will begin analyzing laboratory system strengths and weaknesses and will propose improvements for implementation, including a plan to network all laboratories and improve the sample transportation and analysis system.

Activity 2: Strengthen the capacity of IHAP-HK/L supported facilities to provide high-quality HIV diagnostic services. During each site visit in Haut Katanga, IHAP-HK/L site support coordinators and technical officers checked logbooks containing patient data and QA registers to ensure that they were

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 43 being completed regularly and accurately. They provided technical assistance, including mentorship, to technicians to address issues observed during visits. The IHAP-HK/L Laboratory Advisor will develop SOPs on the steps for participating in HIV testing proficiency administered by the PNLS, and ensure that project-supported facilities participate in proficiency testing. During monthly coaching visits, the IHAP-HK/L Laboratory Advisor and Officer will coach laboratory technicians at facilities that receive a less than perfect score in HIV proficiency tests to improve their diagnostic capabilities.

Activity 3: Improve practices related to management and disposal of biomedical waste. The IHAP-HK/L Laboratory Advisor will provide coaching on disposal of biomedical waste during monthly site visits in Q4. The Laboratory Advisor will also develop and implement a checklist to monitor compliance with waste management protocols and will plan for the purchase of any needed biomedical waste supplies. The IHAP-HK/L technical team will support all service delivery points in developing individual plans for proper disposal of all waste generated as a result of IHAP-HK/L activities, including procedures and plans to package and secure transportation of health care waste to the closest incinerator for destruction or the nearest site for secure burial.

Activity 4: Strengthen the laboratory data management system. During Q4, the IHAP-HK/L technical team will develop data collection tools for laboratory services data and will distribute the tools to laboratory-supported sites. These tools will be reviewed during monthly site visits, and the IHAP-HK/L Laboratory Advisor will provide technical assistance on their use.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 44 Project Administration

IHAP-HK/L continued to take steps in the April through June period to advance project operations and administration with a focus on finalizing recruitment for all open IHAP-HK/L positions and deploying staff. The project also moved forward with key procurements and support for IHAP-HK/L facilities and continued to finalize and submit all required project deliverables.

Human Resources

During this reporting period, PATH continued to gradually deploy former ProVICplus staff shifting to IHAP-HK/L to their new posts in Lubumbashi and Kolwezi, with all staff fully transitioned to IHAP-HK/L by the end of June, and continued recruitment for a Senior Grant Manager. IntraHealth recruited and seconded four staff to the project: HRH/HSS Senior Advisor, Health Information Systems Developer, Referral System Advisor, and Capacity-Building and Quality Advisor. These staff joined the project office in Lubumbashi in June. ICAP issued temporary agreements for Site Support Coordinators and Technical Officers while they continued recruitment for permanent IHAP-HK/L staff.

In an effort to ensure that IHAP-HK/L operates as a united project with all staff using IHAP- HK/L, rather than organizational, branding, PATH coordinated with consortium partners to align relocation packages, per diem rates, and holiday schedules (to the extent possible) to ensure that staff participate as fully integrated and equal members of the project team and promote the “one team, one project” concept.

Deliverables

IHAP-HK/L focused on developing and submitting all deliverables required for project start-up to USAID, including the Grants Management Plan, the Branding Strategy and Marking Plan, and the Environmental Mitigation and Monitoring Plan. IHAP-HK/L also revised the FY17 Implementation Plan and Project Monitoring and Evaluation plan, based on USAID’s feedback, during the reporting period. All deliverables were submitted to USAID by requested deadlines, and USAID approved all deliverables by the end of Q3.

Grants

From April through June, the IHAP-HK/L Finance and Administration team procured and delivered essential commodities and supplies required by facilities to provide HIV services. The IHAP-HK/L Grants team also outlined rationale and developed a budget structure for financial support provided to facilities, HZMTs, provincial PNLS, and provincial DPS, as well as issued direct support letters to facilities for the April through June period. The team also took steps to gather back-up documentation required for full subgrant agreements and began development of a

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 45 request for applications to solicit applications from local NGOs to provide community HIV outreach and prevention, testing, care, and support services.

Operations

In April through June, the IHAP-HK/L Finance and Administration team in Lubumbashi coordinated with the project team in Kolwezi to continue preparations to set up the project office in Kolwezi. Preparations were finalized in early June, and the team moved into the office at the end of June. The IHAP-HK/L Finance and Administration team also worked with PATH’s Country Administrator to continue the search for a proj ect office in Lubumbashi. The team encountered initial challenges identifying an affordable office space large enough to accommodate all project staff but were close to selecting a final location by the end of June. PATH’s Procurement team in Seattle also coordinated with the IHAP-HK/L Finance and Administration team to solicit quotations from vendors for the procurement of five vehicles for the IHAP-HK/L project. A purchase order was signed in early June, with vehicles expected to arrive in Lubumbashi in mid-August to supplement the project’s current fleet of six vehicles.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 46 Annex One: Monitoring and Evaluation Table

PEPFAR indicators Haut Katanga Kamalondo Kampemba Kapolowe Kenya Lubumbashi Panda Rwashi Sakania TOTAL HTS_TST 1,081 7,712 4,655 4,921 6,062 1,794 4,789 4,571 35,585 Unknown 118 725 888 511 482 212 290 655 3,381 Female 588 5,312 2,907 3,318 3,627 1,176 3,510 3,073 23,511 Male 375 1,672 858 1,039 1,953 406 988 840 8,131 Tested positive 54 230 123 233 348 49 143 159 1,339 Positivity rate 5% 3% 3% 5% 6% 3% 3% 3% 4% Unknown 2 11 7 21 21 2 11 7 82 Female 33 150 78 142 228 35 97 102 864 Male 19 69 38 65 100 12 35 50 388 PITC inpatient services 174 647 218 718 534 361 358 322 3,332 PITC pediatrics services 75 430 608 315 289 98 186 460 2,461 PITC malnutrition services 0 0 0 0 0 0 0 0 0 PITC TB clinics 37 185 41 297 49 47 136 69 812 PITC PMTCT (ANC only) clinics 1,113 2,256 1,055 1,230 1,128 438 1,540 1,583 10,343 PITC (other) 656 3,886 2,671 2,001 3,657 816 2,384 1,903 17,974 VCT facility 26 308 62 308 405 34 185 234 1,562 Index testing facility 0 0 0 52 0 0 0 0 0 Male partners 0 2 3 1 4 0 6 4 20

PEPFAR indicators Lualaba Bunkeya Dilala Fungurume Kanzenze Lualaba Lubudi Manika Mutshatsha TOTAL HTS_TST 1,233 3,990 2,637 850 1,266 842 3,378 317 14,513 Unknown 39 211 172 14 91 60 230 5 822 Female 993 2,256 1,864 741 935 559 2,247 221 9,816 Male 200 1,523 598 95 239 223 901 91 3,870 Tested positive 41 126 153 17 78 34 266 7 722 Positivity rate 3% 3% 6% 2% 6% 4% 8% 2% 5% Unknown 2 9 8 0 4 5 20 1 49 Female 30 91 92 13 41 16 147 5 435 Male 6 55 51 6 18 7 90 1 234 PITC inpatient services 27 355 107 11 15 50 257 11 833 PITC pediatrics services 0 4 43 0 10 0 5 0 62

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 47 PEPFAR indicators Lualaba Bunkeya Dilala Fungurume Kanzenze Lualaba Lubudi Manika Mutshatsha TOTAL PITC malnutrition services 0 2 2 1 2 5 34 0 46 Tested positive 41 126 153 17 78 34 266 7 722 PITC TB clinics 81 91 38 15 43 26 151 26 471 PITC PMTCT (ANC only) clinics 565 888 1,043 493 529 333 1,200 86 5,137 PITC (other) 518 2,271 1,058 294 606 335 1,303 182 6,567 VCT facility 42 233 246 33 49 32 268 11 914 Index testing facility 0 146 100 3 12 61 160 1 483 Male partners 2 344 95 3 11 54 119 1 629

PEPFAR indicators Haut Katanga Lualaba TOTAL Target % Achievement HTS_TST 35,585 14,513 50,098 125,499 40% Unknown 3,881 822 4,703 Female 23,511 9,816 33,327 Male 8,131 3,870 12,001 Tested positive 1,339 722 2,061 Positivity rate 4% 5% 4% Unknown 82 49 131 Female 864 435 1,299 Male 388 234 622 PITC inpatient services 3,332 833 4,165 PITC pediatrics services 2,461 62 2,523 PITC malnutrition services 0 46 46 PITC TB clinics 861 471 1,332 PITC PMTCT (ANC only) clinics 10,343 5,137 15,480 PITC (other) 17,974 6,567 24,541 VCT facility 1,562 914 2,476 Index testing facility 52 483 535 Male partners 20 629 649 PMTCT_STAT 87% 64% 79% 100% 80% PMTCT_STAT_N 14,706 5,184 19,890 44,625 45% PMTCT_STAT_D 16,934 8,118 25,052 44,780 56% PMTCT_EID 150 72 222 914 24% PMTCT_ART 90% 93% 91% PMTCT_ART_N 182 112 294 843 35% TX_NEW 1,170 675 1,845 4,042 46%

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 48 PEPFAR indicators Haut Katanga Lualaba TOTAL Target % Achievement TX_CURR 16,251 4,836 21,087 25,708 82% Non-PEPFAR indicators Haut Katanga Lualaba TOTAL Target % Achievement Number of HIV-positive adults and children accessing care and support 16,251 4,836 21,087 16,715 126% services. Percentage of health facilities without stockouts of essential drugs for 97% 100% 98% 96% 102% HIV/AIDS and TB management.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 49 Annex Two: Success Story

Attached.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 50 Annex Three: Trainings and Site Visits

Topic Location Dates Number of participants Trainings and workshops Master training on integrated HIV/AIDS care Lubumbashi April 27–May 2, 2017 19 guidelines Master training on integrated HIV/AIDS care Lualaba (Kolwezi) May 27–June 1, 2017 21 guidelines Training on integrated HIV/AIDS care Rwashi May 18–25, 2017 38 guidelines for service providers from 74 Kampemba 78 facilities in Kenya, Rwashi, Kampemba, Kenya 38 Kamalondo, and Lubumbashi HZs Lubumbashi and Kamalondo 62 Training on IHAP-HK/L M&E system for HZ Lualaba June 7–9, 2017 26 staff in Lualaba Site visits Updating data collection tools, monthly data All 153 sites (106 in Haut Katanga and 47 in Weekly All service providers involved in analysis, EID, and viral load sample collection Lualaba) (April 1–June 30, 2017) HIV activities, temporary site and transportation to the provincial laboratory, support coordinators and monitoring commodities consumption Baseline quality and environmental Lubumbashi (Cliniques Universitaire, April 28–30, 2017 Facility-based service providers assessments for introduction of the QIC Sendwe Center of Excellence, and Hakika and administrative staff, peer approach General Reference Hospital) educators, HZ managers (2), HZ HIV focal points (2), PNLS staff (3), PNMLS staff (1), IHAP- HK/L QA/QI Officer Assessment of the functionality of QIC teams Lubumbashi (Kamalondo General Reference June 13–24, 2017 Site providers from QI team (20) in sites that previously implemented the QIC Hospital, André Barbier, Wantashi, Paul and IHAP-HK/L QA/QI Officer approach Marie Bock, Kampemba General Reference Hospital, Sendwe General Reference Hospital, Dominique Savio, Mary Elmer, Faveur de Dieu, Yambala Coaching health providers on how to correctly 74 sites in 5 HZs (Lubumbashi, Kamalondo, May 1–31, 2017 All facility-based service fill out TB screening records and provide Rwashi, Kenya, and Kampemba) providers involved in HIV adherence counseling to HIV/TB-negative activities, IHAP-HK/L Clinical patients on IPT TB/HIV Officer SIMS visits with USAID team 10 sites in Haut Katanga (8 sites in May 2–12, 2017 All facility-based service Kapolowe HZ and 2 sites in Panda HZ) providers involved in HIV

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 51 Topic Location Dates Number of participants activities, USAID staff (1), and IHAP-HK/L staff (1) SIMS visits with USAID team 10 sites in Haut Katanga (1 site in June 12–23, 2017 All facility-based service Lubumbashi HZ, 1 site in Kampemba HZ, 1 providers involved in HIV site in Kamalondo HZ, 2 sites in Kenya HZ, activities, USAID staff (1), and and 5 sites in Sakania HZ) IHAP-HK/L staff (1) QIC refresher Kamalondo General Reference Hospital (in June 29, 2017 All facility-based service Kamalondo HZ) providers of Kamalondo General Reference Hospital, HZ manager (1), HZ supervisor (1), IHAP- HK/L staff (1) Monitoring 90/90/90 progress with site Garenganze Health Center, Kampemba June 19, 2017 Kheith’Impilo team (5), IHAP- providers and Kheith’Imiplo in 14 sites in Nsangaji Health Center, Rwashi June 20, 2017 HK/L technical staff (5), all Lubumbashi town, focused on: Sion Health Center, Rwashi June 20, 2017 service providers from each site  New strategies (test-and-start, index case Radem Gambela Health Center, Lubumbashi June 21, 2017 trail, multi-month service delivery, St Marcel Health Center, Lubumbashi June 21, 2017 PoDi+, viral load scale-up) St Jean Marc Health Center, Kampemba June 22, 2017  Establishment of current active cohort on Moza Health Center, Kampemba June 22, 2017 ART Clinique Universitaire, Lubumbashi June 22, 2017  Building capacity of local implementing Kiba Health Center, Lubumbashi June 23, 2017 partner staff in carrying out cohort Ebenezer Health Center, Lubumbashi June 23, 2017 assessments Dominique Savio Health Center, Kampemba June 26, 2017 Jardin D’Eden Health Center, Kampemba June 26, 2017 Sendwe Center of Excellence, Lubumbashi June 27, 2017 PoDi+ site, Kenya June 27, 2017

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 52 Master training on integrated HIV/AIDS guidelines, Lubumbashi April 27 to May 2, 2017 Agenda

HEURE PLAGE METHODOLOGIE ANIMATEUR MODERATEUR JOUR 1: le 27/04/2017 MODERATEUR: MCP 8h 30- Accueil des participants et WILLY 9h00 distribution des kits de la formation 9h00- Cérémonie d’ouverture WILLY 9h15 9h15- Présentation des facilitateurs et 9h45 participants - Lecture des TDRs et agenda Exposé Dr Marie Agnès - Répartition des tâches (chef du village, Rapporteur de J1 à J6, mises en train et évaluation) - Attentes des participants et codes des bonnes conduites 9h45- Administration du pré test Dr Marie Agnès 10h15 10h15- Pause-café 10h30 11h30- Généralités sur le VIH: Exposé WILLY 13h00 - Définition des concepts - Epidémiologie du VIH - Voies de transmission du VIH - Facteurs favorisant la transmission 13h00- Pause-Repas 14h00 14h00- Généralités sur le VIH (suite): NADINE 16h45 - Mode de prévention - Approche paquet VIH et organisation des services Généralités sur le CDV/DCIP: - Définition des concepts - Principes et avantages 16h 45- Evaluation de la journée 17h00

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 53 Jour 2: le 28/04/2017 MODERATEUR: Dr NADINE 8h 30- Où en sommes-nous? 9h00 9h 00- Lecture et adoption du rapport J1 Equipe de rap 9h30 9h 30- Généralités sur le CDV/DCIP Exposé WILLY 10h00 (suite): - Technique de déroulement - Cas particuliers - Aspects éthiques et juridiques 10h00- PRESENTATION DES OUTILS exposé NADINE 10h30 DCIP HARMONISEES 10h30- Pause-Café 10h45 10h 45- Notion sur l’andragogie: Exposé DR DARIUS 13h00 - Approche AM MAKELA - Presentation efficace 13h00- Pause-Repas 14h00 14h 00- Notions sur l’andragogie: Exposé DARIUS/ 15h00 - Presentation interactive WILLY - La coformation - Organisation d’une formation 15h 00- Généralités sur la PTME Exposé Dr Marie Agnès 16h45 16 45 H à Evaluation de la journée Application de la Modérateur 17 H grille JOUR 3: le 29/04/2017 MODERATEUR: WILLY 8h 30- Où en sommes-nous ? 9h00 9h00- Lecture et adoption du rapport J3 Equipe de 9h30 rapportage 9h30- - Généralités sur les Exposé Dr Marie Agnès 10h30 interventions de la SR - PTME-compréhensive (Aperçus sur la PTME) - Approche pour la réduction de transmission du VIH de la Mère à l’enfant 10h30- Pause café 10h45 10h45- DCIP PENDANT LA PTME Exposé Nadine 13h00 - Pendant la CPN - Pendant le Travail et l’Accouchement - En post partum Implication du partenaire masculin 13h00- PAUSE REPAS 14h00

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 54 14h00- - Particularités de la PTME Exposé Nadine 15h30 Option B+ - Défis et Difficultés de l’Option B+ 15h30- - Présentation des algorithmes de Exposé Dr Marie Agnès 17h00 PEC de la femme enceinte Traitement ARV de la femme enceinte et allaitante VIH+: - Critères de mise sous ARV - Schéma de 1ère ligne - Schéma de 2è ligne 17H00- Evaluation de la journée 17H15 JOUR 4: le 30/04/2017 MODERATEUR: Nadine 8h 30- Où en sommes-nous ? 9h00 9h00- Lecture et adoption du rapport J4 Equipe d 9h30 rapportage 9h30- - Prophylaxie ARV chez l’enfant Exposé Dr Marie Agnès 10h30 exposé - Diagnostic Clinique et biologique du VIH chez l’enfant exposé 10h30- Pause-café 10h45 10h45- PRESENTATION DES OUTILS Exposé et échanges Marie Agnès 11h30 HARMONISES (PTME) 11h30- - Algorithme du diagnostic VIH Exposé Darius 12h30 de l’enfant de moins de 18 mois - algorithme de la prise en charge de l’enfant de moins de 18 mois - Traitement ARV et critères de mise sous ARV chez le nourrisson infecté au VIH 12h30- Suivi clinique et biologique Exposé Willy 13h00 Prophylaxie au cotrimoxazole Alimentation du nourrisson exposé au VIH - syphilis congénitale (Approches pour l'élimination) 13h00- PAUSE REPAS 14h00 14h00- Approches communautaires ( Paire exposé NADINE 15h30 éducation selon AMM; Superpatient ) 15h30- Les IST: Travaux en groupe MCP 17h00 - Généralités sur les IST - Approche syndromique - Les syndromes et les médicaments - Populations clés et Prévention combinée

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 55 Utilisation des Algorithmes IST OUTILS IST 17h00- Evaluation de la journée 17h15 JOUR 5: le 01/05/2017 MODERATEUR: DR DARIUS 8h 30- Où en sommes-nous ? 9h00 9h00- Lecture et adoption du rapport J4 Equipe d 9h30 rapportage 9h30- - Diagnostic clinique et Exposé DR WILLY 10h30 biologique du VIH chez l’enfant - Classification clinique de l’OMS (chez l’enfant) - Particularités du VIH/Sida en pédiatrie - Traitement ARV de l’enfant 10h30- Pause-café 10h45 10h45- Les Infections opportunistes et Exposé DR WILLY 11h15 coinfections( VIH/TB ET VIH/HB) Prophylaxie au cotrimoxazole Prophylaxie à l’izoniazid 11h15- Suivi clinique et biologique de Exposé DR WILLY 11h45 l’enfant Divulgation du statut sérologique DR NADINE 11h45- Exercices intégrées sur la prise en Travaux en groupe 13h00 charge TAR 13h00- Pause-café 14h00 14h00- Algorithme de dépistage VIH Séance pratique BINOME 14h45 Utilisation et application des tests rapides 14h45- Suivi biologique (tests hépatiques Exposé Dr DARIUS 15h30 et rénaux, bilan hématologique et autres) Comptage CD4 Charge virale Manipulations DBS (préparation éch. et colisage) 15h30- Biosécurité Exposé Dr DARIUS 16h00 Assurance qualité Contrôle de qualité 16h00 – Outils de collecte de laboratoire Dr DARIUS 17h00 17h00 – Evaluation de la journée Modérateur 17h15 Jour 6: le 02/04/2017 MODERATION: Dr WILLY 8h 30- Où en sommes-nous ? 9h00

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 56 9h00- Lecture et adoption du rapport J7 Equipe de 9h30 rapportage 9h30- Classification des ARV et Mode Exposé DR DARIUS 10h30 d’action des ARV Adhérence et observance au TAR Effets secondaires et toxicité liés aux ARV Classification clinique de l’OMS (chez adulte et adolescents) Critères de mise sous ARV/directives OMS/PNLS (Adulte et adolescents) 10h30- Pause – Café 10h45 10h45 – Schéma thérapeutique ARV ligne I Exposé DR DARIUS 14h00 Echec thérapeutique Schéma thérapeutique ARV ligne II Bilan pré thérapeutique traitement des cas spécifiques grossesse, Insuffisance rénale hépatite, Paludisme - Précautions universelles - kit PEP - Interaction médicamenteuse et traitement aux ARV - OUTILS PEC 14h00- Pause-Repas 15h00 15h00- GAS intrants et médicaments VIH DR WILLY 16h00 Gestion des données VIH Canevas unique PNLS Qualité des données CIRCUITS DE RAPPORTAGE 16h00- Post test/Evaluation générale et 17h00 cérémonie de clôture de la formation

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 57 Participant list

N° NOM SEXE ORGANISATION FONCTION 1 NADINE MUYUNGU M PNLS CS PTME 2 MARIE-AGNESMPUEKELA F PNLS/Direction Nationale CS PTME 3 FIDELE KANYANGA M HZMT KAMALONDO MEDECIN CHEF DE ZONE 4 PATRICK BANZA M HZMT KAMALONDO POINT FOCAL VIH 5 MASANGU ILUNGA M HZMT PANDA MEDECIN CHEF DE ZONE 6 RAOUL AHAU MUWAY M HGR PANDA POINT FOCAL VIH 7 HUGUES KAKOMPE M HZMT KAMPEMBA MEDECIN CHEF DE ZONE 8 BASILE NGOY M HZMT LUBUMBASHI MEDECIN CHEF DE ZONE 9 CLAUDINE MUTIMBA F HZMT LUBUMBASHI MEDECIN 10 CHRISTIAN KADIANDA M HGR SAKANIA POINT FOCAL VIH 11 SERGES KALALA M HZMT KAPOLOWE POINT FOCAL VIH 12 GABRIEL KYUNGU M HZMT RWASHI MEDECIN CHEF DE ZONE 13 THIERRY MWANDWE M HZMT KAPOLOWE MEDECIN CHEF DE ZONE 14 MARIE KAPAPA F HGR HAKIKA MEDECIN DIRECTEUR 15 FRANCK MONGA M HGR KENYA MEDECIN DIRECTEUR 16 MWELWA GIFT M HZMT KENYA MEDECIN CHEF DE ZONE 17 MARC KAKOMPE M HZMT KAMPEMBA POINT FOCAL VIH 18 BRIGITTE MWANSA F PNLS CS S&E 19 JEAN KAYEMBE M PNLS COORDONATEUR PROVINCIAL 20 BEN KABEYA M PNLS CHERGE DE LA PEC 21 JONATHAN KATUKU M ZS SAKANIA POINT FOCAL VIH 22 PAUL MUCHAPA M DPS HAUT-KATANGA ANALYSTE 23 ETONYE FAUSTIN M DPS HAUT-KATANGA CHEF DE BUREAU SRC 24 DARIUS MAKELA M PNLS/Direction Nationale CI/IST 25 BELLY BITOTA F PNLS APS 26 DIEUDONNE LUFUA M DPS HAUT-KATANGA ANALYSTE 27 JEANNE KASALI F Laboratoire Provincial/PNLS Chargée de Laboratoire

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 58 Master training on integrated HIV/AIDS guidelines, Lualaba (Kolwezi)

May 27 to June 1, 2017 Agenda

HEURE PLAGE METHODOLOGIE ANIMATEUR MODERATEUR JOUR 1: le 27/05/2017 MODERATEUR: Maman Jeanne 8h 30-9h00 Accueil des participants et WILLY distribution des kits de la formation 9h00-9h15 Cérémonie d’ouverture WILLY 9h15-9h45 Présentation des facilitateurs et Maman Jeanne participants - Lecture des TDRs et agenda Exposé Marie Agnès - Répartition des tâches (chef du village, Rapporteur de J1 à J6, mises en train et évaluation) - Attentes des participants et codes des bonnes conduites 9h45-10h15 Administration du pré test Marie Agnès 10h15-10h30 Pause-café 11h30-13h00 Généralités sur le VIH: Exposé WILLY - Définition des concepts - Epidémiologie du VIH - Voies de transmission du VIH - Facteurs favorisant la transmission 13h00-14h00 Pause-Repas 14h00-16h45 Généralités sur le VIH (suite): WILLY - Mode de prévention - Approche paquet VIH et organisation des services - Généralités sur le CDV/DCIP: - Définition des concepts - Principes et avantages 16h 45-17h00 Evaluation de la journée Jour 2: le 28/05/2017 MODERATEUR: MARIE AGNES 8h 30-9h00 Où en sommes-nous? 9h 00-9h30 Lecture et adoption du rapport Equipe de rap J1 9h 30-10h00 Généralités sur le CDV/DCIP Exposé NADINE (suite): - Technique de déroulement - Cas particuliers - Aspects éthiques et juridiques

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 59 10h00-10h30- PRESENTATION DES Exposé NADINE OUTILS DCIP HARMONISEES 10h30-10h45 Pause-Café 10h 45-13h00 Notion sur l’andragogie: Exposé DR DARIUS - Approche AM MAKELA - Presentation efficace 13h00-14h00 Pause-Repas 14h 00-15h00 Notions sur l’andragogie: Exposé DARIUS/ - Presentation interactive WILLY - La coformation - Organisation d’une formation 15h 00-16h45 Généralités sur la PTME Exposé Marie agnès 16 45 H à 17 Evaluation de la journée Application de la Modérateur H grille JOUR 3: le 29/05/2017 MODERATEUR: WILLY 8h 30-9h00 Où en sommes-nous ? 9h00-9h30 Lecture et adoption du rapport Equipe de J3 rapportage 9h30-10h30 - Généralités sur les Exposé Marie Agnès interventions de la SR - PTME-compréhensive (Aperçus sur la PTME) - Approche pour la réduction de transmission du VIH de la Mère à l’enfant 10h30-10h45 Pause café 10h45-13h00 DCIP PENDANT LA PTME: Exposé Nadine - Pendant la CPN - Pendant le Travail et l’Accouchement - En post partum - Implication du partenaire masculin 13h00-14h00 PAUSE REPAS 14h00-15h30 - Particularités de la PTME Exposé Nadine Option B+ - Défis et Difficultés de l’Option B+ 15h30-17h00 - Présentation des Exposé Marie Agnes algorithmes de PEC de la femme enceinte - Traitement ARV de la femme enceinte et allaitante VIH+: - Critères de mise sous ARV - Schéma de 1ère ligne - Schéma de 2è ligne 17h00-17h15 Evaluation de la journée

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 60 JOUR 4: le 30/05/2017 MODERATEUR: Nadine 8h 30-9h00 Où en sommes-nous ? 9h00-9h30 Lecture et adoption du rapport Equipe d J4 rapportage 9h30-10h30 - Prophylaxie ARV chez Exposé Marie Agnes l’enfant exposé - Diagnostic Clinique et biologique du VIH chez l’enfant exposé 10h30-10h45 Pause-café 10h45-11h30 PRESENTATION DES Exposé et échanges Marie Agnès OUTILS HARMONISES (PTME) - Algorithme du diagnostic Exposé Marie Agnes VIH de l’enfant de moins de 18 mois - algorithme de la prise en 11h30-12h30 charge de l’enfant de moins de 18 mois - Traitement ARV et critères de mise sous ARV chez le nourrisson infecté au VIH 12h30-13h00 - Suivi clinique et biologique Exposé Willy - Prophylaxie au cotrimoxazole - Alimentation du nourrisson exposé au VIH - syphilis congénitale (Approches pour l'élimination) 13h00-14h00 PAUSE REPAS 14h00-15h30 Approches communautaires ( exposé NADINE Paire éducation selon AMM; Super patient ) 15h30-17h00 - Les IST: Travaux en groupe Darius - Généralités sur les IST - Approche syndromique - Les syndromes et les médicaments - Populations clés et Prévention combinée - Utilisation des Algorithmes IST - OUTILS IST 17h00-17h15 Evaluation de la journée JOUR 5: le 31/05/2017 MODERATEUR: DR DARIUS 8h 30-9h00 Où en sommes-nous ? 9h00-9h30 Lecture et adoption du rapport Equipe d J4 rapportage 9h30-10h30 - Diagnostic clinique et Exposé DR WILLY biologique du VIH chez l’enfant

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 61 - Classification clinique de l’OMS (chez l’enfant) - Particularités du VIH/Sida en pédiatrie - Traitement ARV de l’enfant 10h30-10h45 Pause-café 10h45-11h15 - Les Infections opportunistes Exposé DR WILLY et coinfections (VIH/TB ET VIH/HB) - Prophylaxie au cotrimoxazole - Prophylaxie à l’izoniazid 11h15-11h45 Suivi clinique et biologique de Exposé DR WILLY l’enfant Divulgation du statut DR NADINE sérologique 11h45-13h00 Exercices intégrées sur la prise Travaux en groupe en charge TAR 13h00-14h00 Pause-café 14h00-14h45 Algorithme de dépistage VIH Séance pratique Maman Jeanne Utilisation et application des tests rapides 14h45-15h30 Suivi biologique (tests Exposé Maman Jeanne hépatiques et rénaux, bilan hématologique et autres) Comptage CD4 Charge virale Manipulations DBS (préparation éch. et colisage) 15h30-16h00 Biosécurité Exposé Maman Jeanne Assurance qualité Contrôle de qualité 16h00 – Outils de collecte de laboratoire Maman Jeanne 17h00 17h00 – Evaluation de la journée Moderateur 17h15 Jour 6: le 01/06/2017 MODERATION: Maman jeanne 8h 30-9h00 Où en sommes-nous ? 9h00-9h30 Lecture et adoption du rapport Equipe de J7 rapportage 9h30-10h30 - Classification des ARV et Exposé DR DARIUS Mode d’action des ARV Adhérence et observance au TAR - Effets secondaires et toxicité liés aux ARV - Classification clinique de l’OMS - (chez adulte et adolescents) - Critères de mise sous ARV/directives

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 62 OMS/PNLS (Adulte et adolescents) 10h30-10h45 Pause – Café 10h45 – Schéma thérapeutique ARV Exposé DR DARIUS 14h00 ligne I Echec thérapeutique Schéma thérapeutique ARV ligne II Bilan pré thérapeutique traitement des cas spécifiques grossesse, Insuffisance rénale hépatite, Paludisme - Précautions universelles - kit PEP - Interaction médicamenteuse et traitement aux ARV - OUTILS PEC 14h00-15h00 Pause-Repas 15h00-16h00 - GAS intrants et DR WILLY médicaments VIH - Gestion des données VIH - Canevas unique PNLS - Qualité des données - CIRCUITS DE RAPPORTAGE 16h00-17h00 Post test/Evaluation générale et cérémonie de clôture de la formation

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 63 Participant list

STRUCTURE NOMS ET POSTNOMS SEXE NUMERO TELEPHONE JEAN DE LA PAIX MBANGU M 810689530 ZS MANIKA Slyvie ILUNGA F 814094246 MWEWA KALIMA Billy M 997031621 ZS LUALABA NGANDWE MWADI Mady F 993609379 Robert KABESA M 812428900 ZS LUBUDI TARCISSE LUMUNA WA LUMUNA M 816628498 TIMOTHE MUTUNGA M 977056117 ZS MUTSHATSHA FIDELE KABAMA M 994029486 Serge MUSOYA M 993860860 ZS KANZENZE Francoise SANDONGA F 992017640 Nathan KANABWINGI M 810241634 ZS FUNGURUME Denis MWILU M 824297375 Jacques MUKEMBE M 823768827 ZS BUNKEYA Chaly MAMBWE M 812182062 Patrick NDUWA M 817375049 ZS DILALA KET-A-TSHIBANG F 813206331 Cathyna KAYEM F 997192020 Henri MUTOMB M 997738288 PNLS Thierry SABU MWANAW M 817736478 Baltas KABEYA M 991209419 ZS KALAMBA Dauphin KALENGA YAV M 812187033 DPS Issac KASAJ MUKENG M ZS KASAJI MASEJ KAKESE M 977722700 ZS DILOLO Christian NGOMBE M 993318315

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 64 Training on integrated HIV/AIDS guidelines for service providers

May 18 to 25, 2017 Agenda

Heures Jour 1 Jour 2 Jour 3 8h30-9h00 - Cérémonie d’ouverture Où en sommes-nous ? Où en sommes-nous ? - Agenda de la formation Lecture et adoption du rapport J1 Lecture et adoption du rapport - Pré-test J2 9h00- Généralités: - DCIP - Généralités: Def des Généralités sur IO chez 10h30 - Généralités sur le VIH/Sida concepts (10’) - Principe du DCIP l’Adulte ainsi que d’autres - Epidémiologie (15’) − Avantages du DCIP (15’) − complications liées au Technique et déroulement du VIH/SIDA (suite) counseling dans le DCIP (45’) – situations particulières-droit et devoir du PVV- Code juridique et éthique - Généralités sur le VIH/Sida - Retesting Généralités sur IST chez - Epidémiologie l’Adulte ainsi que d’autres complications liées au VIH/SIDA 10h30- Pause-café 10h45 10h45- - Voies de transmission et - Auto-test - Généralités sur IST chez 11h45 modes de prévention du VIH l’Adulte ainsi que d’autres - Diagnostic biologique: complications liées au VIH/SIDA( suite) Approche Test utilisés Syndromique  stratégies de dépistage - Algorithmes de prise en  Algorithme charge des IST -DCIP - Généralités: Définition prélèvement au bout du doigt Le Diagnostic clinique du des concepts (10’) − Principe DBS film VIH: du DCIP (15’) − Avantages du Présentation de la fiche DBS et - classification de l’OMS DCIP (15’) − Technique et charge virale déroulement du counseling dans le DCIP (45’), situations particulières - droit et devoir du PVV- Code juridique et éthique 11h45- 13h30 13h30- Pause repas 14h30 14h30- - DCIP - Généralités: Def des - Présentation sur la charge virale: Traitement aux ARV: 16h00 concepts (10’) − Principe du mode de conservation, transport, - Structure du VIH DCIP (15’) − Avantages du conservation, algorithme des - Cycle de réplication virale DCIP (15’) − Technique et résultats - mode d’action des ARV déroulement du counseling - classification des ARV dans le DCIP (45’)- situations Critère de mise sous ARV particulières- droit et devoir du Effets secondaires et toxicité PVV- Code juridique et liés aux ARVs éthique suite

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 65 16h00- Jeux de rôle - Généralités sur IO chez l’Adulte traitement aux ARV: 17h00 ainsi que d’autres complications - Structure du VIH Evaluation de la journée liées au VIH/SIDA - Cycle de réplication virale - Evaluation de la journée - mode d’action des ARV - classification des ARV - Critère de mise sous ARV Evaluation de la journée NB: Les Co-facilitateurs pourront intervertir l’ordre des plages pour raison de plus d’expertise de l’un ou de l’autre dans certaines matières afin d’avoir une même compréhension partout.

HEURES Jour 4 Jour 5 Jour 6 8h30-9h00- Où en sommes-nous ? - Où en sommes-nous ? - Où en sommes-nous ? - Lecture et adoption du rapport- Lecture et adoption du rapport J4 Lecture et adoption du rapport J3 J5 9h00- Traitement ARV en RDC: - Cas spécifiques: Coïnfection VIH/- Généralités sur la PTME 10h30 - Première ligne TUB - Généralités sur les - Deuxième ligne - Cas clinique coïnfection VIH/TUB interventions de la SR - Troisième ligne - Cas spécifiques suites: INSUFF - PTME-compréhensive REN. VIH PALU, Grossesse et (Aperçus sur la PTME) VIH 10h30- Pause-café 10h45 10h45- Traitement ARV en RDC: - Particularité du VIH/SIDA en - Approche sur la réduction de 12h15 - Première ligne Pédiatrie Diagnostic clinique et la transmission du VIH de la - Deuxième ligne biologique de l’enfant mère à l’enfant - Troisième ligne - DCIP PENDANT LA PTME - Pendant la CPN - Pendant le Travail et l’Accouchement - En post partum 12h15- - Management des effets - Particularité du VIH/SIDA en - Algorithmes de prise en 13h30 secondaires des ARV Pédiatrie Diagnostic clinique et charge de la femme enceinte biologique de l’enfant - Algorithmes de prise en charge de l’enfant de moins de 18 mois 13h30- Pause repas 14h30 14h30- - Prophylaxie post - Particularité du VIH/SIDA en - Prophylaxie ARV chez 16h00 expositionnelle et Précautions Pédiatrie Diagnostic clinique et l’enfant exposé universelles biologique de l’enfant - Diagnostic Clinique et - Echec thérapeutique et son biologique du VIH chez management Traitement en l’enfant exposé 2eme ligne - Algorithme du diagnostic VIH de l’enfant de moins de 18 mois - Prophylaxie au cotrimoxazole - Alimentation du nourrisson exposé au VIH 16h00 - - Adhérence au T3 ARVs - Particularité du VIH/SIDA en - Implication du partenaire 17h00 - Evaluation de la journée Pédiatrie Diagnostic clinique et masculin biologique de l’enfant - Evaluation de la journée - Evaluation de la journée

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 66 Heures Jour 7 Jour 8 8h30-9h00 Où en sommes-nous ? Où en sommes-nous ? Lecture et adoption du rapport J6 Lecture et adoption du rapport J6 9h00-10h30 - Utilisation correcte des outils - Utilisation correcte des outils - Utilisation correcte des outils - Utilisation correcte des outils 10h30-10h45 Pause-café 10h45-11h45 - Utilisation correcte des outils - Utilisation correcte des outils 12h45-13h30 - Utilisation correcte des outils - Divulgation du statut sérologique chez l’enfant 13h30-14h30 Pause repas 14h30-16h00 - Utilisation correcte des outils - Gestion des médicaments et autres intrants VIH - Paquet VIH & organisation des services VIH 16h00-17h00 - Utilisation correcte des outils - Post test - Formalités administratives - Remise des certificats - Clôture de la formation NB: Les Co-facilitateurs pourront intervertir l’ordre des plages pour raison de plus d’expertise de l’un ou de l’autre dans certaines matières afin d’avoir une même compréhension partout.

Participant list (Kenya)

N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 1 DR MASHINI ATOSHA F CS KALEBUKA/MD MEDECIN 2 DR NGOIE MAMIE F HGR/KENYA MEDECIN 3 KAMBAL MUTOMBU F CS KENYA I INFIRMIERE 4 BANZA VENDICIEN M CS KIBA INFIRMIER 5 NGOYA ILUNGA MAMY F CS MAMA NA WA TOTO INFIRMIERE 6 MIREILLE NTUMBA F CS ANDRE BARBIER INFIRMIERE 7 NICKY KABULO M HGR/KENYA INFIRMIER 8 TRESOR LUNGWA M CS PAUL MARIE BOLA INFIRMIER 9 THERESE NKOMBE F CSR BAKHITA INFIRMIERE 10 GODELIVE MWANGE F CSR KALEBUKA INFIRMIERE 11 ROSE SANGO F CS KALEBUKA INFIRMIERE 12 SONI VIRGINIE F CS KENYA I INFIRMIERE 13 JACQUES KAMFWA KOMBE M CS PMB INFIRMIER 14 MIMI KAYUMBA F CS AWADI INFIRMIERE 15 BIBICHE MUSENG F HGR/KENYA INFIRMIERE 16 DANIEL YAMAB M CM WANTANSHI INFIRMIER 17 NADINE UMBA F CS EBEN EZER INFIRMIERE 18 OLIVIER LUKENA M WANTANSHI INFIRMIERE 19 VERO MUJINGA F SC KENYA I INFIRMIERE 20 KIWANGA DAVID M HGR KENYA INFIRMIER 21 GLODYS KANGA F CS ANDRE BARBIER INFIRMIERE 22 DR JEAN MUTEBA M WANTANSHI DOCTEUR 23 ALAIN KASONDINE M CS ACCUEIL INFIRMIER 24 PAPY TSHILEWU M CS MAMA NA WA TOTO INFIRMIER 25 KEMBWISA BERTH F CS UJANA INFIRMIERE 26 ODETTE KATATO F CS ACCUEIL INFIRMIERE 27 BANZA NDALA IMPOSA M CS UJANA INFIRMIER 28 KANDE KANDE M CS ADREE BARBIER INFIRMIER 29 ANNIE NGALIMA F CS MAMAN WA WA TOTO INFIRMIERE 30 YVONNE KITENGE F CS LE ROCHER INFIRMIERE 31 MONIQUE NJIBA F CS LE ROCHER INFIRMIERE 32 NYOTA THERESE F CS KIBA INFIRMIERE

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 67 N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 33 MALISA EUGENE M CS AUADT INFIRMIER 34 LENGE SELEMANI GABRIEL F CS EBEN EZER INFIRMIERE 35 JEAN-MARIE ILUNGA F HGR KENYA INFIRMIERE 36 BELLY BITOTA F PNLS FACILITATEUR 37 MWELWA C. GIFT M HZMT KENYA FACILITATEUR 38 NGOIE MALANIE F CS BAKHITA INFIRMIERE 39 ODILIE NKULU MULONGO F PAUL MARIE BOCK INFIRMIERE 40 JOSEPHINE KAMIN TSHIKOMB F HGR KENYA INFIRMIERE 41 DR BEN K. M PEC/PNLS FACILITATEUR 42 FELICIEN KANYIKA M CS BAKHITA INFIRMIER

Participant list (Rwashi)

N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 1 KYUNGU MALUNDA F HGR/HAKIKA INFIRMIERE 2 SYMPHONOSE SAKUTA F CS AENAF INFIRMIERE 3 IDRIS MUJINGA M DARCY CLINIC INFIRMIER TITULAIRE 4 NGOMBE KETA F HGR/HAKIKA INFIRMIERE 5 AMISI KAMBOYA M CS MWANA BWATO INFIRMIER 6 PAULINE OMBALA DIATA F CS GRACE LOUIS INFIRMIERE 7 JUNIOR MANGENDA M CS ORACLE II INFIRMIER 8 PATRICK MWENZE KASONGO M CS ORACLE II INFIRMIER 9 AUGUSTIN MULAMBA M CS YAMBALA INFIRMIER TITULAIRE 10 SYLVAIN TSHABA M EBEN EZER INFIRMIER 11 JOLIE MANYONGA F RWASHI MED INFIRMIERE TITULAIRE 12 GISELE MALEMBA F P.F VIH HZMT INFIRMIERE 13 CATHY LENGE F CS NSANGAJI INFIRMIERE TITULAIRE 14 HAMIM MUAMBA M CS EBEN EZER INFIRMIER 15 TRESOR KABAMBA M POLYCLINQIUE IMANI INFIRMIER 16 ADAMO MWEGU M RWASHI MED INFIRMIER 17 SYLVIE TSHILELA F POLYCLINIQUE IMANI INFIRMIERE 18 GISELE MUTUKAMBA F TECH DELABO FAVEUR INFIRMIERE 19 MARIE KINDA F HGR HAKIKA DOCTEUR 20 MBIYA CLARISSE F CS GRACE LOUIS INFIRMIERE 21 MONIQUE SHABANI F CS LA FAVEUR INFIRMIERE 22 DR MALOBA KASONGO M HGR/HAKIKA INFIRMIER 23 MERLIN MAKAMPILA M DARCY CLINIC INFIRMIER 24 MASAMBA BOBO M CDM INFIRMIER 25 NICOLE MAZIMBA F HGR/HAKIKA INFIRMIERE 26 NOELLAH WA KILONGO F POLYCLINQIUE IMANI INFIRMIERE 27 BILLY YAV M CS YAMBALA INFIRMIER 28 MARIE NTUMBA F CS LA FAVEUR DE DIEU INFIRMIERE 29 DR WALO LONGANDJO AIMEE F CM SION DOCTEUR 30 DULSE KABULO F CS ATHIAS INFIRMIERE 31 FAIDA SUZANA F CS MWANABWATO INFIRMIERE 32 ESTHER KONDWA F CS NSANGAJI INFIRMIERE 33 KISS KABASELE M CS AMAS INFIRMIER 34 CHATHIE MOTA F CS YAMBALA INFIRMIERE 35 FRANCINE MPANDE F CS AENAF INFIRMIERE 36 MICHELINE MWAMBA F CM SION INFIRMIERE 37 CATHY MUYOYO F CS AENAF INFIRMIERE 38 RUBEN MUTOMBO M CM SION INFIRMIER

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 68 N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 39 DR MARIE KAPAPA F HGR/HAKIKA DOCTEUR 40 JOHN KANDOLO M PNLS INFIRMIER 41 DR GABRIEL KYUNGU M HZMT RWASHI DOCTEUR 42 LYDIE MUSENGE F P.A. INFIRMIERE

Participant list (Kampemba)

N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 1 JORDY KABALA M HGR/KAMPEMBA MEDECIN 2 BIJOU KASONGO F CS FARAJA INFIRMIERE 3 MADO MBULU F CS AMANI INFIRMIERE 4 JUSTIN KABAYELO M CS BOUISSON ARDENT INFIRMIERE 5 FERUZI AROLINE F CS LA GRACE DIVINE INFIRMIERE 6 INGACE ZANGULA M CS RACINE MEDECIN 7 VERONIQUE TSHASHI F CS LA BENEDICTION INFIRMIERE 8 LUBANGI MANU M CM St JEAN MARC MEDECIN 9 KANKU LUNGONGO M CM LA CHARITE MEDECIN 10 CUBAIN MBUYI M CS LA BENEDICTION MEDECIN 11 MARCEL KITENGE M CS MERY THERESA INFIRMIER 12 CENTURNEE MUKENDI F CS SHALOOM TECH. LABO 13 JEAN-LUC ATHARI F CS MERE THERESA MEDECIN 14 HELENE KYASHA M HGR/KAMEPMBA DIRECTRICE NURSING 15 YOLLANDE KUMWIMBA M CS TEGRA INFIRMIERE 16 FABRICE PEMBE M CS MONT CARMEL MEDECIN 17 DANNY MUKID M CM LA CHARITE INFIRMIER 18 JEAN KAKUDJI M CM PAPILLON INFIRMIER 19 DANIEL KALENGA M CS SHALOOM INFIRMIER 20 DR MARCEL KABZAY M CS NYOTA ALFAJIRI MEDECIN 21 LOUIS TSHAV F CS MUNGANGA INFIRMIER 22 DR MATHIEU MUDJINJI M CM PAPILLON MEDECIN 23 DIDINE ILUNGA F CS TEGRA MEDECIN 24 BYPOLHI KASEYA M CS WATOTO INFIRMIER 25 MUFUK KAT YOLLANDE F CS MERE THERESA INFIRMIER 26 YEMBA POTO M CS MERE THERESA INFIRMIERE 27 KASONGO JEANNE F POLY St CHARLES INFIRMIER 28 BALTAZAR KUMWIMBA M CS TEGRA INFIRMIERE 29 LEONIE KABILA F CS GRACE DIVINE INFIRMIER 30 EDOUARD KISIMBA M CS RACINE INFIRMIERE 31 KABANGE NGOY F CS MERY EL MERE INFIRMIER 32 ANDRE KALOMBO M CS MUNGANGA INFIRMIERE 33 MOISE MUSAU M CS St JEAN MARC INFIRMIER 34 NGOIE MUKAMBA M CS WATOTO INFIRMIER 35 VIVIANNE MIKOBI F CS MUNGANGA INFIRMIER 36 LYDIE KALENGA F CM St JEAN MARC TECH. DE LABO 37 NIENGE KALUNGA F CM St CHARLES MEDECIN 38 GUSTAVE PEMBE M CS MAMAN WA MAPENDO INFIRMIER 39 PAPY KADIMA M CS LA RACINE INFIRMIER 40 DR MARC KAKOMPE M HZMT KAMEPMBA FACILITATEUR 41 DR NADINE MUYUNGU F PNLS FACILITATEUR 42 INESS KINYANTA F PNLS FACILITATEUR 43 DR AIMEE KIBWE F HZMT KAMPEMBA P. APPOINTE

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 69 POOL EMMAUS N° NOMS & POST-NOMS SEXE STRUCTURE FONCTION 1 ROBERT LUFUKUIMBA BEKA M JARDIN D’EDEN TECHNICIEN DE LABORATOIRE 2 KABANGE NUMBI F PENNY WISE INFIRMIER T 3 SIMPLICE MUKANDA M BUISSON ARDENT INFIRMIER T 4 BEYA MPUTU M BUISSON ARDENT MÉDECIN 5 PATRICE MUZAL M FARAJA INFIRMIER T 6 AXCEL KABONGO MPOYI M MAISHA INFIRMIER 7 AIMEE KAMIN F SAINTE FAMILLE INFIRMIER 8 MARCEL SAIDI M MONT CARMEL INFIRMIER 9 SAMUEL SAMITAMBA M JARDIN INFIRMIER 10 VALERY NTANKOVU F AMANI INFIRMIER 11 DR BETHY CIALA F M. G MÉDECIN GÉNÉRALISTE 12 CECILE MUKWEZ F FARAJA INFIRMIER 13 MISTA MILWIMBI M SAVIO POINT FOCAL 14 ALAIN KALENGA M MONT CARMEL POINT FOCAL 15 ERIC MWEMA M MAMA WA MAPENDO INFIRMIER 16 DAUDET ILUNGA M HRG/KAMPEMBA MÉDECIN 17 DR JEAN-CLAUDE KABONGO M PENNY WISE MÉDECIN 18 DR DAMIEN MONGA M MÉDECIN MÉDECIN 19 JACQUES KABANGO M AMANI 20 BRIGITTE MULASI F MOZA INFIRMIÈRE 21 AIMEE MAUWA F SAINTE FAMILLE INFIRMIÈRE 22 DADDY KATOMB M SAINT CHARLES INFIRMIER 23 ABDON KISIMBA M AMI MÉDECIN 24 AIME MWAMBA M AMI MÉDECIN 25 UMBUNDA JOHN M HGR 26 THADDEE KAYEMBE M JARDIN D’EDEN INFIRMIER 27 JOLIE KAJIMB F MAISHA INFIRMIER 28 AMISI MULEBA M SAINT CHARLES 29 YAV KILUBA M PENNY WISE INFIRMIER 30 AIME PENGI F HGR/KAMPEMBA INFIRMIÈRE 31 SALVADOR KAZADI M HGR/KAMPEMBA 32 DR PAUL MUCHAPA M DPS ANALYSTE DES FACILITATEUR 33 NGOIE KAZEMBE F INFIRMIÈRE 34 BRIGITTE MWANSA F PNLS FACILITATEUR 35 JUNIOR MUFINDA M MOZA MÉDECIN 36 JOLLY KIPILI F JARDIN D’EDEN INFIRMIÈRE 37 MONIQUE BUPE F MAMA WA MAPENDO 38 BETTY MUKAYA F HGR/KAMPEMBA INFIRMIÈRE 39 GLORIA LONGA F SAVIO INFIRMIÈRE 40 WILLY NGANINGA M PAPILLON INFIRMIER 41 SYLVAIN KALENGA M MAISHA INFIRMIER 42 DR HUGUES KAKOMPE M MCZ/KAMPEMBA FACILITATEUR 43 JEANNINE KABILA F P.A.

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 70 Participant list (Kamalondo and Lubumbashi)

POOL SALAM SALLE I N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 1 DR SERVIE MUBINDAMAWI K M HGR/KAMALONDO DOCTEUR 2 IRENE MAKASUNGA F HGRP/SENDWE INFIRMIERE 3 DR NSIBU VIMA LEVIK M SUALINA DOCTEUR 4 DR BOB MULENGE KILOWELE M S.O.C DOCTEUR 5 MISUNGI LUKAMBA DAPHROSE F CHRINA MEDICLA INFIRMIERE 6 KALONDA KAZADI ALEXIS M HGR/KAMALONDO INFIRMIER 7 ALAMIE MULENGA F CMDC INFIRMIERE 8 DR SAMMY MALOBA M HGR/KAMALONDO DOCTEUR 9 DR MAURICE TSHIBANGU M CMDC DOCTEUR 10 FLORIANE MBOMBO F HGR/SENDWE INFIRMIERE 11 DR YAV TSHIBIND M CUL DOCTEUR 12 FRANCINE KAUIRA F POLYCLINIQUE MEDICARE INFIRMIERE 13 DR WILLIAM KABWE M POLYCLINIQUE MEDICARE DOCTEUR 14 MULAM MUKAZ HENRY M CUL 15 EBAMBI HENRIETTE F CHRINA 16 DALLY MUSANS M LE MELS INFIRMIER 17 DR FAUSTIN NGOIE M SAINT MARCEL DOCTEUR 18 DR UMBA KAULO MICHOU F CMDC DOCTEUR 19 DR ODON PANSHI M CE/UNILU DOCTEUR 20 DR PLACIDE BUKASA M HGR/KAMALONDO DOCTEUR 21 FRANK SANGO M CE/UNILU NFIRMIER 22 DR PATRICK BANZA M HZMT KAMALONDO FACILITATEUR FACILITATION 23 ETONYE FAUSTIN M DPS/FACILITATION FACILITATEUR 24 NGALULA NZENGU SOLANGE F CUL INFIRMIERE 25 ATHY KALUMBA M CE/UNILU INFIRMIER 26 KAHINDO NYAMULI JOSEPHINE F POLYCLINIQUE MEDICARE INFIRMIERE 27 SORA NAMASANGU F ISOS/TFM/LUBUMBASHI INFIRMIERE 28 GENEVE MUISANGA F HGR/KAMALONDO INFIRMIERE 29 ERICK MUTOMBO M CE/UNILU NFIRMIER 30 DR OLIVIER TSHAMALA M HGR/KAMALONDO DOCTEUR 31 DR CHRISTIAN YUMA M P. SHALINA DOCTEUR 32 NAKWEZI KABESA CHRISTELLE F HGR/KAMALONDO INFIRMIERE 33 GRACIA MANYONGA F CE/UNILU INFIRMIERE 34 DR FELLY MWENYI M CE/UNILU INFIRMIER 35 MUTEB KARAJ FRANCINE F CLINIQUE UNIVERSITAIRE INFIRMIERE 36 DR FIDELE KANYANGA M HZMT KAMALONDO FACILITATEUR 37 MWEPU RAISSA F P.A. INFIRMIERE

POOL SALAM SALLE II N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 1 DR NKULU ILUNGA SOCRATE M HZMT DOCTEUR 2 DR DAMAS NGOY NKYULU M MEDECIN/HOP. SENDWE DOCTEUR 3 REDDY MUKIMBI MONGA M MEDECIN/KITUMANINI INFIRMIER 4 DENIS KASONGO WA ILUNGA F DN/POLYCLINIQUE SHALINA INFIRMIERE 5 DR KISIMBA TATADILA AKY M POLYCLINIQUE KITUMANI DOCTEUR 6 EMMANUEL MBUYA M CM STE SCHOLASTIQUE INFIRMIER 7 DR HERVE ILUNGA M CS CRISEM DOCTEUR 8 SR VERONIQUE KAYEMBE F STE SCHOLASTIQUE/AG ADMINISTRATEUR

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 71 POOL SALAM SALLE II N° NOMS ET POST-NOMS SEXE GROUP AFFILIATION FONCTION 9 IVONNE MWENGU F URGENCE PMI/SENDWE INFIRMIERE 10 FYFY ANINGWE F P.F. INFIRMIERE 11 FELICIEN NSENGA M CMAF DELBEKE INFIRMIER KADIMBWE 12 KABAMBI JUSTIN M POLYCLINIQUE ESPERANCE INFIRMIER 13 DR JOELLE MASENGO F MARIA TEREZA DOCTEUR 14 MODESTE EMAY M MARIA TEREZA INFIRMIER 15 DORA KASONGO F CS RADEM INFIRMIERE 16 RACHEL KYABU F MARIA TEREZA INFIRMIERE 17 CHRISTIAN KAYEMBE M RADEM INFIRMIER 18 GAUTHIER KIBAMBE M CS KISEM INFIRMIER 19 MIMIE MUGO F POLYCLINIQUE ADVENTISTE INFIRMIERE 20 BETTY KAFWIMBI F CS RADEM INFIRMIERE 21 NGWEJ MUFIND JEAN-PIERRE M CS ST MARCEL INFIRMIER 22 DR MICHELINE MOYO F POLYCLINIQUE ADVENTISTE DOCTEUR 23 DR NGALULA ANNIE F CUL DOCTEUR 24 ISRAEL LUMINGU M POLYCLINIQUE LES MELS INFIRMIER 25 JOEL TSHIMWANGA M POLYLCINIQUE LES MELS INFIRMIER 26 ROSE KABEDI F ST MARCELE/AG INFIRMIERE 27 DR NATHALIE KAJ F SENDWE DOCTEUR 28 DIAMANTINE KATEMPA F STE SCHOLASTIQUE INFIRMIERE 29 DR PATRICK SANGWA M POLUCLINIQUE ADVENTISTE DOCTEUR 30 AMUZATI AMURI M POLYCLINIQUE DE INFIRMIER L’ESPERANCE 31 DR IGOR MUJINGA M CM ABBE DELIBEME DOCTEUR 32 DR CLAUDINE MATIMBA F HZMT LUBUMBASHI FACILITATEUR 33 DR BASILE NGOY M HZMT LUBUMBASHI FACILITATEUR 34 GISELE MWILANDE F P.A. INFIRMIERE 35 DR CHARLENE MBUYI F CRISEUR DOCTEUR 36 DR DIEUDONNE LUFWA M DPS/ANALYSTE FACILITATEUR

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 72 Training on IHAP-HK/L M&E system for health zone staff in Lualaba

June 7 to 9, 2017 Agenda

Jour et date Heures Activités Facilitateurs Mercredi 07 8h30-9h30 Ouverture de l’atelier, TDRs Coordo Gilbert Juin 2017 9h30-10h30  Formalités administratives Coordo Gilbert  Introduction sur IHAP-HK/L et grande priorités du Projet 10h30-10h45 Pause-Café Bobette 10h30-12h00  Système de collecte et rapportage de Venant données IHAP, M&E PNLS  La qualité des données, 12h-13h00 Pause repas, Bobette 13h00-15h00 Echange sur les indicateurs du canevas unique: Eric  CCC, IST, DCIP, CDV; M&E DPS  Outils correspondants 15h00-16h00 Question débat Venant Clôture de la journée Jeudi 08 8h30-9h00 Lecture et amendement du rapport J1 Venant Juin 2017 9h00-10h00 Echange sur les indicateurs du canevas unique: Venant  PTME M&E2 DPS  Outils correspondants 10h00-10h15 Pause-café Babette 10h15-12h00 Echange sur les indicateurs du canevas unique: Venant  PTME M&E2 DPS  Outils correspondants 12h00-13h00 Pause repas Babette 13h00-15h00 PEC ARV Dr Garry Outils correspondant M&E DPS 15h00-16h00 Question débat Eric Clôture de la journée Vendredi 09 8h30-9h00 Rapport J2 et amendement Venant Juin 2017 9h00-10h00 PEC Soins et soutien Dr Garry Outils correspondant M&E DPS 10h00-10h15 Pause-café Bobette 10h15-12h00 PEC Soins et soutien Dr Garry Outils correspondant M&E DPS 12h00-13h00 Pause repas Bobette 13h00-14h00 Circuits CV et EID Gilbert 14h00-15h00 Question debat Venant 15h00-16h00 Cloture de l’atelier Gilbert

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 73 Participant list

N° Names GENDER ORGANISATION FONCTION CONTACT a) PARTICIPANTS 1 OMER MWENZE M HZMT MANIKA IS-SSP (+243) 81 899 53 20 2 KADANG KAKEZ F HZMT MANIKA DATA MANAGER (+243) 97 048 13 43 3 DANIEL TSHEKA M HZMT KANZENZE IS-SSP (+243) 99 902 82 29 4 CHIRACK MUTONKOLE M HZMT KANZENZE DATA MANAGER (+243) 99 162 82 60 5 GUERRY MUTHUNDA TSHIYAZE M HZMT LUALABA DATA MANAGER (+243) 81 331 94 77 6 THEO LUTULA ILUNGA M HZMT LUALABA SUP ECH (+243) 99 120 25 20 7 MOISE MBUYA M HZMT MUTSHATSHA ENCODEUR (+243) 99 536 00 62 8 VALERIE YAV RUWEJ M HZMT MUTSHATSHA IS-SSP (+243) 97 067 14 14 9 ROBERT MUSUNG M HZMT DILALA IS-SSP (+243) 82 403 30 86 10 BELSCHAZAR KONGOLO M HZMT DILALA DATA MANAGER (+243) 97 588 28 84 11 DENIS MWILU K M HZMT FUNGURUME IS-SSP (+243) 82 429 73 75 12 JEAN BAPTISTE MUKULI M HZMT BUNKEYA DATA MANAGER (+243) 97 136 17 74 13 CHARLY KASHALA M HZMT BUNKEYA IS-SSP (+243) 81 218 20 62 14 GEORGES MUMENA SOMPWE M HZMT LUBUDI IS-SSP (+243) 81 278 90 81 15 ILUNGA SOBA BRUNO M HZMT LUBUDI DATA MANAGER (+243) 81 733 52 25 16 ALAIN CHIMBU M IHAP ENCODEUR (+243) 99 355 39 22 17 SAMUEL SAMITAMBA M IHAP ENCODEUR (+243) 97 096 66 02 18 TRESOR MWANANGOY M IHAP ENCODEUR (+243) 99 143 29 39 19 AMSON MULENDA M IHAP ENCODEUR (+243) 82 553 24 47 20 MUSITI LIBE MARIUS M IHAP ENCODEUR (+243) 81 235 85 26 21 ALEX TSHIAFUILA M IHAP ENCODEUR (+243) 99 854 12 94 22 CLAVERS MALABA M IHAP ENCODEUR (+243) 99 120 71 11 23 ROUSSEL NGOY M IHAP ENCODEUR (+243) 97 282 52 02 24 GRADIE NSUNGIMINA F IHAP ENCODEUR (+243) 97 090 52 30 25 DELPHINE MBEYA F IHAP SUPERVISEUR DE SITES (+243) 81 396 04 32 26 JEANOT OLUTA M IHAP SUPERVISEUR DE SITES (+243) 81 294 64 58 b) FACILITATEURS 1 VENANT ZIHALIRWA M PATH/IHAP M&E ADVISOR (+243) 81 708 57 33 2 GILBERT KAPILA M PATH/IHAP COORDO (+243) 81 708 57 68 3 Dr GARRY WAKIGANA M PATH/IHAP C&S/LUALABA (+243) 81 705 96 21 4 ERIC ESPOIR LANGBA M PATH/IHAP ENCODEUR (+243) 81 514 11 16 5 ISRAEL MBAYA M DPS/LUALABA S,C/PNLS (+243) 97 626 9570 6 TSHIBAMB A MUTOMB HENRY M DPS/LUALABA S&E (+243) 99 773 82 88 7 ISAAC KASAJ M DPS/LUALABA ANALYSTE (+243) 99 065 69 32

IHAP-HK/L YEAR 1 QUARTER 3 REPORT APRIL–JUNE 2017 74