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Integrated Hiv/Aids Project Haut Katanga/Lualaba

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Integrated Hiv/Aids Project Haut Katanga/Lualaba USAID COOPERATIVE AGREEMENT NO. AID-660-A-17-00001 INTEGRATED HIV/AIDS PROJECT HAUT KATANGA/LUALABA Fiscal Year 2018 Quarter 2 Performance Report January 1–March 31, 2018 Submitted: May 15, 2018 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 Abbreviations ................................................................................................................................. iv Executive Summary ....................................................................................................................... vi Key Achievements and Program Progress ...................................................................................... 1 Objective One: Continuum of care for HIV/AIDS services ensured .......................................... 1 Sub-objective 1.1: Increased availability of comprehensive HIV prevention services. .......... 1 Sub-objective 1.2: Expanded comprehensive HIV/AIDS care and treatment services. .......... 9 Sub-objective 1.3: Improved integration of HIV/TB services. ............................................. 12 Sub-objective 1.4: Expanded network and referral systems for other health and social services. ................................................................................................................................. 14 Objective Two: Use of integrated HIV/AIDS services increased at both facility- and community-based levels ............................................................................................................ 16 Sub-objective 2.1: Improved community environment to support healthy behaviors. ......... 16 Sub-objective 2.2: Optimized service delivery models. ........................................................ 16 Objective Three: Health systems strengthened to improve access to services and improve outcomes of PLHIV .................................................................................................................. 21 Sub-objective 3.1: Essential commodities are available and effectively managed at all appropriate levels. .................................................................................................................. 21 Sub-objective 3.2: Improved use of reliable data to continuously improve service delivery quality and effectiveness. ........................................................................................ 23 Sub-objective 3.3: Effective, operational laboratory systems ensured. ................................. 29 Project Administration .................................................................................................................. 34 Human resources ....................................................................................................................... 34 Grants ........................................................................................................................................ 34 IHAP-HK/L YEAR 2 QUARTER 2 PERFORMANCE REPORT JANUARY–MARCH 2018 iii Abbreviations 3TC lamivudine ABC abacavir AIDS Acquired Immune Deficiency Syndrome ANC antenatal care ART antiretroviral therapy ARV antiretroviral AZT zidovudine BAK-Congo Bread and Knowledge Too Congo CIELS Comité Inter Entreprise de Lutte Contre le VIH/SIDA (Interagency Committee for the Fight against HIV/AIDS) CS Centre de Santé (Health Center) CSR Centre de Santé de Référence (Health Referral Center) DATIM Data for Accountability, Transparency, and Impact DBS dried blood spot DCM differentiated care model DHIS 2 District Health Information System 2 DLG dolutegavir DPS Division Provinciale de la Santé (Provincial Health Division) DRC Democratic Republic of the Congo EFV efavirenz EID early infant diagnosis ELIKIA Enhancing Services and Linkages for Children Affected by HIV and AIDS FY Fiscal Year GHSC-TA Global Health Supply Chain—Technical Assistance GPS Global Positioning System HGR Hôpital General de Référence (General Reference Hospital) HIV human immunodeficiency virus HIV/TB HIV and tuberculosis co-infection HPK Hôpital Personnel de Kolwezi (Kolwezi Private Hospital) HRH human resources for health 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 INH isoniazid IPT isoniazid preventive therapy LINKAGES Linkages across the Continuum of HIV Services for Key Populations Affected by HIV LPV/r lopinavir/ritonavir M&E monitoring and evaluation NGO nongovernmental organization NVP nevirapine OPQ Optimizing Performance and Quality IHAP-HK/L YEAR 2 QUARTER 2 PERFORMANCE REPORT JANUARY–MARCH 2018 iv 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 National de Lutte contre le SIDA (National Program for the Fight against AIDS) PNLT Programme National de Lutte contre la Tuberculose (National Program for the Fight against Tuberculosis) PNMLS Programme National Multisectoriel de Lutte contre le SIDA (National Multisectoral Program for the Fight against AIDS) PoDi+ community-based point of antiretroviral distribution QIC Quality Improvement Collaborative RDQA routine data quality assessment RNOAC Réseau National des Organisations d’Assises Communautaires (National Network of Community-Based Organizations) SIMS Site Improvement through Monitoring System SMS short message service SSC site support coordinator STI sexually transmitted infection TB tuberculosis TBIC tuberculosis infection control TDF tenofovir TO technical officer TOR terms of reference TWG Technical Working Group UNAIDS Joint United Nations Programme on HIV/AIDS USAID United States Agency for International Development VCT voluntary HIV counseling and testing VL viral load IHAP-HK/L YEAR 2 QUARTER 2 PERFORMANCE REPORT JANUARY–MARCH 2018 v Executive Summary The Integrated HIV/AIDS Project in Haut Katanga and Lualaba (IHAP-HK/L) is pleased to share the Fiscal Year 2018 (FY18) Quarter 2 (Q2) Performance Report covering the period January 1, 2018, through March 31, 2018. Quantitative impact IHAP-HK/L provided technical assistance and financial support to 106 facilities in Haut Katanga and 47a facilities in Lualaba in providing a comprehensive package of HIV testing, care, and treatment services from January through March 2018. Testing The project tested 123,992 individuals and informed them of their serologic status in FY18 Q1 and Q2, representing 40% of the FY18 annual target (318,195). Among 123,992 individuals tested in the first half of FY18, 4,476 tested HIV positive, a yield of 3.6% (Figure 1). The project’s overall testing yield increased from 3.52% in FY18 Q1 to 3.64% in FY18 Q2. Figure 1. Testing yield, October 2017–March 2018. In FY18 Q2, 62,552 individuals received HIV testing services at the facility and community levels, 1,491 (2.4%) of whom were male partners or other family members of people living with HIV/AIDS (PLHIV) who were on treatment. a IHAP-HK/L supports 49 facilities in Lualaba—data for Centre de Santé Bora and KCC are reported under Hôpital General de Référence Dilala in the DATIM (Data for Accountability, Transparency, and Impact) structure. IHAP-HK/L YEAR 2 QUARTER 2 PERFORMANCE REPORT JANUARY–MARCH 2018 vi Of the 62,552 individuals tested, 2,276 (3.64%) tested HIV positive, 1,466 in Haut Katanga and 810 in Lualaba. The testing yield was higher in Lualaba than in Haut Katanga, 4.2% and 3.4%, respectively, and higher among males (4.2%) than females (3.4%). At the community level, 24 partners or family members of PLHIV were tested at community-based point of antiretroviral distribution (PoDi+) sites in Kenya and Lubumbashi health zones (HZs) from January through March 2018, among whom two tested HIV positive (8%). Of the 17,329 pregnant women received at antenatal care or labor and delivery wards from January through March, 17,109 (99%) knew their HIV status (either knew their status at entry or were tested for HIV and informed of their status). Of these, 214 pregnant women were HIV positive (1.3% seropositivity), of whom 91% started treatment. From January through March 2018, project-supported providers collected 292 dried blood spot (DBS) samples from infants (167 within two months of birth and 125 between two and 12 months of birth) and transported the samples to laboratories in Haut Katanga for analysis. Of the 292 samples analyzed, eight tested positive for HIV (2.7% yield); all infants who tested positive were initiated on treatment. Care and treatment In total, 25,675 adults and children living with HIV/AIDS were enrolled in IHAP-HK/L’s treatment and care cohort by the end of March 2018; 2,370 were newly enrolled in FY18 Q2, which reflects 104% of the 2,276 newly identified HIV-positive adults and children (Figure 2). The greater than 100% linkage to treatment rate is due to multiple factors, including PLHIV who were lost to follow-up and re-engaged in treatment services in Q2 and referrals of newly identified HIV-positive individuals from the LINKAGES (Linkages across the Continuum of HIV Services for Key Populations Affected by HIV) project. Figure 2. Linkage to treatment, October 2017–March 2018. 2,370 2,276 2,161 2,114 FY18
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