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Provic) Year 6 Quarter 1 Report

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Provic) Year 6 Quarter 1 Report DRC INTEGRATED HIV/AIDS PROJECT PROJET INTEGRE DE VIH/SIDA AU CONGO (PROVIC) YEAR 6 QUARTER 1 REPORT October−December 2014 Contract #GHH-I-00-07-00061-00, Order No. 03 Submitted February 27, 2015; Re-submitted April 7, 2015 This document was produced by the ProVIC PATH Consortium through support provided by the United States Agency for International Development, under the terms of Contract No. I-00-07-00061-00. 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 .................................................................................................................. iv Executive summary ................................................................................................................................. v Section I: Progress by technical component ........................................................................................... 1 Intermediate Result 1: Continued access to comprehensive PMTCT and HIV prevention interventions for key populations ....................................................................................................... 1 Sub-IR 1.1: Access to comprehensive PMTCT services according to national norms in ProVIC-supported sites ............................................................................................................... 1 Sub-IR 1.2: Promotion and uptake of pediatric counseling and testing, and improvement in follow-up of mother-infant pairs ................................................................................................. 4 Sub-IR 1.3: Undertaking of prevention strategies for key populations in target areas ................... 6 Activities planned for the next quarter for Intermediate Result 1 ................................................... 9 Intermediate Result 2: Improved access to adult and pediatric treatment .......................................... 9 Sub-IR 2.1: Maximizing access to ART ......................................................................................... 9 Sub-IR 2.2: Maximizing the quality of care and ART services .................................................... 12 Activities planned for the next quarter for Intermediate Result 2 ................................................. 16 Intermediate Result 3: Health systems strengthening supported ...................................................... 16 Sub-IR 3.1: Capacity of provincial government health systems supported .................................. 16 Sub-IR 3.2: Strategic information systems at facility levels strengthened ................................... 17 Activities planned for the next quarter for Intermediate Result 3 ................................................. 19 Section II. Program management update .............................................................................................. 20 Administration and finance .............................................................................................................. 20 Grants management .......................................................................................................................... 20 Environmental monitoring and mitigation activities ........................................................................ 20 PROVIC YEAR 6 QUARTER 1 REPORT OCTOBER–DECEMBER 2014 iii ACRONYMS AND ABBREVIATIONS AIDS acquired immune deficiency syndrome ART antiretroviral therapy ARV antiretroviral medication CSW commercial sex workers DATIM Data for Accountability, Transparency, and Impact DBS dried blood spot DRC Democratic Republic of Congo E2A Evidence to Action EID early infant diagnosis EMMP Environmental Mitigation and Monitoring Plan FANTA Food and Nutrition Technical Assistance III Project FY Fiscal Year GBV gender-based violence Global Fund Global Fund to Fight AIDS, Tuberculosis and Malaria HAART highly active antiretroviral therapy HTC HIV testing and counseling HIV human immunodeficiency virus IDU injection drug user IR Intermediate Result M&E monitoring and evaluation MER Monitoring, Evaluation, and Reporting MOH Ministry of Health MSM men who have sex with men MUAC mid-upper arm circumference NACS nutrition assessment, counseling, and support NGO nongovernmental organization PCR polymerase chain reaction PEPFAR United States President’s Emergency Plan for AIDS Relief PITC provider-initiated testing and counseling PLHIV people living with HIV/AIDS PMTCT prevention of mother-to-child transmission of HIV PNLS Programme National de Lutte contre le SIDA (National HIV/AIDS Program) PNMLS Programme Nationale Multi-Sectorielle de Lutte contre le SIDA (National Multi-Sectorial Program for the Fight against AIDS) PNSR Programme National de Santé de la Reproduction (National Reproductive Health Program) PRONANUT Programme National de Nutrition (Ministry of Health National Nutrition Department) ProVIC Projet Intégré de VIH/SIDA au Congo (Integrated HIV/AIDS Project) QA/QI quality assurance/quality improvement ReCos relais communautaires (community outreach volunteers) SCMS Supply Chain Management System SGBV sexual and gender-based violence STI sexually transmitted infection TB tuberculosis USAID United States Agency for International Development WHO World Health Organization PROVIC YEAR 6 QUARTER 1 REPORT OCTOBER–DECEMBER 2014 iv EXECUTIVE SUMMARY The first quarter of Fiscal Year (FY) 2015 was an important transitional quarter for Projet Intégré de VIH/SIDA au Congo (ProVIC). While ProVIC continued to offer its comprehensive package of care, treatment, and support services through 99 supported health facilities, the quarter was also highlighted by the closure of ProVIC’s activities in Bas-Congo, negotiations and agreement with the Programme National de Lutte contre le SIDA (PNLS) on the scale-up of activities in Bunia, and the integration of Tier.net as an antiretroviral therapy (ART) patient monitoring tool. For several months, ProVIC, the United States Agency for International Development (USAID), and the PNLS (at the national and provincial levels) planned for the withdrawal of ProVIC from Bas- Congo, due to the low prevalence of HIV in the province and the capacity of the Global Fund to Fight AIDS, Tuberculosis and Malaria to absorb ProVIC sites into its program. This allowed ProVIC to shift its resources to Ituri district, Province Orientale, to focus on high-volume health facilities and health zones that have a higher prevalence of HIV. The closure of ProVIC’s Bas-Congo operations was carefully coordinated with the national and provincial governments, Global Fund, health zone offices, and health facilities to ensure a smooth transition, keeping the well-being of beneficiaries at the center of the planning process. In December 2014, after conducting final joint assessments with technical staff from the PNLS and Programme Nationale Multi-Sectorielle de Lutte contre le SIDA (PNMLS) in Bas-Congo, ProVIC sites were formally transferred to local Global Fund partners. This closure was marked by a joint visit from the National PNLS Director, the Deputy Director of the PNMLS, USAID, and the ProVIC Chief of Party, and included a debriefing with the Provincial Minister of Health and the President of the Provincial Assembly. In parallel with the closure of ProVIC’s operations in Bas-Congo, ProVIC and USAID engaged in detailed planning and negotiations with the national and provincial levels of the PNLS in Province Orientale on ProVIC’s expansion into Ituri district, where ProVIC will expand its coverage from seven health facilities in Bunia Health Zone to 32 health facilities across five health zones, adding Rwampara, Nizi, Bambu, and Mungualu. This shift from low-prevalence Bas-Congo to higher- prevalence health zones in Ituri, which borders Uganda, is part of ProVIC’s ongoing efforts to improve cost efficiencies and continually adapt to the nature of the epidemic in the Democratic Republic of Congo. ProVIC significantly upgraded its capacity in patient management in Quarter 1 by integrating the Tier.net patient management tool across most ProVIC-supported sites, which included installing Tier.net and training health care providers in more than 80 health facilities in Kinshasa, Katanga, and Orientale. The Tier.net tool will change the way ProVIC collects and analyzes data on its beneficiary cohort, as the tool manages individual patient data which are then aggregated for analysis at the site, health zone, provincial, and national levels. As the PNLS is using this tool nationally, ProVIC’s Tier.net data are standardized and can be aggregated with data from other non-ProVIC and non-US President’s Emergency Plan for AIDS Relief projects. Going forward, considerable emphasis will be placed on working with health zone- and site-level health care providers to use Tier.net data in their analysis and planning. Prevention of mother-to-child transmission of HIV* The majority of ProVIC’s beneficiaries receive services through the prevention of mother-to-child transmission of HIV (PMTCT) platform, following ProVIC’s acceleration toward PMTCT in 2012 * All targets and results cited in this report are in reference to targets and results established and expected under the AIDSTAR mechanism under which ProVIC is supported from October 2014 to March 2015, half of the annual fiscal year reporting period. PROVIC YEAR 6 QUARTER 1 REPORT OCTOBER–DECEMBER 2014 v and the Strategic Pivot in 2013. A narrative of
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