National HIV/AIDS Support Project (NHASP) Milestone 103 Review of ART Pilot June 2006 In association with: PNG National HIV/AIDS Support Project Table of Contents ABBREVIATIONS AND ACRONYMS................................................................ VI EXECUTIVE SUMMARY, CONCLUSIONS AND RECOMMENDATIONS....... VIII 1. BACKGROUND AND METHODOLOGY ......................................................1 1.1 HIV in PNG .................................................................................................................................... 1 1.2 National Strategic Plan (NSP) on HIV & AIDS .......................................................................... 1 1.3 Antiretroviral Therapy (ART) Roll Out ...................................................................................... 2 1.4 Methodology ................................................................................................................................... 3 2. HEDURU CLINIC REPORT...........................................................................4 2.1 Background..................................................................................................................................... 4 2.2 HIV Seroprevalence and HIV/AIDS at Heduru Clinic and Port Moresby General Hospital . 4 2.3 Methodology of Heduru Clinic Review ........................................................................................ 5 2.4 Current Staffing at Heduru........................................................................................................... 5 2.5 Patient Clinical Pathway ............................................................................................................... 5 2.6 Data systems ................................................................................................................................... 7 2.7 Clinic Facilities ............................................................................................................................... 8 2.8 Pharmacy ........................................................................................................................................ 9 2.9 HIV Patient Population at Heduru............................................................................................... 9 2.10 Referral ......................................................................................................................................... 12 2.11 Occupation, Education, Marital Status and HIV Exposure Category .................................... 13 2.12 Clinical Status............................................................................................................................... 15 2.13 ARV Therapy ............................................................................................................................... 16 2.14 Outcome ........................................................................................................................................ 17 2.15 Conclusions................................................................................................................................... 19 2.16 Recommendations ........................................................................................................................ 20 3 LAE, MOROBE PROVINCE........................................................................22 NHASP – ART Site Readiness Review i PNG National HIV/AIDS Support Project 3.1 HIV and AIDS Team ................................................................................................................... 22 3.2 Background................................................................................................................................... 22 3.3 Current ART services .................................................................................................................. 22 3.4 Staff ............................................................................................................................................... 25 3.5 Infection Control and Standard Safety Precautions ................................................................. 26 3.6 Training, audit and maintenance of professional standards .................................................... 26 3.7 Pharmacy ...................................................................................................................................... 26 3.8 Laboratory Support..................................................................................................................... 27 3.9 Referral Systems, Community and District/Rural Health Linkages ....................................... 28 3.10 Support and relationship with Provincial Administration:...................................................... 29 3.11 Future Plans.................................................................................................................................. 29 3.12 Conclusion: Issues and Challenges ............................................................................................. 29 3.13 Recommendations ........................................................................................................................ 30 4. GOROKA, EASTERN HIGHLANDS ...........................................................32 4.1 Background................................................................................................................................... 32 4.2 Current ART services .................................................................................................................. 33 4.3 Record Keeping ............................................................................................................................ 35 4.4 Staff Capacity ............................................................................................................................... 36 4.5 Infection Control and Standard Safety Precautions ................................................................. 36 4.6 Training, audit and maintenance of professional standards .................................................... 37 4.7 Pharmacy ...................................................................................................................................... 37 4.8 Laboratory Support..................................................................................................................... 38 4.9 Referral Systems, Community and District/Rural Health Linkages ....................................... 39 4.10 Support and relationship with Provincial Administration....................................................... 40 4.11 Future Plans.................................................................................................................................. 41 4.12 Conclusion, Issues and Challenges.............................................................................................. 41 4.13 Recommendations ........................................................................................................................ 42 NHASP – ART Site Readiness Review ii PNG National HIV/AIDS Support Project 5. MT HAGEN, WESTERN HIGHLANDS PROVINCE....................................44 5.1 Background................................................................................................................................... 44 5.2 Current ART services .................................................................................................................. 45 5.3 Staff capacity ................................................................................................................................ 47 5.4 Infection Control and Standard Safety Precautions ................................................................. 48 5.5 Training, audit and maintenance professional standards ........................................................ 48 5.6 Pharmacy ...................................................................................................................................... 48 5.7 Laboratory Support..................................................................................................................... 49 5.8 Referral Systems, Community and District/Rural Health Linkages ....................................... 50 5.9 Support and relationship with Provincial Administration....................................................... 51 5.10 Conclusions, Issues and Challenges............................................................................................ 52 5.11 Recommendations ........................................................................................................................ 53 6. RABAUL, EAST NEW BRITAIN PROVINCE..............................................55 6.1 Background................................................................................................................................... 55 6.2 Current ART services .................................................................................................................. 55 6.3 Staff capacity ................................................................................................................................ 57 6.4 Infection Control and Standard Safety Precautions ................................................................. 57 6.5 Training, audit and maintenance of professional standards .................................................... 57 6.6 Pharmacy .....................................................................................................................................