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Community Perspectives on
HIV Control in Rwanda
Kigali INTEREST Workshop, May 2018
Geraldine UmutesiDeputy Director GeneralImbuto Foundation
Rwanda Health System Pyramid to support community service delivery
RBC, IHDPC Report, 2011
ART sites (98%)
VCT sites (98%)
PMTCT sites (98%)
Community access to HIV services in Rwanda
HIV services coverage in Rwanda, 2018
Community Based Interventions
Ministry of Health & Gov. institutions
Define National Policy & Guidelines
Coordinate National Program Implementation
Partners in HIV Response
Provide technical & Financial support
Contribute to the development of thenational guidelines & Strategies
Civil Society
Support Community HIV Programimplementation
Contribute to the development of thenational guidelines & Strategies
Associations of PLHIV
Provide Peer Adherence Support
Contribute to the development of thenational guidelines & Strategies
HIV Response
Working with Civil Society Organizations and Non-health Sector Institutions
RRP+ Package & Reach
Positive living with
HIV
Prevention
Care & Treatment
Social impact
Advocacy
• More than 120.000 members of which 68% are females and 32% are males. 89% of all members is HIV+. 11% is affected by HIV. (Source: RRP+ annual report 2017)
• The members are grouped according to their level of registration from sector level to national level (associations, cooperatives and NGOs), active in all districts across the country.
• PLHIV are mobilized to actively participate in the HIV response and encouraged to form cooperatives to support their livelihoods.
Community Health Workers
Drivers of Universal coverage
• Established in 1995
• There are 3 CHWs per village
• Roles:
➢ increasing uptake of essential maternal
and child clinical services
➢ follow up and linkages to health services
➢ Encourage pregnant women to attend
the 4 ANC visits,
➢ Encouraging them to test for HIV and
closely following up on drop out cases.
➢ Bringing to health facility presumptive TB cases
This has contributed to 50% decline of new HIV
infections in Rwanda.
Community Health Workers
Imbuto Foundation
E3 : Engage, Educate, Empower
Background
• Established as Protection and Care of Families against HIV/AIDS (PACFA) to respond to
the severe epidemic affecting the Rwandan society.
• In 2007 PACFA had embraced more programmes and changed its name to Imbuto
Foundation.
• Implements over 16 projects in health, education, youth and economic empowerment in
all 5 Provinces of the country.
• Over the past years, close to 400,000 young people were sensitized to be voluntarily
tested for HIV.
• Over 6,000 peer educators were trained in disseminating adolescent sexual reproductive
health, prevention and treatment of HIV&AIDS, treatment and positive living.
• Our Family Package Project supported to PPMTCT national Program using Peer
educators and male engagement
ICON PROJECT
ASRH
Family Package
Mountain Movers HIV prevention among young people (15-24)
12 +
CYRWA
Mentorship
RWANDA Speaks
YFS
i-Accelerator
ICON PROJECT
Yale Young African Scholars Program (YYAS)
Early Childhood Development / (ECD&F)
Edified Generation
Kacyiru Community Knowledge Centre
Promotion of Girls Education Campaign
Promotion of Reading Culture
Twige Neza Dutsinde
IMALI
Community Commitments
Mother to Child Transmission decreased from 10.9% to 1.5% ( 2000-2018)
Community Commitment to #EndAdolescentAIDS
HE The First Lady awarding 5 districts That had no child born HIV-positive from their infected mothersIn the last 5 years
Innovative Community HIV awareness Campaigns
HIV Sensitization campaigns on
HIV prevention and treatment
services involving all partners in
HIV response:
• Ministry of Health leadership
• Partners in HIV response
• People living with HIV
• Youth
• Local leaders
• CSO
• NGOs
• Media
• By increasing access to ART in Rwanda, substantial gains in life expectancy among HIV positive individuals was observed.
• Life expectancy gains for patients’ enrollment into HIV care and ART was demonstrated by improved life expectancy on ART.
• Life expectancy in Rwanda at age 20 gained an additional 45 years, a 35% gain in just ten years
• This nation-wide analysis confirms that ART expansion has population-level health gains
Impact of HIV services to the community
Contribute to HIV case findings towards achieving global targets 90-90-90:
• Uptake of HIV testing services including HIV self testing
• Index testing and partner notification
• Sustain Involvement of all levels in HIV response:
- Local leaders - Development Partners - Media - Partners - Civil Society - NGOs
To #Build the Rwanda We want
Murakoze!