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ESTHER PARTNERSHIPS:A KEY INSTRUMENT FOR

DECENTRALISATION OF HIV CARE AND HSS

IN CAMEROON Jules Motto, ESTHER coordinator in CameroonCaroline Comiti, program manager

Content

1. CONTEXT & JUSTIFICATION

2. ESTHER LOGIC OF INTERVENTION

3. SOME KEY RESULTS

4. CONCLUSION & RECOMMENDATIONS

1 - Context & Justification

• Cameroon : ≈ 20 M inhabitants (projections census 2007)

• 4,3 % seroprevalence HIV (HDS 2011)

• Nb de PLHIV: 560 306 (8,5% are children)

• Need of ART : 260 000 PLHIV

• Coverage of global ART: ≈ 106 000 (with 49% are followed within sites supported by ESTHER)

• 24 National / Regional Hospitals (ATC, 13 are tutors) & 178 HD3

LEVEL OF INTERVENTION OF ESTHER IN CAMEROON

PLWHIV

MOHDLM, DPM, DROST

ATC

Reg LevRHD, CAPR

HCU HCU/DHDH

CBO’S

A way forward to Institutionnal Twinning Partnerships

Partnership

2 - ESTHER logic of intervention

1. Access to care and treatment (Paediatric, STI, OI, E-MTCT, ...)

2. Health system strengthening (training of HRH and equipments )

3. Monitoring and evaluation (support to Health information System : ESOPE)

4. Strategic support and project management : central and intermediate level of the MoH (DDC,RHD)

5. Support to key populations5

C2D/ESTHER: DECENTRALIZATION THROUGH THE TUTORING

2nd generation tutoring

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Other ANC

EPI units CRN/CTN counsellor/Community

ESTHER traditional twinning

National / regional Hospital

Health District Hospital

1st generation Tutoring

Northern Hospital

IMPLEMENTATION

Since 2002Expertise recognized by MoHToday the whole country is

covered : central, regional et peripheral

levels- 13 tutor hospitals

(national/regional: ATC in the 10 regions

- 10 northern hospitals (8 in France & 2 in Germany)

TOGO

ESTHER TWINNING IN CAMEROON

3 - KEY RESULTS

80tan25a566525

0tan26a566526

0tan27a566527

0tan28a566528

0tan29a5665290%

10%20%30%40%50%60%70%80%

% ATC offering global ART% de PLHIV on ART within the ATC & HD% ATC twinned % HD tutored by the ATC% PLHIV on ART on ESTHER sites

Scaling up of Decentralization through tutoring of care of HIV/AIDS

project

DISTRIBUTION OF TRAINED HR WITHIN ESTHER SITES

PECC

Toutes les Formations

PECPS

PEC.TB/VIH

PTME

LABO

Gestion ARV IO

PECP

0%

50%

100%

50% 6%

63%

44%

58%

22%

31%

21% The whole package

4 - Conclusion & recommendations

A. ART Coverage through ATC & tutored HD (49%)

DH/CUCov 49% DH/CU

Cov 49%

MCCov 10%

HCCov

3%10

ATC twinningNorthern Hospital

DEMAND OF THE MOH

HCCov 5%

HCCov 16%

B. ART Coverage through ATC & tutored HD & tutored

health units (80%)

THE WAY FOWARD … UNIVERSAL ACCESS

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THANKS SO MUCH to You and to our partners & donors

CBO’s inCameroon

MINSANTECAMEROUN FRANCE

Région de l’Adamaoua : HR NgaoundéréRégion du Centre HCY- HGY -CH ESSOSRégion de l’Est : HR BertouaRégion de l’Extrême Nord : HR MarouaRégion Littoral : H G. DoualaRégion Littoral : H Laquintinie DoualaRégion Nord : HR GarouaRégion Ouest : HR BafoussamRégion Sud : HR Ebolowa

Hospices civils de LyonCHU MontpellierCHU CreilCHU DijonAPHP TenonHU StrasbourgCHU NancyCHIC CréteilHU Strasbourg

CAMEROUN FRANCERégion Sud Ouest : HR Limbe

Région Nord Ouest : HR Bamenda

HU RostockESTHER AllemagneHU HambourgESTHER Allemagne

The hospitals partners