Collaboration with other partners. (ANNECA,QUAM) to conduct VL mentorships. ⢠Facilitation of one facility personnel w
Progress in scale up of VL/EID & TB Monitoring for Moroto & Kotido Monthly Data Review Meeting March 2018ep
2017) REGIONAL HEALTH INTEGRATION TO ENHANCE SERVICES (OCT IN EASTERN UGANDA (RHITES-E) storing 2016SepPROJECT 2017)
Presentation outline • IP brief profile, Districts they support, # of facilities per district • VL coverage by district
system functionality • Identified best practice in scaling up VLM
• Trends of VL coverage by month • Demand creation strategy to from Oct 2016 to date( COP16), meet the COP16 targets children vs adults.
• VL suppression rates by district
• Challenges and recommendations • EID • TB
USAID RHITES-E Consortium members
USAID REGIONAL HEALTH INTEGRATION TO ENHANCE SERVICES IN EASTERN UGANDA (USAID RHITES-E)
Geographical coverage – Cluster
Districts
Service
Comment
Bukedi cluster
Budaka, Butaleja, Kibuku, Pallisa and Tororo
Comprehensive
Bugisu cluster
Bududa, Bulambuli, Manafwa, Mbale and Sironko
Comprehensive
Sebei cluster
Bukwo, Kapchorwa, and Kween
Comprehensive
Teso cluster
Amuria, Kaberamaido, Kumi, Ngora, Serere and Soroti, Katakwi, Bukedea,
Only RMNCH and TB services will be offered
Coordination with other PEPFAR IPs for strategic integration with HIV
Karamoja cluster
Kotido and Moroto
Only HIV & AIDS (including support to Tokora, abim, kabong and matany Hubs) and Malaria
Coordination with other PEPFAR IPs for strategic integration with RMNCAH
VL coverage for all Clients Mar 17-Feb 18 District
# Health Facilities
Kotido District Moroto District
9 9
Grand Total
18
# Active on VL Valid VL ART eligible Tests OCT coverage for VL ( TX 16- Sept 17 ( # valid CURR-TX NEW) Tests/# eligible for ART) 719 78% 919 1003 96% 1040 1959
1722
88%
VL suppres sion Rate
76% 80% 78%
Quarterly sample Trends 400
342
350
Axis Title
300 250 200
264 227
219
210 188
170
150
129
100 50 0 Moroto Kotido
Apr-Jun17 227 170
Jul-Sep17 342 219
Oct-Dec17 264 188
Jan-Feb18 210 129
VL coverage children (expected Mar 17-Feb 18 is 200% i.e.2 tests/year) District
Kotido District
# Health Facilities
# Children Active on ART eligible for VL ( TX CURR-TX NEW)
VL Valid Tests Mar 17- Feb18
VL coverage ( # valid Tests/# eligible for ART) [ Target 200%]
VL suppressi on Rate
9
70
64
91%
42.2% 46.9%
Moroto District
9
47
64
136%
Grand Total
18
117
128
109%
Target for coverage is 200% since every child and adolescent is to be bled twice every 12 months
PMTCT - Pregnant Valid VL tests
VL suppression rates
District
Number non-suppressed
1st Line
2nd Line
Kotido District
23
78.3%
5
0
Moroto District
12
91.7%
1
0
Grand Total
PMTCT- breastfeeding Valid VL tests
VL suppression rates
District
Kotido District Moroto District Grand Total
42 46 88
78.6% 82.6%
Number non-suppressed
1st Line
2nd Line
8 6 14
0 0
Viral load suppression rates Mar 17-Feb 18
FEMALE
MALE
Valid VL tests
# Suppresse d
Suppression rate (%)
Valid VL tests
# Suppressed
Suppression rate (%)
Kotido
680
522
76.8%
269
211
78.4%
Moroto
983
797
81.1%
577
468
81.1%
1663
1319
846
679
Grand Total
(IP) specific Best practice in VL scale up • Developed a VL tracking dashboard to monitor facility progress
• Collaboration with other partners (ANNECA,QUAM) to conduct VL mentorships • Facilitation of one facility personnel with air time to contact • Constant facility phone call all the clients due for VL reminders on progress • Monthly meetings for facility VL focal persons (VL dashboard • VL campaigns during holiday time review and case conference)
Challenges and recommendations • Migratory population • Care givers lack adequate knowledge on management on Non-suppressing clients(no trained counselors) • Actual IAC not done in most health facilities yet documented as done
• No switch committees & ART clinical CQI team in some sites • Facility management & DHOs not adequately regulating Hub motorcycle movement
Recommendations • Form facility VL CQI and switch committees at all ART sites • Conduct capacity development for IAC counsellors (case managers and mentor mothers) • Engage case managers and mentor mothers to help in client follow up with especial focus on children, adolescents and youth • Intensified mentorship and support
supervision by the DHT to ensure is done and well documented • DHOs to closely supervise hub operations
Quality improvement Projects • Kotido-Increase VL uptake/coverage from 76% to 95% by June 2018All high volume sites (File audits ,generating lists, calling and active follow up by MMs and CMs • Moroto-Reduce VL sample rejection from average 2% to
