PreREAD on PROSPECTING & SELLING for Trainees @DBA 101b (Pre- Session Briefing)
Capstone Session: Integrating Child Counselling in Adult ART Clinics By the end of this session,...
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![Page 1: Capstone Session: Integrating Child Counselling in Adult ART Clinics By the end of this session, trainees should be able to: Explain the key entry points.](https://reader034.fdocuments.net/reader034/viewer/2022051515/551a08675503462e378b4b93/html5/thumbnails/1.jpg)
Capstone Session: Integrating Child Counselling in
Adult ART Clinics
Capstone Session: Integrating Child Counselling in
Adult ART Clinics
By the end of this session, trainees should be able to:• Explain the key entry points to HIV care for children and
adolescents
• Identify the Essential Elements for the continuum of care for children
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Integrating Paediatric Care
• To be effective, paediatric care and treatment interventions need to become an integral part of infant and child survival and health programmes.
• Family centred care model should be promoted.
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Essential Elements for the Continuum of Care for Children
• Mechanism of identifying HIV infected and exposed infants
• Effective referral system• Defined care package• Functional care team• Staff supportive services• Logistics management systems• Health management information systems
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Mechanism of Identifying HIV Infected and Exposed Infants
Ensure all entry points are identifying and testing children– Train them– Provide test kits and all
materials– Provide registers
• Entry points– Paediatric ward– ANC– Maternity– Youth Centre– Therapeutic Feeding– Outpatient Dept– Community– Adult wards
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Organize “Know Your Child’s Status” Day (KYCSD) Campaigns
• Campaign aimed at testing children• Set a date and venue for the activity• Prepare logistics: test kits, personnel• Conduct mobilization during clinic days• Conduct the activity and refer all exposed and
infected children for care
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Establish an Effective Referral System
• Intra-facility (inter-departmental) referrals – Youth Care Clinic to ART clinic– Antenatal Care to ART clinic– ART clinic to laboratory– ART clinic to wards
• Inter-facility referrals• Community to facility referrals
Referral must be written NOT word of mouth
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A Defined Care Package- 10 Point Care Plan
• Early infant diagnosis• Cotrimoxazole prophylaxis
for OI prevention• Growth and development
monitoring• Immunization, nutritional
support, including multivitamins and iron
• Routine quarterly deworming with Mebendazole
• Aggressive management of acute illnesses
• Psychosocial support and palliative care
• Adolescent care and support
• Family-focused care including PMTCT
• ART when indicated and available
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A Functional Care TEAM with a Strategic Direction and a Leader
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Staff Supportive Services
• Capacity Building– Formal/didactic Training– CME
• Multi-disciplinary team meetings• Management-support• Support supervision/mentorship frame work• Exchange programmes/attachments• Prevention and management of staff burn-out
9
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Logistics Management Systems
• Must have stock cards• ARV bi-monthly report and order forms• ARV dispensing logs• Good storage facilities for the drugs
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Health Management Information Systems
What tools are recommended for data collection and reporting?
Data collection tools• EID register• Pre ART register• ART register• ART dispensing log
Reporting tools• Quarterly ART report
books• Bimonthly Logistics
report
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Family Centred Care Approach Should Be Encouraged
• HIV infected children and their parents should be cared for in the same clinic.
• Paediatric HIV and AIDS care and treatment services should therefore be integrated into existing adult ART care services.
Parallel care clinics for children should therefore not be initiated at sites that already
have adult care clinics.
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Integration of Paediatric Services into Adult HIV Clinics
Involves: • Creation of a ‘child-friendly’ clinic environment
– play materials, elementary pictorial books and arts/craft materials
• Ensure availability of child friendly drug formulations (ARVs and OI drugs)
• Re-align appointment with adult caregiver seen in the same clinic
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Integration of Paediatric Services into Adult HIV Clinics
Involves: • Introduce family-focused approach
– Build capacity among staff to care for the children– Active identification of children of the same
household– Focus on pregnant women
• Introduce capacity for routine infant diagnosis• Continuous mentoring by experienced clinicians
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Challenges of Integrating Paediatric HIV Care into Adult HIV Clinic
• Lack of personnel trained in paediatric care• Resistance among adult staff to deal with
children• Poor paediatric and adolescent approach• Lack of ‘child-friendly environment’• Risk of indirect and inadequate disclosure• Weak referral system between paediatric
services and adult HIV clinic
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REVIEW
Why is it important to have an effective referral system for all departments in the clinic?
What are the key points included in the 10 point management plan for HIV+ children?
What are 3 strategies for integrating paediatric services into adult ART clinics?
Integrating Paediatric Care into Adult ART Clinics
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Integrating Paediatric Care into Adult ART Clinics
1. In your team (per facility), think about three specific actions to integrate paediatric HIV counseling in the existing adult clinics
2. When you are ready ask the facilitator to give you a pledge of action form
3. The actions must be completed within the next 3 months
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Self-Assessment
• Drafting a Skills Development Plan• Think about the 4 counselling events:
1. Feeding and HIV Testing for the Exposed Infant2. HIV Testing and Counselling3. Counselling to Prepare for the Start of ART and
Supporting Adherence4. Living with HIV (including Crisis Intervention)
• For each type, identify 2-3 skills to work on• Create an action plan for how you will do it
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We’ve Reached the End of the Course…
We’ve Reached the End of the Course…
But not the end of learning!
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Where We’ve Been
• Introduction: Course Goal, Objectives and Overview
• Module I: Essential Background Paed HIV Counselling
• Module II: Feeding and HIV Testing for Exposed Infants
• Module III: HIV Counselling and Testing
• Module IV: Preparing to Start of ARVs and Supporting Adherence
• Module V: Living with HIV (including Crisis Intervention)
• Capstone: Putting it all together
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Course Objectives
By the end of this 5-day course, trainees should be able to:• Explain the importance of EARLY infant diagnosis and
treatment in order to reduce infant mortality.• Identify the role of effective counselling as part of a
comprehensive approach to the care and treatment of HIV infected infants, children, and adolescents.
• Appropriately use MoH Tools and Guides (Job Aids) to counsel HIV-exposed or infected children, adolescents and their caretakers.
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Course Objectives (2)
By the end of this 5-day course, trainees should be able to:• Demonstrate confidence, knowledge and skills to
communicate with and counsel HIV-exposed or infected children, adolescents and their caregivers.
• Effectively address disclosure, positive living, and stigma and discrimination as key parts of the process for every counselling event.
• Recommend specific actions to improve HIV clinic systems that will result in more effective provision of paediatric HIV counselling services.
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Job Aids for 5As
Paediatric HIV Counselling Flipchart – (all) HIV testing, ARVs, Positive Living
Lukia’s Story – (kids 5-10) stigma, disclosure, adherence
“Thinking About Sex?” Adolescent Booklet (kids 10-18) SRH prevention with positives
Caregiver Booklet – all topics
By the bottom of each page of the Paediatric HIV Counselling Flipchart , you will be prompted to work with your client toward an agreed next steps.
Infant feeding Algorithm – infant feeding risk reduction
Paediatric HIV Counselling Flipchart – infant feeding, disclosure, adherence, abstinence, SRH
Lukia’s Story – disclosure & adherence)
Thinking About Sex?” Adolescent Booklet – SRH prevention with positives
Caregiver Booklet – all topics
Exposed Infants Care GuidelinesTesting Algorithm for HIV Exposed Infants
Child Health Card (2011)
Paediatric HIV Counselling Flipchart – profiling pages
CounsellingHCT Card
ART adherence card
ASSESS ADVISE AGREE ASSIST ARRANGE
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Thank You