Integrated Prevention Campaign Implementation

Dr. Eric Lugada

MD. PhD

Background

HIV diagnosis is critical for prevention and treatment. Prevention of co-infections such as malaria and diarrhea delays disease progression

Preventive interventions such as long-lasting insecticidal bed nets, point-of-use water filters, condoms and HIV counseling and testing (HCT), when implemented on a large scale, reduce malaria, diarrhea and HIV.

Multi disease prevention campaigns can achieve rapid and high coverage at low cost, but have not been widely evaluated in combination with HIV testing and prevention

The Integrated Prevention Campaign, a 7-day campaign held in Kenya in September 2008, combined voluntary HCT with distribution of a CarePack® containing a bed net, water filters, condoms and educational materials.

Method

The campaign– Mobilized stake holders and implemented a 7 day campaign intended to cover 80% of the

population aged 15-49

Post campaign survey– Two-months post-campaign survey to measure uptake of products and utilization of services

Qualitative analysis– Qualitative program evaluating contextual circumstances facilitating or discouraging uptake of

interventions

Costs and cost - effectiveness analysis- Cost and cost-effectiveness

The Campaign Micro planning- obtain buy in from ministry of health, district health authorities, community

leaders, PLWHA networks

Mapped and selected 30 uniformly distributed test sites in Lurambi division in Kakamega district Western Kenya

Recruited and trained 600 personnel; MOH trained counselors, laboratory technicians and product demonstrators

HCT following Kenya MOH guidelines, after obtaining consent and filling national VCT forms. Parallel testing done. QC done by sending 10% of samples for dry blood testing

Group counseling (~20 people) received health education and instructions on how to use the CarePack® contents; bed nets, water filters, condoms.

CD4 cell count was determined at the community level outside traditional health structures, those testing HIV(+) given a 3 months doze of cotrim and referred for further care

Campaign Process

Social Mobilisation

HIV pre-test counselling

Product demonstration

Public healtheducation

messages onnewspapers,

radio, etc

Opt out of HIV testing

Commodity distribution

Pre-Campaign During the Campaign Post-Campaign

Campaign announcement

through banners, road shows, etc

Clientfollow-up

Campaignanalysis

Care for the HIV positives

Testing

Post-testcounselling

Commodity distribution

Registration

Campaign Experience and Delivery of Preventive Interventions

All participating in the campaign received the CarePack®.

Summary campaign results:

The Integrated Prevention Campaign reached universal testing goal in 7 days.

Target population 51,178 sexually-active 15-49 yrs age group

Total tested 47007

Tested in age group 15 to 49 41,040 (>80%)

Women 28906

Women diagnosed HIV+ 1448 (5.0%)

Men 18101

Men diagnosed HIV+ 508 (2.8%)

Lowest HIV prevalence by age 15-19 years (0.8%)

Highest HIV prevalence by age 30-39 years (6.7%)

HIV+ put on cotrimoxazole 96%

Conclusion

Integrated Campaign has the potential to:

– Address multiple public health problems in a country simultaneously thus achieving various national objectives and MDGs in an efficient way.

– Reach universal testing goal in a short time, thus ensuring access to treatment.

– Break the social barriers associated with HIV testing. (stigma and domestic violence)

– Achieve universal coverage with bed nets, water filters resulting in prevention of malaria and diarrhea

– To get people early in the HIV disease cycle.

– Reduce disease programme costs by up to one half in some countries

– Avert significant DALYs in the target population, with economic savings.

– Strengthen health systems

THANK YOU