Maximizing Linkages to OVC Programs PEPFAR 3.0 and OVC Programming: Implications and Promising...
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Transcript of Maximizing Linkages to OVC Programs PEPFAR 3.0 and OVC Programming: Implications and Promising...
Maximizing Linkages to OVC ProgramsPEPFAR 3.0 and OVC Programming: Implications and
Promising Practices for ImpactOVC Task Force Meeting. Oct 7, 2015
Brenda Yamba Acting Senior Orphans and Vulnerable Children AdvisorOffice of the Global AIDS Coordinator & Health Diplomacy
OVC Programs link to HIV cascade
CASE FINDING
Keep kids in TREATMENT
cascade
Foster comprehensive
HEALTH
1.
2.3.
HIV infected
HIV Diagnose
d
Enrolled in Care
ART Eligible
ART Initiated
Retention on ART
1. OVC programs can help find the kids in need of HIV/AIDS treatment
1. Case Finding
1. Partnership between clinic/hospital and OVC program in the community– Identify barriers to accessing services– Formalize collaborating strategy for testing kids/families
and bi-directional referrals for other services.
2. Include knowledge of HIV status in the community/household assessment tools.
3. Identify OVC platforms to link with clinical services4. Skilled OVC staff in pretest counseling & follow-up.
OVC Programs link to HIV Cascade
CASE FINDING
Keep kids in TREATMENT
cascade
Foster comprehensive
HEALTH
1.
2.3.
HIV infected
HIV Diagnose
d
Enrolled in Care
ART Eligible
ART Initiated
Retention on ART
2. Keep kids in the Treatment Cascade: OVC programs can help “plug” the leaky HIV/AIDS treatment cascade for
children
Rosen, PLoS Med 2011; Fox, TMIH 2010
2. HOW OVC programs keep children in the Treatment Cascade
Methods proven to increase adherence and retention in children:• Psychosocial Support (child & caregiver)
– Caregiver & women’s support groups – Peer mentoring– Individual support
• Economic Strengthening of family
OVC program examples of results:• In Zim, 100% of HIV+ <5 retained in C&T – very comprehensive• In Kenya, 95% of HIV+ children linked to care & support.
– Some caregivers are undergoing further counseling to enhance acceptance of the results
• In Mozambique, OVC community workers linked family members to social support and clinical services and returned 68% of treatment defaulters to ART/clinic.
What you can do to keep children in the Treatment Cascade
1. Formalize a partnership between clinical and OVC programs
2. Establish referral system for HIV + children and their caregivers to OVC programs that provide:– Psychosocial support for caregiver & children – Economic strengthening activities like Savings groups
3. Train OVC staff/home visitors in referring for testing, treatment, and guidance on tx adherence, monitoring and addressing LTFU
OVC Programs link to HIV Cascade
CASE FINDING
Keep kids in TREATMENT
cascade
Foster comprehensive
HEALTH
1.
2.3.
HIV infected
HIV Diagnose
d
Enrolled in Care
ART Eligible
ART Initiated
Retention on ART
3. Foster Comprehensive Health for HIV + children
Why children affected by AIDS need attention to comprehensive health
Elevated risk of • Mental health issues –
depression & anxiety• School drop-out• Stunting• Developmental delays• Abuse • Death e.g. when a mother
dies, the chance of her child dying within 24 months increases 10 fold.
HOW to Foster Comprehensive Health
• Early stimulation – training for mothers via mother support groups, in-home or peer mentoring
• Economic strengthening (e.g. savings groups) to support improved nutrition and access to treatment
• Nutrition interventions• Psychosocial support, triage• Help kids stay in school and succeed – gives hope
(mentoring, • Building hope and resilience
Contributions to PEPFAR Central Initiatives
DREAMS will maximize the PEPFAR OVC program to mitigate the social effects of AIDS and therefore reduce HIV risk behaviors and risk exposure among adolescent girls through evidence-based interventions including:• Education subsidies• Social asset building• Parenting/caregiver programs• Cash transfers • Combination socio-economic approaches
ACT will maximize the PEPFAR OVC program’s capacity to “strengthen children’s resilience” by:• Addressing socio-economic barriers in vulnerable families and therefore support
increased treatment entry and retention in children and adults• Scaling up evidence-based interventions • Linking community and clinical services • Enhancing family-centered care• Strengthening the measurement of quality improvement, cost analysis, and outcomes.
Parenting/Caregiver Programs
Cash transfers,
either uncondition
al or with schooling
conditions
Combination socio-economic approaches
Educational subsidy
Strengthening the Family
The Core Package
Example: Cameroon Framing OVC Strategy within HIV Care Continuum
15
Health Systems Strengthening
• Core OVC servicesa) Facilitate access to
HIV/AIDS –related clinical services, e.g. HTC, care, and support
b) Household economic strengthening
c) Promote supportive family environment
d) Comprehensive SRH education and condom programming for adolescents.
• Family counseling to facilitate disclosure and client education.
• Food supplements for clinically malnourished OVC
• Core OVC services
• Adherence counseling and psychosocial support
• Food supplements for clinically malnourished OVC
• Core OVC services
• Adherence counseling and psychosocial support
• Case management to
track and refer those LTFU
• Food supplements for clinically malnourished OVC
• Support transition from
pediatric to adult treatment services
• Core OVC services
Core services for OVC OVC found positive Linkage to clinical care
Support for retention and adherence