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CATIE FORUMSeptember 18, 2013

PLENARY: INTEGRATED HEALTH SYSTEMS:DESIGNING SYSTEMS TO RESPOND

HOLISTICALLY TO THE NEEDS OF CLIENTS

SASKATCHEWAN’S HEALTH SYSTEMS APPROACH TO

HIV

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Outline

Saskatchewan:

• Orientation to the “landscape”

• Epidemiology of HIV

• HIV Strategy implementation

• Approaches to integrating treatment and prevention

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• 13 Health Authorities• Approx 70 First Nations

communities• Population close to

1.1M 44% reside in Regina,

Saskatoon and Prince Albert

Most in the southern half of the province

15% are of Aboriginal descent (First Nations, Metis and Inuit);

6% live on-reserve

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Number and rate of new HIV cases by year, 2002 to 2011

Saskatchewan and Canada

Sources: SK ISDB Database Statistics Canada/Public Health Agency of Canada, 2011

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Epidemiology of HIV in Saskatchewan

Since 2002, steady increase in new cases

• Highest rates of new cases in Canada

• Males have accounted for the majority of new cases

• 76% of new cases associated with IDU

• 81% of new cases self-reported Aboriginal ethnicity

•High rates of co-infection with TB and Hep C

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Defining our Approach

CommunityEngagement/

Education

Prevention/Harm Reduction

Surveillance/Research

Clinical Management

Client-centered

Approaches that are: •Client-centered•Increase Access•Multi-disciplinary

Integration

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Developing the Infrastructure

Improving Public Health System Infrastructure in Canada, 2005

Information and Knowledge SystemsResearch and Evaluation

•Enhanced surveillance

Knowledge Translation into Practice•“Beg & Borrow”

Information Infrastructure•Streamlining

Sufficient & Competent WorkforceHuman Resource Planning•Additional frontline staff•Number and geographic distribution

Training and Career Development•Range of training options and formats•Multidisciplinary Training, Education and Mentorship

Organizational CapacityLeadership/System Governance

•HIV Provincial Leadership Team/Strategy Coordinators

New/Updated Policies•Routine HIV Testing•Case Management•HIV & Pregnancy•Clinical Algorithms•Access to medications/formula

Communication, Collaboration and Strategic Decision-Making

•System Expenditures•Partnerships

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Community Engagementand Education

Community Engagement• First Nations Elders, Leaders, Youth

Community Awareness/Mobilization

Ministry of Health/FNIHB social marketing campaigns• Phase 1 – encourage testing for HIV• Phase 2 – addressing HIV-related stigma• Phase 3 – planning underway with B.C.

HIV PLT website www.skhiv.ca

Social Media

Raising the profile of HIV to increase awareness and educate nationally, regionally and locally

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Prevention, Harm Reduction, Clinical Management

Centers that deliver prevention/well being/harm reduction services• Focusing on integration in the 19 provincially-funded needle exchange programs operating in 7 RHAs • Expansion to additional sites

Improved Access to Health Promotion and Sexual Health Education in Communities

HIV Point of Care Testing (2010)• Currently 21 sites

Funding for Client Transportation

Enhanced Outreach/Case Management

HIV peer to peer networks• Peer programs utilizing PHAs to provide support

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Community Based Supports•HIV Strategy funding allocated to CBOs to develop community based supports proposals based on regional needs.

Outreach ClinicsClient-centred approach to improving access to HIV/Hep C/STI/TB screening, testing, treatment and support in…..•Remote and First Nations communities •Community and “non-traditional” settingsi.e. Food Bank, Primary Care, Methadone Clinics, AIDS Service Organizations

Integrated Approaches

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•Communication and Trust•Engagement•Geography and cultural diversity•Integration of Hep C, TB, STIs•Evaluation•Resources/creating capacity •Address Social Determinants of Health, Stigma and Discrimination

Lessons

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For more information:

Lisa LockieHIV/BBP/IDU ConsultantSaskatchewan Ministry of Health3475 Albert StreetRegina, SK S4S 6X6(306)787-7260llockie@health.gov.sk.ca

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