Partnership as a Tool for Strengthening Primary Health

Partnership as a Tool for Strengthening Primary Health Care in Côte d’Ivoire Ahoua Koné, JD, MPH UW DGH Clinical Assistant Professor Director of Côte d’Ivoire Projects April 5, 2014

Background § How we started § Unmet health needs & partnership with INSP (national public health institution) and Rotary § Provided support to government hospitals struggling as a result of structural adjustment measures § Current Projects in HAI Cote d’Ivoire § CDC-PEPFAR – HIV/AIDS care & Treatment services § Operations Research: Training; Studies (PMTCT Cascade with Pop. Council and USAID; NIH -3 -country PMTCT systems analysis) HEALTH ALLIANCE INTERNATIONAL

Background (continued) § Key country indicators § § § § Independence 1960; relatively peaceful until 2000 Pop: 23 million 57% Literacy rate; IMR 63 U 5 MR 102 HIV prevalence 3. 7% pop. (4. 6% women and 2. 7% men) Per capita GDP: $1, 245 HEALTH ALLIANCE INTERNATIONAL

Implementing Partners HEALTH ALLIANCE INTERNATIONAL

HAI approach to strengthening MOH • Work directly with MOH counterparts • Joint planning of activities • Transparency – sharing of budgets • Financial resources, including for activities, maintenance, rehabilitation, and MOH salary support • Close collaboration with local universities and research institutions (UAO, INSP) and local groups • Joint evaluations and research, including capacity building in research methods

CDC-PEPFAR HIV/AIDS PROJECT GOAL: To expand access to comprehensive HIV/AIDS care and treatment while building capacity and contributing to sustainable service delivery HEALTH ALLIANCE INTERNATIONAL

HAI approach within CDC-PEPFAR project Health System support Health Providers Support Community Partners Support • HAI staff work within MOH offices • On-site training & coaching of health care providers • Supervision & support of local NGOs • Support of roaming doctors to visit sites with no permanent doctor • Reinforcement of the link between community and health facility for care and treatment • Rehabilitation of health facilities • Supplies & materials. • Collaborative OR & quality improvement HEALTH ALLIANCE INTERNATIONAL

Major achievements § Rapid scale up of high-quality, integrated HIV services in the project area § Solid collaboration between CDC, MOH, NGO and UW partners § Involvement of districts for activities related to HIV/AIDS § 147 sites providing C&T, 138 providing PMTCT, 48 providing ART § 5352 patients on ART actively followed HEALTH ALLIANCE INTERNATIONAL

Operations Research Activities GOAL: To provide training and capacity building; to assess major factors associated with performance of health facilities and help resolve such bottlenecks to improve patient care. HEALTH ALLIANCE INTERNATIONAL

PMTCT Flow mapping HEALTH ALLIANCE INTERNATIONAL

Preliminary Findings § Substantial variation in flow map from site to site § Certain steps of PMTCT cascade not completed § Different perceptions of health care providers regarding patient flow and PMTCT cascade HEALTH ALLIANCE INTERNATIONAL

Upcoming Projects – Our wish list § National level operations research to assess scale up of PMTCT Option B § Implementation and scale up of Gene. Xpert TB diagnostics § Malaria operations research: assessing quality of care, including measurement of § Partnership with a school of public health in Guangzhou, China HEALTH ALLIANCE INTERNATIONAL

HAI-CI today • CI-HQ staff (Administrative & Technical) • 50 in-country staff • 5 city offices: Bouaké, Bondoukou, Korhogo, Abidjan, Katiola • 4 regions: Gbêké, Hambol, Poro. Tchologo-Bagoue (PTB) , Gontougou. Bagoue (GB) • 15 health districts HEALTH ALLIANCE INTERNATIONAL

MERCI!