HIV TREATMENT AND CARE IN THE RWANDAN DEFENSE FORCES                Ahmed Abajobir, MPH                   Country Director...
BACKGROUND•   Program Title: HIV Treatment and Care in the Rwandan Defense Forces•   Funding Source: DOD/PEPFAR•   Fiscal ...
RDF FACILITIES AND PROGRAMS             SUPPORTED BY CDU IN RWANDACurrently, the program supports 10 RDF Health Service ou...
RWANDA-ITS LOCATION INAFRICA                         4
LOCATIONS OF CDU SUPPORTEDSITES IN RWANDA                             5
AREAS OF INTERVENTIONS1. HIV prevention among the RDF and the wider public:A. Awareness raising through Anti-AIDS Clubs (A...
AREAS OF INTERVENTION             CONT’DB. Support to VCT services at all RDF health facilities (6 brigade  clinics, one M...
AREAS OF INTERVENTIONS               CONT’DC. Support Male Circumcision Program at 6 RDF facilities:    • Infrastructure r...
AREAS OF INTERVENTIONS               CONT’D2. Care and treatment for RDF personnel living with HIV/AIDSA. Technical and lo...
AREAS OF INTERVENTIONS             CONT’D3. Capacity building of RDF health workers through regular on   the job training ...
AREAS OF INTERVENTIONS            CONT’D5. Financial support for RDF Health facilities (Brigade   Clinics and Hospitals)• ...
AREAS OF INTERVENTIONS             CONT’D6. Financial support for human resource development• Salary support for 16 health...
AREAS OF INTERVENTIONS               CONT’D7. Infrastructure support• Renovation of infrastructure at Rwanda Military Hosp...
AREAS OF INTERVENTIONS                CONT’D8. Provision of Medical and Laboratory Equipment and furniture:• Equipped Rwan...
AREAS OF INTERVENTIONS                 CONT’D9. Ongoing Support to Laboratory Accreditation Process At Rwanda   Military H...
ACHIEVEMENTS• Number of health service outlets supported by DCI with HIV  prevention, care and treatment: 10• Number of he...
ACHIEVEMENTS• Number of pregnant women who received a full package of  PMTCT: 5795• Number of males circumcised: 3,528• Nu...
SUCCESS STORIES• Excellent relationship with donors: DOD/PEPFAR• Considered as a model DOD HIV/AIDS program in Africa• Vis...
CHALLENGES•   Needs vs. available resources•   High turnover of trained health workers•   High cost of some services (e.g....
PICTORAL REPRESENTATION“A PICTURE IS WORTH A THOUSAND WORDS”              Unknown Source                                  ...
Partnership              21
Infrastructure Rehabilitation--Inaugural of theIntegrated HIV/AIDS Treatment and Care Center atRwanda Military Hospital   ...
Infrastructure Rehabilitation of RDF BrigadeClinic--Muhanga                                               23
Rucizi Brigade Clinic                        24
Huye Brigade Clinic                      25
Rwanda Military Hospital—LabEquipment Support                               26
Rwanda Military Hospital—LabEquipment Support                               27
Kaduha Military Hospital--Medical andLab Equipment Support                                        28
Kaduha Military Hospital--Medical andLab Equipment Support                                        29
Kaduha Military Hospital--Medical andLab Equipment Support                                        30
Brigade Clinics--Lab and MedicalEquipment                                   31
Brigade Clinics--Lab and MedicalEquipment                                   32
Brigade Clinics--Lab and MedicalEquipment                                   33
Brigade Clinics--Lab and MedicalEquipment                                   34
Brigade Clinics--Lab and MedicalEquipment                                   35
HIV Prevention Awareness Raising                                   36
HIV Prevention--Testing                          37
HIV Prevention--Condom Promotion                                   38
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Dci rwanda fact sheet as at 13 oct 2012 v2

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Dci rwanda fact sheet as at 13 oct 2012 v2

  1. 1. HIV TREATMENT AND CARE IN THE RWANDAN DEFENSE FORCES Ahmed Abajobir, MPH Country Director Charles R. Drew University of Medicine and Science Charles L. Hilliard, Ph.D., Principal Investigator Funding provided by DoD 1
  2. 2. BACKGROUND• Program Title: HIV Treatment and Care in the Rwandan Defense Forces• Funding Source: DOD/PEPFAR• Fiscal Agent: Charles R. Drew University• Partner: Rwandan Defense Forces (RDF) – Additional Partners: MOH/RBC, PSI, JHPIEGO• Objectives of the program : – Support RDF in providing high-quality HIV treatment and care services for military personnel, their families, and communities living around RDF health facilities – Build capacity within RDF to ensure sustainability of HIV treatment and care programs in Rwanda 2
  3. 3. RDF FACILITIES AND PROGRAMS SUPPORTED BY CDU IN RWANDACurrently, the program supports 10 RDF Health Service outlets:• Six RDF Brigade Clinics: – Huye – Ngoma – Rucizi – Muhanga – Mukamira – Gicumbi• Two Military Hospitals: – Rwanda Military Hospital, Kanombe, Kigali – Kaduha Military Hospital, Nhamagabe District• One Military Medical Rehabilitation Center, Ngarama • One Mobile Care and Treatment Unit (MCTU) that works throughout the country 3
  4. 4. RWANDA-ITS LOCATION INAFRICA 4
  5. 5. LOCATIONS OF CDU SUPPORTEDSITES IN RWANDA 5
  6. 6. AREAS OF INTERVENTIONS1. HIV prevention among the RDF and the wider public:A. Awareness raising through Anti-AIDS Clubs (AACs): – Established and support 11 AACs composed of 575 members including civilians in and around military installations – Provide technical support to 11 AACs through training on participatory communication methodologies – Provide audio-visual materials and sound systems to each of the 11 clubs to support community outreach BCC activities – Provide logistical support (transport and expenses) to AACs for community outreach HIV prevention activities using drama, song and group discussions – Currently initiating technical and financial support for IGA initiatives to sustain AACs 6
  7. 7. AREAS OF INTERVENTION CONT’DB. Support to VCT services at all RDF health facilities (6 brigade clinics, one Military Rehab Centre and two hospitals) – Support ongoing VCT services at all RDF Health facilities through provision of regular technical support in the form of training and supervision in HIV/AIDS Counseling and Testing, as well as routine HIV clinical evaluations and psychosocial support – Support outreach VCT activities to other military installations (e.g. military training centers, as well as communities in the catchment areas of RDF health facilities, including secondary schools) 7
  8. 8. AREAS OF INTERVENTIONS CONT’DC. Support Male Circumcision Program at 6 RDF facilities: • Infrastructure rehabilitation for MC including operating rooms, water systems and waste disposal systems (incinerators) in five health facilities • Provide infection control training for health service providers from all the RDF health facilities, as well as for BMOs and RMOsD. Prevention with Positives: • Established 55 support groups of PLHAs—psychosocial support and positive living • Trained and mobilized 55 lay counselors to facilitate support groups and provide peer to peer home based counselingE. PMTCT: • Provide Technical Support to Health workers: Train based on the national PMTCT Protocol and provide regular supervision • Monthly nutritional support to 100 mothers and children enrolled in PMTCT program 8
  9. 9. AREAS OF INTERVENTIONS CONT’D2. Care and treatment for RDF personnel living with HIV/AIDSA. Technical and logistical support to th Mobile Care and Treatment Unit (MCTU) for HIV+ RDF Personnel deployed in hard-to-reach areas: The services provided include: medical exams, lab tests (including CD4 tests, hematology, Biochemistry), prophylaxis for OIs as well as psychosocial assessment and support.B. Technical and logistical support for Monthly ARV Drug distribution to RDF soldiers deployed in hard-to-reach areas. This includes travel costs for BMOs and RMOs to collect and distribute drugs to PLHAS in their respective battalions. 9
  10. 10. AREAS OF INTERVENTIONS CONT’D3. Capacity building of RDF health workers through regular on the job training and supportive supervision in the areas of: HBHC, HTXS, HVTB, MTCT, PDCS, PDTX , HVLAB, HVCT and MC.4. Technical and material support for HIV Program Monitoring and Evaluation (HVM&E) and HIV Program Strategic Information (HIVSI) through training on data collection, management and reporting as well as through provision of IT equipment, personnel and regular supportive supervision. 10
  11. 11. AREAS OF INTERVENTIONS CONT’D5. Financial support for RDF Health facilities (Brigade Clinics and Hospitals)• Monthly financial support for operational costs of 6 brigade clinics• Monthly financial support for HIV/AIDS outreach activities at Kaduha Military Hospital and Rwanda Military Hospitals to ensure adherence to ARVs• Performance Based Financing (PBF) to Rwanda Military Hospital to ensure quality of services through provision of incentives to high performing staff and services 11
  12. 12. AREAS OF INTERVENTIONS CONT’D6. Financial support for human resource development• Salary support for 16 health workers (Nurses, Lab Techs and Social Workers) at 6 brigade clinics• Salary support for 7 health workers working in the areas of ART, PMTCT, Laboratory and Data management at Rwanda Military Hospital• Salary support to 7 health workers working on VCT, Lab, ART, PSS support and laboratory services at Kaduha Military hospital• Salary support for one physician at Ngarama military rehabilitation center 12
  13. 13. AREAS OF INTERVENTIONS CONT’D7. Infrastructure support• Renovation of infrastructure at Rwanda Military Hospital (Integrated VCT, ART and PMTCT center as well as laboratory facilities and office space)• Renovation of six brigade clinics to upgrade them to Health Center levels as per the national MOH standards this includes extension of OR rooms, installing water systems, building incinerators)• Rehabilitation of laboratory facilities, water systems and waste disposal systems at Kaduha hospital 13
  14. 14. AREAS OF INTERVENTIONS CONT’D8. Provision of Medical and Laboratory Equipment and furniture:• Equipped Rwanda Military Hospital with major laboratory and medical equipment such as state of the art hematology, biochemistry and other related equipment, ICU equipment, as well as office furniture and high voltage power protectors• Provided laboratory, medical and office equipment, including CD4 machines, power generators, computers and accessories, and motorcycles to Kaduha Military Hospital• Equipped 6 brigade clinics with medical and laboratory equipment, as well as furniture and supplies• Provided laboratory, medical and other supplies, as well as start–up medication supplies to Ngarama rehab center. These include: lab equipment, power generators, computers and accessories, as well as motorcycles 14
  15. 15. AREAS OF INTERVENTIONS CONT’D9. Ongoing Support to Laboratory Accreditation Process At Rwanda Military Hospital:• Provided Training on Good Laboratory Practices (GLP)• Provided technical support for the development of appropriate documentation, such as Standard Laboratory Operation Manuals, lab protocols, policies and procedure manual, including development of lab information system—these fulfill requirements necessary for the lab and other services at RMH to be fully accredited.• As a result of these investments, Rwanda Military Hospital Lab has been evaluated by an accreditation agency and attained 4 star achievement--it is now fully accredited 15
  16. 16. ACHIEVEMENTS• Number of health service outlets supported by DCI with HIV prevention, care and treatment: 10• Number of health facilities rehabilitated: 8• Number of health facilities provided with medical, laboratory and office equipment: 9• Number of individuals reached with HIV prevention messages: 73,570• Number individuals provided HIV testing and counseling: 36,766• Number of individuals enrolled in ART: 3,834 16
  17. 17. ACHIEVEMENTS• Number of pregnant women who received a full package of PMTCT: 5795• Number of males circumcised: 3,528• Number of individuals trained on Integrated PMTCT, ART, Ped AIDS HIV/TB management: 232• Number of individuals trained on psychosocial services: 152• Number of AACs formed and currently active: 11• Number of HIV/AIDS support groups formed: 55• Number of HIV/AIDS lay counselors recruited and trained: 55 17
  18. 18. SUCCESS STORIES• Excellent relationship with donors: DOD/PEPFAR• Considered as a model DOD HIV/AIDS program in Africa• Visited by DOD program staff from Angola, Senegal and Ivory Coast for experience sharing• Excellent relationship with RDF Partners: Our program has been visited many times by senior RDF leadership, including the Minister of Defense• Partner protection in the face of funding cuts 18
  19. 19. CHALLENGES• Needs vs. available resources• High turnover of trained health workers• High cost of some services (e.g. Mobile Clinic)• Lack of diversified funding source• Sustainability 19
  20. 20. PICTORAL REPRESENTATION“A PICTURE IS WORTH A THOUSAND WORDS” Unknown Source 20
  21. 21. Partnership 21
  22. 22. Infrastructure Rehabilitation--Inaugural of theIntegrated HIV/AIDS Treatment and Care Center atRwanda Military Hospital 22
  23. 23. Infrastructure Rehabilitation of RDF BrigadeClinic--Muhanga 23
  24. 24. Rucizi Brigade Clinic 24
  25. 25. Huye Brigade Clinic 25
  26. 26. Rwanda Military Hospital—LabEquipment Support 26
  27. 27. Rwanda Military Hospital—LabEquipment Support 27
  28. 28. Kaduha Military Hospital--Medical andLab Equipment Support 28
  29. 29. Kaduha Military Hospital--Medical andLab Equipment Support 29
  30. 30. Kaduha Military Hospital--Medical andLab Equipment Support 30
  31. 31. Brigade Clinics--Lab and MedicalEquipment 31
  32. 32. Brigade Clinics--Lab and MedicalEquipment 32
  33. 33. Brigade Clinics--Lab and MedicalEquipment 33
  34. 34. Brigade Clinics--Lab and MedicalEquipment 34
  35. 35. Brigade Clinics--Lab and MedicalEquipment 35
  36. 36. HIV Prevention Awareness Raising 36
  37. 37. HIV Prevention--Testing 37
  38. 38. HIV Prevention--Condom Promotion 38

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