Burkina Faso | Ghana | Mozambique
| BURKINA FASO | |
Ministry of Health The Government of Burkina has been very proactive in implementing a series of national plans since the emergence of the first AIDS cases in 1986. There has been strong political commitment, an intensification of the scope and range of interventions, and substantial growth in the financial resources being channeled for the national HIV/AIDS programme. Responsibility for issues related to treatment is vested in the Ministry of Health through the Ministry of health AIDS Committee (CMLS/Santé), which is chaired by the Minister and responsibilities for planning and execution rest with the CMLS/Santé Coordination Unit, which includes a Coordinator and several technical and support staff. Ministry of Health AIDS Empowerment and Treatment International (AIDSETI) AIDS Empowerment and Treatment International (AIDSETI), a non-profit organization created in December 1999, is an international network of 22 community-based associations of People Living with HIV/AIDS (PLWHA) focused on providing HIV care and treatment in 14 of the poorest countries of Africa and the Caribbeans. In Burkina Faso, six associations are members of the AIDSETI network: AAS, ALAVI, AMMIE, Espoir Vie, REVS+ and Vie Positive. An initial survey of the six member associations from Burkina Faso indicates that at this time they provide care for about 4,000 HIV+ patients. Of these, 65 percent are in Stages III and IV of the AIDS disease with 3,000 waiting for ARV; 74 percent are women, mostly mothers with children; 34 joined a MTCT programme. Already 125 children are HIV+ orphans. As of December 2003, 330 patients were receiving ART, 30 of them being directly financed by AIDSETI. All the six associations were already providing ARV drugs as of January 2003. The programme is envisioned for three years, beginning 2004 with all activities begun in the first year and continuing throughout. Association Africaine de Solidarité (AAS) In 1991, AAS was launched by a band of friends in Ouagadougou who wished to create an association promoting the social integration of underprivileged young people. It was only in 1992 that it became devoted to the prevention of HIV/AIDS. AAS has developed its activities considerably especially in the realm of comprehensive care of HIV+ people and their families. In 1998, AAS opened a medical care facility, the OASIS Centre. This programme provided HIV+ people with a place to meet, to learn, and to receive medical and psychosocial support while prioritizing the involvement of PLWHA in their own medical care and follow up. AAS is now the largest community care and treatment center in Burkina Faso. It is one of the few facilities providing comprehensive care in a fully integrated way. Activities of fight against the HIV/AIDS:
AAS ALAVI ALAVI is an association that contributes to the fight against HIV/AIDS. Its main activities are: The objectives of ALAVI are: ALAVI Association Vie Positive Prevention activities Medical and psychosocial support for infected people Assumption of responsibility of the Orphans and vulnerable children Income-generating activities, in particular through the granting of Micro loans to PLWHA Association Vie Positive Association REVS+ In 1993, management of patients and people identified as HIV+ was largely absent. Worse, these people were victims of discrimination, stigmatization, abandonment and rejection. It was against this background that an HIV+ woman and some doctors involved in the fight against HIV/AIDS set up a group of automatic support which evolved by June 10, 1997 into the Association REVS+ under the licence N° 8/041/CHECHMATES/SG/DGAT/DLPAJ. REVS+ is an organization at the community level which gathers people infected and affected by the AIDS virus and which to date represents 1004 adult members including 340 vulnerable orphans and children (VOC). REVS+ in Bobo Dioulasso: At the beginning of the 1990’s, health professionals at the tuberculosis regional centre and the dermatology service of the hospital were confronted with the problem of revealing seropositivity to patients detected with the virus. Testing was made without the knowledge of the patients and the announcement did not take place systematically. The doctors justified this practice by the impossibility of offering support once the announcement was made. 'Think tanks ' of medical and social sector professionals were instituted to better organize the announcement and to ensure follow-up for the people concerned. These groups led to the creation of an Association for the promotion of the announcement and counseling (APRODEC). Funding from the French co-operation allowed the creation of structures for testing and counseling as well as a research centre to carry out studies on impact of HIV as a growing number of people learn their seropositivity. Association REV+ Espoir et Vie Espoir et Vie’s main activities are: :: Prevention activities through awareness and promotion of methods of protection (educational talks, promotional activities) One hundred and twenty five people receive medical care including medicines for the most common opportunistic infections, provided mostly through donations. The organization does not directly prescribe ARVs but gives financial support to clients to pay for treatment, and offers medical and psychosocial support together with informational workshops on ARVs. Thirteen members of the organization are currently under ARV. Espoir et Vie Appui Moral, Materiel et Intellectuel a l'Enfant (AMMIE) Located in Yatenga, a remote province in the north of Burkina Faso, AMMIE is one of the only organizations providing care to HIV+ people outside Ouagadougou and Bobo Dioulasso, Burkina Faso’s two larger cities. It brings together teachers, doctors and nurses with the goal of improving the quality of life in isolated villages. Their priorities are: Activities of education: The doctors who are affiliated with the organization prescribe ARV and provide medical and psychosocial follow-up to 45 patients under ARV treatment. AMMIE Sainte Camille Sainte Camille Medical Centre (CMSC) in Ouagadougou was the first prevention of mother-to-chid transmission (PMTCT) site of Burkina Faso. Created in the 60s, it was founded by Camillian Fathers. CMSC has a convention with the Ministry of Health. The CMSC is specialized in mother and child health, and offers a large panel of services (pediatric day hospital, education and nutrition centre, maternity, laboratory, pharmacy, etc.) to women from the poorest urban areas. In 2002, the CMSC was the first site to implement free PMTCT (with financial support from WHO, Italy, and UNICEF. In 2003, the CMSC started to offer free PMTCT+, using ART offered by a private company from Burkina and technical assistance from ESTHER and Italy. Being a pilot site in PMTCT in Burkina Faso, CMSC plays a critical role in the diffusion of experience and training. St. Camille - Centre Medical Centre d'Information, de Conseils et de Documentation (CICDoc) The CICDoc was created in 1999 by seven of the most dynamic associations fighting against HIV/AIDS in Burkina Faso (two of which, AAS and ALAVI, are also members of AIDSETI, and have submitted their proposals to TAP as part of the AIDSETI network). CICDoc plays the role of a coordination and concertation body for these associations and many practitioners are already very active in the fight against HIV. In 5 years, CICDoc developed prevention activities, care & support activities, lobby, support to vulnerable children, psychosocial and financier support for PLWHA. CICDoc benefited from the technical and/or financial support of many partners, such as UNDP, USAID, Catwell, the German Cooperation (GTZ) and the Embassies of Denmark, France, and the Netherlands. With the CICDoc network, the Centre Médical du Camp de l’Unité (CMCU) is in charge of prescribing ARV to all the associations part of the network at the national level. It is the CMCU, which welcomes patients coming from all partners. Under the TAP, the Ministry of Health is likely to encourage CICDoc member associations to partner with additional district hospitals, to expand geographic coverage. Currently, 50 patients from 5 associations benefit from ART thanks to a grant of ARV from TAN ALIZ. Over the past year, 18.944 people participated to voluntary counseling testing (VCT) and among them 2.021 were declared HIV positive. More than 1.500 patients are still waiting for ARV. ICDoc Association des Femmes Africaines face au Sida (AFAFSI) AFASI’s main activities are: AFAFSI Associations des Jeunes pour la Promotion des Orphelins (AJPO) AJPO’s main activities are: AJPO
At the origin, La Bergerie F.U.C. was the idea of a French Pastor who set up La Bergerie in France. This inspired a leader of a local Protestant community in Burkina Faso to go on a study visit to France. At the end of his stay, La Bergerie Burkina was born and officially recognized in 1994. La Bergerie is linked to the Protestant Church of the Assemblies of God, a significant force in Burkina Faso. The Baptist Church of Coulommiers (France) sent medicines and other materials to the Church of Bika, which were distributed to church members and the general public. By this time, La Bergerie Burkina had 3 departments: health and humanity, development education, and evangelism. The approach within the association was, first and foremost, a spiritual one. One of the heads of the health department was struck by the fact that, when leaving the hospital, PLWHA had to come to terms with the difficulties of being cared for. This led to the birth of La Bergerie F.U.C. - which stands for “Faith, World, Compassion”. The reasons for setting it up were: 1) the search for more effectiveness, 2) the desire to work for development and, 3) in particular, in the care of PLWHA. At the end of 1996, given the experiences of the members working at the National Hospital Centre (CHN), who saw people suffering and helpless, it was considered necessary to move into care, through the opening of a care centre called “Compassion”. At first, the association was composed of 90% health workers, a few religious leaders (pastors in the Protestant Church) and affected people. The activities undertaken are primarily; The objectives of La Bergerie – F.U.C. are: La Bergerie Union des routiers burkinabe de lutte contre le Sida (URBLS) In Ouagadougou URBLS undertakes HIV prevention in railway stations and along highways. In Bobo-Dioulasso, the URBLS has been providing care and support for HIV+ truck drivers and their families since the beginning of 1998. URBLS’ work complements the work of other local organizations namely the CADI (HIV test center) and REVS+ (PLWHA organization). In terms of home-based care the active patient file of the organization of the second half of 2004 included 52 families. A team of ten cares for patients at the hospital and at home and brings medicines to patients or refers them to other organization. A doctor volunteers his services and prescribes both medical exams and ARVs. Because of the health insurance plan of Bobo 45 families receive some or all of the medicines they need. Finally, income-generating activities (micro-credit) have recently started helping 16 families. The Association undertakes the following: URBLS
SOS Sida is a non-profit Association, non-denominational and apolitical. It was created in September 1991 and recognized on January 12, 1992 under decree n° 017-92-CHECHMATE/SG/OF/PAJ. The SOS SIDA Association undertakes the following: Association SOS SIDA |
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| GHANA | Institutional arrangement chart |
National AIDS/STI Control Programme (NACP) Ghana’s national response to the HIV/AIDS situation is organized through the Ghana AIDS Commission (GAG), established in September 2000 under the Office of the President and charged with coordinating a multi-sectoral response programme, with broad based, high-level representation of all key sectors (15 Ministers of State are represented). The GAG has delegated issues concerning treatment and care of PLWA to the Ministry of Health’s National AIDS/STI Control Programme (NACP). NACP is a division within the Disease Control Unit of the Public Health Directorate. It serves as the focal point for the TAP within the Ghana Health Service (GHS). Dr. Nii Akwei Addo Family Health International - Ghana Formed in 1971, Family Health International (FHI) is among the largest and most established nonprofit organizations active in international public health with a mission to improve lives worldwide through research, education, and services in family health. FHI manages research and field activities in more than 70 countries to meet the public health needs of some of the world's most vulnerable people. FHI works with a wide variety of partners including governmental and nongovernmental organizations, research institutions, community groups, and the private sector. Through its global reach and local action FHI helps countries and communities to: In collaboration with NACP and other partners, FHI has piloted a comprehensive programme for care, treatment and support for PLWHA including VCT, PMTCT, MOIs and ART. In this programme FHI provided technical support and funds for the training and refresher training for health personnel, refurbishment of sites, provision of equipment (computer and laboratory equipments), drugs including ART, staff and community based programmes. As a TAP Implementing Partner (IP), FHI has the responsibility of supervising and coordinating the TAP activities in four private clinics/hospitals, namely Narh-Bita Hospital and Odorna Clinic in the Greater Accra Region and Bomso Clinic and AngloGold Hospital in Ashanti Region. Family Health International-Ghana National Catholic Health Service (NCHS) The National Catholic Health Service (NCHS), a faith-based organization with a network of 31 hospitals and 66 clinics located in mainly rural communities, has collaborated with the Ministry of Health and other international agencies to undertake programmes in HIV/AIDS since 1986. It piloted a home-based care programme in one of its institutions that became a model for the MOH in rolling out its own programme. One of its institutions was among the first two pilot sites for ART in 2001 under the FHI START programme. Since April 2004, the NCHS in partnership with Catholic Relief Services (CRS), is involved with AED and Futures Group International in a joint HIV/AIDS programme entitled: Ghana Capacity Strengthening for HIV/AIDS Prevention and Impact Mitigation Programme in 3 regions of Ghana (Ashanti, Eastern and Western) funded by USAID. The NCHS seeks under the TAP project to initiate HIV treatment in six hospitals in Ashanti, Eastern and Western Regions as an added component to existing HIV/AIDS programmes in these facilities and also as a pilot project to document the learning experiences from the implementation of the project so as to make available information that can be used in improving ART in Ghana and elsewhere. NCHS will work in its community mobilization activities with Private Enterprises Foundation (PEF) to target employees of small to medium scale enterprises working within the rural communities in which the facilities are situated. It will also work with National AIDS/STI Control Programme (NACP), using national guidelines, protocols and HIV/AIDS logistics information systems to provide care and treatment to PLWHA. National Catholic Health Service |
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Ministry of Health The National Council to Combat HIV/AIDS (CNCS) was created in 2000 and is responsible for coordinating HIV/AIDS activities (including prevention, education, and care) among major partners (Government, civil society, donors, national and international NGO), as well as for mobilizing resources to fund the multi-sector response to the pandemic. It is headed by the Prime Minister and includes the Minister of Health as Vice President. While CNCS is responsible for overall coordination, the Ministry of Health is responsible for implementing treatment and all health related aspects of HIV/AIDS. Ministry of Health Pathfinder International Pathfinder International is a non-governmental organization with an international staff of 392 people located in 17 field offices around the world. Its Headquarters are in Watertown, Massachusetts. Pathfinder began implementing family planning/reproductive health (FP/RH) programmes in Mozambique in 1997 and is now the lead TA provider in the area of adolescent sexual and reproductive health (ASRH). Pathfinder supported programmes address governmental and NGO capacity building; multisectoral coordination; advocacy for youth involvement and youth friendly programming; and gender awareness and equity as a fundamental component of all activities. Pathfinder's early work in Mozambique was supported through USAID funding. Working in close cooperation with the MOH at national, provincial, and district levels, and in partnership with two NGO sub-grantees AMODEFA and SALAMA, Pathfinder focused its efforts in three northern provinces (Nampula, Zambezia, and Niassa). The programme provided TA to implementing partners to improve access, availability, use, and quality of MCH/RH services. TA was also provided to expand/improve RH and MCII interventions by PVOs and international NGOs. Organizational development of NGO sub-grantees was at the center of programme design, as was a focus on ASRII, Community-Based Distribution/Services (CBD/CBS), integrated services, quality of care, infection control, FP, and post-abortion care. In the follow-on award, Pathfinder was a subcontractor to JSI on the Health Service Delivery Support (HSDS) Project (1/01-12/03), and was responsible for RH, community health and epidemic response components. Under HSDS, Pathfinder worked at the central level and provincial levels to improve maternal and RIi care through training in RH, essential obstetric care (EEC), infection prevention and ASRH. RH manuals developed by Pathfinder under a previous project were revised and are currently widely applied by the MOI I. Nine youth friendly service delivery points were established, and maternities throughout Nampula and Zambezia were made functional when renovation and equipping complemented training. At the community level, where Pathfinder provided technical input into materials development and strategies for community involvement, IMCl/CS and RH interventions were integrated via NGO work with CLCs and ACSs. Achievements in the area of epidemic response included the revision of training manuals and courses, protocols, and significant advances in the use of national databases and epidemiological profiles. One of Pathfinder's basic precepts is to work through and with implementing partners, building interventions in support of their strategies and plans. Lessons learned under HSDS re-confirmed this principal. Concurrent with its initial USAID award, Pathfinder was selected in 1999 to serve as executing agency for UNFPA for the GOM's ASRH initiative by providing overall technical leadership and coordination; this role is ongoing. The multisectoral project, Geraçâo Biz (GB) addresses youths' lack of knowledge, skills and access to youth-friendly services (YTS). Pathfinder has fostered coordination amongst three Ministries (Health, Education, and Youth and Sports). Using a holistic approach to youth development and placing emphasis on HIV/AIDS prevention, activities are conducted at the central, provincial, district, school and community levels, such that this multisectoral experience provides Pathfinder with highly relevant knowledge of province and local government dynamics, which are needed for rapid project start-up. Pathfinder also demonstrated its capacity for quick scale-up in 2003-2004, when the GB model was replicated in Inhambane Province in association with the Foundation for Community Development (FDC). In an 18-month project period, Pathfinder and FDC established a solid, functioning network of school and community based peer educator activities with strong foundations for sustainability. GB was expanded to Maputo Province in 2001, with coverage in several districts, including Manhica. In Maputo Province, GB reaches out-of-school youth through 47 youth associations and serves in-school youth through 11 schools. Health services are offered at 10 YFS delivery points which provide counseling, prenatal services, family planning and contraception, and HIV testing. Pathfinder's experience in developing GB through providing TA to the DPS/Maputo has provided us with an understanding of ASRH issues and services in the province, including the institutional structures/relationships between provincial and district levels. Beyond Pathfinder's direct experience in Mozambique, national policies, strategies and plans for reducing maternal mortality, RH, IMCI and community health will all guide the design and implementation of activities under this project. The 2002-2005 Work Plan to Reduce Maternal and Perinatal Mortality provides the theoretical bases upon which to found appropriate interventions and specific activities that should be undertaken at all levels of the health system. Similarly, the MOH's Policies and Strategies for Reproductive Health clearly lays out the objectives, expected results and components included in this area. IMCI and Community Health strategies have also been well developed within the MOH, and in the area of epidemic response, MOH training/data collection systems were revised with HSDS support, such that all key CS/RH areas have theoretical foundations and/or guidelines upon which to build TA. Pathfinder International The Community of Sant’Egidio The Community of Sant’Egidio was founded in Rome in 1968. It is a lay Christian association and it also has formal recognition as a Non-Governmental, non-profit organization (NGO). The Community has never identified itself with political parties. Ever since its beginning, the Community of Sant’Egidio was the voice of the poor and marginalized. It is characterized by a strong commitment of its members to the underprivileged in the social life of the places where the Community is established. The Community of Sant’Egidio counts at present 50.000 members around the world who, voluntarily, are committed to the struggle against poverty and for peace in 70 countries, while pursuing their personal family life and professional careers. Community of Sant’Egidio Health Alliance International (HAI) The Mozambique Health Committee was originally founded in 1988 by a group of international staff, or collaborators, at the request of the Government of Mozambique, and is formally recognized as a nongovernmental, non-profit organization (NGO). The original focus of the organization, now known as Health Alliance International (HAI), was to support the rebuilding of the severely damaged health infrastructure in the central region, after a decade-long armed conflict. After nearly 20 years of working in Mozambique, programmatic activities have expanded to include HIV/AIDS, maternal and child health interventions and malaria. However, the focus on strengthening the national public health infrastructure remains a basic tenet of the organization. Health Alliance International draws staff members and advisors from around the world. Additionally, the rich experience and expertise of University of Washington faculty, graduate students, and volunteers add greatly to our work. In particular, our technical staff is substantial experience in many aspects of international health. HAI
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