XIX International AIDS Conference


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WEPE698 - Poster Exhibition

Exit planning and transition of HIV care and treatment services: a case study from Guyana

V. Allread, N. Jordan-Martin, D. Storm, A. Norberg

University of Medicine and Dentistry of New Jersey, FXB Center, School of Nursing, Newark, United States

Background: This abstract outlines key interventions in developing a PEPFAR-supported network of care and treatment and successfully transitioning that network to the host country Ministry of Health (MOH). Between 2005 and 2011 the Guyana MOH worked with the Centers for Disease Control and Prevention (CDC) and François-Xavier Bagnoud Center, a technical assistance (TA) partner, to establish and scale-up comprehensive HIV care and treatment in that country's public sector.
Methods: In 2008 a 3-year transition plan (TP) was developed in consultation with MOH and CDC. TP implementation included: MOH leadership and workforce sensitization (2008); assessing, strengthening and expanding human resource capacity through training and mentoring (2009-10); integrating HIV clinics with primary care clinics (2010-11); staggered transfer of staffing and delivery of services from the TA partner to MOH (2010-11); and post-transition monitoring (2010-11).
Results: By March 2011, the TP was successfully executed with no disruption in service delivery or facility closures ? making Guyana the first PEPFAR-supported country to assume all functions of its HIV program previously supported by TA partners. The TP also resulted in increased physician retention ? through the implementation of cutting-edge training programs. From 2004 until March 2011, the number of HIV service outlets increased from 2 to 22 (16 of which provided antiretroviral therapy (ART)) and, despite decreasing HIV prevalence (from 2.5% in 2005 to 1.2% in 2009), the number of individuals on ART increased from 362 to 2,075. By March 2011, 6,790 and 3,314 individuals had received palliative care and ART respectively.
Conclusions: Implementation and TA activities should be developed and executed with a clear exit strategy. Sensitization and ongoing dialogue with MOH leadership and health workforce facilitates support for the transition. A detailed TP and close monitoring of such in collaboration with MOH and funders is integral to anticipating and addressing impediments to the process.

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