Help 100 Babies Be Born HIV-Free in Togo

 
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Every year, World AIDS Day is a time to reflect on both the successes we have had so far in the movement against HIV infection, and the challenges that we still face. It is an opportunity to draw the global community’s attention once more to the epidemic and to reorient our response. This year’s theme was “closing the gap” between access to care and those who need services. The World Health Organization stated:

“World AIDS Day 2014…is an opportunity to harness the power of social change to put people first and close the access gap. Ending the AIDS epidemic by 2030 is possible, but only by closing the gap between people who have access to HIV prevention, treatment, care and support services and people who are being left behind. Closing the gap means empowering and enabling all people, everywhere, to access the services they need.”

To commemorate World AIDS Day, Hope Through Health’s Togolese partner AED-Lidaw hosted a fair with collaborators fhi360 and an Anti-AIDS high school club. After the welcoming remarks from AED’s Executive Director, the Anti-AIDS club performed a sketch about a teenager who discovers she is seropositive. The skit walked through scenes that audience members knew too well—the sister’s grief, her parents’ disbelief and anger, and her friends’ misconceptions. Everyone laughed at lines that they had heard before: “What do you mean I have HIV? But I go to church every Sunday!” The sketch ended with the reminder to “exclude HIV, not people living with HIV” and words of encouragement: “together, we can achieve our goal of zero new infections and zero cases of discrimination”.  

Over 100 community members participated in AED’s all-day outdoor fair, with games such as sack racing, musical chairs, and rope climbing. Prizes were given to winners, including condoms, spaghetti, and soap. The most coveted prize was a packet of hair weaves. Almost as passionately as they competed in musical chairs, teams battled it out in a test-your-knowledge HIV/AIDS question and answer game. In conjunction with the lively fair, AED staff offered an all-day open door clinic for HIV and other STD testing, where our staff served over 60 people.

Looking ahead 2015, Hope Through Health is not only focusing on access to care, but the quality of services we deliver. Our team in Togo is in the midst of preparing a Quality Improvement Plan, based on gaps in services in 2014. These indicators that will be collected quarterly through 2015 will help us do right by our patients, and deliver the care that—as humans—they deserve. 

Dear Friend,

I am happy to share our latest quarterly progress report with you.

This report highlights our Orphans and Vulnerable Children Program that provides comprehensive support services to over 160 children living with and affected by HIV/AIDS. Your generosity allows us to serve these children and over 1,800 adults living with HIV/AIDS in the Kara region of northern Togo. On behalf of our friends in Togo, thank you for your support!

We hope you enjoy this new report covering July to September 2014. Please feel free to contact us with any questions or comments.

Sincerely, 
Kelly Lue
Development and Program Associate
Hope Through Health


Attachments:

Dear Friend, 

I am excited to share Hope Through Health's latest quarterly progress report with you.

This report highlights a new initiative that has brought family planning services to women in Togo who previously had little or no access to family planning options.  Family planning allows women and their families to make informed decisions about their health and lives.  This project furthers Hope Through Health's commitment to providing the highest quality healthcare services to those in need.  The work of Hope Through Health is only possible thanks to your generous support.  We sincerely appreciate your partnership and continued commitment to ensuring health as a human right!

We hope you enjoy this report.  Please contact us with any questions or comments.

Sincerely,
Jenny Schechter, MSW, MPH
Executive Director, Hope Through Health


Attachments:

Dear Friend,

I am excited to share Hope Through Health's 2013 Annual Report. Inside you will find highlights of our accomplishments from the past year, which would not have been possible without your support.       

These highlights include enhanced technological capacity of our staff and clinics, improved maternal and child health services, and a strengthened Community Health Worker program. In 2014, Hope Through Health will continue to build on this success and develop new ways to improve healthcare services for our patients. We hope you will take a moment to read this inspiring report. On behalf of our friends in Togo, thank you for your generosity and commitment to providing health and inspiring hope.

Sincerely,

Jennifer Schechter, MSW, MPH

Executive Director, Hope Through Health 


Attachments:

On December 21, 2013, HTH/AED hosted its first ever year-end conference, which summarized the work done in 2013 and provided a forum for discussion on how to improve the quality of care provided by HTH/AED. Over 50 people were in attendance, including HTH/AED’s entire staff, the president of AED and other members of the board, administrators and doctors from local hospitals and other NGOs, a university professor, and interested patients of HTH/AED. The conference was organized by Dr. Spero Houndenou, HTH’s new medical director, who hopes one day to establish HTH/AED as a well-known model for high-quality HIV care on a national or even global level. The day-long conference was comprised of a mix of presentations from individual departments and two panel discussions on broader topics: improving the quality of clinical care and evaluating community-based approaches to care.

Alicia Post 2-1

The audience listens attentively to speakers during the first ever HTH/AED Year-End Conference

Dr. Houndenou gave the first presentation, explaining retention rates and treatment adherence using the analogy of water flowing through leaky pipe – HTH/AED tries its best to capture a large volume of patients, but there are steps along their path to health where some of the patients are lost. For example, a couple patients “leak out” every time their pastor encourages them to stop taking their HIV medication or when they don’t have the means to get to the clinic pharmacy once a month. One goal for the new year is to better identify and plug up those leaks so that every patient who starts their treatment with HTH/AED continues to benefit fully from HTH/AED’s services.  This process is already underway at HTH/AED for patients on lifesaving antiretroviral therapy (ART).  As Dr. Houndenou reported, less than 1% of the more than 880 patients on ART at HTH/AED were “lost to follow up” according to national standards, in 2013.

By contrast, the medical team raised a concern about how well HTH/AED is monitoring pre-ART patients. In Togo, ART is distributed free of charge, but due to a national shortage, is only given to registered patients below a certain threshold of health (CD4 count under 350). HTH/AED assumes the role of being both an ART-prescriber and an ART-dispensary, meaning that the clinic keeps strict records and follows a set of nationally-mandated protocols in exchange for the privilege of providing ART to their eligible patients in-house. It is relatively easy to monitor the patients on ART; each new medical consultation and test result is recorded in a standardized, government-issued blue notebook, and whether patients come to the dispensary on time to pick up a new month-long supply of ART is a proxy indicator of whether or not patients are taking their medicine (it also ensures that they visit the clinic and get a check-up once a month). However, for  patients who are not yet on ART, their medical records are much less standardized and they come into the clinic much less often (once every three months, and sometimes more if they are in poor health). It is harder for the medical staff to monitor how well these patients are managing their own health and dealing with opportunistic infections (infections that take advantage of the weakened immune systems of people living with HIV and can be very dangerous), and it is difficult to distinguish between patients who stay away because they are healthy and patients who stay away even when they are in need of care. The non-standardized forms make it more difficult to keep track of these patients, and it’s harder for the clinic to monitor when they should reach out to see how they’re doing. Hopefully, with the help of the new database we are building, in 2014 HTH/AED will make progress towards improved monitoring of pre-ART patients.

Alicia Post 2-2

In addition to hearing statistics that summarized the year from various departments (highlights: 44 babies were born and all tested HIV-negative at 18 months, less than 1% lost-to-follow-up of ART patients, new preventative campaigns were deployed in churches and hotels), there were panel discussions which led to interesting conversations and open exchanges among all participants.
Later in the day, I was even asked to sit on the community health panel as one of the “experts” to present my work from last summer shadowing HTH/AED’s community health workers (you can read more about that project here)! It was pretty exciting but I was also nervous to present (in French no less) to a group of people with so much experience and wisdom when it comes to HIV care. Below you can see a picture of the white board diagram I drew during my presentation, spelling mistakes and all. The basic summary of my presentation was that, based on my experience shadowing 6 community health workers on approximately 30 home visits, HTH/AED is succeeding right now in using their CHWs as “arms,” extending the reach of the clinic out into the community, but could benefit from re-conceiving the CHW program as a bridge between the clinic and patients, bringing medical care out to the patients and also allowing for information flow back into the clinic. For those of you who can’t read French, the purple describes what I noticed the CHWs doing well: explaining their disease and treatment in an accessible way, encouraging patients to advocate for their own health, promoting treatment adherence, and filling prescriptions for bed-ridden or hospitalized patients. Currently, the only information coming back into the clinics is in the form of non-standardized notebooks that very few people at the clinic look at other than the CHWs. I’m excited to see how our mobile health app project this winter (look out for a blog post about it soon!) can facilitate information flow back to the clinic to be used by the medical staff to get a more complete picture of their patients’ health as a whole.

Alicia Post 2-3

At the end of the conference we all ate  together and people who were interested stayed in the room to hang out and chat about all the information that had been presented. Despite some bumps in the road (we had a power outage all day long, meaning that no one could use the projector to display the slides made for their presentations), the conference did a great job of grounding HTH/AED as a site of research, learning, and innovation as well as being a fantastically successful health care provider. The conference also emphasized that HTH/AED is always looking for constructive criticism and open to new ideas, in an effort to try to improve their quality of care.

-Alicia, MIT Student Volunteer, GlobeMed at MIT Member

For more posts from  GlobeMed at MIT please visit: http://globemed.mit.edu/category/iap2014grow

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Organization

Project Leader

Jennifer Schechter

Volunteer
Medway, MA United States

Where is this project located?

Togo   Health
Map of Help 100 Babies Be Born HIV-Free in Togo