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.
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.
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
Hope Through Health is excited to share a new quarterly progress report for July 2013 to September 2013. This report illustrates the impact your support has on the lives and health of our patients in Togo!
Among the highlights included in this report are profiles of our talented team in Togo and updates on new projects and partnerships. Hope Through Health is happy to share details on three new technologies we will be using to improve care for our patients in Togo. We thank you for your continued support which allows us to improve and expand our services in Togo!
Check out our report: Hope Through Health Progress Report, July-September 2013
Sincerely,The Hope Through Health Team
Almost ten years ago, I met a brave, young woman named Rose. She told me her story about how her life had been upended by HIV, losing her child and home. Despite such tragedy she was determined to live. I had the opportunity to start working with Rose and a motivated group of people living with HIV toward a singular goal, to realize their right to lifesaving HIV/AIDS treatment. This was how Hope Through Health started.
Today, I am in Kara, Togo with Jenny (HTH Executive Director) and our son Julien to visit friends and colleagues and to see the progress HTH has made toward that goal. Although I lived and worked in Kara for over three years as a Peace Corps volunteer and have visited annually for the last 7 seven years, this visit has been distinct. I am overwhelmed by the progress I see.
What does this progress look like?
Progress is seeing a filled clinic, staffed mainly by individuals living with HIV, providing care to over 1,600 patients annually including 152 children. Progress is seeing over 40 healthy babies that are HIV free because of an effective prevention of mother to child transmission program. Progress is seeing new partnerships formed to expand HTH’s model in order to provide care to thousands more women and children. Progress is seeing my dear friend, Rose, one of the first individuals started on ARV therapy in 2005, healthy, holding and hugging my son Julien.
We have come so far and this has happened because of your partnership. It has happened because thousands of supporters like you are unwilling to accept the status quo and believe, like Rose, that all individuals have a right to health care. There are no words to adequately express my gratitude for your support. So I will simply say thank you, on behalf of our colleagues and patients, for the progress I see today.
Warmest regards,Kevin Fiori, Jr. MD, MPHCo-founder & Associate Director, Hope Through Health
I am excited to share Hope Through Health’s first quarterly progress report. Our hope is that this report will keep you informed about the impact that your support is having on the patients we serve in Togo, West Africa. In the attached report we share with you an honest portrayal of the successes and challenges we face in attempting to improve quality and expand access to health care for the most underserved in northern Togo.
The first quarter of 2013 was an exciting period of growth for Hope Through Health and our partner organization, AED-Lidaw.
• Our central Kara Clinic was recognized by the Ministry of Health for maintaining the highest adherence and lowest rates of loss to follow up in the Kara Region.
• Staff implemented a new Monitoring, Evaluation and Quality dashboard designed with the help of Partners In Health and participated in computer literacy training conducted by MIT students from our partner organization, GlobeMed.
• In the US, our first annual report was released (http://hthglobal.org/files/HTH_2012_Annual_Report.pdf), we launched a new partnership with One Day’s Wages and our Annual NYC Benefit, held in January, was a huge success.
As with all of our efforts, this report is a work in progress and we welcome your feedback. Please reach out to me or any member of our team with your questions and suggestions. We would love to hear from you and continue this dialogue about the transformative impact your support has on improving the health of individuals and communities in Togo.
Dear Friend,I am honored to share Hope Through Health's 2012 Annual Report, which highlights the many accomplishments that have been made possible through your support over the past year. Please read the stories and statistics highlighted in this document knowing that you have contributed directly to impacting the lives of the thousands we serve in Togo, West Africa.
Building upon the tremendous success of last year, we have already begun to implement ambitious new programs in an effort to further improve the quality of health care services available to the Togolese. As we continue to expand access to lifesaving health care services abroad, we hope that we can count on you for your renewed support now and in the years to come. Thank you for all you have done to support the mission of Hope Through Health -- we are grateful for your steadfast commitment to providing health and hope to our friends in Togo.Sincerely,Jennifer SchechterExecutive DirectorHope Through Health
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