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COLLABORATION BETWEEN CU-ICAP ETHIOPIA AND THE PSYCHOSOCIAL UNIT AT ADAMA HOSPITAL Yoseph Gutema Pediatric/PMTCT Advisor ICAP Ethiopia Kigali, Rwanda October 21,2009 Supporting Sustainable Adherence to HIV Prevention, Care & Treatment ICAP Technical Workshop October 19-22, 2009Kigali, Rwanda
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Page 1: Ethiopia Pediatric Presentation


Yoseph GutemaPediatric/PMTCT Advisor ICAP Ethiopia Kigali, RwandaOctober 21,2009

Supporting Sustainable Adherence to HIV Prevention, Care & TreatmentICAP Technical WorkshopOctober 19-22, 2009Kigali, Rwanda

Page 2: Ethiopia Pediatric Presentation

Adama Hospital

Located in Adama town Adama hospital is a 250-bed regional referral

hospital The catchment population of the hospital is

estimated to be 5 million In Adama Town(until September 2009) no of street children= 867 no of OVC = 1020 no of sexually abused children= 526

Page 3: Ethiopia Pediatric Presentation

Adama Hospital

In Adama hospital, no of children ever enrolled in care

= 1411/ 7192(19 %) no of children ever started on ART =

639/3477(18.3 % )

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Adama Hospital ART Center


Adama Referral Hospital Comprehensive Chronic HIV care and Training Center



Page 5: Ethiopia Pediatric Presentation

Adama Hospital ART Center

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Adama Hospital Pediatric Friendly Clinic

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Adama Hospital Pediatric Friendly Clinic

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Cumulative no of Infants & Children Ever Started and Ever Enrolled in Care at Adama Hospital

Age Category Cumulative ever enrolled in care

Cumulative ever on ART

Lost to F/U amongst patients on ART

Infants < 18 months 458 174 10 (5 .7% )

Children 18-59 months

317 114 13(11%)

Children 5-14 years 636 351 42(11%)

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UTCSA at Adama Hospital

Psychologist is hired to attend to needs of children in community Provides psychological support for abused

children Provides care and support for abandoned

children Facilitate age determination service for

children in conflict with the law

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Unit for Treatment of Children who need Special Attention

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ICAP-E and UTCSA Collaboration

Problems identified in our HIV-infected children Orphanhood Mental health problems Child abuse Homeless

Collaborate with the psychologist as part of the MDT to meet the special need of the children enrolled in care at Adama Hospital

Page 12: Ethiopia Pediatric Presentation

Psychosocial problems referred from ART Clinic

Serial Number Type of problems Number

1 Adherence 9

2 Psychological problemsFear of expressing ideasDepressionLoss of hopeAnger


3 Behavioral problems StealingCheatingQuarrelling


4 Academic problemsDropping –out schoolAbsenteeismLate-coming


Ruby Fayorsey
What is the serial number and what is the number in the last column? Can you describe some of the adherence problems like you have listed in the other rows?
Ruby Fayorsey
School failure, school avoidance
Preferred Customer
Do you want to change to oppositional defiant
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Services Provided by the MDT

Psychological support Child Centered Counseling Play Therapy

Sand box/tray Anatomically correct dolls Different games. Puppets

Medical support

Ruby Fayorsey
You will have to explain some of this stuff what kind of psychological support is provided?
Ruby Fayorsey
What games?
Ruby Fayorsey
Related to adherence??
Ruby Fayorsey
Is this different from what is provided by the ART clinic?
Ruby Fayorsey
Is there any specific support provided to nonadherent children? this is all very general and not specific. Would suggest you have two slides with two brief illustrative cases. Describe the problem, how it was identified by the nurse and what was done by the psychologist using the services mentioned here.
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8 Yrs old child (sexually abused)

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14 yrs old child (sexually abused)

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Next Steps

Establishment of Pediatric Peer support Group/ buddies

Expanding the service to other ICAP supported facilities

Adama Pediatric Psychosocial unit will be model center

Ruby Fayorsey
Formalizing the process;create tools to help nurse identify children with MH and or special needs