Integrated Prevention Campaign Implementation Dr. Eric Lugada MD. PhD
Integrated Prevention Campaign Implementation
Dr. Eric Lugada
MD. PhD
Background
HIV diagnosis is critical for prevention and treatment. Prevention of co-infections such as malaria and diarrhea delays disease progression
Preventive interventions such as long-lasting insecticidal bed nets, point-of-use water filters, condoms and HIV counseling and testing (HCT), when implemented on a large scale, reduce malaria, diarrhea and HIV.
Multi disease prevention campaigns can achieve rapid and high coverage at low cost, but have not been widely evaluated in combination with HIV testing and prevention
The Integrated Prevention Campaign, a 7-day campaign held in Kenya in September 2008, combined voluntary HCT with distribution of a CarePack® containing a bed net, water filters, condoms and educational materials.
Method
The campaign– Mobilized stake holders and implemented a 7 day campaign intended to cover 80% of the
population aged 15-49
Post campaign survey– Two-months post-campaign survey to measure uptake of products and utilization of services
Qualitative analysis– Qualitative program evaluating contextual circumstances facilitating or discouraging uptake of
interventions
Costs and cost - effectiveness analysis- Cost and cost-effectiveness
The Campaign Micro planning- obtain buy in from ministry of health, district health authorities, community
leaders, PLWHA networks
Mapped and selected 30 uniformly distributed test sites in Lurambi division in Kakamega district Western Kenya
Recruited and trained 600 personnel; MOH trained counselors, laboratory technicians and product demonstrators
HCT following Kenya MOH guidelines, after obtaining consent and filling national VCT forms. Parallel testing done. QC done by sending 10% of samples for dry blood testing
Group counseling (~20 people) received health education and instructions on how to use the CarePack® contents; bed nets, water filters, condoms.
CD4 cell count was determined at the community level outside traditional health structures, those testing HIV(+) given a 3 months doze of cotrim and referred for further care
Campaign Process
Social Mobilisation
HIV pre-test counselling
Product demonstration
Public healtheducation
messages onnewspapers,
radio, etc
Opt out of HIV testing
Commodity distribution
Pre-Campaign During the Campaign Post-Campaign
Campaign announcement
through banners, road shows, etc
Clientfollow-up
Campaignanalysis
Care for the HIV positives
Testing
Post-testcounselling
Commodity distribution
Registration
Campaign Experience and Delivery of Preventive Interventions
All participating in the campaign received the CarePack®.
Summary campaign results:
The Integrated Prevention Campaign reached universal testing goal in 7 days.
Target population 51,178 sexually-active 15-49 yrs age group
Total tested 47007
Tested in age group 15 to 49 41,040 (>80%)
Women 28906
Women diagnosed HIV+ 1448 (5.0%)
Men 18101
Men diagnosed HIV+ 508 (2.8%)
Lowest HIV prevalence by age 15-19 years (0.8%)
Highest HIV prevalence by age 30-39 years (6.7%)
HIV+ put on cotrimoxazole 96%
Conclusion
Integrated Campaign has the potential to:
– Address multiple public health problems in a country simultaneously thus achieving various national objectives and MDGs in an efficient way.
– Reach universal testing goal in a short time, thus ensuring access to treatment.
– Break the social barriers associated with HIV testing. (stigma and domestic violence)
– Achieve universal coverage with bed nets, water filters resulting in prevention of malaria and diarrhea
– To get people early in the HIV disease cycle.
– Reduce disease programme costs by up to one half in some countries
– Avert significant DALYs in the target population, with economic savings.
– Strengthen health systems
THANK YOU