Abiodun, Onaopemipo

School of Public Health

MS

Cote d'Ivoire

Cote d'Ivoire - Technical Assistance in Support of HIV/AIDS Prevention, Care and Treatment in the Republic of Cote d'Ivoire

Through the CDC funded 5-year “Technical Assistance in the Support of HIV Prevention, Care, and Treatment Programs” Project (October 1, 2013 – March 31, 2018), Jhpiego is supporting CDC’s country operational plan (COP) for Côte d’Ivoire and the Ministry of Health and Fight Against AIDS (MSLS) and PNPEC’s (National Program to Fight against HIV/AIDS) National Strategy to establish sustainable approaches for the reduction of morbidity and mortality due to HIV/AIDS among vulnerable populations.

The approved five year goal and objectives are:

Goal: To provide technical assistance to the Government of Côte d’Ivoire to improve its capacity to reduce the morbidity and mortality of people living with HIV/AIDS and prevent infections in newborns by increasing access to high-quality PMTCT services, and increasing access to cervical cancer prevention.

Project Objectives:

1.         By Year 2, the MSLS and CDC/PEPFAR implementing partners have the capacity to improve access to and uptake of quality cervical cancer screening services for HIV-infected women.

2.         By Year 3, the grantee should have assisted the MSLS to develop, implement and evaluate an integrated chronic care model for HIV-infected individuals, among other chronic diseases for each level of the health pyramid.

3.         By Year 5, the MSLS has a demonstrated capacity to plan and scale up effective, integrated HIV PMTCT, testing and counseling, and care and treatment services within the existing health care and social services systems, including the management of chronic diseases such as HIV/AIDS.

To scale-up a sustainable cervical cancer prevention (CECAP) program for HIV positive women, Jhpiego is building on its previous work under the University Technical Assistance Project II.  In that project Jhpiego successfully demonstrated the feasibility of implementing a quality cervical cancer screening program for HIV positive women using visual inspection with acetic acid (VIA) to detect pre-cancerous lesions with immediate treatment of eligible lesions using cryotherapy at 20 facilities. This new project is focusing on scaling up nationwide in partnership with the government and partners.

Jhpiego will begin year 2 of the project April 1, 2015.

In addition, Jhpiego won a 3ie award to conduct an impact evaluation to determine the impact of an integrated chronic care model on retention rates among adults recently initiated on ART. The evaluation is slated to start in January and end by September.

Global Health Mentor: Heather Harrison, Senior Program Officer, Jhpiego

When I decided to apply for a Global Health Established Field Placement, specifically the “Technical Assistance Project in support of HIV/AIDS Prevention, Care and Treatment in the Republic of Cote d’Ivoire”, I had a lot of thoughts running through my mind. Firstly, I thought it was a great opportunity since I was actively pursuing a career path in international health through my masters program and until that point, my first-hand knowledge of the public health concerns of a developing country was limited to my experience in Nigeria, where I was born and raised. Secondly, I felt like things had been leading up to this experience since I had minored in French and had been hoping for the ideal opportunity to practice and improve my language skills. So I gladly applied, all the while feeling a bit apprehensive about how things would go if my application were accepted since it would be a totally new experience.

As fate would have it, my application was accepted and off I went to Abidjan, Cote d’Ivoire to start my 4 month internship with Jhpiego Cote d’Ivoire. Funny enough, Abidjan felt very familiar to me since the tangible differences with Nigeria were not quite stark, apart from the language. The foods, everyday sights, and sounds reminded me of where I called home. During my internship, I was able to make comparisons between the health systems and public health concerns of Cote d’Ivoire and Nigeria.

When I joined the Jhpiego Cote d’Ivoire team, plans were underway to begin the implementation of a chronic care model that will integrate HIV care and treatment with the care of other chronic maladies, in order to increase the enrollment and retention of people living with HIV (PLWHIV) in care. This project, accompanied by a cervical cancer prevention project (CECAP) that was rounding off when I arrived, was part of a bigger package of technical assistance to the Government of Cote d’Ivoire to reduce the morbidity and mortality of people living with HIV/AIDS in Cote d’Ivoire. Like Nigeria, Cote d’Ivoire has a relatively high adult HIV prevalence, at 3.0%, which is the highest in francophone West Africa. I was very appreciative of the opportunity to work with Jhpiego on the chronic care model and witness first-hand the steps that were taken to work with Cote d’Ivoire’s Ministry of Health and Fight against HIV/AIDS (MSLS) to plan the implementation of the model and ensure its sustainability. I also got the opportunity to travel to lesser-known parts of Cote d’Ivoire during a trip to collect data for the evaluation of the model, and see some of the health centers where the chronic care model will be implemented. Between road trips through terrain that reminded me of more rural parts of Nigeria, the time spent at the health centers allowed me to envision how the chronic care model would fit into the existing system of care for PLWHIV. Such a model holds a lot of promise but will also have to contend with issues like the motivation of health workers, in light of their existing work-load and what they’ve grown accustomed to, which is a recurring issue when working with Human Resources for Health (HRH). Another recurring issue in health service provision in Cote d’Ivoire and other LMICs is how to ensure quality and standardization of care. I went from knowing very little about approaches to address this issue to delving into one of such approaches, known as SBMR (Standards Based Management and Recognition), while analyzing data to evaluate the effects of its implementation by Jhpiego in Cote d’Ivoire.

I can say without a shadow of doubt that my field placement was a learning experience. This time last year, Cote d’Ivoire was just another country on the map to me. But now, what I’ve learnt about its people, history, culture and health systems has inspired me to pursue more opportunities to work internationally in global health. And I’m certain that the lessons learnt during this experience have made me more prepared to pursue such opportunities. 

Myself and the Jhpiego Cote d'Ivoire Team:

Abidjan, Cote d'Ivoire:

Daoukro, Cote d'Ivoire:

Grand Bassam, Cote d'Ivoire:

Myself and the Jhpiego Cote d'Ivoire Team:

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