LARC PROJECT: MALAWI
Malawi team: Piggs Peak, Swaziland, May 2017
Malawi team: Entebbe, Uganda November 2016
Malawi team: Dar es Salaam, Tanzania August 2016
Malawi Team: Johannesburg, South Africa July 2016
(Front row) Thokozire Reuben Mwenda; Dorothy Ngoma; Maxwell Pangani
To increase access to quality viral load testing services at Mitundu Rural Hospital by 80% though a strengthened identification process of eligible clients and demand creation.
The objective of the project is to engage the community through a viral load campaign toward viral load test demand creation. Despite knowledge about viral load testing in facility staff, there are challenges that are preventing eligible ART clients from being identified and VL samples being collected. Mitundu Rural Hospital currently targets 40 clients on ART each week. The objective is to scale up the target by 80% to 72 clients a week. To achieve this the project will:
• Promote community based campaigns to sensitise the communities around the Mitundu Rural Hospital catchment area about the importance of VL testing. The sensitisation meetings will be carried out in the clinic waiting areas and also at community gatherings.
• Promote formulation of Community ART Groups (CAGs) which are self-help groups of clients on ART. Members of the CAGs are usually from the same geographical region and more willing to disclose their status to each other. Members of the CAGs will take turns to collect medications for others in the group following a strict protocol.
• Visual tools that explain the concept of VLT (posters, pamphlets and fliers), as well as clear written instructions displayed in ART clinics as to when VLT should be performed will also be developed. The aim is to empower clients on ART to both request that a VL test be performed at the appropriate times and to understand the VL results and the potential implications.
• Expert clients will also be identified and trained to promote community awareness about viral load testing. These Health Surveillance Assistants (HSAs) will provide enhanced adherence counselling and will be provided with registered to track patients with high viral loads to ensure they complete the adherence intervention; have repeat viral load testing; and are switched according to the national algorithm.
• Establishment of a teen club at the ART clinic to specifically target adolescents and support adherence to ART regimen. The teen club will meet monthly and enjoy social activities as well as share experiences about living with HIV and adherence issues.
• Establishment of a Community Advisory Body (CAB) which will be made up of traditional leaders, political leaders, religious leaders, and business persons of the area. This will be our entry point into the community. The CAB will be oriented on issues of adherence and viral load testing.