Community-Facility Framework

The Bi-directional clinical community and OVC Referrals, linkages and Service Delivery implementation strategy.

(Community health facility framework) was funded by US.Centers for Disease Control (CDC) through Baylor College of Medicine and Children’s Foundation under SNAPS West Project ( April 2017- March 2018), to leverage and strengthen the capacity of communities in achieving 90-90-90 targets and ensuring delivery of quality health and psychosocial services along a continuum of response.

The core package of community based services focuses on evidence-based interventions that complement and/or extend facility based services. They are organized around the 90-90-90 and combination prevention frameworks, and are informed by the need for;

1) Identifying more HIV-positive individuals through improved contact tracing and highly targeted community based testing,

2) The differentiated service delivery approach recommended in the WHO Consolidated Guidelines on the use of ARVs for Prevention and Treatment of HIV (2015),

3) The importance of addressing social and community factors affecting adherence and retention,

4) The benefits of case management, and

5) leveraging the OVC platform. The package also draws on opportunities in leveraging the OVC platform.

A strengthened two-way linkage between facility and community structures is paramount for improving access to and ensuring the quality of care, treatment and prevention services.

Achievements for April 2017-March 2018:

During this partnership, RCRA has registered a numbers of achievements in a short time, among them, include;

A total of 669 HIV positive clients who missed appointments, client with adherence problems, and TB clients have been identified from health facilities and clients have been successfully followed up and

643 clients have been brought back to care after thorough psychosocial support and home based care and support.

A total of 2717 referrals from the community to the facility were made and 2412 clients have been able to receive a service making effective referral completion 89%. Similarly, 154 referrals from the facility to the community/RCRA were made and completed making it 100%.

A total of 582 Boda bodas riders and some of their partners, sex workers, index client contacts in Hima town council with support from Hima HC III, Bugoye Sub county, RMS HC III and Bugoye HCIII, Maliba HCIII, Kitswamba HC III were served through targeted HTS, risk reduction counseling and condoms distribution.

The 35 new positives identified were all successfully linked and enrolled to care. A total of 293 pregnant mothers have been mapped, referred and linked for appropriate services like ANC and elimination of Mother to Child Transmission (eMTCT) and have successfully received the service. A total of 218 HIV positive clients eligible to form and join CCLAD groups have been identified and supported to form groups with 44 CCLAD groups being successfully formed. This has been done with the support of health facilities. A total of 24 TB clients were successfully  identified by community health workers at health facility level and have been followed up successfully in the community to trace their contacts; 64 TB contacts have been screened and 12 suspects identified and referred for TB diagnosis.