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Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria

Received: 28 April 2021     Accepted: 14 May 2021     Published: 26 May 2021
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Abstract

The 2013 WHO HIV guidelines provided effective antiretroviral regimens to reduce perinatal transmission to below 2%. The option-B approach of providing antiretroviral drugs was adopted by Nigeria, which contributed 32% of global gaps in Preventing Mother to child transmission (PMTCT). In Plateau State, which had 7.7% HIV prevalence, incessant ethnoreligious conflict created challenges impacting on HIV service delivery and access to treatment centers. PMTCT diagnostics conducted by the lead HIV implementing Partner (IP), revealed that several communities in Jos, Plateau State, lacked HIV treatment centers, but were also unable to access existing centers because of conflict related partitioning of Jos, calling for specialized strategies and collaboration to scale-up to affected communities. To bridge existing challenges related to distrust amongst communities, the intervention strategy identified six community oriented resource persons (CORPs), of same ethnoreligious dispensation as people in affected communities, who also possessed HIV programing competencies, to lead the intervention. The project methodology included engagement of community gatekeepers and Plateau HIV stakeholders, who generated context specific strategies to enter these communities and scale-up HIV/PMTCT. The lead CORPs included a female public health/HIV physician, another clinician who owned a community hospital, a HIV laboratory personnel, a HIV trained Data officer, a religious cleric/youth leader and a female expert patient cum member of Federation of Muslim women association of Nigeria (FOMWAN). Collaborating with various stakeholders, they birthed a community faith based organization they called Muslim Health Initiative of Nigeria (MUHIN). This served as platform for community engagement to scale-up HIV/PMTCT services. The Lead HIV Partner supported, engaged and funded MUHIN to provide context specific scale-up to address existing gaps. MUHIN identified, assessed, upgraded and activated twenty-eight community clinics for HIV/PMTCT service deliver, building on existing Maternal, child and New-born health (MNCH) structures. They provided HIV trainings, MNCH materials, national data-capture tools and capacity building to the identified facilities, staff and CORPs. They stratified according to facility capacity, and linked them using the Hub-and-spoke model, to provide HIV testing, PMTCT and Antiretroviral therapy (ART) services. In order to bridge existing human resource for health gaps existing at the clinics, community health workers and HIV positive women who had successfully completed PMTCT programs were engaged and trained according to task shifting and task sharing (TSTS) guidelines, in preparation for HIV/PMTCT activation using HCT as entry. We conclude that detailed diagnostics, planning and utilization of context-specific strategies including TSTS are critical for successful project outcomes.

Published in International Journal of HIV/AIDS Prevention, Education and Behavioural Science (Volume 7, Issue 1)
DOI 10.11648/j.ijhpebs.20210701.13
Page(s) 15-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Prevention of Mother to Child Transmission, Human Immunodeficiency Virus, Plateau State, Community Oriented Resource Persons, Ethnoreligious, Conflict and Scale-up

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Cite This Article
  • APA Style

    Tinuade Abimbola Oyebode, Zuwaira Hassan, Tolulope Afolaranmi, Musa Tanko Umar, Francis Magaji, et al. (2021). Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 7(1), 15-26. https://doi.org/10.11648/j.ijhpebs.20210701.13

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    ACS Style

    Tinuade Abimbola Oyebode; Zuwaira Hassan; Tolulope Afolaranmi; Musa Tanko Umar; Francis Magaji, et al. Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2021, 7(1), 15-26. doi: 10.11648/j.ijhpebs.20210701.13

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    AMA Style

    Tinuade Abimbola Oyebode, Zuwaira Hassan, Tolulope Afolaranmi, Musa Tanko Umar, Francis Magaji, et al. Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria. Int J HIV/AIDS Prev Educ Behav Sci. 2021;7(1):15-26. doi: 10.11648/j.ijhpebs.20210701.13

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  • @article{10.11648/j.ijhpebs.20210701.13,
      author = {Tinuade Abimbola Oyebode and Zuwaira Hassan and Tolulope Afolaranmi and Musa Tanko Umar and Francis Magaji and Maria Pawa and Patrick Akande and Solomon Sagay and Jerry Gwamna and Prosper Okonkwo and Phyllis Kanki},
      title = {Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria},
      journal = {International Journal of HIV/AIDS Prevention, Education and Behavioural Science},
      volume = {7},
      number = {1},
      pages = {15-26},
      doi = {10.11648/j.ijhpebs.20210701.13},
      url = {https://doi.org/10.11648/j.ijhpebs.20210701.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhpebs.20210701.13},
      abstract = {The 2013 WHO HIV guidelines provided effective antiretroviral regimens to reduce perinatal transmission to below 2%. The option-B approach of providing antiretroviral drugs was adopted by Nigeria, which contributed 32% of global gaps in Preventing Mother to child transmission (PMTCT). In Plateau State, which had 7.7% HIV prevalence, incessant ethnoreligious conflict created challenges impacting on HIV service delivery and access to treatment centers. PMTCT diagnostics conducted by the lead HIV implementing Partner (IP), revealed that several communities in Jos, Plateau State, lacked HIV treatment centers, but were also unable to access existing centers because of conflict related partitioning of Jos, calling for specialized strategies and collaboration to scale-up to affected communities. To bridge existing challenges related to distrust amongst communities, the intervention strategy identified six community oriented resource persons (CORPs), of same ethnoreligious dispensation as people in affected communities, who also possessed HIV programing competencies, to lead the intervention. The project methodology included engagement of community gatekeepers and Plateau HIV stakeholders, who generated context specific strategies to enter these communities and scale-up HIV/PMTCT. The lead CORPs included a female public health/HIV physician, another clinician who owned a community hospital, a HIV laboratory personnel, a HIV trained Data officer, a religious cleric/youth leader and a female expert patient cum member of Federation of Muslim women association of Nigeria (FOMWAN). Collaborating with various stakeholders, they birthed a community faith based organization they called Muslim Health Initiative of Nigeria (MUHIN). This served as platform for community engagement to scale-up HIV/PMTCT services. The Lead HIV Partner supported, engaged and funded MUHIN to provide context specific scale-up to address existing gaps. MUHIN identified, assessed, upgraded and activated twenty-eight community clinics for HIV/PMTCT service deliver, building on existing Maternal, child and New-born health (MNCH) structures. They provided HIV trainings, MNCH materials, national data-capture tools and capacity building to the identified facilities, staff and CORPs. They stratified according to facility capacity, and linked them using the Hub-and-spoke model, to provide HIV testing, PMTCT and Antiretroviral therapy (ART) services. In order to bridge existing human resource for health gaps existing at the clinics, community health workers and HIV positive women who had successfully completed PMTCT programs were engaged and trained according to task shifting and task sharing (TSTS) guidelines, in preparation for HIV/PMTCT activation using HCT as entry. We conclude that detailed diagnostics, planning and utilization of context-specific strategies including TSTS are critical for successful project outcomes.},
     year = {2021}
    }
    

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    T1  - Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria
    AU  - Tinuade Abimbola Oyebode
    AU  - Zuwaira Hassan
    AU  - Tolulope Afolaranmi
    AU  - Musa Tanko Umar
    AU  - Francis Magaji
    AU  - Maria Pawa
    AU  - Patrick Akande
    AU  - Solomon Sagay
    AU  - Jerry Gwamna
    AU  - Prosper Okonkwo
    AU  - Phyllis Kanki
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    T2  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
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    JO  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
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    AB  - The 2013 WHO HIV guidelines provided effective antiretroviral regimens to reduce perinatal transmission to below 2%. The option-B approach of providing antiretroviral drugs was adopted by Nigeria, which contributed 32% of global gaps in Preventing Mother to child transmission (PMTCT). In Plateau State, which had 7.7% HIV prevalence, incessant ethnoreligious conflict created challenges impacting on HIV service delivery and access to treatment centers. PMTCT diagnostics conducted by the lead HIV implementing Partner (IP), revealed that several communities in Jos, Plateau State, lacked HIV treatment centers, but were also unable to access existing centers because of conflict related partitioning of Jos, calling for specialized strategies and collaboration to scale-up to affected communities. To bridge existing challenges related to distrust amongst communities, the intervention strategy identified six community oriented resource persons (CORPs), of same ethnoreligious dispensation as people in affected communities, who also possessed HIV programing competencies, to lead the intervention. The project methodology included engagement of community gatekeepers and Plateau HIV stakeholders, who generated context specific strategies to enter these communities and scale-up HIV/PMTCT. The lead CORPs included a female public health/HIV physician, another clinician who owned a community hospital, a HIV laboratory personnel, a HIV trained Data officer, a religious cleric/youth leader and a female expert patient cum member of Federation of Muslim women association of Nigeria (FOMWAN). Collaborating with various stakeholders, they birthed a community faith based organization they called Muslim Health Initiative of Nigeria (MUHIN). This served as platform for community engagement to scale-up HIV/PMTCT services. The Lead HIV Partner supported, engaged and funded MUHIN to provide context specific scale-up to address existing gaps. MUHIN identified, assessed, upgraded and activated twenty-eight community clinics for HIV/PMTCT service deliver, building on existing Maternal, child and New-born health (MNCH) structures. They provided HIV trainings, MNCH materials, national data-capture tools and capacity building to the identified facilities, staff and CORPs. They stratified according to facility capacity, and linked them using the Hub-and-spoke model, to provide HIV testing, PMTCT and Antiretroviral therapy (ART) services. In order to bridge existing human resource for health gaps existing at the clinics, community health workers and HIV positive women who had successfully completed PMTCT programs were engaged and trained according to task shifting and task sharing (TSTS) guidelines, in preparation for HIV/PMTCT activation using HCT as entry. We conclude that detailed diagnostics, planning and utilization of context-specific strategies including TSTS are critical for successful project outcomes.
    VL  - 7
    IS  - 1
    ER  - 

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Author Information
  • Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Plateau AIDS Control Agency (PLACA), Jos, Nigeria

  • State AIDS/STI Control Program (SASCP), Plateau State Ministry of Health, Jos, Nigeria

  • Center for Disease Control and Prevention (CDC), Abuja, Nigeria

  • Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Center for Disease Control and Prevention (CDC), Abuja, Nigeria

  • AIDS Prevention Initiative in Nigeria (APIN), Abuja, Nigeria

  • Infectious Diseases & Immunology, Harvard School of Public Health, Boston, MA, USA

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