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SASKATCHEWAN S HEALTH SYSTEMS APPROACH TO HIV CATIE FORUM September 18, 2013 PLENARY: INTEGRATED HEALTH SYSTEMS: DESIGNING SYSTEMS TO RESPOND HOLISTICALLY TO THE NEEDS OF CLIENTS 2
Outline Saskatchewan: Orientation to the landscape Epidemiology of HIV HIV Strategy implementation Approaches to integrating treatment and prevention 3
13 Health Authorities Approx 70 First Nations communities Population close to 1.1M 44% reside in Regina, Saskatoon and Prince Albert Most in the southern half of the province 15% are of Aboriginal descent (First Nations, Metis and Inuit); 6% live on-reserve 4
Number and rate of new HIV cases by year, 2002 to 2011 Saskatchewan and Canada Sources: SK ISDB Database Statistics Canada/Public Health Agency of Canada, 2011 5
Since 2002, steady increase in new cases Highest rates of new cases in Canada Epidemiology of HIV in Saskatchewan Males have accounted for the majority of new cases 76% of new cases associated with IDU 81% of new cases self-reported Aboriginal ethnicity High rates of co-infection with TB and Hep C 6
Defining our Approach Community Engagement/ Education Client-centered Surveillance/ Research Integration Prevention/ Harm Reduction Approaches that are: Client-centered Increase Access Multi-disciplinary Clinical Management 7
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Developing the Infrastructure Sufficient & Competent Workforce Human Resource Planning Additional frontline staff Number and geographic distribution Training and Career Development Range of training options and formats Multidisciplinary Training, Education and Mentorship Organizational Capacity Leadership/System Governance HIV Provincial Leadership Team/Strategy Coordinators Information and Knowledge Systems Research and Evaluation Enhanced surveillance Knowledge Translation into Practice Beg & Borrow Information Infrastructure Streamlining New/Updated Policies Routine HIV Testing Case Management HIV & Pregnancy Clinical Algorithms Access to medications/formula Communication, Collaboration and Strategic Decision-Making System Expenditures Partnerships Improving Public Health System Infrastructure in Canada, 2005 9
Community Engagement First Nations Elders, Leaders, Youth Community Awareness/Mobilization Ministry of Health/FNIHB social marketing campaigns Phase 1 encourage testing for HIV Phase 2 addressing HIV-related stigma Phase 3 planning underway with B.C. Community Engagement and Education HIV PLT website www.skhiv.ca Social Media Raising the profile of HIV to increase awareness and educate nationally, regionally and locally 10
Prevention, Harm Reduction, Clinical Management Centers that deliver prevention/well being/harm reduction services Focusing on integration in the 19 provincially-funded needle exchange programs operating in 7 RHAs Expansion to additional sites Improved Access to Health Promotion and Sexual Health Education in Communities HIV Point of Care Testing (2010) Currently 21 sites Funding for Client Transportation Enhanced Outreach/Case Management HIV peer to peer networks Peer programs utilizing PHAs to provide support 11
Community Based Supports Integrated Approaches HIV Strategy funding allocated to CBOs to develop community based supports proposals based on regional needs. Outreach Clinics Client-centred approach to improving access to HIV/Hep C/STI/TB screening, testing, treatment and support in.. Remote and First Nations communities Community and non-traditional settings i.e. Food Bank, Primary Care, Methadone Clinics, AIDS Service Organizations 12
Lessons Communication and Trust Engagement Geography and cultural diversity Integration of Hep C, TB, STIs Evaluation Resources/creating capacity Address Social Determinants of Health, Stigma and Discrimination 13
For more information: Lisa Lockie HIV/BBP/IDU Consultant Saskatchewan Ministry of Health 3475 Albert Street Regina, SK S4S 6X6 (306)787-7260 llockie@health.gov.sk.ca 14
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