Doctors with Africa CUAMM Founded in 1950 by prof. Canova Doctors with Africa CUAMM was the first NGO operating in the health field recognized by Italy 1300 people sent in Africa throughout the years 4330 years of service in Africa 40 countries of intervention MISSION: Carrying out long term projects to guarantee that everyone has access to quality health services. Committed in capacity-building and training of human resouces in Italy and in Africa, in the reaserch and scientific popularization fields. Promoting Health as a foundamental and universal human.
Doctors with Africa CUAMM Doctors with Africa CUAMM is present in 7 African countries (Angola, Ethiopia, Mozambique, Sierra Leone, South Sudan, Tanzania, Uganda) with: 78 volonteers 37 principal cooperation projects and about a hundred of support initiatives that offer backing for the activities of: 15 hospitals 25 districts (public health activities, maternal-child health care, Aids, TB and malaria, training and capacity-building) 3 rehabilitation centers 4 nursing schools 3 universities (in Uganda, Mozambique and Ethiopia) Sierra Leone
Strengthening health system Health System Strengthening Framework, WHO, 2007 - Policy and programs - Human resources - Infrastructures - Financing - Heath information system - Innovation and operational research
Continuum of care Referal to higher level Demand of care Decentr. treatment Follow up
Doctors with Africa CUAMM Tuberculosis care and treatment
The continuum of care approach - TB Community and families: Promotion of sustainable Community based DOT. Decentralization of TB services (health extension workers) Primary and secondary level: Management of Smear negative cases Integration of Tb/HIV services and management of treatment complication, Paediatric TB (diagnostic and treatment), Use of new technology (genexpert) in rural areas. Rural Hospital: Management of Smear negative cases Integration of Tb/HIV services and management of treatment complication, Paediatric TB (diagnostic and treatment), Use of new technology (genexpert) as predictor of MDR e referral to culture (Bactec) Management of MDR and 2 nd line treatment, Referral system: Avoid diagnostic delay Recover of defaulters
Case study: Angola TB control 2000-2005 MAAEE: tb control programme in Uige and Luanda province 2005-2010 Global fund R4: 11/18 provinces of Angola 2011-2014 Global fund R9: 18/18 provinces of Angola PR CUAMM Expansion of DOT services in conflict and post conflict phase PR UNDP Expansion of DOT services in development phase Strengthening the PNCT at central, provincial and district level PR MINSA Expansion of DOT services Strengthening the PNCT at central, provincial and district level Promote community based DOT Unmet challenges: TB/HIV and MDR
Angola TB control
Angola TB control From 69% to 73% From a mean of 45% to 70% % of achievement of minimum standard for quarter report in each province supported
Angola TB control From 19% to 77% 46% of patient are delaying
Doctors with Africa CUAMM HIV / AIDS
The continuum of care approach HIV / AIDS Community and families: Awareness campaign for prevention Home based care and peer to peer support groups Primary and secondary level: Voluntary counselling and testing Management of HAART. Rural Hospital: Management HAART with CD4 monitoring Integration of Tb/HIV services and management of treatment complication, PMTCT Paediatric TB (early diagnosis PCR and treatment), Management of 2 nd line treatment Referral system: Improve access to services Recovery of defaulters
Case study: Mozambique peer to peer support Beira city, Mozambique Beira city has one of the highest HIV prevalence in Mozambique; up to 25% in pregnant women The reported prevalence on the group aged 15 24 is 13% Access to HIV services, especially PMTCT has been described as a cascade *Graph form South Africa and Zambia
Case study: Mozambique peer to peer support Peer to peer support group Create in 2005 became a local association legally recognized in 2011 Kuplumussana links health service to communities ensuring support to HIV+ women, access to health services and adherence to treatment. Kuplumussana ensure the recovery of defaulters
Mozambique PMTCT and pediatric HIV Defaulters tracing and recovery Sample of home visits 2.954 Children identified 2.460 Children lost 544
Doctors with Africa CUAMM: Research and Innovation
CUAMM s approach to research
Innovation: technology / approach
Doctors with Africa CUAMM trends and new scenarios
The Urban vs Rural scenario
Communicable vs non communicable diseases
The double burden scenario
Thank you! Andrea Atzori a.atzori@cuamm.org