Ministry of Health (MOH) Grant for Sustainable HIV/AIDS Response in Guyana

Activities

Outcomes

Short Term Outcomes
(1-2 Years)

Intermediate Outcomes
(3-4 Years)

Long Term Outcomes
(5+ Years)

Conduct operational assessment of current key populations (KP) HIV programs

Detail the level of adherence/compliance of MOH program managers and senior staff to key population program implementation requirements

Identify operational gaps in key populations’ program delivery (stock-outs of materials, difficulty recruiting and retaining providers, inability to reach targeting populations using recommended strategy, etc.)

Develop new and revised key populations’ programming addressing operational and uptake challenges identified by administrators and end-users

Inform provider training agenda based on self-reported needs of HIV-infected key populations

Conduct end-user assessment of current key populations HIV programs

Identify barriers to access and uptake of clinical services by HIV-infected members of key populations

Describe preferred service delivery options as reported by HIV-infected key populations (e.g. hours of operation, location, attending clinical staff type, clinical service gaps)

Increased access to HIV clinical services for key populations

Improved uptake of HIV clinical services by key populations

Reduced disparities between the general and key populations in HIV transmission and clinical outcomes (e.g. GP prevalence 0.8-1.3% vs KP prevalence 19-24%)

Provide HIV best clinical practices trainings to clinicians at national and regional sites (offering should be open to clinical staff from NGOs)

Increased adherence of clinicians to international HIV clinical and treatment guidelines

Increased provider awareness of operational strategies for clinical management of HIV-infected members of key populations

Increased collaborative care provision between national clinical treatment centers and civil society care and support organizations

Increased access to and quality of HIV clinical care, especially for MSM and commercial sex workers (CSW)

Improved linkage to and retention in care, especially for MSM and CSW

Develop and pilot a single, consolidated HIV/AIDS care quality improvement strategy and assessment tool

Implement and integrate consolidated HIV/AIDS care quality improvement strategy and assessment tool

Increased efficiency in monitoring quality of care at the main MOH service delivery sites (efficiency as indicated by the number of administrative areas assessed in a visit and number of measures included in a single chart review)

Improved quality of care at the main MOH service delivery sites

Increased documentation of linkage to care

Design and develop a pilot HIV/AIDS electronic database for patient monitoring

Implement and integrate HIV/AIDS electronic database for patient monitoring

Increased availability of strategic information (SI) for patient monitoring (adherence, CD4 count, viral load, HIV genotyping and phenotyping where applicable)

Improved ability to use patient data for program monitoring at the national level

Develop, pilot and implement a patient linking strategy with a single, robust patient unique identifier across all MOH programs

Improved case tracking of HIV-infected clients across other MOH programs (e.g. TB, STI, PMTCT)

Increased integration of HIV care with other comorbid conditions under the MOH management

Improved quality of care

Improved patient outcomes as documented in chart reviews and patient monitoring databases

Develop and pilot an enhanced surveillance strategy for National AIDS Program Secretariat (NAPS) data linkage

Decreased client duplication across multiple monitoring indicators used for reporting

Increased cost savings by reducing excessive procurement spending (test kits, drugs, educational materials etc.)

Develop and pilot a revised case surveillance form to include transmission risk

Increased volume and quality of strategic information on key populations and other vulnerable group

Increased data utilization for program targeting to reach MSM, CSW and transgender (TG)

Increased data reporting on KP and vulnerable groups (risk and outcomes)

Conduct data management and analysis trainings

Increased capacity of HIV program officers for data analysis within the MOH

Increased country ownership for HIV data management and utilization

Improved program monitoring and evaluation

Conduct HIV Drug Resistance (HIVDR) testing

Report HIVDR trends among enrolled care patients

Increased availability of strategic information to revise treatment guidelines with specific emphasis on the management of drug resistance for regimen selection and switching

Reduced incidence of acquired HIV Drug Resistance

Reduced HIV-related morbidity and mortality

Conduct open case conferences with NGOs at the National Care and Treatment Center (NCTC)

Reduced loss to care

Increased rate of patient re-engagement after loss to care

Increased proportion of patients retained in care

Improved quality of HIV care

Reduced HIV-related morbidity and mortality

Conduct routine adherence assessments and transmission risk reassessment among retained care clients

Improved detection of adherence challenges

Reduced incidence of treatment failure

Reduced incidence of acquired drug resistance

Improved quality of HIV clinical care

Reduced viral load

Reduced incidence of opportunistic infections

Develop and pilot an HIV/AIDS-specific quality improvement strategy and assessment tool for laboratory services

Increased availability of strategic information around laboratory performance

Reduced turnaround time for HIV confirmatory test results

Increased quality checks for rapid testing using gold standards (ELISA and Western Blot)

Improved quality of laboratory service delivery

Maintenance of a safe blood supply

Conduct an HIV drug resistance capacity assessment at national public health reference laboratory (NPHRL)

Increased availability of strategic information around HIVDR testing at NPHRL

Increased data for decision making ability around initiating HIVDR testing locally and the required inputs

Monitor current infection control practices at HIV and TB care sites

Decreased risk of TB/HIV nosocomial infections

Decreased incidence of TB among HIV-infected patients in care

Reduced TB/HIV-related morbidity and mortality for the coinfected

Develop a clinical cascade at the national level for ongoing program monitoring and evaluation (M&E)

Improved program management by highlighting areas of need across the continuum of care

Improved program quality

Reduced HIV-related morbidity and mortality

Establish and build capacity for Caribbean regional support, including analysis

Increased collaboration with peers and technical support resources within the Caribbean region

Increased availability of sustainable HIV technical assistance outside of USG or international multilaterals