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Overview of ESTHER model: Status and perspectives. Dr Gilles Raguin Director www.esther.fr . ESTHER is a public operator . Ministry of Health in Partner countries. Capacity building Training Lab support PSM M and E Psycho -social support. PARTNERSHIPS. HOSPITALS AND - PowerPoint PPT Presentation
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Overview of ESTHER model:Status and perspectives
Dr Gilles Raguin Director
www.esther.fr
IAS, july 2012
FRENCH HOSPITALS
Ministry of Health in Partner countries
Capacity building
• Training
• Lab support
• PSM
• M and E
• Psycho -social support
HOSPITALS ANDCBOS IN
PARTNER COUNTRIES
PARTNERSHIPS
ESTHER is a public operator
IAS, july 2012
19 partner countries 15 in Africa BéninBurkina FasoBurundiCamerounCôte d’IvoireGabon GhanaLibériaMarocMaliNigerRCA SénégalTchad Togo 3 in Asia
CambodgeLaosVietnam1 in the
Carribean : Haïti
IAS, july 2012
173 sites supported by ESTHER in 2011
IAS, july 2012
RESULTS 2011 (1): 158.000 PVVIH on ART
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RESULTS 2010 (2) for 113 367 pts(2011 results pending)
Nb sitesassesses
Nb sites withdata
Nb patients Nb patients On ART
Nb persons with PSS
Treatment Sites
121 100 113 367 74 500 (66%) 35 831
N and % of LTFU at M12
43% 11%
143 sites in 17 countries assessedResponse rate: 79%
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RESULTS (3)Indicators Availability Number (%) % Range
N patients 94% 113 367 NA
N and % children < 2 yrs on ART
23% (19/82 sites) 803 (34%) 8% – 100%
N and % neonates w DNA PCR < 3 months
29% 786 (84%) 11% – 100%
N and % pregnant women w complete PMTCT
63% ( 54/86 sites) 1 784 (58%)
8% – 100%
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Training: a priority in order to mitigate the Health Human resources crisis
En 2011, 4400 health providers trained
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Psychosocial support: a know how and a priority for ESTHER
855 counselors and community health workers trained
132 partner CBOs
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Main mode of intervention: hospital partnerships
46 french hospitals involved
2011 : French caribean hospitals
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Types of expertise mobilized
Doctors (77%)Nurses, midwives and labtechs (15%)
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Hospital Twinnings in 2012: limits and perspectives
• Capacities limited by financial crisis and health reforms
• New modes of intervention linked to external funding (UNITAID/AFD/GF) w specific TORs (52%)
• New strategies and objectives: Health system strengthening, MCH (MDGs 4 and 5), patient safety, more operational research
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FOCUS 1 : Mother and child 2010
• 12 000 pregnant women with PMTCT
• 4 000 neonates with early infant diagnosis
35 reference maternities in 12 countries
FOCUS 2 : Laboratory strengthening
In 2010, 88 laboratories supported by ESTHER In 17 countries
-Imrprove access to innovative technologies for VLT: OPPERA project (UNITAID)-Strengthen lab networks
?
IAS, july 2012
% of Lab offerin
g HIV te
sting
% of Lab offerin
g CD4
% of Lab offerin
g VL
% of Lab offerin
g genotyp
ing
% of Lab offerin
g EID
% of Lab offerin
g the TB
diagnosis
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
FOCUS 3 : Key populations
Prisoners inCôte d’Ivoire IDUs in
Dakar
MSM in CAR
-Discrimination still major-MSM and IDUs in Africa: the hidden epidemic
?
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Conclusion• Hospital partnerships is the backbone of ESTHER
programs (solidarity and expertise)• However, evolutions are ongoing to adapt to new
constraints and new fundings• Strategy 2012-2014– 1/ Move from a site approach to a national approach,
aligned on national strategies and a bilateral-multiteral approach
– 2/ Move from a vertical, disease based approach, to a more transversal approach: health system strenthening
IAS, july 2012
aknowledgements• To the 28 ESTHER staff members at the headquarters
and 73 local staff in countries• To all hospital and CBOs partners in french hospitals
and partner countries • To the technical and financial partners
IAS, july 2012
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