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CATIE FORUMSeptember 18, 2013
PLENARY: INTEGRATED HEALTH SYSTEMS:DESIGNING SYSTEMS TO RESPOND
HOLISTICALLY TO THE NEEDS OF CLIENTS
SASKATCHEWAN’S HEALTH SYSTEMS APPROACH TO
HIV
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Outline
Saskatchewan:
• Orientation to the “landscape”
• Epidemiology of HIV
• HIV Strategy implementation
• Approaches to integrating treatment and prevention
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• 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
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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
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Epidemiology of HIV in Saskatchewan
Since 2002, steady increase in new cases
• Highest rates of new cases in Canada
• 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
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Defining our Approach
CommunityEngagement/
Education
Prevention/Harm Reduction
Surveillance/Research
Clinical Management
Client-centered
Approaches that are: •Client-centered•Increase Access•Multi-disciplinary
Integration
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Developing the Infrastructure
Improving Public Health System Infrastructure in Canada, 2005
Information and Knowledge SystemsResearch and Evaluation
•Enhanced surveillance
Knowledge Translation into Practice•“Beg & Borrow”
Information Infrastructure•Streamlining
Sufficient & Competent WorkforceHuman 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 CapacityLeadership/System Governance
•HIV Provincial Leadership Team/Strategy Coordinators
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
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Community Engagementand Education
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.
HIV PLT website www.skhiv.ca
Social Media
Raising the profile of HIV to increase awareness and educate nationally, regionally and locally
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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
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Community Based Supports•HIV Strategy funding allocated to CBOs to develop community based supports proposals based on regional needs.
Outreach ClinicsClient-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” settingsi.e. Food Bank, Primary Care, Methadone Clinics, AIDS Service Organizations
Integrated Approaches
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•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
Lessons
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For more information:
Lisa LockieHIV/BBP/IDU ConsultantSaskatchewan Ministry of Health3475 Albert StreetRegina, SK S4S 6X6(306)[email protected]
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