The Role of Community Health Workers in EnhancingCare and Treatment through defaulter tracing and effective

referrals

Presenter: Christine Nzilani, Aphiaplus KaMili (Kenya Red Cross)

NOPE 6th Biennial International Conference on Peer Education, Sexuality, HIV&AIDS

KICC, 18th-20th June 2014.

Outline of Presentation

• Background • Objective • Description and Methodology • Lessons Learned • Next Steps• Questions and Answers

Background

• Defaulter tracing for clients on ART is one of the activities embarked on by Community Health Workers at household level to reach clients who have dropped from care and treatment .

• Improving defaulter tracing and effective referrals and subsequent linkage to care and treatment is a key priority in scaling up HIV services. Unfortunately, defaulter tracing and effective referral with a focus to linkage to care and treatment in health facilities has remained a major challenge due to stigma associated with being HIV positive

Background

• This has resulted in low enrolment rates and in other cases clients who are enrolled into care and treatment drop out.

• Defaulter tracing and effective referrals are an important strategy in encouraging increased and sustained uptake of care and treatment.

• Community Health Workers through APHIAPLUS KAMILI trace and refer ART defaulters as an approach for retention of HIV clients in Kiambu County. 

Objective

• To identify at least 90% of ART defaulters, ensure 100% effective referral and linkage to Comprehensive Care Centres (CCC) in order to increase retention on care.

Description and Methodology

• House hold mapping and registration has been done which is one of the ways the CHWs are able to identify ART defaulters.

• CHWs work closely with the peer educators based at the Comprehensive Care Centres in the link health facilities to identify specific defaulters.

Description and Methodology

• Signs have been placed at link facilities that instruct patients where to find the Comprehensive Care Centres without difficulty once they have been referred.

• 743 clients are currently on care in Ngoliba, Ithanga and Munyu Health Centres.

Lessons learned

• There has been an increment in the number of ART defaulters traced, referred and retained through household visits by community health workers .  

Lessons Learned Cont…

• Defaulter tracing, when combined with effective referrals provides a platform for Community Health Workers to link and support clients and ensure retention on care.

Lessons Learned Cont…

• Defaulter tracing and referrals, when implemented within Community Units has the potential to substantially increase uptake of HIV testing and subsequently linkage to care in the hard to reach rural areas of Kenya.

Next Steps

• There is need to strengthen existing referral linkages for those testing HIV positive within the community.

• Community Health workers should be supported across the board to trace and effectively refer ART defaulters. 

Next Steps

If one CHW voice is a powerful statement, how about 1000?

Thank You!

Any Questions?