38. Support and participate in national efforts to improve and integrate the use and impact of pediatric diagnostics for TB and HIV and develop national strategies to optimize the use of new technologies and interventions. 

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71. Equip, mobilize, and support faith leaders, FBOs, people in places of worship, and the wider community to create awareness of the importance of HIV testing of infants and children of people living with HIV. Demand that national school curricula include scientifically appropriate information on HIV prevention, testing and treatment. 

 

72. Combat stigma and discrimination among faith leaders and within communities of faith around HIV prevention, testing and treatment. Create demand for client-centered and stigma-free care within health facilities as well as access to community-based treatment. 

 

73. Further collaborate and coordinate community mobilization, education and outreach to find otherwise hard-to-reach children, adolescents, youth and adults for age appropriate prevention education, testing, and linkage to and continuity of treatment, health, psycho-social and spiritual support services and integrate into the national system. 

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Action 10: Promote the revision of national procurement plans to align with WHO recommended regimens and the Optimal Formulary, and support the provision of reliable forecasts and the consolidation of orders.

Action 22: Support the early adoption of priority formulations and diagnostics and take steps to facilitate their wider roll-out, including by developing introductory guidance, materials, and other tools for health facilities.

Action 27. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to ARVs among children.

Action 28. Raising awareness in global fora about the unmet diagnostic and treatment needs of children with HIV.

Action 29. Promote uptake by mobilizing their networks of hospitals and community structures to distribute paediatric medicines in hard to reach places and in situations of conflict and crisis.

Action 34. Increase efforts to share information on the roll-out of new paediatric formulations, including lessons learned.

April 2021

In 2020, CMMB reached 10,467 children with HIV counseling and testing in Haiti.

ACTION 10 : CMMB Haiti participates in national quantification workshops and in quarterly national logistics meetings. Clinical and supply chain teams work together toward rollout of the optimized regimen. Updated national pediatric guidelines on HIV care and treatment and regimen optimization have been disseminated; healthcare providers have been regularly trained on pediatric care; site staffs have been supported on pediatric regimen optimization; and all HIV-positive children in Alesida sites’ catchments receive optimized ART. 

CMMB participated in the revision of the national guidelines to include use of DTG in children less than 30 Kg. Since December 2020, CMMB has worked on training Health care providers on uptake of optimal pediatric treatment- Pediatric – use of DTG in children less than 30Kg following national guidelines.

ACTION 22 : CMMB Haiti developed and disseminated a, updated pediatric ARV dosage poster to all Alesida sites to facilitate pediatric ARV administration. At pediatric sites, 85% children active on ART received a pillbox in March 2020.

ACTION 27:  In Haiti, CMMB has deployed about 190 field agents to work with communities to raise awareness and disseminate correct knowledge on preventing and treating HIV in children. Young people who are HIV positive provide pediatric patient education on adherence in the community.

Through the Faith Community Initiative, CMMB is working with faith leaders any health structure to tackle stigma and discrimination towards children living with HIV

ACTION 28 :In Haiti, CMMB advocates at national cluster meetings with relevant stakeholders, including the Ministry of Health, Centers for Disease Control and Prevention, PSM, and other Implementing partners to ensure availability of pediatric formulations to facilitate adherence.

 

ACTION 29 : In Haiti, community health workers help distribute ART in communities. A strategy of directly observed therapy (DOT) is raising pediatric adherence toward improved viral load; 75% of children were covered by DOT as of September 2020. With DOT Implemented across the CMMB network The Viral suppression increased from 63% to 86% in December 2020 using DOT strategy

 

ACTION 34 : CMMB Haiti conducts regular virtual training sessions on pediatric HIV care and treatment updates for clinicians and case managers, focusing on best practices and lessons learned on strategies such as DOT, detectable viral load class for adolescents and caregivers, HIV status disclosure for young children, and use of youth champions. 

Since update of national guidelines in January 2021, Healthcare providers at CMMB network have been trained for uptake pediatric DTG for children < 30 kg.

October 2020

Between 2017 and 2019, CMMB reached 56,583 children and adolescents with HIV counseling and testing in Haiti, 1,921 children under five in South Sudan under Anisa II, and 7,205 in Zambia under SAFE.

Action 10:  CMMB South Sudan has worked in coordination with the ministry of health, PEPFAR, and the Global Fund to streamline procurements to prevent drug stockouts during the Covid-19 pandemic to optimize multimonth dispensing (MMD) of antiretroviral drugs.

CMMB Haiti participates in national quantification workshops and in quarterly national logistics meetings. Clinical and supply chain teams work together toward rollout of the optimized regimen. Updated national pediatric guidelines on HIV care and treatment and regimen optimization have been disseminated; healthcare providers have been regularly trained on pediatric care; site staffs have been supported on pediatric regimen optimization; and all HIV-positive children in Alesida sites’ catchments receive optimized ART. 

Action 22: CMMB Zambia has supported early adoption of priority formulations and diagnostics. Health workers in areas and facilities where we work have been oriented on the guidelines. We have supported government to print essential forms. 

CMMB Haiti developed and disseminated a pediatric ARV dosage poster to all Alesida sites to facilitate pediatric ARV administration. At pediatric sites, 65% children active on ART received a pillbox in March 2020.

Action 27: In South Sudan, CMMB has worked in collaboration with community health volunteers and with the State Ministry of Health, health departments in Ezo, Nzara, and Yambio county, and civil society organizations to provide static and mobile services for HIV counseling and testing in eight remote communities. 

CMMB Zambia works with volunteers and neighborhood health committees to raise awareness among newly pregnant women for the need for early ANC, toward early HIV detection. All ANC attendees are now tested for HIV. 

In Haiti, CMMB has deployed about 190 field agents to work with communities to raise awareness and disseminate correct knowledge on preventing and treating HIV in children. Young people who are HIV positive provide pediatric patient education on adherence in the community.

Action 28: In South Sudan, CMMB has put its efforts to increasing awareness of testing and working toward achieving UNAIDS 95–95–95 targets. In Haiti, CMMB advocates at national cluster meetings with relevant stakeholders, including the Ministry of Health, Centers for Disease Control and Prevention, PSM, and other Implementing partners to ensure availability of pediatric formulations to facilitate adherence.

Action 29: In South Sudan, CMMB works with networks of CSOs and people who are HIV positive, emphasizing community drug dispensing, reaching both mothers and children, and improving access to pediatric ARVs. We are scaling up of point of care Xpert in early infant diagnosis to regional hospitals in areas with a high HIV burden.

Under CMMB Zambia, volunteers conduct community DBS collection. Pediatric treatment can be accessed only at health centers to ensure adherence and the close child monitoring necessary toward correct dosing. Health workers regularly do community ART distributions, especially in hard-to-reach areas. Mothers’ support groups promote ART adherence.

In Haiti, community health workers help distribute ART in communities. A strategy of directly observed therapy (DOT) is raising pediatric adherence toward improved viral load; 75% of children were covered by DOT as of September 2020.

Action 34: In South Sudan, CMMB participates regularly in quarterly meetings and has reviewed pediatric data at country level. Data on transition to optimized regimes and VL suppression among children are closely monitored.

In Haiti, CMMB Haiti conducts regular virtual training sessions on pediatric HIV care and treatment updates for clinicians and case managers, focusing on best practices and lessons learned on strategies such as DOT, detectable viral load class for adolescents and caregivers, HIV status disclosure for young children, and use of youth champions. 

119. Advocate for and support Ministries of Health to rapidly transition to optimal paediatric formulations as outlined by the latest WHO guidelines, provide coordinated support for the development and implementation of transition plans, inform clinicians and patients of the value of transitioning to new formulations, and ensure communication of reliable information on the availability of new formulations in-country.

 

120. Support the scale up of access to priority formulations and diagnostics and take steps to facilitate their wider roll-out, including by performing operational research, developing introductory guidance and education, materials, and other tools for health facilities and local community health structures.

 

121. Promote the revision of national procurement plans to align with WHO recommended regimens and the EML-C, and support the provision of reliable forecasts and the consolidation of orders.

 

122. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to TB diagnosis and treatment among children in close collaboration with other stakeholders.

 

123. Raise awareness in local, national, and global fora about the unmet diagnostic and treatment and prevention needs of children with or at risk for TB.

 

124. Foster and more actively participate in coordinated and collaborative advocacy to:

  • Increase funding for TB research & development, introduction and scale-up of priority paediatric drugs and formulations; 

  • Accelerate regulatory processes for rapid adoption and uptake of optimal paediatric TB drugs and formulations; and

  • Ensure sustainable access to optimal TB testing and treatment for infants and children.

 

125. Tackle the TB stigma and discrimination in communities, schools, and healthcare settings that prevent children and adolescents living with TB or at risk of TB from accessing testing and treatment, including promotion of awareness of the difference between infection and disease  and include messages of hope regarding treatment of both HIV and TB.

 

126. Promote uptake by mobilizing their networks of hospitals and community structures to distribute paediatric medicines in hard to reach places and in situations of conflict and crisis.

 

127. Support and increase TB treatment initiation and retention for children, adolescents, and families by:

  • Identifying all TB-exposed children and connecting them to treatment and preventive TB treatment through FBO clinics and within communities of faith; 

  • Reducing TB stigma and discrimination through mobilization and evidence-based education and training of faith leaders and faith communities

April 2021

In Haiti, CMMB Haiti conducted trainings to Pediatric healthcare providers about (TB and HIV clinic) TB screening, contact tracing- as a result there was an increase of identification of new cases specially in adolescents.  CMMB Haiti provides initiation of treatment and follow up until treatment is completed.