March 2022

In 2021, CMMB reached 7,193 children with HIV counseling and testing in Haiti, with an increasing pediatric testing yield of 1.3%. 

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ACTION 27: ​

• Through the Faith and Communities Initiative (FCI), CMMB is working with faith leaders to tackle stigma and discrimination toward children living with HIV. In November 2021, 1264 faith leaders have been trained on HIV educational updates, COVID-19, and the new Messages of Hope about scientific progress and changes in HIV care and treatment that have enhanced life with HIV.

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ACTION 29:

• In Haiti, community health workers help distribute ART in communities: 79.2% of patients received ARVs at fixed points or at home at least once in 2021.  Community health workers are responsible for collecting children’s most recent weight and for providing appropriate information on ARV administration to caregivers.  Pediatric ARVs are being administered in communities to about 60% of all children with chronic adherence issues, either by a trained “mother leader” or by a “treatment facilitator” living in the community. The directly observed therapy strategy (DOTS) has been implemented in all ALESIDA pediatric sites to provide adherence support to caregivers and to ensure the availability of ARV administration in the community for unsuppressed young children. As of September 2021, 90% of unsuppressed young children had benefitted from DOTS, for a 96% resuppression rate.

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ACTION 34:

• Since the last updates of national guidelines in December 2020 then in June 2021 and January 2022, healthcare providers in the CMMB network have been trained on pediatric DTG for all children. As of January 2022, 96% of ALESIDA’s pediatric HIV cohort had transitioned to a DTG-based regimen.

 

October 2021

 In 2021, CMMB reached 7,193 children with HIV counseling and testing in Haiti, with an increasing pediatric testing yield of 1.3%.

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 antiretroviral therapy (ART). 

• CMMB participated in the revision of the national guidelines to include use of dolutegravir (DTG) in children weighting less than 20 kilograms.  Since December 2020, CMMB has worked to train healthcare providers on uptake of optimal pediatric treatment—specifically, on the pediatric use of DTG in children weighing less than 20 kilograms, following national guidelines.  

ACTION 22:

• CMMB Haiti developed an updated poster on pediatric dosing of antiretroviral drugs (ARVs) and disseminated it to all ALESIDA sites to facilitate pediatric administration of ARVs. This pediatric ARV dosage poster was also shared with the Programme National de Lutte contre le SIDA (PNLS; National Program for the Struggle against AIDS) and disseminated at the national level. At pediatric sites, 85% of children active on ART received a pillbox in March 2020.

ACTION 27:

• In Haiti, CMMB has deployed about 290 field agents to work with communities to raise awareness and disseminate correct knowledge of preventing and treating HIV in children. Young people who are HIV positive with durable viral suppression have been recruited as Young Champions to provide pediatric patient education on adherence in the community for both caregivers and adolescents. 

• Through the Faith and Communities Initiative (FCI), CMMB is working with faith leaders to tackle stigma and discrimination toward children living with HIV. During the current fiscal year (FY2021), 1264 faith leaders have been trained on HIV educational updates, COVID-19, and the new Messages of Hope about scientific progress and changes in HIV care and treatment that have enhanced life with HIV.[1]

ACTION 28:

• In Haiti, CMMB advocates at national cluster meetings with relevant stakeholders, including the Ministry of Health, the Centers for Disease Control and Prevention, and Global Health Supply Chain Program—Procurement and Supply Management (GHSC-PSM) and other Implementing partners to ensure the availability of pediatric formulations to facilitate adherence. 

ACTION 29:

• In Haiti, community health workers help distribute ART in communities: 79.2% of patients received ARVs at fixed points or at home at least once during the fiscal year.  Community health workers are responsible for collecting children’s most recent weight and for providing appropriate information on ARV administration to caregivers.  Pediatric ARVs are being administered in communities to about 15% of children with chronic adherence issues, either by a trained “mother leader” or by a “treatment facilitator” living in the community. The directly observed therapy strategy (DOTS) has been implemented in all ALESIDA pediatric sites to provide adherence support to caregivers and to ensure the availability of ARV administration in the community for unsuppressed young children. As of August 2021, 90% of unsuppressed young children had benefitted from DOTS, for a 96% resuppression rate.

ACTION 34  :

• CMMB Haiti conducts regular virtual and in-person training sessions on pediatric HIV care and treatment updates for clinicians and case managers. These sessions focus on best practices and lessons learned on strategies such as DOTS, detectable viral load class for adolescents and caregivers, HIV status disclosure for young children, and the use of youth champions. A pediatric HIV disclosure protocol is under development in collaboration with Hôpital Saint-Damien, a reference hospital for pediatric care at the national level.

• Since the update of national guidelines in January 2021, healthcare providers in the CMMB network have been trained on pediatric DTG for children weighing less than 30 kilograms. As of August 2021, 86% of ALESIDA’s pediatric HIV cohort had transitioned to a DTG-based regimen.

 

April 2021

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

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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.

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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.

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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

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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.

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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.

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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. 

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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.

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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.

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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.

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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.

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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. 

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