Cote d’Ivoire remains with a high HIV prevalence rate (3.2%) in the general population. However, some positive results are observed as a result of efforts made in the fight against HIV mainly thanks to PEPFAR support. ACONDA has contributed to that nationwide effort.
Since 2006, Aconda has become a PEPFAR direct partner and has extended its program to 138 facilities at each level of the health system in 16 health districts at the end of July, 2017. The total number of new patients enrolled on ART at the end of June 2017 (Third quarter of Fiscal Year 2017) was 6,903(18% of PEPFAR supported patients on ART). During these eleven years of implementation of the HIV program with the support of PEPFAR, ACONDA has significantly, based on its district-implementation approach, contributed to extend the coverage of HIV services for it to reach all its dedicated health districts areas including many rural health facilities. The health system has been strengthened to provide a HIV package services integrated into the nationwide minimum health service package. However, there still remain some challenges ahead: infant early diagnosis remains weak (37%) at two months of age and 63% at six months of age). Efforts have to be made on children identification at point of entries and enrollment on ART (5%) and on patient’s retention (73%); the “Test and Start” strategy has to be more integrated into the care providers practices; the link with the community must be improved; data management and its use to make decision should be enhanced; the local health authorities specifically the DHMT have to be more involved in HIV services coordination and management.
Our purpose in the next five years throughout this application is in one part, to definitively consolidate on the one hand the quantitative aspects of the program by: enhancing capacities of the infrastructures, the equipment, the human resources and the HIV care integration; and on the other hand, strengthen the qualitative aspects by: improving HIV-service quality, Community and the Clinical networks and also the DHMT involvement so as to make the local health system stronger. The ultimate aim of our proposal is to ensure sustainability to the program in order to contribute to UNAIDS fast track 90-90-90 goals for the country.