The collaboration between CBCHS and EGPAF has resulted in tremendous progress in Cameroon, but much work remains. Only an estimated 53 percent of pregnant women living with HIV received the most effective regimen to reduce the risk of mother-to-child transmission of HIV, leaving approximately 14,000 HIV-positive pregnant women and their newborns at risk (UNAIDS 2011). Additionally, only 11 percent of children living with HIV in Cameroon are receiving the medication they need to remain healthy.
In 2011, CBCHS was selected by the U.S. Centers for Disease Control and Prevention (CDC) to implement a five-year PMTCT project (“The HIV-Free Cameroon Project: Expanding Coverage and Improving the Quality of Facility and Community-Based Prevention of Mother to Child Transmission of HIV Programs in the North West and South West Regions of Cameroon under the President’s Emergency Plan for AIDS Relief”) in two regions with the highest HIV prevalence in Cameroon, the North West and South West Regions. This is the first major implementation project CDC has funded in Cameroon, and will greatly increase the sustainability and prominence of CBCHS. EGPAF will support CBCHS with technical assistance to implement the project. CBCHS is the prime on this award; EGPAF and the Clinton Health Access Initiative are sub‐partners.
EGPAF continues to provide direct financial support and technical assistance for PMTCT implementation in Adamawa, Center, Littoral, and West Regions.
Now in its second decade, EGPAF’s partnership with CBCHS has increased the capacity and sustainability of a highly effective local partner to implement critical services – and continues to improve the health of women, children, and families living in Cameroon.
Together in partnership, EGPAF and CBCHS are:
- Increasing access to HIV testing and counseling;
- Providing ARV prophylaxis to HIV-positive mothers and HIV-exposed infants;
- Building laboratory capacities and expanding early infant diagnosis of HIV to facilities in Cameroon; and
- Providing a comprehensive approach to HIV care and treatment services, including psychosocial support services and women’s health services.
The HIV-Free Cameroon Project: Expanding Coverage and Improving the Quality of Facility and Community-Based Prevention of Mother-to-Child Transmission of HIV Programs in the North West and South West Regions of Cameroon under the U.S. President’s Emergency Plan for AIDS Relief
Throughout this five-year CDC/PEPFAR-funded project, Cameroon Baptist Convention Health Services (CBCHS) will collaborate with the Cameroon Ministry of Public Health, EGPAF, the Clinton Health Access Initiative (CHAI), and community-based partners to expand prevention of mother-to-child transmission of HIV (PMTCT) services, increase the HIV-free survival of infants, and reduce HIV-related morbidity and mortality of families in all 17 districts of the South West Region and 18 districts of the North West Region. EGPAF will focus on the provision of targeted technical assistance to CBCHS in the areas of:
Strengthening the Monitoring and Evaluation of Prevention of Mother-to-Child Transmission of HIV Programs
- PMTCT implementation
- Monitoring and evaluation
- Communications and documentation
- Training and technical assistance for project start-up
- Operations (including agreement management)
- Capacity building/sustainability/transition to the Ministry of Public Health
With support from UNICEF, EGPAF is providing targeted technical assistance to improve systems for monitoring and evaluation (M&E) of prevention of mother-to-child transmission of HIV (PMTCT) programs in Cameroon, Lesotho, and Zambia. In Cameroon, EGPAF will continue to support the Ministry of Health in implementing and training health care staff on the country's revised PMTCT guidelines, including finalizing data collection tools and registers as well as revising PMTCT and maternal, neonatal, and child health integrated program indicators. EGPAF also is playing a key role in providing technical support in the implementation of M&E–related components of Cameroon’s elimination of mother-to-child-transmission (eMTCT) plan.
Call to Action
With funding from the United States Agency for International Development (USAID) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), EGPAF implemented the eight‐year global Call to Action (CTA) project in 12 countries, including Cameroon (from 2006 through 2007). This project sought to improve access and expand care and support for quality prevention of mother-to-child transmission of HIV (PMTCT) services, while enhancing technical leadership and documenting successful program models. By project end, EGPAF had provided nearly four million women with access to PMTCT and antenatal care services.
In Cameroon, the project achieved impressive HIV counseling and testing results. The program offered opt-out testing, and in the more than 200 EGPAF-supported facilities, 100% of women accepted counseling, with 92% of those requesting testing. EGPAF also partnered with local organization Cameroon Baptist Convention Health Services (CBCHS) to provide community-level family planning through more than 90 HIV/AIDS family support groups. Condoms were provided at no charge to those who were sexually active, and family planning lectures were given to women attending antenatal care (ANC) and infant welfare clinics.
Reaching More in Need: PMTCT Enhancement through Expanded Implementation and Operations Research
(The Bill and Melinda Gates Foundation: 2006–2011)
The Bill and Melinda Gates Foundation funded this project that was designed to expand access to prevention of mother-to-child transmission of HIV (PMTCT) services in 10 countries including Cameroon, allowing EGPAF to fill critical gaps, ensuring continued service delivery in resource-limited countries, and leveraging other donor resources to increase access to PMTCT services. Under this project, EGPAF:
- Provided support and technical assistance to host country governments to strengthen commitment to scale up PMTCT services
- Trained thousands of government personnel at the site, district, and provincial levels to build health care worker capacity to provide HIV services
- Strengthened integration with other essential services
- Improved linkages to care and treatment
In Cameroon, EGPAF conducted a two-year study (the CORE study), which sought to find the most successful method for scaling up the provision of antiretroviral (ARV) regimens for PMTCT and establish a continuum of care system that efficiently enrolls HIV-positive PMTCT clients and HIV-exposed infants into care and treatment. The study compared two referral systems and found that when linkage nurses drew blood from HIV-positive women on the day of diagnosis and transported it to the nearest care and treatment center for CD4 testing, the overall mother-to-child transmission (MTCT) rate was 3.1%, half the program’s previous rate. The lessons learned from the CORE study were used in the overall PMTCT program to improve the referral of HIV-positive pregnant women from PMTCT to care and treatment.
Prevention of Mother-To-Child Transmission of HIV (PMTCT) Partnership
(Johnson & Johnson: 2008–2012)
The EGPAF-Johnson & Johnson (J&J) partnership was designed to expand coverage and improve the quality of prevention of mother-to-child transmission of PMTCT services, as well as demonstrate global leadership in PMTCT by replicating and documenting best practices in 11 country programs, with additional support for clinical service programs in Cameroon, India, and Malawi. By project end, EGPAF had reached more than 2.6 million women – including nearly 54,000 in Cameroon – with access to PMTCT services, and succeeded in integrating PMTCT into routine maternal and child health (MCH) services by training health personnel and developing tools and job aides. In Cameroon, EGPAF worked with local partner organization Cameroon Baptist Convention Health Services (CBCHS) to offer comprehensive and holistic wrap-around services to PMTCT clients and their families to ensure their medical, nutritional, educational, and psychosocial needs were met. To ensure program sustainability in the final years of the project, EGPAF focused its efforts on building staff capacity surrounding documentation, advocacy, and resource mobilization.