Country Spotlight: Côte d’Ivoire
Our Work in Côte d’Ivoire
EGPAF/Côte d’Ivoire supports the provision of family-based HIV/AIDS care services through a broad range of activities, including:
- Expanding provision of comprehensive PMTCT services;
- Expanding access to HIV/AIDS care and treatment services;
- Strengthening health systems and building workforce capacity; and
- Developing and supporting psychosocial programs for individuals living with and affected by HIV and AIDS.
EGPAF/Côte d’Ivoire is dedicated to advancing basic and operations research leading to improvements in HIV/AIDS prevention, care, and treatment. Research activities in Côte d’Ivoire are looking at a broad range of issues, including:
- Nutrition counseling and practices among children born to HIV-positive mothers;
- Clinical and immunological outcomes of patients receiving antiretroviral therapy (ART);
- Prevalence of HIV among hospitalized children;
- Evaluation of cervical cancer prevention programs in the context of HIV; and
- Acceptability and feasibility of home-based HIV testing in rural settings.
EGPAF is a global advocate for policies that address the needs of women, children, and families living with and affected by HIV and AIDS. In Côte d’Ivoire, EGPAF has used its technical expertise in global program implementation to:
- Strongly support the national care and treatment program in the development and dissemination of a national guideline document for pediatric AIDS management; and
- Advocate for and support the development of easy-to-use and affordable early infant diagnosis methods appropriate to local settings.
As of March 31, 2013, EGPAF-supported programs in Côte d’Ivoire have:
- Provided nearly 1.2 million women with PMTCT services.
- Enrolled more than 245,000 patients into HIV care, including nearly 15,000 children under the age of 15.
- Started nearly 122,000 individuals on antiretroviral therapy (ART) for HIV/AIDS, including more than 6,600 children under the age of 15.
Key Projects in Côte d’Ivoire
Strengthening Community-Based HIV/AIDS Prevention and Care Services in the Underserved Northern and Western Regions of the Republic of Côte d'Ivoire (CDC/PEPFAR: 2010-2015)
Project Keneya is a community-based project, the primary goal of which is to strengthen HIV/AIDS prevention and care services. It was designed as a response to the needs of orphans and vulnerable children (OVC), families and caretakes of OVC, and people living with HIV in the Vallee de Bandama and Savanes regions of Côte d'Ivoire. The project has four key areas:
- "Abstinence/be faithful" prevention messaging
- Care and support for people living with HIV
- OVC identification, assessment and support
- Voluntary counselling and testing (VCT)
HIV Care, Support & Treatment: Implementation of Program for the Care of HIV/AIDS (CDC/PEPFAR: 2011-2016)
The primary goal of Project Djidja is to build a strong and sustainable response to the HIV/AIDS epidemic in selected regions of Côte d’Ivoire. Project Djidja's service delivery components are currently offered in five regions: Gbêkê, Hambol, Bélier, Sud-Comoé, and Abidjan 2. EGPAF is working with government and community partners to build their technical and organizational capacity to carry out and supervise HIV activities in preparation for the full transition of HIV prevention, care and treatment services to Ivorian institutions.
Call to Action (USAID/PEPFAR: 2002-2010)
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 Call to Action (CTA) project in 12 countries, including Côte d’Ivoire (from 2005 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. CTA’s work was conducted in accordance with national health policies and within national AIDS response frameworks. EGPAF-supported programs:
- Integrated HIV counseling and testing and antiretroviral (ARV) prophylaxis regimens into existing maternal and child health (MCH) services;
- Improved patient flow, HIV counseling techniques, testing algorithms, drug distribution, and other aspects of program delivery;
- Supported basic clinic improvements and worked to ensure provision essential commodities;
- Engaged in community mobilization activities;
- Trained health care workers and educated mothers about infant feeding;
- Provided technical assistance for program implementation, monitoring and evaluation, and psychosocial support.
Helping Expand Antiretroviral Treatment for Families and Children (Project HEART) (CDC/PEPFAR: 2004-2012)
Project HEART was launched in 2004 in Côte d’Ivoire, South Africa, Tanzania, and Zambia, and in 2006 in Mozambique. This eight-year project, funded through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Centers for Disease Control and Prevention (CDC), saw dramatic results. In 2010, one out of every 10 PEPFAR-supported ART patients in sub-Saharan Africa received their treatment through Project HEART. By early 2012, more than one million men, women, and children received HIV care and support; more than 2.5 million pregnant women received HIV counseling and testing; more than 66,500 pediatric HIV infections were prevented; and more than half a million people started lifesaving antiretroviral therapy (ART). Working with a network of more than 215 international and local partners, Project HEART dramatically improved delivery of HIV/AIDS services and ultimately strengthened national health systems by:
- Supporting HIV prevention, care, and treatment services at more than 510 ART sites and 1,053 prevention of mother-to-child transmission of HIV (PMTCT) sites throughout five countries;
- Building the clinical, managerial, financial, and administrative capacity of local health providers and partners to more effectively provide HIV services;
- Strengthening program and data quality;
- Improving the technological and physical infrastructure of health facilities;
- Providing sub-awards to local partners and Ministries of Health at the district and provincial/regional levels, in coordination with capacity building
Project HEART’s innovative practices – most notably using a decentralized district approach, scaling up performance-based financing, and piloting new, easy-to-use technology – have served as best practices that have been authorized and disseminated by Ministries of Health and other implementing partners.
In Côte d’Ivoire, EGPAF coordinated with the Ministry of Health to expand PMTCT services and integrate those services with access to ART for pregnant mothers, partner and family testing, and screening for tuberculosis. In its role as an innovator and national leader in PMTCT services, EGPAF began the first opt-out voluntary counseling and testing program. The subsequent introduction of provided-initiated counseling and testing to reflect changes in international guidelines has increased HIV testing uptake. EGPAF supported TB/HIV integration and infection prevention activities at 56 EGPAF-supported TB sites and at 70 ART sites, and expanded TB/HIV services to 18 additional TB centers.
EGPAF/Côte d’Ivoire supported 412 PMTCT and care and treatment sites over the life of the project, and achieved the following:
- Provided over 790,000 women with access to services to prevent transmission of HIV to their babies;
- More than 180,000 individuals, including more than 12,600 children, have been enrolled into our care and support programs;
- 671,213 pregnant women have been tested for HIV through EGPAF-supported programs;
- Supported services at 476 ART sites and 2,231 PMTCT sites.
Care and Treatment and PMTCT at former Global Fund sites in Côte d'Ivoire (CARE: 2007-2008)
The goal of this Global Fund-funded program was to reduce the prevalence, sickness, and death caused by HIV and AIDS in Côte d’Ivoire by strengthening the capabilities related to prevention, HIV care and treatment, and community mobilization and awareness. The program worked to strengthen site-level capacity for prevention of mother-to-child transmission of HIV (PMTCT) and the prevention and treatment of sexually transmitted infections, and also provided medical and psychosocial support for people living with HIV and AIDS. As a sub-grantee to CARE, EGPAF provided PMTCT and monitoring and evaluation support.
Country adaptation of the 2010 World Health Organization recommendations for the prevention of mother-to-child transmission of HIV: Download PDF
Project HEART End-of-Project Report: Download PDF
Transitioning Large-Scale HIV Care and Treatment Programs to Sustainable National Ownership: The Project Heart Experience: Download PDF
Project HEART End-of-Project Report: Côte d'Ivoire: Download PDF