Transcript People DO NOT have labels - Gateway Health Institute

PWUD
PWID
MSM
Sex Worker
MSM/W
Transgender
HIM HEALTH
A Social Franchise for Key Affected Populations
in low to middle income countries
Gauteng – South Africa
ASTRA STUDY: UK
"The majority of these men would not consider or self-refer to traditional harm reduction services. Our findings
highlight the need for cross-agency collaboration between HIV treatment and drug support organizations to
provide tailored services for HIV-positive MSM who use recreational drugs, and with national HIV and STI
prevention programs to address recreational drug use." - Lancet HIV
Population Fund/PEPFAR Study in Kaduna, Nigeria
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Interventions for MSM should address risks associated with both sexual behaviors and recreational drug and
alcohol use.
MSM-friendly clinics can be an effective way to reach a high number of MSM and provide risk reduction services.
Soweto Study
50% of MSM also sleeps with women.
Thailand study
61% of transgender (male to female) received money or gifts in exchange for sex
PWUD
High proportion of young recreational drug users engage in transactional sex
to obtain drugs – especially young straight (heterosexual) men.
Poor Health Seeking Behavior
Among men in General and specifically men in Key Affected Population Groups
The poorer you are the more likely you are to engage in high risk behavior and less
likely you are to seek help from health services
Male Health
Seeking Behavior
“Many studies have
documented low rates
of medical helpseeking among men.
This has been
associated with
poorer health
outcomes in men such
as diagnosis delay,
higher mortality rates,
and increased burden
on the healthcare
system.” SAMJ
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Reasons for Poor Health Seeking Behaviour
Stigma and Discrimination – MSM, Transgender
women, “addicts”, PLWHIV etc
Embarrassment, distress, and/or fear related to
using health services - ideas about masculinity that
imply men are ‘weak’ for seeking help.
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Privacy and Confidentiality
Inconvenient Service Hours
COST
Shortcomings in scope of services provided
Poor communication/rapport with health
professionals: Men were uncomfortable with health
professionals who were not polite, rushed without explaining
important information, used medical jargon, and lacked sensitivity to
their needs.
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Viewing symptoms as minor and insignificant:
This often resulted from men’s lack of knowledge about
symptoms and low interest in their body and health.
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Need for emotional control: Some men felt that by
worrying about their symptoms they were ‘losing control’ of
their emotions (SAMJ)
CARE EDUCATION RESEARCH
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HIM Health Program – to address poor HSB
Focus on MEN – to reach male members of key populations
Branding – NB not to brand as Drug or HIV Clinic
Brand as Sexual Health Clinic for MEN
One Stop Service
Bias Free Zone
Competent health care workers
Privacy and Confidentiality
Involve peers in education, counseling, information dissemination,
risk reduction strategies and harm reduction programs
• Cost effective
• Talk Openly about Sex
One Stop
•Outreach
•IEC – Info, Education and
Communications
•Counseling
•Diagnostics – Rapid tests,
GeneXpert
•Risk Reduction – HIV/STIs
•Biomedical Interventions –
condoms, Water based lube (also
female condoms for anal sex)
•PrEP & PEP & TasP
•Harm Reduction - PWUD
•NSP (needle & Syringe Programs)
•MAT (medically assisted Treatment)
•OST (Opiod Substitution Therapy)
•Treatment – STIs and HIV and
Addiction Meds
•Vaccinations – HPV, HBV
OUTREACH
Peer involvement
After Hours
Reach “hard to reach”
populations and the poor
Contains :
•Information
•Diagnostics/Screening
•Counseling
•Treatment
•Harm Reduction
•Risk Reduction
•STI Screening
•HIV Testing
•VL Monitoring
•CD4 Monitoring
•Istat – biochemistry &
Hematology
•Short waiting times
•Same day results – mins to hours
•No need to come back for results
•Results sms-ed to client
•Follow up advice sms-ed to
client
•Save money – less transport
fees, less time away from work
etc.
•Data Collection
•Surveys
•Web & Mobile app based
information
•Web and mobile based Help from
HCW and medical professionals
•HCW Training and Education : HCW
Empowerment
•USSD Apps for men in rural areas –
e.g. USSD games and questionnaires
•Incentives: Free airtime, SMS
bundles and vouchers for medicine
•Assisting the poor with MHealth
medicine vouchers and free advice
•“Please Call Me” service
• Improved Health Seeking Behavior of Key Populations and
men in general in low and middle income countries
• Reduction in HIV acquisition and high risk behavior among
key population groups and subsequently the general
population
• Harm Reduction for PWUD or PWID
• Reduction in stigma and discrimination experienced by key
pops from especially HCW
• Measure success based on SF4Health metrics – cost
effectiveness, quality of services, equity, impact and user
uptake.
• Sustainable program that is scalable to be rolled out
Nationally and across borders
PROGRAMS
HIM HEALTH – men in key population groups
Our HIM program focuses specifically on male members of key populations. Men historically find it
difficult to seek health advice and care. Our aim is to improve health seeking behaviour and health
outcomes of men through research, outreach, information dissemination and social franchising
MAT - aimed at PWUD and PWID
MAT is our Harm Reduction spokesperson that represents
harm reduction as best available option for dependence on
drugs. Drug use contributes greatly to increased risk behaviour
among all populations groups.
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Needle and syringe programs (NSPs)
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Medically Assisted Treatment/Opioid substitution therapy
(OST) and other drug dependence treatment
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HIV testing and counselling
• Antiretroviral therapy
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Prevention and treatment of sexually transmitted infections
• Condom distribution programs for people who inject drugs and
their sexual partners
• Targeted information, education and communication for
people who inject drugs and their sexual partners
• Vaccination, diagnosis and treatment of viral hepatitis and HPV
• Prevention, diagnosis and treatment of tuberculosis
PROGRAMS
mHealth – MobiTech Gateway
With the support of our technology partners we create innovative technology to
bring health information to hard to reach populations and people in remote,
resource limited settings. We also develop mobile technology to ensure
community healthcare workers are empowered with knowledge at their fingertips.
Research
We aim to improve services rendered to PLWHA by involving ourselves in research focussed
on health seeking behaviour and social franchising of health.
Gateway health aims to develop a new model of social franchising for health aimed at men –
male sexual health centre and mobile clinics.
To have an effective social franchising we need more research on quality of services
rendered, cost effectiveness of services, equity and the impact we have on health outcomes.
More research is needed on the effect of social franchising on expansion of health services.
PROGRAMS
Key POPs – Home Testing
Home Testing for members of key pops with clear instructions, online or telephone
counselling. IEC on follow ups. “Please Call Me” Service. Advice to attened Express Labs for
further screening, and clinics for treatment and care.
Company Profile
Vision
Mission
• GHI reaches out to people
affected by HIV or at risk of
acquiring HIV, especially key
affected populations. We
aim to have a positive
impact on the healthseeking behaviour and
health outcomes of hard to
reach populations through
education, research,
innovative technology and
integrated healthcare
services
• To become a regional force in
delivering comprehensive health
care solutions to hard to reach
populations and those in low
resource settings by working with
our partners to ensure access to
information, the latest
technologies and integrated
healthcare services. Gateway is
committed to improve health
outcomes for communities we
serve and the delivery of
community-oriented, culturally
sensitive, and affordable health
care solutions throughout South
Africa and the region.
Values
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Quality
We strive for excellence in everything that we do and measure the quality of our programs and
services to enable us to learn and improve.
Cost Effectiveness
We ensure our services and programs are cost effective to enable the poorest of the poor to
benefit.
Zero stigma and Discrimination
We empathize with the needs of our clients and aim for a world free of any form of stigma and
discrimination. Our Health centres will be bias free zones
Innovation
To use the latest technologies available for the benefit of hard to reach and key affected
populations and to contribute to beating the global HIV pandemic.
Respect
We build honest and ethical relationships with each other, clients, their families and the community
by preserving individual dignity, supporting choices and valuing diversity.
Ethics
We ensure our services and programs are rendered in an ethical way, respecting privacy and
confidentiality and putting the patients right to autonomy first.
Equity
We will ensure that our services reach the poorest of the poor
Our Team
Dr Coenie Louw – Medical Director
With an MBChB and Dip HIV Management SA, Coenie has a passion for
HIV and TB and sexual health in general. He has 20 years experience as
medical practitioner, worked in the NGO field for more than 5 years, first
as Global Program Director and then as Country Director in SA for
LittleBigSouls International Charitable Foundation.
Coenie focuses on key affected populations especially MSM and People
Who Use Drugs. He is currently running the MAT drug awareness
campaign, is the founder of SANPUD (The South African Network of
People who Use Drugs) and is a member of the South African Addiction
Medicine Society, the HIV Clinicians Society and the International AIDS
Society ,as well as committee member for Africa at the Global
Breastfeeding Initiative of the UN.
OUR TEAM
Maggie Mogale – Program Director
As National Project Co-ordinator of the National Professional Teachers
Organisation of South Africa for the Prevention, Care and Treatment
Access (PCTA) Project and Project Director of the Education Labour
Relations Council (ELRC) Maggie has established herself as achiever in the
field of program management.
Maggie conducted HIV research, both quantitative and qualitative, as per
organisational needs. She was responsible for policy development and
executive decision-making and conducted the union’s Human RightsHIV/AIDS national and provincial workshops. She also actively researched
the latest developments in health and HIV/AIDS management. She
developed and implemented the organization’s public relations, marketing
and stakeholder management strategies.
Our Team
Pieter Fourie – Financial Director
With a BCom Financial Management, Pieter has 12 years’
experience in the financial field. He has been involved with the
ELRC-PCTA project that was funded by PEPFAR from 2007 – 2011.
He also worked as finance officer on several South African
Government Projects rolled out by the Department of Education.
He is currently the executive officer of NAPTOSA.
CONTACT US
www.gatewayhealthinstitute.org
Programs
[email protected]
MAT Campaign
[email protected]
@HIMHealth
© 2014 Gateway Health Institute NPC 2014/191675/08
•Reckitt Benckiser SA
•SA Medical Research Council – Drug and
Alcohol abuse program
•Cepheid
•Mobi Health Tech
•INPUD via SANPUD
•Rorotika Technologies
•Mashadane Research Center
•Drug Surveillance SA