In all, 12 hospital twinning sites and 2 networks of 18 associations were supported by ESTHER in 2008.

Partners who are present

Chronology

In Benin, ESTHER took over from FSTI (1999-2000) and the FFO (2001) who had initiated a programme for the treatment of 400 PLWHA within the framework of the Beninois Initiative for Access to ARV therapy (IBAARV). In August 2002, an agreement was signed between the French and Beninois Health Ministers thereby opening ESTHER twinnings in the southern region (Cotonou and Porto-Novo). These twinnings were then extended to the central and northern regions of the country.

Beginning in 2005, ESTHER operations, beyond its own activities, have been characterised by an agreement signed with the Global Fund and the UNDP (Principal Recipient of funds for Benin until 2006). This agreement dealt with the support, monitoring and evaluation of the implementation of actions financed by the Global Fund: training for care providers and ARV prescribers and mediators, support for a higher scale of access to ARV therapy and support of people receiving treatment. Social and psychological support was therefore entirely organized on a national level with ESTHER support. Beyond mentorship, ESTHER network experts were mobilised for training, monitoring and organization of association, mediator and community activities not only for ESTHER sites but also for other national treatment and care sites.

Twelve hospital twinning sites have been developed. Two association networks (9 associations in each network) have been financed since 2006. ESTHER initiated training for trainers in Benin: the transfer of competences therefore began between sites. In 2008, support at certain decentralised sites was launched in the central (Lokossa, Abomey, Davougon, Gohomey, Pobé) and northern (Parakou) regions of the country.

At the end of June 2008, the ESTHER Initiative was contributing to the treatment of 6,110 regularly monitored patients receiving ARV therapy including 529 children (or nearly 60% of the total adult beneficiaries in the country).

MAJOR ACTIVITIES IN 2008

§ Reinforcement of the capacities of those who provide care and support

- Training in the prescription and dispensing of ARV.

- Training in the diagnosis and treatment of OI.

- Training in paediatric treatment and PMTCT.

- Training in therapeutic education and adherence.

- Training in hospital hygiene and good paramedical practices.

- Internships in France and South-South Internships principally in Côte d´Ivoire for PMTCT/paediatric internships.

§ Psychosocial support of patients

- Support of 25 mediators compensated by ESTHER, working at the 12 ESTHER sites (pre and post-test counselling, promotion of adherence, patient orientation).

- Economic support (microcredit) of PLWHA through the promotion of revenue-generating activities.

- Transport and analysis financial support for indigent patients.

- Nutritional guidance.

- Care for orphans and vulnerable children (OVC).

§ Consultations to aid adherence and therapeutic education

- Creation of a therapeutic education and adherence aid file that is common to all sites supported by ESTHER.

- First Scientific Days on adherence and full-time employees (FTE) organized by the Paediatric Department of the HIA (Army Teaching Hospital) in September 2008, gathering ESTHER sites to evaluate and exchange information on the state of practice in Benin.

- Mentorship mission with French partners.

- 3 FTE training courses (28 people trained by the Louis Pasteur Clinic).

§ Biology - virology

- Recommendations for equipment reorganization and purchase.

- Financial support for the operation of a laboratory (generator).

- Collection of viral load samples in the outlying regions.

- Reagent support and device maintenance.

- Equipment support (CD4 counter at the Davougon Centre, CHD-O biochemical automation, spectrophotometer in Gohomey).

- Training of laboratory technicians (CHD Parakou).

- Internship in France for the reference laboratory manager.

§ Monitoring and evaluation

- Initial and complementary training on ESOPE software.

- Installation of the new version of the software (in the network).

- ESOPE supervision missions organized at partner sites.

- 1 reinforcement mission for Beninois trainers in Mali.

§ PMTCT/Paediatrics

- Support for PMTCT/paediatric activities: in situ training of personnel, convoying of samples, financing of milk suitable for infants.

- Support for the setting up of a national paediatric plan (partnership with the Clinton Foundation).

- Internships in paediatrics/PMTCT (in France and in Côte d´Ivoire) and reception of interns from the sub-region.

§ Central Medicine Procurement and Supply (CMPS)

- Technical assistance for CMPS (response to a tender from the Global Fund, 2^nd quarter 2007): validation of the procurement centre as sub-beneficiary of GF (Autumn 2008).

- Drawing up of the PSM plan (Procurement and Supply Management) for the 2^nd phase of GF Round 5, September 2008 (contract with UGFM).

- Software for the management of medicines.

§ Support in the decentralisation of treatment

- Support for outlying treatment sites.

§ Support for the national system

- Financial support for the Cours Ouidah (attribution of scholarships), North partners involved in the curriculum.

- Development of ESOPE as a tool for national monitoring and evaluation (under discussion).