ESTHER in COTE D'IVOIRE

ESTHER SUPPORT SYSTEM

Partners who are present

ABIDJAN

SASSANDRA

DABOU

COTE D´IVOIRE

CEPREF at the FSU in Yopougon

Port Bouet General Hospital

Abidjan Association Network (Yopougon)

CeDReS (CHU Treichville laboratory)

Abidjan Prison

FRANCE

ISPED, University of Bordeaux

and

CHU Bordeaux (from the end of 2007)

APHP Necker

CHU Bordeaux (Gradigan-Bordeaux Prison)

COTE D´IVOIRE

Sassandra General Hospital

10 outlying health centres

Sassandra Association Network

FRANCE

Annecy Hospital Centre

COTE D´IVOIRE

Protestant Hospital of Dabou

Dabou General Hospital and outlying health centres

FRANCE

Vannes Hospital Centre

Chronology

The FSTI was initiated by President Jacques Chirac and Bernard Kouchner, Health Secretary of State at the time, during the 10th International Conference on Aids and STD in Africa in Abidjan in December 1997. Until 2002, the FSTI was significantly involved in Côte d´Ivoire in numerous initiatives including the supplying of ARV and participation in a pilot project for prevention of mother-to-child HIV transmission (PMTCT). The ESTHER Initiative took over from the FSTI on April 14, 2004, the date the Administrative Arrangement was signed between the two Health Ministries. New partnerships have been created on the basis of former cooperation relations between the CePReF and the ISPED of Bordeaux, the Protestant Hospital of Dabou and the Vannes Hospital, the Department of Infectious Diseases at CHU Treichville and Gonesse Hospital, Sassandra Hospital and Annecy Hospital.

Since then, given the continuing unstable situation in the country, the activities supported by ESTHER have been conducted by the principal Ivoirian NGO partner-operator ACONDA-VS-CI. This collaboration has made it possible to set up treatment sites and reference centres for the treatment and care of PLWHA in Dabou, Sassandra and Yopougon.

Beginning in 2007, exchanges between French and Ivoirian hospital partners could resume and new inter-hospital cooperation through ESTHER was initiated:

§ In March 2007, a joint hospital project between Port Bouet Hospital and CHU Bordeaux;

§ In the second semester of 2008, 2 new projects were initiated: a partnership between the CeDReS Laboratory at the CHU Treichville and the laboratory at the APHP Necker (support for decentralisation of paediatric treatment and care) and a second project on prevention and treatment in prison through a twinning of the Abidjan Prison (MACA) Infirmary, CHU Bordeaux and the Bordeaux Prison Dispensary.

Two association networks made up of four associations in Abidjan and two in Sassandra ensure the continuity of care with a view to setting up a treatment platform.

At the end of June 2008, the ESTHER Initiative was contributing to the monitoring of 12,050 PLWHA and 7,543 patients receiving ARV therapy including 590 children.

MAJOR ACTIVITIES IN 2008

§ Training patient care

- 302 health and community care providers trained locally or abroad: including 41 people trained in nutrition, 17 in scientific communication, 20 in the management and dispensing of medicines, 42 (multi-sites) in the management of care provider "burnout", approximately 60 people in hygiene and exposure accidents.

- MACA Prison: training of 29 people in care and 31 prison educators.

- 5 care providers trained in the university certificate programme, 5 trained in practical internships in French hospitals. And 57 association members trained in associative life and working in a network as well as managing activities that generate income.

§ Reinforcement of the technical platform

- Finalisation of equipping the laboratory at the Port Boué General Hospital.

- Equipping 11 health structures in minor laboratory equipment within the framework of the decentralisation of care in rural zones (Sassandra and Dabou).

§ Support in the decentralisation of care

- Sassandra District: 5 peripheral centres and in the Dabou District: 6 health centres (equipment, training, detection, PMTCT...)

- Yopougon Quarter (Abidjan), devolution of activities conducted at the CEPREF Centre with the creation of a treatment network with 6 other health structures in the quarter.

§ Voluntary Detection Centre in Sassandra

Operations support.

§ Support for civil society organizations, PLWHA associations and links with treatment structures:

- Nutritional support, activities that generate income, counselling for PMTCT, legal counselling, reception of patients in transit, promotion of the availability of care.

§ Supply and dispensing circuits

- Training of pharmacists and pharmacy managers in the dispensing of ARV in collaboration with REMED and PSP (National Purchasing Centre).

§ Support for decentralisation

- CeDReS Laboratory at CHU Treichville (virological monitoring and early diagnosis in children).

- MACA: prevention, detection and treatment in prison (HIV/TB).

§ Institutional support

- In collaboration with the Johns Hopkins University and connection with the PNPEC, ESTHER developed a National Directory of Treatment Centres, Detection Centres and PMTCT Centres published at the end of 2007.

- Participation in the drawing up of a proposal for Round 8 of the Global Fund entitled "treatment of HIV in prisons".

2008 IN NUMBERS

17 outlying sites supported within the framework of the decentralisation of activities (Dabou, Sassandra and the Yopougon Quarter).

2 new projects launched in 2008 (CeDReS at CHU Treichville and MACA Prison).

9 mentorship missions with partners from the North.
 
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