ESTHER SUPPORT SYSTEM

Partners who are present

Chronology

ESTHER support in Mali began in September 2002. It was first oriented toward reinforcement of therapeutic reference site capacities in Bamako (Point G., Gabriel Touré Hospital, CESAC and INRSP), then at the provincial hospitals in Kayes and Sikasso. Beginning in 2005, ESTHER support extended to actions by Malian civil society organizations with the view to promoting comprehensive care and the sustainability of treatment. This community support system was from that time effective in the three ESTHER partner provinces. In 2007, support in the decentralised sites in the district (CSRef) was launched in the Bamako region and in 2008 in the Kayes and Sikasso regions.

At the end of 2008, the ESTHER Initiative was contributing to the treatment of 15,956 regularly monitored patients receiving ARV therapy, including 1,200 children.

In addition, ESTHER accompanied the setting up of a system to monitor a national cohort with the ESOPE software programme as well as the organization of a diagnostic and monitoring network for opportunistic infections and tuberculosis. The monitoring of a mother-child cohort was initiated in 2007 in the Paediatric Department of the Gabriel Touré Hospital in order to study the feasibility of improved care for mothers and a decrease in mother-child transmission. Since 2008, a project to support the CCSLS has accompanied the extension of paediatric treatment sites and the installation of a paediatric excellence site at the Gabriel Touré Hospital.

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.

- Training in the use of CD4 counters.

- Training in psychosocial counselling in partnership with Sida Info Service.

§ Psychosocial support of patients

- Reception and lodging centres.

- Culinary workshops.

- Counselling for voluntary detection.

- Visits to patients' homes.

- Consultations and therapeutic education clubs.

- Hospital reception services.

- Support of orphans (access to schooling, training for godmothers).

- Reinforcement of the institutional capacities of PLWHA associations.

§ Biology

- Continuous training in good laboratory and CD4 count practices.

- Training in the use of viral load and in PCR on dried blood spots (DBS)

- Support in reagents and equipment maintenance.

- Equipment support (CD4 counter at Gabriel Touré Hospital, Elisa chain at Sikasso Hospital).

§ Treatment of opportunistic infections

- Support for OI treatment at all sites supported by ESTHER and setting up of a network for a diagnostic and quality control system with the DEAP at the University of Bamako.

§ PMTCT/Paediatrics

- Monitoring of the mother-child cohort at the Gabriel Touré Hospital in Bamako.

- Reinforcement of paediatric treatment at Kayes and Sikasso Hospitals

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

- Support for the setting up of a circuit of PCR sampling on blotting paper.

§ Procurement and dispensing circuits

- Training at the CHMP (for handling of hazardous materials) for those responsible for the national pharmacy sector.

§ Support for the decentralisation of treatment

- 2 USACs in the urban zone (Communes 1 & 5 of Bamako)

- 4 CSRef in the rural zone (Kéniaba ib Kayes, Koutial, Kadiolo & Bougouni in Sikasso)

§ Support for the national system

- Setting up of computerised monitoring of patients (ESOPE) in connection with the national information system, training and support of the actors.

- Second phase of the ESTHER evaluation of Mali.

- Contribution to the organization of the Annual HIV Days in Bamako.

- Help in the creation of a national paediatric plan.

- Participation in symposiums on PMTCT.

- Participation in the work of the Regional Orientation Council of Sikasso (CROCEP).