ACHAP in partnership with Emory University empowered WASH Champions from 5CHAs from 5 African countries in Nairobi, Kenya

The Center for Global Safe Water, Sanitation, and Hygiene at Emory University (CGSW) developed an assessment tool to evaluate WASH conditions within health Care facilities in low- and middle-income countries. This tool is known as the WASH Conditions Assessment Tool.

The tool helps to do the following:

  • Develop a comprehensive overview of the status of WASH conditions, infrastructure and resources in a given HCF
  • Provide real-time data for information and prioritization of activities to improve WASH in HCF
  • Contributing to the evidence base for advocacy for WASH in HCF

ACHAP Secretariat in partnership with Emory University with support from Water lines USA hosted a training on WASH in Health facilities in the second week of June 2018 from 11th to 16th in Nairobi, Kenya . The training brought together participants from 5 CHAs (Christian Health Associations), members of ACHAP coming from 5 African countries such as Lesotho, Ghana, Zimbabwe, Uganda and Kenya.

Two-day gathering of CHAs-ACHAP members with IMA World Health team in Nairobi, Kenya

IMA World Health, ACHAP key partner organized a two-day gathering(29-30 May, 2018) in Nairobi. Kenya of more than 20 representatives from several country offices and partners from the Africa Christian Health Associations Platform. The goal was to build capacity in storytelling, photography and communications ethics and to create a support and sharing network among field and HQ communications staff.

The ACHAP’s Biennial Conference and General Assembly meeting in Yaoundé, Cameroon from February 25 to March 1, 2019

The ACHAP’s Biennial Conference and General Assembly meeting in Yaoundé, Cameroon from February 25 to March 1, 2019.

Theme: Re-Igniting Primary Health Care: The role of ACHAP.

In 1978, World Health Organization (WHO) collaborated with the World Council of Churches to formulate the Alma-Ata declaration, which affirmed Primary Health Care (PHC) as a vehicle to guaranteeing access to health care as a fundamental human right. The vision as interpreted intended to keep people healthy and productive within their communities. The assumption too was that a majority of the health needs of communities could be met within a well-functioning primary health care system that would guarantee access to quality affordable health services-promotive, preventive and curative services. Yet, to date, there are still fundamental gaps in providing access to affordable quality health services to needy populations.

Over the years, Christian faith-based health providers (FBHP)/CHAs, financed their health programmes and hospitals mainly by external assistance (medical supplies, medicines, missionary/expatriate medical staff, etc.), and to a limited extent out-of-pocket payment from patients, albeit heavily subsidized. However, due to changes in development paradigm, FBHPs/CHAs are facing dwindling or withdrawal of donor support for both capital and recurrent expenditure. This has culminated into a search for sustainable and alternative funding mechanisms to support the Church’s mission in health. These include, but not limited to, new models of health financing being experimented by some FBHPs. Given the need for financial sustainability of the Church in health, ACHAP needs to explore/appraise the feasibility of innovative financing models for PHC.

Historically, CHAs have always contributed significantly in responding to demographic and epidemiological transitions especially in fragile settings in sub-Sahara Africa. Hence, CHAs have always served as buffers of country health systems.  Therefore, in implementing PHC for UHC, the role of CHAs cannot be overemphasized.

Generally, the faith-based health systems, spearheaded by CHAs, are noted for innovations with potential assets that could be leveraged to optimize primary health services, deliver public value and complement national health systems. Accordingly, ACHAP recognizes the need for innovative partnerships, responsive and resilient health systems especially in re-engineering PHC towards achieving Universal Health Coverage/Sustainable Development Goals (UHC/SDGs).

Hence, the conference theme: Re-Igniting Primary Health Care: The role of ACHAP.

 

CHAN, The Christian Health Association of Nigeria , champion in HIV related Stigma and discrimination reduction among Health workers.

In Nigeria, there was legislation against stigma and discrimination towards people living with HIV (the Anti-discrimination Act, 2014) after a 2010 HIV stigma index survey by the Network of people living with HIV in Nigeria (NEPWHAN), however a follow up on study in 2015 still concluded that stigma and discrimination was still high ranging from 5.2% to 25.8%.

The effects of the foregoing is that there is low utilization of HIV services due to internalized stigma, lowered self-esteem, depression, and negative changes in behavior (e.g., not using the available services) because of the fear of stigma and discrimination at the community level and healthcare settings. People refuse or delay testing for HIV and to access healthcare services.

Need to engage and train health providers towards elimination of stigma and discrimination in Nigeria

Reports of unethical treatment of PLHIV in healthcare settings including HIV testing without consent, unauthorized disclosure and breaches of confidentiality, labeling, gossip, verbal harassment, differential treatment and even denial of treatment. They are evident. Healthcare Providers also experience stigma and discrimination. Hence, it has been established that healthcare providers delay from accessing healthcare services because of the fear of stigma and discrimination. Furthermore, the April 2017 issue of online Journal of medical science featured an article that placed prevalence rate of HIV/AIDS-related stigma among the health personnel in Nigeria at 15.4%. This is quite worrisome and hence stigma reduction seminars and workshops would go a long way toward mitigating this trend. Nigeria’s national strategy too is seeking to address this through strategic actions that include ensuring that health care institutions provide the information and support necessary to make sure health care workers have access to HIV prevention (Including the universal precautions needed for prevention of occupational transmission of HIV and PEP), as well as access to treatment and that they are protected from discrimination in their workplaces.

ACHAP working with CHAN to increase demand and increase retention for HIV Services by engaging health workers in selected areas in Nigeria

The reduction of the HIV/AIDS-related stigma and discrimination amongst healthcare providers will be helpful for not only the marginalized groups, PLHIV and their associates, but also for the healthcare providers themselves. With 60% of all new infections in Western and Central Africa occurring in Nigeria and only about half the adults living with HIV being on treatment, it is important to ensure that no barriers exist towards achieving the 90-90-90 targets.

ACHAP is working with Christian Health Association of Nigeria (CHAN) to create demand and increase retention for HIV services by engaging health workers in selected states of Nigeria (these states were identified among other reasons based on their HIV prevalence, being part of the fast track states, presence of CHAN member institutions with comprehensive HIV programs and adequate number of health care workers) working with 10% of the 358 member facilities of the CHAN network.

These states are as below:
Zone A: Benue state
ZONE B: Plateau and Kaduna states
Zone C: Oyo and Ogun states

TOTs – Training of trainers with health workers conducted by CHAN with the support of ACHAP in Nigeria

In the very beginning of July,2018 CHAN conducted a TOT with health workers on HIV protocols and stigma and discrimination with the following objectives towards eliminating stigma and discrimination in health care settings of the CHAN network by:

  1. Raising awareness on stigma and discrimination including in the context of rights for people living with HIV and the negative impact of stigma
  2. Supporting the enforcement of protocols and code of conduct (including the patient charter) that enhances patient rights and obligations at health facilities
  3. Support the enforcement of protocols and code of conduct that enhance the protection of health workers from occupational exposure to HIV

This will be achieved through developing a checklist for a stigma free facility environment and putting policies in place, having a code of conduct in place to guide HCW at workplace., conducting capacity-building programs for HCW to update their knowledge on HIV/AIDS, developing and action plan on S& D as well as putting on place a monitoring and evaluation program.
The training curriculum was adapted from other member UNAIDS, CHAs or from groups in Nigeria that have worked on stigma and discrimination. A pre and post-test questionnaire was also administered to the trainees.

Religious leaders included with the help of NINERELA

It is important to recognize the influence that religious leaders have on communities. For this reason therefore, as part of ensuring that communities are receptive to the renewed effort and commitment by health workers to reduced stigma and discrimination, CHAN is working with NINERELA, to sensitize religious leaders around targeted health facilities to mobilize their communities to access care. Capacity building workshops will be held with the religious leaders to sensitize them on stigma and discrimination. It is hoped that the religious leaders will speak out and work in collaboration with the CHAN health facilities to encourage access to testing as well as care and treatment.