Cargando…

Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19

INTRODUCTION: The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fr...

Descripción completa

Detalles Bibliográficos
Autores principales: Omam, Lundi-Anne, Jarman, Elizabeth, Ekokobe, Wilfred, Evon, Agbor, Omam, Esther Njomo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669421/
https://www.ncbi.nlm.nih.gov/pubmed/34906187
http://dx.doi.org/10.1186/s13031-021-00427-9
_version_ 1784614776690704384
author Omam, Lundi-Anne
Jarman, Elizabeth
Ekokobe, Wilfred
Evon, Agbor
Omam, Esther Njomo
author_facet Omam, Lundi-Anne
Jarman, Elizabeth
Ekokobe, Wilfred
Evon, Agbor
Omam, Esther Njomo
author_sort Omam, Lundi-Anne
collection PubMed
description INTRODUCTION: The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fragile and conflict-affected settings. Since 2016, more than 680,000 Cameroonians have been internally displaced due to the conflict in the North West and South West regions (NWSW). This conflict has impacted on the health system with numerous attacks on health facilities and staff, reducing access to health care for internally displaced persons. The outbreak of COVID-19 further reduced humanitarian responses for fear of spreading COVID-19. Mobile clinics were utilized as a model of care in piloting DSD for HIV in conflict-affected settings within the COVID-19 context. METHODS: The HIV DSD framework was used to evaluate a project that used mobile clinics in 05 divisions across the NWSW to provide primary health care to internally displaced persons in hard-to-reach areas. These mobile clinics were operated in the COVID-19 context and integrated HIV services in the benefit package. The mobile clinics mainstreamed HIV and COVID-19 sensitization during community mobilization, HIV consultations, HIV testing and referrals, and in some cases antiretroviral (ARV) dispensation. The project ran from March to October 2020. The results from the evaluation of this model of HIV care delivery were analysed in 06 of 08 mobile clinics. RESULTS: In 07 months, a total of 14,623 persons living in conflict-affected settings were sensitized on HIV, 1979 received HIV testing from which 122 were positive and 33 placed on ARVs. 28 loss-to-follow up people living with HIV were relinked to treatment and 209 consultations for persons living with HIV were conducted. Despite the good collaboration at regional and field level, there was distrust by ARV centers for humanitarian organizations. CONCLUSION: Mobile clinics are a model of care which could be leveraged in fragile and conflict-affected settings as an alternative model of care for HIV DSD to ensure continuum of HIV care and treatment. However this should be integrated within the benefit package of primary health care services offered by mobile clinics.
format Online
Article
Text
id pubmed-8669421
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-86694212021-12-14 Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19 Omam, Lundi-Anne Jarman, Elizabeth Ekokobe, Wilfred Evon, Agbor Omam, Esther Njomo Confl Health Research in Practice INTRODUCTION: The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fragile and conflict-affected settings. Since 2016, more than 680,000 Cameroonians have been internally displaced due to the conflict in the North West and South West regions (NWSW). This conflict has impacted on the health system with numerous attacks on health facilities and staff, reducing access to health care for internally displaced persons. The outbreak of COVID-19 further reduced humanitarian responses for fear of spreading COVID-19. Mobile clinics were utilized as a model of care in piloting DSD for HIV in conflict-affected settings within the COVID-19 context. METHODS: The HIV DSD framework was used to evaluate a project that used mobile clinics in 05 divisions across the NWSW to provide primary health care to internally displaced persons in hard-to-reach areas. These mobile clinics were operated in the COVID-19 context and integrated HIV services in the benefit package. The mobile clinics mainstreamed HIV and COVID-19 sensitization during community mobilization, HIV consultations, HIV testing and referrals, and in some cases antiretroviral (ARV) dispensation. The project ran from March to October 2020. The results from the evaluation of this model of HIV care delivery were analysed in 06 of 08 mobile clinics. RESULTS: In 07 months, a total of 14,623 persons living in conflict-affected settings were sensitized on HIV, 1979 received HIV testing from which 122 were positive and 33 placed on ARVs. 28 loss-to-follow up people living with HIV were relinked to treatment and 209 consultations for persons living with HIV were conducted. Despite the good collaboration at regional and field level, there was distrust by ARV centers for humanitarian organizations. CONCLUSION: Mobile clinics are a model of care which could be leveraged in fragile and conflict-affected settings as an alternative model of care for HIV DSD to ensure continuum of HIV care and treatment. However this should be integrated within the benefit package of primary health care services offered by mobile clinics. BioMed Central 2021-12-14 /pmc/articles/PMC8669421/ /pubmed/34906187 http://dx.doi.org/10.1186/s13031-021-00427-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research in Practice
Omam, Lundi-Anne
Jarman, Elizabeth
Ekokobe, Wilfred
Evon, Agbor
Omam, Esther Njomo
Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title_full Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title_fullStr Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title_full_unstemmed Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title_short Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
title_sort mobile clinics in conflict-affected communities of north west and south west regions of cameroon: an alternative option for differentiated delivery service for internally displaced persons during covid-19
topic Research in Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669421/
https://www.ncbi.nlm.nih.gov/pubmed/34906187
http://dx.doi.org/10.1186/s13031-021-00427-9
work_keys_str_mv AT omamlundianne mobileclinicsinconflictaffectedcommunitiesofnorthwestandsouthwestregionsofcameroonanalternativeoptionfordifferentiateddeliveryserviceforinternallydisplacedpersonsduringcovid19
AT jarmanelizabeth mobileclinicsinconflictaffectedcommunitiesofnorthwestandsouthwestregionsofcameroonanalternativeoptionfordifferentiateddeliveryserviceforinternallydisplacedpersonsduringcovid19
AT ekokobewilfred mobileclinicsinconflictaffectedcommunitiesofnorthwestandsouthwestregionsofcameroonanalternativeoptionfordifferentiateddeliveryserviceforinternallydisplacedpersonsduringcovid19
AT evonagbor mobileclinicsinconflictaffectedcommunitiesofnorthwestandsouthwestregionsofcameroonanalternativeoptionfordifferentiateddeliveryserviceforinternallydisplacedpersonsduringcovid19
AT omamesthernjomo mobileclinicsinconflictaffectedcommunitiesofnorthwestandsouthwestregionsofcameroonanalternativeoptionfordifferentiateddeliveryserviceforinternallydisplacedpersonsduringcovid19