Solthis Therapeutic Solidarity and Initiatives for Health

NIGERFighting HEPATITISFighting HIV / AIDS

Context :

Niger has a concentrated HIV epidemic among certain population groups, with low prevalence in the general population. According to data collected in 2020 by Spectrum, the prevalence rate is estimated at 0.23%, with a declining trend over the past five years. AIDS-related mortality has fallen from 7.77 per 100,000 unhabitants in 2015 to 5.25 in 2019 (Spectrum 2020 data). Factors that contribute to this mortality include: delayed treatment, difficulties in accessing health services due to distance and stigmatisation of people living with HIV and AIDS. According to the 2019 second generation Integrated Bio-Behavioural Study (IBBS), the HIV epidemic in Niger remains concentrated among certain key populations, namely sex workers, men who have sex with men and prisoners.

A relatively young structure, the he National AIDS and Hepatitis Control Programme (PNLSH), in charge of the fight against AIDS at the national level, is facing difficulties related to

• Insufficient HR in terms of numbers and quality, particularly in relation to the departure of people in key positions, vacancies, and the recent assumption of duties by key professionals in the Programme;
• A need to (re)implement technical and organisational processes and tools, to review the distribution of roles and responsibilities within the team and the modes of collaboration and coordination between the services that make up the PNLSH.
• Major challenges in the quality of care (changes in therapeutic lines), data (active files, monitoring of stocks) requiring close monitoring by the Care and Evaluation departments.
• Other more recent difficulties related to errors in the HIV inputs ordered.

The PNLSH requested technical support from Solthis to strengthen its capacity to manage, monitor and improve the quality of the HIV/AIDS response in Niger.

General objective of the mission: To strengthen the capacities of the PNLSH to manage, monitor and improve the quality of the response to HIV/AIDS in Niger.

Specific objectives :

• OS1: Support the PNLSH in the development of its transition plan for the migration of the active file of PLHIV towards the new therapeutic regimens recommended by the WHO;
• OS2: Strengthen the capacity of the NACP to control the national active file of PLHIV and monitor the application of national therapeutic guidelines;
• SO3: Support the development of the toolkit associated with the new national HIV guidelines and its appropriation by the actors in the HIV response.

Expected results :

• The PNLSH is implementing and monitoring its transition plan to the new treatment regimens (adults and children), adapted to the context of antiretroviral supplies in Niger
• The PNLSH has put in place its mechanism for updating the active file of PLWHA and ensures regular monitoring of the application of therapeutic lines;
• The NACP has tools to facilitate the implementation of the new guidelines for the care of PLHIV;
• The NACP has trained HIV response actors (medical, para-medical and community) on the new national HIV guidelines and associated tools.

In order to ensure the sustainability of the results of the mission and the ownership of the deliverables by the PNLSH, the team of experts will have to pay particular attention to capacity building throughout the mission. Training and joint elaboration of deliverables with progressive empowerment of the beneficiary are encouraged. The team of experts will have to propose a methodological approach along these lines in its terms of reference, which will be discussed and validated with Expertise France and the PNLSH.