Solthis Therapeutic Solidarity and Initiatives for Health

NIGERCAPACITY BUILDINGFighting HEPATITISFighting HIV / AIDSFighting tuberculosisImprove the health of children in Africa

Context

Despite the intensification of Prevention of Mother-to-Child Transmission (PMTCT) interventions in Niger, major challenges remain in ensuring that women living with HIV are screened and cared for, and that their children are regularly monitored up to the age of 18 months in the 1,115 health facilities offering PMTCT services in Niger. As part of its efforts to improve its performance framework in terms of PMTCT indicators, Niger has received funding from the Strategic Initiative for Differentiated Delivery (DSD) through the provision of technical assistance from Solthis in 2023 to address shortcomings in the screening and treatment of HIV/syphilis-positive pregnant women and HIV-exposed children. This first phase of technical assistance helped to improve the performance of PMTCT indicators at 33 sites in 18 health districts in 5 priority regions of Niger, by training providers and regional focal points, setting up a coaching system and providing regular support for the players involved. In view of the positive results of the first phase, the PNLSH has asked Solthis to continue its support for 2024 in the first 33 pilot CSI sites as part of a second phase, and will also be scaling up in 42 new sites, giving a total of 75 priority sites in 5 regions of the country.

General objective

Support for improved HIV/AIDS and syphilis screening and care for exposed pregnant women and newborns in 75 PMTCT sites in 5 regions of Niger.

Specific objectives

• SO1: Strengthen the technical capacity of service providers and district focal points to offer differentiated screening services for pregnant women in the 75 priority sites. 
• SO2: Improve treatment for women diagnosed as HIV-positive (HIV-Syphilis-HVB) during pregnancy in the 75 priority sites.
• SO3: Improve the quality of monitoring of PMTCT activities by strengthening regional and district players in the 75 priority sites.
• SO4: Create a framework for reviewing PMTCT performance at both regional and national levels, involving all those involved in preventing mother-to-child transmission of HIV/Syphilis and HVB, in order to enable scaling-up.

Planned Activities

• Exploratory fact-finding mission on the obstacles to screening and treatment in 2 health districts (Tahoua and Maradi) despite the availability of inputs, in collaboration with the LASDEL research laboratory.
• Identification of focal points in the new health districts.
• Identification of new providers at PMTCT sites involved in childbirth and post-natal monitoring of infants (2 people per IHC, i.e. 75×2= 154 people).
• Training of focal points in coaching and differentiated service provision (1 wave of 3-day training for the 33 coaches).
• Training of PMTCT site providers in the provision of differentiated services in the context of PMTCT (3 waves of 3-day training for 25 PMTCT CSI providers).
• Review and validation of the new simplified coaches’ roadmap.
• Regular monthly coaching (for the first 3 months) then quarterly (from Q2 onwards) by mentors for the 42 new healthcare providers, following a needs assessment and as part of a roadmap drawn up jointly (1 visit per month for the first 6 months).
• Regular quarterly coaching by mentors for the 33 former sites, as part of a simplified roadmap drawn up jointly.
• Refresher training for site coaches and service providers following difficulties encountered during the first 6 months of operation (33 coaches and 75 service providers for 2 days).
• Provision of information-gathering aids (registers and other needs to be identified) for 42 CSIs in 5 regions.
• Six-monthly formative supervision from the central level to the sites.
• Bimonthly supply meeting with the PNLSH GAS team.
• Quarterly performance review meeting of targeted sites under supervision at regional level under the supervision of regional HIV/syphilis/HVB coordinators, regional pharmacists with support from central level and SPIS.
• Annual performance review of PMTCT indicators at national level under the supervision of the PNLSH.