Solthis has been active in Guinea since 2008, at the request of Guinean authorities. Solthis operations in Guinea are helping to improve patient care through capacity building and decentralization of care delivery in the battle against tuberculosis, HIV/AIDS, malaria, Ebola and mother-to-child transmission.
Population (millions)
11,8
Life expectancy at birth
56,1
HDI rank
179
Fertility rate
5
Infant mortality per 1,000 births
101
Number of physicians per 10,000 population
1
Total health expenditures
6 %
UNDP, 2014 Human Development Report
Health priorities
Infectious and parasite-vectored diseases, especially malaria, respiratory infections, diarrheic diseases, tuberculosis and HIV/AIDS remain the leading causes of death. Young children and pregnant women are the populations most affected by these diseases.
Starting in December 2013, Guinea had to cope with the Ebola epidemic that triggered a major health crisis, which revealed the weaknesses in the country's health system. The disorganization of all health services had a serious impact on access to care for everyone. In particular, continuity of care for people with chronic diseases such as HIV was severely disrupted.
Operational context
Started: 2008
Main partners: PNPCSP (national health care and STD/HIV/AIDS prevention program, under the Ministry of Public Health) and CNLS (national committee to battle AIDS)
45 sites supported: for the health information system (HIS), including 21 sites for the medical and infection prevention component (focused on Ebola)
Team: 20 health professionals, including 13 nationals
8 main areas of operation: Conakry and the Boké, Labé, Mamou, Faranah, Kankan, N’Zérékoré and Kindia regions
In 2008, Guinean authorities approached Solthis to guide them in extending public healthcare delivery to patients infected with HIV/AIDS. Since then, the goal has been to improve access to quality care for all patients by strengthening national agencies and decentralizing care to expand access to antiretroviral treatment via new health structures in Conakry and Boké, and by fostering better coordination of care delivery for seropositive patients.
2008-2013: Improved care in the Donka and Ignace Deen national hospitals in Conakry and Boké regional hospital; decentralization of care to eight new sites in the Conakry and Boké regions; technical assistance for supply management and upgrading the health information system
2013-2016: Implementation of the CASSIS (capacity for access to care and the health information system) project and continued decentralization of care in nine new sites, plus support for the health information system at all HIV treatment sites in the country
Presentation of the poster "Low retention of patients in antiretroviral treatment during recent Ebola outbreak in Conakry" during the International AIDS Conference 2016 in Durban Dowload the poster En savoir plus sur la IAS
JIKI TRIAL – Favipiravir Ebola Guinea – Publication in PLOSmedicine
The INSERM and other partners of the JIKI trial, among which Alima, Doctors w/borders, the Red Cross published a research paper in PLOSmedicine : see this publication The JIKI clinical trial seeked to test the effectiveness of Favirapir among people infected with the Ebola virus in Guinea. Solthis is pleased to have been able to participate in a modest degree to this project by facilitating the achievement of this trial on the spot through its team based in Conakry.
“Managing Risk in Fragile States: Putting Health First!
Optimising the Efficiency of the Global Fund's Grants”
This evidence-based report is the result of a work over several months, including 4 missions (Guinea, Mali, Niger and Sierra Leone) and interviews with 140 stakeholders. Through this work, we identified bottlenecks in the implementation of the Global Fund's grants in the field, showing that the Global Fund's Risk Management Policy is not well-adapted to fragile states. The additional safeguard measures which have been put in place by the Secretariat after the investigations of the Office of the Inspector General were meant to mitigate the financial risks and to reassure donors. However, experiences in challenging operating environments clearly show that these measures are mainly focused on financial risks and have caused significant malfunctions that jeopardise both the impact and the sustainability of the programmes. In order to make progress and to cope with the challenges specific to fragile states, we think it is now time for the Board members and the donors of the Global Fund to opt for an ambitious and innovative policy, which would put financial risk at its proper place: behind risks to public health. The main recommendations we are addressing in the report aim to place the public health risk at the centre of the mechanism, by:
Improving the balance between the analysis and the management of the different risks.
Simplifying and clarifying the control procedures: limit the number of contractors and the levels of validation.
Defining indicators or objectives for terminating additional safeguard measures to encourage appropriation and capacity building.
Investigating the possibility of an increased presence of the Global Fund in the field, by missions of several weeks or several months.
Adapting the indicators and procedures of performance-based funding and accountability measures to fragile states.
Analyse des enjeux d’un partenariat public/privé (PPP) en matière de prise en charge du VIH/Sida. Etude de cas dans la région minière de Boké (République de Guinée)
Prof. C. Katlama, Prof. G. Brücker et S. Calmettes
On the occasion of its General Assembly, Solthis held Wednesday, July 6 at the Pitié-Salpêtrière, the 4th day meeting. Teams Solthis and partners in the field were present, especially from Mali, Guinea, Niger and Haiti. The presentations are available below on this page.
HIV testing: a challenge?
Y. Yazdanpanah, F. Huber, R. Tubiana, M. Idé
At the "Test and Treat", screening is an important theme in African contexts, as in Western countries. Also, the first workshop of the Scientific Day Solthis it was dedicated, moderated by Dr. M. Ide (Niger) and Dr. R. Tubiana (Paris). In his introduction, Dr. F. Huber (Solthis) presented the technical aspects of "rapid tests" raising the question of the limits of these tests, and the problem of lack of due process and the frequent inability to meet the temperature conditions recommended by the suppliers. This presentation was followed by a review of different screening strategies and the historical evolution of paradigms: the screening called "voluntary" to "provider-initiated testing for carers" as advocated by WHO and the various authorities health. Aspects of "cost effectiveness" of screening were then analyzed by Prof. Y. Yazdanpanah (Tourcoing). Dr. F. Lamontagne (Solthis Guinea) and Prof. M. Cisse (Guinea) have supported these statements by the West African experiences Solthis on screening in the care environment "opt out". If this type of screening "at the initiative of the caregiver" has made great advances in PMTCT or in tuberculosis centers, much remains to be done in other departments of medicine, where a high proportion of patients is not detected, not supported. Mobilization on this issue is more strategic than ever.
Despite the investment of Solthis on supply issues (ARV, all health products ...), stock-outs, especially for ARVs, are still common in the field and directly threaten the health of patients. The session dedicated to these issues was conducted by two doctors Dr. B. Diallo (Mali) and Dr. PM Girard (Paris). E. Guillard (Solthis Pharmacy Manager) said the overall functioning of the supply before presenting the main causes that lead to situations of stockouts. The threat of disruption of Guinea in February 2011 was taken as an example to highlight the failures at different levels of decision making. Teams in the field of pharmacy Solthis and their partners then described their daily actions, emphasizing the mode of intervention or Solthis tools developed together, such as coordinating groups and committees for monitoring supplies, tables edge compilation, analysis, alerting, quantification tools ... Finally, J. Langlois (Sidaction) and F. Foguito (TAW), representing civil society, concluded the session by the role of associations to fight against breakage, and more widely to improve the quality of care.
Prof. V. Calvez (Pitié-Salpêtrière, Paris) presented the situation of primary resistance throughout the world, before recalling the consequences attributable to virological choice of first-line treatments. He raised the problem of low genetic barrier of molecules commonly used in countries with limited resources (especially NNRTIs), especially when access to viral load is small or nonexistent.
This session, moderated by Prof. M. Cisse (Guinea) and Dr. G. Breton (Paris), addressed the issue of retention of patient care in the circuit, through various initiatives. After a general introduction of G. Lurton (Solthis), Dr. M. Ide (National Hospital of Niamey) lamented the difficulties of long-term monitoring of HIV patients in Niger, based on the experiences of ambulatory treatment center and day hospital in Niamey. The experience of Medecins du Monde, supporting marginalized populations in integrated centers in Asia, was reported by Dr. N. Luhman. Finally, Dr. Claude Pean, Haitian Institute Pereo Fame, introduced the operation of the center of Port-au-Prince, who has built an international program based on improving the encrypted performance.
High prevalence of transmitted drug resistance in HIV-1-infected Antiretroviral-naïve Patients from Conakry, Guinea ConakryAuthor(s) : M. Diakite, C. Charptentier, P. Bellecave, M. Cisse, G. Peytavin, B. Djoudalbaye, L. Pizarro, C. Katlama, F. Huber, B. Masquelier, D. Descamps
Evolution de la prise en charge du VIH à Ségou entre 2003 et 2009 Author(s) : L. Diakité, D. Katilé, , N. Diallo, A. Doumbia, MS. Koné, B. Coulibaly, A. Sidibé, Y. Coulibaly, A. Akondé, G. Lurton, F. Huber Download the presentationEvaluation de la mise en place du dépistage et de la prise en charge du VIH au centre antituberculeux Carrière, à Conakry (Guinée) Author(s) : LM. Camara, B. Bah, D. Touré, P. Kourouma, L. Hajouji, C. Katlama, F. Huber, O. Sow Download the presentationDélégation de la prescription des antirétroviraux aux paramédicaux dans la PTME à Ségou (Mali) Author(s) :A. Doumbia, A. Sidibé, AT. Traoré, A. Akondé, F.Z.T. Sangaré, DC. Traoré, M. Maiga, AM. Soumaré, F.D. Cissé, SD. Naman, G. Lurton, C. Katlama, F. Huber Download the presentationCharge virale en routine dans un pays à ressources limitées : le cas du Niger Author(s) : Dr Hanki, H. Yahayé, S. Mamadou, I. Aboubacar, R. Ali Maazou, I. Dillé, C. Dézé, S. Diallo, F. Huber, M. Amadou, F. Maïga Download the presentationL'épidémiologie des perdus de vue dans les programmes VIH/SIDA Author(s) : E. Poulet, M. Pujades-Rodriguez Download the presentationL'approche anthropologique des ruptures de suivi médical des personnes vivant avec le VIH : l'exemple de Kayes (Mali) Author(s) : S. Carillon, V. Petit Download the presentationLes patients sous ARV perdus de vue : l'expérience de l'ONG WALE Author(s) : D. KatiléDownload the presentation
Analyse de la situation de la santé maternelle et infantile dans les centres de santé pour l’introduction de la PTME en Guinée
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