HIV Peer Mentors in Morogoro

As coverage of HIV prevention, care and treatment services expands and programs mature, greater attention is being paid to strengthening the capacity of health systems to provide and sustain high quality HIV and AIDS services, including antiretroviral therapy (ART), prevention of mother-to-child transmission (PMTCT), voluntary medical male circumcision (VMMC), HIV counseling and testing, integration of HIV services with other clinical services, home-based care and community support, injection safety, and medical waste management.

Improvement methods help HIV and AIDS programs to: 1) provide services for all who need them, 2) retain all those who access services in the continuum of care, and 3) achieve optimal health outcomes for all those who are retained in care.  Strategies to improve coverage of HIV-infected mothers by PMTCT services, especially in antenatal care and at delivery, and improve the follow-up of mother-baby pairs can maximize the uptake of PMTCT services and promote HIV-free survival by assuring that all eligible infants and mothers get needed PMTCT services.  Adult treatment, care, and support can be improved by applying a chronic care model to service delivery and strengthening linkages with community and home-based care.

Avoiding the word “HIV” to bring women in for testing – a good strategy?

Kim Ethier Stover

Senior Improvement Advisor, USAID ASSIST Project/URC

I recently took a trip to Mozambique to gather learning around the Partnership for HIV-Free Survival's (PHFS) Community Demonstration Project, led by ASSIST. In Gaza Province in Mozambique, we worked with three health facilities, Licilo, Chissano, and Incaia, and their catchment communities. I had the opportunity to meet with community groups participating in the project, bairro (community) improvement teams and Health Committees, consisting of bairro improvement team representatives, at the Health Centers.

A health worker's perspective on improving PMTCT services through a community-based system in Mozambique

Percina Paulo Mathe

Maternal and Child Health Nurse, Licilo Health Post/Mozambique

The following blog is written by Percina Paulo Mathe, a health worker in Mozambique,and was originally published in January. ASSIST is highlighting Percina's story as as part of World Health Worker Week (April 6-10). The original Portuguese entry is below the English translation.

My name is Percina Paulo Mathe, I’m a 32-year-old maternal and child health nurse in Licilo in Gaza Province, Mozambique.

After my training on PMTCT, I found it was hard to apply it in my community because there were many barriers to the community approach. For example, often all the information about a patient stayed within the hospital without being passed on to those in their own community or neighborhood who could support the patient. Language was also a barrier; sometimes topics were not explained in the hospital in the same terms as in the community, whereas using a common language would increase what is truly understood by the patient and the community, taking into account the rumors that exist in the community.  For me such incomplete communication was like trying to fight a poisonous tree by just cutting off some branches; leaving the trunk and the roots means that when the rain comes, the tree will just grow back.

There is no end to education

Faith Mwangi-Powell

Chief of Party, Kenya, USAID ASSIST Project/URC

As the USAID ASSIST Project in Kenya enters its third year, I am reminded of the reflections of the Indian speaker, mystic and philosopher, Jiddu Krishnamurti, who once remarked: “There is no end to education.  It is not that you read a book, pass an examination, and finish with education.  The whole of life, from the moment you are born to the moment you die, is a process of learning.”

Addressing gender-based violence prevention and treatment in a training curriculum to improve the quality of health instruction in Nicaragua

Ivonne Gómez Pasquier

Chief of Party, Nicaragua, USAID ASSIST/URC

Danilo Núñez Aguirre

Quality Improvement Advisor, Nicaragua, USAID ASSIST/URC

Through the USAID ASSIST Project, our team in Nicaragua is supporting the institutionalization of improvement methods and pre-service training in HIV services in medical and nursing schools at eight universities to develop the skills of nursing and medical professors to apply a teaching package for quality care.

A gender-responsive approach to achieve an AIDS-free generation

Elizabeth Romanoff Silva


Women account for an estimated 58% of the total number of people living with HIV globally and according to the UNAIDS GAP Report, close to 60% of all new HIV infections among young people ages 15-24 were among girls and young women, with 80% of these HIV positive girls and young women living in Sub-Saharan Africa. Other at-risk groups which have disproportionately higher rates of HIV include sex workers, drug users, men who have sex with men and other LGBTI persons, among others. It is critical that HIV/AIDS programs and services employ a gender-responsive approach that identifies and responds to the specific needs, barriers, and issues affecting each at-risk group, based on the socially constructed roles, behaviors, attributes, and activities that a community considers appropriate for each group, in order to provide the best quality of care.

HIV and key populations: providing care where it is most needed

Anisa Ismail

Improvement Specialist, USAID ASSIST Project/URC

As a virus, HIV does not discriminate. But when combined with social and economic factors affecting health such as gender, sexual orientation, and poverty, HIV becomes a virus that manifests much more strongly in some groups over others. In public health language, these are our key populations- the groups of people who experience a heightened risk of being infected with HIV due to one of more of those factors.

Key populations include sex workers, men who have sex with men (MSM), people who inject drugs (PWID), and transgender persons.

World AIDS Day: Reflections on 'closing the gap' through improving care

Pamela Marks

Senior Improvement Advisor, USAID ASSIST Project/URC

Today is World AIDS Day. It is time for us to reflect on the history of the HIV virus and how it has affected and changed our lives over the past three decades. It is also a time to remember those that have died because ARVs were not available or accessible, HIV testing was not available or accessible, and communities were not fully aware and educated about HIV/AIDS and how to reduce their risk and/or protect themselves. We now have no excuse for those HIV-infected to not know their status or not have access to life-saving ARVs.

The importance of implementing a complete package of HIV Continuum of Response

George Aluma Lwanga

Quality Improvement Advisor, Uganda, USAID ASSIST/URC

In October 2012 the USAID ASSIST project set out to improve HIV care through the HIV Continuum of Response (HIV COR) collaborative in 49 health facilities across the country. This improvement work was/ is done in partnership with USG- supported implementing partners in the regions; one such facility is Kuluva Hospital in West Nile region. HIV COR aims at reducing new infections and providing comprehensive care for the positives.

Male partners play a critical role in improving retention of the mother-baby pairs in care in Ivukula, Uganda

Joyce Draru

Quality Improvement Officer, Uganda, USAID ASSIST Project/URC

Retaining HIV positive mothers and their babies in care is a key component of the Partnership for HIV – Free survival initiative. Retention contributes to the success in reduction in the number of new HIV infections among HIV exposed babies as well as keeping their mothers alive. Supporting PHFS facilities in Uganda, sites have introduced changes such as offering eMTCT services to the mother-baby pairs at one service point and keeping the pair’s care cards together.

My sex worker encounter

Edward Broughton

Director, Research and Evaluation, USAID ASSIST Project/URC

No – this isn’t a kiss-and-tell but names and some details have been slightly changed to protect the innocent and those not exactly so. It is the story of what really happened in Melbourne where I was for the 20th International AIDS Society Conference. This occurred not at the conference, but at the bed-and-breakfast where I was staying.