Expanding Treatment and Care in Cote d'Ivoire

Partners: Societe des Caoutchoucs de Grand Bereby (SOGB)
Location: Cote d'Ivoire
Objective: To provide HIV education, prevention of mother-to-child transmission (PMTCT) services, and access to care and treatment services to surrounding communities

Sustainability is a critical component of successful HIV/AIDS programs. In 2003, SOGB, one of Cote d'Ivoire's largest rubber companies located 400 kilometers west of Abidjan, decided to begin a comprehensive workplace program for its employees. However, they soon found that implementing with partners would create a more efficient and cost-effective program - ensuring sustainability. In September 2005, with funding from PEPFAR, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) initiated a model for HIV prevention, care, and treatment for SOGB. EGPAF partnered with the SOGB Health Clinic to create sustainability while providing HIV education, prevention of mother-to-child transmission (PMTCT) services, and care and treatment for SOGB's 4,000 workers, their 16,000 family members, and the 10,000 people living in surrounding villages.

The SOGB Health Clinic, staffed by five trained care providers led by a medical doctor, is the referral center for a system of 18 "health huts" serving the plantation's 18 villages. Each "hut" is staffed by a trained community health worker, who provides HIV education and counseling and enrolls pregnant women in antenatal care/PMTCT programs. EGPAF provided lab equipment, data-management tools, and training for the technical staff, as well as drugs and lab supplies through the national procurement system. This process saves SOGB money, which it reinvests in prevention and community-awareness campaigns. The SOGB lab serves as a reference lab for two neighboring health districts, with no charge for the patients. SOGB health workers also provide practical training and supervision for the neighboring districts' care providers.

The number of HIV-infected patients enrolled in care rose from 55 in September 2005 to 311 in December 2006, with 152 on highly active anti-retroviral therapy (HAART) because of this innovative approach. Uptake of PMTCT services has been dramatic, with the number of women tested increasing from 187 to 1,057. More than 90% of the 65 HIV-positive women (6.1% of women tested) received nevirapine for PMTCT of HIV/AIDS and further onsite post-natal care for both mothers and children. In addition, strong support from SOGB has facilitated the establishment of antiretroviral treatment (ART) and PMTCT sites in a neighboring district.

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