Solthis Therapeutic Solidarity and Initiatives for Health

MALISTRENGTHENING SYSTEMS AND HEALTH SERVICESFighting HIV / AIDS

Context

The reform of the health sector in Mali, comprising several strategic axes, is now the reference for both the government and technical and financial partners in the fight for better health in the country. With reference to this reform, Mali’s strategic vision is to ensure an integrated, effective, efficient and sustainable response to HIV/AIDS, tuberculosis and viral hepatitis in order to put an end to these epidemics. This includes, among other things, the transition to the Integrated National Strategic Plan for HIV, Tuberculosis and Viral Hepatitis. This single plan for the three epidemics is an innovation in terms of taking into account all the needs and a correct and judicious distribution of resources in order to be effective on the ground while maintaining a real synergy of actors.

Some figures:

• HIV prevalence rate: 1.1% in general population
• Epidemic concentrated in key populations:
  • Men who have sex with men (MSM): 12.6% ;
  • Transgender: 11.7% ;
  • Sex workers (SWs): 8.7% ;
  • Injecting drug users: 5.1%. 
• 10,000 cases of TB per year (estimate), only 2/3 are detected.
• Multidrug-resistant tuberculosis: 28 cases in 2016, 54 in 2020.

To accompany this reform and strengthen the fight against HIV and tuberculosis, the Global Fund to Fight AIDS, Tuberculosis and Malaria, one of Mali’s most important partners since 2005, has awarded Mali a new grant of US$ 162,137,776 over the next three years (2021-2023). Solthis has been asked to support the implementation of this grant and to contribute to the achievement of the objectives of the Integrated National Strategic Plan for HIV, TB and Viral Hepatitis (PSNI) 2021-2025 in Mali.

Objectives

In line with the National Integrated Strategic Plan for HIV, TB and Hepatitis, Solthis’ intervention aims to contribute to the improvement of HIV care in 37 priority sites belonging to different levels of the health pyramid: University Hospitals, Regional Hospitals, Reference Health Centres (CSRéf) and indirectly in the CSCom in the district of Bamako and in the regions of Kayes, Koulikoro, Sikasso, Ségou and Mopti.

Following on from the work carried out in the previous phase of this grant (NFM2), Solthis will support the deployment of the multidisciplinary coaching approach to help improve the quality of HIV/AIDS care in the targeted health facilities. In particular, the intervention will target the strengthening of the HIV care package at the different stages, from screening to long-term follow-up and suppression of the viral load of patients, especially for the most at-risk populations: pregnant mothers, young people and adolescents, ….

In order to continue the transition of the intervention to the national level and to promote coordination, this work will strongly involve the health care teams of the health structures and will be carried out jointly with the management teams of the CSLS-THB (Sectoral Coordination of the Fight against AIDS, Tuberculosis and Hepatitis B), of the regions and health districts, through collaboration with AMPRODE-Sahel and CRS for the Tuberculosis component.

Activities

• Train and supervise 400 coaches who will then be in charge of the quality improvement process, together with the health care teams of the health care facilities,
• Strengthen the capacity of health professionals (on viral load demand: delivery, results reporting and case management, monitoring and evaluation).

Expected results

• • The capacity of health professionals to manage HIV is strengthened.
  • Retention (ability to stay in care) of people living with HIV is improved.

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