A9.1 Component 1: Care, support and treatment
The CST component is the main program area for REACH. CHAI will spend significant amount of time and resources to promote the program, build the Provincial Steering Committees, develop relationships with key stakeholders, and recruit and develop new staff and CoE sites. A monitoring framework will be developed in the first quarter and baseline data collected for all program indicators. Systems for collection of monitoring data will be collected.
The establishment of the seven new CoE will occur progressively over the first 18 months. Some sites will be started in clusters to optimise training and use of other resources. CHAI will also establish two new offices in Sorong and Nabire in addition to strengthening its two existing regional offices in Jayapura and Wamena. These will serve as hubs for the CHAI teams and their activities across districts. Hiring of new CHAI and CoE staff will happen progressively over 18 months. While there are significant staffing needs for this program, this rolling approach to recruitment will enable a manageable process.
Current sites -
The Jayapura CHAI and CoE teams will be increased to their full staff complement. The teams will provide technical assistance to puskesmas in Jayapura District. They will also develop an expansion plan to support Kerom and Sarmi districts and begin implementation. The teams will initiate support to Pegunungan Bintang to establish that CoE and establish an ART site at the district hospital. Finally, the CHAI and CoE teams will support the GoI’s new ‘test and treat’65 policy in Jayapura through technical assistance at Abepura hospital and Dok II hospital.
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The Wamena CHAI and CoE teams will be increased to their full staff complement. The teams will work with puskesmas in Jayawijaya District. They will also develop an expansion plan to support Lanny Jaya, Tolikara, Membramo Tengah, Yalimo, Yahukimo and Nduga districts and begin implementation. They will also provide assistance to Mulia to establish the CoE and an ART site at Mulia hospital.
New sites -
New CoE will be established in the following order: Sorong, Nabire, Enarotali, Mulia, Pegunungan Bintang, Fak Fak, and Manokwari.
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Sorong and Nabire will have CHAI offices established in the first six months of the program. Sorong in West Papua will be prioritised since it is also one of MoH’s ‘test and treat’ sites. Nabire has a large underserved HIV positive population.
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Other CoE expansion in the first year will include Enarotali and Mulia. In Enarotali there is strong political will to implement and it shares with Nabire a large underserved HIV positive population. While it is the centre of political unease in Papua, Mulia also has a highly motivated hospital team and Medecins du Monde staff that are willing to transition to CHAI and continue working there.
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The other CoE sites in Pegunungan Bintang, Fak Fak, and Manokwari will be established in the first 18 months of the program. However, REACH will monitor its progress and may alter its implementation pace through an adaptive management approach.
The phased establishment of CoE and hospital and puskesmas sites supported by REACH is set out in Table 19.
Table 19: Phased expansion of Centres of Excellence and REACH supported hospitals and puskesmas
Establishment of CoE and number of hospitals and puskesmas joining REACH
|
Year 1
Jul – Dec 2012
|
Year 1
Jan – Jun 2013
|
Year 2
Jul – Dec 2013
|
Year 2
Jan – Jun 2014
|
Year 3
Jul 2014 – Jun 2015
|
Year 4
Jul 2015 – June 2016
| |
Centres of Excellence
| |
CoE Jayapura and CoE Jayawijaya
|
2
|
|
|
|
|
| |
CoE Sorong and CoE Nabire
|
2
|
|
|
|
|
| |
CoE Enarotali and CoE Mulia
|
|
2
|
|
|
|
| |
CoE Pegunungan Bintang, CoE Fak Fak and CoE Manokwari
|
|
|
3
|
|
|
| |
Hospitals and puskesmas
| |
Hospitals
|
4
|
4
|
4
|
5
|
|
| |
Puskesmas
|
10
|
15
|
20
|
21
|
32
|
22
|
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