A.S.S.I.S.T. – Access to an Integrated Health System for TB/HIV Services in Guinea is a two-year initiative promoted by ACAP in partnership with the University of Rome Tor Vergata (TVG) and the local health center Dispensaire Maternité Saint Gabriel (DSG). The objective is to reduce mortality and the incidence of HIV through universal access to HIV/TB prevention and treatment in Guinea, increasing the access of the population in Conakry, Coyah, and Dubréka to free and quality HIV/TB healthcare services. A needs analysis, conducted by a team of experts, has highlighted the need to intervene in strengthening the healthcare system regarding three problems:
- Geographical and economic inaccessibility of diagnostic and treatment sites for HIV/TB, especially in peripheral contexts, often leading to late diagnosis in patients and, therefore, contributing to high mortality among HIV/TB patients.
- Scarcity of adequate facilities, drugs, and laboratory reagents for HIV/TB, which hinders the equitable distribution of HIV/TB healthcare services across the territory, significantly impacting access to care.
- High patient loss within the diagnosis and treatment circuit, as even many of the most equipped centers at the national level often fail to ensure continuity of service, interrupting the treatment cascade.
Based on these aforementioned problems and the experience and collaborations established over the years, ACAP has identified the following needs on which it aims to have an impact through this initiative:
- Increase access to diagnostic and treatment sites for HIV/TB in peripheral areas: To address the needs of patients who face high transportation costs to reach the center in Conakry, a package of free care and analyses will be provided. Additionally, the services offered in peripheral areas of Conakry (Matoto) and rural areas of Dubréka and Coyah will be strengthened to achieve greater decentralization while maintaining high treatment quality. This will be achieved through the establishment of a coordinated inter-hospital system known as the “Hub & Spoke” (H&S) model for integrated management of HIV/TB services.
- Reduce mortality among people with HIV/TB: This need will be addressed by promoting greater integration of HIV/TB services. In addition to the Dixinn Center hub, active TB case finding and molecular diagnosis will be extended to the peripheral spokes of Dubréka, Coyah, and Matoto.
- Improve the performance of the Prevention of Mother-to-Child Transmission (PMTCT): ACAP will enhance PMTCT by providing counseling to pregnant women through training community agents, which will also be open to operators from other facilities. Early diagnosis in children will be increased by utilizing the laboratory at the Dixinn Center and installing a dedicated GeneXpert machine at DSG.
- Increase HIV/TB testing and patient adherence: New counselors will be trained, and front-desk services will be established in the three peripheral centers to increase testing at different entry points. Furthermore, retention will be strengthened through improved communication and referral strategies, as well as enhanced psychosocial support and therapeutic education. Lastly, a specific research study will be conducted to identify the reasons for insufficient retention and the main barriers to accessing testing, PMTCT, and HIV/TB care services in peripheral contexts, both urban and rural.
Partner del progetto
- Università degli Studi di Roma “Tor Vergata”
- Dispensaire Maternité Saint Gabriel