Collaboration to Stop an Epidemic

The burden of HIV/AIDS in Achham is among the worst in the world. Achham has the highest prevalence of HIV/AIDS of any district in Nepal, largely due to the number of men who seek work in India and come back infected. To respond to this challenge, there are numerous community-based organizations that try to prevent the further spread of the epidemic by reaching out to people living with HIV and AIDS. The government piloted its community and home based care (CHBC) model in Achham to expand the continuum of care beyond the medical treatment hospitals and health posts provide. Nyaya Health has also participated in efforts to combat HIV/AIDS as an integral part of our health care delivery model. We have recently become an HIV Center- authorized to initiate and maintain treatment for affected individuals. Our medical director just participated in a government training for the CHBC program and our community health program reaches out to affected individuals through follow-up visits. However, the efforts of all of these different organizations and providers have not been coordinated resulting in duplicated efforts and wasted resources.

A couple of weeks ago, I was asked to do some research regarding HIV interventions conducted in other resource-limited settings around the world and current efforts in our local community to determine what Nyaya could do to coordinate efforts and fill in gaps in the current services. As a result of this research, yesterday we held our first Community Partners Meeting with representatives of the organizations working to combat HIV in the region. The objective of this first meeting was to simply get everyone in the room together to share current programs, target groups, and successes. Nyaya also presented recent local HIV epidemiological information from our patient record database. The tone was quite friendly and the meeting seemed to be a success. By the end, everyone present was excited to continue the collaborative efforts through monthly meetings hosted in a rotating schedule by each of the organizations. Hopefully, future meetings will provide a way for the various organizations to collaborate in a more meaningful way.

The other successful outcome of the first Community Partners Meeting was the support the organizations present gave to Nyaya’s new idea of reaching out to caregivers of people living with HIV/AIDS - a traditionally neglected group in HIV care. From my initial research, I had ascertained that in Achham, there is not a structure that provides caregivers of people living with HIV and AIDS with support, guidance, or a community of peers. I proposed the idea of a caregivers’ support group facilitated by the community health workers in each village. We are drawing up the specific plans now and hope to reach out to other stakeholders and begin trainings for the community health workers prior to the next monthly Community Partners Meeting.

Representatives from a number of community based and government
organizations at the first Community Partners Meeting to combat HIV