Supervisors from Rwanda’s national Treatment and Research AIDS Center (TRAC Plus) praised the quality of HIV clinical services they witnessed during an evaluation visit to Nyagatare District Hospital in January.The IntraHealth-led USAID HIV/AIDS Clinical Services Program (HCSP) supports the  hospital, located in the Eastern Province of Rwanda.

The Nyagatare Hospital staff, 10 doctors and 78 nurses, provides on-site clinical care to the district’s  329,000 people.  As of January 2009, the hospital had provided HIV services and follow-up to 2,113 adults and 57 children; of these, 405 adults and 33 children are receiving antiretroviral therapy (ART). 

The HCSP took over support to the Nyagatare Hospital from the Multisectoral AIDS Project (MAP) 18 months ago and provides intensive assistance with sub-grant management, staff training, and health provider coaching. Clinical care specialists and clinical support officers from IntraHealth offer regular mentoring at the site with an emphasis on improving the quality of care in counseling and testing (CT), and ART and prevention of mother-to-child transmission of HIV (PMTCT) services. HCSP staff give ongoing supportive supervision to health care providers to ensure that a systematic clinical examination of every patient takes place, medical records are filled out accurately, and children receive appropriate care and follow-up—including having their weight and other vital measures taken. In addition, IntraHealth supplies mentoring to providers to ensure that national protocols are followed for all aspects of patient care. HCSP is building on the success in clinical HIV care to integrate family planning, maternal and child health, and gender-based violence services in the Nyagatare Hospital and other health centers in the district.

TRAC Plus reports show that HCSP scores 100% for the following key clinical care indicators:

• HIV-positive children on Cotrimoxazole prophylaxis
• Medical records’ completeness
• TB screening at enrollment visits
• HIV-positive women’s hospital deliveries
• CD4 count reading and follow-up
• Pharmacy attendance linkages to medical care
• Bookkeeping of appointment registers.

In addition, 83% of children in families with at least one HIV-infected parent have been tested for HIV. According to Nyagatare Hospital Director, Dr. Jean-Baptiste Sahaha, IntraHealth’s exceptional support is paying off; he declares that in just one year with IntraHealth his hospital’s performance-based financing score rose from 62% to 85.5%.