Framework, Roles and

Responsibilities
HIV user fees elimination

05th June 2020

Daniel Mabongo,
Coordinator,
RTG-HIV, SWR.
 Plan
• Background
• Package
• Actors
• Roles and Responsibilities
• Process

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 Background
• 531396 PLWHIV in Cameroon (2018)
• 2.8% HIV prevalence 15-49 years (EDS 2018)
• 17350 related deaths (2018)
• 23000 new infections (2018)

• HIV reponse (90-90-90 goal)

• Strategy is to eliminate HIV related out-of-pocket expenditures in
order to increase up take and national coverage
• Ensure at least 77% of PLWHIV have been tested, placed on ART
and have their viral load supressed
• MOH decision of April 4th 2019 and manual of procedures
provide guidelines for implementation
 Package
• Package 2007 : screening, early infant diagnosis, medical files,
antiretroviral treatments (ART), prevention of opportunistic
diseases
• Additions 2020 : Antenatal and routine consultations, medical
booklets, testing and follow up, CD4 and viral load, HIV+ pregnant
women biological track records(cell blood count, urine test strip,
blood glucose) and Cytobacteriological test of Sputum
• Expectations
 Improve HIV Aids Epidemiological repoonse
 Improve management indicators (testing, treatment and viral load)
 Improve financial solvency of PLWHIV
 Ensure PLWHIV equity and access to Health Care
 Pave way for Universal Health Coverage
 Actors
Level Actors
Central Prime Ministry, MINFIN, MOH
(Strategic) Steering Committe
Technical secreterial
NACC, TFPs

Regional Governor
(Intermediate) Regional Delegation of Public Health
RTG-HIV, SWRFHP & CDVA

Peripheral 18 District Health Services

(Operational) 128 HFs (Treatment Centers)
1 Reference Laboratory
Local councils
Community representatives
 Roles and responsibilities
Central (Strategic)
Actors Roles and responsibilities
MOH, TFP Capacity building in HIV Management
Organise Health Care providers
Set up system to motivate health care personnel
Establish operations manual
Coordination, effect implementation and
Sanction
Develop conventions, policies, texts, etc
National communication strategy
MOH (Finance) Develop administrative and Financial mangement
tools
NACC Develop performance tools
Map out exhisting devices and SWOT analysis
CENAME National quantification and supply chain for HIV
commodities
 Roles and responsibilities
Regional (Intermediary)
Actors Roles and responsibilities
RDPH Coordination, governance and sanction
List of trained providers
Link HFs to reference laboratory
RTG HIV Identify treatment centers
Capacity building in HIV Management
Monitoring and evaluation
Conduct satisfaction surveys
SWRFHP Resource mobilisation and management
Compile and analyse reports
Organise coordination meetings
Quantification and supply chain for HIV commodities
Community sensitisation
CDVA Verification and validation of HIV user fees
Compile and analyse supervision reports
 Roles and responsibilities
Peripheral (Operational)
Actors Roles and responsibilities
District Health Link between Region and Periphery
services Monitoring of Health Facilities
Follow up referrals to and fro laboratory
Organise verification and validation
Facilitate community sensitisation
Participate in coordination and sanctions

Reference (National Early Infant Diagnostic Reference

Laboratory Laboratory)
Recieve samples for Viral Load tests
Carry out tests
Despatch results to health faciltities
Record keeping and declaration
Facilitate verification and validation
 Roles and responsibilities
Peripheral (Operational)
Actors Roles and responsibilities
Health Facilities Screening (Children, pregnant women, adults)
(Treatment centers) Consultation for PLWHIV
2 RH – CTA Counceling
128 – HU Sample collection
Biological tests (for pregnant women)
Sophisticated tests (CD4 and Viral load) sample
collection and transmission or referal
Quantification and management of HIV
commodities
Dispensing of ARVs
Record keeping and declaration
Facilitate verification and validation
 Process

Population Health Facility Regulators

(Regional and
Central)
-Verify / validate
-Patient -Consultation
-Reimburse
-Pregnant -Testing
Women -Operational guide
-Dispensing
-PLWHIV -Control
-Recording
-Other -Sanctions
-Declaration
targets
Thanks for Your Kind Attention