Together, We Can: The Mingende Report (2011)

In the forthcoming pages, we will explore the innovative methods and processes that have led to the Mingende Rural Hospital’s (MRH’s) successful follow up for the continuum of care to reduce fall-out rates and improve timely ART provision as well as adherence. We will study the collateral factors aiding the hospital in its mission, examine the incremental effects of integration of health care services, understand what we can learn from these good practices, and deliberate on whether we can apply some of these suitably elsewhere. We will meet the people, explore the stories, analyse the key lessons, and witness hope.Some of the lessons learned from the Mingende experience, covered in greater detail in the following pages, and good practices include the following:

1. Strong leadership drives excellence.

2. The PPTCT programme serves to strengthen MCH, and integration of services allows for timely ART interventions and care.

3. Clear maintenance of records aids stringent follow-up of mothers on ART and therefore, Prong 4 effectiveness: ARV for mothers’ own health.

4. Greater involvement of people living with HIV ensures follow-up of positive mothers and mobilizes community support.

5. Clear delineation of roles of staff, who are each responsive and responsible, improves service efficiency.

6. Identification of and swift responses to specific needs of the public, unique initiatives such as men’s clinic and involvement of community leaders in hospital’s outreach help tackle issues in a holistic manner.

7. Strong linkages with support services such as rural health centres and aid posts reduce loss of mothers to follow up.

8. The effects of these good practices are multiplied by a critical factor that sees the hospital management supporting and caring for its staff, whether it is housing them in staff quarters within the hospital premises, or training them as they work, thus keeping the morale high among staff members. This in turn, translates into quality care for patients visiting the various clinics.

Through the Mingende experience, we can confidently state that PPTCT programmes are creating a holistic health care environment with mothers and children cared for equally, while related community facilities are continuing to work towards educating men and engaging whole families to approach health centres for voluntary confidential counselling and testing (VCCT).