D.5.Increasing VCT services utilization through Outreach Testing Programme.
Malawi AIDS Counseling and Resource Organization, which was established in April 1995, provides VCT services to individuals, families and communities in order to reduce transmission of HIV and impact of HIV and AIDS. The Organization has three stand-alone sites, one in each region to serve the communities with VCT services. Through out the years of operation, it has been observed that many people, especially from rural areas find difficulties to access services because of long distances they have to travel. The sites are located in urban areas serving a smaller segment of the population. There was and still is high demand for VCT services in rural areas, especially now that ARVs are becoming more available. The scenario led to a decision of scaling-up impact of VCT services through sites expansion programme. The expansion strategy includes new stand-alone sites and outreach testing services. This paper discusses experiences with outreach testing that started in 20004.
In the year 2004, 13 Outreach Testing Sites were established in the three regions of the country. These are distributed as follows: Enguchwini, Kamwe, Mpherembe, Mhuju and Khosolo health centres in the North; Kabudula, Ndaula, Chileka and Ming’ong’o health centers in the Centre; and Mdeka, Makata, Mpemba and Mfera health centers in the South. Mhuju and Khosolo receive additional financial support (transport and lunch allowances) from Harvest Help Find Your Feet Project and Action AID respectively.
Each site operates once a week, except Khosolo, which operates on three consecutive days during each visit once a moth; counselors spend nights there because of long distance. Two counselors provide both counseling and testing services at the sites (there is no separate laboratory). This reinforces privacy and confidentiality. The results waiting time is used for continuation of Preventive Counseling.
The sites were inspected to ensure conformity to optimal standards for delivery of quality services. VCT check list developed by VCT National Sub-committee was used as a guide in identifying suitable sites for VCT services. Two rooms are provided at each site to accommodate two counselors. In each room, a minimum of three chairs (to accommodate couple counseling) and one table are provided.
The sites were selected, among other reasons, on the basis of availability of other service providers to provide care and support on referral basis. The support system includes health centres clinical services, community support groups and Home-based care Programme. Clients that need additional care are referred to one or more of these groups for appropriate support. Community sensitization on VCT benefits, stigmatization and discrimination is being carried out by other providers i.e. MOH staff, NGOs and CBOs.