A Place of Hope for Nicaraguans at Risk of HIV

Posted February 10, 2020
Impact Area HIV & TB

by Alejandra Cabrera, PASMO

Marlex finally fell asleep after nearly two weeks of feeling very ill. The 30-year-old Nicaraguan had been losing weight due to diarrhea. It wouldn’t stop, even with the over-the-counter medication he had taken.

Marlex’s partner, Jael, looked on with concern. He was worried that Marlex’s health wouldn’t improve. Switching off the bedroom lamp and stepping into the adjacent room, Jael spent the next few hours scouring Google, and then Facebook, for answers to Marlex’s symptoms. It was on Facebook where he finally found what he was looking for.

“I’m so thankful I found ‘Versátil’,” Jael says.

Versátil, a Facebook Fan Page created by the Pan American Social Marketing Organization (PASMO), works to reach at-risk men who have sex with men (MSM) like Marlex with information and referrals to HIV prevention services, including HIV testing and counseling, under USAID’s Combination Prevention Program for HIV in Central America.

“I suspected it was HIV,” recalls 32-year-old Jael. “I needed to find the right place for us to get tested together”.

After sending a private message to a PASMO cyber-educator through the Versátil Fan Page, Jael was able to schedule an appointment for himself and Marlex to receive HIV testing services at the PASMO office in Nicaragua’s capital city of Managua, not too far from where they lived. Though Jael’s test returned with a negative result, Marlex had a reactive result. He was soon confirmed as HIV positive at a local comprehensive care clinic, where he began to receive care and treatment.

From October 2018 to September 2019, the Combination Prevention Program in Nicaragua reached 1,278 at-risk MSM, their partners and other key populations such as transgender women, providing testing services to 762 clients. 8% had reactive tests results, or one of every 13 tests. More than 93% of individuals were reached online through cyber-educators. When a test has a reactive result, the client is referred to one of PASMO’s “online patient advocates,” who is responsible for providing in-depth and personalized support and follow-up for each case. With support from these advocates, PASMO can ensure that those with reactive results confirm their test and become linked to the public comprehensive care services. where they can begin treatment as soon as possible.

After months of treatment, Marlex’s health had begun to improve significantly. He credits early detection, private and friendly HIV testing services and ongoing support for his new outlook on health and life.

“We’ve been through some difficult times,” says Jael. “But we’re now in a good place, a place of hope.”

Banner image courtesy of Alejandra Cabrera, PASMO

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Here’s what it looks like in practice.

In July 2020, PSI Angola, alongside the Angolan digital innovation company Appy People, launched Kassai, an eLearning platform that targets public sector health workers in Angola. Through funding from USAID and the President’s Malaria Initiatve (PMI), Kassai features 16 courses in malaria, family planning, and maternal and child health – with plans to expand learning topic areas through funding from ExxonMobil Foundation and private sector companies. A partnership with UNITEL, the largest telecommunication provider in Angola, provides all public health providers in Angola free internet access to use Kassai.

Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities. The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

Implementing the SLPM digital ecosystem brings numerous benefits to health systems. It allows for more strategic and efficient workforce training and performance management, enabling ministries of health to track changes in health workers’ knowledge, quality of care, service utilization, and health outcomes in real time. The ecosystem also supports better stewardship of mixed health systems by facilitating engagement with the private sector, aligning training programs and standards of care, and integrating private sector data into national HMIS. Furthermore, it enables the integration of community health workers into the broader health system, maximizing their impact and contribution to improving health outcomes and strengthening primary healthcare.

A Place of Hope for Nicaraguans at Risk of HIV

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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