Doctors Without Borders/Médecins Sans Frontières (MSF) is an international medical humanitarian organization created by doctors and journalists in France in 1971.
Today, MSF provides independent, impartial assistance in more than 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters. MSF provides independent, impartial assistance to those most in need. MSF also reserves the right to speak out to bring attention to neglected crises, challenge inadequacies or abuse of the aid system, and to advocate for improved medical treatments and protocols.
MSF program in Arua - Uganda
Arua is situated in the West Nile Region, North West of Uganda, at 45 minutes of the RDC border and at 1h of the Sudanese border by car. It is 6-7 hours by car, and 1 hour by plane from Kampala. It is a town of 83,000 inhabitants. Although English is spoken by many people, the predominant language is Lugbara. Swahili, Alur, Lingala and Arabic are also spoken by some segments of the population. Religion-wise, the town is divided between Islam and Christian adherents. Basic services are available in the town. Security is not currently a significant problem. The prevalence of HIV in Uganda is estimated to be approximately 5 to 7 %.
Arua Regional Referral Hospital which is the referral hospital for West Nile reion, has 400 beds, projected to have an extra 500 in the near future. Technically there is an Out Patient Department (OPD), Surgical, Medical, Isolation, Paediatric, Antenatal and Labour and Maternity wards as well as support services such as Xray and a laboratory. The Arua Hospital AIDS Programme (AHAP) has taken over from The AIDS Support Organization (TASO) and the activities managed by MSF currently include HIV Counseling and Testing (HCT), PMTCT, nutrition, TB services, Adult Isolation Ward and the HIV/AIDS inpatient and outpatient services. The prevalence of HIV in Uganda is estimated to be approximately 6.3%.
MSF involvement in Arua dates from 2000 in its role of supporting the Ministry of Health (MoH) Prevention of Transmission from Mother to Child (PMTCT) program. Subsequently MSF began an HIV/AIDS Clinic at the end of 2001 and as of July 2002 offered antiretroviral (ARV) medication. This is situated in a purpose built clinic. There are currently over 9000 people actively followed up with HIV/AIDS and an accumulative of over 19,000 were enrolled since the start of the program. People with HIV are seen in the clinic during the week with a 3 months appointments. Laboratory services are able to provide the majority of required tests. Viral Load is available using external laboratory facilities.
Decentralization in line with WHO guidelines for provision of ARVs in resource limited settings commenced in Jan 2005 in Koboko. After the activities extended to other districts like Nebbi, Adjumani and Oli. These cohorts are relatively small and MSF is currently closing the decentralized support.
Overall there is a significant amount of data collected for each of the activities (though not all entered into a database) and reporting, including separate MSF and MoH reports for the same activity. The monitoring of the project is mostly carried out vertically (unlinked to other monitoring systems used for different activities), which has led to difficulty in reviewing project data and ensuring data quality for program monitoring. With increasing demands for accountability (ex. drug consumption and MoH reporting) there is a risk for overlap and duplication of information in different tools. It is highly recommended to simplify the tools and integrate the MoH reporting into the project activities and reduce duplication. The first step for this should be a mapping of all data tools and reports.
In general, the FUCHIA database is well maintained by a data team; however there is concern that there is absence of a standard unique ID system. This leads to duplication of patient records and disorganization in patient information and is likely to contribute to the high LFU rate in the program. The retrospective PMTCT data entry is been recently finalized allowing for better analysis.
Position and function
See job profile
Please send cv, motivation letter and hereunder document fulfilled before the 9th of January 2012 to cdecoster@paris.msf.org For further information about the position please contact : Elisabeth Poulet, elisabeth.poulet@epicentre.msf.org.
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