Participants:
Mena Attwa, Senior Program Manager (Coptic Hope Center – Kenya); Eman Labib, Program Manager (Coptic Church Hospital – Zambia)
Faculty Supervisor:
Mbithe Anzaya
Program:
MDI-Kenya Class of October 2006
History of the Agency:
Coptic Hospital was established in 1994 in Nairobi, Kenya, as part of the Coptic Orthodox Church in Africa. After years of providing HIV-related services, Coptic created the Hope Center for Infectious Diseases, which features a comprehensive care and treatment program for HIV/AIDS management. The program is a collaborative effort between Coptic and the University of Washington, with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) and support from the Government of Kenya.
CHIP Project:
Based on the rapid scale-up of its services, Coptic’s CHIP focused on expanding its HIV/AIDS program to three new locations while maintaining high-quality services, measured by 90% of active patients on highly-active antiretroviral therapy (HAART) by the end of March 2007. The new sites were located across Kenya and Zambia, so expansion also meant facing new challenges that resulted from managing over long distances.
To achieve its objective, Coptic created administrative systems to monitor and evaluate the work of the new clinic staff. This included staff recruitment and training, senior management site visits, reporting and program evaluations, enrollment and retention data analysis, and regional program adjustment to match the local needs of each clinic’s target community.
Changes Made:
In 2006, Coptic began expansion to three clinics in Kenya and Zambia. By 2008, Coptic had also built a pediatric clinic, developed a tracer and home care program, started a treatment literacy program, increased enrollment to over 13,000 patients across three locations in Kenya and one in Zambia, and increased clinic capacity and space with the construction of the new building. HIV/AIDS services now include lab testing, an ARV and opportunistic infection drug program, counseling, social work services, voluntary counseling and testing, prevention of motherto-child transmission, treatment literacy, community outreach, a cervical cancer screening program, a full pediatric clinic, and a tracer and home program.
As of September 2008, enrollment in Coptic’s HIV programs in the four centers included:
- 450 patients daily
- 325 average monthly enrollment
- 8,132 patients on anti-retroviral treatment
- 13,806 total patients enrolled
Lessons Learned:
This project required integrating many resources, including a reliable internet connection, staff, equipment, time and funding. The project also needed the cooperation of many stakeholders, including Coptic Mission, the Kenyan and Zambian Ministries of Health, CDC/PEPFAR, the University of Washington, and Churches Health Association of Zambia. Management faced internal challenges, such as reducing turnover and motivating staff to share common goals, as well as external challenges, such as communication and stigma for client enrollment. However, the
program gained institutional buy-in, as “all of our supporters were pushing for the expansion,” Attwa recalls.
Other MDI alumni from Coptic include Dr. Samir Aida, Nadia Kist, Mina Saleeb and Salesio Nyamu. Coptic has applied MDI frameworks to enhance all of its programs, restructure and strengthen the organization, train and develop staff, and create a sustainable expansion plan. Attwa and the management at Coptic have embraced the CHIP frameworks and continue to apply these concepts to new programs as Coptic expands to Tanzania,
Congo and Nigeria.