In South Sudan, there are over 18,000 children under the age of 15 living with HIV. Lack of pediatric- and adolescent-focused HIV counseling and testing, limited tracking of HIV-positive pregnant women, and lack of early infant diagnosis are bottlenecks for pediatric case finding and treatment uptake. As a result, only two percent of eligible HIV-positive children are enrolled in antiretroviral therapy (ART).
To address these challenges, ICAP, with funding from PEPFAR through CDC, is partnering with the Ministry of Health in South Sudan, to provide comprehensive HIV services in Al Sabah Children’s Hospital, the only pediatric hospital in the country. Established in Juba in 1983, Al Sabah Children’s Hospital remains the only facility specializing in a number of pediatric services, including expanded immunization, treatment of malnutrition, and general outpatient medical services.
“We have a high load of pediatric patients of all kind, including HIV,” said Dr. Justin Bumo, Executive Director of Al Sabah Children’s Hospital. “We had been diagnosing children with HIV infection, but we were not able to treat them.”
Instead, the hospital would send HIV positive pregnant women and children to other facilities with limited and suboptimal pediatric services. Many patients were lost to follow-up.
With over 11,000 admissions and 23,000 outpatient visits and numerous pediatric child services already in place, Al Sabah Children’s Hospital is the ideal setting to provide pediatric HIV care and treatment, as well as serve as a referral and training hub for HIV and other infectious diseases in the country.
ICAP worked with the MoH and hospital management to develop a site readiness assessment checklist to identify strengths and weakness related to infrastructure, human resources for health, and other gaps in services. Using the results from the findings, ICAP and partners identified rooms in the hospital for HIV care and treatment, selected staff for training, and linked the hospital to the national supply chain system so ART medicines would be readily available.
ICAP clinical specialist trained 13 health care workers onsite in basic HIV care and treatment, pediatric diagnosis, and patient monitoring and treatment. In addition, ICAP provided trainings on PIMA CD4 machines for rapid viral load monitoring for children.
In the past month, 10 parents and children have been enrolled in HIV treatment at Al Sabah Children’s Hospital.
“This is an incredible accomplishment,” said Florence Bayoa, ICAP country director in South Sudan. “The implementation of ART services at Al Sabah Children hospital is the beginning of a long-scale-up of HIV care and treatment for children in South Sudan.”