Introduction:
The focus is on the innovative approaches employed to address the challenges posed by banditry and insecurity in Niger State, Nigeria. Specifically, the focus is on enhancing viral load sample collection for people living with HIV (PLHIV) who face various barriers due to their occupation, geographical location, and limited access to communication networks. The aim is to achieve a high viral load sample collection rate and coverage despite the prevailing security challenges.
Method:
To ensure the holistic viral load sample collection of PLHIV clients who are in insecurity prone areas who are either displaced from their homes, engaged in farming during the week or are in the hard-to-reach areas; several integrated community approaches were employed to reach them for sample collection despite the current security challenges which includes:
Weekend community viral load sample collection strategy was implemented, which allowed for convenient sample collection for clients who were engaged or not reached over the weekday thereby increasing the coverage among this specific group.
A market day sample collection system was established. This helped to reach clients who are displaced from their homes who occasionally find their way to the market either to buy or sell items for survival and are immediately identified by our community case workers and taken to appropriate places within the community and bled.
Religious congregations, such as Friday Muslim Prayers and Sunday Church congregations, were also leveraged to reach clients in this insecurity prone axis, who will occasionally find their way to these religious places for worship.
Collaboration with community vigilante groups and internally displaced peoples` (IDP) camps was also crucial in overcoming the impact of insecurity on viral load sample collection in the communities. By establishing partnerships with these groups, viral load sample collection from PLHIV clients was made possible as well as guaranteeing the safety of the providers in those communities.
Result:
These innovative approaches, implemented by the ACE-4 team, resulted in an impressive achievement of 96% viral load sample collection and 94% viral load coverage during the first quarter of the fiscal year 2023, despite the heightened banditry attacks and insecurity in Niger State which involved more local Government areas.
Conclusion:
These efforts exemplify the importance of adaptability and creative problem-solving in public health interventions, particularly in the face of complex security challenges. Innovative Integrated community interventions are key in the breech of the negative impact of insecurity in the care of PLHIV clients. Policy makers and healthcare providers should recognize the importance of community innovative approaches in health service delivery especially in the care of PLHIV clients.
Authors: Uchenna Nwanchor E, Francis Eluke, Musa Salami, Saliu Idris, Etsetowaghan Andrew