Tegalrejo Public Health Centre, a Hospitable ‘Home’ for PLHIV
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CST Approaches, PLHIV Health Improves
June 6, 2024Limitation is not an Obstacle: South Atambua Public Health Centre Strategy to End LFU
Limited resources are often used as an excuse to justify the inefficiency of HIV control programs. This is different at South Atambua Public Health Centre. The HIV team at this health center in the Belu district has made various efforts to innovate, including implementing a personal approach strategy. Health workers' approach to PLHIV can increase ARV adherence and reduce the Lost-to-follow-(LFU) rate.
South Atambua Public Health Centre, Belu Regency
Atambua South Public Health Centre is located in Belu Regency, East Nusa Tenggara. HIV and AIDS cases in this border district, based on data from the Belu District Health Office, were recorded from 2013 to 2022, cumulatively totalling 807 people. In detail, 369 were HIV cases, 438 were AIDS cases, and 89 AIDS deaths were recorded. Based on gender, 401 males and 406 females were recorded. Regarding age, PLHIV, with a productive age of 25-49 years, dominated. In comparison, for the East Nusa Tenggara province itself, Belu Regency is still listed as the top five in 2023 HIV and AIDS cases, as explained by the East Nusa Tenggara Provincial AIDS Commission.
Atambua Selatan is recorded as the health centre with the most HIV patients in Belu Regency. As of May 2022, 135 people were living with HIV in the South Atambua sub-district, the highest among other sub-districts in the Belu district.
Aploina Berek, who manages HIV services at South Atambua Public Health Centre, explained that the health centre serves one village and four sub-villages. Given the size of the service area and the limitations, South Atambua Public Health Centre always runs its services by maximising available resources. Aploina and the team running the HIV programme are trying to make specific innovations to address the challenges.
South Atambua Public Health Centre, took a more comprehensive approach to prevention by implementing HIV screening for tuberculosis patients before they began Digital Adherence Technology therapy. South Atambua Public Health Centre could identify eight new HIV cases in 2023 since the dedication of health workers who continuously encourage HIV testing among key populations and high-risk individuals.
Aploina Berek, HIV Program Coordinator in South Atambua Public Health Centre
Aploina and Agustinus Mali Teuk, the head of the public health centre, agreed that a personal approach to assisting new PLHIVs is essential to prevent them from avoiding treatment and ending up with LFU. However, there was a case of LFU in South Atambua Public Health Centre. With a continuous personal approach, PLHIVs could change their perspective and return to routine treatment.
Furthermore, Aploina explained that a personal approach to PLHIV is the basis that must be mastered by health workers, especially when there are PLHIV with special needs. One of the PLHIV assisted by Puskesmas Atambua Selatan is a woman with a movement disability. According to Aploina, it is necessary to specifically recognize and find out what the PLHIV needs so that a health worker can provide services that meet the needs of the PLHIV. The health center does not just serve according to standard operational procedures but can accommodate the needs of PLHIV.
South Atambua Public Health Centre is also actively involved in collaborative activities with the district government, communities, and institutions such as CD Bethesda YAKKUM. During 2023, the HIV team and the head of the public health center were involved in various collaborative activities initiated by CD Bethesda YAKKUM and the Belu District Government. Activities are diverse, ranging from workshops, seminars, and socialization. Outreach activities to the community are carried out by routinely conducting counseling to the community about HIV and AIDS and Sexually Transmitted Infections (MS) using various communication, information, and educational media in outreach. South Atambua Public Health Centre also continues to improve pre- and post-diagnostic HIV counseling services. Furthermore, although sometimes there is resistance, South Atambua Public Health Centre strengthens the partner notification program.
In addition to outreach activities, South Atambua Public Health Centre also pays serious attention to the triple elimination program for every pregnant woman who accesses the service. For Aploina, improving the Prevention of Mother-to-Child Transmission (PMTCT) strategy is essential.
The head of South Atambua Public Health Centre also revealed that the community's role in the AIDS Care Community significantly reduces the LFU rate. Although there are limitations, for Agustinus, the role of the AIDS Care Community, especially housewives, is very strategic because they can reach groups that medical or health workers may not touch.
Overall, HIV program managers at South Atambua Public Health Centre feel they provide the best service possible despite their limitations. Limited material resources, such as buildings and facilities, can be compensated for by human resources, which are willing to go the extra mile and set aside time and energy to go directly to the community to assist and reach out more broadly. Aploina gave an example: although they do not yet have special psychosocial services for PLHIV, the HIV service team of Puskesmas Atambua Selatan is happy to make unique visits to the homes of PLHIV and families who need more attention because of difficulties in managing their mental health.
South Atambua Public Health Centre hopes to better carry out its HIV prevention mandate by improving the quality of services and health workers and the completeness of communication, information, and education media that is more in line with the community's needs.
(Meta Ose Margaretha br Ginting)
