What does World Vision Do?

Bosnia and Herzegovina
TB and HIV Prison Settings and Continuity Care
World Vision Bosnia & Herzegovina
October 16-18, 2012, Estonia
Bosnia and Herzegovina on Map
Estonia
Bosnia and Herzegovina
Basic information Bosnia and Herzegovina
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Area: 51,209.000 km²
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Total population of country: 3,8 milion
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Mountainous country (62% of the land more
than 700 m above sea level)
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Continental and Mediterranean climate
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Divided into two entities: FBiH, RS and Brcko
City district
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Political and administratively complex
framework in B&H: state, entity and regional
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Three health care systems: state, entity and
regional levels
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The Ministry of Civil Affairs of Bosnia and
Herzegovina is in charge of the overall
coordination of health issues at the state level.
TB&HIV GF Grant
Bosnia and Herzegovina
TB
• 1996 - political commitment was made to DOTS Strategy
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2007 - GF TB Grant was awarded to BiH - Further Strengthening of DOTS Strategy in
Bosnia and Herzegovina
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2010 - World Vision B&H start with implementation of SSF GFATM TB Project
– Objective 1: Increase Capacity for Case Detection:
– Objective 5: Improve TB Control in Roma and Other Vulnerable Population
HIV
• 2006 - GF HIV Grant - World Vision B&H start with implementation of SSF GFATM
HIV Project R5 and R9:
– Objective 6: Introduce HIV Prevention in Roma Communities and Former
Displaced Persons
– Objective 1: Maximize Coverage of Effective HIV Prevention and Care Among
Most-At-Risk Population and STIGMA reduction
World Vision B&H - GFATM TB Project
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Objective 1 of TB project: Increase
Capacity for Case Detection
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Engagement of:
– 2 National TB M&E Coordinators
– 27 Regional/Cantonal Coordinators
– 75 Patronage Nurses/Technicians
– 2 Trainers nominated by entity health
ministry
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Organization of the trainings for 800 health
care profesions including:
– TB staff doctors/specialists (170)
– TB Family doctors (354)
– TB laboratory staff (200)
– TB staff nurses (113)
Total trained: 837 health profesionals
World Vision B&H - GFATM Project
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The Roma are de facto the largest
national minority in Bosnia and
Herzegovina, app 80.000
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The largest number of Roma in BiH is in
social need - health, housing, education
and employment
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No health insurance
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The percentage of Roma employed within
the public sector in BiH is extremely
adverse and ranges between 2-3%
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The most common source of income for
Roma today is self-employment,
specifically in the sector of secondaryraw
materials collection and waste recycling.
World Vision B&H - GFATM TB&HIV Project
World Vision B&H - SSF GFATM TB Project
Objective 5 of TB project: Improve TB Control in Roma and Other Vulnerable Population
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Establishment of 4 Roma Regional TB Centers
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Engagement 4 Roma coordinators, 16 outreach workers, and 50 nurses
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Development of the program model and the plan of implementation strategy of DOTS TB
in Roma communities
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Sensitization and mobilization of the Roma on the prevention of TB thru outreach work
(3.102 Roma)
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Sensitization and mobilization of social and health workers in Roma issues (203
workers)
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Screening and monitoring of TB in Roma communities (177)
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TB patients on DOT by PPN (76 patients)
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Distribution of combined food-hygienic parcels for TB patients (1937 parcels)
World Vision B&H - GFATM HIV Project
Objective 1 of HIV project: Maximize Coverage of Effective HIV Prevention and Care
Among Most-At-Risk Population and STIGMA reduction
•
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Establishment of 3 HIV Info Centers
Engagement 3 Roma coordinators, 20 outreach workers
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Organization of trainings for outreach workers and representatives of 3 Roma Info
Centers
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Sensitization and mobilization of the Roma people on the prevention of HIV/AIDS, thru
outreach work (4.120 Roma)
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Sensitization and mobilization of Roma community leaders on HIV and AIDS issues
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Sensitization and mobilization of health workers in Roma issues, with aim to improve
SBC with the Roma (67 workers)
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Roma community members conducted VCT (236 Roma)
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Distribution of condoms (38.045 condoms)
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Distribution of IEC materials (14.461 material)
Prisons in Bosnia and Herzegovina
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Total population of country:
3,8 milion
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Number of prisoners in
country: 2.668*
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Number of prisoners rate:
69/100.000 population *
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Turnover of prisoners per
year: No data
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Number of prisons: 15
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Capacity of prisons: 3204**
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State level
Ministry of Justice BH
State prison:
The Detention Unit at the state level
20-30 cells
Entity level:
Federal Ministry of Justice
Capacity app 1600 beds
Prison:
KPZ Zenica
676
Prison:
KPZ Tuzla
169 beds
Prison:
KPZ Sarajevo
257 beds
Prison:
KPZ Bihac
40 beds
Prison:
KPZ Mostar
144 beds
Prison:
KPZ Ustikolina
No data
Prison:
KPZ Orasje
No data
Prison:
KPZ Busovaca
No data
*Data from 2007
** Not relable data
State prison:
Institute for Execution of Criminal Sanctions,
Detention and other Measures of BiH
300 beds/will be finished in 2013
Entity level:
The Republic of Srpska Ministry of Justice
Capacity 1604 beds
Prison:
KPZ Kula
228 beds
Prison:
KPZ Foca
490 beds
Prison:
KPZ Trebinje
74 beds
Prison:
KPZ Doboj
237 beds
Prison:
KPZ Bijeljina
134 beds
Prison:
KPZ Banja Luka
441 beds
Basic information of prisoners
Federation BH
Number of prisoners per year
Overall TB situation in
Bosnia and Herzegovina
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In 2009, 2010, 2011 incidence rate was 50 per 100 000 population
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Prevalence rate 60 per 100 000 population.
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Number of TB cases in 2009: 1772
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Number of TB cases in 2010: 1.390
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According to the relevant Global WHO Report, the overall treatment success for
new smear positive rate is 92% and the case detection is estimated to be 91%
for all forms.
Overall TB and MDR situation in prisons in
Bosnia and Herzegovina
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Number of TB cases in BH in 2011: 1.425
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Number of TB cases diagnosed in prisons in 2011: 2
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Guidelines for TB treatment: National TB Programme NTP approved in
accordance with WHO Global Program
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TB is diagnosed in prisons (sputum collection, X-ray, blood samples): upon
arrival
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Only few TB cases detected in the past years
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The proportion of MDR of all TB patients: 7 out of wich 1 in prison
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MDR patients get second line treatment
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Analysis in prison: smear, culture, DST (Drug susceptibility testing), rapid tests,
X-ray, DST to first line in BH Lab and second line medicines in Borstel
HIV situation in prisons and in
Bosnia and Herzegovina
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1989: first HIV positive person registered
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Total number of HIV cases in B&H: 196 (116 AIDS)
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In 2011: 26 new HIV positive persons, (11 patients developed AIDS)
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Low HIV prevalence country: 0,1%
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83 patient living with HIV under the supervision of health services, (63 ARV)
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Number of HIV cases diagnosed in prisons: None
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Prisoners are tested on request
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Total number of HIV-infected prisoners: 1 person
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In last 10 years HIV situation is stable in prisons
HIV situation in
Bosnia and Herzegovina
HIV&IDU situation in prisons in
Bosnia and Herzegovina
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WHO guidelines are in use
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ARV is available in prison
system and distributed by
health workers
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One prison in B&H with
specialized sanatoriums for
TB, mental and other
patients
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No prisons specialized for IDU-s, they are placed in every prison
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No accurate data for number of IDU-s in prisons
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Socio-demographic background of HIV and TB cases in prisons: immigrants and
other vulnerable groups
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Regularly education, information sharing, counseling, syringe exchange, for IDU
thru GFATM and health system
Prison system`s integration with national
treatment programme and health workers
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Prison system's integration is in the line with national TB and HIV substitution
treatment programme
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Finances the services in prisons: Ministry of Internal Affairs BH and GFATM
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If the prisoner is released before TB, ARV or substitution treatment is over,
health institutions and VCT (18) centers are available
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Trainings for the prison staff on TB and HIV issues are done continuous, thru
health system and NGOs (GFATM )
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No HIV or TB cases among the prison staff related to occupational exposure
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Annualy examination for health care providers TB and HIV if is neccessary
Thank you!