The BRIDGES_PLUS is a locally driven effort to ensure the continued improvement, expansion, and long-term sustainability of comprehensive, family-centred, quality-focused HIV prevention, care, and treatment services in six high HIV prevalent states in Nigeria currently supported by CIHP under the BRIDGES project, these states demonstrate gaps in accessing HIV AIDS care and treatment from the National figures and have high populations of PLWHIV who require care/treatment.

The BRIDGES_PLUS aims to provide community and hospital based care and treatment using an integrated approach, effective linkages (e.g. hub and spoke model) and service coordination to ensure continuity of comprehensive service delivery; local capacity building for stewardship to sustain services on the long term. Service delivery activities will be supported through 275 service delivery entities, including public and private health facilities and CBO. The project will make an important contribution to PEPFARs 31212 global targets and take significant strides towards sustainability. CIHP will implement quality HIV care, support and treatment services across all thematic areas in line with national guidelines, protocols, and regimens. We will build on our role as CDCs lead implementing partner for PMTCT to leverage and expand partnerships to harmonize PMTCT support and promote a combination prevention approach, prioritizing youth MARP and with balanced gender-sensitive messaging to address the identified barriers to prevention. In addition, CIHP through the project will increase access to care and support activities through provision of ongoing health-facility and community/home-based services to optimize the quality of life for HIV-infected clients and their families.

CIHP will facilitate the establishment of community based support groups, Home based Care teams made up of volunteers with prior medical experience will be formed within each support group

CIHP will train these volunteers on all aspects of HBC including Adherence and psychosocial counselling, provision of PHDP services, Basic nursing, pain and OI management, and routine screening and syndromic management of STIs

CIHP will provide HBC kits and establish relevant linkages with CBOs, primary and secondary health facilities.

Integrate BCK logistics system into other existing commodities management system such pharmacy and logistics team., and follow up closely with the

Facility based HBC focal persons will be identified in comprehensive facilities and selected PHCs to coordinate community home based care (CHBC) activities and referrals.

CIHP will identify VC using the national child status index (CSI) tools to increase access to services for VC and their caregivers through Health facilities and CBOs

CIHP will organize and conduct meetings to train, educate/mentor and coach staff at CBOs, members/jurors of the family courts, village heads/chiefs, child protection committee members and coalition committee members, State Federal Ministry of Women Affairs Desk officers and Social Welfare Officers.

Provide schools fees and educational materials to selected children in primary, secondary and vocational training institutions across the 4 states through the CBOs

Conduct quarterly site visits to mentor and coach CBOs program staff on developing gender audit tools, gender sensitive indicators, budgets, PEFPAR selective and age based criteria for identifying and selecting vulnerable children.

CIHP will support CBOs to conduct educational programs for families on the needs of vulnerable children, Identify and link them to sources of community social support (community food banks, micro-credit, education, legal and health institutions

Support CBOs to maintain linkages and partnership with other programs USGs MARKETS to build capacities of families in approaches of ensuring that food is available all the year round

CIHP will support the intensification of TB case finding among PLHIV at all supported sites by providing clinical screening for TB for all clients accessing HIV counselling and testing

CIHP will collaborate with the National TB Control program and State TB control program for the regular supply of INH for eligible PLHIV on the IPT program.

Train TB care providers/site clinicians on TB/HIV management and support the printing and supply of TBIC materials, SOPs and guidelines to the supported sites

Institute TB contact-tracing mechanisms at DOTS sites.

Establish TB infection control activities by facilitating TBIC meetings on a quarterly basis at the supported sites.

Provide supervision and mentorship on TBIC activities to the HCWs of the supported sites.

CIHP will emphasize the early identification and enrolment of children into care and treatment services from multiple sources including paediatric wards, out-patient departments and labor wards

Voluntary counseling and testing of adolescents will be encouraged by setting up adolescent friendly clinics.

HIV-infected children will receive a standardized preventive care package including basic care kits, LLITN, Water Guard, water vessels, ORS, disinfectant and soap.

Infants and children who are eligible for ART will receive appropriate first or second-line therapy and will be regularly monitored for drug efficacy and toxicity

Those not yet eligible for ART will be monitored for growth and development, screened for TB and given prophylaxis (IPT) for TB when indicated, receive cotrimoxazole prophylaxis (CPT) following national guidelines and managed for opportunistic infections as needed. Ready-to-Use-Therapeutic Feeding (RUTF) using criteria agreed upon by the USG in-country and GON teams will be provided

CIHP will conduct paediatric ART trainings, ongoing CMEs and Continuous Quality Improvement (CQI) activities

Renovate and equip laboratories to have capacity to perform clinical laboratory tests.

Build lab personnel capacity to procure, supply lab reagents; and maintain equipment.

Implement lab quality management plans and strategies for a sustainable quality management system; build lab personnel capacity on the quality management system; mentor facility lab quality officers on development of site-specific SOP, quality manuals, safety manuals, and related documents

Promote and support laboratory service integration by establishing linkages between ART and non-ART general laboratory units.

Train and mentor HCW on universal precautions/PEP per national guidelines

CIHP will establish monthly data review meeting at community-based organizations and facilities through the use of data for planning and decision making.

Provide capacity building and supportive mentorship to state and facility staff to carry out secondary analysis of service statistic to use data for programmatic decision making

Provide computers and computer accessories to all new supported comprehensive sites to support electronic database platforms

Provide capacity building and supportive mentorship to state and facility staff to carry out secondary analysis

CIHP will build capacity of HCW on appropriate use of blood and blood products, safe blood collection procedures, provision of commodities, increase community awareness and strategic linkages with other partners working with SBFA/ lead IP in blood safety.

CIHP will collaborate with the National Blood Transfusion Services (NBTS) to promote blood safety and strengthen linkages of safe blood facilities to the nearest NBTS centres according to the National hospital linkage program to ensure appropriate screening of blood for TTIs with EIA.

CIHP will establish blood transfusion committees in facilities as well as create new ones in newly supported sites. Blood transfusion committees will be integrated with existing safe injection and waste disposal comities to ensure efficiency and harmonization of activities.

CIHP will develop a pool of low risk voluntary, non-remunerated blood donors by collaborating with NBTS in the development of a nationwide voluntary donor recruitment system, organizing and providing technical support for blood donation drives in supported hospital facilities and nearby communities.

CIHP will use standard questionnaire for donor screening and work with lead blood safety IP and NBTS to develop standard counselling messages for donor counselling and care.

CIHP will promote biomedical prevention through the promotion of safe injections and proper disposal of infectious waste generated in all facilities it supports, targeting directly health care workers at these facilities and surrounding communities.

CIHP will build capacity by training and retraining all health care providers (doctors, nurses, lab personnel, waste handlers) in safe injections and waste disposal.

CIHP will provide protective and waste disposal commodities and devices waste handlers and other HCW; these commodities will include: industrial boots, gloves, face masks, vacutainers, protective goggles, face masks, protective aprons and lamina hoods as well as other commodities such as sharp containers, bench absorbent pads, biohazard bags, spill kits and hazard neutralization materials.

CIHP will renovating/repair existing incinerators and providing new incinerators where required to promote appropriate waste disposal and ensure that bio-medical and other infectious waste generated from all its supported sites are properly disposed.

CIHP will key into the Integrated USG approach to expiry management by participating in all waste drive process to ensure proper management of expiries of laboratory reagents and drugs.

CIHP will to key into the Integrated USG approach to expiry management by participating in all waste drive process to ensure proper management of expiries of laboratory reagents and drugs.

Capacity of peer health educators will be built to form abstinence clubs in the community providing platform for increasing knowledge on adolescent sexual and reproductive health

CIHP will integrate prevention counselling and other services for PLWH into family planning and MNCH clinics as part of the PHDP intervention and build the capacity of HCW to identify and manage STIs

CIHP will support the provision of job aidS, IEC materials and prevention commodities to promote facility based combination prevention activities

CIHP will promote biomedical prevention through the promotion of safe injections and proper disposal of infectious waste generated in all facilities it supports, targeting directly health care workers at these facilities and surrounding communities.

CIHP will build capacity by training and retraining all health care providers (doctors, nurses, lab personnel, waste handlers) in safe injections and waste disposal.

CIHP will provide protective and waste disposal commodities and devices waste handlers and other HCW; these commodities will include: industrial boots, gloves, face masks, vacutainers, protective goggles, face masks, protective aprons and lamina hoods as well as other commodities such as sharp containers, bench absorbent pads, biohazard bags, spill kits and hazard neutralization materials.

CIHP will renovating/repair existing incinerators and providing new incinerators where required to promote appropriate waste disposal and ensure that bio-medical and other infectious waste generated from all its supported sites are properly disposed.

CIHP will key into the Integrated USG approach to expiry management by participating in all waste drive process to ensure proper management of expiries of laboratory reagents and drugs.

CIHP will to key into the Integrated USG approach to expiry management by participating in all waste drive process to ensure proper management of expiries of laboratory reagents and drugs.

CIHP will implement PHDP activities were implemented at the facilities by providing oTI commodities and Lab reagents..

CIHP will promote safer sex through the distribution of condoms to CBO and facilities with emphasis on 'being faithfu'l, correct and consistent condom use with non-marital partners for general population and constant condom usage for PLHIVs

CIHP will reach most at risk persons with comprehensive combination prevention intervention.

Capacity of CBOs will be built to address behaviour change and deliver prevention messages to MARPS and PLHIV

CIHP will provide comprehensive package of intervention to pregnant women attending ANC and implement the triple regimen prophylaxis FOR pregnant women in all comprehensive sites and high volume PHCs

CIHP will build the capacity of HCWs in Kaduna, Benue and Gombe and Kogi states to carry out high quality PMTCT services while facilities will be supported with PMTCT guidelines

CIHP will utilize the services of CBOs to create demand for PMTCT services and TBAs capacity will also be built on referral of the pregnant HIV positive women who patronize them.

The CIHP will introduce the use of cohort PMTCT registers to improve longitudinal tracking of mother and baby pair interventions.

CHIP will establish mother to mother support groups in all comprehensive facilities and high volume PHCs and train mentor mothers to provide peer adherent support to the newly diagnosed HIV infected pregnant women to reduce LTFU.

CIHP will provide transport and logistic support to state officials to conduct PMTCT joint quarterly facility mentoring visits.

Implement test and treat policy in all the PHCs to overcome challenges with delay in providing ARV prophylaxis in HIV infected pregnaneal time CD4 results

Ensure the collection and timely reporting of accurate Logistics data from sites; by ensuring that all SDPs utilize appropriate LMIS tools for their routine handling of commodities,

Build the capacity of Program staff in other thematic areas (PMTCT, Adherence and M&E) on LMHC to increase collaboration for site level support in the area of logistics

CIHP will coordinate the quantification exercise for commodities (ARVs, OI drugs, laboratory supplies, BCK materials, Mama packs etc) and develop procurement plans

Collaborate with SCM, PEPFAR and MOH to train facility staff on Logistics Management of HIV/AIDS Commodities (LMHC).

Conduct regular stock audit, document and report all discrepancies noticed also provide feedback to sites on such discrepancies

Ensure use of job aids on guidelines for proper storage of commodities to supported stores

CIHP will work with GON to expand access to comprehensive ART services through activation new sites in underserved areas.

Strategically ensure prompt enrolment of eligible patients on treatment through various innovative approaches .

Ensure periodic assessment of program performance and quality by facilitating biannual SOC assessment exercise, and other CQI activities including DQA.

CIHP will build capacities of designated PHCs to provide onsite ART refills and follow up for stable patients devolved from overwhelmed comprehensive facilities

Coordinate and facilitate the training and mentorship of health care providers on HIV/AIDS treatment

Monitor service quality via quarterly review of priority indicators with facility staff and state officials.

Ensure availability of National Adult treatment guidelines, job aids and SOPs in the various states

Train and mentor health care providers on PEDIATRICS HIV/AIDS treatment. as well as provide periodic guidance through CMEs at facility level, focused mentoring and preceptor ship

CIHP will strategically focus on early identification of HIV infection status and reaching HIV positive children needing treatment through various innovative approaches. These include the support of paediatrics HIV diagnosis; enhanced and focused paediatric case finding and referral to treatment

Support the provision paediatrics IEC materials, SOP, national guidelines and job aids (dosing guides, cue cards, patient flowcharts, and management algorithms) to comprehensive facilities

Ensure access to appropriate laboratory tests (CD4 %, chemistry, and haematology) in all comprehensive sites.

Establish youth friendly/ paediatric services and support groups to provide psychosocial support for children of PLHIV and reinforce adherence