Cameroon Link participates in New Bell District COORDINATION MEETING OF OCTOBER 2021

Eliszabeth Glaser Pediatric AIDS Foundation, EGPAF, sponsored the New Bell District Coordination Meeting of 12th October 2021 at Design Hotel in Bali-Douala presided over by the representative of the regional delegate for public health in the Littoral. Mrs. BAYICKE Chimene made a presentation of the objective of the meeting and designated minute s secretaries. She told participants that it was an opportunity to make an evaluation of progress in the prevention of the spread of HIV in the past three months, exchange on the challenges and make proposals on the best strategies to fill the gaps created by obstacles. She focused her attention on the coordination of activities in the health district during the month of September 2021. The officer in charge of monitoring and evaluation presented data collected for the 4th cluster and the results expected. The data was discussed and validated after a question and answer session. There was followed by the moderation of presentations of the different project sites, trigulation of data from the sites and validation. Dr. Sih made a presentation on the situation of HIV therapeutic drugs , the stock and challenges during delivery in each site site. It was noted that some sites like Baptist Hospital Mboppi with over 5.000 PLHIV do not receive enough stock to satisfy patients and most patients receive their ART monthly and not quarterly or bi-annually as recommended by the protocols.

The leader of the TB Unit made a presentation of activities in her sector and it was noted that some patients receive treatment but it is not documented. The coordinators of the different sites were advised to update their data for presentation of the real situation in each site. Some patients change their residential areas and telephone numbers and are lost during tracking especially when they move from one region to another. It was advised that tracking should be done and coordinators of TB in the new sites of the patients informed for better follow up. Mrs. Abomo presented the best strategies for tracking TB patients to guarantee that treatment protocols are respected to avoid transmission to other persons. At New Bell Prison, patients are sent home after completing their prison terms without notification of the health official there. This was given as the reason for incomplete data. If the health centre in New Bell Prison was notified, follow up would have been easier as the staff in the new location of the patients would have been notified to continue follow up. Coordinators of Community based organizations, CBOs, were given the opportunity to make presentations on the activities in their different sites with challenges and suggestions for amelioration of performance. Mr. Mekal of the GTR/AIDS in the littoral presented a review of activities of CBOs during the month of September 2021 in New Bell District. Challenges in relation with the different communities were presented and solutions proposed to improve for better results. The meeting ended with an elaboration of a plan of action for follow up of recommendations. Facilitators were Dr. Mossi, Dr. Sih, Dr. Etoa Mebara, Dr. Bayicke Chimene, Mr. Mekal, Dr. Nyemb Grace of EGPAF and Arnold Ndille of EGPAF, Mme Audrey Sah of GTR. Participants were coordinators of CBOs and UPEC Majors from the lead sites in New Bell, Mboppi, Ad Lucem, CMA Congo, Nkololoun and New Bell Prison. The CBOs were APSUPES, KAMITIK, New Way, FESPAC, and Cameroon Link. There were also representatives of the community, COSADI, COSA, representative of pharmacies and the associate of monitoring and evaluation from New Bell. Cameroon Link was given the opportunity to present the way forward since the signing of protocol agreement with GTR/AIDS for Littoral. To get a clear picture of how prepared Cameroon Link is, we have below traced activities and evaluation sessions organized at the level of the CBO and UPEC since the 10-page protocol document between GTR/Littoral and Cameroon Link was endorsed on the 4th June 2021 and deposited at Hopital General Douala and Baptist Hospital (CBC) Mboppi. Reports of the meetings and working sessions at Baptist Hospital and New Bell District level were shared with staff for updates. The focal point of CBOs, has coached staff of Cameroon Link on the filling of the DAILY APPOINTMENT REGISTER FOR PLHIV on ARV and the HIV Anti-retroviral dispensation register. Since the 14th July, 2021 the CBOs’ Focal Point for Baptist Hospital (CBC) Mboppi, the UPEC Coordinator and EGPAF Project representative, have trained and informed Cameroon Link staff on the management of Cohorts through the registers and sharing of data. Cameroon Link Participates in training on differential models for dispensation The Chief of District of Cite de Palmiers –Douala presided over a training on the diferent models of dispensation of ARV at Bano Palace Hotel on Monday, 25th October 2021 and this brought together team leaders from the health facilities, health technicians, Carers of PLHIV, nurses and persons from community based organisations involved in community dispensation of ARV to PLHIV. The Focal Point of the activity in Cite des Palmiers, Dr. Fon, animated the training session. In the opening address of the Chief of Cite des Palmiers, he said it was an opportunity to share information on the strategies for an efficient delivery of ARV to PLHIV, collecting information o th challeneges and sharing possible solutions for amelioration of services and closing gaps for better results.

Dr. Fon introduced two exposes on the different models for dispensing ARV and a review of the document on registering deaths caused by HIV and transferred PLHIV from one site to another and documentation of anonymous ICT cases. Comments and remarks were made on contributions made by activities related to Family Planning, Prevention of Mother to Child Transmission, district services and PEPFAR before a review of recommendations and key points. This report takes a look at the 10 different models for dispensing ARV and those involved in the execution of each model and how to go about it. The different models for dispensing ARV is an approach which aims at simplifying and adpting services relatd to HIV taking into account the different services awaited by the different groups o PLHIV. This approach also aims at reducing unnecessary cost attributed to the health system. This centers resources of the health facility on persons who need them most. This directive explains the the procedure for documenting the differential models of services (DSD) of dispensation of ARV to patients. It equally defines the different models and codes corresponding to each of them. This directive is for explotation by all staff of CTA and UPEC. It is used in all health facilities (FOSA), UPEC, CTA in the regions of the south and the Littoral. The primary tool of different models for dispensing ARV is the dispensation register of ARV , considering the fact that there are no variable permitting it possible to record the different models in the register. The column for commnts will be used for this purpose. In addition, the dispensation form of the the support groups, ARV registers of CBOs can also serve as source of documentation of thedifferent models of dispensation. Differential models of ARV dispensation (DSD) Individual models based in health facilities (FOSA) DSD1 – Accelerated service (Fast Tracking Services) Definition: Anold patient on ARV without any complaints is received directly at the pharmacy without passing through the medical consultation or para-medical Dispensators: Pharmacists, pharmacy assistant or ACCR Comment to be documented: At the time of dispensation, the consultant registers the the DSD1 Code in the column dedicated for recording the differential model of the patient served. DSD2 - Dis pensation on escort (Rapid Pick Up) Definition:The patient is escorted by a staff of the health facility (FOSA). Dispensator: Pharmacists, pharmacy assistant or ACCR Procedure of dispensation: See definition Comment to be documented: At the time of dispensation, the consultant registers the the DSD2 Code in the for recording the differential model of the patient column dedicated served. DSD3 – Service Convivial (Friendly Services) Definiion: PLHIV receive ARV in a space specially arranged and this a a child friendly corner, adolescent friendly corner, male partner, VIP. And others. Dispensator: Medical Officer/Coordo,Major, ACCR Procedure of dispensation: The dossir of the PLHIV is used as the liaison for dispensation and update in the register for dispensation. The dispensator collects the drugs of the patient and proceed to dispensation proper. Comment to be documented: At the time of dispensation, the consultant registers the the DSD3 Code in the column dedicated for recording the differential model of the patient served. DSD4 – Horaire Flexible (Flexible hours and Odd hours) Definition: The PLHIV is dispensed in the health facility (FOSA) out of normal classical working hours of service and during week ends and public holidays. of dispensation Dispensator: APS, Medical Officer/Coordo, Nirses, ACCR Procedure: ARV are dispensed to the PLHIV out of official working hours and the medical consultation document of the patient is used for updating the register of dispensation. Comment to be documented: At the time of dispensation, the consultant registers the the DSD4 Code in the column dedicated for recording the differential model of the patient served. Model of the group based at the health facility (FOSA) DSD5 – Support group within the health facility (Facility Support Group) Definition: These are PLHIV dispensed within the health facility support group. Dispensator: APS, Medical Officer/Coordo, Nirses, Pair Educators Procedure: ARV are dispensed to the PLHIV during meetings of the support group and the dossier of the patient used for updating the register of dispensation Comment to be documented: At the time of dispensation, the consultant registers the the DSD5 Code in the column dedicated for recording the differential model of the patient served. DSD6 – Dispensation Familiale (Family Dispensation) Definition: The ARV of the patient is collected from the health facility (FOSA) by a a parent of PLHIV. Dispensator: Pharmacists, pharmacy assistant or ACRR Procedure of dispensation: See definition Comment to be documented: At the time of dispensation, the consultant registers the the DSD6 Code in the for recording the differential model of the patient column dedicated served DSD7 – Pair Support Group ( Community led ART Delivery) Definition: The ARV of the patient is are dispensed by a member of a community group of the patient of which he is a member. Amd is served from a health facility (FOSA).collected from the health facility (FOSA) by a a parent of PLHIV. Dispensator: Le pair ( Peer) Procedure of dispensation: The Peer collects the ARV from the health facility (FOSA) and fills the update before collecting the drugs by the patient. Comment to be documented: At the time of dispensation, the consultant registers the the DSD7 Code in the for recording the differential model of the patient column dedicated served. The form signed by the patient is returned to the health facility for documentation. DSD8 – Dispensation a domicile (Home Delivery) Definition: The patient is dispensed at home by a staff of a health facility ( Nurse or APS) Dispensator: APS, ACRR, Medical Officer and Nurse Procedure of dispensation: A form for dispensation/distribution is filled by the dispensator during collection of the drugs at the pharmay. The PLHIV signs on the form to confirm reception of the product and the form is used for update of the dossier of the patient served and in the register of dispensation. Comment to be documented: At the time of dispensation, the staff registers the DSD8 Code in the dispensation register of differential model of the patient column dedicated as served. The form signed by the patient is returned to the health facility for documentation Model of the group based in the community DSD9 – Support Group (CBO Support Group) Definition: The patient is dispensed within the frame work of support group in the community . Dispensator: Responsibility of CBO Procedure of dispensation: A form for dispensation/distribution is filled by the responsible staff of the pharmacy during collection of the drugs at the community pharmacy. The PLHIV signs on the form to confirm reception of the product and the form is used for update of the dossier of the patient served in the register of dispensation. Comment to be documented: At the time of dispensation, the staff of the health facility (FOSA) registers the DSD9 Code in the dispensation register of differential model of the patient column dedicated as served. The form signed by the patient is returned to the health facility for documentation. DSD10 – Dispensation Familiale en Communaute (Family Clinic Community) Definition: Thedrugs of the the patient dispensed is collected at the office of the CBO/OBC, by a PLHIV or a family member of the PLHIV. Dispensator: OBC Procedure of dispensation: A form for dispensation/distribution is filled by the responsible staff of the pharmacy during collection of the drugs at the community pharmacy. The PLHIV signs on the form to confirm reception of the product and the form is used for update of the dossier of the patient served in the register of dispensation. Comment to be documented: At the time of dispensation, the staff of the health facility (FOSA) registers the DSD10 Code in the dispensation register of differential model of the patient column dedicated as served. The form signed by the patient is returned to the health facility for documentation. List of PLHIV for Community Dispensation of ARV – HOPITAL GENERAL/Cameroon Link No Serial Code Name Start Date Contact Residence Tel. No Age 20 – 24 years Age 20 -49 years Age 50 years M F M F M F 1 LT01/01/21/001 Ekongolo Jean M. 08.10.08 G. Souza 653567844 x 2 LT01/01/21/002 Tchamamba Chris 01.09.08 Meleke 697709846 x 3 LT01/01/21/003 Bo0kop Dorine 04.08.09 Miang 67545110 x 4 LT01/01/21/004 Kouague Dorice 01.11.09 Mundani 691929237 x 5 LT01/01/21/005 Kenemben Nathali 15.06.10 Miang 695397746 x 6 LT01/01/21/006 Essoh Fridolin 12.07.10 Souza 674162430 x 7 LT01/01/21/007 Ndongue Bebey 10.06.10 Mangamba 695147378 x 8 LT01/01/21/008 Guekam Auriele 11.02.09 Miang 699213812 x 9 LT01/01/21/009 Kedi Rose 06.09.11 Miang 697966972 x 10 LT01/01/21/010 She Julienne 06.07.11 Bessounkang 694532230 x 11 LT01/01/21/011 Wangue Emile 02.08.10 Bwapaki 679475950 x 12 LT12/16/2160 Heen Fonyuy Anna 20.8.09 Rail Sodiko 677101300 x 13 LT01/01/21/013 Eke Ndong E. 12.04.10 Mangamba 694791550 x 14 LT01/01/21/014 Ngasse Christine 08.05.13 Mangamba 694779215 x 15 LT01/01/21/015 Mbah Christabell 10.09.11 Souza 676188126 x 16 LT01/01/21/016 Menekeng Isabele 11.01.12 Mandouka 670215551 x 17 LT01/01/21/017 Mouako Ewane 19.12.11 Souza 696444053 x 18 LT01/01/21/018 Njikiale Victor 08.05.12 Mbonjo 693596004 x 19 LT01/01/21/019 Abomo Yvette 12.07.13 Qtier Hausa 696152040 x 20 LT01/01/21/020 Elisabeth Njoh 20.03.10 G.Souza 691425868 x 2 14/ 2 2 Observations All decisions should be analyzed and adapted to the problem of each PLHIV before execution. This means that patients should be at the center of the pre-occupation of CBOs. It should be noted that Hopital General is a CTA and Baptist Hospital Mboppi is an UPEC. This defines and determines the level and intensity of health practice delivery. A register has to be bought for recprding activities of support groups and home visits. The staff of the CTA and UPEC are requested to support the CBOs during the execution of their activities in the community. DSD accelerated services are carried out by the APS ( Companions of HIV Patients). They are 10 DSD groups concerned with dispensation of ARV as explained above specific spaced in the CTA, UPEC and community. PLHIV should be encouraged to give the names of their partners during the execution of anomymous ICT activities. This can be done by asking them to put the names in a box where ARV are dispensed, because most patients would not like to speak about their partner or partners. Advise them to put the telephone numbers which could be used in contacting them. This technique has been tested and results were positive. PLHIV should be questioned every month on their situation as the ARV are taken and especially if there are any side effects or opportunistic cases. This helps to reduce any resistance of HIV.

Cameroon Link engages in Community Dispensation of ARV for PLHIV

Monthly Report of October 2021 The Themonth started with the first weekly evaluation and review meeting. The UPEC Coordinator, Dr. Serge Djombissie welcomed the participants after prayers. Each focal point presented a report on the work realized. In the reports, issues related to the daily appointment register for PLHIV on ART were handled. These included the data of viral load collection (VL), ART Code, initials of first and last name of patients, sex, age, contact telephone numbers address of residential area of patients and general observations. The general observations indicate the actual situation of patient, which include transfer of patients, search of PLHIV who have not shown up for more than three months and follow up initiatives to get their where about or whether they are dead. On the appointment register is put the date of the next appointment and month the patient has to show up at the health facility (FOSA) for a check up.

The officials insisted on punctuality for meetings and dispatching of reports. Focal points are requested to get their reports ready ahead of the meeting day to share knowledge on the global situation for appreciation. There are focal points that arrive at meetings without completed reports. It was suggested that focal points should be coached on making presentations during meetings to familiarize them on the technique of reporting. Since the hospital operates with two languages, English and French, both will be used for expression where necessary. Each focal point in the presentation gives the number of patients expected during the week and month with the number of persons who showed up and number of absentees. A percentage of the result is given as out-come. The number of persons screened and initiated on ART is also presented. Baptist Hospital of Mboppi has 23 Cohorts currently caring for over 5.000 PLHIV. These include different age groups starting from babies, persons above 10 years and persons above 40 years. Men and women married and not married. The hospital is caring for over 5.000 PLHIV has the problem of insufficiency of ART for multi-months dispensation. The quantity received is not enough and the hospital has adoptd monthly dispensation instead of quarterly semester deliveries. At Baptist Hospital Mboppi, members of Cameroon Link were attached to the pharmacy to learn about the circuit for dispensation of ART and the different types of ART available. James Achanyi Fontem continues coaching at the consultation level to get insights on the different approaches and difficulties for receiving and interviewing patients during checkups with the UPEC. It was noted that each patient has a particular attitude and the approach and collection of information is diverse. There are patients that do not respect their appointment dates and the reasons are collected like illness and travel or busy occupations periods. The number of tablets he/she has is asked and this facilittes in taking the decision on the number of tablets to be served the patients. Some patients’ complained of side effects of the ART they received like itching and rashes on the skin. They are asked when the itching started and the type of water they bath with. Most of those who complained of itches use water from the wells. This means the wells need some purification with a few drops of camel water regularly. Due to the nature of daily occupations of some patients, a request is proposed for change of the time to take the ART. Some prefer in the morning and others in the evening. The patients are advised to respect the time for taking their ART. They are informed that the most recent generic of ART is programmed for early in the morning and preferably at 07H00 because it keeps the patient awake throughout the day. IF TAKEN IN THE EVENING, IT RETARDS SLEEP. Other types of tablets make the patient to be dizzy and it is advised to take them in the evening instead of the morning. All pregnant mothers who arrive to start pre-natal consultation are screened automatically. This facilitates decision making on the therapeutic ART FOR THE PROTECTION OF THE MOTHER AND FEATUS. Special files are opened for pregnant mothers and newly delivered babies. It should be recalled that the Baptist Hospital in Mboppi receives over 5.000 patients on ART and data is updated during weekly meetings on Tuesday afternoon coordinated by the UPEC boss, Dr. Serge. During the meetings, focal points present data collected and report on attendance or respect of appointments by patients and difficulties encountered. There are cases of patients who want to be served multiple months ART because they have left Douala for their villages in other regions. Asked whether they needed a transfer to their new residences or locations, they refuse and prefer to be served from CBC Hospital Mboppi. Asked whether they have any persons who could collect their ART and send to them where they are now residing, they hesitate giving any names. The ART given now to patients covers only a period of one month and patients have to go to the health facility every month to be served. Some patients are married but both do not live in the same town or home. This is a problem. For patients on ARV, it is important to understand that the treatment is for life and there should be no break. A break gives the virus opportunity to become resistant. If a patient cannot go to the health facility to collect his/her ARV, a relative or friend should be sent to do so. Patients should avoid having bruises or openings on the skin. It creates opportunities for infections. Often the part of the body infected swells as a sign and this must be treated immediately. The patients should be able to say if he/she is having any side effects during treatment. These are often issues that need to be handled and addressed quickly. Child care is very important for mothers that are breastfeeding. Babies that breastfeed are always very alert and interested in what happens around them. They act sometimes like adults in search of things they can carry along with them. It may be your phone, your keys or anything attractive. Babies suck the breast anywhere and it should be known that it is the right of the baby. The breast of a woman is for producing the baby’s milk. Baptist Hospital in Mboppi promotes exclusive breastfeeding for the first six months after the birth of a baby and follows up the mother with a rapid test to guarantee that it is safe. As concerns the time for taking the ARV either in the morning or in the evening, an alarm clock is necessary because it awakens the patient and reminds him/her of the time to take the ART.

The report of validation for the month of August and September 2021 was presented to highlight the information needed by UPEC and GTR-Sida/ Littoral. This report covered the number of new cases diagnosed and the number of patients served with ARV. The objective of community dispensation is to reduce long waits of patients when they arrive the health facility (FOSA) and to reduce distances from their residences and spending on transport fares to collect their drugs. The UPEC Coordinator emphasized on the need to remind patients on the appointments for collection of their ARV two days to the stipulated date. Patients who fail to show up for appointments for three months are directed to the health facility (FOSA) for retesting or screening after counseling. New Horizon, the project to monitor cases of children infected has been launched. The pilot phase is currently taking place in Yaoundé and Douala. It is after the pilot phase that activities will be spread throughout the republic. The virus and its development in the body is explained by actors involved in prevention. The virus spreads very fast where the patient is faced with other problems related to itching, rashes, fever, tuberculosis, malnutrition, diarrhea just to name a few. When the virus penetrates the body, it hides in blood cells and reduces CD4 known as soldiers. Illnesses related to skin diseases show up as signs. One-third of children infected die because their cells are weak. Children with HIV I die before the age of 5 years, while those infected by HIV II die before the age of 10 years. The number of CD4 varies with age and synthoms. At the third level, the symptoms’ of tuberculosis and diarrhea show up. When a patient arrives the health facility (FOSA) with an opportunistic problem, the viral charge load (CV) test is done before any prescription. It was noted that Index Testing at Baptist Hospital Mboppi has been very low and it is below 5%. The coordinator said this sector of HIV prevention activity has been dormant and needs to be activated. He encouraged actors to improve on their strategy working with sex workers. At least 36 cases should be identified weekly. Line listing activities need to be improved also to improve on data collection. This will be considered as evidence of what is happening in the district. Actors were invited to dialogue in the whatsapp group and share their experiences. Generally, messages are put on the group for reaction, but no responses are received. The purpose of the group is to harmonize the strategies in what everybody should be doing. Doing the same thing and updating knowledge at the same time improves on work. Sensitization messages should be harmonized. Actors should avoid frightening patients, especially on the adoption of certain conduct and attitudes like drinking or eating bitter kola for example. The use of telephones for booking appointments is necessary. Each time one is with a patient, the telephone number given should be verified immediately. Often, some patients give wrong telephone numbers and some even change their numbers and residences without notifying the UPEC or APS in charge. Patients will give all types of excuses for not taking their ARV regularly, Actors should emphasize on the need to respect the time announced during prescription and report if they have any difficulties. They are advised to use alarm clocks and watches as reminder tools. This is important. Another specialized group of counsellors has been introduced at Baptist Hospital Mboppi. These counsellors focus and target single mothers who are parents with children without husbands. It has been observed that this group of mothers hav specific problems and requests to be tackled very strategically. They were given the opportunity to explain what their work consists of and how they are going to work with UPEC actors attached to the Mboppi hospital during weekly evaluation meeting. It was noted that some of these mothers refuse to disclose their situation, though they need support. There are women living with many men but do not disclose their situation to the partners because they fear to be abandoned. It was advised that actors should encourage patients to adhere to their treatment. There should be continuous monitoring by actors. Actors should make efforts to counsel both partners because this creates better security for their health and wellbeing. The role of the counsellor is to educate and convince patients to adhere on the right decision. EGPAF has put an incentive for motivating actors to improve on their performances. Those who will succeed to convince parents and sex workers to join in the HIV prevention strategy wagon and adopt positive strategies will be compensated monthly if they come up with one case or more each week. Way Forward from October 21 To get a clear picture of how prepared Cameroon Link was, a third and final site evaluation took place on the 27th October 2021 and we have below traced activities and evaluation sessions organized at the level of the CBO, Hopital General and UPEC Mboppi. We organized working sessions with Cameroon Link staff on startegies for collaboration with Hopital General and Baptist Hospital Mboppi. The CBO Focal point, the UPEC Coordinator of Baptist Hospital Mboppi and EGPAF Representative at the district were guided by the focal point of CBOs on updates of appropriateness of Cameroon Link . Staff immediately engaged in the adaptation of the instructions received. From the month of July 2021, staff of Cameroon Link started attending evaluation meetings of CBOs and APS to learn about the circuit of ARV and dispensation in the community through reports presented by actors already involved in the system. This concerned reporting on data of PLHIV in each health area, the respect of appointments, sensitization and counselling of PLHIV just to name a few activities. Reports of the meetings and working sessions at Baptist Hospital and New Bell District level were shared with staff for updates. The focal point of CBOs, has coached staff of Cameroon Link on the filling of the DAILY APPOINTMENT REGISTER FOR PLHIV on ARV and the HIV Anti-retroviral dispensation register. Since the 14th July, 2021 the CBOs’ Focal Point for Baptist Hospital (CBC) Mboppi, the UPEC Coordinator and EGPAF Project representative, have trained and informed Cameroon Link staff on the management of Cohorts through the register and sharing of data. They have been informed that some 500 PLHIV will be handled by Cameroon Link CBO in Bonaberi-Douala. For this reason, the training at the UPEC has focused on two main registers used during community dispensation of HIV anti-retroviral therapy drugs notably: 1. DAILY APPOINTMENT REGISTER FOR PLHIV ON ART 2. TRACKING REGISTER FOR RESEARCH OF PLHIV ABSENCES OR LOSS In the dispensation register each of the 17 Cohorts will occupy one page in the register and it was explained that the patients will be drawn from the period 2008 to 2019. Patients will be followed up by Health Facilities (FOSA) for 24 months before they are transferred to CBOs when their Viral Loads (CV) are considered stable. The 500 patients announced will be classified at Cameroon Link under 17 Cohorts as follows: 1. January 2000 – July 2008 2. August 2008 - August 2009 3. September 2009 - August 2010 4. September 2010 – July 2011 5. August 2011 – July 2012 6. July 2012 – MAY 2013 7. June 2013 – March 2014 8. April 2014 – December 2014 9. January 2015 – August 2015 10. September 2015 – March 2016 11. April 2016 – August 2016 12. September 2016 – February 2017 13. March 2017 – July 2017 14. August 2017 – March 2018 15. April 2018 – September 2018 16. October 2018 – December 2018 17. January 2019 – December 2019 After the first evaluation of the Cameroon Link site, a second evaluation was expected in the month of September 2021 before effective transfer of PLHIV to the community site for dispensation of ARV. Cameroon Link has prepared tracks to facilitate access to Cameroon Link in Bonaberi and these tracks are shared with patients put on the transfer list. The staff designated and trained to participate in the dispensation process at Cameroon link is as follows: 1.James Achanyi Fontem, Team Leader, Tel.: +237 677758840 2.Ojong Helen Ayamba, Nurse, +237 651776537 3. Kamdom Dzukam Christaine Laure, Asistant Nurse. +237 699877186 4. Mbon Flavie Marcelle , +237 675445953 5.Tsopgue Kemti Sandry Doriane, +237 675171014 Evaluation of monthly activities The report shows the following: No of patients expected: 20 No of patients received: 20 No of patients absent with the number of months inclusive: 0 No of patients that have abandoned their treatment: 0 No of home visits organized: 3 No of patients recovered: 0 No of support groups: 2 No of Men: 6 No of women: 14 It should be noted that most of the PLHIV in the residential area of Bonaberi are Internally Displaced Persons (IDP). It is the role of the CBO to organize home visits to encourage patients who abandoned their treatment to continue taking their drugs and the home visits are reported every three months The cohorts covered by Cameroon link are from 2000 to 2018 Cameroon Link started identifying the residences’ and localization zones of patients to facilitate planning of home visits. The telephone numbers of patients are recorded with the name of a family relative who can pick up the drugs of the patients if he/she cannot come to Cameroon Link office. This information is noted on the CBO tracking sheet. The beginning of the 2021/2022 activities started on the 1st October 2021.