AFISE Delivering multidisciplinary services at Baylor Ro
Delivering multidisciplinary services
at the Romanian HIV Centre of Excellence
Issues The establishment of the Romanian Centre of Excellence
(COE) in 2007 provided an opportunity to develop and deliv-
er upon standards multidisciplinary medical and psychosocial
services for all children, adolescents and adults in Constanta
County- Romania; the concept of the COE is the public pri-
vate partnership, which is offering sustainability and commu-
nity linkages.
Description BIPAI is one of the largest providers worldwide of comprehen-
sive care and treatment for HIV-infected children and families.
Established in 1996, BIPAI has built and operates Children’s
Clinical Centers of Excellence (COE) in Botswana, Lesotho,
Swaziland, Malawi and Uganda in sub-Saharan Africa, as well
as in Romania. In 2007, the mortality rates of less than 1% per
year recorded at the centre in Romania due to delivery of mul-
tidisciplinary services qualified the centre as a centre of excel-
lence. The centre is a partnership between Infectious Diseases
Hospital in Constanta, BIPAI, Texas Children’s Hospital and
Baylor College of Medicine Houston, as well as Abbot Fund,
USA.
The initial complex model of care proposed by BIPAI is now
extended to all HIV infected patients in Constanta region, re-
gardless of age. The services that the centre provides are: HIV
care, opportunistic infections, psychosocial services at the
centre and through home visits, TB management, Ob/Gyn
services, PMTCT and dental services.
Results At the end of 2008, about 840 patients were registered at the
centre, with 777 on ARV; around 463 unduplicated patients
received various types of psychosocial support; couple coun-
seling, especially for serodiscordant couples, and PMTCT are
becoming increasingly important. The centre has expanded
its services in the community, by offering rapid VCT. During
2008, more than 4000 persons accessed these services and 23
cases were reactive.
Lessons learnt Services need to be able to offer continuity of care, regardless
of age, and to respond to changing needs in accordance with
life tasks at different life stages. Partnerships are key for success
and sustainability. Motivating a team comprising individuals
from different organizations is best achieved by mutual adop-
tion of agreed upon and to some extent comprehensive goals
and objectives. The idea of aiming for excellence was inspiring.
Next steps The centre operations will be supported by an electronic med-
ical record system and by scaling up strategic partnerships.
Authors:
A. M. Schweitzer, Baylor Black Sea Foundation
S. Mihale, Baylor Black Sea Foundation
M. W. Kline, Baylor International Pediatric AIDS Initiative
N.R. Calles, Baylor International Pediatric AIDS Initiative
S.Rugina, Infectious Diseases Hospital Constanta
J. Richardson, Abbott Fund