MSF Operational Research: Studies, Results, Impact (Episode 1)

MSF Operational Research: Studies, Results, Impact (Episode 1)


Beira is the second major city in Mozambique.
In Beira, we have a seaport located there, so this attracts a lot of sex workers which are concentrating at the truck stops and barracks.
In 2016, we started this pilot study which is on (PrEP) for key populations, which are family sex workers and and MSM (Men having Sex with Men). The main objective is to prevent HIV. It’s a two-year study which we have to
implement and to see the feasibility the acceptability and also the demand for
PrEP in this area. To start with, the research was conducted in
Jordan and Lebanon, these are two countries that were very much
affected by the Syrian crisis because of the huge influx of Syrian refugees into
these countries. This creates a huge health burden on them and overstretched
the healthcare system. This study basically compiled all the data of the
Syrian patients living with diabetes that where seen at MSF clinics in Jordan
and Lebanon. First we describe the characteristics of these patients that
were enrolled in our programs, from the start up to the end of September 2017. Then we assessed the six month of treatment outcome of diabetes care in
these specific patients. The study I’m supporting is a mixed
method research that aims at providing data on the condition of life of
migrants in in Brussels. MSF along with other organizations and civil society
actors in 2017 engaged in what is called the humanitarian HUB, which is basically
a center placed in Gare du Nord in Brussels that provides a comprehensive
package of services for undocumented migrants, and migrants in transit in
the city. The research, as I said, is aimed at providing a picture of this
population accessing the humanitarian hub, specifically what we would like to
know is who are these people, what are their needs,
and what are the reasons why they are coming to this center, and why they are
not able to find these services elsewhere in the city. It’s a very
delicate context, very challenging, it changes continuously, because it’s dependent on political dynamics in the country and in the city. The result was
amazing, and surprisingly we found high acceptability and also
high demand of PrEP. People are taking PrEP for different reasons. They want to
be protected of course, this is the main reason, but they also want to have a
second protection when they are using condoms – in case a condom breaks and in a lot of other other situations. In general, we found the PrEP are accepted by the key population. Out of more than 13,000 patients that were seen in MSF clinics in Jordan and Lebanon – so we are talking about four different sections –
out of them, 53% are Syrian refugees that live with
diabetes. The majority of these patients – 93% of them – have type-2
diabetes, or the non insulin-dependent diabetes, and the majority of them – that
is 90 percent – they come to us at the first visit with an already
diagnosed diabetes. After six months of care, or after six months in the program,
we were able to drop the overall mean of the HBA1C from 9.1 in all patients
with diabetes to 7.7. HBA1C is an indicator that help us assess how well
controlled our diabetes is on a longer term. I personally think that it’s a very
interesting experience, it’s a very interesting research project because it
it sees the collaboration between an operational researcher and an advocacy
person. The expectations are to indeed have a demographic picture of all of the
migrants transiting through through the hub, but also, on the other hand, what we would like to know, through their voices and testimonies, is their condition of
life in the city. This study was implemented together
with the Ministry of Health of Mozambique. So this study will be the the
basic information for implementing PrEP, to scale up at the national
level. It will be the start for our country to implement PrEP, so it can
be available for people at any level. This is our major goal, to
have PrEP scaled-up in Mozambique for for the key population and also in
general if it’s possible. It’s really good to see that we are able to achieve good outcome of care despite many many challenges that we face in this context
like the context of Jordan and Lebanon. So it’s good that we are
able to put a number on on this to start with. This is also only a first step
there is a lot of evidence needed, on the NCD-topic in general, dealing with the Syrian refugees – specifically
because we also use simplified models of care, we use adapted protocols. So there
is a need for us to understand a bit more how the model of care that we use
and the different models of care affect the treatment outcomes. So the results of
this research will be used in a report that we aim at disseminating amongst
governmental actors and civil society agencies, in order to raise awareness on
the condition of life of the migrants in Belgium and their suffering, but also
to possibly show that there’s a possibility to to give these
migrants the needed services and care.

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