PCEA Chogoria Hospital – Longitudinal Care And Linkage Officer.

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CHAK-CHAP UZIMA -LONGITUDINAL CARE AND LINKAGE OFFICER

Job Purpose:

The Longitudinal Care and Linkage officer will provide guidance related to linkages through the continuum of testing to enrolment (Test & Treat), continuity of care, patient retention strategies, and adherence support.

Primary Responsibilities:

• Ensure that 100% of newly identified Positive clients are linked within supported facilities.
• With the guidance of a clinician or TAS Lead; Conduct TPS session/health talk in support group (group or one-on-one) for newly identified Positive clients.
• Ensuring linkage to care of all HIV-positive clients and same-day treatment initiation through the ‘handshake’ approach
• Escort Newly identified clients and hand over to TAS lead for enrollment and ART initiation process
• With guidance from HTS lead, support behavior interventions, peer support, assisted partner services and conduct home visits
• Track and monitor the implementation of linkage activities, using agreed indicators as guided by the HTS lead
• Serving as a point of contact and information base between the community and facility
• With guidance from the HTS lead, Participate in screening for eligibility of clients in OPD
• Reviewing the HTS Registers/KenyaEMR daily to ensure that all clients are tracked for initiation on antiretroviral therapy (ART)
• To identify, Mop up non linked clients for assessment and tracing in liaison with CHVs and peer educators;
• In liaison with TAS Lead coordinate all existing Cohort support groups for newly identified positive clients and ensure 100% attendance; Ensure registration of new clients and timely follow up.
• Implement patient tailored support at facility level; Listen to and document their complains with the aim of finding solutions especially to those complains that might be hindrance to good adherence/Clinic Appointment
• Collaborate with community health volunteers and peer educators and HTS /TAS teams to provide telephonic tracing services for patients lost to ART initiation or on follow up for linkage
• Promoting the ‘Welcome Back’ strategy and Implement case management of clients returning to care or returning for linkage
• Remind clients on their appointment days through the appropriate means e.g. voice calls, text or WhatsApp;
• Participate to coordinate and manage the activities of the facility Wits linkage hub.
• Keep a tracking log of identified challenges, Compile weekly reports on the outcomes of tracking and tracing activities
• Actively tracking and documenting patients who have transferred out of the facility/Linkage to other facilities
• Compile weekly data and submit data for telephonic tracing to the TAS lead
• Participating in the facility’s bi-weekly and monthly data review meetings.
• Supporting the facility staff with data collection, collation and verifications related to the linkage
• Tracking linkage targets, and preparing and submitting monthly reports
• Submitting daily, weekly and monthly data reports to the facility
• Participate in Multi-Disciplinary Teams (MDTs) to discuss EACs/ CQI meetings to discuss linkage Performance.
• Any other duties as may be assigned by the supervisor.

Professional Qualifications:

NASCOP Certified HIV Testing and Counselling Professional/ Adherence related course

Experience:

4 years’ relevant work experience, 2 years’ experience at community level

Skills:

• Interpersonal and communication skills
• Analytical and report writing skills
• Computing skills

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