# Presentation: 679879

## Project CAM H90“Creation  of a Treatment, Rehabilitation and Social Reintegration network in Central America”

**Project CAM H90****“****Creation  of a Treatment, Rehabilitation and Social Reintegration ****network in Central America”**

**Rubi Blancas**
**Project Coordinator**
**CAM H90**
**June 2006**

## I n t r o d u c t i o n

**I n t r o d u c t i o n**

## OBJECTIVE:

** **

**OBJECTIVE:**

***“******To strengthen the structures of treatment, rehabilitation and social reinsertion through  training, equipment and network resources, by developing  a  Liaison Centre  in each Central American country.”***

## Duration

**Duration**

-  **Four years  and  half**
** ****Three work phases, each one last  one year and a half.**
**  ****Started in 2004, we are developing the second phase.**

**FUNDING **

**Project CAM H90 received funding from the “Fund for the Fight against Drug Trafficking**”** of the Government of Luxembourg, a total amount of  1, 700, 000 USD was granted for the development of the three phases.**

## COUNTERPARTS to Project CAM H90  

**COUNTERPARTS to Project CAM H90 **

**UNODC**

## Team for CAM H90

**Team for CAM H90**

- First
- level of attention
- Health Sector

## Achievements First Phase   

- _2004_
- Regional Technical Committee  organized.
- Methodology for national studies and
- Directories on the existing infrastructure
- of treatment, rehabilitation
- And social reintegration.
- Intranet designed

**Achievements First Phase **** **_** **_

- _  __2005_
- Based on the results of each national
- study:
- A Liaison Centre was selected.
- Formal agreements were signed with all counterparts
- National strategies incorporating
- national programs and Project CAM H90.
- First pilot training introductory course
- On Addictions was set On Line.
- Minimun Treatment Standards Workshops
- Investment on infrastructure of LC.

- _2006_
- Belize incorporated.
- Training strategy based on 3 modules
- elaborated by consensus.
- Support of new counterparts in training
- Looking forward to stablish collaboration
- of the Mexican Government
- in the elaboration of the Data Collection,
- Surveillance and Evaluation System (SISVEA)
-           and the ASI from United States.

## NATIONAL STUDIES 

**NATIONAL STUDIES **
**Geopolitical context**
**Socioeconomical context**
**Research and studies**
**Legal frame**
**Human Resources **
**Treatment standard norms**
**Centres acreditation**
**Treatment models**
**Treatment demand**
**Infraestructure**
**Human resources training**
**Mortality and morbility**
**Vulnerale groups attention**
**Existing networks**
**Evaluation to treatment programmes**
**General conclusions and recomendations**

## Guatemala  

**Guatemala  **
**Main treatment model:  CASA HOGAR (characteristics: AA -12 steps method, religious appeal, rehabilitated personnel)**
**Number of Treatment Centers: 58- only Guatemala City **
**More crack available in the market due to the reproduction of illegal laboratories**
**Amapola (opium) has increased**
**Risk factor: More than 50% of population is young (15-35) **
**Human rights violation within treatment centres**
**No minimun standards of treatment- in process**
**Health sector does not attend drug dependants **
**Few studies on consumption trends **
**More consumption in men than in women**
**High consumption trend of estimulants in men**
**High consumption trend of      in women**
**Both estimulants and      are not perceived as drugs **
**Crack is the most consumed drug between 14-15 years old population  **

## NICARAGUA

**NICARAGUA**

## HONDURAS                                                               EL SALVADOR

**HONDURAS                                                               EL SALVADOR**

- 1. Atención Inmediata	2. Manejo de Comorbilidad	3. Intervención Temprana
- 4. Tratamiento Ambulatorio	5. Tratamiento Residencial	6. Tratamiento Hospitalario
- 7. Grupos de Autoayuda

## NATIONAL STUDIES

**NATIONAL STUDIES**
**Panama                                                                      Costa Rica**
** **

## Results of National Studies

**Results of National Studies**

**Consumption more than one drug. **
**Payment of drug dealers with drugs. **
**Initiation age decreased.**
**New drugs, combination.**
**Fisical impacts: HIV, hepatitis, mental disorders.**
**Low price high availablity **

**Low self esteem**
**No information and lack of perception of the psysical impact**
**Main consumption on men/ productive age (15-35)**
**Family desintegration**
**Unemployment, **
**School desertion**
**Economic/ corruption impact at country level**
**Stigma  women**

-  Weak treatment resources and infrastructure/ reinforce brief interventions and ambulatory services
-  12 steps AA/ Mutual support groups are the mayority.
- Lack of training
- No patient refferal
- No coordination between main actors.
- No up dated data on comsumption trends.
- No information systems available
- Some lack of treatment standards.
- Lack of funding
- No evaluation (either in program and operation levels)
- Lack of coordination between countries to attack commun problems.
- Lack of emphasis in specific pop.

**Consumption**

**      ****Needs**

**Bio-psico-social**

## Liaison Centres 

**Liaison Centres**** **

## Liaison Centres for Project CAM H90 

**Liaison Centres for Project CAM H90 **

**Main characteristics and functions:****  **

- National leadership  and inter-institutional coordination to accomplish  the following:
- Conduct  continuous training approaches towards other treatment centres (Minimum treatment standards, treatment courses, detection and exchange of best practices, etc..)
- To promote the practice of the un existent/ the most weak treatment modalities at a national level.
- To achieve and lead the reference and counter reference of patients
- Mobilization of human resources (social service), materials, patients and funding (example: grants, scholarships diffusion).
- Development and promotion of a Data Recollection, Surveillance and Evaluation System.
- To recollect data, analysis and promote scientific research.
- Support the elaboration of drug demand public policies.

- Liaison Centre

## Training goals based on national needs 

**Training goals based on national needs **

## Training Strategy for Central America 

**Outcome 1:**
**Who will be trained?**

- First level of Attention

- NGO ́s
- professionals

- NGO ́s
- Non professionals

- Main problems

- Addictions is not a topics of the curricula for health professionals
- No training led before (CR, SAL, HON)
- 70%-80% of the attention is done by non professionals
- No minimum treatment standards
- No network, reference / counter reference of patients
- No common registry
- No data recollection
- No evaluation

- Solutions

- Liaison Centres will
- Multiply in the first national campaigns  an _integral _training proposal.
- Promote minimum
- treatment standards. Useful for both non professional and health professionals

- Liaison Centres will
- promote a data recollection, surveillance and evaluation system for the region/bilingual for Belize/ and compatible with other instruments used.

**Training Strategy for Central America **

## Data Recollection, Surveillance and Evaluation 

**Data Recollection, ****Surveillance and Evaluation **

## Data Recollection, Surveillance and Evaluation System

**Data Recollection, Surveillance and Evaluation System**

**Originally, Project CAM H90 only demanded a reference **
**and counter reference patient software for the treatment, rehabilitation and social reinsertion **
**network, however, national studies led us know the need for encouraging the generation of **
**information from treatment centres, analysis, research evaluation and the feedback towards public policies.**

**For that reason the proposal for this software require of more elements:**
- Data collection
- Surveillance
- Evaluation
- Generate research
- Create comparable data, shared and processed by the Liaison Centres in a format available through the intranet.

**Benefits:**
- Information collected through the network of Project CAM H90.
- Liaison centre as coordinator and responsible for promoting and adapting the system to national needs.
- Indicators/variables can match with those used by other surveillance systems in Canada, Mexico and the United States to allow cooperation and research with neighbor countries. (ensure general platform)
- Individual platform: each country will define their specific indicators.
- UNODC providing Intranet for sharing data  and statistics.

## Second and Third Phase of Work 

- Year  2006:
- Identification of variables/ indicators and consensus from countries to develop a general platform, yet each country will incorporate specific indicators to their Data Collection, Surveillance and Evaluation System.
- Petit committee to review indicators and adapt them to national needs.
- Training to Liaison Centre Teams/ Reproduction of the On Line course carried out by each Liaison Centre.
- Elaboration of software and paper version of the Data Collection, Surveillance and Evaluation System.
- Year 2007:
- Two training campaigns on Treatment Standards
-        and 3  module strategy
- Referral of Patients
- Evaluation on the quality of the training
- Collection of data will initiate on 2007, reference and
-       counter reference of patients.

**Second and Third Phase of Work**** **

## Next Steps 

**Looking forward:**
**Activities to improve the infrastructure of treatment centres with treatment standards .**
**Activities to support treatment standards in those centres that had not been able to incorporate them.**
**Volunteers/ professional resources mobilization in the network. **
**Ensure patient referral/ and coordination between NGO ́s and primary care. **
**Building capacity activities based in the particular needs of each country.**
**Improve the primary care with training (PAHO/WHO).**
**Develop research networking and this way collaborate with national authorities with strategic information (NIDA).**
**Support on assessment for national governments to use the information from the Liaison Centres to update and complement/ or elaborate their national policies or programs with evidence based information (SAMHSA).**
**Continue with training initiatives. **
**To improve social reintegration with agreements and mechanisms between the private sector, government and Liaison Centres.  **
**Detect and promote main areas for vocational training.**
**Incorporate prevention and community based related activities to the network according to national on going programs (no duplication).**
**Reinforce the use of the Data Collection, Surveillance and Evaluation System and start a regional analysis in collaboration with CCP.**
**Search for partners to reinforce activities and funding.**

**Next Steps**** **