CompanionApp

Eastern and Southern Africa is home to more than 60 per cent of children and adolescents worldwide living with HIV. In 2018 an estimated 1.8 million children and adolescents aged 0-19 years, in Eastern and Southern Africa were living with HIV. Approximately 65,000 of the region’s children and adolescents died of an AIDS-related cause in the same year and mainly due to poor follow up, adherence to antiretroviral treatment. Girls are the hardest hit by the rate of new HIV infections which increases dramatically between the ages of 15 and 24 years. Until recently, adolescents have been a blind spot in the HIV response, both in terms of data availability and programmatic implementation.( UNICEF 2018 Report)

In Rwanda, The Statistics from the recent Rwanda Demographic Health Survey and Rwanda Population bases HIV impact assessment revealed that the Prevalence of HIV among young adolescents (those aged 10-14 years) was 0.4%, corresponding to approximately 5,900 young adolescents living with HIV in Rwanda, for a total of 216,000 people living with HIV among those aged 10-64 years.  Data from the Rwanda 2022-2023 National HIV Program report indicates that the HIV prevalence among adolescent from 15-19 ranges between 0,4% up to 0.7%. with Annual HIV incidence among adults 15-64 years in of 0.08%.

Rwanda made significant progress in HIV investment, testing and treatment, according to the Rwanda Biomedical report in 2022, Regarding expenditures, the total contributions to the HIV/AIDS National Strategic Plan for the FY 2022/2023 were USD 165,737,726 with more than USD 24,839,743 contributed by the GoR and 140,897,983 USD by Development Partners with more than 10% of the budget used to address the adherence to treatment with little outcomes.

Statistics from The Rwanda Population-based HIV Impact Assessment (RPHIA2020) shows that As of December 2019; 198,658 People living with HIV (PLHIV) were on antiretroviral treatment(ART) which translates an ART coverage for all estimated PLHIV nationally was 87.2%. 

Ensuring strict adherence to ART is required for optimal virological and immunological outcomes, prevention of drug resistance, and longer survival, With a very high percentage (27%) of non-adherent to Antiretroviral Treatment (ART) in general population and more than 40% of the youth are non-adherent to antiretroviral treatment which can be associated with   the 2020 UNAIDS Rwanda reporting approximately 2900[2300 - 3500]deaths due to AIDS.

Moreover there is still have HIV incidence in Key Population and mostly young Girls ranging 15-24 which is still highly associated with lack to access to pre and post exposure prophylaxis.

the study done by Rwanda Biomedical center in 2019 revealed that more than 40% of young people HIV patients on antiretroviral treatment are not adherent and have a poor follow up, The study also revealed that not only 19% of people on antiretroviral treatment checked for CD4 count and viral load in a course of year 2019. 

CompanionApp is a mobile application linking young people living with HIV/AIDS and health care providers with mission to improve patients follow up, adherence to antiretroviral treatment and access to pre and post exposure prophylaxis as well as reduce complications related to poor adherence to treatment(HIV related deaths, new HIV infections and mother to child transmission...). The application is in the patient's phones and in the hospital server. it provides the following services in a youth and confidently friendly manner: 

• The reminder to take medication (Dose, time and frequency) and directly inform the system if he/she took the medication(it will help with the documentation)
• The reminder to go for check up of viral load and CD4 count with a GPS location of the nearest clinics
• Online safe ordering and confidential home delivery of antiretroviral treatment including Pre and post exposure prophylaxis.
•  Safe and family planning services. 
• Directly Contact his Doctor and got response within 1 hour. 
• Networking with other HIV positive patients ,shares life experience 
• CompanionApp will alert the Doctor if the patient passes 2 days without reply on companion or missed the check up appointment

In the next 5 years, Companion App aim to raise antiretroviral treatment adherence up to 99% , to decrease the mortality rate due to AIDS and decrease ARVS drug resistance due to poor adherence. 

We aim to increase Comprehensive HIV and sexuality education to adolescents by providing platform with Sexual and reproductive health information and services including contraceptions. 

we aim to generate a database through our app with such information( the adherence rate, drug resistance, opportunistics, Pre and post exposure prophylaxis use) which can inform policymakers

Last but not least, CompanionApp  will create Jobs for youths and promote inclusivity where employed people will be people living wjth HIV . 

here is a link to our solution demo: CompanionApp on Youtube

Our Target Population are mainly youth and key Population living with HIV in Rwanda. 

In Eastern and Southern Africa is home to more than 60 per cent of children and adolescents worldwide living with HIV. In 2018 an estimated 1.8 million children and adolescents aged 0-19 years, in Eastern and Southern Africa were living with HIV. Approximately 65,000 of the region’s children and adolescents died of an AIDS-related cause in the same year and mainly due to poor follow up, adherence to antiretroviral treatment. Girls are the hardest hit by the rate of new HIV infections which increases dramatically between the ages of 15 and 24 years. Until recently, adolescents have been a blind spot in the HIV response, both in terms of data availability and programmatic implementation.( UNICEF 2018 Report)

In Rwanda, The Statistics from the recent Rwanda Demographic Health Survey and Rwanda Population bases HIV impact assessment revealed that the Prevalence of HIV among young adolescents (those aged 10-14 years) was 0.4%, corresponding to approximately 5,900 young adolescents living with HIV in Rwanda, for a total of 216,000 people living with HIV among those aged 10-64 years.  Data from the Rwanda 2022-2023 National HIV Program report indicates that the HIV prevalence among adolescent from 15-19 ranges between 0,4% up to 0.7%. with Annual HIV incidence among adults 15-64 years in of 0.08%.  Moreover the recent Rwanda NAtional HIV program reported around 12000 Females sex workers with a HIV prevalence of more than 35%. We still poor access to pre and post exposure prophylaxis.

Our Team is made of male and female Young people all under 35 years old with extensive experience with working with People living with HIV, moreover the Product design and validation was made with deep consultation of the association of young people living with HIV in Rwanda.

Our Team members are  composed of medical doctors, nurses and Clinical psychologists and 1 software engineer and a young person living with HIV.  Our team have volunteered and worked in the community level and referral hospitals extensive n HIV clinics  in Rwanda. all Companion App  members has all interacted with HIV patients who come to seek care at their respective clinics and hospitals and the project idea resulted from the picture of HIV statistics largerly of the youth attending HIV clinics. CompanionApp members connect with patients beyond clincal care and utilize their experience to address other factors affecting patients's quality of life. 

over the years of our clinical service in community, young people and key population has been a key strategic patner in implementation of our activities. 

We applied for the ethical clearance to pilot our mobile application in HIV Clinics in KIgali, We received  the approval to pilot with a sample size of 275 Young people living with HIV , 20 Healthcare providers in a period of 12 months, in 3 district hospitals and 10 Health centers.

Our CompanioApp is unique and unconventional .it is simple but solves the complex issues and has potential to transform Sexual and reproductive health of young an Key Population living with HIV . CompanionApp dealing with poor adherence that cause new HIV infections, access to Pre and Post exposure prophylaxis and confidential deliver of Antiretroviral treatment among young and Key population. The Government of Rwanda uses more than 21,230,453 US$ in dealing with poor adherence and its related outcomes with poor outcomes our solution will provide alternative ways to improve efficiency and create lasting solutions for young people living with HIV    

Moreover Companion App is the digital youth friendly patient engagement platform that facilitates patient-healthcare provider communication throughout the care continuum and monitor patients daily adherence to antiretroviral treatment using Broadband connection and USSD for people with limited access to internet

Statistics Rwanda utilities regulatory authority shows that there is high penetration of Smartphone in the Rwanda youth(70% have smartphones ) and every single household in Rwanda has a phone which can use USSD. Companion comes to smooth and ease the work of Community health workers to Visit and remind the patient to take medications, CompanionApp provide accurate data on adherence to ART and other youth friendly services. 

CompanionApp will primarily benefits people living with HIV in Rwanda by improving their sexual health and quality of life. Our open access mobile application resource will be a novel asset for HIV patients by making good  adherence to their medications, improve their sexual life and less risky of the new infections to other populations. Lastly Companion App will be online resource of Comprehensive Sexual education including HIV education and mental health therapy and will be first resource of that kind in Rwanda . 

In the next five years , our impact will be releted to :

• To increase the Antiretroviral treatment adherence up to 98 % 

• To decrease the annual HIV related deaths from 2500 to less than 200  and decrease drug resistance related to poor adherence to treatment.

•  to gain accurate data due to the documentation ( the adherence rate , drug resistance, common complication developed) 

• To Increase the demand and safe use of pre and post exposure prophylaxis among young and Key populations

• To create 8 permanent jobs and (15-20) temporary jobs mainly employing HIV+ people and contribute to the development of our country by paying  taxes.

Companion Mobile App will raise adherence to antiretroviral treatment and increase the use of pre and post exposure prophylaxis together with easier  patient follow up using technology. 

Adherence to treatment will increase the CD4 count and decrease the HIV viral load among patient living with HIV

The increase of CD4 count and decrease of HIV viral load will reduce hIV related deaths and decrease the HIV transmission as we know that people undetected Viral load can not also transmit HIV. this will dramatically the sexual and reproductive health of young people and key populations living with HIV . this will contribute to the governement's mission and global target to EndHIV by 2030 . 

CompanionApp will fundamentally bring sexual and reproductive health including HIV services to the forefront of young people and key population health in particular. By addressing the root cause of poor adherence, low level of Comprehensive sexual education including HIV education, poor patient communications and follow up plan. we have a potential to impact 82% of all patients living with HIV in Rwanda with specific focus to adolescents(15-29 old ages) . these strategic approaches will help to attract big donors such as UNFPA,USAID and foundation to collaborate to take CompanionApp scale up. 

Companion App work as an online app which uses a 3G,4G broad connection , due to the fact that Rwanda is a developing country with limited connection especially in remote areas. we have upgraded our system to use SSD code for people with limited connection to cover our target populations with less minimal challenges of connectivity. 

Markers of potential scale and sustainability include involvement of partners who can help take the proposed innovation to scale, potential to leverage or generate funding to sustain proposed innovations and alignments to the national health plan of country in which it is being implemented. 

CompanionApp has 10 staff in general including 4 permanent workers and 5 contractual and 1 intern

4 permenent staff include 3 co-founders and 1 young HIV patients representatives 

5 contractual are selected based on the work availability to support the existing team and most importantly we have provided a space to 1 young adolescent female to work in our team to share and transfer knowledge to young people . 

4 years. CompanionApp was founded in 2018 with 3 co-founders, In 2019, Companionapp was recognized by the WHO Africa region as promising Health innovation in Africa. link accessed here : https://innov.afro.who.int/inn...In 2020, We received recognition from the University of Rwanda and  was selected to be among the best innovation in Health care by National Commission for sciences and technology . in 2022 We have developed the application and available on Android phone :https://app.companion.rw/ .we applied and received  the ethical clearance to pilot companionapp as an observational randomized clinical trial with 275 HIV patients in a period of 12 months.

CompanionApp initiative combines the promotion of sexual and reproductive health and rights including HIV services , gender transformative practices with the goal to primarily allow adolescents, youth and Key Population to realize their sexual and reproductive health and rights  and improve their health. To execute our mission it doesn’t only require individuals efforts rather a collective efforts of committed individuals ,experts and beneficiaries to promote inclusivity .

Our initiative open opportunity to create a more socially equal environment for our team member including women, girls and men to create a strong foundation .

In our permanent member staff, we recruited HIV patient representative, health care professionals and engineers to ensure our quality service is planned and served well. Moreover to that we have involved in our team  individuals with diverse education background to facilitate thinking capacity and skills sharing among our teamworking spirit .

Companionapp Business Viability lies 4 ways :

CompanionApp is planning to do a randomized control trial, if results confirm our hypothesis we will sell our product(App) to the government and Health development partners.

CompanionApp is targeting a huge awaiting market for the follow-up of people living with HIV/AIDS In Rwanda,

we have around 10 referral hospitals , more than 45 districts hospitals, 512 Health Centers (all having HIV clinics)

• HIV Clinics will have to buy the system at an affordable amount (1000US$) for better follow up of their patients.
• Patients will have to pay at least 5 US $ per year to use of our applications and the money will help permanent running of the project. (we will also charge patients according to the social economic classes as defined by the government of Rwanda. 

We plan also to charge Data access agreements. And last but not least we plan also to gain money through grant and donations ( from partners and donors)

Our product is Mobile application accessed to androids and apple and using USSD code

USSD code for limited connections will be charged 10 Rwandan francs per day for each user.

We aim to reach the breakeven in the next 2 years following the completion of Pilot Project. CompanionApp is planning to do a randomized control trial, if results confirm our hypothesis we will sell our product(App) to the government and Health development partners.

CompanionApp is targeting a huge awaiting market for the follow-up of people living with HIV/AIDS In Rwanda,

we have around 10 referral hospitals , more than 45 districts hospitals, 512 Health Centers (all having HIV clinics)

• HIV Clinics will have to buy the system at an affordable amount (1000US$) for better follow up of their patients.
• Patients will have to pay at least 5 US $ per year to use of our applications and the money will help permanent running of the project. (we will also charge patients according to the social economic classes as defined by the government of Rwanda. 

We plan also to charge Data access agreements. And last but not least we plan also to gain money through grant and donations ( from partners and donors)