SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ... SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
BANGLADESHCAMBODIANEPALPHILIPPINESseven sub recipients and implementers,as well as networks of organisationsactive in HIV-related activities. Manyof these organisations are engaged indirect service delivery to MARPs andPLHIV (HIV TC, STI, BCC andother supportive activities) in variousdistricts. This group has also worked asa link between community and servicecentres. Religious and faith-basedorganisations have taken initiativesparticularly in HIV prevention, careand support in informal settings andare effective at community level.Few respondents expressed that ASRHis linked bi-directionally; ASRHrelated materials include HIV in theirtraining manuals and implementationguidelines. Comprehensive preventioneducation and services for young peoplecombine a range of interventions thatinclude access to youth friendly services,community based mobilisation andpeer support, and in-school education.Examples include the ReproductiveHealth Initiative for Youth in Asia(RHIYA) project in Nepal and UnifiedBudget Work plan project executedby UNFPA and implemented byFPAN in 2005-2006 in Mahottariand Kapilvastu districts. Evaluationfindings include greater self-esteemand self-efficacy, and knowledge aboutSRH issues, increased condom andcontraceptive use, reduced number ofsexual partners, and greater likelihoodof seeking appropriate treatment forSTI symptoms.Most of the respondents reportedthat although the involvement andparticipation is increasing, youth havebeen poorly involved in the responseof SRH and HIV programming. Theyare more involved in situation analysisand implementation rather thanplanning, budgeting and evaluation.The Ministry of Education hasexpanded the life skills based educationprogramme in the past two years withsupport from UNICEF. While 3.1per cent (880/27,888) of all schoolsprovided Life Skills Based Education(LSBE) in 2006, this has increased to5.6 per cent in 2007 and now in 2009has further increased to 7.56 per cent.LSBE is being implemented in over 20districts in the country through formalcurricula or extra-curricular activities(as peer education), but the coverageand expansion is slow.B. Planning Managementand AdministrationAlmost all the respondents reportedthat there is no joint planning of SRHand HIV. Of the few who reported thatthis is done at the DoHS and MOHPlevel, the detractors were quick to pointout that this is mainly for administrativepurposes. There is no integrated budget,and monitoring and coordination ofactivities are weak.Some respondents reported thatsome CBOs, NGOs, poly clinics andnursing homes, and medical colleges areproviding integrated services.C. Human Resources andCapacity DevelopmentThere is a shortage of competentservice providers. The recruitmentand retention of health professionals,particularly doctors and nursing staff,has remained problematic, particularly82
in hill and mountain districts. Frequenttransfer of health workers and theneed for constant training is anotherfactor affecting motivation and servicedelivery. Retention is more acute in theNGO sector.There is limited capacity fortraining.Trainers are not up-to-date ontraining (content and pedagogy);There is a shortage of teaching/learning equipment and material;Transport facilities for monitoringand supervision of field training arelacking.There is inadequate opportunity andcapacity for needs-based in-servicetraining on HIV/AIDSTraining needs are not knownfor different categories of serviceproviders and there are inadequatein-service training opportunities.Clinical services related to ART, HIVTC, PMTCT, OI and STI are impactedby:Challenges related to deploymentand retention of health professionals,particularly in hill/mountaindistricts.Frequent transfer of health workersleading to a need for constanttraining.Lack of supportive supervisionwithin the health system .Supervision of NGO-deliveredservices not linked to the governmentsystem.Most of the respondents agreed thatorientation and training should begiven on linkage and integrationbetween SRH and HIV, stigmaand discrimination, and counseling.Training on proposal writing, advocacy,PMTCT, VCT counseling, RHprotocols and laboratory – standardoperating procedures (SOPs) were alsoneeds that were expressed.Capacity building on SRH and HIVincorporates avoidance of stigma anddiscrimination, gender sensitivity, andconfidentiality of reproductive rightsand choices. There are separate trainingmanuals for pre-service and in-servicetraining through the National HealthTraining Center of the Ministry ofHealth and Population for serviceproviders.The curricula for secondary educationand teacher training, through Ministryof Education, has incorporated safe sex,sexual health stigma, sexual violence,condoms and reproductive rights forstudents and teachers.D. Logistics/SuppliesWhile SRH logistics and suppliesare procured and supplied throughLogistics Management Division, HIVsupplies are procured from UNDPand supplied through NCASC. Hencethere is a two track system of supplychain for drugs and test kits and othercommodities. USAID, through FHIand the DELIVER project, have alsoprovided support for the nationallogistics supply of HIV commodities.83
- Page 51 and 52: daily lives and take priority overH
- Page 53 and 54: Promote the social acceptability of
- Page 55 and 56: References20 years of HIV in Bangla
- Page 57 and 58: 337
- Page 59 and 60: Annex 6: Figure 2: National AIDS Mo
- Page 61 and 62: INSTITUTIONALCAPACITY FORHIV/AIDS A
- Page 63 and 64: AbstractBackgroundThe HIV epidemic
- Page 65 and 66: NMCHCNRHPNSRSHNational Maternal Chi
- Page 67 and 68: management system, and health servi
- Page 69 and 70: universal access to HIV prevention,
- Page 71 and 72: In order to support the linked resp
- Page 73 and 74: ased violence, unplanned pregnancy/
- Page 75 and 76: The essential services package forr
- Page 77 and 78: care, and VCCT and ANC;Family plann
- Page 79 and 80: Strategy for RSH in Cambodia 2006 -
- Page 81 and 82: Logistics management proceduresfor
- Page 83 and 84: ReferencesStrategic Plan for HIV/AI
- Page 85 and 86: INSTITUTIONALCAPACITY FORHIV/AIDS A
- Page 87 and 88: ABSTRACTBackgroundThere are a numbe
- Page 89 and 90: planning products from DHOs/DPHOs.A
- Page 91 and 92: priority. A large part of the preve
- Page 93 and 94: the major breakthrough in linking t
- Page 95 and 96: guidelines especially those related
- Page 97 and 98: Court responded to the petition byi
- Page 99 and 100: 34building on the technical strengt
- Page 101: million from donors. As a percentag
- Page 105 and 106: uilding for home-based care through
- Page 107 and 108: is from GFATM. It sets targetsand d
- Page 109 and 110: SRH and HIV programmes are runverti
- Page 111 and 112: IX. REFERENCES1. Adolescent Health
- Page 114 and 115: BANGLADESHCAMBODIANEPALPHILIPPINES9
- Page 116 and 117: BANGLADESHCAMBODIANEPALPHILIPPINES9
- Page 118 and 119: BANGLADESHCAMBODIANEPALBackgroundTh
- Page 120 and 121: BANGLADESHCAMBODIANEPALPHILIPPINESC
- Page 122 and 123: BANGLADESHCAMBODIANEPALPHILIPPINESt
- Page 124 and 125: BANGLADESHCAMBODIANEPALPHILIPPINES1
- Page 126 and 127: BANGLADESHCAMBODIANEPALPHILIPPINEST
- Page 128 and 129: BANGLADESHCAMBODIANEPALPHILIPPINESi
- Page 130 and 131: BANGLADESHCAMBODIANEPALThe protocol
- Page 132 and 133: BANGLADESHCAMBODIANEPALPHILIPPINESP
- Page 134: BANGLADESHCAMBODIANEPALPHILIPPINES1
BANGLADESHCAMBODIANEPALPHILIPPINESseven sub recipients <strong>and</strong> implementers,as well as networks of organis<strong>at</strong>ionsactive in <strong>HIV</strong>-rel<strong>at</strong>ed activities. Manyof these organis<strong>at</strong>ions are engaged indirect service delivery to MARPs <strong>and</strong>PL<strong>HIV</strong> (<strong>HIV</strong> TC, STI, BCC <strong>and</strong>other supportive activities) in variousdistricts. This group has also worked asa link between community <strong>and</strong> servicecentres. Religious <strong>and</strong> faith-basedorganis<strong>at</strong>ions have taken initi<strong>at</strong>ivesparticularly in <strong>HIV</strong> prevention, care<strong>and</strong> support in informal settings <strong>and</strong>are effective <strong>at</strong> community level.Few respondents expressed th<strong>at</strong> A<strong>SRH</strong>is linked bi-directionally; A<strong>SRH</strong>rel<strong>at</strong>ed m<strong>at</strong>erials include <strong>HIV</strong> in theirtraining manuals <strong>and</strong> implement<strong>at</strong>ionguidelines. Comprehensive preventioneduc<strong>at</strong>ion <strong>and</strong> services for young peoplecombine a range of interventions th<strong>at</strong>include access to youth friendly services,community based mobilis<strong>at</strong>ion <strong>and</strong>peer support, <strong>and</strong> in-school educ<strong>at</strong>ion.Examples include the ReproductiveHealth Initi<strong>at</strong>ive for Youth in Asia(RHIYA) project in Nepal <strong>and</strong> UnifiedBudget Work plan project executedby UNFPA <strong>and</strong> implemented byFPAN in 2005-2006 in Mahottari<strong>and</strong> Kapilvastu districts. Evalu<strong>at</strong>ionfindings include gre<strong>at</strong>er self-esteem<strong>and</strong> self-efficacy, <strong>and</strong> knowledge about<strong>SRH</strong> issues, increased condom <strong>and</strong>contraceptive use, reduced number ofsexual partners, <strong>and</strong> gre<strong>at</strong>er likelihoodof seeking appropri<strong>at</strong>e tre<strong>at</strong>ment forSTI symptoms.Most of the respondents reportedth<strong>at</strong> although the involvement <strong>and</strong>particip<strong>at</strong>ion is increasing, youth havebeen poorly involved in the responseof <strong>SRH</strong> <strong>and</strong> <strong>HIV</strong> programming. Theyare more involved in situ<strong>at</strong>ion analysis<strong>and</strong> implement<strong>at</strong>ion r<strong>at</strong>her thanplanning, budgeting <strong>and</strong> evalu<strong>at</strong>ion.The Ministry of Educ<strong>at</strong>ion hasexp<strong>and</strong>ed the life skills based educ<strong>at</strong>ionprogramme in the past two years withsupport from UNICEF. While 3.1per cent (880/27,888) of all schoolsprovided Life Skills Based Educ<strong>at</strong>ion(LSBE) in 2006, this has increased to5.6 per cent in 2007 <strong>and</strong> now in 2009has further increased to 7.56 per cent.LSBE is being implemented in over 20districts in the country through formalcurricula or extra-curricular activities(as peer educ<strong>at</strong>ion), but the coverage<strong>and</strong> expansion is slow.B. Planning Management<strong>and</strong> Administr<strong>at</strong>ionAlmost all the respondents reportedth<strong>at</strong> there is no joint planning of <strong>SRH</strong><strong>and</strong> <strong>HIV</strong>. Of the few who reported th<strong>at</strong>this is done <strong>at</strong> the DoHS <strong>and</strong> MOHPlevel, the detractors were quick to pointout th<strong>at</strong> this is mainly for administr<strong>at</strong>ivepurposes. There is no integr<strong>at</strong>ed budget,<strong>and</strong> monitoring <strong>and</strong> coordin<strong>at</strong>ion ofactivities are weak.Some respondents reported th<strong>at</strong>some CBOs, NGOs, poly clinics <strong>and</strong>nursing homes, <strong>and</strong> medical colleges areproviding integr<strong>at</strong>ed services.C. Human Resources <strong>and</strong>Capacity DevelopmentThere is a shortage of competentservice providers. The recruitment<strong>and</strong> retention of health professionals,particularly doctors <strong>and</strong> nursing staff,has remained problem<strong>at</strong>ic, particularly82
Change language