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 ...
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uilding for home-based care throughPL<strong>HIV</strong> support groups, particularlyin skill development such as flowermaking <strong>and</strong> joss stick making. A formalagreement has been established withthe Chettrap<strong>at</strong>i clinic for RH services.Meetings are held on a quarterly basis.Shortage of equipment <strong>and</strong> space,insufficient staff time, lack of staffsupervision, <strong>and</strong> moder<strong>at</strong>e staffmotiv<strong>at</strong>ion are all contributory factorsfor the less than effective servicedelivery. Low salaries <strong>and</strong> a high workload were cited as reasons for low staffmotiv<strong>at</strong>ion.Teku HospitalTeku hospital is one of the ART sitesin the country offering prevention <strong>and</strong>management of STIs, provider initi<strong>at</strong>edtesting <strong>and</strong> counselling, OI tre<strong>at</strong>ment<strong>and</strong> ART services. The facility followsup on ART clients every quarter <strong>and</strong>half yearly through NAPN <strong>and</strong> PL<strong>HIV</strong>support groups. It also refers clients forART in 25 districts. Although it hasno formal agreement, it works throughVolunteer Welfare community <strong>and</strong>“Sparsh” for IDU clients.Efficiency of service has suffered due totransfer of staff. As a result, workloadof service providers has increased.However, stigm<strong>at</strong>is<strong>at</strong>ion of <strong>HIV</strong>services has decreased. Given the lackof space, privacy is poor. Guidelines forproviding ART are available but there islack of staff training. Motiv<strong>at</strong>ion levelsof staff are low.M<strong>at</strong>ernity HospitalM<strong>at</strong>ernity hospital is one of thePMTCT sites in Nepal. The hospitalprovides family planning, m<strong>at</strong>ernalhealth services, prevention <strong>and</strong>management of STIs, prevention ofunsafe abortion <strong>and</strong> management ofpost-abortion care; provider–initi<strong>at</strong>edtesting <strong>and</strong> counselling, tre<strong>at</strong>ment forOI, <strong>and</strong> <strong>HIV</strong> prevention inform<strong>at</strong>ion<strong>and</strong> services for the general popul<strong>at</strong>ionincluding condom provision <strong>and</strong>PMTCT comprehensive services. Itrefers clients to Teku hospital for ART<strong>and</strong> advanced lab tests for <strong>HIV</strong> rel<strong>at</strong>edcases.Shortage of space for offering priv<strong>at</strong>e <strong>and</strong>confidential service, low staff motiv<strong>at</strong>iondue to lack of training <strong>and</strong> lack oftransparency in selection for trainingwere cited as moder<strong>at</strong>e constraints.With the increase in workload, skillswere developed thereby increasingefficiency. Cost of services for the clients<strong>and</strong> facility <strong>and</strong> stigm<strong>at</strong>is<strong>at</strong>ion of <strong>HIV</strong>clients decreased.FPAN provides comprehensive <strong>SRH</strong>services such as FP, prevention <strong>and</strong>management of STIs (syndromic casemanagement <strong>and</strong> lab test for VDRL),prevention <strong>and</strong> management of genderbasedviolence, <strong>and</strong> prevention ofunsafe abortion <strong>and</strong> management ofpost abortion careFPAN has integr<strong>at</strong>ed provider initi<strong>at</strong>ed<strong>HIV</strong> testing <strong>and</strong> counselling. It referscases to Sahara Plus for psycho socialsupport, counseling for PMTCT <strong>and</strong>85
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