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 ...
BANGLADESHCAMBODIANEPALPHILIPPINESBangladesh) and Masjid Council forCommunity Advancement (MACCA)The programme has the supportof 18 implementing agencies andnumerous collaborating partners. TheBAP focused on providing preventionservices among MARPs. As a followup to the BAP, Modhumita, (a newcooperative agreement with USAID)started in October 2009 with aboutUS$13 million and will continue till2013. The programme’s overarchingobjective is to support an effective HIVprevention strategy through improvedprevention, care, and treatment servicesfor MARPs, and a strengthenednational response.c. Global Fund to FightAIDS, Tuberculosis andMalaria (GFATM) supportedprogrammes:There are three programmes fundedby GFATM Round 2 (March2004-November 2009). Round 2is a grant project for prevention ofHIV among youth and adolescentsamounting to US$19.7 million,managed by Save the Children USA.Round 6 of the GFATM grant (US$40million) aims to limit the spread andimpact of HIV in the country byproviding prevention services amongMARPs, and improving the capacityto deliver high quality interventions.The government of Bangladesh is theprincipal recipient for both the grants.1.4 National Policy andGuidelines for SRHR andHIV/AIDS LinkagesThere is only one national policydeveloped for adolescent sexualreproductive health and rights.However, no policy has been developedfor SRHR in general. The SRH strategyplan has not been revised since it wasdeveloped.All RH issues are broadly highlightedin the National Health Policy, HNASPand also in the Population Policy. RHprogrammes include safe motherhood,family planning, maternal nutrition,unsafe abortion, neonatal care,emergency obstetric care, adolescenthealth care, infertility, and preventionand control of RTIs / STDs, and HIV.The programmes are directly managedby the DGFP, in cooperation withnational and international NGOs.In Bangladesh women require specialattention in HIV interventions dueto their social, economic and politicalstatus. Women are four times more likelyto contract HIV than men. Howeverwomen’s lower social and culturalstatus causes them to have less access toeducation, employment opportunitiesand health care, including opportunitiesfor HIV tests, counselling and medicalcare. Women are often subjected to earlymarriage, sexual abuse and violence inintimate and marital relationships. Anincreasing number of women are forcedto sell their bodies as the only way tosurvive and provide for their children.Men who buy sex from women areoften reluctant to use condoms.Women have little negotiating power.Even within their marriages, they mayhave unprotected sex with their spouseswho might be engaging in one or morehigh-risk behaviours, and be exposed toHIV.12
Many important national guidelines,manuals and strategy documents weredeveloped in recent years for SRHand HIV (see annex 4). While thecoverage of HIV prevention activitieswas limited during the first part of thisdecade, the national HIV programmewas progressively scaled up in its qualityand coverage.Outcomes from the HATI project in2008 revealed that more than 110,000clients received services and informationfrom the 146 drop-in-centres and4,195 were referred to VCT serviceproviders. In 2008, a total of 849,200people attended education sessions onHIV/AIDS. During the course of itsimplementation, the project reachedover 3.4 million people with sucheducation sessions.By the end of 2008, 37,275 patients hadreceived STI services. In the previousthree years (2005-2007), a total of139,780 people benefited from STIservices. Among the targeted groups,some behaviour change was observedover the four year (2005-2008) period.More sex workers are capable ofconvincing their clients to use condoms– 44 per cent of male and 67 per centof female sex workers used a condomwith their last client. There has beenan increase in the overall demand forcondoms among all target groups, andmore people at risk received VCTsupport. In addition, the attitude ofcommunities towards street-based sexworkers and HIV/AIDS has changedpositively and harassment by lawenforcing agencies has reduced. 34 percent of IDUs used sterile equipment attheir last injection.Despite being a low HIV prevalencecountry, the HIV epidemic receivedhigh priority in the health sector ofBangladesh. The focus has been on theneed for prevention programmes, withina broader framework that addresses theneed for treatment, care and support ofPLHIV. After extensive consultationand involvement of ministries, NGOs,the private sector and the affectedcommunity, the Second NationalStrategic Plan for HIV-AIDS, 2004-2010 was adopted, with a strong focuson its first strategic objective: to providesupport and services for priority groups(those with the highest HIV prevalenceand risk).The four other objectives are: 1) toprevent vulnerability to HIV infection;2) promote safe practices in the healthcare system; 3) provide care andtreatment services to PLHIV; and 4)minimise the impact of the epidemic.Subsequently, in order to address gapsand to elaborate further on the SecondNational Strategic Plan, NASP, withthe assistance of UNAIDS, developedthe ‘National AIDS Monitoring andEvaluation Framework and OperationalPlan’ covering 2006 to 2010.NASP has recently started a projecton PMTCT with UNICEF and is theonly linkage programme between SRHand HIV. Other than that NASP hasdeveloped several national guidelines,manuals and policies/strategies onspecific intervention areas (see annex:4).The NASP has taken the initiativeto revise and update the NationalStrategic Plan for HIV/AIDS. Therevision address issues such as gender13
- Page 2 and 3: Published by:International Council
- Page 5 and 6: Table ofContentChapter Titles Pages
- Page 7 and 8: INTRODUCTIONThe 2009 AIDS Epidemic
- Page 9 and 10: REVIEW OF LINKAGES BETWEEN SEXUAL A
- Page 11 and 12: ROUNDTABLE MEETING ON LINKAGES BETW
- Page 13 and 14: Mr Roberto M Ador, Executive Direct
- Page 15 and 16: Session 3: Health Systems Strengthe
- Page 17 and 18: Model for Public-Private Partnershi
- Page 19 and 20: CONCLUSIONSuccessful linkages betwe
- Page 21 and 22: INSTITUTIONALCAPACITY FORHIV/AIDS A
- Page 23 and 24: AbstractBackground: There are a num
- Page 25 and 26: the highest export earnings. The pr
- Page 27 and 28: grass-roots based service deliveryi
- Page 29 and 30: However, condom use was low amongho
- Page 31: 2and Save the Children, USA, and is
- Page 35 and 36: voluntarily, among project particip
- Page 37 and 38: ut all sources have consistently sp
- Page 39 and 40: USA) and the World Bank ledconsorti
- Page 41 and 42: the Prevention of Parent to ChildTr
- Page 43 and 44: access to services for their consti
- Page 45 and 46: for planned prevention, treatment a
- Page 47 and 48: e accomplished if there is supporta
- Page 49 and 50: In addition, not all services canbe
- 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
Many important n<strong>at</strong>ional guidelines,manuals <strong>and</strong> str<strong>at</strong>egy documents weredeveloped in recent years for <strong>SRH</strong><strong>and</strong> <strong>HIV</strong> (see annex 4). While thecoverage of <strong>HIV</strong> prevention activitieswas limited during the first part of thisdecade, the n<strong>at</strong>ional <strong>HIV</strong> programmewas progressively scaled up in its quality<strong>and</strong> coverage.Outcomes from the HATI project in2008 revealed th<strong>at</strong> more than 110,000clients received services <strong>and</strong> inform<strong>at</strong>ionfrom the 146 drop-in-centres <strong>and</strong>4,195 were referred to VCT serviceproviders. In 2008, a total of 849,200people <strong>at</strong>tended educ<strong>at</strong>ion sessions on<strong>HIV</strong>/<strong>AIDS</strong>. During the course of itsimplement<strong>at</strong>ion, the project reachedover 3.4 million people with sucheduc<strong>at</strong>ion sessions.By the end of 2008, 37,275 p<strong>at</strong>ients hadreceived STI services. In the previousthree years (2005-2007), a total of139,780 people benefited from STIservices. Among the targeted groups,some behaviour change was observedover the four year (2005-2008) period.More sex workers are capable ofconvincing their clients to use condoms– 44 per cent of male <strong>and</strong> 67 per centof female sex workers used a condomwith their last client. There has beenan increase in the overall dem<strong>and</strong> forcondoms among all target groups, <strong>and</strong>more people <strong>at</strong> risk received VCTsupport. In addition, the <strong>at</strong>titude ofcommunities towards street-based sexworkers <strong>and</strong> <strong>HIV</strong>/<strong>AIDS</strong> has changedpositively <strong>and</strong> harassment by lawenforcing agencies has reduced. 34 percent of IDUs used sterile equipment <strong>at</strong>their last injection.Despite being a low <strong>HIV</strong> prevalencecountry, the <strong>HIV</strong> epidemic receivedhigh priority in the health sector ofBangladesh. The focus has been on theneed for prevention programmes, withina broader framework th<strong>at</strong> addresses theneed for tre<strong>at</strong>ment, care <strong>and</strong> support ofPL<strong>HIV</strong>. After extensive consult<strong>at</strong>ion<strong>and</strong> involvement of ministries, NGOs,the priv<strong>at</strong>e sector <strong>and</strong> the affectedcommunity, the Second N<strong>at</strong>ionalStr<strong>at</strong>egic Plan for <strong>HIV</strong>-<strong>AIDS</strong>, 2004-2010 was adopted, with a strong focuson its first str<strong>at</strong>egic objective: to providesupport <strong>and</strong> services for priority groups(those with the highest <strong>HIV</strong> prevalence<strong>and</strong> risk).The four other objectives are: 1) toprevent vulnerability to <strong>HIV</strong> infection;2) promote safe practices in the healthcare system; 3) provide care <strong>and</strong>tre<strong>at</strong>ment services to PL<strong>HIV</strong>; <strong>and</strong> 4)minimise the impact of the epidemic.Subsequently, in order to address gaps<strong>and</strong> to elabor<strong>at</strong>e further on the SecondN<strong>at</strong>ional Str<strong>at</strong>egic Plan, NASP, withthe assistance of UN<strong>AIDS</strong>, developedthe ‘N<strong>at</strong>ional <strong>AIDS</strong> Monitoring <strong>and</strong>Evalu<strong>at</strong>ion Framework <strong>and</strong> Oper<strong>at</strong>ionalPlan’ covering 2006 to 2010.NASP has recently started a projecton PMTCT with UNICEF <strong>and</strong> is theonly linkage programme between <strong>SRH</strong><strong>and</strong> <strong>HIV</strong>. Other than th<strong>at</strong> NASP hasdeveloped several n<strong>at</strong>ional guidelines,manuals <strong>and</strong> policies/str<strong>at</strong>egies onspecific intervention areas (see annex:4).The NASP has taken the initi<strong>at</strong>iveto revise <strong>and</strong> upd<strong>at</strong>e the N<strong>at</strong>ionalStr<strong>at</strong>egic Plan for <strong>HIV</strong>/<strong>AIDS</strong>. Therevision address issues such as gender13
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