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 ...
BANGLADESHCAMBODIANEPALPHILIPPINESprogrammes. For example the HIV/AIDS programme in Bangladesh ispart of the HNPSP, PRSP and alsoappears in the ARHR policy paper.However the HIV/AIDS policy doesnot include issues of SRH. At theimplementation level, there are no bidirectionallinkages among the twoprogrammes. The FP programme that isrunning in the country does not includeVCT, PMTCT, and HIV programmes.However the VCT programmes carriedout by NGOs include FP issues.Respondents from the NGO sector saythat HIV/AIDS is usually mentionedwhen providing reproductive healthcareservices. However there is no linkagebetween the two programmes. Theministry of health reports that HIVprogrammes have been given priority inthe National Health Policy. However,national programmes on SRH do notinclude HIV prevention treatment,care and support issues such as VCTand HIV treatment, although SRHservices include BCC on HIV.All respondents agreed that the linkageis very weak and is vaguely designedbecause the strategies and policies weredeveloped at different points of time.As a result, linkage between policiesand programmes was not possible.Respondents from the NGO sectorsaid that both the programmes arerunning vertically because of the specificmandates of the organisations anddonors. The MoHFW is responsiblefor the overall policy, the DGFP isresponsible for the planning andimplementing of SRH programmes,and the DGHS is responsible for healthservices. The NASP was developedunder the DGHA to act as the focalpoint for developing all HIV/AIDSpolicy strategies and implementationof the programmes. Some respondentswere of the opinion that there aregaps between the two organisationsproviding support in SRH and HIV/AIDS in the country. Findings alsorevealed that none of the departmentswere concerned with linking SRH andHIV.1.5 Budget Funding andBudgetary SupportThe government has mobilised loansand grants from development partners,including the World Bank, GFATM,UN agencies, and other multilateraland bilateral donors, to supportinterventions to prevent and treatHIV among particularly vulnerablepopulations.ANational AIDS Spending Assessment(NASA) has yet to be carried out in thecountry. Much of the funding for HIVin Bangladesh comes from internationaldonors. Programmes under HNPSP /HIV are mainly funded by the WorldBank, the ADB and the GoB poolfunding. Table 3 below shows majorfunding sources and projects during theyears of the current national strategy.Tables 5A and 5B show the totalamount spent for the six major strategiccomponents of the programme.Spending for advocacy and technicalsupport was much higher than othercategories. Government financing forthe programme was less in comparisonto international not-for-profit sources,mainly international non-governmentalorganisations. Different financingsources have specific functional focus,16
ut all sources have consistently spenthighest on prevention, care and support.Spending on programme managementand administration needs careful andcautious interpretation; a detailedbreakdown of expenditure is necessaryto be able to draw conclusions. As thefinancing of national response is heavilyreliant on international funding, so is themanagement of funds. In other words,a large proportion of available fundsis managed (or spent) by or throughmultilateral agencies and INGOs.2. Systems2.1 PartnershipsIn Bangladesh partner organisationson SRHR related issues are mainlyfrom Sweden, working closely withthose from the Netherlands (EKN),DFID, WHO, and UNFPA. Swedensupports the sector programme inhealth where donors give their supportto the government via the World Bank.An example is the Urban PrimaryHealthcare Programme (UPHCPH)which is supported by Sweden via ADB,together with DFID and UNFPA.Development partners have beenplaying a significant role in theprevention and control of HIV inBangladesh, building the capacity ofgovernment to plan, design, implementand monitor the national HIVprogramme. Development partners arefrom multilateral bodies such as UNagencies, bilateral donors, internationalNGOs, and national and internationalresearch organisations such as IEDCRand ICDDR,B respectively. Theexisting HIV interventions are mainlysupported by USAID (through FHI),GFATM (through Save the Children-317
- 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 and 32: 2and Save the Children, USA, and is
- Page 33 and 34: Many important national guidelines,
- Page 35: voluntarily, among project particip
- 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
- Page 83 and 84: ReferencesStrategic Plan for HIV/AI
- Page 85 and 86: INSTITUTIONALCAPACITY FORHIV/AIDS A
BANGLADESHCAMBODIANEPALPHILIPPINESprogrammes. For example the <strong>HIV</strong>/<strong>AIDS</strong> programme in Bangladesh ispart of the HNPSP, PRSP <strong>and</strong> alsoappears in the ARHR policy paper.However the <strong>HIV</strong>/<strong>AIDS</strong> policy doesnot include issues of <strong>SRH</strong>. At theimplement<strong>at</strong>ion level, there are no bidirectionallinkages among the twoprogrammes. The FP programme th<strong>at</strong> isrunning in the country does not includeVCT, PMTCT, <strong>and</strong> <strong>HIV</strong> programmes.However the VCT programmes carriedout by NGOs include FP issues.Respondents from the NGO sector sayth<strong>at</strong> <strong>HIV</strong>/<strong>AIDS</strong> is usually mentionedwhen providing reproductive healthcareservices. However there is no linkagebetween the two programmes. Theministry of health reports th<strong>at</strong> <strong>HIV</strong>programmes have been given priority inthe N<strong>at</strong>ional Health Policy. However,n<strong>at</strong>ional programmes on <strong>SRH</strong> do notinclude <strong>HIV</strong> prevention tre<strong>at</strong>ment,care <strong>and</strong> support issues such as VCT<strong>and</strong> <strong>HIV</strong> tre<strong>at</strong>ment, although <strong>SRH</strong>services include BCC on <strong>HIV</strong>.All respondents agreed th<strong>at</strong> the linkageis very weak <strong>and</strong> is vaguely designedbecause the str<strong>at</strong>egies <strong>and</strong> policies weredeveloped <strong>at</strong> different points of time.As a result, linkage between policies<strong>and</strong> programmes was not possible.Respondents from the NGO sectorsaid th<strong>at</strong> both the programmes arerunning vertically because of the specificm<strong>and</strong><strong>at</strong>es of the organis<strong>at</strong>ions <strong>and</strong>donors. The MoHFW is responsiblefor the overall policy, the DGFP isresponsible for the planning <strong>and</strong>implementing of <strong>SRH</strong> programmes,<strong>and</strong> the DGHS is responsible for healthservices. The NASP was developedunder the DGHA to act as the focalpoint for developing all <strong>HIV</strong>/<strong>AIDS</strong>policy str<strong>at</strong>egies <strong>and</strong> implement<strong>at</strong>ionof the programmes. Some respondentswere of the opinion th<strong>at</strong> there aregaps between the two organis<strong>at</strong>ionsproviding support in <strong>SRH</strong> <strong>and</strong> <strong>HIV</strong>/<strong>AIDS</strong> in the country. Findings alsorevealed th<strong>at</strong> none of the departmentswere concerned with linking <strong>SRH</strong> <strong>and</strong><strong>HIV</strong>.1.5 Budget Funding <strong>and</strong>Budgetary SupportThe government has mobilised loans<strong>and</strong> grants from development partners,including the World Bank, GFATM,UN agencies, <strong>and</strong> other multil<strong>at</strong>eral<strong>and</strong> bil<strong>at</strong>eral donors, to supportinterventions to prevent <strong>and</strong> tre<strong>at</strong><strong>HIV</strong> among particularly vulnerablepopul<strong>at</strong>ions.AN<strong>at</strong>ional <strong>AIDS</strong> Spending Assessment(NASA) has yet to be carried out in thecountry. Much of the funding for <strong>HIV</strong>in Bangladesh comes from intern<strong>at</strong>ionaldonors. <strong>Programmes</strong> under HNPSP /<strong>HIV</strong> are mainly funded by the WorldBank, the ADB <strong>and</strong> the GoB poolfunding. Table 3 below shows majorfunding sources <strong>and</strong> projects during theyears of the current n<strong>at</strong>ional str<strong>at</strong>egy.Tables 5A <strong>and</strong> 5B show the totalamount spent for the six major str<strong>at</strong>egiccomponents of the programme.Spending for advocacy <strong>and</strong> technicalsupport was much higher than otherc<strong>at</strong>egories. Government financing forthe programme was less in comparisonto intern<strong>at</strong>ional not-for-profit sources,mainly intern<strong>at</strong>ional non-governmentalorganis<strong>at</strong>ions. Different financingsources have specific functional focus,16
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