SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...

access to services for their constituencymembers as well as contributing tothe planning and policy developmentprocesses. They are also active inadvocacy at various levels to ensureaccess to ART and other services.The group has been successful inmany advocacy outcomes and hascontributed to accessing ART as wellas ensuring ART adherence. This groupis also active in positive prevention andensuring the rights of infected/affectedchildren and women.2.2 Planning Managementand AdministrationAll respondent were of the opinion thatSRH and HIV programmes run by thegovernment and NGOs do not haveany linkages. However respondentsagreed that SRH or HIV is alwaysspoken about as one and this has nowbecome part of the mainstream healthsector. The lack of linkage of SRHand HIV programmes is due to it notbeing included in the project objectives;neither do donors request for them tobe overlapped. The other issue that wasidentified was the lack of an integratedbudget. Monitoring and coordinationof activities were also weak.2.3 Human Resources andCapacity DevelopmentThe recruitment and retention of healthprofessionals, doctors and nursing staff,particularly in the remote district levelsis a problem that needs to be addressed.Although there is a National TrainingCurricula this does not include issueson HIV and SRH. At the same time,trainers themselves are not skilledenough despite having well documentedtraining materials prepared by variousNGOs for the government. Thereis a shortage of learning equipmentand material; transport facilities formonitoring and supervision of fieldtraining are lacking. There is inadequateopportunity and capacity for needsbasedin-service training on HIV/AIDS. Training needs have not beenidentified for different categories ofservice providers, and inadequate inservicetraining opportunities. Clinicalservices related to ART, HIV TC,PMTCT, OI and STI are impactedby:Challenges related to deploymentand retention of health professionalsin the rural areasFrequent transfer of governmenthealth workers leading to a need forconstant trainingInability to retain health workers inthe NGO sector due to unfavourablepay scalesLack of supportive supervisionwithin the health systemSupervision of NGO-deliveredservices not linked to the governmentsystem.Almost all respondents felt that thereis an urgent need for orientation andtraining on linkage and integrationbetween SRH and HIV, stigma anddiscrimination, and counselling.Training is also required on proposalwriting, advocacy, VCT counselling,RH protocols and laboratory standardoperating procedures (SOPs). At thesame time the target group for thesetrainings should cover all levels that23