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

for planned prevention, treatment andcare activitiesThe National Strategic Plan logicallyplaces the custodial role of HIV dataand the monitoring and evaluationprocess in the hands of the NASP.However, it does not elaborate on otherkey components of a monitoring andevaluation (M&E) system, such asindicators with specific data sourcesand frequency of reporting. The overallgoal of the national M&E frameworkis to guide the gathering of strategicinformation needed to improve theefficiency, effectiveness and impact ofresponses to the epidemic, as well asensure accountability of all partnerswho are contributing to the nationalAIDS response. The national M&Eframework goes further in specifyingthose details. Building on existingM&E sub-systems and practices, theframework spells out the data needsand sources for assessing programmeperformance and measuring the overallgoals of the national response – whichare to reduce the spread of HIV andimprove the quality of life of those whoare affected and infected (NSP missionstatement). There is HIV relatedsupportive supervision using checklistsfor VCT, ART, PMTCT, and STI butsupervision is weak. Quality data is notavailable specially to analyse HIV statusby age and sex. However this M&E plandoes not have any structure to show theintegration of SRH programmes.Most of the respondents have theirown organisational monitoring systemsavailable for the services they provide.3. Service DeliveryAccording to all respondents thereare no direct integrated SRH andHIV services available for the clients.To some the services that are beingprovided are not at satisfactory levelsbecause NGOs and private hospitalsare providing services to clients underspecific guidelines and procedures.IDUs are the most vulnerable groupsfor HIV transmission. Many PLHIVare discriminated during HIV testing/diagnosis by health care providers(doctors, nurses, laboratory techniciansetc.). Given the level of discriminationfaced by PLHIV while getting treatmentfrom government hospitals, local clinicsor from health care providers, some havedecided not to go to a hospital whenneeded. Many also face discriminationfrom their work place. One of the mainreasons behind this is the issue ofstigmatisation. Though HIV tests areavailable in some private health settings,in many cases there is no guarantee ofcounselling support or confidentiality.Many HIV positive people testedboth in private and governmentfacilities have seen their names andother personal details published in thelocal or national media. Social values,lack of adequate information, thestigma attached to HIV and AIDS,and the lack of confidentiality are notencouraging for people, especially theyounger population, to seek out HIVtests.Activities to prevent transmissionin health care settings have focusedon: training health care providers onuniversal precautions to prevent HIV inhealth care settings, and more recently,25