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 ...
BANGLADESHCAMBODIANEPALPHILIPPINESappropriate treatment.As a result, the linkages betweenrelated health services need to bestrengthened, as well as those betweenhealth services and the communityat large. Since 2007, the NCHADShas worked with the National MCHCentre in collaboration with partners(WHO, CHAI, US-CDC) to developa new strategy called a linked responseapproach to establish and implementa pilot project at operational districtlevel. This approach aims to focuseffectiveness at the operations district(OD) level by building capacity to: (1)increase access to comprehensive HIVprevention education, HIV testing, careand treatment; (2) strengthen existingreproductive health services includingPMTCT; and (3) contribute to thestrengthening of Cambodia’s overallhealth care system. This approachwas started in 2008 and continuesto be expanded to other operationaldistricts to prevent maternal-childHIV transmission including sexualreproductive health and HIV infection,while strengthening the referral systembetween OI/ART, STI, ANC, FP,safe abortion, adolescent health, andMNBH.The linked response approach is alignedwith the overall framework betweenthe HIV strategic plan and PMTCTstrategic plan including reproductivehealth strategies. In collaborationwith two centres (NCHADS andNMCHC) the plan is to implementthis approach by a joint-developmentof a HIV proposal and comprehensiveplan within the continuum of careoperational framework and targets setyearly.4. HIV strategy includes SRHissuesHIV testing and counseling services areonly available at referral hospitals, andselected health centres. ANC clinicslocated in public health centres canprovide on-site counselling and testingand education to women on preventingHIV transmission during pregnancy.According to the Strategic Plan forHIV/AIDS and STI Prevention andCare in Health Sector from 2008 –2010, the focus is on strengthening theexisting health care system in order toincrease access to comprehensive HIVprevention and education, to improvethe referral and linkage between healthand community based services (betweenVCCT, OI/ART, STI, ANC, familyplanning, safe abortion, adolescenthealth, and maternal & newbornhealth), and to provide a framework ofactivities for the acceleration of timelyresponse to achieve the goal of universalaccess of HIV and reproductive healthprevention and care and treatmentfor all people by 2010. Therefore,NCHADS works with NMCHC toestablish the linkage programme toimplement a linked response approach(including PMTCT and reproductivehealth). Included as part of the strategyplan is a core strategy to increase accessto HPITC at health services (ANC, FP,STI and TB patients) where it is vitalto provide complete care to clients – toencourage them to seek HIV testing,and to provide counselling related tofertility and reproductive choices forPLHIV.50
In order to support the linked responseapproach FP services located in healthcentres should provide women witheducation about birth spacing, theprevention of HIV and STIs, andPMTCT services. All clients, includingwomen and their partners, should beencouraged to receive HIV testing.Also all pregnant clients should beseen for ANC services. HIV-positivewomen should be referred to a site withART and PMTCT services whereARV prophylaxis are provided.Working closely with village healthvolunteers, traditional birth attendants(TBA) and unofficial medicalpractitioners plays an important role inconducting outreach activities to bringpatients into health care facilities fortesting, counselling, care and treatment.This integration will also allow facilitybasedproviders to identify morepatients in need among those seekingcare in the linked response network.In addition, home-based care teamsand self-help support groups can workclosely with referral hospitals andhealth centres to scale up referrals andinitiate follow-up.HIV in Cambodia is primarilytransmitted through heterosexualintercourse, via commercial and quasicommercialsex. HIV has become aholistic issue and affects everyone.According to the CDHS, only 12.3per cent of married women have everbeen tested for HIV, and very fewwomen have been tested in the courseof ANC (12 per cent in 2005). Therisk of transmission from mother tochild remains high. Among womenwho tested HIV positive in the 2005CDHS, 2.2 per cent were pregnant atthe time, and 35.9 per cent were in theless than 24 months post-partum group.With this result, the NRHP locatedwithin the NMCHC identified severalentities responsible for developing orstrengthening linkages and partnershipswith key ministries, departments,programmes, and sectors. In workingwith the NCHADS and NMCHC,the NRHP has developed policies andstrategies which were related to HIVand STI, and reproductive and sexualhealth strategies by linking health andcommunity based services (as describedin linked response SoP).PMTCT services are offered withinexisting maternal child services. In2001, the PMTCT service started ademonstration project using an “opt in”testing approach in a few sites, providingsingle dose of Nevirapine, and scalingupnationwide.In 2006, provider-initiated testingin PMTCT services was introducedby the MoH. At the same time, theCambodia PMTCT guidelines wererevised in line with the 2006 WHOPMTCT recommendations, andemerging scientific evidence to includemore efficacious combination regimensfor women who do not qualify for ARTfor their own health, and ART forwomen with more advanced disease.In late 2003, the HIV continuum ofcare system including VCCT serviceand ARV treatment for PLHIV wasestablished, and then expanded to otheroperational districts where mothers andtheir babies can be referred for ARVprophylaxis.51
- 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 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: universal access to HIV prevention,
- 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
- Page 87 and 88: ABSTRACTBackgroundThere are a numbe
- Page 89 and 90: planning products from DHOs/DPHOs.A
- Page 91 and 92: priority. A large part of the preve
- Page 93 and 94: the major breakthrough in linking t
- Page 95 and 96: guidelines especially those related
- Page 97 and 98: Court responded to the petition byi
- Page 99 and 100: 34building on the technical strengt
- Page 101 and 102: million from donors. As a percentag
- Page 103 and 104: in hill and mountain districts. Fre
- Page 105 and 106: uilding for home-based care through
- Page 107 and 108: is from GFATM. It sets targetsand d
- Page 109 and 110: SRH and HIV programmes are runverti
- Page 111 and 112: IX. REFERENCES1. Adolescent Health
- Page 114 and 115: BANGLADESHCAMBODIANEPALPHILIPPINES9
- Page 116 and 117: BANGLADESHCAMBODIANEPALPHILIPPINES9
- Page 118 and 119: BANGLADESHCAMBODIANEPALBackgroundTh
BANGLADESHCAMBODIANEPALPHILIPPINESappropri<strong>at</strong>e tre<strong>at</strong>ment.As a result, the linkages betweenrel<strong>at</strong>ed health services need to bestrengthened, as well as those betweenhealth services <strong>and</strong> the community<strong>at</strong> large. Since 2007, the NCHADShas worked with the N<strong>at</strong>ional MCHCentre in collabor<strong>at</strong>ion with partners(WHO, CHAI, US-CDC) to developa new str<strong>at</strong>egy called a linked responseapproach to establish <strong>and</strong> implementa pilot project <strong>at</strong> oper<strong>at</strong>ional districtlevel. This approach aims to focuseffectiveness <strong>at</strong> the oper<strong>at</strong>ions district(OD) level by building capacity to: (1)increase access to comprehensive <strong>HIV</strong>prevention educ<strong>at</strong>ion, <strong>HIV</strong> testing, care<strong>and</strong> tre<strong>at</strong>ment; (2) strengthen existingreproductive health services includingPMTCT; <strong>and</strong> (3) contribute to thestrengthening of Cambodia’s overallhealth care system. This approachwas started in 2008 <strong>and</strong> continuesto be exp<strong>and</strong>ed to other oper<strong>at</strong>ionaldistricts to prevent m<strong>at</strong>ernal-child<strong>HIV</strong> transmission including sexualreproductive health <strong>and</strong> <strong>HIV</strong> infection,while strengthening the referral systembetween OI/ART, STI, ANC, FP,safe abortion, adolescent health, <strong>and</strong>MNBH.The linked response approach is alignedwith the overall framework betweenthe <strong>HIV</strong> str<strong>at</strong>egic plan <strong>and</strong> PMTCTstr<strong>at</strong>egic plan including reproductivehealth str<strong>at</strong>egies. In collabor<strong>at</strong>ionwith two centres (NCHADS <strong>and</strong>NMCHC) the plan is to implementthis approach by a joint-developmentof a <strong>HIV</strong> proposal <strong>and</strong> comprehensiveplan within the continuum of careoper<strong>at</strong>ional framework <strong>and</strong> targets setyearly.4. <strong>HIV</strong> str<strong>at</strong>egy includes <strong>SRH</strong>issues<strong>HIV</strong> testing <strong>and</strong> counseling services areonly available <strong>at</strong> referral hospitals, <strong>and</strong>selected health centres. ANC clinicsloc<strong>at</strong>ed in public health centres canprovide on-site counselling <strong>and</strong> testing<strong>and</strong> educ<strong>at</strong>ion to women on preventing<strong>HIV</strong> transmission during pregnancy.According to the Str<strong>at</strong>egic Plan for<strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong> STI Prevention <strong>and</strong>Care in Health Sector from 2008 –2010, the focus is on strengthening theexisting health care system in order toincrease access to comprehensive <strong>HIV</strong>prevention <strong>and</strong> educ<strong>at</strong>ion, to improvethe referral <strong>and</strong> linkage between health<strong>and</strong> community based services (betweenVCCT, OI/ART, STI, ANC, familyplanning, safe abortion, adolescenthealth, <strong>and</strong> m<strong>at</strong>ernal & newbornhealth), <strong>and</strong> to provide a framework ofactivities for the acceler<strong>at</strong>ion of timelyresponse to achieve the goal of universalaccess of <strong>HIV</strong> <strong>and</strong> reproductive healthprevention <strong>and</strong> care <strong>and</strong> tre<strong>at</strong>mentfor all people by 2010. Therefore,NCHADS works with NMCHC toestablish the linkage programme toimplement a linked response approach(including PMTCT <strong>and</strong> reproductivehealth). Included as part of the str<strong>at</strong>egyplan is a core str<strong>at</strong>egy to increase accessto HPITC <strong>at</strong> health services (ANC, FP,STI <strong>and</strong> TB p<strong>at</strong>ients) where it is vitalto provide complete care to clients – toencourage them to seek <strong>HIV</strong> testing,<strong>and</strong> to provide counselling rel<strong>at</strong>ed tofertility <strong>and</strong> reproductive choices forPL<strong>HIV</strong>.50
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