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

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