BANGLADESHCAMBODIANEPALPHILIPPINESThe SoP for CoPCT for entertainmentworkers (EWs) is to implement areproductive <strong>and</strong> sexual health approachin transactional sex service environmentsby developing <strong>and</strong> monitoring EWcommunic<strong>at</strong>ions str<strong>at</strong>egy to outlinebehavioural communic<strong>at</strong>ions objectives<strong>and</strong> key messages/channels.Implement<strong>at</strong>ion of areproductive <strong>and</strong> sexualhealth approach intransactional sex serviceenvironmentsAccording to the joint st<strong>at</strong>ement,between the NCHADS <strong>and</strong> NMCHC,the establishment of a linked responseapproach, including PMTCT of <strong>HIV</strong><strong>and</strong> reproductive <strong>and</strong> sexual healthprogrammes, will be prioritised <strong>and</strong>exp<strong>and</strong>ed to 55 oper<strong>at</strong>ional districts by2012. The NCHADS is responsiblefor the health sector response to <strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong> STI care <strong>and</strong> tre<strong>at</strong>ment.This is implemented <strong>at</strong> the oper<strong>at</strong>ionaldistrict level through a continuumof care package <strong>and</strong> STI control th<strong>at</strong>includes VCCT <strong>and</strong> <strong>HIV</strong> testingamong pregnant women as entry pointsfor PMTCT services. The linkedresponse approach includes inp<strong>at</strong>ient<strong>and</strong> outp<strong>at</strong>ient care for <strong>HIV</strong>/<strong>AIDS</strong>with OI <strong>and</strong> ART services, <strong>and</strong> thestrengthening of referral mechanismswithin <strong>and</strong> between community-basedsupport <strong>and</strong> facility-based services.The NMCHC is responsible for otherreproductive health services, includingANC, PMTCT, safe delivery, MNBH,FP, <strong>and</strong> postpartum care.With the continu<strong>at</strong>ion of the continuumof care (CoC) <strong>HIV</strong>/<strong>AIDS</strong> programme<strong>and</strong> its expansion into the wider healthsystem, plus improving PMTCTservices <strong>and</strong> other reproductive <strong>and</strong>sexual health programmes, Cambodiais facing financial resource gaps for theimplement<strong>at</strong>ion of these programmes.There are separ<strong>at</strong>e funding sourcessupporting the implement<strong>at</strong>ion of <strong>HIV</strong><strong>and</strong> <strong>SRH</strong> programmes from USAID,US-CDC, WHO, <strong>and</strong> GFATM, withfunding support for <strong>SRH</strong> programmesmainly from HSSP2 including UNFPA<strong>and</strong> KFW. According to the GlobalFund (GF) <strong>HIV</strong> proposal Round 9, all<strong>HIV</strong> care <strong>and</strong> tre<strong>at</strong>ment <strong>and</strong> PMTCTprogrammes, including linked response<strong>and</strong> reproductive <strong>and</strong> sexual healthactivities, are funded by the GF grant.There is a separ<strong>at</strong>e monitoring systemfor <strong>HIV</strong> <strong>and</strong> <strong>SRH</strong> programmes. In2010, NCHADS, NMCHC, <strong>and</strong> otherpartners developed a joint monitoringtool <strong>and</strong> reporting form<strong>at</strong> to monitorthe linked response approach, includingPMTCT <strong>and</strong> reproductive <strong>and</strong> othersexual health activities.Addressing gender, stigma<strong>and</strong> discrimin<strong>at</strong>ion in<strong>HIV</strong> <strong>and</strong> <strong>SRH</strong> str<strong>at</strong>egies/policies.Based on the n<strong>at</strong>ional str<strong>at</strong>egy for <strong>SRH</strong>programmes in Cambodia, genderis inseparable from reproductive<strong>and</strong> sexual health <strong>and</strong> is essentialfor the effective development <strong>and</strong>implement<strong>at</strong>ion of programmes <strong>and</strong>services. Women <strong>and</strong> girls are oftenmore vulnerable in Cambodia, due totheir lower st<strong>at</strong>us within the family <strong>and</strong>community. Their biological differencesincrease their vulnerability to gender-52
ased violence, unplanned pregnancy/childbirth, <strong>and</strong> an increased <strong>HIV</strong> risk.Male involvement in reproductive <strong>and</strong>sexual health activities is an importantstep towards increasing gender equity,<strong>and</strong> the successful implement<strong>at</strong>ion of<strong>SRH</strong> programmes.Since the CoC programme wasestablished <strong>and</strong> exp<strong>and</strong>ed to otherODs, stigma <strong>and</strong> discrimin<strong>at</strong>ion amongPL<strong>HIV</strong> has been reduced. Because ofthe CoC programme, <strong>HIV</strong>/<strong>AIDS</strong>care has not only focussed on medicalcare but has also included a wide rangeof services, such as psychological,social, <strong>and</strong> legal support. The needfor comprehensive care is thereforecrucial. People <strong>at</strong> risk need infectionprevention support, <strong>and</strong> preventionefforts need to be closely linked to care<strong>and</strong> tre<strong>at</strong>ment. These should cover arange of important areas - raising theawareness of PLHA how not to infecttheir loved ones, helping those <strong>at</strong> highrisk protect themselves by identifyingtheir st<strong>at</strong>us, <strong>and</strong> avoiding infection.One of services of the CoC is theMMM programme which is offered byreferral hospitals. These programmesare conducted via half-day monthlymeetings th<strong>at</strong> provide a cruciallink between PLHA <strong>and</strong> healthprofessionals <strong>at</strong> the hospital. The MMMprogramme also aims to reduce stigmawithin the referral hospitals, as well asself-stigma experienced by PLWHA.Through MMM meetings, healthcareproviders gain an underst<strong>and</strong>ing ofnon-clinical issues, daily struggles <strong>and</strong>the gaps in medical underst<strong>and</strong>ingof PLWHA. PLWHA receiveinform<strong>at</strong>ion about their illness <strong>and</strong>their tre<strong>at</strong>ment programme, <strong>and</strong> howto access all the resources available tothem. They also learn from each other,sharing their successes <strong>and</strong> challenges,gradually becoming more confident <strong>and</strong>competent in self-care <strong>and</strong> appropri<strong>at</strong>ehealth-seeking behaviour<strong>Policies</strong>, Str<strong>at</strong>egies,Guidelines <strong>and</strong> St<strong>and</strong>ardOper<strong>at</strong>ing ProceduresSince the <strong>HIV</strong> epidemic was detected<strong>and</strong> became a major health issue inCambodia, some important <strong>and</strong> timelypolicies, str<strong>at</strong>egies, guidelines, <strong>and</strong>st<strong>and</strong>ard oper<strong>at</strong>ing procedures havebeen developed, upd<strong>at</strong>ed <strong>and</strong> adaptedaccording to the needs <strong>and</strong> scope ofprogramme implement<strong>at</strong>ion.D<strong>at</strong>a analysed from the <strong>HIV</strong> <strong>and</strong> STIn<strong>at</strong>ional survey, political commitment,the joint-n<strong>at</strong>ional programme for <strong>HIV</strong>/<strong>AIDS</strong>, STI, <strong>and</strong> other reproductive<strong>and</strong> sexual health programmes form thebases upon which the changing <strong>HIV</strong>situ<strong>at</strong>ion is managed.<strong>Policies</strong>, str<strong>at</strong>egies, guidelines, <strong>and</strong>st<strong>and</strong>ard oper<strong>at</strong>ing procedures havebeen upd<strong>at</strong>ed <strong>and</strong> are available tosupport the implement<strong>at</strong>ion of <strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong> STI/RTI programmes,PMTCT <strong>and</strong> other reproductivehealth programmes. These are:Health Sector Str<strong>at</strong>egic Plan 2008 –2015The Str<strong>at</strong>egic Plan for <strong>HIV</strong>/<strong>AIDS</strong>Prevention <strong>and</strong> Care in Health Sector2008 – 2010 is composed of <strong>HIV</strong>prevention <strong>and</strong> care components suchas: i) BCC; ii) STI/RTI, prevention53
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Table ofContentChapter Titles Pages
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INTRODUCTIONThe 2009 AIDS Epidemic
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REVIEW OF LINKAGES BETWEEN SEXUAL A
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ROUNDTABLE MEETING ON LINKAGES BETW
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Mr Roberto M Ador, Executive Direct
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Session 3: Health Systems Strengthe
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Model for Public-Private Partnershi
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CONCLUSIONSuccessful linkages betwe
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- Page 23 and 24: AbstractBackground: There are a num
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- Page 29 and 30: However, condom use was low amongho
- Page 31 and 32: 2and Save the Children, USA, and is
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- Page 47 and 48: e accomplished if there is supporta
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- Page 53 and 54: Promote the social acceptability of
- Page 55 and 56: References20 years of HIV in Bangla
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- Page 63 and 64: AbstractBackgroundThe HIV epidemic
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- Page 83 and 84: ReferencesStrategic Plan for HIV/AI
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- Page 87 and 88: ABSTRACTBackgroundThere are a numbe
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