BANGLADESHCAMBODIANEPALPHILIPPINES<strong>and</strong> care; iii) CoC <strong>at</strong> oper<strong>at</strong>ionaldistrict level; iv) health facility-basedcare services to strengthen <strong>and</strong> supportthe referral <strong>and</strong> follow-up linkagesof CoC within different health careservices including adult OI/ARTservices, pedi<strong>at</strong>ric <strong>AIDS</strong> care services,PMTCT <strong>and</strong> other reproductive <strong>and</strong>sexual health services; v) community<strong>and</strong> home-based care services to ensurereferrals, linkages, follow up <strong>and</strong>adherence of PLHA to <strong>HIV</strong>/<strong>AIDS</strong>care <strong>and</strong> tre<strong>at</strong>ment including VCCT/OI/ART/STI/RH/FP, safe abortion,vi) VCCT to strengthen <strong>and</strong> supportlinkages between different health careservices within the CoC; vii) <strong>HIV</strong> <strong>and</strong>STI surveillance; viii) <strong>HIV</strong> research; ix)planning, monitoring <strong>and</strong> reporting; x)d<strong>at</strong>a management; logistic management;<strong>and</strong> other components including linkedresponse approach to support PMTCTof <strong>HIV</strong>, FP <strong>and</strong> other <strong>SRH</strong> services.N<strong>at</strong>ional Str<strong>at</strong>egic Plan forreproductive <strong>and</strong> sexualhealthOper<strong>at</strong>ional framework for the CoCfor PL<strong>HIV</strong> in Cambodia includingactivities to support MNBH byproviding educ<strong>at</strong>ion on MNBH <strong>and</strong><strong>HIV</strong>/<strong>AIDS</strong>; encouragement <strong>and</strong>referral of pregnant women to ANCservices; provision of inform<strong>at</strong>ion,support <strong>and</strong> referral of pregnant womento PMTCT services; follow-up ofpositive-diagnosed mother <strong>and</strong> child;referral of pregnant women to healthcentres, VCCT, <strong>and</strong> birth spacingservices.Policy for implement<strong>at</strong>ionof VCCTSoP for PEP in health facility services.There are no guidelines as yet for PEPfor sexual assault.Policy for 100 per cent condom useprogramme th<strong>at</strong> was upd<strong>at</strong>ed to SoPfor CoPCT for EWsThe Policy, Str<strong>at</strong>egies, Guidelines,<strong>and</strong> SoPs rel<strong>at</strong>ed to <strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong>STD, <strong>and</strong> PMTCT <strong>and</strong> other RSHprogrammes has been developed overa three to five year period, <strong>and</strong> willbe upd<strong>at</strong>ed every two or three yearsaccording to the need <strong>and</strong> changing<strong>HIV</strong> situ<strong>at</strong>ion.The guiding principles of the NSRSH,outline four key components th<strong>at</strong>underlie the str<strong>at</strong>egy. These includehuman rights/empowerment; genderequity; multi-sectoral partnerships,linkages, <strong>and</strong> community involvement;<strong>and</strong> evidence-based interventions <strong>and</strong>approaches. The results clearly indic<strong>at</strong>eth<strong>at</strong> gender issues cannot be separ<strong>at</strong>edfrom reproductive <strong>and</strong> sexual healthissues.Women <strong>and</strong> girls are often morevulnerable in Cambodia, due totheir lower st<strong>at</strong>us within the family<strong>and</strong> community <strong>and</strong> their biologicaldifferences th<strong>at</strong> often lead to genderbasedviolence, unplanned pregnancy/childbirth, <strong>and</strong> <strong>HIV</strong> risk. In addition,the str<strong>at</strong>egic plan mentions th<strong>at</strong> theincreasing involvement of men is animportant means to promoting genderequity. It also helps to improve men’shealth-seeking behaviour, <strong>at</strong> the sametime helping men <strong>and</strong> their familiesprevent <strong>HIV</strong> infection <strong>and</strong> otherinfectious diseases.54
The essential services package forreproductive health is provided byboth public <strong>and</strong> priv<strong>at</strong>e facilities <strong>and</strong>integr<strong>at</strong>ed into other health servicedeliveries such as STI/RTI careservices for the general popul<strong>at</strong>ion, <strong>and</strong>family health clinics for entertainmentworkers, PMTCT, ANC <strong>and</strong> FP.The general services package furtherincludes condom use, diagnosis <strong>and</strong>tre<strong>at</strong>ment of RTIs, primary preventionfor <strong>HIV</strong>, <strong>and</strong> VCCT for <strong>HIV</strong>.In order to explain to PL<strong>HIV</strong> the levelof risk of <strong>HIV</strong> <strong>and</strong> STI transmissions,positive prevention messages can beoffered <strong>at</strong> all <strong>HIV</strong> health care services.Messages such as the use of condomsamong PL<strong>HIV</strong> <strong>and</strong> their partners <strong>and</strong><strong>HIV</strong> stable couples, <strong>and</strong> inform<strong>at</strong>ion to<strong>HIV</strong> positive women <strong>and</strong> their partnersth<strong>at</strong> they have the right to choose tohave children or not.The str<strong>at</strong>egic plan for <strong>HIV</strong>/<strong>AIDS</strong>2008-2010 <strong>and</strong> SoP to initi<strong>at</strong>e alinked response proposes to strengthenexisting reproductive services, <strong>and</strong> toincrease access to <strong>HIV</strong> preventioneduc<strong>at</strong>ion, VCCT, <strong>and</strong> care <strong>and</strong>tre<strong>at</strong>ment among target popul<strong>at</strong>ions,i.e. the general popul<strong>at</strong>ion of pregnantwomen <strong>and</strong> their babies, PL<strong>HIV</strong>, <strong>and</strong>other MARPs such as EWs <strong>and</strong> menwho have sex with men (MSM).The linkage between health facility <strong>and</strong>community based services to improvereferral systems is the main str<strong>at</strong>egy <strong>and</strong>activity of the linked response approachto increase p<strong>at</strong>ient access to healthservices (STI, OI/ART VCCT, ANC/PMTCT), FP, PAC, <strong>and</strong> MNBH.It aims to increase the coverage ofoutreach activities implemented bycommunity <strong>and</strong> home based services,allowing more p<strong>at</strong>ient referrals to healthfacility services.The SoP for a continuum of care <strong>and</strong>tre<strong>at</strong>ment approach for female EWsin Cambodia was approved in l<strong>at</strong>e2008. This replaces the previous SoPfor outreach <strong>and</strong> peer educ<strong>at</strong>ion, <strong>and</strong>100 per cent condom use programmefor sex workers in Cambodia, whichfocused on linkage between <strong>HIV</strong>prevention <strong>and</strong> care, tre<strong>at</strong>ment <strong>and</strong>support, <strong>and</strong> other health care servicesincluding <strong>SRH</strong> services for most <strong>at</strong> riskpopul<strong>at</strong>ion (e.g. EWs, MSM, <strong>and</strong> otherMARPs).This more recent SoP outlines clear roles<strong>and</strong> responsibilities, <strong>and</strong> a coordin<strong>at</strong>edstructure for EW networks using peereduc<strong>at</strong>ors <strong>and</strong> facilit<strong>at</strong>ors. Accessto <strong>and</strong> coverage of EWs <strong>and</strong> otherMARP groups has increased, with theprovision of awareness-raising issues on<strong>HIV</strong> among MARPs <strong>and</strong> an improvedreferral system to access health careservices. Str<strong>at</strong>egy 3 of the SoP forDPCT rel<strong>at</strong>es to a reproductive <strong>and</strong>sexual health approach in transactionalsex service environments, <strong>and</strong> is focusedon:Developing targeted <strong>SRH</strong>communic<strong>at</strong>ion tools for EWs <strong>and</strong>other MARPs;Ensuring the availability ofcondoms/lubricants <strong>and</strong> RH/FPinform<strong>at</strong>ion in <strong>and</strong> around targetedentertainment establishments <strong>and</strong>high-risk areas; <strong>and</strong>Providing inform<strong>at</strong>ion on otherFP methods through the active55
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Published by:International Council
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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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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
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- 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 and 70: universal access to HIV prevention,
- Page 71 and 72: In order to support the linked resp
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- Page 77 and 78: care, and VCCT and ANC;Family plann
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- 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
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- Page 111 and 112: IX. REFERENCES1. Adolescent Health
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- Page 118 and 119: BANGLADESHCAMBODIANEPALBackgroundTh
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BANGLADESHCAMBODIANEPALPHILIPPINES1
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BANGLADESHCAMBODIANEPALPHILIPPINEST
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BANGLADESHCAMBODIANEPALPHILIPPINESi
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BANGLADESHCAMBODIANEPALThe protocol
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BANGLADESHCAMBODIANEPALPHILIPPINESP
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BANGLADESHCAMBODIANEPALPHILIPPINES1
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