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

More documents

Recommendations

Info

BANGLADESHCAMBODIANEPALPHILIPPINESfor prevention programmes within abroader framework that addresses theneeds for treatment, care and supportof PLHIV. The National HIV/AIDSStrategy was developed as a policy inthe context established by the five yearplan, and recognises the links betweenHIV control efforts and broaderdevelopment goals.The National HIV/AIDS Strategy,2006-2011 aims at achieving all HIVand AIDS commitments and targetsincluded within these initiatives. TheMDGs declare that the spread ofHIV should be halted by 2015 withdecreasing epidemic levels.The strategic plan prioritises reducingthe spread of the HIV epidemicand ensuring access to preventionprogrammes. The strategy recognisesthat more effort is required to achievean adequate coverage of MARPs.Many respondents reported thatthere is a joint planning for PMTCT,especially community based PMTCTprogramming between SRH and HIVdepartments. The SBA policy andtraining guidelines include PMTCT.HIV strategy favours Venereal DiseaseResearch Laboratory (VDRL) testswhere the services are available. Postexposure prophylaxis (PEP) is onlyavailable for service providers but notfor survivors of sexual assault. Most ofthe participants reported that protocolsand manuals are being used for bothRH in health facilities and PMTCT,VCT and ART service delivery sitesfor HIV.Most of the respondents were unawareof any law on gender based violence.However all expressed the view thatthis is in the preparation process withsupport from rights activists for thelaw on GBV (Forum for Women, Lawand Development). However theywere of the opinion that the media’shighlighting of the issue of GBV hasled to the increase in case reporting. Theenforcement of law has been weakenedfor some time in the country due to theon-going peace process and politicaltransition. Nepal is in the process ofdrafting a new constitution for a federalrepublic through 601 members of theConstituent Assembly (CA).HIV strategy and policy includes familyplanning in PMTCT and programmingfor dual protection. Both are budgetedin the national plans. However, SRHstrategy is not included and is therefore,not budgeted as a part of the nationalplans. The HIV strategy addresses HIVrelated stigma and discrimination andvulnerability factors related to MARP(MSM, SWS, IDUs and migrants, andyoung populations within the contextof MARPs).There is no clinical guideline on SRHfor women living with HIV. PEP isnot available for survivors of sexualassault but male and female condomsare described in the SRH protocols.There is no guideline for routine testingfor HIV and syphilis among pregnantwomen, although the strategy favoursroutine VDRL testing, where servicesare available.Although VDRL tests are carried outroutinely, testing for HIV is done in thePMTCT and VCT sites only. Mostof the respondents routinely consultthe national standards, protocols and74
guidelines especially those related toVCT, PMTCT and ART.However it was noted that saidguidelines, especially RH relatedprotocols, are not used in the privatesectors, including medical colleges inNepal. These institutions are guidedby their own hospital guidelines andprotocols.Pursuant to the Eleventh Amendmentto the Muluki Ain (code of conduct),the legal age for marriage for both sexesis 20 years; however, where the parentsor guardians consent to the marriage,the minimum age is 18 years for bothsexes. Generally, a marriage must beperformed with the consent of bothparties. Marriages entered into withoutthe free and full consent of both partiesare voidable.In Nepal, the legal age of consentfor HIV testing is 18 years. Anyone18 years or older requesting VCTis deemed able to give full informedconsent. Children (below 14 years) andminors (under 16 years) cannot legallyprovide consent.Under the following circumstances,HIV testing may be recommended tominors:Children born to HIV positivemothers (HIV exposed children)Children and adolescents withclinical indicators of HIV/AIDSVulnerable children and adolescentsat increased risk of HIV infection(e.g. street children)Children and adolescents whoengage in high risk behaviour suchas sex work or injecting drug useChildren and adolescents who havebeen sexually abusedAdolescents who are sexually activeor are marriedIn these circumstances, the counselloror clinician will need to explore with theminor and/or their parent/guardian:Whether it is in the best interest ofthe minor to be tested for HIVWhether the minor and/or parent/guardian would benefit fromcounselling and testingWho will provide consent?Whether, when and how the minorwill be informed of the HIV testresult (disclosure to children)Consent for HIV testing ofadolescents (young peopleunder the age of 18)All young people under the age of18 accessing VCTs should haveaccess to preventive counsellingregardless of their marital status andwhether or not parents or guardiansconsent. Counselling should includeinformation on SRH and FP. HIVtesting may be undertaken withoutparental consent on a case-by¬-casebasis, if the counsellor determines thatthe minor has sufficient maturity tounderstand the testing procedures andresults. Adolescents can be designatedas ‘mature’ or ‘emancipated’ minors ifthey are married, pregnant, and sexuallyactive, or are already parents.75
Page 2 and 3:
Published by:International Council
Page 5 and 6:
Table ofContentChapter Titles Pages
Page 7 and 8:
INTRODUCTIONThe 2009 AIDS Epidemic
Page 9 and 10:
REVIEW OF LINKAGES BETWEEN SEXUAL A
Page 11 and 12:
ROUNDTABLE MEETING ON LINKAGES BETW
Page 13 and 14:
Mr Roberto M Ador, Executive Direct
Page 15 and 16:
Session 3: Health Systems Strengthe
Page 17 and 18:
Model for Public-Private Partnershi
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 and 70: universal access to HIV prevention,
Page 71 and 72: In order to support the linked resp
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: the major breakthrough in linking t
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 118 and 119: BANGLADESHCAMBODIANEPALBackgroundTh
Page 120 and 121: BANGLADESHCAMBODIANEPALPHILIPPINESC
Page 122 and 123: BANGLADESHCAMBODIANEPALPHILIPPINESt
Page 126 and 127: BANGLADESHCAMBODIANEPALPHILIPPINEST
Page 128 and 129: BANGLADESHCAMBODIANEPALPHILIPPINESi
Page 130 and 131: BANGLADESHCAMBODIANEPALThe protocol
Page 132 and 133: BANGLADESHCAMBODIANEPALPHILIPPINESP
Page 134: BANGLADESHCAMBODIANEPALPHILIPPINES1
show all

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

Create successful ePaper yourself

Delete template?

Save as template?