Browse POLICY Project (1995-2006) Materials
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Country and regional assignments reflect those made at the time of production and may not correspond to current USAID designations.
List entries are alphabetical by title and contain the title, abstract, language, and then the filename which is hyperlinked and will open in a new browser window. Many files are PDFs but some of the older ones are Word documents.
As HIV/AIDS has evolved from being viewed as a public health issue-to be dealt with primarily by doctors and scientific researchers-to being recognized as an epidemic that affects every aspect of a country's national and socioeconomic development, the need for strong commitment and leadership has become even more apparent. The need for strong leadership is acutely felt in low prevalence countries where there is still an opportunity to contain the spread of the epidemic. But for many reasons, isolating, defining, and measuring what "political commitment" really is has been difficult. This paper reflects on key questions surrounding political commitment and leadership in the HIV/AIDS arena. It begins with a review of what we know about political commitment today-why it matters, what its characteristics are, how it has been measured to date, and how it can be strengthened. The paper then turns attention to the multi-country pilot assessment study in Asia, reviewing common themes from the country studies, analyzing lessons learned, and providing concluding thoughts and recommendations for future study and action.
Political commitment and leadership are essential for creating an enabling environment that promotes the development and growth of appropriate, sustainable HIV/AIDS policies and programs. The need for strong leadership is acutely felt in low HIV prevalence countries where there is still an opportunity to contain the spread of the epidemic. However, “political commitment” is a term that is often used without a clear sense of what it means, how it affects programs, when it can be most effective, and how it can be strengthened by advocates and policymakers. Building on experience with monitoring national program efforts in the family planning/reproductive health, maternal health, and HIV/AIDS fields, the POLICY Project developed a questionnaire that assesses various aspects of political commitment. POLICY then worked with local counterparts to pilot test the questionnaire in four low-prevalence countries in Asia. The pilot studies show that the political commitment assessment guide can serve as a useful tool for helping HIV/AIDS advocates and policymakers analyze a country’s national political commitment and leadership for confronting HIV/AIDS. In-country researchers can use the assessment guide to tailor questions to their country’s unique context. Such research can lay the foundation for identifying areas of strength and weakness in the country’s HIV/AIDS program and highlighting areas for future advocacy and policy change efforts.
In less than a quarter of a century, the HIV/AIDS outbreak has become the most outstanding challenge worldwide. Over 30 million lives have been lost due to this devastating disease and about 40 million people are estimated to be living with HIV. HIV/AIDS causes unacceptable human suffering to the infected and affected individuals, their families, communities, and nations. Nepal has been affected by this complex epidemic, with an estimated 0.5 percent of the population being HIV positive (National Estimates of Adult HIV Infections–Nepal, 2003, NCASC, March 2004). Even a conservative estimate puts the number of people living with HIV or AIDS (PLWHA) in Nepal at over 61,000. Although HIV/AIDS prevalence in the Nepal Police Service is not known, it is reasonable to estimate that it is comparable with the national average of 0.5 percent. The prevalence may be even greater due to the nature of police work, which places them in vulnerable situations. An effective HIV/AIDS response requires adequately addressing the social and structural epidemics of poverty, conflict, war, gender inequality, stigma and discrimination, and human rights violations, which are fertile grounds for the spread of HIV/AIDS. These issues highlight the significant need for an educational program for the Nepal Police. This curriculum seeks to contribute to this purpose.
A research report assessing the current situation for people living with HIV/AIDS in Nepal. The report addresses discrimination and stigma through legal reform.
This report assesses how the Greater Involvement of People Living with HIV/AIDS (GIPA) Principle is being implemented in the ANE region. Five USAID Missions and 12 implementing agencies (IAs) in the region participated in the assessment, which was undertaken in May and June 2003 in Cambodia, India, Nepal, Philippines, and Viet Nam. The purpose of the assessment was to ascertain how Missions, IAs, and NGOs are incorporating GIPA principles into their organizations and into the programmatic work they support and implement. A self-administered questionnaire was completed by 23 respondents from Missions, IAs, and NGOs.
Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
The support of the media is considered to be essential in strengthening the response to HIV/AIDS and addressing the human development challenges posed by the epidemic. As an influential advocate of social change, the media needs to play a positive role in preventing the spread of HIV/AIDS and in reducing its impact. In fact, it is the media’s responsibility to inform, educate, and lead. But the question is, has it been able to play this role effectively? This review analyzes the role of the media and the reporting trends on HIV/AIDS issues in Nepal in order to better understand how the media reports in order to foster effective partnership with it. This report will help in assessing the general trend of coverage on HIV/AIDS issues. It is expected to help the government and nongovernmental organizations (NGOs) working in the area of HIV/AIDS to devise more influential advocacy strategies. It is also expected to help in deciding on the choice of media for dissemination of information and messages on HIV/AIDS.
In 2003, the POLICY Project implemented a core package in Nepal, which was designed to create a model for increasing the meaningful participation of injecting drug users (IDUs) in the HIV/AIDS policymaking environment. Activities centered on bringing together recovering IDUs to form a network, thereby developing their leadership capacity and knowledge of HIV prevention in order to advocate for HIV treatment, support, and care. This report describes how the project took on a life of its own and helped transform a loosely organized network into an established nongovernmental organization (NGO). The following list exemplifies the breadth of the project's achievements: 1) Nepal's first IDU network was created, which united IDUs and increased their leadership capacity. 2)549 IDUs participated in training sessions throughout the country. 3)IDUs advocated with donors and policymakers for care, treatment, and support, including free drug rehabilitation services, for people living with HIV/AIDS (PLHAs). 4)IDUs developed strategic relationships among themselves and with policymakers, donors, and HIV service and drug rehabilitation organizations. 5)The network successfully used the media to raise awareness of stigma and discrimination against IDUs and PLHAs.
Nepal CP final.doc
Armed forces, police, and other uniformed services around the world face a serious risk of HIV and other sexually transmitted infections (STIs), due to the nature and characteristics of their profession. As a civil force, the Nepal Police work closely with the population in all areas of the country and subsequently are frequently exposed to groups with increased vulnerability to HIV/AIDS. Although the risk of contracting HIV through performing the normal duties of uniformed services employees is so low as to be almost non-existent, there are other factors that can contribute to the vulnerability of uniformed services personnel. The overall objectives of the HIV/AIDS strategy for the Nepal Police are to halt the spread of the HIV/AIDS epidemic within the police force, their partners and families; to sensitize them toward the rights of vulnerable groups and their access to HIV/AIDS services, and to ensure that policing practices do not exacerbate the impact of the epidemic in Nepal through impeding HIV prevention initiatives. In order to meet these objectives, this strategy has been developed. The strategy broadly focuses on prevention as the fundamental basis for an effective response within the Nepal Police. The strategy recognizes the importance of research, accurate surveillance systems, and evaluation and monitoring of interventions. The strategy is guided by underlying principles including a rights-based approach, high-level leadership and commitment, reduction of stigma and discrimination, and greater involvement of people living with HIV/AIDS (GIPA).
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The 1994 ICPD intensified the worldwide focus on reproductive health policies and programs. Officials in many countries have worked to adopt the recommendations in the ICPD Programme of Action and to shift their population policies and programs from an emphasis on achieving demographic targets for reduced population growth to a focus on improving the reproductive health of their population. This paper presents information from case studies carried out in Bangladesh, India, Nepal, Jordan, Ghana, Senegal, Jamaica, and Peru to assess each nation's process and progress in moving toward a reproductive health focus. The case studies show that within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on the national health agenda. All countries have adopted the ICPD definition of reproductive health either entirely or in part. Policy dialogue has occurred at the highest levels in all countries. The countries have also achieved considerable progress in broadening participation in reproductive health policymaking. Bangladesh, Senegal, and Ghana have been particularly effective in involving NGOs and civil society organizations in policy and program development. In some of the other countries, however, the level of participation and political support for reproductive health may not be sufficient to advance easily to the next crucial stage of implementation. The case studies indicate almost uniformly that countries are grappling with the issues of setting priorities, financing, and implementing reproductive health interventions. Bangladesh has made the greatest progress in these areas while India, Nepal, Ghana, Senegal, Jamaica, and Peru are beginning to take steps toward implementation of reproductive health activities. Jordan continues to focus primarily on family planning. Several challenges face these countries as they continue to implement reproductive heath programs. These challenges include improving knowledge and support of reproductive health programs among stakeholders; planning for integration and decentralized services; strengthening human resources; improving quality of care; addressing legal, regulatory, and social issues; clarifying the role of donors; and maintaining a long-term perspective regarding the implementation of the ICPD agenda. Despite many encouraging signs, limited progress has been achieved in actually implementing the Programme of Action; this finding is neither surprising nor unexpected. It took more than a generation to achieve the widespread adoption and implementation of family planning programs worldwide, and that task is far from complete. The key to continuing progress lies in setting priorities, developing budgets, phasing-in improvements, and crafting strategies for implementation of reproductive health interventions.
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This brief examines the extent to which the 1994 ICPD has shaped reproductive health policies and programs in Bangladesh, Ghana, India, Jamaica, Jordan, Nepal, Peru, and Senegal. Within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on their respective national health policy agendas. The progress illustrated by the case studies is a logical beginning for defining and adopting reproductive health policies and principles, while building political and popular support. However, whereas well-established reproductive health services, such as family planning and maternal and child health, have remained high priorities, the case studies indicate that a continued effort will be required to place more sensitive issues, such as gender-based violence and reproductive rights, on the policy agenda. In addition, in some countries, a greater level of participation and political support for reproductive health may need to be cultivated before the countries are able to advance to the next crucial stage of implementation. Countries also need sufficient financial resources to implement the expanded reproductive health programs and services envisioned by the ICPD—resources that most respondents suggested were not immediately forthcoming.
This report summarizes the POLICY Project in Nepal from 2002-2006. This report addresses the policy environment when the project began, major accomplishments, and remaining challenges to the enabling evironment for HIV and AIDS programming in Nepal.
Strengthening the HIV & AIDS Policy Environment in Nepal- Nepal Final Report.pdf
The greater involvement of people living with HIV/AIDS (GIPA) is being promoted as a cornerstone of HIV/AIDS prevention and care and support. The concept of GIPA emerged as a formal statement at the Paris Summit on AIDS in 1994. However, the concept of PLHA involvement expressed by GIPA has been a feature of community responses to HIV/AIDS from very early in the epidemic. This research analyzes the perceptions of GIPA in Nepal from the perspective of policymakers, international organizations, NGOs, and people living with HIV/AIDS (PLHAs).