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.
This publication provides a concise overview of the current situation; analyzes the future course and impact of HIV/AIDS in the region; outlines recommendations for responding to the epidemic; and highlights promising programs that are already underway. Importantly, the report is designed as a user-friendly tool to help both government policymakers and civil society advocates encourage policy dialogue and commitment to address HIV/AIDS throughout the region. Focusing on the HIV/AIDS situation in Cambodia, the People's Democratic Republic of Laos, Thailand, and Viet Nam, the report also draws attention to six issues that are of particular concern in the region: 1) Women and HIV/AIDS, 2) Children Affected by HIV/AIDS, 3) Health Care Delivery and Costs, 4) Implications for Development, 5) Cross-border Issues, and 6) HIV/AIDS and Tuberculosis. Promoting an enabling policy environment, responding to the entire continuum of care (including prevention, care, and mitigation), and empowering vulnerable groups are among the strategies that are noted as central to an effective HIV/AIDS response in the Mekong Region.
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.
The purpose of this paper is to outline the international and national legal instruments that apply to HIV/AIDS in Vietnam and to examine those instruments, as well as government policies, from a human rights perspective.
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.
Final report of a study to investigate mechanisms to maximize the greater involvement of people living with HIV/AIDS (GIPA) within the HIV/AIDS policy and program development, implementation and evaluation process in Vietnam.
User fees are gaining widespread use in government health programs as a means of alleviating pressure on constrained budgets as demand for services increases. Concerns that fees reduce access to services among the poor have led to the promotion of fee exemption mechanisms in order to protect those unable to pay for services. The exemptions, however, may not effectively ensure access among the poor because (1) informal fees and other costs associated with seeking and receiving services are not alleviated by most exemption mechanisms and (2) exemption mechanisms are poorly implemented. The low proportion of formal fees to total costs to the consumer and the unpredictable nature of informal fees and other costs of access may actually work against formal fee exemption mechanisms. Even though little is known about how well fee and waiver mechanisms function for maternal health services, it is important to understand whether exemption mechanisms alone hold promise for protecting access for the poor or whether the mechanisms need to be supplemented with other strategies. This study was conducted simultaneously in five countries: Egypt, India (Uttaranchal), Kenya, Peru, and Vietnam. The objectives were to survey actual costs to consumers for antenatal and delivery care; survey current fee and waiver mechanisms; assess the degree to which these mechanisms function; assess the degree to which informal costs to consumers constitute a barrier to service; and review current policies and practices regarding the setting of fees and the collection, retention, and use of revenue.
Several countries bordering Viet Nam have experienced rapid increases in HIV infection rates in the last few years. During the 1990s, the HIV/AIDS epidemic also expanded quickly in Viet Nam. As of April 2003, Viet Nam had recorded 64,801 people infected with HIV, although estimates put the figure more realistically between 150,000 to 200,000. Major factors contributing the epidemic include a thriving commercial sex industry in which condom use is not the norm and sex workers are targeted with punitive actions rather than monitored for health problems; frequent population migration; injecting drug use; substantial sexual links between drug users and other communities; limited public discussion of HIV/AIDS; and pervasive stigma. The HIV/AIDS epidemic in Viet Nam is still in the “concentrated epidemic” stage. The disease has spread rapidly in specific subpopulations, particularly among injecting drug users (IDUs), sex workers, and males who have sex with males (MSM); however, it is not yet well established in the general population. However, the current status of the epidemic does not mean that it is compartmentalized or restricted to these groups. The active networks of risk within and among these subpopulations and the general population will determine the epidemic’s future course.
Synthesis of the Socioeconomic Impact study.