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HIV/AIDS
More recent HIV/AIDS publications are available.Internal stigma is the product of the internalization of shame, blame, hopelessness, guilt, and fear of discrimination associated with being HIV-positive. It can affect caregivers and family members, who also may internalize feelings of shame, guilt, or fear. Internal stigma can have a profound effect on HIV prevention, treatment, and care. This document explores the difference between internal and external stigma, the contributing factors, and potential ways of addressing stigma, including indicators and steps to empowerment.
English
Internal_Stigma.pdfThis document has been compiled by the International Institute for Educational Planning (IIEP)/UNESCO HIV/AIDS Impact on Education Clearinghouse in cooperation with POLICY /Futures Group. It aims to bring together, for ease of access, national and education sector HIV/AIDS policies and strategies adopted by governments to manage the impact of HIV/AIDS on their country or more specifically their education systems, to help protect their populations from infection and to care for those who are infected or affected by HIV/AIDS. These resources are provided for information purposes only and inclusion of a policy or strategy in this document does not necessarily signify approval on the part of IIEP/UNESCO or POLICY/Futures Group.
English
IIEP_POLICY.pdfThis guide provides an interactive approach to provide simple tools to assist in the process of formulating realistic and context specific plan to guide the future HIV/AIDS work in the Anglican Community.
English
AIDSps.pdfIn Ghana there is a dearth of studies on the economic impact of HIV/AIDS. In recognition of the possible consequences of HIV/AIDS on business concerns, a desk review of existing data was carried out. In addition, a number of senior managers were interviewed to ascertain the measures that have been put in place in various institutions to prevent and control HIV infections among their staff and to minimize the economic impact of the disease on the business. The purpose of this initial review was twofold: i. to determine what additional information is needed to facilitate the development of an advocacy tool for the sensitization of management at the workplace; and ii. to encourage various business institutions to assess in realistic manner what HIV means to them and to develop an appropriate response.
English
Ghanaecimb.pdfThe Fourth Edition of "AIDS in Ethiopia" is an update on the current information available on the HIV/AIDS situation in Ethiopia. The data upon which this edition is based has doubled in the past year. The third edition of "AIDS in Ethiopia (2000) used 15 surveillance sites. The current version is based on data from 34 sites, of which 28 are urban sites and 6 are rural sites. A special national level expert group meeting was convened to arrive at the national prevalence rate using the sentinel surveillance data. As a result of discussions of the expert group, Estie, a site formerly presumed to be a rural site, with an HIV prevalence rate of 10.7 percent in 2001, was reclassified as an urban site. This reclassification of Estie led to a 2001 estimate of HIV prevalence of 6.6 percent. The national adult HIV prevalence of 6.6 percent is less than the prevalence of 7.3 percent presented in the third edition. It is to be noted that this change in national HIV prevalence does not imply that the HIV epidemic in Ethiopia is declining. The current estimate is merely a result of more extensive surveillance data and the reclassification of Estie as an urban site. Urban HIV prevalence rates continue to be high at 13.7 percent while the HIV prevalence rate for rural areas remains relatively low at 3.7 percent. HIV prevalence for Addis Ababa is estimated to be 15.6 percent. The number of persons living with HIV/AIDS in 2001 is estimated at 2.2 million, including 2 million adults and 200,000 children. Approximately 10 percent of these or 219,400 are full blown AIDS cases. The highest prevalence of HIV is seen in the group 15 to 24 years of age, representing "recent infections". The age and sex distribution of reported AIDS cases shows that about 91 percent of infections occur among adults between 15 and 49 years. Given that the age range encompasses the most economically productive segment of the population, the epidemic impacts negatively on labor productivity. Work time is lost through frequent absenteeism, and decreased capacity to do normal work as the disease advances. There are also social consequences of the epidemic as caregivers and income generating members of the family die leaving behind orphans and other dependents. These events lead to an aggravation of the problems of poverty and social instability. The data also show that the number of females infected between 15 and 19 years is much higher than the number of males in the same age group. This discrepancy is attributable to earlier sexual activity among young females with older male partners. Although the government has made progress in the areas of education, access to health care and economic development, the AIDS epidemic is eroding those gains. The limited empirical data that is available shows that hospital bed occupancy rates for HIV/AIDS cases are increasing. The health care sector, military and the mobile work force are likely to be significantly affected. In view of the above issues, several measures need to be taken. Data from more rural sites needs to be included to represent rural areas more effectively. Attention to be focused on preventing the new generation from acquiring the infection, as they represent a "window of hope". More empirical research on the economic and social impact of HIV/AIDS needs to be conducted. There is a need to mobilize the efforts of the government, non-governmental organizations, community based organizations and other civil society organizations in providing care and support to people infected and affected by HIV/AIDS.
English
ETH_AIM_2002.pdfAIM booklet
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Ethaimbk.pdfAIM projections and impacts.
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AIDS_in_Kenya.pdfOver two decades since the first AIDS case was described in Kenya, HIV/AIDS still remains a huge problem for the country in its efforts for social and economic development. Responses to the pandemic have evolved over time as people became aware of this new disease, as they experienced illness and death among family members, and as services have developed to confront this epidemic. Initially many segments of society expressed denial of the disease. Early in the epidemic in Kenya political commitment was limited. While awareness of AIDS has been nearly universal for more than a decade, misconceptions still abound and many still have not dealt with this disease at a personal or community level. The purpose of AIDS in Kenya has been to inform leadership and citizens of the country about the epidemic, make projections about its impact, and describe policy. Emphasis of the publication now shifts; this edition: " describes the level and trends of HIV infection; " assesses the breadth and depth of knowledge of HIV; " identifies behavioural patterns associated with these trends; " provides information on HIV prevalence from VCT clients, STI patients and blood donors; " describes the scale-up in HIV prevention services; " analyses the interaction of the TB and HIV epidemics; " describes the expansion of HIV care and treatment; and " assesses the socio-economic impact and costs of AIDS.
English
KEN_AIDS_7thEd.pdfA status report on the sociopolitical, economic, and policy climate on drug availability for People Living with HIV/AIDS (PLWHA) and recommendations for future access.
English
NIG_ADOI.pdfCountries in the Asia-Pacific region have reached a crossroads in their HIV/AIDS response. The ability of countries in the region to maintain low national HIV prevalence levels will depend on their success in rapidly scaling up prevention, care, and treatment. The argument for responding quickly is compelling: the longer governments wait to adopt interventions, the higher the eventual cost in lives, productivity, and national as well as household medical expenses. The leadership and resources needed for rapid scale up requires strong political commitment and action from the countries’ highest leaders. “Act Now”—a joint publication of the Asia-Pacific Leadership Forum on HIV/AIDS and Development (APLF), UNAIDS, and the USAID-funded POLICY Project—encourages leaders from across the region to vigorously combat the epidemic before the situation worsens. Responses will have their greatest impact if countries act when national prevalence is still low.
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ANE_ActNow.pdfFour background papers prepared for the Plenary Session on HIV/AIDS of the AGOA Forum address issues related to the HIV/AIDS crisis.
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AGOA_Overview.PDFThis paper describes the AGOA objectives and explains how HIV/AIDS may affect our ability to achieve those objectives.
English
AGOA_1.PDFThere is a growing literature that discusses the impact of HIV/AIDS on prospects for development (Barnett and Whiteside, 2002, provides an excellent overview). Less attention has been paid to the impact of development on the spread of HIV/AIDS. The process of development often leads to rural–urban migration, increased trade and transport, and the attenuation of family relations due to physical separation. These processes pose challenges in the fight against HIV/AIDS. On balance, economic growth and development support the fight against AIDS, yet the process of development must be managed effectively to assure that economic development and the fight against AIDS work together to benefit sub-Saharan Africa. Workplace programs are cost-effective. AGOA factories provide ideal environments for implementation of HIV/AIDS prevention, care, and treatment programs that are mutually beneficial for the companies and societies.
English
AGOA2003_1.pdfAGOA representatives met late in 2001, again in 2002, and now for a third time in December 2003. Background papers from previous meetings suggested a number of actions that AGOA member countries could consider to enhance the effectiveness of responses to the threat of HIV/AIDS. This paper summarizes a few issues and actions, linking the actions specifically to (1) finance and planning ministries, (2) trade, labor, and commerce ministries, (3) the business sector, and (4) donors and assistance agencies. The delegates could discuss which key actions they would like to monitor and possibly report on at the next AGOA forum. They are welcome to recommend fresh approaches to maximize the benefits that can derive from a results-oriented, cooperative effort in the fight against HIV/AIDS.
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AGOA2003_2.pdfThis paper describes the challenges ministries of finance and planning face in responding to the HIV/AIDS epidemic.
English
AGOA_2.PDFThe accompanying tables provide background data on health spending in AGOA countries; background data on successful applications for grants from the Global Fund to Fights AIDS, Tuberculosis and Malaria and grants received by AGOA countries under the World Bank Multisectoral AIDS Program (MAP) for Africa; and background data on HIV/AIDS prevalence. These data may help orient and clarify discussion of progress and objectives.
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AGOA2003_3.pdfThis paper addresses challenges faced by ministries of trade and commerce in addressing the HIV/AIDS crisis, particularly in the areas of intellectual rights, trade practices, tourism, the world of work, and international competitiveness.
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AGOA_3.PDFThis paper discusses ways in which the private business sector is responding to the issue of HIV/AIDS.
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AGOA_4.PDFDescribes POLICY's approach to HIV/AIDS
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POLICY_HIV.pdfDescribes POLICY's approach to human rights, stigma and discrimination
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ATC_Human_Rights.pdfThe purpose of this paper is to examine the costs and savings associated with making FP services available at HIV/AIDS treatment centers. The paper will summarize study findings that discuss how providing contraception to HIV-negative and HIV-positive women can help to prevent new infections among women and reduce the risk of a child becoming HIV positive due to an unintended pregnancy or of subsequently becoming an orphan because the child's mother or father dies of AIDS-related causes. The paper will also present estimates of the costs and savings of including family planning in existing HIV-related care and treatment services in the original 14 Emergency Plan focus countries.
English
FP-HIV Integration Costs and Savings Final.pdfAround the world, in myriad ways, individuals are working to fight stigma and discrimination and promote human rights in order to combat the HIV epidemic. 'Breaking Through' highlights the contributions of people who are speaking out against stigma, discrimination, and human rights violations. Some of those profiled are people living with HIV. It is our hope that readers will be inspired by the approaches and stories presented in this booklet. The individuals profiled represent a fraction of those who are confronting stigma and discrimination and promoting human rights. Their stories reflect the dedication and spirit of countless others who are working toward enabling environments that support the inclusion of people living with HIV and vulnerable groups and that foster effective, just responses to the epidemic.
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Breaking Through.pdfAt long last, academics, researchers, activists, service providers, and people living with HIV are beginning to understand and articulate the consequences of addressing (or not addressing) and measuring HIV-related stigma and discrimination. This paper reviews the present understanding of HIV-related stigma and discrimination as they relate to vulnerability, and suggests approaches for stigma reduction. It explores and examines what constitutes HIV-related stigma and discrimination, what effects they have on behavior and HIV responses, and what we can do to reduce them.
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Breaking_the_Cycle.pdfAt long last, academics, researchers, activists, service providers, and people living with HIV are beginning to understand and articulate the consequences of addressing (or not addressing) and measuring HIV-related stigma and discrimination. This paper reviews the present understanding of HIV-related stigma and discrimination as they relate to vulnerability, and suggests approaches for stigma reduction. It explores and examines what constitutes HIV-related stigma and discrimination, what effects they have on behavior and HIV responses, and what we can do to reduce them.
French
Breaking the cycle_FR.pdfAs part of the POLICY Project’s investigations into the delivery of family planning (FP) services in the context of high HIV prevalence, six focus group discussions were held in Cambodia in December 2004. The aim of these discussions was to document the views of FP users, service providers, and HIV-positive (HIV+) women on the accessibility and quality of FP services, particularly in light of the HIV/AIDS epidemic in Cambodia.
English
CamFP-HIV_FGDs.pdfHIV-related stigma and discrimination (S&D) has accompanied the AIDS epidemic from the start. Fear of and actual experience with stigma and discrimination reduce an individuals willingness to practice prevention, seek HIV testing, disclose his or her HIV status to others, ask for (or give) care and support, and begin and adhere to treatment. As efforts to address S&D increase, so does the need for a set of standard tested and validated S&D indicators. Yet measures that can both describe an existing environment, and evaluate and compare interventions, are lacking. This report suggests ways to begin the process of quantitatively measuring HIV-related stigma in an effort to help practitioners, policymakers and donors evaluate their programs.
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Measure HIV Stigma.pdfInvolving men in reproductive healthcare could help Cambodia achieve some major development goals, such as a decreased maternal mortality rate and an increased contraceptive prevalence rate. Involving men could also help reduce the overall prevalence of HIV/AIDS—an outcome possible only if men are involved not just as clients of RH care but also as partners, service providers, policymakers, teachers, and project managers. Until today, male involvement in RH in Cambodia has been relatively underdeveloped. Despite the availability of a few contraceptive methods for men, maternal and child health (MCH) programs provide most RH care, strategic plans and services lack indicators for men, and most service providers are not equipped or trained to accommodate male clients. RH facilities tend to be female-oriented; as a result, men are often reluctant to avail themselves of services. Men’s reluctance to access RH care can also mean that barriers to accessing health, such as distance and cost, which affect both men and women, are even more influential in preventing men from seeking RH counseling or treatment or even seeking services as partners. To expand and strengthen male involvement in reproductive health in Cambodia, this report offers the following recommendations: • A set of guidelines to mainstream male involvement need to be developed and distributed. • Agencies interested in implementing male involvement in reproductive health must plan for a long-term commitment. • Campaigns need to be implemented that educate seemingly “low-risk” social and demographic groups. • Current education campaigns need to be reviewed in the context of male involvement and should not, for example, reinforce gender inequities or the notion that condom use is restricted only to high-risk situations. • Existing services should be made more “male-friendly,” with service providers undergoing additional training and engaging in effective outreach activities. • The private health sector should be directly involved in efforts that foster male involvement.
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MaleInvolv_Cam.pdfPOLICY, GNP+ and GTZ collaborated to develop new tools to increase PLHA involvement in the Global Fund CCMs. "Challenging, Changing, and Mobilizing: A Guide to PLHIV Involvement in Country Coordinating Mechanisms" is a handbook developed for use by PLHA already working on HIV/AIDS with some prior knowledge of the Global Fund. The handbook includes information on the Global Fund and CMM basics, how to be an effective CCM member and how to improve CCMs through the greater involvement of PLHAs. The handbook will be available in early 2005. The aim of the handbook is to increase and improve the meaningful participation of People Living with HIV (PLHIV) on Global Fund Country Coordinating Mechanisms (CCMs) across the world. This development will undoubtedly enhance the ability of the Global Fund to be an effective force in serving the communities most in need and will also contribute to facilitating PLHIV access to Global Fund resources. This handbook is the product of numerous consultations and input of over 400 people living with HIV (PLHIV) from more than 30 countries in every region of the world, with the vast majority of those involved living in developing countries and countries in transition. This handbook was created primarily for PLHIV who are already working on HIV/AIDS issues in their country and who have some prior knowledge of the Global Fund. It is anticipated that many in the target audience will already be involved in some aspect of work that is related to the Global Fund, perhaps through membership on a CCM, as members of networks represented on a CCM, or as sub-recipients of Global Fund grants. Some may not be directly involved at present, but may have an interest in learning more about the Global Fund and in advocating for inclusion of a network or organization on the CCM in a specific country or region.
Russian
CCM_Handbook_RUS.pdfThis is a compilation of significant information and data on the current situation of child survival in Nigeria. Facts have been drawn from a wide range of sources including the Nigeria Demographic and Health Survey (1999), Population Bureau, Federal Office of Statistics, National Planning Commission, UNICEF’s Children’s and Women’s Rights in Nigeria: A Wake-up Call—Situation Assessment and Analysis (2001), survey reports, academic articles, policy and programme documents, budget documents, and publications from development partners. This document is intended to serve as a concise public source of data on the major child survival issues in Nigeria and to assist policymakers to “put children first” in national priorities and in the design of public policies.
English
NIG_CSrevised.pdfAs 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.
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PC_Synthesis.pdfThis paper identifies eight interventions for HIV/AIDS prevention, care, and treatment of construction workers. Where prevalence is low, cost of the eight interventions is 0.14 percent of the cost of a major construction project. With high prevalence levels of ten percent of the workforce, costs of the package of interventions would still fall below one percent of total project costs. These percentages are low enough to permit contractors to include the costs of such services among the indirect costs for worker injury protection, insurance and emergency care without substantially increasing total project costs. Economics of AIDS and Access to HIV/AIDS Care in Developing Countries, Issues and Challenges The following series of documents (in PDF) are the chapters of this book, which was assembled by ANRS in June 2003. This paper is part of a book which contributes to the debate on expanding access to HIV/AIDS treatment in developing countries. It presents an important and innovative aspect of the work of the ANRS (Agence Nationale de Recherches sur le Sida), one of the few agencies to have initiated research in this field. Its aim is to increase the engagement of the economic and social science perspective so as to clarify international and national discussions about the best way to overcome the scandalous inequality in access to HIV/AIDS treatment between poor and rich region of the world. For more information on the book follow this link: http://www.iaen.org/papers/anrs.php/
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McGreevey.pdfThis report examines the present situation of both the HIV/AIDS epidemic in Cambodia and the progress of its FP program. It examines the trends in funding, staff resources, impact of the epidemic on personnel, and the activities of the government, private health sector and nongovernmental organizations (NGOs) in both sectors. Finally, the report will examine the efforts being made to integrate HIV/AIDS and FP services so that they jointly address these issues that are having such a profound effect on Cambodia’s development.
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CamFP-HIV_analysis.pdfThis study is an investigation into the status and trends of family planning (FP) and reproductive health (RH) programs within the context of Ethiopia’s heightening HIV/AIDS epidemic. By helping individuals and couples control the number and timing of pregnancies, family planning provides far-reaching benefits (Dayaratna et al., 2000). In addition, by reducing unintended and high-risk pregnancies, family planning can lower the instances of maternal and child injury, illness, and death associated with childbirth and unsafe abortions (Shane, 1997). Ethiopia has not been able to expand FP services to satisfy the increasing unmet need in the country, and its maternal mortality ratio (MMR) ranks as one of the world’s highest. At the same time, Ethiopia is among the countries that have been hardest hit by the HIV/AIDS epidemic. The findings of this study are expected to inform policy and program managers about the various dimensions of HIV/AIDS and family planning in Ethiopia.
English
EthiopiaFP-HIV.docThis study was designed to document the extent to which Kenya has managed both its family planning/reproductive health (FP/RH) and HIV/AIDS programs in the context of the high HIV prevalence (14%) the country is experiencing. In order to gain further insights on the dynamics of the FP program (FPP) in the country, interviews were conducted with 16 key informants from relevant government ministries/departments, NGOs, collaborating agencies, and donors. Questions touched on specific issues of FP/RH and HIV/AIDS regarding funding levels, staffing/personnel issues, integration and role of nongovernmental organizations (NGOs) and the private sector in FP/RH and HIV/AIDS programs. The background information for the study was obtained from several policy documents and other related official documents such as strategic plans, relevant survey results/reports, development plans, and statistical abstracts.
English
Ken_FPHIV.pdfThis study forms part of an investigation by the POLICY Project on how countries have been managing family planning in the face of high HIV/AIDS prevalence. This report describes recent trends in family planning/reproductive health (FP/RH) and HIV/AIDS service delivery in Zambia. The study was conducted in two parts. First, the desk review of documents on FP/RH and HIV/AIDS was carried out. The second part involved in-depth interviews with selected stakeholders in FP/RH and HIV/AIDS service delivery. Respondents included representatives from the Ministry of Health/Central Board of Health (MOH/CBOH), National AIDS Council (NAC), donor agencies, nongovernmental organizations (NGOs), and cooperating partners as well as public and private service providers. Questions were asked about the FP/RH and HIV/AIDS programs with regard to the status of the programs, funding levels, staffing and personal issues, the role of NGOs and the private sector, and health sector reform.
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Zam_FPHIV.pdfProgress toward achieving the goals of the Declaration of Commitment on HIV/AIDS and the Millennium Development Goals requires significant expandsion of HIV/AIDS programs to foster a supportive environment, to prevent new infections, to care for those already infected, and to mitigate the social and economic consequences of the epidemic. One measure of progress is the percentage of people living in low- and middle-income countries who have access to key prevention and care services. This report presents the results of an assessment of the coverage of several key health services in 2003. It updates and adds information to a similar report on coverage in 2001. This report includes results from 73 countries, including most low- and middle-income countries with more than 10,000 people living with HIV/AIDS in 2003. The information presented here relies on service statistics and expert assessment. These data focus on the quantity of services provided and do not address the quality of those services. The results should be interpreted with caution but are useful in indicating the progress made in the last two years toward future goals. The results of this analysis suggest that most people in low- and middle-income countries do not have access to many key prevention services. Utilization is very low for voluntary counseling and testing (VCT) with an estimated 6.1 million visits per year or 0.2 percent of adults 15–49. Approximately 10 million pregnant women are offered services to prevent mother-to-child transmission of HIV (PMTCT), about 8 percent of all pregnant women in these countries. About 70,000 women receive AZT or nevirapine to prevent HIV transmission to the newborn child, only 3 percent of all HIV-positive pregnant women.
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CoverageSurveyReport.pdfThis report includes results from 69 countries, including most low- and middle-income countries with more than 10,000 people living with HIV in 2005. The information presented here relies on national service statistics and expert assessment. These data focus on the quantity of services provided and do not address the quality of those services. In many countries, national consensus workshops were held to validate the data. Estimates of the population in need of each service have been derived from demographic and epidemiological statistics and may not correspond to national estimates of need, but are used here to present coverage estimates that are comparable across countries and regions. For countries that did not participate in the survey, we have used regional averages to estimate the number of people served. The results should be interpreted with caution, but are useful in indicating the progress made in the last two years toward future goals. For all regions combined, prevention services are provided to about 33% of sex workers, 9% of men who have sex with men, 34% of prisoners, and 16% of children living on the street. Twenty-six countries reported having prevention programs for injecting drug users, most from Eastern Europe and Asia. The most common type of program was information and education on risk reduction, which is provided for about one million injecting drug users. Needle and syringe exchange programs reach less than half as many (400,000) and drug substitution programs reach only about 32,000. Estimates of the number of injecting drug users are highly uncertain, but coverage of harm reduction programs is still low in most lowand middle-income countries. In short, significant progress has been made in most areas since 2001, but the only programs that provide access to most people who need services are AIDS education in the schools and condoms. Some regions have achieved universal access for some services, such as ART in Latin America. In most other areas, greater effort will be required to expand services to meet the goal of universal access.
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HIVCoverage20051.pdfExcel file with the country annex tables to accompany the document, "Coverage of selected services for HIV/AIDS prevention, care, and treatment in low- and middle-income countries in 2005."
English
FINAL HIV Coverage Survey 2005 - Country Annex Tables.xlsAn overview of the HIV/AIDS situation and policy advocacy in Latin America, this guide serves as a tool to develop strategies to advocate for sexual health policies, particularly for men who have sex with men.
Portuguese
LAC_ASICALguide_Portuguese.pdfDe Frente a la VIDA is a photojournal that features the stories of 10 people living with HIV/AIDS in Mexico. It was developed as part of POLICY's "Mo Kexteya" Project on stigma and discrimination in Mexico. Media reporting and images can profoundly influence public perceptions of HIV/AIDS. This photojournal aims to help change stereotypical portrayals of PLHAs by presenting positive images of PLHAs and their everyday experiences in a range of settings. The photojournal is being used in advocacy work and in journalist training sessions to help improve reporting on HIV/AIDS and people affected by the disease.
Spanish
MoKexteya.cfmBased on proceedings of an October 2003 workshop conducted in Guatemala with support from POLICY Project and the International HIV/AIDS Alliance, this Spanish manual is an important contribution to the literature on best practices, lessons learned, and case studies in HIV/AIDS/STI prevention for MSM in the region. Presented in terms of processes, impact/results, and monitoring and evaluation, the document is also a useful tool for designing and improving HIV/AIDS/STI prevention programs. With attention to regional cooperation, communication, capacity building, advocacy, and financing of MSM HIV/AIDS/STI prevention programs, the manual provides comprehensive and practical guidelines for program planners as well as policymakers.
Spanish
LAC_MSM_sp.pdfA report from a workshop held by the East-Central Division of the Seventh Day Adventist Church, bringing together people from five continents to put forth a united front in the battle against the spread of HIV/AIDS. The workshop sensitized church leaders to the issues of HIV/AIDS, identified priority actions and put forth policy reccomendations to the church Executive Committee.
English
ken_ecd_sdaps.pdfEnglish
SEImpact_Africa.PDFEnglish
angola.pdfEnglish
benin.pdfEnglish
botswana.pdfEnglish
burkina.pdfEnglish
congodrc.pdfEnglish
cotedivo.pdfEnglish
ethiopia.pdfEnglish
ghana.pdfEnglish
kenya.pdfEnglish
madagasc.pdfEnglish
malawi.pdfEnglish
mali.pdfEnglish
mozambiq.pdfEnglish
namibia.pdfEnglish
nigeria.pdfEnglish
rwanda.pdfEnglish
senegal.pdfEnglish
southafr.pdfEnglish
swazilan.pdfEnglish
tanzania.pdfEnglish
uganda.pdfEnglish
zambia.pdfEnglish
GhanaNatEst2000.pdfSentinel surveillance systems for HIV are designed to provide information on trends to policy makers and program planners. The data are useful for understanding the magnitude of the HIV/AIDS problem in certain geographic areas and among special populations and for monitoring the impact of interventions. These data also can be used to prepare estimates of national HIV prevalence suitable for advocacy purposes and district planning. This paper describes the approach used in Malawi to develop an estimate of adult HIV prevalence. The methodology and assumptions reported here were developed during a workshop organized by the National AIDS Control Programme (NACP) in Lilongwe in September 1999 and updated for 2001 during a workshop in Lilongwe in May 2001. Participants represented the NACP, National Statistical Office, MACRO, College of Medicine, Ministry of Health and Population, University of Malawi, Department of Human Resources Management and Development, CDC and the POLICY Project.
English
MalSS.pdfA technical working group organized by the National AIDS Commission has used the latest sentinel surveillance results for 2003 to estimate national HIV prevalence in Malawi. This report describes the methodology, assumptions and results of that work.
English
MALNatEst2003.docThe HIV/AIDS epidemic is having a wide impact on Nigeria. One of the more alarming is the emerging cohort of AIDS orphans and other vulnerable children (OVCs)—children who have lost either or both of their parents to AIDS. Experiences from other countries, such as Ethiopia, Uganda, and South Africa, where the epidemic is more advanced, tell us that AIDS orphans face serious threats to their well-being, and these threats can have far-reaching and long-term effects on society, public health, and the economy. Nigeria, like many sub-Saharan African countries, has a young population. Current estimates indicate that about 44 percent of the country’s population is under age 15. Unfortunately, a sizable proportion of these children have lost either one or both their parents. This report provides an estimate of orphans (under age 15) that have lost their parents to AIDS-related and non-AIDS-related causes for the 36 states of Nigeria and the Federal Capital Territory (FCT) between 2000 and 2015. The paper also briefly describes the methodology and data used to develop the estimates.
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Nig_Orp_Proj.pdfThe objective of POLICY’s HIV/AIDS Program in Mexico is “to support the government’s effort to enhance the quality and sustainability of HIV/AIDS/STI services in targeted states.” The focus of the project in the three initial states of Yucatán, Guerrero and Mexico has been to promote coalition building and a participatory strategic planning process among diverse stakeholders. POLICY has worked in Mexico at the bequest of and in close collaboration with CENSIDA, the national agency responsible for oversight of HIV/AIDS services and prevention programs in Mexico. The principal purposes of the evaluation were to understand what worked well, where POLICY’s tools have been most successful, and what could be learned from mistakes. The evaluation was also an opportunity to elicit some lessons learned from the Multisectoral Citizens’ Groups (MCGs) in the first three states where the project has been active and to codify some common principles from POLICY’s process from the varied experiences in different states. Another area of inquiry focused on identifying other complementary processes that POLICY and CENSIDA could employ to strengthen the effectiveness of governmental and nongovernmental groups in transforming the policy process in targeted states. There was general agreement among all of the project’s stakeholders that they had made significant contributions to improvements in HIV/AIDS prevention activities and in the quality of services in Mexico by supporting local initiatives. Similarly, there was strong praise for the quality and dedication of the POLICY staff. In particular, the clients in the three states interviewed during the evaluation expressed an overwhelmingly positive experience with the project. The project has supported the formation of active MCGs in three states (Guerrero, Mexico, and Yucatán). Project staff also tried to organize a similar group in the Federal District (D.F.) but found that it was difficult to build the same level of commitment and coordination. Instead of supporting the formation of a MCG in the D.F., POLICY helped to develop a local council for HIV/AIDS prevention (CODFSIDA). Toward the end of 2001 POLICY had expanded its work to Campeche, Chiapas, Oaxaca, Quintana Roo, and Veracruz. The MCG in Yucatán will work with the groups in Campeche and Quintana Roo. This represents a new phase in the project whereby older groups provide technical assistance for the formation of new groups. Another innovation is that local groups in the newly participating states are conducted by the members of the multisectoral groups rather than by outside consultants.
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Mexi_eval.pdfThis report provides a summary analysis of the resources required to achieve the broad objectives outlined in Kenyas National AIDS Strategic Plan (KNASP). The report specifically provides summary information on the key interventions as laid out in the KNASP (2005-2010) and the financial resources required for a credible response to the epidemic. The report also includes the best estimates on the current coverage of those interventions; the current assumptions about HIV/AIDS capacity required to scale up coverage; the best current estimates; and the current and projected HIV/AIDS resources. The data specific to Kenya were obtained using a combination of: 1) key informant interviews with representatives from government, US government agencies, UN institutions, and local universities; 2) a review of six existing HIV/AIDS budgets in Kenya; 3) review of international literature; and 4) various demographic and economic surveys conducted on HIV/AIDS interventions in Kenya.
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KEN_NASP.pdfThe right to own and inherit property is a crosscutting right that traverses the realm of civil, political, economic, social and cultural rights. This right is central to the true empowerment of everyone in society (men, women, boys and girls) and is a key developmental right. It is the common right to all societies and cultures. It is central to securing the dignity of all members of the society. Emerging legal and social trends, as they relate to the ownership and inheritance of property, indicate a practice that has largely worked out to the detriment of women in virtually all communities and social classes in Kenya. They include the laws relating to property, to marriage and dissolution of marriage, land registration systems, and the social and cultural attitudes that determine the actual enjoyment of these rights. Compounding the problem is the HIV/AIDS pandemic, which has caused massive destitution, displacements, blame-passing and mistrust in nearly all communities in Kenya. The high stigma associated with it has increased the vulnerability of women in this regard. In no other community in Kenya is the twin problem of societal and cultural practices - which discriminate against women and thereby translate into widespread of HIV/AIDS - more stark than within Luo Nyanza. It is against the backdrop of the realisation of this continuing trend of violation of womens (especially, but by no means limited to widows) right to property ownership and inheritance rights and the urgency of the problem in the face of HIV/AIDS pandemic that the POLICY Project Kenya ( funded by the Futures Group) and Kenya National Commission on Human Rights (KNCHR) (funded by the Governance Justice Law and Order Sector reform program) came together inspired by the same need to work on enhancing the enjoyment of this right by women in Kenya.
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KEN_InheritanceRights.pdfAn overview of the HIV/AIDS situation and policy advocacy in Latin America, this guide serves as a tool to develop strategies to advocate for sexual health policies, particularly for men who have sex with men.
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GUIA_HSHps.pdfGuidelines and overview of forthcoming PLHA Handbook in Vietnamese
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PLHA_CCMvt.pdfGuidelines and overview of forthcoming PLHA Handbook.
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PLHA_CCM.pdfGuidelines and overview of PLHA Global Fund Handbook.
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PLHA_CCMth.pdfThis manual provides guidelines for employers and employees on issues of HIV/AIDS and Human Rights in employment. The overall objective this manual is to assist employers, employees and would be employees, to take action and make informed decisions pertaining to employment, HIV/AIDS and human rights. The manual applies both to the formal and informal sectors. Knowledge of human rights in the workplace will assist employers and employees to challenge policies and programmes that violate the rights of people living with HIV/AIDS.
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ZM_EMPGUIDE.pdfIn 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.
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NEP_PoliceCurriculum.pdfThis is a brief introduction to the “HIV/AIDS National Emergency Action Plan” (HEAP) for HIV/AIDS in Nigeria. For an effective and coordinated response to the AIDS epidemic there is a need for the development of an overall National Strategic Plan. The process of doing this encompasses several elements of which the situation and response analyses have already been completed. The HEAP is the next step.
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HEAP.pdfA study of the print media in Cambodia in 2003 found that HIV/AIDS reporting was often sensationalistic or voyeuristic, displaying little respect for the dignity of people living with HIV/AIDS who were usually depicted as victims or objects of sympathy. This resource has been developed as a result of recognition that there was no media guide to meet the growing demands of reporters covering the increasingly complex HIV/AIDS issues.
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CAM_MediaGuide.pdfBuilding on a participatory process that began more than a year ago with technical support from POLICY/South Africa, the Anglican Church of the Province of Southern Africa has adopted a provincial HIV/AIDS strategic plan for 2003–2006. Forged diocese-by-diocese, the plan represents the best of the Anglican Church’s collective wisdom and is designed to ensure that local approaches are used to address local concerns. Among the provisions in the document are plans to: ? Expand care and support efforts for people living with HIV/AIDS (PLWHA) through a trainer-of-trainers program involving members of the Mothers Union and the Anglican Women’s Fellowship; ? Conduct a pilot project on voluntary counseling and testing to explore the feasibility of providing these services through faith-based communities; ? Establish “Lay Leadership Training Academies” and clergy schools and training programs to build leadership skills, improve pastoral care, and strengthen commitment to address HIV/AIDS; ? Form of a committee on Sexuality Education and HIV Prevention to develop prevention programs and curricula geared toward youth; and ? Collaborate with multisectoral partners to outline a workplace policy on HIV/AIDS and catastrophic illnesses in order to help reduce stigma and discrimination. In addition, the participatory process used to develop the strategic plan is documented in a training manual so that it can be used as a model for other community- and faith-based organizations.
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CPSA.pdfEnglish
f-aidscomp.pdfResponding to HIV/AIDS requires addressing a number of priorities, including preventing new HIV infections (among vulnerable groups and the general population), caring for people living with HIV/AIDS and their families, and mitigating the impacts of the pandemic. But what level of resources should be devoted to prevention programs for youth? Or to the development of new voluntary counseling and testing (VCT) sites? Or to the provision of antiretroviral (ARV)therapy? Or to support for AIDS orphans? There is no one correct answer to these questions. Each country must consider its own needs, goals, and circumstances in order to determine the appropriate combination of interventions. And these decisions often take place in the context of constrained resources – further emphasizing the importance of allocating resources wisely. In addition, emerging needs, challenges, and opportunities are increasingly highlighting the need to combine the best thinking from government and civil society stakeholders regarding HIV/AIDS resource allocation decisions. Designing and implementing an HIV/AIDS national program is complex and important. Prevention, treatment, and palliative care costs are a significant component of the health budget. In most national strategic plans, however, although the activities to be undertaken are clearly outlined, the activities are not tied to specific prevalence goals the countries wish to attain. Millions of dollars are spent annually to prevent HIV infection without a thorough understanding of the most effective way to allocate these funds. Since the budgets are not linked to the plan’s goals, there is no way for the planners to know what would happen if more or less resources were available or if resources were allocated differently.
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GFlyer.pdfEnglish
toolkit.cfmThe National AIDS Control Council has realized the need to mainstream gender issues in programmes/projects since mainstreaming gender issues in the planning, implementation and evaluation of programmes strengthens the effectiveness of the response to HIV and AIDS. The overall goal of this toolkit is to sensitise policy and senior level decision makers on key HIV, AIDS, and Gender issues. It offers guidelines to use when planning and formulating gender responsive policies and programmes relating to HIV and AIDS.
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KEN_GenderToolkit.pdfA research report assessing the current situation for people living with HIV/AIDS in Nepal. The report addresses discrimination and stigma through legal reform.
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NEP_LegAudit.pdfGovernment agencies are the largest employers in many countries, but too little attention has been given to strengthening HIV/AIDS prevention, care, and treatment programs for government employees and their families. This book offers practical guidance on creating or expanding HIV/AIDS workplace programs for civil services.
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WW_PubSectGuide.pdfEnglish
Ethadhiv.pdfThis briefing book is intended to provide information about the HIV/AIDS epidemic in Ghana. This material is also available as a slide show or interactive computer presentation. The information is provided in four sections: Background: What we know about HIV/AIDS in Ghana today Projections: The number of people who might develop AIDS in the future Impacts: The social and economic impacts of AIDS Interventions: What needs to be done to prevent the spread of HIV/AIDS Policy: Policy issues and the National Strategic Framework, and institutional structure that have been put into place to combat the epidemic
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GHA_AIM3rdEd.pdfThis report is designed as an advocacy tool to assist policymakers and other stakeholders in stimulating dialogue about sustainable, contextually appropriate responses to HIV/AIDS in Ghana. The report seeks to provide an overview of the current HIV/AIDS situation in Ghana; project the future direction of the epidemic using the best available data; highlight some of the key social and economic impacts of the pandemic; and discuss strategies that will be needed to reduce the spread of HIV/AIDS, improve care and support, and mitigate associated impacts.
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HIVAIDS_IN_GHANA_CURRENT SITUATION.pdfThis report presents the latest estimates of the extent of the HIV/AIDS epidemic in Malawi and discusses some of the implications. The report is based on the results of an AIDS Impact Model application.
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MAL_AIDS.pdfFour-page bulletin summarizing AIM results in nine Francophone African countries. (Benin, Burkina Faso, Cameroon, Cote D'Ivoire, Guinea, Mali, Niger, Senegal, and Togo.
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HIV9.pdfThe HIV/AIDS epidemic has become a serious health and development problem in many countries around the world. The Joint United Nations Programme on AIDS (UNAIDS) estimates the number of HIV infections worldwide at about 36.1 million by the end of 2000. About 25.3 million infected people—70 percent of the total—were in sub-Saharan Africa. In 2000 alone, 5.3 million people became newly infected with HIV. Another 21.8 million persons have already died from the disease since the beginning of the epidemic, mostly in Africa. In 2000, about 600,000 children became newly infected with HIV, nearly all of whom were infants born to HIV-infected mothers. Nine of 10 newly infected infants were in sub-Saharan Africa. The virus that causes AIDS has already infected and is infecting many Africans. About 20 percent of the entire adult population aged 15–49 is currently infected in nine southern African countries—Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe. This is a staggering level, and most of these people do not even know they are infected. From the beginning of the epidemic through 2000, about 4.4 million persons may have developed AIDS in southern Africa, although most of these have not been officially recorded. No cure is available for AIDS, and the disease threatens the social and economic well being of the countries.
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SoAf10-01.pdfEnglish
Talkpts.pdfThis briefing book is intended to provide information about the HIV/AIDS epidemic in Zimbabwe. This material is also available as a slide or interactive computer presentation. The information provided includes: what we know about HIV/AIDS in Zimbabwe today, the number of people who might develop AIDS in the future, the social and economic impacts of AIDS, and what needs to be done to prevent the spread of AIDS.
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Zimaim.pdfThis 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.
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HIV_Mekong.pdfIn many countries around the world, the majority of new infections are occurring in women, particularly adolescents and young adults. Developing appropriate responses to the gender issues that continue to make both women and men vulnerable to HIV is critical to all efforts to prevent HIV transmission, improve care and support for PLWHA and their families, and mitigate the impacts of the HIV/AIDS pandemic. This publication provides program planners with practical, field-based insights on integrating gender into HIV/AIDS programs. The publication's guidelines, examples of promising responses, and analysis of gaps emerged from in-depth interviews with nearly 60 program officers from USAID and its partners during 2001 and 2002. The Gender and HIV/AIDS Task Force of the Interagency Gender Working Group supplemented insights gained from these interviews with other literature reviews to produce this synthesis document.
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HowToIntegrGendrHIV.pdfAIDS Impacts in eight Francophone African countries.
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FHAimpact.pdfAIDS Impact Model Update Bulletin (Vol. 1 No. 2) 2001
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Imp2.pdfAIM projections, sentinel surveillance
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brochura_sida.PDFThis 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.
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ANE_GIPA.pdfThis paper provides an overview of the rationale for integrating family planning into HIV programs, as well as lists of resources that can be used for policy development and policy implementation to integrate FP into HIV policies and programs. It is a companion document to the CD-ROM of the same name, which contains the actual resources listed. The paper is divided into seven sections: 1. International conventions (FP and HIV-related service integration) 2. National HIV policies and FP 3. VCT policies and FP 4. PMTCT policies and FP 5. ART policies and FP 6. Operational policies 7. Additional resources
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ImplementingPoliciesandPrograms.pdfIn the past few years, South African hospitals have become overcrowded and in many facilities AIDS patients outnumber patients with other illnesses. Home-based care is considered as an alternative to traditional institutionalised care, and focuses on palliative care within the home. The increasing number of patients hospitalised for an extended period of time has stretched the resources of the health care system. Discharging patients into the care of a home care programme allows for a shorter stay at the hospital, making more beds available for other patients and reducing costs to the institution. Releasing patients into the care of competent agencies that deliver quality home-based care services can allow hospital staff to have peace of mind and enhance the morale of health care providers in the face of an overwhelming situation. In 1999 POLICY Project supported seven hospices to incorporate the Integrated Community-based Home Care (ICHC) model into their operational activities. This report documents the critical elements of the ICHC model and reflect on the experiences of those working in the field. Objectives of the research were to: 1) identify and discuss key similarities and differences between the hospice ICHC model and other home-based care models used in South Africa; 2) identify and critically review the core elements related to the ICHC model as implemented by Hospice Association of South Africa; and, 3) highlight key aspects of best practice related to the hospice ICHC model.
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SA_Hospice.pdfThe 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.
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VIE_HumanRights_HIV.pdfThis collection of stories highlights HIV-related advocacy work in communities around the world. This manual begins a process of documenting HIV/AIDS policy advocacy stories as a means of preserving them and making them available to others as more and more people become involved in HIV/AIDS advocacy issues. In all, 16 advocacy organizations are profiled in "Moments in Time." Although the stories focus on HIV/AIDS, the advocacy models are applicable to other settings and other issues. In fact, the developments in HIV/AIDS advocacy over the past 20 years can be helpful to other advocacy issues, just as other advocacy issues have been instrumental in the development of HIV/AIDS advocacy.
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MomentsFR.pdfThis brochure describes the KENEPOTE program. KENEPOTE is a network of HIV-positive teachers, founded in 2003 by two HIV-positive teachers. KENEPOTE aspires to create an environment where teachers with HIV and AIDS will be free from fear, shame, denial, stigma, and discrimination. The KENEPOTE mission is to build the capacity of it's members in advocacy for the reduction of stigma and discrimination, protection of rights of HIV-positive teachers, orphans and vulnerable children; increase access to psychosocial support services and skills to teachers; prevent further spread of HIV and AIDS in collaboration with other stakeholders by bringing positive change in attitude and behavior of communities to HIV and AIDS.
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KEN_KENPOTEBrochure.pdfThis is a report of the first wrokshop held in Kenya for HIV-positive teachers in December 2004. It was organised by KENEPOTE and the POLICY Project. The goal of the workshop was to sensitise HIV-positive teachers and important education-sector stakeholders on KENPOTE goals, vision, mission, and objectives. The workshop further hoped to get HIV-positive teachers to share their workplace and life experiences and to explore ways in which they could unite to address the challenges facing them, given their great potential as Kenyan agents of change.
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KEN_KENEPOTE.pdfReport Of The First South African National Home/Community Based Care Conference held 18 - 21 September 2002. The conference aimed to provide strategic direction for the delivery of care and support services through HCBC programmes in South Africa, and also to focus on strengthening their impact. An overview of the specific aims, objectives and expected outputs are contained in the section “The HCBC Conference at a glance” on page 5. Debates and presentations were structured around four tracks, and focused on issues that have been identified as critical barriers to developing HCBC ser vices. The tracks of the conference were: Context for Care, Continuum of Care, Par tners for Care, and Living Positively.
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Khomanani_ConfRpt.pdfExecutive summary of the First South African National Home/Community Based Care Conference held 18 - 21 September 2002. The conference aimed to provide strategic direction for the delivery of care and support services through HCBC programmes in South Africa, and also to focus on strengthening their impact. An overview of the specific aims, objectives and expected outputs are contained in the section “The HCBC Conference at a glance” on page 5. Debates and presentations were structured around four tracks, and focused on issues that have been identified as critical barriers to developing HCBC ser vices. The tracks of the conference were: Context for Care, Continuum of Care, Par tners for Care, and Living Positively.
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Khomanani_ExecSum.pdfThe first behavioural survey conducted in the Nigerian Armed Forces to elicit behavioural information that would contribute to a better understanding of the dynamics and underlying factors of the spread of sexually transmitted diseases (STDs) and HIV/AIDS in the military was carried out between May and August 2001. The nationally representative survey was conducted amongst nearly 1,600 military personnel randomly selected from the three service arms of the Nigerian Armed Forces. Detailed information on the knowledge and attitudes regarding STDs and HIV/AIDS and on risky behaviour patterns was elicited. Also, information on some socio-demographic factors that could have possible explanatory value or confounding effects was obtained. The survey reveals that Nigerian military personnel are very educated and dedicated, with long-term career investments in the military that imply personal and professional hardships and risks. Of concern is that Nigerian military personnel find themselves in professional and personal situations that lead to engaging in high-risk behaviours that could put them at risk of contracting STDs, including HIV. Furthermore, in view of the fact that military personnel live with and interact freely with the civilian population, they could serve as a potential core transmission group for these infections to the larger population. This is of great concern and calls for prompt interventions. Whilst military personnel are more aware of HIV/AIDS than the general population, more could be done by the Nigerian military to protect their dedicated officers and men to the extent possible from the risks to which they are exposed.
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Nig_AFPAC_KAB.pdfSpanish-language version of the GOALS brochure.
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GFlyer-Spanish.pdfBackground, projections and impacts of HIV/AIDS in Haiti.
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impact.pdfEnglish
learning.cfmHIV/AIDS interventions are currently being designed and carried out in the developing world. Some of these interventions are evaluated by randomized controlled trials, with accompanying cost analyses, and others are evaluated with small cross-sectional surveys. The process of designing and evaluating interventions can be difficult and time-consuming due to the wide variety and complexity of epidemiologic and ethical issues related to HIV/AIDS. In order to provide assistance to those responsible for implementing prevention studies and to those studying the results, a systematic review of the HIV/AIDS and sexually transmitted infections (STI) intervention literature was conducted. The literature review was used to develop a searchable Excel workbook of published and non-published HIV/AIDS intervention studies in the developing world. (PDF File)
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HIV-AIDSLiteratureDB.PDFExcel Spreadsheet companinon to Literature Database for Evaluating HIV/AIDS Interventions.
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Literature Database 1 Mar 20081.xlsSummary report of the evaluation of the master trainers programme. Local government councillors and officials were trained in order to build the capacity of local governments in addressing the HIV/AIDS epidemic.
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SA_LGEval.pdfDuring the process of formulating the Kenya National HIV/AIDS Strategic Plan, some of the gender dimensions of the epidemic had been recognised. It was noted that a striking feature of the epidemic was its impact on women as compared to men; the incidence of HIV/AIDS among women was rising at a shocking rate and women were being infected at an earlier age than men were. However, explicit strategies that focused specifically on gender issues were not included in the development of policies or programmes under the five priority areas. In 2001, as the gender aspects of the epidemic became clearer and it was recognised that gender was playing a crucial role in the dynamics of the HIV/AIDS pandemic, the National AIDS Control Council established a Technical Sub-Committee on Gender and HIV/AIDS Task Force. It was agreed that the best approach would be to engender the existing Kenya National HIV/AIDS Strategic Plan because it is the key document that guides and co-ordinates all responses to HIV/AIDS in Kenya. The Technical Sub-Committee’s mandate was to formulate guidelines and create a strategic framework through which gender concerns could be integrated into the analyses, formulation and monitoring of policies and programmes relating to the five priority areas of the Kenya National HIV/AIDS Strategic Plan so as to ensure that the beneficial outcomes are shared equitably by all – women, men, boys and girls. The gender analysis and mainstreaming strategies contained in this document are centrally informed by two National AIDS Control Council commissioned field studies carried out in October 2001 and May 2002. The findings of the field studies illustrate how different attributes and roles societies assign to males and females profoundly affect their ability to protect themselves against HIV/AIDS and cope with its impact. Examples range from the gender issues that render both men and women vulnerable to HIV infection to the ways in which gender influences men and women’s responsibility for, and access to, treatment, care and support. The findings from the field studies and the resulting gender analyses illustrate that gender roles and relations powerfully influence the course and impact of the HIV/AIDS epidemic. Gender-related factors shape the extent to which men, women, boys and girls are vulnerable to HIV infection, the ways in which AIDS affects them, and the kinds of responses that are feasible in different communities and societies. The control of the spread of HIV/AIDS is dependent on the recognition of women’s rights in all spheres of life and therefore, women’s empowerment is an important tool in the fight against HIV/AIDS. Because the HIV/AIDS pandemic is fuelled by gender inequalities, a proactive engendered response is required to minimise its impact. It is through this document that the Technical Sub- Committee on Gender hopes to ensure that the gender dimension of the HIV/AIDS epidemic does not remain just an intellectual idea, but through the identified strategies becomes a practical tool for guiding policy decisions and programming for all activities under the umbrella of the Kenya National HIV/AIDS Strategic Plan for 2000 - 2005.
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Kenya_NACC_Gender.pdfRecognizing the serious nature of HIV/AIDS and its impact on South Africa, the Department of Public Service and Administration (DPSA) initiated the Impact and Action Project in January 2000 which aims to ensure that the Public Service is able to sustain quality service in spite of the progression of the AIDS pandemic. In consultation with stakeholders, the DPSA developed a policy framework and regulations to guide departments on the minimum requirements to effectively manage HIV/AIDS in the workplace and to ensure a coordinated public response. This guide complements the regulations and provides practical advice and information on how to implement the regulations.
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SA_HIVguide.pdfEnglish
Moz_Manual.pdfUNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort.
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APIreport.pdfUNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort.
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APIreportrus.pdfThe 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.
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NEP_MediaReview_HIV.pdfUNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort.
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APIreportsp.pdfEnglish
CAM_MSM.pdfIn October 2002, under the slogan "South African Men Care Enough to Act", a National Men's Imbizo was held bringing some 400 men together from around the country to bring awareness to the need for men's involvement in HIV/AIDS. At this meeting, an Interim National Task Team was elected as a first organizational step towards the formation of a broad-based countrywide men's forum. Coordinating the responses of the men's sector is considered paramount to developing effective strategies in the four priority areas identified in the HIV/AIDS and STD Strategic Plan for South Africa (2000-2005): • Prevention • Treatment, care and support • Human and legal rights, and • Research, monitoring and evaluation In February 2003, following the Imbizo, a meeting was held between the Government AIDS Action Plan (national and provincial structures), the USAID-funded POLICY Project and the men’s sector national working group to plan the next steps. Based on outcomes of the Imbizo (see South African Men Care Enough to Act: Report on the National Men's Imbizo on HIV/AIDS, 2002) the decision was made to further engage the men's sector through a series of consultative workshops at the provincial level. These would follow on from provincial report-back meetings held after the Imbizo, strengthening the involvement of men in HIV/AIDS activities. The workshops would, as part of the government's broader Partnership Against AIDS programme, create a solid platform for discussion and collaboration in the men's sector. Through the establishment of provincially-coordinated men's networks, it is hoped this crucial sector will begin to play a more constructive, holistic and influential role in rising to the social and cultural challenges presented by HIV/AIDS. Provincial workshops would provide the men with an opportunity to develop coherent plans to guide their actions as individuals, as groups, and as partners with other sectors. This report documents the process and outcomes of these provincial meetings.
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SA_mensprovince.pdfUNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort.
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APIreportfr.pdfThis report focuses on the role of midwives in the prevention, detection, and treatment of HIV/AIDS and STIs and is based on a study in a rural community in Mexico. The document provides recommendations for improving the relationship between midwives and public health programs to better equip midwives to prevent, detect, and treat STIs and HIV/AIDS.
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MEX_Midwives_STI.pdfThis collection of stories highlights HIV-related advocacy work in communities around the world. This manual begins a process of documenting HIV/AIDS policy advocacy stories as a means of preserving them and making them available to others as more and more people become involved in HIV/AIDS advocacy issues. In all, 16 advocacy organizations are profiled in "Moments in Time." Although the stories focus on HIV/AIDS, the advocacy models are applicable to other settings and other issues. In fact, the developments in HIV/AIDS advocacy over the past 20 years can be helpful to other advocacy issues, just as other advocacy issues have been instrumental in the development of HIV/AIDS advocacy.
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MomentsFULL.pdfFinal 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.
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Kenya_Condom_Policy.pdf32-page booklet summarizing the Malawi National HIV/AIDS Policy developed and printed with assistance from the USAID-funded POLICY Project, UNDP, and UNAIDS.
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NationalHIVpolicySummary.pdfHIV/AIDS has compelled individuals and societies to re-evaluate their attitudes, prejudices and behaviours underscoring the need for an enlightened public policy that promotes support and care rather than coercion, tolerance and compassion rather than discrimination, protection of human rights and dignity rather than stigmatisation and exclusion. It is hoped that this policy document, directed to all cooperating partners, including Ministries, Departments and Agencies (MDAs), the private sector, PLWHA, NGOs, CBOs, and civil society organisations at large, religious bodies, institutions of learning and development partners provides such a positive response. The Government of Ghana expects all sectors to be involved in the implementation of programmes.
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GHA_AIDS_Policy.pdfHome-based care is an approach to care provision that combines clinical services, nursing care, counseling and psycho-spiritual care, and social support. It represents a continuum of care, from the health facility to the community to the family to the individual infected with HIV/AIDS, and back again. The Government of Kenya regards home-based care as a viable mechanism for delivering services because it has important benefits for everyone on that continuum. This guide summarizes the existing policy framework defining and supporting home-based care in Kenya. It then presents the preferred approach to programme design and service delivery.
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Ken_HBC.pdfThese guidelines spell out the basic component of home care services, the programmatic standards, and the requirements for service delivery.
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KEN_HBCPS.pdfThis report is a summary of the existing HIV/AIDS national policies and plans among countries in SADC. It is intended to provide a snapshot of the current status of policy formulation in the region and to suggest future steps to strengthen the policy environment for an effective response to the epidemic. Much of the information in this report is derived from national HIV/AIDS policies, strategic plans, HIV/AIDS policies for specific sectors and work plans.
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SADC.pdfArmed 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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NEP_PoliceStrategy.pdfThe role of policy in improving program outcomes in the family planning/reproductive health (FP/RH), safe motherhood, and HIV/AIDS fields has been increasingly recognized. Despite this increased recognition, “policy” is often seen as a black box. Existing frameworks or models focus on some aspects of policy—the stages of policy development, decision makers and stakeholder institutions, the intent and content of a policy, or its implementation—yet none captures all policy components. This paper provides a practical framework to analyze components of family planning, reproductive health, maternal health, and HIV/AIDS policies. The Policy Circle framework is presented and the six “Ps” of policy are described: Problem, People/Places, Process, Price Tag, Paper, and Programs/Performance. Each component of the Policy Circle can be analyzed using a variety of tools. The Policy Circle is not intended to be linear or even circular, but places the problem or issue to be solved at the center. The six policy “Ps” of the Policy Circle operate under the broader contextual forces of politics, society, and economics. The Policy Circle has wide applicability. The proposed framework can be used to analyze different policy levels, including national and local policies and sectoral and operational policies. In the case of FP/RH, the Policy Circle can be viewed through different lenses specific to three overarching concerns: youth, gender, and human rights. Each of the six “Ps” points to important aspects of policy that need to be considered to ensure comprehensive policy analysis of the issue or area of concern to which the Policy Circle is applied. Visit the Policy Circle online - click here
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wps-11.pdfNigeria is in the early stages of carrying out its new national policy on sexuality and reproductive health education. Worldwide, school-based programs are an important element of efforts to improve the reproductive health of young people. This paper reviews the international experience and its implications for Nigeria.
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wps-12.pdfThe Greater Involvement of People Living with HIV/AIDS (GIPA) principle has become the most enduring legacy of the Paris Declaration. GIPA has been incorporated into national and international program and policy responses and taken up as a model of best practice in the response to HIV/AIDS. Since the Paris Summit in December 1994, GIPA has been endorsed in numerous international statements, most recently by the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS in its Declaration of Commitment on HIV/AIDS (United Nations, 2001). Ten years after the Paris Summit, the issue of meaningful involvement of people living with HIV/AIDS (PLHAs) in policy development remains largely unexplored. A number of questions linger: Has GIPA become a “bandwagon” policy slogan without significant meaning? What are the benefits of adhering to the GIPA principle and does this lead to better policies? How do PLHAs and others measure and determine progress? To answer these questions, the POLICY Project conducted a study of PLHA involvement in five countries. This report seeks to address how PLHAs are meaningfully involved in policy formulation by exploring key issues related to the GIPA principle and its effects.
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WPS14.pdfDespite some attempts to integrate family planning with sexually transmitted infection (STI) and HIV/AIDS services, policies and programs continue to treat them as unrelated areas of intervention. Furthermore, international attention to the HIV/AIDS pandemic has overshadowed attention to family planning, particularly in Africa where the HIV/AIDS epidemic is most acute. Yet family planning is closely related to two components of HIV/AIDS services: prevention of mother-to-child transmission (PMTCT) and voluntary counseling and testing (VCT). Is there a role for family planning in the context of HIV/AIDS programs? This paper analyzes how international guidelines, national HIV/AIDS policies and PMTCT and VCT policies have addressed family planning in 16 high-HIV prevalence countries. It also describes major gaps in the various countries’ policy environment.
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wps-09.pdfEl SIDA ha sido uno de los mayores retos para las
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op-03es.pdfLe SIDA représente depuis 20 ans un défi de taille
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op-03fr.pdfAIDS has presented a major challenge to African societies during the last two decades. Governments throughout the region have struggled to develop effective policies and programs to address the epidemic. This report presents case studies of the policy process in nine Anglophone African countries. Each country has employed a unique approach to policy development; the results are equally diverse. This report describes some of the country experiences and highlights areas of similarity and difference as well as major problems addressed by Anglophone African countries. The information has been distilled into a framework that captures key elements of the policymaking process. The major components of the framework are as follows: Problem identification and need recognition. Countries have passed through several stages in their response to the AIDS epidemic, including medical response, public health response, multisectoral response, and focused prevention and treatment. During the early phases, countries saw little need for a comprehensive AIDS policy. However, the need for a policy response grew as countries adopted multisectoral approaches to the epidemic and the broad impacts of AIDS on human rights, economic growth, society, and families emerged. Information collection. Once a decision to develop a policy is made, the next step usually is to obtain expert opinion—through consultant reports, interviews, or workshops. Drafting. Drafting is usually the task of small working committees. Some countries drafted policies quickly with a minimum of outside participation while others relied on a number of drafting committees that sought input and consensus from a range of interests. Review. In some cases, draft policies were debated widely and reviewed by thousands of people as a result of special regional meetings and dissemination efforts. In other cases, little outside review took place. As a consequence, policies often languished, with no champions pushing for review and approval. Approval. National AIDS policies have been approved at one of three levels: the minister of health, the cabinet, or Parliament. Implementation. Some policies have been implemented through operational or strategic plans or through the establishment of committees to develop operational guidelines. In many cases, elements of the policy can be implemented even before the full policy is adopted. Interest groups may be encouraged to take the lead in disseminating and implementing parts of the policy that are of particular interest to them. Most policies contain some components that can be implemented immediately though administrative actions; other components require efforts to develop specific legislation and to obtain funding. Each country policy addresses a large number of specific issues. Despite several cultural, social, and legal differences among the countries studied, the issues surrounding key policy topics show many similarities. The following are among the topics that were most difficult to resolve: HIV counseling and testing; pre-employment testing; orphans; AIDS education in schools; condom advertising; mandatory condom use in brothels; condom distribution in prisons; willful transmission of HIV; and HIV and abortion. In some instances when it was difficult to achieve consensus, policymakers simply eliminated issues from policy consideration. For example, most policies do not address willful transmission of HIV. In other cases, vague wording requires the issue to be addressed in national policy, with the exact meaning left to interpretation through implementation guidelines. The key lessons that have emerged from the case studies are summarized below. Identifying AIDS as a problem does not translate into recognition of the need for a comprehensive AIDS policy. The need for a comprehensive policy may become apparent only when the epidemic becomes so severe that a large portion of the population is affected or when the advocacy efforts of specific groups convince decision makers of the importance of a policy response. There are many approaches to drafting and review. Some countries rely on a high level of participation. Although greater participation lengthens the time required for drafting and review, it builds momentum for the policy and often shortens the time required for approval. As a result, highly participatory approaches may actually require less time for policy development than policies drafted rapidly by a small group of experts who then struggle for years to gain approval. The most participatory processes have produced the broadest policies covering a wide range of key issues. Such policies, it is expected, will prove to be the most effective, but the outcome remains to be demonstrated. Once approved, policies can be implemented in many ways. Some aspects of a policy (such as approval of condom advertising) may be implemented directly, in some cases even before the policy is formally approved. Other policy issues can be implemented only through enabling legislation, with the development of guidelines, or as part of a strategic plan. Countries may lack the resources to implement all facets of a policy at once. Interest groups may need to take the lead in advocating for the implementation of specific portions of the policy that most interest them.
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op-03.pdfGiven the scarcity of resources available to implement the ICPD Programme of Action, this paper assesses effective interventions and their cost for three main components of reproductive health: family planning, safe motherhood, and STD/HIV/AIDS prevention and treatment. The paper also suggests some of the economic criteria governments can use to determine the role of the public sector in providing and/or financing reproductive health services. Family Planning Ensuring that individuals have access to a range of family planning methods and related information can help reduce unwanted pregnancy and thus maternal mortality. Promotion of condoms can help prevent the spread of sexually transmitted diseases (STDs). Family planning is most effectively provided through a range of channels, including clinics, community-based distribution, social marketing programs, and the private sector. Comparing the costs of service delivery approaches is problematic in that each channel tends to serve different clients. Contraceptive methods involve a range of costs; IUDs and sterilization tend to be the least expensive methods per couple-year of protection (CYP), although both have high "up-front" costs. The pill tends to be the least expensive supply method. Family planning, however, is most effective if a range of methods is available so that clients can select a method that matches their needs. One solution to the scarcity of resources may be for governments to subsidize all contraceptive methods for the poor and only lower cost methods for other groups and to require users to pay for the incremental cost of more expensive methods. Safe Motherhood An estimated 40 percent of pregnant women develop complications that require the assistance of a trained provider; 15 percent require medical care to avoid death or disability. Good prenatal care is important; given current screening tools, however, it is not prudent to spend resources on screening as the sole mechanism for predicting women's risk of developing complications. Instead, prenatal care should, among other activities, educate all women about danger signs, possible complications, and where to seek help. Micronutrient supplementation, including vitamin A, iron, folic acid, zinc, and calcium, show promising results in helping to improve pregnancy outcomes and reduce maternal mortality. The most crucial interventions for safe motherhood are to ensure that a health worker with midwifery skills is present at every birth, that transportation is available in case of emergency, and that quality and timely emergency care is available at the referral level. It is not only important that adequate access to emergency care be available but that women, families, and the community have confidence in the referral system and higher levels of care. Communities use emergency obstetric care services that they know to be functioning well. Nearly two-thirds of maternal deaths occur in the postpartum period; therefore, the World Health Organization (WHO) recommends that, if possible, community health workers visit women not attended at birth within 24 hours of delivery and again within three days. In many low-income countries, effective and safe postabortion care can significantly reduce maternal mortality rates by as much as one-fifth. Furthermore, such care can reduce overall health care costs as it is not uncommon for most beds in emergency gynecology wards to be occupied by women suffering from abortion complications, the treatment of which can cost five times the annual per capita health budget. The high cost of postabortion care can be reduced by switching from sharp curettage to manual vacuum aspiration (a safer and less expensive method), establishing referral systems and links with family planning and other reproductive health services, and preventing abortion through family planning. Substantial additional resources may not be required to improve emergency obstetric care. Most of the cost of providing such care is already paid through the maintenance of hospitals, health centers, and health care staff. Instead of creating new medical facilities and hiring new staff, emergency obstetric care can be improved by renovating existing facilities and training staff, including midwives and general practice physicians. STD/HIV/AIDS The best combination of STD/HIV/AIDS activities and services is general information and education, improved health-seeking behavior for STD treatment, wide access to condoms, and STD services with focused attention to core transmitters. WHO advocates the use of the syndromic management approach to managing STDs. This approach has limitations, however. It functions well for men with symptomatic urethral discharge and for women with genital ulcer disease, but not for women with vaginal discharge. The women who receive medical attention are often overtreated with drugs. More work is needed to develop cost-effective approaches to screening and treating reproductive tract infections. There are promising treatments to prevent mother-to-child transmission of HIV. Nevirapine has recently been shown to reduce transmission dramatically from mothers to infants at a fraction of the cost of treatment with Zidovudine (AZT) (US$4 compared with US$100), although universal HIV screening is not part of prenatal care in many developing countries and would raise the cost of prevention. Maternal syphilis diagnosis and treatment is also cost-effective. Blood screening for HIV/AIDS in high-prevalence areas has proven cost-effective. HAART (highly active antiretroviral therapy) for HIV/AIDS-infected individuals presently costs about US$8,000 to US$10,000 per person. Governments and donors will not be able to cover the cost of such treatment. In many developing countries, less than 1 percent of people living with AIDS will ever be treated, even if all reproductive health donor funds were allocated for that purpose. Information, Education, and Communication (IEC) and Behavior Change Communication (BCC) IEC and BCC have the potential to be highly effective in helping promote good reproductive health. Properly executed, IEC and BCC can encourage individuals to take preventive measures to protect their reproductive health as well as seek appropriate reproductive health services. IEC and BCC activities warrant government support if they convey appropriate messages to target audiences and are associated with services already in place. In the absence of these conditions, IEC and BCC activities are not only ineffective but also give rise to unsatisfied demand. Some Economic Criteria for Governments to Use in Deciding Whether They Will Provide and/or Fund Services From an economic standpoint, governments should intervene in reproductive health care if intervention increases efficiency and productivity in the health sector. Governments should redistribute resources to ensure equitable access to reproductive health services by all individuals. Governments should subsidize activities with large external or social benefits that go beyond the individual. Governments must regulate all sectors to ensure high-quality care and equitable access to reproductive health services. Government services are rarely more efficient than private sector services. Governments should encourage development of the private sector and provide subsidies to the poor so that they can afford needed services. To encourage development of the private sector, governments should provide similar subsidies to all providers (rather than only to government providers) either directly or through income transfers to individuals so that consumers can choose their own provider, thereby spurring competition and, it is hoped, better quality services for all. Governments should not provide subsidies to those able to pay for reproductive health services. Growing evidence suggests that some users, particularly in middle-income countries, can pay for family planning, maternal health, and postabortion care services. After reviewing implementation of the ICPD Programme of Action, the international community has reached consensus that certain basic services should be provided at the primary health care level and subsidized for those who cannot afford to pay for them. In low-income countries, where most individuals are too poor to pay for services, evidence suggests that it would be desirable for governments to subsidize family planning services, prenatal care that includes physical examinations, postpartum provision of family planning information and services, and postabortion services. In addition, skilled attendance at delivery and a functioning referral system and emergency care are essential to reduce maternal mortality. As for STD/HIV/AIDS, resources should be focused on prevention activities such as promotion and distribution of condoms to prevent STDs, STD treatment for high-risk groups, improved health-seeking behavior for STD treatment, and maternal syphilis treatment. Where HIV screening is part of prenatal care, provision of Nevirapine or AZT for infants of HIV-positive mothers may be feasible. While governments should strive to ensure that their citizens have access to reproductive health services as agreed at the ICPD and ICPD+5, policymakers will have to begin with a narrower set of interventions consistent with current resource and capacity levels and decide how to phase in additional services as resources become available. It is clear that a substantial amount of work on costing interventions and services and measuring their effectiveness is necessary before we can say, with greater assurance, what combination of services works at the most reasonable cost. Data collected in one country or service delivery setting may not apply in others, and further research is needed. Still, while the data are not comprehensive or perfect, policymakers and others can use the information at hand to help make difficult decisions, especially on what to provide to low-income clients through public sector facilities or financing.
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op-05.pdfAfter the return to civilian rule and “re-certification” for USAID programs, the POLICY Project was among the first of USAID’s implementing partners to establish a program in Nigeria. The POLICY Project’s purpose was to strengthen the policy process in population, reproductive health, and HIV/AIDS as a basis for improved services. The project began working in Nigeria in late 1999, and set up an office with local staff by mid-2000. In 2002, the scope of the project was expanded from HIV/AIDS, population, and reproductive health to include child survival. POLICY’s principal partners in government were federal line ministries, two national commissions (planning and population), and the National Action Committee on AIDS(NACA), a multisectoral committee that develops and coordinates the national response to HIV/AIDS. Outside government, POLICY engaged in policy development, advocacy, and targeted public information activities with several national and regional Christian and Islamic bodies and numerous non-governmental organizations (NGOs) and community-based organizations(CBOs), including six NGO networks and one network of HIV/AIDS researchers. The project also worked at the state level by advocating for national policies in several states, developing an adolescent reproductive health policy and strategic plan in Edo State, and focusing on the northern states through activities with both federal ministry and NGO partners. Collaboration with donor agencies included communication and attendance at each other’s meetings on shared concerns, and technical or financial input on specific tasks such as assessments for donor program planning and co-sponsorship of conferences and events. POLICY and some donors also participated as stakeholders in NACA and in activities such as advocacy visits to states.
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NIG_PP_Nigeria.pdfThe POLICY Project, in collaboration with the Ministry of Social Affairs, Veterans, and Youth Rehabilitation, and CARE Cambodia, facilitated a two-day workshop on August 23 and 24th, 2004, titled 'Orphans and Vulnerable Children Dialogue Workshop'. Participants included a multi-sector group of representatives from government ministries, NGOs, Civil Society groups, donors, Bhuddist pagodas, people living with HIV/AIDS, and children who have been orphaned due to HIV/AIDS. The purpose of the workshop was to disseminate findings of two research studies that have been conducted by the POLICY Project and CARE, Cambodia, in urban and rural areas of Cambodia; to make program and policy recomendations for improving Cambodia's response to the OVC crisis; and to coordinate with stakeholders from all sectors in order to move forward to address OVC issues at the program and policy levels. This report provided a summary of the activities and results of the workshop. (Hard copy available in English and Khmer)
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CAM_OVC_PolicyDialogue.pdfThe prevention of mother-to-child transmission (PMTCT) model is a computer program that evaluates the costs and benefits of intervention programs to reduce vertical transmission of HIV. As part of the intervention, the PMTCT model contains seven possible treatment choices: long course ZDV; short course ZDV following the Thailand, PETRA Arm A, and PETRA Arm B regimens; intrapartum and neonatal ZDV only; the HIVNET 012 regimen of single dose nevirapine to the mother and child; and universal nevirapine (nevirapine provided to all women and children at the time of delivery without checking for HIV status). In addition to these seven treatment options, the model also allows the percentage of women undergoing a Cesarean section, as well as the percentage of women that breastfeed their infants exclusively and with mixed breastfeeding and food supplements, to be specified. For each of the treatment options, PMTCT requires various data, including the costs of these interventions, and possible user fees to offset these costs. The vertical transmission rate of HIV is provided as a program default and also varies by treatment option, mode of delivery, and method of feeding.
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PMTCTmnE.pdfEl modelo de prevención de la transmisión materno-infantil (PTMI) es un programa de computación que evalúa los costos y beneficios de los programas de intervención a fin de reducir la transmisión vertical del VIH. El modelo PTMI, como parte de la intervención, contiene siete opciones de tratamiento: ZDV de tratamiento largo; ZDV de tratamiento corto según los regímenes de los estudios PETRA Rama A y PETRA Rama B de Tailandia; ZDV intrapartum y neonatal únicamente; el régimen del HIVNET 012 de una dosis única de nevirapina a la madre e hijo; y nevirapina universal (nevirapina administrada a todas las mujeres y niños al momento del parto sin comprobar su condición de infección por VIH). Además de esas siete opciones de tratamiento, el modelo también permite especificar el porcentaje de mujeres con parto por cesárea, así como el porcentaje de mujeres que amamantaron a sus hijos exclusivamente y de aquellas que combinaron la leche materna con suplementos alimentarios. PTMI exige, para cada una de las opciones de tratamiento, diversos datos, incluso los costos de esas intervenciones y posibles cuotas del usuario para compensar esos costos. La tasa de transmisión vertical del VIH se incluye como valor predeterminado del programa y varía según la opción de tratamiento, tipo de parto y método de alimentación.
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PMTCTmnS.pdfLe modèle de prévention de la transmission mère-enfant (PTME) est un programme informatique qui évalue les coûts et les avantages des programmes d'intervention destinés à réduire la transmission verticale du VIH. Dans le cadre de l'intervention, le modèle PTME contient sept options de traitement possible : ZDV de longue durée ; ZDV de courte durée selon le régime de Thaïlande, PETRA bras A, et PETRA bras B ; ZDV intrapartum et néonatal seulement ; formule HIVNET 012 de névirapine administrée en dose unique à la mère et à l'enfant ; et névirapine à couverture universelle administrée à toutes les mères et à tous les enfants à l'accouchement, sans vérification de leur statut sérologique. Outre ces sept options thérapeutiques, le modèle permet aussi de spécifier le pourcentage des femmes qui subissent une césarienne, ainsi que le pourcentage des femmes qui allaitent leur enfant exclusivement, ou conjointement avec une alimentation de substitution, selon le cas. Pour chacune de ces options, le modèle PTME doit disposer de différentes données, dont le coût de ces interventions et la participation éventuelle aux frais afin de compenser ces coûts. Le taux de transmission verticale du VIH est une valeur par défaut, fournie par le programme, qui varie en fonction de l'option thérapeutique considérée, du mode d'accouchement et de la méthode d'alimentation.
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PMTCTmnF.pdfHaiti's National Strategic Plan for the Control and Prevention of HIV/AIDS
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Haiti_PSN.pdfThis document presents a summary of the global OVC situation and identifies policy-level gaps in national responses to the growing crisis. Importantly, the report proposes a country-level OVC "policy package" and offers recommendations to guide future policy dialogue and action. Adopting laws that protect the rights of all children, encouraging multisectoral collaboration, placing a special emphasis on educational opportunities, and establishing systems to identify the most vulnerable children are all crucial aspects of a comprehensive OVC policy response.
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OVC_Policies.pdfThis report reflects on the achievements and lessons learned from the POLICY II Project (20002006). POLICYs HIV activities are supported by the Presidents Emergency Plan for AIDS Relief through the United States Agency for International Development (USAID). POLICYs HIV activities have been implemented through 27 country offices and four regional programs bringing the projects presence to over 30 countries around the world. POLICYs efforts have led to the adoption of 33 policies, plans, and strategies at national and regional levels; strengthened networks of people living with HIV in 11 countries and for the Asia and Pacific region; and more than 150 faith- and community-based groups mobilized through small grants to build local capacity to carry out HIV activities. This report higlights the achievements of the project in five key technical areas: policy formulation, leadership and advocacy, resources and data for decisionmaking, reducing vulnerablity, and multisectoral engagement.
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HIVEOP.pdf.pdfThis document presents a summary of the global OVC situation and identifies policy-level gaps in national responses to the growing crisis. Importantly, the report proposes a country-level OVC "policy package" and offers recommendations to guide future policy dialogue and action. Adopting laws that protect the rights of all children, encouraging multisectoral collaboration, placing a special emphasis on educational opportunities, and establishing systems to identify the most vulnerable children are all crucial aspects of a comprehensive OVC policy response.
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OVC_PoliciesFr.pdfProceedings from the workshop 'Prevention of HIV/AIDS in Uttar Pradesh', January 29-31, 2004. The workshop brought together policy makers, bureaucrats, program managers, people living with AIDS, academicions and activitist to discuss and debate the present state of affairs and discuss means of strengthening prevention and control of HIV/AIDS in the state. 25 papers were presented by experts on different themes and best practices.
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IND_PrevHIV_UP.ps.pdfThis study documents experiences and analyzes the underlying causes and factors related to availability, access, effectiveness, and gaps in health services for women living with HIV or AIDS. The report also provides recommendations for formulating a sensitive and appropriate response to the healthcare needs of women living with HIV/AIDS and improving HIV prevention.
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MEX_WomenLWHA.pdfKenya’s family planning (FP) success has been overshadowed by the HIV/AIDS epidemic, which was declared a national crisis in 1999. Data from the 2003 Demographic and Health Survey in Kenya (KDHS) provide a cautionary tale of the unintended outcomes associated with the shift in attention of programs and resources from family planning primarily to HIV/AIDS. From a steady rise in contraceptive prevalence from 27 percent in 1989 to 39 percent in 1998, contraceptive prevalence stalled and remained at 39 percent in 2003. Yet, the surveys have consistently shown that many women report wanting to delay or limit future births but are not using any FP method. In the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support of AIDS programs, the answer to this question is crucial. The purpose of this study was to explore how family planning is being implemented in Kenya in the context of high HIV prevalence. A similar study was conducted in Zambia.
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Ken_FGD.pdfIn the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support AIDS programs, the answer to this question is crucial. The objective of this study was to document the status and trends in Zambia’s family planning (FP) program in the context of high prevalence of HIV/AIDS. A similar study was conducted in Kenya. This qualitative research study used focus group discussions (FGDs) to examine the views of 215 service providers, HIV-positive (HIV+) women, and FP/antenatal care (ANC) clients on the need for family planning within the context of the HIV epidemic. The study was conducted in Lusaka, Livingstone, Kitwe, and Kabwe in 2003.
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Zam_FGD.pdfA workshop report summarizing the skills government employees learned to effectively implement HIV/AIDS programs at the department level.
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SA_DPSAIndabaIII.pdfReport on Workshop to Disseminate HIV/AIDS Prevalence Data in Mozambique
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MozWksp9_01.pdfThe following report provides a summary analysis of the resources required to achieve the broad objectives outlined in Cambodia’s National Strategic Plan (NSP). This report outlines the costs associated with each strategic objective.
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CAM_costing.pdfThe purpose of this report is to identify laws considered impediments to HIV/AIDS prevention and care, suggest law reforms considered necessary to advance HIV/AIDS prevention and care, and suggest enactment of laws considered necessary to advance HIV/AIDS prevention and care in Tanzania. The information in the report is presented in three parts, constituting fifteen chapters, references, and annexes.
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TZlawreview.pdfThis collection of stories highlights HIV-related advocacy work in communities around the world. This manual begins a process of documenting HIV/AIDS policy advocacy stories as a means of preserving them and making them available to others as more and more people become involved in HIV/AIDS advocacy issues. In all, 16 advocacy organizations are profiled in "Moments in Time." Although the stories focus on HIV/AIDS, the advocacy models are applicable to other settings and other issues. In fact, the developments in HIV/AIDS advocacy over the past 20 years can be helpful to other advocacy issues, just as other advocacy issues have been instrumental in the development of HIV/AIDS advocacy.
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MomentsSP.pdfPart of the Siyam'kela Project, which aims to pave the way for stigma-mitigation by developing well-researched indicators of HIV/AIDS stigma and discrimination. This document presents the findings that informed the development of indicators for internal and external stigma and the findings which informed guidelines for stigma intervention. This document is also a qualitative exploration of stigma experiences and perceptions in focus groups.
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SA_Siyam_fieldwork.pdfPromising practice of stigma-mitigation efforts from across South Africa: Reflections from the faith-based organizations, HIV/AIDS managers in the workplace, and people living with HIV/AIDS who interact with the media. This document is part of the Siyam'kela project, which has been designed to explore HIV/AIDS stigma, an aspect of the HIV/AIDS epidemic, which is having a profouncly negative effect on the response to people living with, and or affected by HIV/AIDS. This document focuses on promising practices which reduce stigma and discrimination.
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SAF_Siyamkela_PromisePractice.pdfPart of the Siyam'kela Project, which aims to pave the way for stigma-mitigation by developing well-researched indicators of HIV/AIDS stigma and discrimination. This document presents findings of research related to HIV/AIDS and the media and reccomendations.
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SA_Siyam_mediaguide.pdfPart of the Siyam'kela Project, which aims to pave the way for stigma-mitigation by developing well-researched indicators of HIV/AIDS stigma and discrimination. This document presents findings of research related to HIV/AIDS and faith based organizations and recommendations for FBOs working in the field of HIV/AIDS.
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SA_Siyam_FBO.pdfPart of the Siyam'kela Project, which aims to pave the way for stigma-mitigation by developing well-researched indicators of HIV/AIDS stigma and discrimination. This document presents findings of research related to HIV/AIDS and the workplace and recommendations for work-place policy.
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SA_Siyam_workplaceguide.pdfIn 2002, the POLICY Project embarked on an HIV/AIDS stigma research project in a country that has a substantial HIV/AIDS epidemic. The POLICY Project developed HIV/AIDS indicators and guidelines for stigma mitigation through a participatory, consultative process. The project carried out a qualitative research study in three sectors that play a leadership role in South Africa: the faith-based sector, national government departments, and the media. The research was conducted in communities across South Africa, and of the focus group participants, 85 percent were black, 55 percent were women, and 43 percent were people living with HIV/AIDS. HIV/AIDS indicators were developed to assist HIV/AIDS program managers to monitor and evaluate the effectiveness of their stigma mitigation efforts. Comprehensive guidelines were also developed to guide and strengthen HIV/AIDS programs to ensure that HIV/AIDS stigma mitigation programs are mainstreamed, resulting in a comprehensive and effective response to the HIV/AIDS epidemic in South Africa. Further funding has been secured through USAID/South Africa to continue the project and ensure that the findings, tools, and documents from this research will be used, tested, and improved and that they inform training interventions in the next phase of the project.
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SA_core_pkg__final_.pdfThis report describes the National Men's Imbizo on HIV/AIDS held October 4-5, 2002. The purpose of the imbozo was to mobilize and senstize men to become more active in HIV/AIDS activities, and to encourage networking between these men.
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Mens_Imbizo.pdfThe following document was written by a team of leading economists and social scientists in response to the question, “What is the state of the art in the field of AIDS and economics”. This question was intentionally designed to provide authors with the ability to focus on the issues that they felt were most critical. As a result, each chapter represents a unique perspective on the question at hand.
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SOTAecon.pdfThis report is a result of qualitative research investigating the challenges to GIPA, conducted in Cambodia from March 2003 - March 2005, as well as outcomes from training programs conducted with HIV-positive Cambodians over the same period. The research seeks to develop a deeper understanding of the role of HIV-positive people in the Cambodian response to the HIV/AIDS epidemic. The research examined the experiences and perceptions of HIV-positive people, HIV/AIDS service providers, policy makers and programmers related to the challenges to HIV-positive people's meaningful involvement in the design and implementation of AIDS policy and programming in Cambodia. The study also gathered information from HIV-positive people and HIV/AIDS service providers, policy makers and programmers to identify the necessary mechanisms to promote and sustain involvement. The study provided an opportunity to reflect on the level of involvement of people infected and affected by HIV and AIDS and to promote dialogue amongst HIV-positive people and other stake-holders to secure their greater involvement in Cambodia's response to the epidemic.
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CAM_StepsToEmpower_En.pdfRecent international initiatives reflect, and are responding to, a worldwide movement for greater access and equity in HIV-related treatment. The new millennium has witnessed growing support from the global community to increase access to antiretroviral (ARV) treatment for those most in need. The global shift in support for treatment access, coupled with declining drug prices and the availability of generic drugs, has led many in the field to recognize that the barrier to treatment is no longer simply a matter of financial resources. This paper seeks to define treatment governance and address the roles that stigma and discrimination and the greater involvement of people with AIDS play in the policies and programs that are designed in response to the HIV/AIDS epidemic.
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Treatment_Governance.pdfEnglish
POLICY_FBO_and_HIV_Factsheet.pdfThis 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.
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Strengthening the HIV & AIDS Policy Environment in Nepal- Nepal Final Report.pdfEnglish
Tanzania_National_Policy_on_HIV-AIDS.pdfMany people see an effective AIDS vaccine as the best solution to the HIV/AIDS pandemic. A considerable amount of funding and research effort is devoted to developing an effective vaccine. Ten years ago many scientists had hoped that a vaccine would be available by now. Most scientists are still optimistic that vaccines will be developed and many candidates are being tested. Programs to implement vaccination need to be developed in order to be ready when vaccines do become available. The nature of those programs will depend on the characteristics of each vaccine. How much does it cost? How effective is it? How long does protection last? The answers to these and other questions will help determine issues such as: Who should be vaccinated? Should regular re-vaccinations be scheduled? How much funding will be needed? Do vaccination campaigns need to be supported with safe sex messages? What will be the impact of the vaccine on the epidemic? This study uses two computer simulation models to investigate the effects of various vaccine characteristics and implementation strategies on the impact and costeffectiveness of vaccines in different contexts. A simulation model from the Imperial College is applied to data from rural Zimbabwe and the iwgAIDS model is applied to Kampala and Thailand. The models are used to investigate the effects of efficacy, duration, cost and type of protection on impact and cost-effectiveness. The models also illustrate the merits of targeting public subsidies to various population groups: all adults, teenagers, high- risk groups and reproductive age women. The impact of vaccines on the epidemic is compared with the impact of other prevention interventions, such as condom use and behavior change. Finally, the models are used to explore the extent to which behavioral reversals may erode the positive benefits of the vaccine. A highly effective, long- lasting, inexpensive vaccine would be ideal and could make a major contribution to controlling the HIV/AIDS pandemic. However, vaccines that do not attain this ideal can still be useful. A vaccine with 50 percent efficacy and 10 years duration supplied to 65 percent of all adults could reduce HIV incidence by 25 to 60 percent depending on the context and stage of the epidemic. Better efficacy and longer duration would provide even more impact. Programs focused on teenagers or high-risk populations have less overall impact but would provide significant benefits at much less cost than those reaching all adults. Behavioral reversals could erode much of the benefits of vaccination programs so it will be important to combine vaccination with continued messages about the importance of safe behaviors. The cost of the vaccines is not known at this time. At a cost of $10 or $20 per person vaccinated the cost per infection averted would be as low or lower than other prevention interventions. Higher costs for the vaccines and the need for many booster shots could reduce the cost-effectiveness significantly.
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Vaccine_World_Bank_article.pdfTo begin to protect young men and young women from this heightened risk of HIV/AIDS, it is important that policymakers and program managers gain a better understanding of transactional sex among youth. Policymakers and program managers need answers to questions such as: Are youth at higher risk of engaging in transactional sex than other groups? What factors influence youth to engage in transactional sex? And, what subgroups of youth are particularly vulnerable to engaging in transactional sex? This study seeks to answer these questions by exploring whether adolescent boys and girls are at higher risk for engaging in transactional sex than older men and women by analyzing data from the Demographic and Health Surveys (DHS) from 12 sub-Saharan African countries including Benin, Burkina Faso, Central African Republic (CAR), Chad, Guinea, Kenya, Mali, Niger, Nigeria, Togo, Zambia, and Zimbabwe. We also examine the relationship between young men and young women’s individual socio-demographic characteristics and the probability that they will engage in the exchange of sex for money.
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Trans_Sex.pdfThe HIV and AIDS epidemic is a health and development crisis throughout much of sub-Saharan Africa, including Zimbabwe. Analysis of the most recent sources of information indicated that 24.6 percent of the entire adult population ages 15-49 is currently infected, making Zimbabwe one of the most seriously affected countries in the entire world. This document was prepared under the sponsorship of the Ministry of Health and Child Welfare and National AIDS Council. It is intended to provide information about the HIV and AIDS epidemic in Zimbabwe as one way to contribute to improved multi-sectoral planning and policy dialogue.
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ZIM_AIM.pdfThe 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).
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NEP_HeartofMatter.pdfUNAIDS, USAID, and the POLICY Project developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a current profile of national effort and a measure of change over time. The API was applied to 40 countries in 2000; a revised index was applied in 54 countries in early 2003. The results show that program effort is relatively high in the areas of political support, policies, and planning with average scores above 70 percent of the maximum effort. Prevention programs and the legal and regulatory environment are the next most highly rated components with scores between 60 and 70 percent. The human rights component received the lowest score. Respondents reported that legal structures are in place to protect human rights but that resources and enforcement efforts are lacking. Resource availability and mitigation effort also received low scores. By region, Eastern and Southern Africa has the highest overall scores. West and Central Africa and Asia also scored relatively high, with Latin America and the Caribbean and Eastern Europe somewhat lower. The average score for all countries increased slightly from 56 percent in 2000 to 59 percent in 2003. The largest increases were for political support, resources, and care and treatment. The API survey shows clearly that all countries have some organized effort to combat the HIV/AIDS epidemic. Most countries have good policies and organizational structures in place. The weakest areas are in the implementation of the policies and plans. Countries with the strongest effort, such as Brazil, Senegal, Thailand, and Uganda, all have strong political commitment and a national consensus that lead to significant effort to implement comprehensive programs.
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API2003.pdfEnglish
JamPESRpt_rev_.PDFCambodia is among the countries most severely affected by the HIV/AIDS epidemic in Asia. In 2003, an estimated 123,100 adults in Cambodia were living with HIV/AIDS and 60,000 children were affected by HIV/AIDS. In responding to the epidemic, donors, policymakers, and program planners have had little country-specific information regarding the impact of HIV/AIDS and the effectiveness of interventions, impeding their ability to make decisions regarding resource allocation and program design. In response to this lack of data, the Royal Government of Cambodia (RGC) and the POLICY Project carried out this study, which served a dual purpose: (1) to identify the social and economic impact that HIV/AIDS is having on children, adolescents, and their guardians, and (2) to help policymakers, donors, and development partners identify policies and programs that would likely be effective in mitigating the impact of HIV/AIDS. This study demonstrates that it is imperative that policymakers, program managers, donors, nongovernmental organizations (NGOs), PLHAs, and orphans and vulnerable children work together to identify a means of providing services that target the most vulnerable children while addressing the unique needs of every child. The recommendations set forth in this study are based on the study findings, as well as findings from a workshop that was held in August 2004.
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CAM_OVC_En.pdfCambodia is among the countries most severely affected by the HIV/AIDS epidemic in Asia. In 2003, an estimated 123,100 adults in Cambodia were living with HIV/AIDS and 60,000 children were affected by HIV/AIDS. In responding to the epidemic, donors, policymakers, and program planners have had little country-specific information regarding the impact of HIV/AIDS and the effectiveness of interventions, impeding their ability to make decisions regarding resource allocation and program design. In response to this lack of data, the Royal Government of Cambodia (RGC) and the POLICY Project carried out this study, which served a dual purpose: (1) to identify the social and economic impact that HIV/AIDS is having on children, adolescents, and their guardians, and (2) to help policymakers, donors, and development partners identify policies and programs that would likely be effective in mitigating the impact of HIV/AIDS. This study demonstrates that it is imperative that policymakers, program managers, donors, nongovernmental organizations (NGOs), PLHAs, and orphans and vulnerable children work together to identify a means of providing services that target the most vulnerable children while addressing the unique needs of every child. The recommendations set forth in this study are based on the study findings, as well as findings from a workshop that was held in August 2004.
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CAM_OVC_Kh.pdfSeveral 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.
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VIET_SEI.pdfSynthesis of the Socioeconomic Impact study.
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VIET_SEI_BP.pdfTo the Other Side of the Mountain is a toolkit written for and to be used by those living with and affected by HIV and AIDS. It includes five modules focused on disclosure, the rights of people living with HIV, effective communication and facilitation, and advocacy. The goals of the toolkit are to share lessons and experiences and build the capacity of PLHIV to actively participate in the response to HIV.
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Other side of the mtn_toolkit.pdfThis one page flyer highlights the accomplishments of POLICY's multisectoral citizen's groups in Mexico.
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MCGOct03.pdfUganda has had laudable success in reducing HIV prevalence in the country and is still focused on strengthening and scaling up prevention, treatment and care, and support efforts. Currently, over 1 million people are estimated to have received HIV counseling and testing, over 500,000 HIV-positive individuals are receiving palliative care and over 60,000 are receiving antiretroviral therapy (ART). Access to services has increased as service delivery sites have expanded into rural areas. With a prevalence rate that appears to have stalled at around 7 percent and new infections continuing to occur among those of reproductive age, the epidemic still requires policy and program attention.
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Uganda TOO Final 12 20 05.pdfSpanish
Answering_the_Call_SPANISH_FINAL.pdfMalawi has one of the highest national HIV prevalence rates in the world. The National AIDS Commission (NAC) estimates that the country has an adult (15-49) HIV prevalence rate of 15 percent. There are about one million Malawians who are HIV positive and over 265,000 reported cumulative cases of AIDS. By 1999, approximately 250 Malawians became infected with HIV on a daily basis and 40 percent of all new reported AIDS cases occurred in people under the age of 30. Stigma and discrimination surrounding HIV/AIDS serve as barriers to the proper care, treatment, and support of people living with HIV/AIDS (PLWHA); discourage people from seeking voluntary counselling and testing (VCT) – an important aspect of prevention efforts and an entry point into care and the facilitation of positive living among PLWHA; and hinder the development of an enabling environment that promotes disclosure and living openly with HIV/AIDS. These results have consequences at the individual, family, community, and national levels as all efforts to prevent HIV transmission and mitigate the impacts of the HIV/AIDS epidemic are undermined by stigma and discrimination. This qualitative research study is based on data collected through focus group discussions (FGDs) with PLWHA in Malawi. It is part of a broader National HIV/AIDS Advocacy Project being executed by the Malawi Network of People Living with HIV/AIDS (MANET+) in fulfilment of the objective of advocating for the integration of stigma and discrimination-related issues into the National HIV/AIDS Policy. It emphasises three areas: care, treatment, and support services by PLWHA; VCT services; and disclosure of sero-status (by self and others). This report also explores the importance of greater involvement of PLWHA. The purpose of the National HIV/AIDS Advocacy Project is to catalyse the formulation of supportive HIV/AIDS policies, laws, and regulations.
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MALA_MANET_FGD.pdfThis study was commissioned by CARE Cambodia and the Policy Project, and is intended to provide NGOs and the public sector with an overview of the current situation regarding voluntary confidential counselling and testing (VCCT) in Cambodia as well as to highlight some options for developing greater NGO/government interaction on VCCT. Both CARE and the Policy Project are committed to services that are built on a rights-based approach, and for this reason a key focus of the study is to identify ways of increasing the involvement of people living with HIV/AIDS (PLHA) in the design, development and monitoring of services.
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CAMB_VCT.pdfThis flyer describes Policy Builder, a software program that is being developed to help guide companies through this challenge of developing an HIV/AIDS policy for the workplace.
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PolicyBuilder.pdf