LIST OF ACRONYMS. Acquired Immune Deficiency Syndrome Community-Based Organisations Centre for the Development of People

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2 PREFACE The National HIV/AIDS Strategic Framework for Ghana has been formulated in recognition of the developmental relevance of the disease. It is an issue that requires a holistic, multi-sectoral

3 TABLE

4 CHAPTER SEVEN

5 LIST OF ACRONYMS AIDS CBO CEDEP CHAG Acquired Immune Deficiency Syndrome Community-Based Organisations Centre for the Development of People Christian Health Association

6 MOYS MTCT MTEF NACP NBTS NBSSI NCCE NCWD NDPC NFED NGO NPC OPD OVI PEP PIP PLWHA PTA PR RCC RHMT SP SSNIT SSS STD TBA Ministry of Youth and Sports Mother to Child Transmission Medium Term Expenditure Framework National AIDS Control Programme National Blood Transfusion Service National Board for Small Scale Industries National Commission on Civic Education National Commission for Women and Development National Development Planning Commission Non-Formal Education Division Non Governmental Organisation National Population Council Out-Patient Department Objectively-Verifiable Indicators Post Exposure Prophylaxis Population Impact Project People Living With HIV/AIDS Parent Teacher Association Public Relations Regional Coordinating Council Regional Health Management Team Strategic Plan Social Security and National Insurance Trust Senior Secondary School Sexually Transmitted Diseases Traditional Birth Attendants

7 CHAPTER INTRODUCTION ONE 1.1 Background The first 42 cases of Human Immune-Deficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) in Ghana were recorded in 1986, mainly among women who had travelled outside

8 Illliilllllii^^!SSillM^lili;gililSfe^>iSll^ilil!ii^i^fill!s^ p p^^pl^^^pi lillfiyilllb^^^ li l l llflllll^ The Demographic Factor Ghana's population is estimated at 18,412,529 with a growth rate of 2.5% according to preliminary results of the 2000 Population and Housing Census. Life expectancy currently stands

9 1.1.2 The Socio-Economic Factor Even though poverty levels have been estimated

10 ated with HIV infection. The economic cost of HIV/AIDS to employers (though not determined), in terms of care, absenteeism and re-training, is high and continues to rise. HIV/AIDS is expected to put severe stress on families, the health sector and other sectors of the economy. Recent estimates indicate that the annual cost of treatment of opportunistic infections in an AIDS patient

11 an arrangement within the Ministry of Health for both the implementation and co-ordination of the programme. Since then, a Short-Term Plan, and Medium-Term Plans I and II have been developed. In addition, a National HIV/AIDS and STI Policy has also been developed

12 Transmitted Diseases (STDs) and ensuring safe blood transfusion. Overall management of STDs in the health sector (both private and public orthodox and traditional providers) remains weak

13 Major Recommendations of the Response Analysis Adopting a developmental approach to HIV/AIDS through the involvement of both health and non-health sectors; Strengthening the co-ordination of stakeholder responses at national, regional and district levels;. Resource mobilisation and access to funds;

14 Finally, there is a draft National HIV/AIDS and STI Policy document that has provided the impetus for the development of this strategic framework. There is, therefore, a conducive policy environment from which the HIV/AIDS strategic framework has drawn lessons and inspirations.

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16 Fig.

17 CHAPTER GOALS AND OBJECTIVES TWO 2.1 Goal

18 Intervention 1: Prevention of New Transmission of HIV Promoting safer sex particularly among the most vulnerable groups in the country; Providing effective management of STDs; Minimising the risk of transmission through blood and blood products;

19 Incidence of new HIV infections among the youth and other vulnerable groups reduced by 30% by the year Condom-use rate of casual sex increased to 60%. 30% of communities and-health facilities with adequate arrangements to care for PLWHA attained by the year 2005.

20 , CHAPTERTHREE PREVENTION

21 To achieve significant reduction in the number of sexual partners by sexually active individuals

22 empowering women to negotiate for safer sex; Making condoms acceptable, accessible and affordable. 3. Intensifying Poverty Reduction Programmes

23 ii) Out-of-school youth Out-of-school youths are generally difficult to identify as a homogenous group, but they constitute

24 The promotion of consistent use of both male and female condoms by commercial sex workers

25 The Challenge^) The challenge(s) will

26 Key Sectors The key sectors identified to implement activities are the Ministry of Health/ Ghana Health Service (MOH/GHS), Ghana Registered Midwives Association (GRMA), Ministry of Defence (MOD), Ministry of Communication (MOC), Ministry of Education (MOE), and Private Practitioners. 3.3 Prevention of HIV Transmission through Transfusion of Blood and Blood Products Transmission of HIV through transfusion of blood and blood products is believed to account for about 5% of all transmission in Ghana. The National Blood Transfusion Service is already implementing

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28 Expected Outcome

29 Counselling male partners, apart from mothers on MCTC. Expected Outcome Vertical transmission from mother

30 Expected Outcome Voluntary Counselling and Testing (VCT) would be widely available and accessible, and well patronised throughout the country by the year Programme Targeting The strategies would be targeted at the following sectors: Health Institutions especially ante-natal clinics;

31 CHAPTER CARE AND SUPPORT F_OUR The provision

32 Providing access to anti-retrovirals and drugs for opportunistic infections to PLWHA; Providing laboratory support in using anti-retrovirals and drugs;

33 Promote positive attitudes and a supportive environment from family members, friends

34 Programme Targeting These strategies would be directed at the following sectors:

35 CHAPTERFIVE ENABLING ENVIRONMENT 5.1 Creating a Supportive Legal, Ethical and Policy Environment for HIV/AIDS Programmes In Ghana, HIV/AIDS

36 right to equality and freedoms. There

37 Expected Outcomes Positive attitudes

38 CHAPTERSIX DECENTRALISED IMPLEMENTATION

39 for coordinating

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41 6.1.4 District, Community

42 Fig. 4 - Institutional Arrangement

43 CHAPTER. RESEARCH, MONITORING AND EVALUATION SEVEN Effective implementation of the Strategic Framework depends largely on a well laid-out research, monitoring and evaluation (RME) mechanism that will guide stakeholders to establish

44 Strategies

45 ducted

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55 ^sy^ iff 5 s *»!"' 2. Ml 5 M

56 APPENDIX H: TECHNICAL TEAM NAME ORGANISATION RANK Core Members 1. Apewokin,

57 APPENDIX ill: OVERSIGHT COMMITTEE MEMBERS NAME ORGANISATION Adibo, Moses (Dr.) Ministry

58 SELECTED REFERENCES 1. Angapa

59 22. Ministry of Health/Maternal and Child Healthcare (Jan 1999). National Reproductive Health Service Protocols. 23. Ministry