Essential minimum package ALHIV service provision: Community level

Transcription

1 Essential minimum package service provision: Community level Partner or Actor COMMUNITY HEALTH WORKERS (CHWs) Minimum components Key Activities Key Accountable Provide communitybased HCT Support treatment and care of HIV testing and counselling with referral of to Treatment, care and support for, including a focus on adherence and disclosure Support for families and care-givers CBOs Communitybased HCT service providers CHWs Key Technical Partner(s) WHO, UNICEF NGOs FBOs Existing Tools Guidance on role of CHWs Missing Tools/ Gaps Monitoring Indicator(s) Number of tested Monitoring activities of CHWs TRADITIONAL, CULTURAL AND COMMUNITY LEADERS Create an enabling environment (challenging stigma and fostering change) Ensure implementation of in line with national laws and policies Promote uptake of HCT Mobilize support for Create awareness for social change to eliminate stigma Strengthen local councils to protect Monitor programme implementation Local government Cultural and religious organizatio n at local level Media (including traditional media) See table Utilization of By-laws protecting Community involvement Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Community Level Page 1 of 4

2 SCHOOLS Promote HIV status awareness HCT in schools Establish a supportive environment for in schools Elimination of stigma Ensure comprehensive sexuality education and facilitating access to Links with Providing Universal access to quality education Dissemination of accurate information about HIV. Development of education curriculum that address SRHS. Teacher sensitization and training. Provide outreach programs Support adherence among Encouraging HCT in schools Support peer groups Referral mechanisms Mental, legal and social support Sensitization of students on rights of MOE School Heads Teachers UNESCO UNICEF CBOs Civil society Community See table Schools integrating PLHIV needs into school policy Countries revising curriculum to include comprehensive sexuality education HCT in schools Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Community Level Page 2 of 4

3 COMMUNITY BASED ORGANIZATIONS Implement quality community Facilitate community support for all and Build capacity of the community to be self sustaining Promote HIV status awareness Adherence support Support for disclosure Sensitize community on needs of Facilitate integration of at community level Collect and share data Hold community discussions Facilitate referrals to units Support youth IGAs CBOs/NGOs Community Health Workers Health extension TBA Peer educators PLHIV/ support groups NGOs Local politicians and community Communit y-based guidelines (see table) Database of different providers working at different levels to facilitate follow-up and links between service providers, schools, CBOs and Stigma index Countries implementing evidenceinformed protocols for adherence, disclosure, mental, etc. Level of community participation in hip positions JUDICIAL AND LAW ENFORCEMENT SYSTEM Contribute to the development of laws that promote and protect the rights of Enforce policies and legislation that protect the rights of Sensitizing community on the rights of Community level activities that develop legal literacy on: property rights, sexual abuse etc. Promotion of rights (, food, education, identity etc.) Legal Aid Legislators Police Community courts UNICEF, ILO Human rights groups (CSOs) Law association organization UN agencies PLHIV Networks Lobbying and Advocacy Groups Country laws and policies Advocacy and informati on materials relating to existing laws and policies Availability of laws that promote rights of Laws and policies repealed or enacted and implemented Number of reported cases contravening laws Number of cases prosecuted Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Community Level Page 3 of 4

4 Human rights country report YOUTH LEADERS Promote meaningful involvement of the in hip positions Ensure respectful involvement of in planning and implementing intercvetions Advocate/mobilize for hip positions for young people Engagement in promoting the rights of, including their right to participate NGOs and CBOs UNICEF, UNESCO, UNFPA Ministry of NGOs A range of materials available on young people s participat ion Active involvement of young people, including in planning and implementing interventions Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Community Level Page 4 of 4

5 Essential minimum package for for living with HIV: Level Intervention and level HIV DIAGNOSIS Minimum components Active identification of Linkage to care, treatment and support Elimination of stigma surrounding testing Key activities Provision of PICT in Testing through PMTCT programmes HCT available through VCT Key accountable Health (, FBO, NGO) VCT (, FBO, NGO) Key technical partner(s) FBOs, NGOs, CBOs involved with the provision of HCT Private providing HCT Existing tools Gaps Monitoring indicators Protocols and Legal barriers Guidance on (informed consent PITC and for minors) client Advocacy, initiated HCT availability, Guidance on HCT for young people awareness of HCT Not always ensitive/friendly Linkages between testing and treatment/care/ support Policies and protocols to link HIV negative with prevention Number of year olds who have been tested Number of 10-14, year olds found to be HIV positive and in treatment/care Age disaggregation of WHO/ UNAIDS indicators TREATMENT, CARE AND SUPPORT (FACILITY LEVEL) Disclosure of HIV status to adolescent Disclosure of HIV status to parent/caregivers, friends, etc. Protocols and guidance on disclosure among children and Training staff on disclosure (to about their HIV status and to supportive adults/peers) Staff of working with (doctors,, counsellors) with adequate training Parents and care-givers Friends and peers Support groups for PLHIV or Schools Guidelines on positive disclosure Guidelines on disclosure to children and IMAI Lack of protocols or training on disclosing HIV status Lack of training on helping to disclose to potential sources of support Knowledge about HIV status Disclosure to others in support network Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Level Page 1 of 4

6 Prevention, early diagnosis, treatment and referral for mental ill and psychosocial problems Mental IEC materials distribution Sensitization of staff on mental illness symptoms (e.g. depression) Screening for mental Treatment for mental problems and counselling support Referral for mental Counselling support for care givers Staff of working with (doctors,, counsellor) with adequate training Religious Support Groups for PLHIV and groups Volunteers Teachers Peers International AIDS Alliance Stigma Tool Guidance on counselling IMAI Lack of awareness and negative attitudes towards mental illness Lack of training for Training gap in: School matrons, & teachers Human resources School attendance and making academic progress Clinical mental parameters Adherence High-risk behaviours (e.g. alcohol and substance use) Improve sexual and reproductive Prevention of unsafe sex Provision of a broad range of ASRH/HIV prevention IEC materials Active STI screening and management Counselling on reproductive choices and contraception, and provision of family planning commodities Condom promotion and provision of supplies (dual protection): condoms, gels, etc. Pregnancy testing and pregnancy care (referral) doctors, and counsellors UN (UNFPA, WHO, UNESCO) FPA NGOs (FHI, IPPF) involved with ASRH and HIV prevention MOE UNESCO guidelines Mildmay guidelines Auntie Stella ASRH and HIV prevention materials for and (IMAI, OP, etc.) Guidance on linking HIV and ASRH prevention and Legal barriers (informed consent, confidentiality, evolving capacity) Awareness/attitudes of to becoming sexually active Availability of commodities Capacity of to respond to the ASRH needs of Linkages to existing ASRH Religious ASRH knowledge and reported behaviours Age at sexual debut Contraception rates Use of condom at last sex Availability of PEP, condoms, contraception Quality of service indicators Linages between (ANC,, FP, ASRH, PMTCT) Age disaggregation of core indicators Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Level Page 2 of 4

7 Prevention, screening and treatment of opportunistic infections (OI) OI screening for all Treatment and prophylaxis for OI Availability of drugs. e.g. Cotrimoxazole, antimalarials Linkages with TB service Support groups working with Schools Available protocols and guidance on prevention and management of OIs (e.g. WHO) Training of Availability of drug supplies Linkages between (e.g. with TB, malaria Proportion of screened for OIs HIV clinical care Monitoring of Clinical HIV staging and monitoring at each visit Growth monitoring (weight, height) Tanner s staging Nutritional counselling Psychosocial support HCT and other HIV testing ART Guidelines IMAI Adherence Trained to respond to the needs of Retention of in program Mortality rates Laboratory tests Rapid HIV testing CD4, Viral load testing Dry Blood Sample (EID) Sputum smear Biochemistry (LFT, RFT) Haemoglobin concentration Other; Syphilis Pregnancy etc. Laboratory technicians Guidance on good laboratory practice Availability of laboratory and supplies Quality assurance Timely availability of test results Quality control at national level ART initiated Adherence to ART Reliable access to first- and second-line ARVs Initiation to ART Monitoring of Health facility managers Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Level Page 3 of 4, UN organisations NGOs WHO ART guidelines, National ART guidelines Health trained to respond to the needs of Regular supply of ARVs CD4/HIV staging when treatment started Number of on

8 treatment failure and side-effects Adherence monitoring and counselling Donors (PEPFAR) ARVs Number of eligible for ART initiated within a month Percentage of on second-line treatment Integration of PMTCT with ART and other for Provision of PMTCT HAART prophylaxis Laboratory monitoring FP and nutrition counselling Follow-up of pregnant Follow-up of HIV exposed infants and families (including older children) UN NGOs Available guidance on PMTCT Available guidance on linking HIV and ASRH Lack of awareness Lack of trained Poor linkages between Rates of women attending PMTCT Infant HIV infection rates attending PMTCT Strengthening referral systems within and between Secondary Care for a range of (e.g. ART complications, mental ) Nutrition Legal Adolescent friendly NGOs working with/for Family and community levels staff and staff of referral (doctors,, counsellors) Community UN NGOs/CBOs Existing protocols for referral between and within Availability and awareness of other Follow-up on referrals Routine reviews Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Level Page 4 of 4

9 Essential minimum package for ADHIV service provision: Family level Partner or Actor Minimum components Key Activities Key Accountable Key Technical Partner(s) Existing Tools Missing Tools (Gaps) Monitoring Indicator(s) PRIMARY CARE GIVER (PCG) Home-based management of Provide of supportive environment for to reach full potential Build the capacity of families to understand HIV through training and discussion about HIV Formation and promotion of peer support groups for Support families to improve communication with Strengthen life skills of in decisionmaking, dealing with conflict, etc. PCG peer support group to share experiences PCGs and other family members Religious and community Local politicians Clan/tribal Health Care Workers CHWs NGOs/CSOs Spiritual Social Services Families Matters training course for parents (CDC) One child at a time (FHI) Pill boxes Soldier game Snakes & Ladders game (MSF) Guidance and training package on the minimum components for primary care givers PCGs and family members have improved knowledge of how to support adherence and disclosure received information of SRH from PCG PCG s awareness of Number of training courses run for PCGs Number of PCGs trained HEADED HOUSEHOLD Support the heading the household to provide care and support for his/her siblings Recruit and train community volunteers to mentor Regular weekly home visits for support Identification of CBOs to support the support groups Trace family/relatives Mentors Trainers and supervisors of the mentors Mentors As above As above Pop Council materials from work in Rwanda on mentorship for child headed households. Specific tool to meet the special needs of headed households (for, for mentors, for CBOs) Number of heads of households receiving support Recommendations of the 2 nd Global Consultation on, Kampala Essential Minimum package for : Family Level Page 1 of 1