Day 19 Digest (May 25, 2006)
In today’s posting, we have several comments and information on a publication that may be useful to forum participants.
Comments:
- a comment from Abebe Shibru, working for IntraHealth in Ethiopia. Abebe tells us more about the Mothers’ Support Groups mentioned earlier in the forum.
- a question from Ward Rinehart for Dr Li on integration in China
- a comment from Margaret Gitau on integration in Keyna
- a comment from Theresa Lynne on working with young people in South Africa
We have also included information on a new guide for submitting proposals to the Global Fund for integrated programming from Lisa Schechtman of the Global AIDS Alliance. The Guide explains how to develop a proposal to the Global Fund that could include sexual and reproductive health programming under the HIV component of funding.
We have one more formal day of discussion. Remember, to share your thoughts, you can either:
- Send your comment to fphivintegration@ibp.wa-research.ch
- Log into the forum website at http://my.ibpinitiative.org/Community.aspx?c=d1f835b2-0c72-420a-9ade-88186b49abe7 with the username and password you received.
ONLINE ARCHIVE
Postings are also archived at http://www.fpandhiv.org/videoconference/cpieventpage.php along with all the resources mentioned in the forum, including the guide mentioned today. You do not need to know your username and password to read the postings on the web site. While you are there, please take a look at the web site as well. It was developed to bring together in one place all the relevant resources on integration of family planning and HIV/AIDS prevention and services.
We look forward to continuing these discussions even after the official end of the forum on Friday. Thanks to everyone for participating and for sharing your questions, concerns, and experiences!
Best regards,
HCP and INFO Teams
Abebe Shibru – IntraHealth Ethiopia
Dear the forum participants:
I would like share this to you. In May 24th 2006, we honored mothers living with HIV in Ethiopia.
The Mothers program, mothers 2 mothers, is part of IntraHealth's technical support for PMTCT service provision at the health center and community level in Ethiopia under PEPFAR support.
Various social, cultural and economic issues closely related to AIDS infection requires more than just a medical approach as a response - especially for pregnant women and new mothers living in developing countries. Medical care may be beneficial, but only if accessed.
Anti-retroviral (ARV) therapy and infant feeding practices may be effective, but only if adhered to properly. Additionally, the stigma associated with HIV/AIDS infection, the lack of women's empowerment, and the deficiency of appropriate and culturally sensitive clinical support services, even in facilities providing PMTCT services, means that many women go through their ordeal alone, confused and afraid. The mothers program provides a support network for women and their partners.
IntraHealth Ethiopia, through US support, believes that the strength and success of the mother's support initiative depends on the utilization of previously untapped resource. These resources are the mother themselves.
Mothers, living with HIV, serving as peer mentors and educators, can ensure continued access to medical care for pregnant women and postpartum mothers, and adherence to ARV therapy and infant feeding practices that will lower the incidence of vertical transmission of the disease. Through peer-peer mentoring and support groups, mothers living with HIV can help de-stigmatize the disease and empower HIV+ women to have hope and take control of their social, economic and sexual lives
I wanted to share this with you.
Warmest Regards,
Message from the IntraHealth Ethiopia team
Abebe Shibru,
Intrahealth International PMTCT Team Leader
Tel. 2511 6627480/81/82
Mobile: 251.911.40.85.83
P.O. Box 9658
Addis Ababa
Ward Rinehart - question for Dr. Li
Dear Dr. Li,
It is heartening to hear your report of the success of family planning workers providing HIV prevention and care services in Henan Province.
May I ask two questions?
First, you mentioned that stigma against persons with HIV has been greatly reduced there. Could you please tell us about the special activities have helped to reduce stigma?
Second, there has been concern raised about whether health care providers who are already offering one service have the time to integrate another service into their work. Could you comment, please, on the effect of integrating HIV activities into the work of family planning providers in Henan? Is there any concern that now they have too much to do and cannot meet all the family planning and HIV needs? Also, you mention efficiency. Could you tell us, please, about ways found to make service delivery as efficient as possible?
Many thanks.
Ward Rinehart
Center for Communication Programs
Johns Hopkins Bloomberg School of Public Health
Margaret Gitau - Kenya Integration Experience
Hallo
I have been keenly following the forum as it has progressed.I work with the Ministry of Health Kenya and was actively involved in the integration the Heidi Reynods discussed in week one.
There are two issues i would like to respond to.FP and HIV are housed in different divisions. What we have done is to ensure that we work together through being co-chairs of the various committees that deal with integration. We co-chair the FP/VCT committee and the PMTCT committees. This way, both divisions deal with issues in their dockets.
As regarding the issue of lay counselors in the VCT rooms, we used the guidelines from the Division of reproductive health which have allowed Community health Distributors (CBD) to dispense pills using simple checklists. They are however allowed to issue 2 cycles and then refer to a trained FP provider. The approach we have used is to ensure that all clients are given the information and then given the choice to decide.
We are in the process of integrating VCT into Family planning clinics. From my experience on the policy level and the actual implementation, what is really needed is the process to be owned by the public sector due to ownership and sustainability. Keep up the good work of linking up various communities to share eaxperiences.
Margaret Gitau
ART Programme officer
National Aids/STI control Programme
Kenya
Theresa Lynne - South Africa on working with young people
Sanibonani to all at the forum Thank you for your contributions
I have been very interested in the discussion although it is difficult for us to be online and send and receive emails.
I work for a HIV / AIDS organisation with a focus on prevention. We work with and train young people (18 - 30 years) through a variety of interactive processes including theatre. We then deliver services in schools, universities and companies. Our organisation is youth participatory and working towards being youth-led.
We do not view anything to do with "health" as separate from each other so if we are speaking /working /training in relation to HIV testing then by implication the outcome of that concerns us and so family planning is part of that outcome whatever the current circumstances of the person.
Young people are very interested in learning about themselves and their health - reproduction, nutrition etc and are hungry for information, frank discussion and advice and to discuss their values alongside the impact of what we call "restricted choices". We never presume to tell people what they should do and work in such a way as it is the participants who offer ideas and information and explore what the outcomes of various choices might be e.g. a young HIV positive woman who has an HIV negative partner grieving for the loss of having children suddenly finding out that actually there are choices - things to think through with her partner before making this decision. Myths to prevent both pregnancy and HIV are prevalent even though with tv programmes and poster boards it feels like overdose, many young people do not see those images as relating to them.
I guess what we are saying is that we all need to be supported in feeling comfortable to talk widely and frankly in their own languages with service users and to accompany them as they think through what different options might mean for them. For us capacity, time and money are huge issues however if we can focus on the person we are with in that present moment it is surprising what we are able to do in even the most resource limited situation.
Thank you again
Theresa Lynne
Themba HIV/AIDS Organisation
Braamfontein
Johannesburg
South Africa
We are all HIV+ until proven negative - Let's get tested now!
Lisa Schechtman: New Guide for Integration of Sexual and Reproductive Health into HIV/AIDS Programming
Guide for Submitting HIV/AIDS Component Proposals to the Global Fund to Fight AIDS, TB and Malaria, Round 6 and Beyond
Sexual and reproductive health (SRH) is intricately connected with the AIDS epidemic that continues to ravage individuals and communities around the world. With over 40 million people infected with HIV, drastic measures must urgently be added to the prevention and treatment efforts already underway. In particular, women and girls continue to acquire HIV at disproportionately high rates, due to socio-economic disempowerment, gender-based violence, and other factors; SRH services particularly target this population, providing an entryway for HIV services, and vice versa. It is for these reasons that the Global AIDS Alliance and other nongovernmental organizations, service providers, and international agencies are advocating for a commitment to health programming that operationalizes the delivery of integrated SRH and HIV/AIDS programmes.
The Global Fund to Fight AIDS, Tuberculosis and Malaria, a unique multilateral partnership that has proven itself the most successful mechanism in the world for fighting these diseases, has recently announced the impending launch of Round 6 of its grant-making activities. In preparation for this round, Integration of Sexual and Reproductive Health into HIV/AIDS Programming: Guide for Submitting HIV/AIDS Component Proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria, Round 6 and Beyond is designed to support SRH and HIV implementing organizations in countries eligible for Global Fund funding in submitting SRH-HIV proposals under the Global Fund’s HIV/AIDS component for Round 6. Despite wide-ranging consensus that integrated SRH-HIV programming is severely lacking from the current HIV response, recent research by the International Planned Parenthood Federation (IPPF) among its Member Associations (MAs) around the world determined that lack of knowledge about the Global Fund and its processes is among the most important barriers to seeking SRH-HIV support from the Global Fund.
This Guide responds to the low number of SRH-related proposals included in Country Coordinated Proposals in previous Global Fund funding rounds, and to the expressed need of MAs to learn more about the nexus of SRH and HIV and about ways in which to get involved with the Global Fund and its in-country structures. The Guide is intended for all organizations working to implement SRH programming, applying also to those that are not IPPF MAs. The Guide highlights important links between SRH and HIV/AIDS. Finally, the Guide emphasizes the key components of a proposal to the Global Fund that would benefit SRH programming under the HIV component of funding. The sections throughout the Guide can stand alone and may be used as independent reference sections, or the Guide may be read in its entirety.
Click here to download the PDF version (70 p.)
For more information, contact:
Lisa Schechtman
Policy & Grassroots Associate
Global AIDS Alliance
1413 K Street NW, 4th Floor
Washington, DC 20005
lschechtman@globalaidsalliance.org
(202) 789-0432 ext. 212