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Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS

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Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS Semi-Annual Report (Jan - Jun 2008) Submitted August 1, 2008 Family Health International/Nepal USAID Cooperative Agreement #367-A-00-06-00067-00 Strategic Objective No. 9 Table of Contents List of Acronyms........................................................................................................................... ii Executive Summary...................................................................................................................... 1 I. Introduction ............................................................................................................................... 2 II. Program Management............................................................................................................. 4 A. Human Resources..................................................................................................................4 B. Partnership Management and Development ......................................................................4 C. Coordination and Collaboration..........................................................................................5 D. Technical Assistance and International Travel ..................................................................5 III. Technical Program Elements (Progress and Results by Results Areas)........................... 6 IV. Monitoring and Evaluation Update.................................................................................... 14 V. Constraints.............................................................................................................................. 15 i List of Acronyms AMDA Association of Medical Doctors of Asia APF Armed Police Force ART Anti-Retroviral Therapy ASHA Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS APRO Asia Pacific Regional Office IBBS Integrated Biological Behavioral Surveillance UCAAN Universal Coverage for Children Affected by HIV and AIDS CABA Children Affected by AIDS CHBC Community and Home-Based Care DACC District AIDS Coordination Committee DFID Department for International Development, UK DPHO District Public Health Office DQA Data Quality Audit EPC Essential Package of Care FHI Family Health International FSW Female Sex Worker GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria IA Implementing Agency IDU Injecting Drug User IHS Integrated Health Services M&E Monitoring and Evaluation MARP Most At Risk Population MIS Management Information System MoHP Ministry of Health and Population MSM Men who have Sex with Men NAP National Action Plan NAP+N National Association of People Living with HIV/AIDS in Nepal NCASC National Centre for AIDS and STD Control NPHL National Public Health Laboratory OI Opportunistic Infection PEP Post Exposure Prophylaxis PLHA People Living with HIV/AIDS PMTCT Prevention of Mother to Child Transmission SOP Standard Operating Procedure SRM Surveillance, Research, Monitoring and Evaluation STI Sexually Transmitted Infection UCAAN Universal Access for Children Affected by AIDS in Nepal UNDP United Nations Development Program UNICEF United Nations Children’s Fund USAID United States Agency for International Development VCT Voluntary Counseling and Testing VSO Volunteers Services Overseas WAD World AIDS Day WHO World Health Organization ii Executive Summary This report covers the fourth semi-annual period January – June 2008 for the Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS (ASHA) Project in Nepal. The ASHA Project is currently implemented by three major partners namely FHI as the prime, Constella Futures and Association of Medical Doctors of Asia (AMDA). The Project works through 48 local implementing agencies (IA) in 36 districts in close collaboration with National Centre for AIDS and STD Control (NCASC). During this period ASHA Project signed two sub-agreements with IAs. Key activities and achievements during this reporting period include the following: • Provided technical assistance to government and other key stakeholders in the areas of HIV commodity delivery; voluntary counseling and testing (VCT); sexually transmitted infection (STI); prevention of mother-to-child transmission (PMTCT); pediatric HIV training; children affected by HIV and AIDS; national HIV program assessment; laboratory services; communication; surveillance; 3rd national AIDS Conference; qualitative study on men who have sex with men (MSM) and tesro lingi (third gender); and monitoring and evaluation (M&E). • Conducted risk reduction activities and reached nearly 43,000 people among the most-at-risk populations (MARPs) in the Eastern, Central, Western, Mid-Western and Far-Western Regions along the main transport routes and in major cities out of which more than 60% were new for the reporting period. Nearly 67% of the MARPs reached during this reporting period were either Female Sex Workers (FSWs) or their clients. • Modified the Integrated Health Services (IHS) delivery mechanism by having AMDA cover most of Eastern Terai region and local NGOs cover the Central Terai region. The service delivery is now fully functional. • Provided VCT services for injecting drug users (IDUs) in 3 sites. • Provided STI diagnosis and treatment services at 28 sites to 4,442 people (both old and new clients) from MARPs. • Provided VCT and an Essential Package of Care (EPC) for people living with HIV/AIDS (PLHA) at 33 sites. • Provided Community and Home-based Care (CHBC) services through 12 partners who have 19 teams. • Provided HIV counseling, testing and results to 9,924 people and palliative care to over 2,442 people. • Completed the GOALS model analysis and trained key stakeholders. • Conducted District AIDS Co-ordination Committee (DACC) orientation in 9 districts and with 6 additional districts scheduled for the coming months. Constraints faced during the reporting period include uncertain security situation in the Terai region, Constituent Assembly elections and slow progress through technical working groups to push major decisions 1 I. Introduction This report covers the fourth semi-annual period (January – June 2008) for the Advancing Surveillance, Policies, Prevention, Care and Support to Fight HIV/AIDS (ASHA) Project in Nepal. During this period the ASHA Project partners signed agreements with two new Implementing Agencies (IAs) (see Table 3), and continued to support the national response for HIV and AIDS through technical assistance to government and civil society as well as field based prevention to care, support and treatment activities.. Key activities and achievements during this reporting period include the following: • Provided technical assistance to government and other key stakeholders in the areas of HIV commodity delivery; voluntary counseling and testing (VCT); sexually transmitted infection (STI); prevention of mother-to-child transmission (PMTCT); pediatric HIV training; children affected by HIV and AIDS; national HIV program assessment; laboratory services; communication; surveillance; 3rd national AIDS Conference; qualitative study on MSM and tesro lingi (third gender); and monitoring and evaluation (M&E). • Conducted risk reduction activities and reached nearly 43,000 people among the most-at-risk populations (MARPs) in the Eastern, Central, Western, Mid-Western and Far-Western Regions along the main transport routes and in major cities out of which more than 60% were new for the reporting period. Nearly 67% of the MARPs reached during this reporting period were either Female Sex Workers (FSWs) or their clients. • Modified the Integrated Health Services (IHS) delivery mechanism by having AMDA cover most of Eastern Terai region and local NGOs cover the Central Terai region. The service delivery is now fully functional. • Provided VCT services for injecting drug users (IDUs) in 3 sites. • Provided STI diagnosis and treatment services at 28 sites to 4,442 people (both old and new clients) from MARPs. • Provided VCT and an Essential Package of Care (EPC) for people living with HIV/AIDS (PLHA) at 33 sites. • Provided Community and Home-based Care (CHBC) services through 12 partners who have 19 teams. • Provided HIV counseling, testing and results to 9,924 people and palliative care to over 2,442 people. • Completed the GOALS model analysis and trained key stakeholders. • Conducted District AIDS Co-ordination Committee (DACC) orientation in 9 districts and with 6 additional districts scheduled for the coming months. 2 Figure 1: ASHA Project Service Sites and Program Districts 3 II. Program Management A. Human Resources New Hires/Resignations During this reporting period the ASHA Project hired the following personnel. Table 1: New Personnel for ASHA Project (January – June 2008) Name Position Title Start Date Remarks Ms. Pema Sherpa Receptionist January 2, 2008 Replacement of Merina Baidya who was promoted to Administrative Assistant Ms. Beti Maharjan Cleaning Assistant February 15, 2008 Replacement of Sarita Thapa Magar who resigned on medical grounds and passed away in June 2008 Ms. Sushmita Bantawa Program Associate April 1, 2008 Replacement of Lisa Nagarkoti who left ASHA Project to continue further education abroad in Australia Table 4: Resignations from ASHA Project (January – June 2008) Name Position Title Resignation Date Remarks Sarita Thapa Magar Cleaning Assistant January 21, 2008 Left on medical grounds and passed away in June 2008 Lisa Nagarkoti Program Associate February 9, 2008 Left to continue
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