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National HIV/AIDS Strategic Action Plan Kosovo 2018-2022

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National HIV/AIDS Strategic Action Plan Kosovo 2018-2022 REPUBLIKA E KOSOVËS REPUBLIKA KOSOVA – REPUBLIC OF KOSOVO Ministria e Shëndetësisë/Ministarstvo Zdravdsva/ Ministry of Health National HIV/AIDS Strategic Action Plan Kosovo 2018-2022 Ministry of Health of Republic of Kosovo Contents Acronyms ...................................................................................................................................................... 3 Introduction .................................................................................................................................................. 5 Kosovo – Country Context ............................................................................................................................ 6 HIV/AIDS: Background and situation analysis ............................................................................................... 7 Organizational structure of the National HIV response ............................................................................ 9 CSO landscape/engagement in HIV response ......................................................................................... 10 Funding sources for HIV national response ............................................................................................ 11 HIV/AIDS National Strategic Plan (NSP) for 2018-2022 .............................................................................. 14 Overarching Goal of the HIV/AIDS NSP ....................................................................................................... 14 SPECIFIC OBJECTIVE 1. Reduce the impact of HIV in general population and key populations by strengthening HIV prevention interventions and improve access to services ....................................... 14 SPECIFIC OBJECTIVE 2. Improve the health status and quality of life of people living with HIV by providing universal access to treatment, health care and other support services ................................ 18 SPECIFIC OBJECTIVE 3. Ensure sustainable response to HIV through strengthening coordination, leadership and financial and political commitment of the Government. .............................................. 19 SPECIFIC OBJECTIVE 4. Ensure sustainable response to HIV through resilient health systems strengthening interventions ................................................................................................................... 23 SPECIFIC OBJECTIVE 5. Empowerment and engagement of CSO in HIV policy, programming, advocacy and HIV services in the community through Community Systems Strenghtening ................................. 25 Costing HIV/AIDS NSP ................................................................................................................................. 26 Monitoring and Evaluation ......................................................................................................................... 27 Appendices .................................................................................................................................................. 28 Bibliography ................................................................................................................................................ 29 Acronyms AIDS Acquired Immune Deficiency Syndrome AP Action Plan ART Anti-Retroviral Treatment ARV Anti-Retroviral CCM Country Coordination Mechanism CDF Community Development Fund CSO Civil Society Organizations CSS Community systems strengthening FSW Female Sex Worker GDP Gross Domestic Product GF Global Fund HDI Human Development Index HIV Human Immunodeficiency Virus IBBS Integrated Bio-behavioral Surveillance Survey KP Key Populations LGBT Lesbian, Gay, Bisexual and Transgender LMIC Lower-middle income country M&E Monitoring and evaluation MICS Multi Indicator Cluster Survey MMT Methadone Substitution Therapy MOH Ministry of Health MSM Men who have Sex with Men NASA National AIDS Spending Assessment NGO Non-Governmental Organization NEP Needle and Syringe Exchange Programs NRL National Reference Laboratory NSP National Strategic Plan OST Opioid Substitution Therapy PHC Primary Health Care PIT Provider Initiated Testing PLHIV People Living with HIV PMTCT Prevention of Mother-to-Child Transmission PSM Procurement supply chain management PWID People Who Inject Drugs SHA System of Health Accounts SHC Secondary Health Care SO Specific objectives (NSP) STI Sexually Transmitted Infections SW Sex Worker THC Tertiary Health Care TG Transgender People TGF The Global Fund TPA Transition Preparedness Assessment VCT Voluntary Counselling and Testing WHO World Health Organization Introduction Current national HIV/AIDS Strategic Plan for 2018-2022 years in Kosovo is based on the previous national HIV/AIDS plans, the Global Fund HIV grants, as well as on the recommendations provided by the WHO mission commissioned in 2014 to review previous strategic plan and HIV programme, and on the findings and recommendations from the Transition Preparedness Assessment study completed in 2017. Preceding National Strategic Plans for HIV 2009-2013, and 2015-2019identified strategic objectives and priority areas, however none of the plans included comprehensive M&E framework and national indicators to measure the progress achieved and assess program challenges. Previous Strategic Plans werenot either costed, or approved by the Government to have enforceable power. Transition Preparedness Assessment (TPA) completed by Curatio International Foundation through the financial support from the Global Fund grants in Kosovo involved desk review and in-depth interviews (IDIs) with key stakeholders from the Government institutions, donor organizations, civil society organizations and constituencies. The quantitative and qualitative data were entered into the TPA excel- based tool and a summary score for transition risk was set at 18.33% indicating high risk for HIV programme transition in the country. Based on the TPA findings, sets of recommended actions were developed and validated through participatory process and consensus-building, national consultation workshops held in February-March, 2017 in Pristina. These recommendations have been incorporated into the current HIV NSP to ensure smooth transitioning from the external support to uninterrupted and adequate domestic funding of full-scale HIV national response in Kosovo. The HIV NSP is in line with the country’s strategic vision outlined in the recently endorsed Health Sector Strategy 2017-2021 which aims at “improving the quality of services, responding to the requests for health services and efficiency of the delivery of these services, improving of financing while also improving the access to services for vulnerable groups facing various barriers in access to services.”1Even though that currently Health Sector Strategy includes the section on HIV/AIDS, the priority areas for HIV prevention, treatment and care services are scarcely described. However, there is a declared political commitment from the Government of Kosovo that the vision and strategic objectives outlined in the HIV NSP 2018-2022 will be adequately reflected in the Health Sector Strategy which is reviewed “each year based on new priorities in order to serve in drafting the Medium-Term Expenditure Framework.”2 Current National HIV Strategic Plan for 2018-2022 is a result of joint efforts and contributions of professionals from the Ministry of Health and medical institutions; representatives from other national organizations, civil society organizations and key constituencies. The Ministry of Health believes that the current NSP reflects the dedication and hard work of every individual engaged in the NSP preparation process. Special thanks should be extended to the MoH staff, CCM and Community Development Fund (CDF) - the GF grants principal recipient,for facilitating theNSP development process. Exceptional gratitude should be expressed to the GF Portfolio Manager in Kosovo, as well asDr. Edona Deva,Head of TGF HIV 1Health Care Sector Strategy 2017-2021. November 2016 Ministry of Health. Kosovo 2Health Care Sector Strategy 2017-2021. November 2016 Ministry of Health. Kosovo, p.10 programme, Dr. ilirHoxha – the local consultant, and Curatio International Foundation for their valuable contribution to the NSP development. Kosovo – Country Context Demographic Characteristics: The Republic of Kosovo has an area of 10,908 km2 and 1,804,944 inhabitants.1The population growth (annual %) has remained positive though under 1% from 2002 till 2014. It started declining over the last three years reaching its lowest in 2015 when the population annual growth reduced to (-0.09.%). The average life expectancy in Kosovo in 2011 was estimated to be 76.7 years (for males - 74.1 years and for females - 79.4 years)3.Morbidity data, including maternal and infant mortality data is not available on the WB database. Human Development Index increased incrementally from 0.68 in 2007 to 0.74 in 2016 but still remains the lowest in Europe. Economic indicators:Kosovo is one of the poorest countries in Europe with Gross Domestic Product (GDP) of € 3,084 per capita, or 257 euro per month.1 Real growth rate of GDP for 2013 compared to 2012 was 3.2%, according to estimates of Macroeconomics Unit of the Ministry of Finance of Kosovo. Poverty headcount ratio at national poverty lines (% of population) has been declining – from 45.1% in 2005 to 29.7% in 2011 (the latest available data). According to the World Bank Report on Poverty Assessment in Kosovo in 2011, 29.7% of the population lived below
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