SRH HIV/AIDS
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The purpose of this training-of-trainers (ToT) manual on comprehensive SRHR of most-at-risk adolescents and young people is to enable trainers to build the professional skills of their national counterparts to provide quality services to... more
The purpose of this training-of-trainers (ToT) manual on comprehensive SRHR of most-at-risk adolescents and young
people is to enable trainers to build the professional skills of their national counterparts to provide quality services to
targeted populations according to recognized standards and to disseminate knowledge in the region.
people is to enable trainers to build the professional skills of their national counterparts to provide quality services to
targeted populations according to recognized standards and to disseminate knowledge in the region.
Diese Studie ist die erste Zusammenstellung von bundesweiten Beispielen direkter, institutioneller und struktureller Diskriminierung und Stigmatisierung von Bulgar_innen und Rumän_innen mit zugeschriebenem oder tatsächlichen... more
Diese Studie ist die erste Zusammenstellung von bundesweiten Beispielen direkter, institutioneller und struktureller Diskriminierung und Stigmatisierung von Bulgar_innen und Rumän_innen mit zugeschriebenem oder tatsächlichen Roma-Hintergrund in Deutschland.
Die Diskriminierung von Bulgar_innen und Rumän_innen, denen häufig und insbesondere wenn sie in prekären sozio-ökonomischen Verhältnissen leben ein Roma-Hintergrund zugeschrieben wird, ist eine Realität. Die gesellschaftlichen und institutionellen diskriminierenden Praktiken und Diskurse gegen diese Migrant_innen, die stark von einem in der deutschen Gesellschaft verwurzelten und nach neusten Studien wachsenden Antiziganismus geprägt sind, zeigen sich insbesondere in den in der vorliegenden Bestandsaufnahme untersuchten Bereichen Verwaltungs- und Bildungswesen. Auch wenn die nach Deutschland migrierenden Rumän_innen und Bulgar_innen als EU-Staatsbürger_innen dem europäischen Recht unterliegen und demnach die gleichen Rechte genießen sollten, werden ihnen diese - wie die vorliegende Bestandsaufnahme zeigt – häufig verwehrt.
Die Interviews und Fallbeispiele dieser Studie weisen darauf hin, dass insbesondere bulgarische und rumänische Migrant_innen mit sozio-ökonomischen Schwierigkeiten und/oder einer gebrochenen Bildungsbiographie, die gezwungenermaßen meist in den marginalisierten „Brennpunktkiezen“ der untersuchten Städte versuchen, sich eine neue Existenz aufzubauen, sowohl von den dortigen Behörden als auch innerhalb des Schulsystems systematisch diskriminiert werden. Diese Diskriminierung, die häufig antiziganistische Züge trägt, ist a) der politischen und medialen Debatte über die „Armutsmigration“ von Rumän_innen und Bulgar_innen nach Deutschland, b) der verschärften Gesetzgebung insbesondere im Bereich der EU-Freizügigkeit, c) den hieraus resultierenden behördlichen Praktiken verbunden mit d) einem häufig „ethnisierten“ Blick aller involvierten „Stakeholder“ und e) dem eher undurchlässigem, diskriminierendem deutschen Schulsystem geschuldet. Hier zeigen sich klassische Züge direkter, institutioneller und struktureller Diskriminierung, häufig verbunden mit antiziganistischen Diskursen und Ressentiments.
Die Diskriminierung von Bulgar_innen und Rumän_innen, denen häufig und insbesondere wenn sie in prekären sozio-ökonomischen Verhältnissen leben ein Roma-Hintergrund zugeschrieben wird, ist eine Realität. Die gesellschaftlichen und institutionellen diskriminierenden Praktiken und Diskurse gegen diese Migrant_innen, die stark von einem in der deutschen Gesellschaft verwurzelten und nach neusten Studien wachsenden Antiziganismus geprägt sind, zeigen sich insbesondere in den in der vorliegenden Bestandsaufnahme untersuchten Bereichen Verwaltungs- und Bildungswesen. Auch wenn die nach Deutschland migrierenden Rumän_innen und Bulgar_innen als EU-Staatsbürger_innen dem europäischen Recht unterliegen und demnach die gleichen Rechte genießen sollten, werden ihnen diese - wie die vorliegende Bestandsaufnahme zeigt – häufig verwehrt.
Die Interviews und Fallbeispiele dieser Studie weisen darauf hin, dass insbesondere bulgarische und rumänische Migrant_innen mit sozio-ökonomischen Schwierigkeiten und/oder einer gebrochenen Bildungsbiographie, die gezwungenermaßen meist in den marginalisierten „Brennpunktkiezen“ der untersuchten Städte versuchen, sich eine neue Existenz aufzubauen, sowohl von den dortigen Behörden als auch innerhalb des Schulsystems systematisch diskriminiert werden. Diese Diskriminierung, die häufig antiziganistische Züge trägt, ist a) der politischen und medialen Debatte über die „Armutsmigration“ von Rumän_innen und Bulgar_innen nach Deutschland, b) der verschärften Gesetzgebung insbesondere im Bereich der EU-Freizügigkeit, c) den hieraus resultierenden behördlichen Praktiken verbunden mit d) einem häufig „ethnisierten“ Blick aller involvierten „Stakeholder“ und e) dem eher undurchlässigem, diskriminierendem deutschen Schulsystem geschuldet. Hier zeigen sich klassische Züge direkter, institutioneller und struktureller Diskriminierung, häufig verbunden mit antiziganistischen Diskursen und Ressentiments.
The World Bank Assisted HIV/AIDS Programme Development Project (HPDP) II has been providing support to civil society organizations (CSOs), LACAs and Line Ministries in Ekiti State under the supervision of the Ekiti State AIDS Control... more
The World Bank Assisted HIV/AIDS Programme Development Project (HPDP) II has been providing support to civil society organizations (CSOs), LACAs and Line Ministries in Ekiti State under the supervision of the Ekiti State AIDS Control Agency (EKSACA) for the implementation of priority activities that support the scale – up of prevention, care and support programs in the state as outlined in the State Strategic Plan (SSP). The project is designed to enhance both the public (LM and LACA) and the private sectors (CSOs/PSOs) capacity on HIV responses within the state, promotion of behavioral change, scale up of facility based responses, and ensuring sustainable access to prevention commodities.
The goal of HPDP II is to reduce the risk of HIV infections by scaling up prevention interventions and to increase access to and utilization of HIV counseling, testing, care and support services. The project is aimed at creating an enabling environment for reducing the spread and mitigating the negative impact of HIV/AIDS through sustainable integrated HIV/AIDS services and strong health information management systems for effective evidence based and result oriented performance.
The World Bank and the Ekiti State Government agreed in 2010 on a US$5 million credit facility to support a five - year ‘HIV/AIDS Programme Development Project (HPDP) under the Bank’s Multi-Country AIDS Programme (MAP) Initiative. The Project was used to support a State-wide, Comprehensive and Multi-Sectoral Response to HIV and AIDS, including public and private sector response. EKSACA supported 10 Line Ministries and 16 Local Government Areas in Ekiti state under the public response structure while the agency selected through a competitive bidding process 20 CSO/PSOs to implement the community based private sector component of the state response plan. The third component of the project is dedicated to strengthening the institutional arrangements of SACA/LACA and implementing partners for more responsive planning, monitoring and evaluation, policy development and ultimately results – based implementation.
This report describes the findings of an evaluation assessment of the HPDP II conducted by two consultants recruited by Ekiti State AIDS Control Agency (EKSACA). The primary objective of the evaluation was to assess the extent of implementation of activities, document accomplishments, constraints, identify gaps, identify plausible best practices for replication and scale-up, and proffer recommendations for more effective and efficient programme implementation.
Following this general overview which provide overall summary of the effectiveness and gains of the HPDP II in Ekiti State, the first chapter of the report presents an introduction and background information on the HIV/AIDS Response in Ekiti State. Chapter two presents the scope of work and objectives of the evaluation. Chapter three presents a description of the methodology used by the consultants for the evaluation assignment. Chapter four in this report presents the findings and a discussion of the data generated and recommendations based on category of player (LM, CSO, LACA).
The HPDP II built on the substantial success of Project I and also utilized the existing institutional structure in the state. The project addresses key emerging sector issues that have been identified by the agency in partnership with a range of stakeholders through evidence – based epidemiological and behavioral surveys. To achieve its set objectives, there was a strong need to scale – up HCT, PMTCT, and ART facilities across the state. Between 2011 and 2016 the HPDP II support for ART facilities grew by 75% from four (4) facilities in 2011 to 16 facilities in 2016. This scale – up brought care and support closer to the door step of those in need and reduce time and cost of accessing treatment for PLHIV within the state. Prevention of mother to child transmition also got a remarkable boost with a 89.2% increase in number of PMTCT facilities across the state, while HCT facilities supported by the project grew from 128 facilities in 2011 to 152 in 2016 a 15.8% improving over the period. The scale up of prevention, detention, retention, treatment and care centres across the local government areas of the state resulted in improved number of clients accessing services and reduced the waiting time across the state
The goal of HPDP II is to reduce the risk of HIV infections by scaling up prevention interventions and to increase access to and utilization of HIV counseling, testing, care and support services. The project is aimed at creating an enabling environment for reducing the spread and mitigating the negative impact of HIV/AIDS through sustainable integrated HIV/AIDS services and strong health information management systems for effective evidence based and result oriented performance.
The World Bank and the Ekiti State Government agreed in 2010 on a US$5 million credit facility to support a five - year ‘HIV/AIDS Programme Development Project (HPDP) under the Bank’s Multi-Country AIDS Programme (MAP) Initiative. The Project was used to support a State-wide, Comprehensive and Multi-Sectoral Response to HIV and AIDS, including public and private sector response. EKSACA supported 10 Line Ministries and 16 Local Government Areas in Ekiti state under the public response structure while the agency selected through a competitive bidding process 20 CSO/PSOs to implement the community based private sector component of the state response plan. The third component of the project is dedicated to strengthening the institutional arrangements of SACA/LACA and implementing partners for more responsive planning, monitoring and evaluation, policy development and ultimately results – based implementation.
This report describes the findings of an evaluation assessment of the HPDP II conducted by two consultants recruited by Ekiti State AIDS Control Agency (EKSACA). The primary objective of the evaluation was to assess the extent of implementation of activities, document accomplishments, constraints, identify gaps, identify plausible best practices for replication and scale-up, and proffer recommendations for more effective and efficient programme implementation.
Following this general overview which provide overall summary of the effectiveness and gains of the HPDP II in Ekiti State, the first chapter of the report presents an introduction and background information on the HIV/AIDS Response in Ekiti State. Chapter two presents the scope of work and objectives of the evaluation. Chapter three presents a description of the methodology used by the consultants for the evaluation assignment. Chapter four in this report presents the findings and a discussion of the data generated and recommendations based on category of player (LM, CSO, LACA).
The HPDP II built on the substantial success of Project I and also utilized the existing institutional structure in the state. The project addresses key emerging sector issues that have been identified by the agency in partnership with a range of stakeholders through evidence – based epidemiological and behavioral surveys. To achieve its set objectives, there was a strong need to scale – up HCT, PMTCT, and ART facilities across the state. Between 2011 and 2016 the HPDP II support for ART facilities grew by 75% from four (4) facilities in 2011 to 16 facilities in 2016. This scale – up brought care and support closer to the door step of those in need and reduce time and cost of accessing treatment for PLHIV within the state. Prevention of mother to child transmition also got a remarkable boost with a 89.2% increase in number of PMTCT facilities across the state, while HCT facilities supported by the project grew from 128 facilities in 2011 to 152 in 2016 a 15.8% improving over the period. The scale up of prevention, detention, retention, treatment and care centres across the local government areas of the state resulted in improved number of clients accessing services and reduced the waiting time across the state
Background: Female Sex Workers (FSWs) are main drivers of the HIV epidemic in Nepal. The work environment of sex work in Nepal is differentiated into establishment based (e.g. massage parlors, dance restaurants, hotels and lodges) and... more
Background: Female Sex Workers (FSWs) are main drivers of the HIV epidemic in Nepal. The work environment of sex work in Nepal is differentiated into establishment based (e.g. massage parlors, dance restaurants, hotels and lodges) and street based (e.g. streets, parks and markets). The study compares HIV, syphilis and risk behaviours among establishment-based FSWs and street-based FSWs in Kathmandu Valley of Nepal. Materials and Methods: Cross-sectional bio-behavioral surveys in 2006, 2008, 2011 and 2015 aimed to sample 2093 FSWs using two stage cluster sampling in the Kathmandu valley. Statistical analysis used chi-squared tests and logistic regression models to assess differences of HIV, syphilis and risk behaviors among street-based FSWs and establishment-based FSWs. Results: The study included 39.7% street-based FSWs and 60.3% establishment-based FSWs. The street-based FSWs had lower education levels, older age groups, separated, longer duration of sex work and inconsistent condom used with clients than establishment-based FSWs (p<0.05). Establishment-based FSWs were lower exposure to HIV intervention programs and pervasive alcohol consumption and use of drugs (p<0.05). The multivariate analysis showed that street-based FSWs were more likely of HIV test (aOR=1.25, 95%CI=1.04, 1.49), HIV (aOR=4.72, 95%CI=2.19, 10.15) and syphilis (aOR=7.96, 95%CI=3.49, 18.15) than establishment-based FSWs. Conclusion: Street-based FSWs possessed higher risk behaviour and have higher HIV and syphilis prevalence. HIV prevention interventions targeting FSWs should consider risks and vulnerability of street-based FSWs.
Introduction: this article reflects on data that emanated from a programme evaluation and focuses on a concept we label ‘distributed-efficacy’. We argue that the process of developing and sustaining ‘distributed-efficacy’ is complex and... more
Introduction: this article reflects on data that emanated from a programme evaluation
and focuses on a concept we label ‘distributed-efficacy’. We argue that the process of
developing and sustaining ‘distributed-efficacy’ is complex and indeterminate, thus
difficult to manage or predict. We situate the discussion within the context of UNAIDS’
recent strategy — Vision 95:95:95 — to ‘end AIDS’ by 2030 which the South African
National Department of Health is currently rolling out across the country.
Method: A qualitative method was applied. It included a Value Network Analysis, the
Most Significant Change technique and a thematic content analysis of factors associated
with a ‘competent community’ model. During the analysis it was noticed that there were
unexpected references to a shift in social relations. This prompted a re-analysis of the
narrative findings using a second thematic content analysis that focused on factors
associated with complexity science, the environmental sciences and shifts is social
relations.
Findings: the efficacy associated with new social practices relating to HIV risk-reduction
was distributed amongst networks that included mother—son networks and
participant—facilitator networks and included a shift in social relations within these
networks. Discussion: it is suggested that for new social practices to emerge requires the
establishment of ‘distributed-efficacy’ which facilitates localised social sanctioning,
sometimes including shifts in social relations, and this process is a ‘complex’, dialectical
interplay between ‘agency’ and ‘structure’.
Conclusion: the ambition of ‘ending AIDS’ by 2030 represents a compressed timeframe
that will require the uptake of multiple new bio-social practises. This will involve many
nonlinear, complex challenges and the process of developing ‘distributed-efficacy’ could
play a role in this process. Further research into the factors we identified as being
associated with ‘distributed-efficacy’ — relationships, modes of agency and shifts in
social relations — could add value to achieving Vision 95:95:95.
and focuses on a concept we label ‘distributed-efficacy’. We argue that the process of
developing and sustaining ‘distributed-efficacy’ is complex and indeterminate, thus
difficult to manage or predict. We situate the discussion within the context of UNAIDS’
recent strategy — Vision 95:95:95 — to ‘end AIDS’ by 2030 which the South African
National Department of Health is currently rolling out across the country.
Method: A qualitative method was applied. It included a Value Network Analysis, the
Most Significant Change technique and a thematic content analysis of factors associated
with a ‘competent community’ model. During the analysis it was noticed that there were
unexpected references to a shift in social relations. This prompted a re-analysis of the
narrative findings using a second thematic content analysis that focused on factors
associated with complexity science, the environmental sciences and shifts is social
relations.
Findings: the efficacy associated with new social practices relating to HIV risk-reduction
was distributed amongst networks that included mother—son networks and
participant—facilitator networks and included a shift in social relations within these
networks. Discussion: it is suggested that for new social practices to emerge requires the
establishment of ‘distributed-efficacy’ which facilitates localised social sanctioning,
sometimes including shifts in social relations, and this process is a ‘complex’, dialectical
interplay between ‘agency’ and ‘structure’.
Conclusion: the ambition of ‘ending AIDS’ by 2030 represents a compressed timeframe
that will require the uptake of multiple new bio-social practises. This will involve many
nonlinear, complex challenges and the process of developing ‘distributed-efficacy’ could
play a role in this process. Further research into the factors we identified as being
associated with ‘distributed-efficacy’ — relationships, modes of agency and shifts in
social relations — could add value to achieving Vision 95:95:95.
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