CORE Group Fall Meeting 2011

HIV/AIDS Comprehensive Model

HIV/AIDS Comprehensive Model

Contents: History HARP strategy HIV Treatment Centers Other HARP Applications Possible HARP Applications Future Plans

Food for The Hungry Christian relief and development organization

founded in 1971 Present in 26 countries with a focus on health

and nutrition, child education, livelihoods and disaster risk reduction

In FY09 funding was approximately $204m, half was USG funds (In FY10 received 2 NEFAPS totaling $185m including food- huge increase!)

Focus on developing programs concentrating on quality improvement and behavior change.

Known for developing/using: care groups, barrier analysis, etc.-

FH HIV Strategy and PolicyHistory: in HIV/AIDS Bringing Hope: Multi-intervention program in

Ethiopia, Kenya, Uganda, Rwanda, Mozambique. Church-based HBC, OVC, Prevention

FH team created curriculums like Faithfulness in Marriage/Keys to a Healthy Relationship, Prevention of Sexual Abuse, and updated Choose Life

FH received PEPFAR funds through AHA (AERDO HIV/AIDS Alliance) for prevention grant in Ethiopia, Mozambique, Nigeria and Haiti

FH was sub to World Concern in Haiti for (Prevention, OVCs, and Palliative Care) and CHAMP for reducing vulnerabilities of HIV+ people and their families.

FH HIV Strategy and PolicyHARP Strategy Highly Active Retrovirus Prevention:

– A synergistic approach to HIV. – A combination between Behavioral

approaches, Biomedical approaches and Social, Justice and Human Rights approaches

Strategy: Prevent HIV and AIDS using a combination of biomedical, behavioral, structural, and care approaches.

Objective: to provide quality, family-oriented support to people infected and affected by HIV and AIDS.

Behavioral Change

Treatment/ antiretroviral/ STI/antiviral

Biomedical Strategies

Social Justice and

Human Rights

Highly Active

HIV/AIDS Prevention

(HARP)

FH’s Highly Active Retrovirus Prevention (HARP) Approach. Based on Coates and others, 2008

FH HIV Strategy and Policy

HARP Strategy For HARP to occur and be scaled-up

the community and the support of strong leaders is essential.

It requires access, linkages, or information to be provided so that clients receive a complete mix of biomedical, behavioral, structure and care approaches.

FH HIV Strategy and Policy

Strategic Approaches to HARP

Comprehensive Approach:

Provide a full package for each HIV intervention.

Integrated Approach: Ensures every HIV intervention client

receives services from various HIV interventions.

FH HIV Strategy and Policy

Strategic Approaches to HARP Tailor projects and messages to the

local context Each country and regions within countries will adapt their projects according to the latest scientific information, best and promising practices, local conditions

Building the Capacity of Others Such as governmental facilities, churches, CBOs,

FBOs, NGOs and others to help them to provide high quality HIV services.

FH HIV Strategy and Policy

Strategic Approaches to HARP Emphasizing sustainable approaches

and handover to local entities Sustainable approaches involve local and national

stakeholders at every level of program design, implementation and management

Integrating HIV with other health programs and servicesWhich ensure that participants in FH’s programs will have access to a full range of services.

FH HIV Strategy and Policy

Strategic Approaches to HARP Partnering with a variety of

organizationsLike public, private, government, donor, research, community and local organizations

Experiential learning for FH’s staff FH encourages and arranges visits between

fields, participation in conferences, workshops and other learning opportunities.

FH HIV Strategy and Policy

Strategic Approaches to HARP Working through both health facilities

and communities Combine the efforts between the health facility

and community to ensure quality services can reach all targeted communities.

High Quality Monitoring and Evaluation

FH has a vast array of monitoring and evaluation tools that can be used to increase the

measurability of results.

FH HIV Strategy and Policy

Strategic Approaches to HARP Evidenced-based, innovative and

research focused programming Aspect of programming that enables FH to

contribute to the body of knowledge, as well as to partner with research facilities such as universities.

Gender issues are considered in the design, implementation and measurement

Ensuring that the differing impacts on men and women, boys and girls are considered.

FH HIV Strategy and Policy

Strategic Outcomes to HARP Impact:Physical, mental, spiritual and social health will improve, meeting 70% of their indicator targets. Scale: 70% of FH fields use the HARP approach. Influence:On the cross-cutting issues like poverty, stigma and gender-based violence.

FH HIV Strategy and Policy

HARP ApplicationHIV Treatment Center Tumaini in Marsabit, Kenya and New Life

Medical Center in Kitgum, Uganda Providing a comprehensive treatment

package Partnership between many organizations Integrating HIV services with other medical

services such as MCH, FP and TB

FH HIV Strategy and Policy

HARP ApplicationHIV Treatment Center Integrating community and facility Will be handed over to FBO after

building their capacity Exchange field visits between the

two clinics Research is approved to be done in

the Tumaini

FH HIV Strategy and Policy

HARP ApplicationTB Integration in FH treatment centers Identified by symptoms Tested for TB Chest X-ray could also be requested Treat TB and test for HIV in case

status is unknown Treat TB and consider HAART if

positive

Kenya

Uganda

FH HIV Strategy and Policy

HARP Application- Global Fund, Kenya

GF R7 PR: Care Kenya Activities: youth outreach, testing and

counseling, ARV’s meetings and youth teams

GF R10 PR: Red Cross Activities: support ARV’s, Increase coverage

of PMTCT, HTC, PEP, reach MARPS with services and build the capacity of other CBO’s

FH HIV Strategy and Policy

HARP Application- AphiaPlus, Kenya

Led by Pathfinder, include FH, MSH, IRC, and Intra-health

Covering Zone 5 Provide expanded HIV/AIDS services,

Maternal/Child health, Population services Provide linkages to other USAID projects Provide services through health facility

and community

FH HIV Strategy and Policy

HARP Application- PrevSida, Haiti USAID’s national general population HIV

prevention program (led by WV) IGA, SRH, educational support, legal

support, etc.- through a variety of partners Training FBO partners Local CBOs, FBOs, MOE, MOH Building in discussions on gender roles,

violence, substance abuse in order to reduce vulnerabilities for girls

FH HIV Strategy and Policy

Possible HARP Applications– PMTCT projects that include prenatal

and postnatal follow up, community mobilization and providing needed ARV’s

– Testing and counseling services connected to referral centers and community groups using mobile, moonlight and stand alone services

– Linkages to wrap-around services such as nutrition programs, food security, income-generation and education services.

FH HIV Strategy and Policy

Possible HARP Application– Home based care projects connected to

health facilities, T&C and prevention messages

– OVC projects connected to different service providers in order for a more holistic service to the OVC and their household

– Behavior Change projects that include elimination and minimization of risk

Future PlanModel Replication

TumainiKenya

NLCUganda

Ethiopia MOZ.

Center 2Kenya

Center 3 Kenya

Center 2 Uganda

SudanBurundiRwanda

DRC

Comprehensive Treatment Approach

Future Plan

Treatment Prevention IGA OVC/HBC

Health CDP WASH

Capacity building

HIV/AIDS Comprehensive Model