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Workshop: HIV/AIDS interventions in emergency settings and the IASC Guidelines

Workshop: HIV/AIDS interventions in emergency settings and the IASC Guidelines. FIRST EDITION. Workshop overview. Session 1. Five sessions: 1. 4 . Workshop Overview. Introduction. Context. 2. Brief presentation Participatory activities and/or group discussion. +. Challenges. 3.

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Workshop: HIV/AIDS interventions in emergency settings and the IASC Guidelines

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  1. Workshop:HIV/AIDS interventions in emergency settingsand the IASC Guidelines FIRST EDITION

  2. Workshop overview Session 1

  3. Five sessions: 1. 4. Workshop Overview Introduction Context 2. Brief presentation Participatory activities and/or group discussion + Challenges 3. Practical Measures Introduction to the IASC Guidelines 5.

  4. To discuss: the broader context for HIV/AIDS in emergency settings. the key challengesrelated to HIV/AIDS programming in emergency settings. different interventions for addressing HIV/AIDS in emergency settings in a multisectoral approach. To introduce: information provided in the IASC Guidelines Workshop Purpose

  5. Explain the relationship between HIV/AIDS and emergencies Strategically address the challenges related to HIV/AIDS programming in emergency settings Apply a multisectoral approach to HIV/AIDS interventions Use the IASC guidelines for HIV/AIDS interventions in emergency settings Workshop ObjectivesBy the end of this workshop you should be able to…

  6. Introducing the HIV/AIDS Context Session 2

  7. In small groups, reflect on your individual experiences in a past or current emergency. Did/do you consider HIV/AIDS to be important in this emergency? If yes, why? If no, why not? Which individuals or groups do/did you view as most vulnerable to HIV/AIDS? Why? Could there be others? Discussion

  8. Context for HIV/AIDS Interventions in Emergency Settings Purpose: To discuss the broader context for HIV/AIDS in emergency settings. To discuss vulnerability to HIV/AIDS in emergencies. Who is vulnerable? Why? To discuss the link between HIV and emergencies

  9. World leaders commitment – 2015. HIV/AIDS integral to the achievement of the MDGs. Goal 6 states: ‘to halt and begin to reverse the spread of HIV/AIDS by 2015’. HIV/AIDS in all contexts, includingemergencies. The Global Context: HIV/AIDS and the Milennium Development Goals

  10. Global estimates of HIV and AIDS as of end 2004

  11. Countries in Conflict (2003)

  12. Countries in Crisis (2003)

  13. HIV/AIDS in emergency HIV/AIDS as emergency HIV/AIDS as emergency in emergency HIV/AIDS & Emergencies: 3 perspectives Haiti Swaziland southern Africa famine

  14. HIV/AIDS, Emergencies and Vulnerability

  15. Vulnerability to HIV infection: Emergencies generate situations of high risk to HIV infection Vulnerability to crisis: HIV/AIDS undermines existing coping strategies and may reduce social stability and available resources HIV/AIDS, Emergencies and Vulnerability

  16. Who is vulnerable to HIV/AIDS in emergencies? • Everyone is vulnerable to HIV/AIDS • Groups that are vulnerable: women, children, the poor, mobile populations, injured people (blood transfusions) • Other groups at risk of HIV infection include: The armed forces, police, humanitarian workers, truck drivers.

  17. How do emergencies increase HIV/AIDS related vulnerability? Reduce social stability/ support Overwhelm or destroy essential public services Reduce household and community resources Increase personal insecurity and risk of sexual assault. How do emergencies increase HIV/AIDS related vulnerability? Disruption of social norms and care capacity Services cannot manage HIV/AIDS related requirements Assets and social safety nets deplete Risk of HIV infection increases

  18. Conflict-affected populations: How does HIV/AIDS contribute?

  19. The trajectory of a crisis:How does HIV/AIDS contribute? Chronic livelihood insecurity. HIV/AIDS undermines livelihood security. Shocks such as drought or conflict tip situation into acute emergency. HIV/AIDS increases vulnerability to shocks. Acute crisis develops, with increased risks to lives and livelihoods. HIV/AIDS-affected people/households have less capacity to respond and sustain more severe losses/impacts.

  20. Summary Points

  21. Key Challenges to HIV/AIDS Programming in Emergencies Session 3

  22. Purpose: To identify specific HIV/AIDS- related problems that apply in different emergency scenarios. To discuss HIV/AIDS as a key issue in the workplace for responding personnel To discuss the key challengesrelated to HIV/AIDS programming in emergency situations. Session 3The Challenges in Implementing HIV/AIDS Interventions in Emergency Settings

  23. Readyour group’s specific emergency scenario. Drawing on your experiences, identify the likely HIV/AIDS-related challenges in this situation. Write each challenge on a separate card. Cluster togethercards with similar problems,and stick the card-clusterson flip chart(s). Stick chart(s) on wall for a gallery walk Group Activity (45-60 min)What are the challenges in implementing HIV/AIDS interventions in different emergency situations?

  24. Addressing HIV/AIDS in emergency settings: challenges and problems • Collapsed/inadequate health and public services. • Limited financial, social & economic resources. • Lack of information (on infection levels, trends, target populations, ...). • Special situations of emergency-affected populations (access, security, language, culture, stigma..) • Institutional and human resource constraints.

  25. HIV/AIDS in emergency HIV/AIDS as emergency HIV/AIDS as emergency in emergency Health and public services collapse or are inadequate In conflicts, infrastructure is destroyed/services collapse High HIV infection rates and related infections overwhelm existing services Public services are doubly overwhelmed by HIV/AIDS and additional demands

  26. Financial, social & economic resources arestretched, depleted and constrained

  27. Lack of information(infection levels, trends, target populations, ...)

  28. Special situations of emergency-affected populations • Remote/inaccessible locations • Ongoing hostilities/unsafe conditions • Lack of safe road/air access Constrain access, limits coverage of target population and range of services Increase exposure of women and children to HIV/AIDS Increased risk of abuse and exploitation, particularly of women and children Language barriers, cultural perception of certain issues, gender roles, stigma, etc Limit translation of existing interventions and reutilization of tools/ methods

  29. Lack, attrition and death of skilled and support personnel constrain program implementationand human resource capacity building. Response to humanitarian assistance appeals biased in favour of ‘life saving’ interventions Humanitarian assistance funding parameters often do not link to long-term HIV/AIDS reduction programmes. Institutional and Human Resource Constraints

  30. Summary – Key Points

  31. Practical measures: The planning and response matrix Session 4

  32. Purpose: To strengthen awareness of the multisectoral nature of HIV/AIDS interventions in emergencies. To build skills in inter-disciplinary collaboration in reducing HIV/AIDS in emergencies To introduce the HIV/AIDS matrix for minimum response in emergencies. Practical Measures for Implementing HIV/AIDS Interventions in Emergency Settings

  33. Reducing HIV/AIDS in emergency settings Why a multisectoral approach? Previously, HIV/AIDS was viewed primarily as a health-sector concern We now know that HIV/AIDS is a multisectoral responsibility HIV/AIDS priorities must be integrated into emergency planning/response

  34. Ten complementary clusters of sectoral responses. Threephases of response Emergency preparedness Minimum response Comprehensive response Introducing the Matrix for HIV/AIDS actions in emergencies

  35. Matrix for HIV/AIDS actions in emergencies: focus on minimum response Sector Emergency preparedness Minimum response Comprehensive response Coordination Assessment/monitoring Protection Focus on: Minimum Response Water/sanitation Food security Site planning Health Education  Behaviour Change Com HIV/AIDS at work

  36. Return to your group from the previous exercise. Take your group’s flipchart with you. Distribute roles to group members – ensure there is at least one observer / rapporteur. Conduct a meeting in which representatives of the different sectors address identified challenges. Observers / rapporteurs documentgroup process. Group Activity - Role Play (60-90 min)Planning multisectoral HIV/AIDS responses:

  37. Coordination action priorities:Minimum response requirements  The goal of coordination efforts is to meet humanitarian needs effectively and coherently. Establish coordination mechanisms Coordination works best when all stakeholders work together to establish a shared set of ethical and operational standards

  38. Assessment and Monitoring: Minimum response requirements  In emergencies, accurate information is often lacking, especially in conflicts. Assess baseline data This allows a shared/uniform understanding of health trends and patterns. It strengthens coordination across agencies Set up and manage a shared database This allows progress to be tracked and improves the management of HIV/AIDS Monitor activities

  39. Protection:Minimum response requirements  Prevent and respond to sexual violence and exploitation Gender-based violence intensifies in conflict. It increases the risk of Transmission of HIV and STIs. Orphaned and separated children face higher risks of abuse, exploitation and recruitment into fighting forces. Protect orphaned & separated children Ensure access to condoms for military, peacekeepers and humanitarian staff Peacekeepers, humanitarian staff and armed forces are vulnerable to STIs

  40. Water, Sanitation and Hygiene Protection:Minimum response requirements  People with weakened immune systems are less able to manage diarrhoeal diseases and other opportunistic infections. Consider HIV in water and sanitation planning Access to safe and culturally acceptable toilets and water points helps protect women and girls from sexual harassment and abuse.

  41. Food Security and Nutrition:Minimum response requirements  Target food aid to affected and at-risk households/communities. Protect food security of HIV/AIDSaffected and at-risk households and communities. Plan nutrition and food responses for populations with high HIV infection. Distribute food aid to affected households and communities. Promote appropriate care and feeding practices for PLWHA.

  42. Shelter and Site Planning:Minimum response requirements  Sites for displaced people should reduce the vulnerability of female-headed households and separated children, especially girls. Establish safely designed sites It may be necessary to set up a specific safe place within the site to protect separated children and female-headed households.

  43. Health:Minimum response requirements  Ensure access to basic health care for the most vulnerable Ensure IDU appropriate care Ensure a safe blood supply Manage the consequences of sexual violence Provide condoms and establish condom supplies Ensure safe deliveries Establish syndromic STI treatment Practise Universal Precautions

  44. Education:Minimum response requirements  Schools are effective sites for HIV/AIDS awareness, promoting human rights, tolerance and non-violent conflict resolution Ensure children’s access to education In HIV/AIDS-affected populations, parents may be less able to impart essential life skills. Children and young people who attend school are more likely to delay the age of first sex.

  45. Behaviour Change Communication:Minimum response requirements  Communication in emergencies helps people to maintain/adopt behaviours that reduce the risk of contracting HIV/AIDS. Provide information on HIV/AIDS prevention and care. It also helps those affected by or living with HIV/AIDS to access services and support.

  46. HIV/AIDS in the Workplace:Minimum response requirements  Prevent discrimination by HIV status in staff management Workplace information and education help increase respect, tolerance and understanding of workers with HIV/AIDS Provide post-exposure prophylaxis (PEP) for humanitarian staff PEP is a short-term antiretroviral treatment that reduces the risk of HIV infection after potential exposure.

  47. Summary – Key Points

  48. Introducing the IASC Guidelines Additional IASC HIV/AIDS resources Session 5

  49. Purpose: To provide background and context for the development of the guidelines To introduce the guidelines and their content To introduce complementary HIV/AIDS resources developed by IASC Introducing the IASC Guidelines

  50. Inter-Agency Standing Committee (IASC) was established in 1992 by GA Resolution 46/182. Primary mechanism for interagency decision-making in complex emergencies and natural disasters. IASC Task Force on HIV/AIDS in Emergency Settings developed these guidelines. WHO/What is the IASC? http://www.humanitarianinfo.org/iasc

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