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Explore the challenges faced by Line Ministries in tackling HIV/AIDS, strategic response initiatives, coordination efforts, capacity building, and lessons learned in Sierra Leone.
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Coordinating Line Ministry Response To HIV/AIDS Sierra Leone’s Experience African Region Consultation on HIV/AIDS 14 – 18 February 2005, Addis Ababa, Ethiopia
Presentation Outline • Background • Challenges/Issues of Line Ministries responding to HIV/AIDS in their sectors • Strategic Response to address those issues • Challenges of Line Ministry Response • Lessons Learned
Background • Population is estimated at 5 million (Over 60% Muslims, 35% Christians and 5 % Others) • 1986 Establishment National AIDS Committee (NAC) • 1987 first HIV+ case registered • 1987 NAC was transformed into National AIDS Control Programme within the Ministry of Health and Sanitation. HIV/AIDS the business of Ministry of Health. Result -Lack of consistent commitment from the political leadership • Absence of strong advocates to champion the cause • Lack of appreciation of the developmental implication of the epidemic
Background Cont. • 2001 institution of Cabinet Sub-Committee on HIV/AIDS and Start of collaboration to with IDA with other partners to design a multi-sectoral HIV/AIDS Programme for Sierra Leone (SHARP) • 2002 Policy on HIV/AIDS enacted (1st in the History of SL) • 2002 NAC and NAS constituted to Coordinate National Response • 2002 CDC estimates HIV Prevalence at 0.9% (1st in the History of SL) • October 2002 SHARP effective & First time involvement of Non-Health Line Ministries in HIV/AIDS Control in Sierra Leone • 2004 Preliminary results of the first antenatal study reported an overall national prevalence of 3.4%
Issues/Challenges • Issues/Challenges foreseen onMulti-Sectoralityof HIV/AIDS Programmes - Three Key Issues to Respond To: - How do we ensure that these new comers actively participate in the drive to contain the epidemic? (Capacity Building) - How do we ensure that the activities of these players are not duplicated and to ensure that we derive value for money? (Coordination) - How do we ensure that partner support towards HIV/AIDS in ministries are coordinated? (Coordination and Openness)
Strategic Response to Issue of Capacity • How do we ensure that these new comers actively participate in the drive to contain the epidemic? • Establishment of HIV/AIDS Focal Point Offices and Constitution of Management Teams within Ministries • 15 Focal point Offices and Management Teams have been Established • Development of a Template Work Plan on HIV/AIDS focussing on awareness and partnership collaboration/creation • 14 Public Sector Institutions are getting support from NAS to implement Work Plans
Strategic Response to Issue of Capacity cont. • Training of Management Teams on basic facts on HIV/AIDS, modes of transmission, STls, Condoms and VCT, PMTCT, Stigma and Care for Persons infected, Financial Management etc. This has resulted to: • HIV/AIDS understood as a Development Issue • Commitment and active support of decision makers • Mobilisation of Resources (Counterpart and from Donors) to scale-up activities • Sensitisation of staff to recognize their personal risks to HIV infection and to be motivated to change • Knowledgeable, compassionate and skilled staff etc. • Increased involvement of staff in HIV/AIDS activities
Strategic Response to Issue of Coordination Inter-Departmental Coordination Mechanisms - Establishment of HIV/AIDS Focal Point Offices and Management Teams within Ministries for mainstreaming HIV/AIDS - Monthly meetings to review the activities of the Focal Point Person in the implementation of HIV/AIDS Work Plan Inter-Ministerial Coordination Mechanisms • Establishment of a Network of Permanent Secretaries that meets on a quarterly basis to review the performance of Line Ministries • Programme meetings of Focal Points convened by the Establishment Secretary’s Office (Department Responsible for Public Service) Result • Willingness to Learn, reflect and share experiences
Strategic Response to Issue of Coordination cont. Partner Collaboration - Programme meetings of partners operating in the Ministries - Sharing of information and joint programme implementation • Involvement of partners in programme design and resource mobilization Result • Provision of additional resources from partners to scale-up and to compliment activities in Ministries e.g. UNFPA, UNICEF, ADB, US DoD and most recently ILO - Technical and logistical support to the Ministries
Challenges of Line Ministry Response • Providing services for untargeted group • Synchronizing programmes (NAS and Partners) • Ministries raising the 10% counterpart funding • Continuous technical backstopping and monitoring of activities • Scaling-up and its Coordination
Lessons Learned • Template Work Plan for Line Ministries focussing on awareness creation and partnership collaboration contributes to the success of mainstreaming HIV/AIDS into the Ministry’s Delivery mechanism. • Community involvement in implementation of certain activities creates ownership and commitment from community members • Continuous Technical Backstopping to be provided by the Coordinator of the Public Sector Response to the HIV/AIDS Focal Point/Management Team to address problems as they arise • Advocacy of Top Leadership of the Ministry (Minister/Permanent Secretary) is required for commitment.