Transcript EngenderHealth/UNFPA Project – Ethiopia/Ukraine

EngenderHealth/UNFPA Project –
Ethiopia/Ukraine
• Strengthening the integration of HIV prevention in
maternal health services.
• Increasing the capacity of MCH programme
managers and health providers to undertake HIV
prevention interventions for HIV-negative pregnant
and post-partum.
• Increasing access for prevention, treatment, care,
and support services for HIV-positive women and
adolescent girls.
Cost Analysis
• The costs were calculated for the following prevention
interventions:
– Behaviour change communication materials
– Group education sessions
– HIV/STI prevention counselling (including condom
demonstration/distribution and counselling on dual
protection)
– Voluntary counselling and testing
• Calculations of direct costs were based on staff time and
service/clinical procedure-specific supplies for the above
interventions.
• Calculations of indirect costs, including in-service training,
renovations, meetings, and space, were based on dividing
indirect costs among clients.
Average Costs and Savings
Country
Average cost of
providing HIV
prevention
services to
MCH clients at
pilot sites
($US)
Average savings
in ARV treatment
costs for averted
infections in
mothers ($US)
Ethiopia
$ 2,016
$ 60,480
Average savings in Average net
PMTCT treatment
savings ($US)
and OVC support
for averted
infections in
mothers and
infants ($US)
$ 10,976
$ 69,440
RH and VCT centre integrated
(India)
Costs
RH service alone = Rs. 130
VCT service alone = Rs. 86
40
35
30
25
20
15
10
5
0
Separate services = Rs.216
RH services/clinic day
VCCT services/clinic day
Feb-06
Jan-06
Dec-05
Nov-05
Oct-05
Sep-05
Aug-05
Jul-05
Jun-05
May-05
Apr-05
Mar-05
Feb-05
Jan-05
Dec-04
Nov-04
Oct-04
Combined services = Rs. 144
Sep-04
# Services per Clinic Day
Services used
Population Council/USAID
Benefits of Adding Family Planning to PMTCT Services
in 14 High Prevalence (PEPFAR) Countries, by 2007
200,000
150,000
100,000
FP
50,000
FP
PMTCT
-
FP
PMTCT
Child infections averted
Child deaths averted
Unintended pregnancies
averted to HIV+ women
FP
32,000
55,000
155,000
PMTCT
39,000
20,000
Source: USAID: www.usaid.gov/pop_health/pop/techareas/familyplanning/fppmtct.pdf
Cost-effectiveness of adding family
planning to PMTCT services
Cost per infection averted
Cost per child death averted
PMTCT
FP added to
PMTCT
1,300
660
USD
USD
2,600
360
USD
USD
Cost per pregnancy averted to HIV
positive mother
Source: USAID: www.usaid.gov/pop_health/pop/techareas/familyplanning/fppmtct.pdf
130
USD
Status of Prevention Efforts
Source: Bringing HIV Prevention to Scale, powerpoint presentation (amended), Global HIV Prevention Working Group,
June 2007, www.GlobalHIVPrevention.org
Intensifying HIV Prevention – Policy Actions
 Promote, protect, respect
human rights
 Build multisectoral
leadership
 Involve people living with
HIV
 Address cultural norms and
beliefs
 Promote gender equality
 Promote knowledge and
awareness
 Promote sexual &
reproductive health and HIV
linkages
 Support community- based
responses
 Reach affected groups &
populations
 Strengthen financial and
human capacity
 Remove legal barriers to
prevention
 Invest in new prevention
technologies
Intensifying HIV Prevention: UNAIDS Policy Position Paper 2005
http://www.unfpa.org/publications/detail.cfm?ID=255&filterListType=1
Intensifying HIV Prevention – Programmatic Actions
 Prevent sexual transmission of
HIV
 Prevent mother-to-child
transmission of HIV
 Prevent the transmission of HIV
through injecting drug use,
including harm reduction
 Ensure the safety of the blood
supply
 Prevent HIV transmission in
health-care settings
 Promote greater access to
voluntary HIV counselling and
testing while promoting principles
of confidentiality and consent
 Integrate HIV prevention into
AIDS treatment services
 Focus on HIV prevention among
young people
 Provide HIV-related information
and education to enable individuals
to protect themselves from
infection
 Confront and mitigate HIV-related
stigma and discrimination
 Prepare for access and use of
vaccines and microbicides
Intensifying HIV Prevention: UNAIDS Policy Position Paper 2005
http://www.unfpa.org/publications/detail.cfm?ID=255&filterListType=1
Gender Transformative Initiatives
Responsibility of men and boys for transforming their attitudes and behaviours in the
household, society, and in the wider world through, e.g., comprehensive sexuality and gender
education, and working with men on transforming models of masculinity to respect the human
rights of women
Strategies that empower women to exercise their rights, including to education, health services,
political representation, economic opportunities, freedom from want, violence, and harmful
cultural practices
Actions for Consistent & Correct Condom Use
Increase supplies of quality male and
female condoms
Provide condoms free of charge or at
affordable prices
Increase and diversify distribution
points
Promote both male and female
condoms for dual protection
Address negative perceptions and
myths about condoms with practical
advice
Build capacity of health providers and
clients to negotiate condom use
Preventing HIV in women, especially young women and girls
Initiate comprehensive sexuality education that promotes equality between men & women,
skills building & respect for human rights
Establish sexual and reproductive health care that integrates HIV
Address legal and policy barriers to accessing SRH and HIV care (e.g. age of consent, etc.)
Scale-up comprehensive PMTCT
Build self-esteem and impart skills for equality
in relationships.
Enforce legal age of marriage and prevent
child marriage
Empower economically
Eliminate stigma and discrimination against
women and girls, due to their sex and HIV status