The document summarizes HIV prevention projects funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) in Serbia over 12 years. It discusses programs targeting vulnerable groups including injecting drug users, sex workers, men who have sex with men, prisoners, Roma people, and those living with HIV. Key activities included harm reduction, substitution treatment, condom distribution, counseling, and testing. Challenges faced included stigma, limited funding, and integrating services into the healthcare system. Over 200,000 people were reached through various programs implemented by the Ministry of Health and NGO partners across Serbia.
Integrating Community Strategy with HIV Programs:A Research Paper Appropriate...Stephen Olubulyera
Integrating Community Strategy with HIV Programs-A Research Paper Appropriate for Turkana County Setting-A review of evidence and implementation strategies
Learning Disabilities: Share and Learn Webinar – 27 April 2017NHS England
Creating a Dynamic Approach to Risk Stratification (including dynamic risk registers)
This webinar aims to share learning to help TCPs in developing a dynamic approach to risk stratification (which includes a developing dynamic risk register). The webinar provides the latest guidance from the national Transforming Care Programme and a real life example of how a TCP has approached the problem on the ground.
This webinar covers some of the same material as one run previously for North region TCPs on dynamic risk registers but also builds on that material with the latest guidance.
Peter Yeboah, MPH, MSc, Executive Director of the Christian Health Association of Ghana shares how CHAG works with the Ministry of Health in Ghana to provide health care and addresses challenges and how the organizations works to overcome them.
Integrating Community Strategy with HIV Programs:A Research Paper Appropriate...Stephen Olubulyera
Integrating Community Strategy with HIV Programs-A Research Paper Appropriate for Turkana County Setting-A review of evidence and implementation strategies
Learning Disabilities: Share and Learn Webinar – 27 April 2017NHS England
Creating a Dynamic Approach to Risk Stratification (including dynamic risk registers)
This webinar aims to share learning to help TCPs in developing a dynamic approach to risk stratification (which includes a developing dynamic risk register). The webinar provides the latest guidance from the national Transforming Care Programme and a real life example of how a TCP has approached the problem on the ground.
This webinar covers some of the same material as one run previously for North region TCPs on dynamic risk registers but also builds on that material with the latest guidance.
Peter Yeboah, MPH, MSc, Executive Director of the Christian Health Association of Ghana shares how CHAG works with the Ministry of Health in Ghana to provide health care and addresses challenges and how the organizations works to overcome them.
NACP (National AIDS Control Programme) launched on February 12 ,2014. The Objectives was:
- Reduce new infections by 50% (2007 Baseline of NACP III)
- Comprehensive care, support and treatment to all persons living with HIV/AIDS
The purpose of this briefing is to help you to identify the immediate priority actions to commission effective end of life care.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
The general population HIV prevalence stands at 5.1%(THMIS 2011/12) down from 18% in 1990.
HIV and STIs prevalence are also high among KP's, HIV is 31.4% while other STI has an average of 26% prevalence.
The number of KP's is not known, although there are fledgling groups of KP's which have started advocating for the Right to Health of KP's including protection against HIV infection, care and treatment to PLHIV KP's.
Putting insight into action – local authority response to the coronavirus pan...Si Chun Lam
Putting insight into action – local authority response to the coronavirus pandemic
Presentation to the Analytics Reading Group at Warwick Business School (WBS) on 9 November 2020
https://www.wbs.ac.uk/events/view/6771
Southwark and Lambeth-based projects Knee High Design Challenge, Diabetes Modernisation Initiative and Pathway explore what it takes to maintain change in the local healthcare system: understanding the issue & adapting to ever-changing context; gathering & maximising evidence; and building & maintaining meaningful relationships.
Find out more at www.gsttcharity.org.uk
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
On 9 February 2016 Guy's and St Thomas' Charity brought together health professionals, decision-makers, voluntary organisations, patient representatives and others in Lambeth and Southwark to explore ways of improving health by looking outside the confines of healthcare. We wanted to showcase and discuss approaches to improving health outcomes which tackle the wider aspects that impact on people’s wellbeing – from housing to education or social connections.
Speakers:
- Imogen Moore – Citizens UK
- Jeremy Swain – Thames Reach
- Catherine Pearson – Healthwatch Lambeth
- Ollie Smith – Guy’s and St Thomas’ Charity
Find out more about the event and our work supporting new ideas in health at www.gsttcharity.org.uk
Commissioning Integrated models of care
Kent LTC Year of Care Commissioning Early Implementer Site
Alison Davis, Integration Programme Health and Social Care, Working on behalf of Kent County Council and South Kent Coast and Thanet CCG's
Dr. Tonny Tumwesigye, Executive Director of the Uganda Protestant Medical Bureau describes the organizations composition and mission and explores how faith communities can be engaged in family planning education and promotion.
La voz de los pacientes en los proyectos de integracion de servicios del nhs ...Societat Gestió Sanitària
Ponencia a cargo del director de politicas y colaboraciones del National Voices en el National Health Service inglés, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
NICE have now published three guidelines which are relevant to the care and support of older people:
Home care: delivering personal care and practical support to older people living in their own homes
Transition between inpatient hospital settings and community or care home settings for adults with social care needs
Older people with social care needs and multiple long-term conditions
Alongside hosting three workshops, the NICE Collaborating Centre for Social Care is hosting a FREE webinar to introduce these guidelines together and enable frontline practitioners and managers to consider how they can support practice improvement.
NACP (National AIDS Control Programme) launched on February 12 ,2014. The Objectives was:
- Reduce new infections by 50% (2007 Baseline of NACP III)
- Comprehensive care, support and treatment to all persons living with HIV/AIDS
The purpose of this briefing is to help you to identify the immediate priority actions to commission effective end of life care.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
The general population HIV prevalence stands at 5.1%(THMIS 2011/12) down from 18% in 1990.
HIV and STIs prevalence are also high among KP's, HIV is 31.4% while other STI has an average of 26% prevalence.
The number of KP's is not known, although there are fledgling groups of KP's which have started advocating for the Right to Health of KP's including protection against HIV infection, care and treatment to PLHIV KP's.
Putting insight into action – local authority response to the coronavirus pan...Si Chun Lam
Putting insight into action – local authority response to the coronavirus pandemic
Presentation to the Analytics Reading Group at Warwick Business School (WBS) on 9 November 2020
https://www.wbs.ac.uk/events/view/6771
Southwark and Lambeth-based projects Knee High Design Challenge, Diabetes Modernisation Initiative and Pathway explore what it takes to maintain change in the local healthcare system: understanding the issue & adapting to ever-changing context; gathering & maximising evidence; and building & maintaining meaningful relationships.
Find out more at www.gsttcharity.org.uk
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
On 9 February 2016 Guy's and St Thomas' Charity brought together health professionals, decision-makers, voluntary organisations, patient representatives and others in Lambeth and Southwark to explore ways of improving health by looking outside the confines of healthcare. We wanted to showcase and discuss approaches to improving health outcomes which tackle the wider aspects that impact on people’s wellbeing – from housing to education or social connections.
Speakers:
- Imogen Moore – Citizens UK
- Jeremy Swain – Thames Reach
- Catherine Pearson – Healthwatch Lambeth
- Ollie Smith – Guy’s and St Thomas’ Charity
Find out more about the event and our work supporting new ideas in health at www.gsttcharity.org.uk
Commissioning Integrated models of care
Kent LTC Year of Care Commissioning Early Implementer Site
Alison Davis, Integration Programme Health and Social Care, Working on behalf of Kent County Council and South Kent Coast and Thanet CCG's
Dr. Tonny Tumwesigye, Executive Director of the Uganda Protestant Medical Bureau describes the organizations composition and mission and explores how faith communities can be engaged in family planning education and promotion.
La voz de los pacientes en los proyectos de integracion de servicios del nhs ...Societat Gestió Sanitària
Ponencia a cargo del director de politicas y colaboraciones del National Voices en el National Health Service inglés, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
NICE have now published three guidelines which are relevant to the care and support of older people:
Home care: delivering personal care and practical support to older people living in their own homes
Transition between inpatient hospital settings and community or care home settings for adults with social care needs
Older people with social care needs and multiple long-term conditions
Alongside hosting three workshops, the NICE Collaborating Centre for Social Care is hosting a FREE webinar to introduce these guidelines together and enable frontline practitioners and managers to consider how they can support practice improvement.
Design, Modelling & Analysis of Safety Impact Guard for Heavy Duty VehicleAM Publications
The problem of accident is a very acute in highway transportation. Traffic accident leads to loss of life and
property. We cannot avoid accidents completely but impact of accident we can reduce by applying safety measures, safety
instrument. Safety impact guard is one of the safety instruments which can reduce collision impact at rear end collision
when accident occurs. Also provide safety against under ride crashes which is cause due to passenger vehicle collides
with the truck or trailer. Proposed design of safety impact guard includes crushing element as force destroying material.
Because of that when rear end collision is occurs the force or energy or impact is destroyed due to crushing action.
Another aim of this project is to reduce the height of safety impact guard from ground so that the truck under ride
crashes should be avoided. So that we can save the life and prevent the loss of property. The objective of this entire
project would be of possible design of rear impact guard which provides safety against rear end collision.
This paper presents the development of smart order system in restaurant. The development of the system is
primarily concerned to integrate and provide network system rather than the stand alone system which indicates the use of
networking capabilities could provide efficient data communication as well as improved the management in restaurant. The
development of the system strictly follows the system development life cycle. Generally, the system can be divided into 2 main
components which are hardware design which are not discussed in details here and system development which primarily goals
of the paper. The results indicate that the system works fine with the data communication works as planned.
WIRELESS DEVICE POSITIONING AND FINDING INTRUDER USING RSSAM Publications
Wireless security is the prevention of unauthorized access or damage to computers using wireless networks.
The risks to users of wireless technology have increased as the service has become more popular. Wi-Fi can be less
secure than wired connections (such as Ethernet) because an intruder does not need a physical connection. By any
chance if the wireless device attacked by intruder it is hard to locate the device. Locating a wireless device in a Wi-Fi
network by calculating the distance of each node and localize the wireless accurately. A common measure to deter
unauthorized users involves hiding the access point's name by disabling the SSID broadcast. While effective against the
casual user, it is ineffective as a security method because the SSID is broadcast in the clear in response to a client SSID
query. Another method is to only allow computers with known MAC addresses to join the network. The robust location
estimation assumes the reference location in the target environment, the proposed location system maps the input to the
physical location using RSS algorithm. In SSID is the application software used to list the set of wireless device available
in the surrounding and it used to create a gpx file. Converting gpx file in a table format for further distance estimation.
Sandwich structures are now extensively used everywhere due to their high strength and less weight. In
this paper the impact tests on adhesively bonded sandwich beams are carried out. Sandwich beams with GFRP as a
core material having aluminium facesheets are transversely impacted by a rigid projectile at various impact velocities
of the projectile with the help of pneumatic gun. Various failure modes exhibited by the sandwich beams are
encountered which involves large inelastic deformation, core shearing and delamination etc.
SSR Damping Using GCSC and TCSC in Wind FarmsAM Publications
Wind Power is environmental friendly, emission free green source of energy and presently is growing in the fastest pace. Recent development concentrates at integrating doubly fed induction generator (DFIG) based wind power source coupled with capacitive flexible alternating current transmission system (FACTS) controllers suitable for long distance power transfer. However the extensive use of series capacitive compensators is faced with challenges of subsynchronous resonance (SSR) phenomenon which leads to turbine generator shaft failure if not prevented. This paper presents two methods of damping SSR phenomenon using gate controlled series capacitor (GCSC) and thyrister controlled series capacitor (TCSC)
In this issue of paradise 3.0 magazine.we the editorial team is proud to publish the articles to build
our next generation in a smarter way and empowering people with the touch of the button with the
power of technology.
Survey: Elliptic Curve Cryptography using Scalar Multiplication AlgorithmsAM Publications
Stopping unauthorized access to corporate information systems is crucial for many organizations. In which
Communication security is playing one of the key area of interest to protect the sensitive/valuable data. The data used in
communication is very sensitive/valuable and needs to be protected and made abstract from intruders of system or over the
network. The recent way to provide precious security mechanism of Network security is Cryptography using Elliptic Curve
architectures which is based on the arithmetic of elliptic curves and discrete logarithmic problems. ECC schemes are public-key
based mechanisms that provide Cipher text (Encryption), digital signatures and key exchange algorithms. The most crucial
operation in the cryptosystem is the scalar multiplication operation. In this paper, we study various scalar multiplication
algorithms with respect to the efficiency, weight and features etc. This paper gives an idea about algorithms and the areas where
we need to researchers can proceed further in the computation of cryptosystem.
Improved Utilization of Infrastructure of Clouds by using Upgraded Functional...AM Publications
This paper discusses a propose cloud infrastructure that combines On-Demand allocation of resources with
improved utilization, opportunistic provisioning of cycles from idle cloud nodes to other processes. Because for cloud
computing to avail all the demanded services to the cloud consumers is very difficult. It is a major issue to meet cloud
consumer’s requirements. Hence On-Demand cloud infrastructure using Hadoop configuration with improved CPU
utilization and storage utilization is proposed using splitting algorithm by using Map-Reduce. Hence all cloud nodes which
remains idle are all in use and also improvement in security challenges and achieves load balancing and fast processing of
large data in less amount of time. Here we compare the FTP and HDFS for file uploading and file downloading; and
enhance the CPU utilization and storage utilization. Cloud computing moves the application software and databases to the
large data centres, where the management of the data and services may not be fully trustworthy. Therefore this security
problem is solve by encrypting the data using encryption/decryption algorithm and Map-Reducing algorithm which solve
the problem of utilization of all idle cloud nodes for larger data.
Implementation Secure Authentication Using Elliptic Curve CryptographyAM Publications
Elliptic curve cryptography is the most efficient public key encryption scheme based on the elliptic curve concepts that
can be used to create faster, smaller, and efficient cryptographic keys. As a use of network increase for critical transaction, so
huge damages are caused by intrusion attacks hence there is the need of computer network security. To protect network against
various active and passive attack, various technique have been suggested. Mobile devices have many differences in their
capabilities, computational powers and security requirements. The security of mobile communication has stopped the list of
concerns for mobile phone users. Confidentiality, Authentication, Integrity and Non-repudiation are required security services for mobile communication.
MRC/info4africa KZN Community Forum | July 2012info4africa
Zukiswa Fipaza of the International Centre for AIDS Care and Treatment Programmes (ICAP) highlighted the activities of the Centre's MOSAIC Men’s Health Initiative and its role in supporting the Implementation of the National Strategic Plan for HIV and AIDS, STIs and TB (NSP). MOSAIC utilises an integrated and co-ordinated approach that aims to provide a tailored package of prevention, treatment, care and support services for men who have sex with men (MSM). By scaling up HIV-related services and support mechanisms for the MSM community, MOSAIC contributes towers South Africa’s national goal of reducing new HIV infections and strengthens health, whilst providing a model for expansion to other districts and service areas.
These posters were presented by Sydney Sexual Health Centre staff at the 2017 Australasian HIV & AIDS Conference in Canberra.
Topics included:
- Joint Care Planning in an Urban Publically Funded Sexual Health Centre: A New Case Management Model
- The Sexual Health Counsellors Association of NSW (SCAN): a Statewide Organisation for Sexual Counsellors in Publically Funded Sexual Health Centres
- Co-production as Model for the Facilitation of Learning About Challenges Faced by Those with Diverse Genders, Sexes and Sexualities
- Difficulties in Engaging Thai and Chinese Sex Workers in Smoking Cessation: a Cautionary Tale
- Unnecessary Examinations: What Would Be Missed if we Avoid Genital Exams for Women with Uncomplicated Vaginal Discharge?
The mission of the Sexually Transmitted Diseases (STD) Control Program is to reduce the occurrence of STDs through disease surveillance, case and outbreak investigation, screening, preventive therapy, outreach, diagnosis, case management, and education.
In cooperation with the Research and Evaluation Division of BRAC, Copenhagen Consensus Center organized roundtable discussions with an aim to figure out smarter solutions to the most problematic issues facing Bangladesh.
The intersection of opioid use and HIV is well documented. More than one-third of all AIDS cases in the U.S. are directly or indirectly linked to injection drug use. Additionally, dependence and abuse of pain relievers is on the rise; people living with HIV/AIDS who suffer from chronic pain may be at particular risk. Opioids are highly addictive and mortality among illicit opioid users is estimated at 13 times that of the general population. The SPNS Buprenorphine Initiative investigated the effectiveness of integrating buprenorphine opioid abuse treatment into HIV primary care settings.
This Webcast is the first in a series under the new SPNS Integrating HIV Innovative Practices project (www.careacttarget.org/ihip) to assist providers in replicating SPNS work in their sites. This Webcast will introduce providers to the SPNS Buprenorphine Initiative, its findings, its synergy with the National HIV/AIDS Strategy, and provide an overview of opioid use and HIV.
The subsequent Webcast in the series will examine the clinical aspects of buprenorphine therapy, best practices, and implementation guidance. See also Integrating Buprenorphine Therapy Into HIV Primary Care Settings, a monograph on best practices, available at: https://careacttarget.org/content/integrating-buprenorphine-therapy-hiv-primary-care-settings.
Report is made on the basis of inclusion guidelines for civil society organizations in the process of making regulations: Official Gazette of Republic of Serbia (conclusion 05 number 011-8872/ 2014), adopted by the Government of Republic of Serbia in Belgrade, on 26. August 2014. LAIC advisory process was conducted with the aim to engage and build a partnership public administration bodies and civil society organizations for active participation in the preparation, decision-making and monitoring with initiatives European Commission in order to ensure their effective and efficient implementation.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners
The Wessex Health Partners (WHP) strategic alliance has brought together partners from across Dorset, Hampshire and the Isle of Wight to explore how research and innovation (R&I) can improve population health.
The event, which was a first of its kind for Wessex, saw health and care and R&I leaders gather to discuss the key challenges and priorities for the region, and explore opportunities to address them through increased collaboration and partnership working.
More than 100 people attended the event, which took place at Southampton Science Park on Friday 15 March.
Primary care in Europe: can we make it fit for the future?Nuffield Trust
In this slideshow, we explore how and why primary care organisation and delivery needs to change and the factors driving this.
We draw on case studies from various European primary care experts who presented at the European Health Summit 2013, an event supported by KPMG, to review the extent to which different models of primary care are already achieving the characteristics of successful primary care, and how they are doing this.
Similar to Hiv prevention and care in serbia where are we after 12 years of gfatm funding - katarina mitić (20)
Changes of sexual practices of people living with hiv after initiation of ant...
Hiv prevention and care in serbia where are we after 12 years of gfatm funding - katarina mitić
1. HIV Prevention and Care in Serbia –
WHERE ARE WE after 12 years of GFATM
funding
Katarina Mitic
Maja Aleksic Ramadan
MoH of Serbia
2. HIV Prevention projects
implemented by the MoH of Serbia
GFATM Approved two five-year projects for Serbia to the
Ministry of Health as a Principal Recipient:
• Round 6 project in the amount of 9,186,190 EUR
(implemented from 1 June 2007 to 31 May 2012).
• Round 8 project in the amount of 5,783,639 EUR
(implemented from 1 July 2009 to 30 September 2014),
Total value of grants is 14,968,929 EUR
3. Goal: To stop the spread of HIV infection among
particularly vulnerable groups and to provide care,
support and treatment to people living with HIV
Specific objectives:
1. Providing universal
access to prevention, care,
support and treatment of
especially vulnerable
groups
2. Enhancing the quality of
care , treatment and
support for people living
with HIV
3. Creating environment
that provides support to
HIV prevention efforts
4. Strengthening the
capacity of health systems
to develop effective ,
affordable and sustainable
services for people living
with HIV
Implementers:
• MoH/Project Implementation Unit
• Non-governmental organizations
• Health authorities :
o Clinics for Infectious Diseases
o Psychiatric clinics/ centers for substitution
therapy
o Institutes for Public Health
• Ministry of Justice/Penitentiary
institutions
• Ministry of Labour and Social
Policy/Institutions for children and youth
deprived of parental care the
4. Activities
Field activities in the community in
order to change behavior among
IDUs , SWs, MSM, prisoners, young
Roma, children and youth in
institutions of social care
Counseling and testing for HIV
Condom distribution
Monitoring Performance of ARV
therapy
Care and support to chronically ill
Strengthening civil society in
response to HIV infection
Reducing stigma and discrimination
associated with HIV at all levels
Strengthening the national
system for monitoring and
surveillance of HIV infection
and targeted research
5. The project focused on the following vulnerable groups :
• Injecting drug users ( IDUs )
• Sex worker ( SWs)
• Men who have sex with men ( MSM )
• Young Roma and other marginalized youth
• Prisoners
• Children and youth placed in social welfare institutions
(juvenile delinquents, children in foster families) , and
• People living with HIV ( PLHIV )
6. Where do we work?
More than 40 towns in
Serbia
More than 60 institutions
and organizations
More than 70 projects
7. Harm Reduction - NSPs
The exchange of sterile
injecting equipment
4 Regional centers / NGOs
(Belgrade, Novi Sad ,
Kragujevac, Nis)
Since June 2007, a total of
3,887 new clients reached
Training on HIV prevention for NGO
activists ( peer educators , outreach
workers ) , police officers working in
health and social care
Expansion of the program and the formation
of so-called . mobile field teams working
with IDUs
Fieldwork : exchange of sterile equipment ,
distribution of condoms and IEC
materials, education on HIV / AIDS,
referral to VCT and treatment of sexually
transmitted infections
Strengthening the capacity and functional
connectivity of all relevant actors in the
NGO sector and institutions of the system
8. Needle Syringe Programs
Achievement
367,000 sets of sterile injecting
equipment and 14,000 boxes for
disposal of used accessories
distributed
Acquired 4 field vehicles (medical
mobile units)
Educated NGO activists for field
work and VCT , established
cooperation between the IPHs and
NGOs
Health care and social workers ,
police officers and pharmacists,
sensitized to work with IDUs
IEC materials (developed in
accordance with IDUs’ particular
needs), and condoms distributed
Challenges
Insufficient knowledge and lack
of understanding of the general
population for the program
Difficulties in promotion/
extension of programs, and
attracting of beneficiaries/IDUs
Treatment of injecting drug
related problems
Reducing stigma and
discrimination
The problem of contamination
in the local community
Implementation of programs in
the penitentiary institutions
Problems in cooperation
between institutions and NGOs/
private sector
9. Substitution treatment
The overall objective of this
program was to improve existing
services and to introduce
additional, as to include 3,000
IDUs in substitution treatment
26 centers for substitution
treatment in 20 cities (in health
institutions , covering three
levels of care )
Since June 2007 , a total of 2,719
new clients reached
Specific objectives:
Develop a stable network of
institutions working with IDUs
involved in substitution program
Decentralize services of the
methadone therapy at primary
health care level
Initiate positive changes in the
behavior of IDUs , supporting
their social rehabilitation and
inclusion into the health system
Encourage change in attitudes
and behavior towards IDUs
Promote respect for human
rights of IDUs
10. Substitution Treatment
Achievement
Improved legislation
Adopted “National guidelines
for substitution treatment”
Health workers trained
Centers’ premises refurbished
Increased number of health
institutions that provide
treatment
Introduced buprenorphine
Organized supervision
Established cooperation
between centers and IPHs (VCT
centers)
Challenges
One coordinating body, continuous
support ( budget and policy) for the
prevention of HIV / AIDS, care and
treatment of IDUs
Republic Expert Committee / MoH
(consensus of profession,
communication )
Further sensitization and training of
health professionals to work with
drug addicts
Defining the place and role of the
program in primary health care/
expansion of the program
Enhancing cooperation with the
penitentiary institutions , police,
centers for social work, labor market
11. HIV prevention
among sex workers
5 NGOs - Kikinda , Novi
Sad , Beočin , Novi Sad,
Belgrade , Kragujevac,
Nis, Zajecar ...
Since June 2007, a total
of 2,711 new clients
reached
• Developed standardized protocol / guide
for field work
• Organized trainings for field workers and
magistrate judges
• IEC material developed and distributed
• 3 vehicles for field work procured,
specially adapted to the needs of SWs
• Engaged professionals to perform
examinations, provide advice
(psychological, social , legal ) in mobile
units
• Provided counseling on HIV and STIs ,
IEC materials , condoms and lubricants ,
and instructions for VCT/ testing with
rapid tests
12. HIV Prevention among sex workers - challenges
Incorporation of services into the system/ sustainable funding of
services provided in the field
Increasing the availability of HIV prevention services for SWs as
multiple vulnerable clients
The inability to make decisions, low income , limited “mobility ",
auto- stigma
Stigma, discrimination, violence (from insults to physical
violence and economic exploitation)
Further sensitization of health care/ social workers, police
officers , improving mutual communication
Changes in legislation and policies
13. HIV Prevention among man having sex with men
4 NGO - Belgrade , Novi Sad,
Sabac , Valjevo , Loznica ,
Sremska Mitrovica , Kragujevac,
Nis , Uzice, Cacak
Since June 2007, a total of 47,367
new beneficiaries reached
Provided counseling about HIV
and STIs, IEC materials ,
condoms, lubricants, and
referral for VCT/ rapid tests
Procured one vehicle for field
work
Developed standardized
protocol/ guide for field work
Conducted trainings for field
workers, health care workers,
police officers, journalists, in
order to reduce stigma and
discrimination against the LGBT
population
Provided online counseling
Provided fees for project
coordinators and administrators,
field workers, and consultants in
mobile teams
14. HIV Prevention among MSM Population - challenges
Increase in HIV prevalence among MSM population
Decentralization of health services for MSM
Bridging the gap between health care and other state
institutions whose clients are MSM
The sustainable funding of services provided on the
ground ( NGOs)/networking in the local community
Homophobia
Stigma and discrimination (status of HIV-positive
MSM )
15. HIV Prevention among Prisoners
The program is implemented in 12
prisons (as of June 2007, a total of
6,214 inmates reached)
Developed a “National guideline for
Health in Prisons” (HIV prevention,
treatment of drug addiction)
Conducted trainings on substitution
treatment for medical workers and
associates, and established
cooperation between penitentiary
institutions and substitution centers
Penitentiary staff trained on HIV,
hepatitis and other STIs prevention,
and their knowledge transferred to
inmates through workshops
Conducted training on VCT for health
workers and associates
Established cooperation with VCT
centers in the community, as well as
with NGOs that perform rapid HIV
testing in mobile units
•Multiple ways of HIV and STIs
transmission (injecting drugs,
sexual route of transmission,
tattoos, violence)
• Standardization of services for
substitution treatment among
prisons
•Establishing better
communication between
penitentiary and health
institutions in order to improve
monitoring, reintegration , and
resocialization
•Empower NSP, expand condoms
and lubricants distribution
16. HIV Prevention among Roma
3 NGOs - 10 cities ( Subotica, Novi
Sad, Subotica, Sombor , Smederevo
, Kraljevo , Kragujevac, Nis , Vranje ,
Bor, Obrenovac )
Since June 2007 , a total of 25,698 new
Roma reached
Achievement
Organized and conducted
training sessions for peer
educators and outreach workers
IEC material developed
Health mediators who provide
counseling for behavioral
change and risk reduction
included in a field work
Provided referrals for VCT,
treatment of STIs and screening
for tuberculosis
Challenges
Further improvement of health
care of Roma population, by
providing information
Changing attitudes towards
reproductive health ( rights and
obligations )
Increased access to health and
social institutions through peer
support, support of Roma
mediators
Legal representation in cases of
violations of the rights of
patients
17. HIV prevention among children and Youth deprived of
parental care/placed in institutions
Center for Protection of Infants ,
Children and Youth , Belgrade,
Zvečanska 7 ( 10 cities )
Education of staff and children/
youth using a “Guide for Life
Skills Based Education”
Since June 2007 , a total of 1,733
beneficiaries reached
The training program based on life
skills ( LSBE ) takes place in
cooperation with the homes for
children deprived of parental care
centers, foster care (foster families )
and social welfare centers in Serbia
Education of staff/teachers and
other professional workers, and
children /youth ( as peer educators )
Manual accredited at the Ministry of
Education
The program covers children and
young people in 10 institutions and
foster families
Distributed IEC materials , condoms
VCT testing, and referrals for
VCT/STIs centers
18. Enhancing the quality of care , treatment and support
for people living with HIV
Treatment Literacy
The standardized curriculum that
should encircle the topic of use and life
with ARV therapy :
• Immunology and virology
• Antiretroviral therapy
• Side effects , opportunistic
infections
• Resistance and interactions with
other medications
• Adherence
• Proper nutrition
• Reproductive health
• The long-term life managing with
ARV therapy
740 people living with HIV trained
Other activities
7 PLHIV organizations reached 1,006
people in six towns in Serbia
Strengthening regional centers and
support the formation of new
organizations to support PLHIV
Rent and refurbishment of premises,
honoraria for coordinators,
administrators, consultants
Trainings for the improvement of
knowledge and skills/ courses that can
expand chances for employment
(computer, languages, driving)
Legal and administrative counseling
Reference to professional services to
obtain/ maintain rights to social and
health care
Psychosocial support for PLHIV and
families
Trainings in the local community
(informing, networking, advocating)
19. Voluntary Confidential Counseling and Testing
VCCT
16.340 counseled and tested in 36 health care institutions, institutions for
execution of penal sanctions and CSOs
23 institutes of public health in Serbia connected through regular quarterly
meetings, joint participation in promotions, campaigns, marking significant
dates
Services in penitentiary institutions
Trainings on principles of VCCT conducted
Established the system of referral and reporting between institutions and
NGOs
Developed VCT national data-base
Participation of employees of IPHs in the work of mobile teams (vehicles),
enabling hard to reach populations to receive the services in a place that suits
them and where they will not feel threatened, stigmatized and discriminated
against
Strengthening Capacities (research of second generation surveillance of HIV
infection)
20. Health systems strengthening to develop
effective, affordable and sustainable services for
people living with HIV / AIDS
Bio-behavioral research (4)
Research on the quality of life of people living with HIV
The survey on knowledge, attitudes and behavior of health
workers (KAB) related to HIV infection
Survey in general population
PLHIV Stigma Index survey
Strengthening the National M&E System
21. Creating an environment that supports the HIV
prevention efforts
Trainings
123 training, trained 2,540
participants
• Trainings on HIV prevention
for NGOs Strategic planning
• Project design and
fundraising in the local
community
• Training for journalists,
priests and decision-makers
• Training on the principles of
bio- behavioral research
Health communication :
Establishing a structure for
transmitting messages tailored
to the unique needs of target
groups
Improving communication skills
of those who should pass the
messages
The implementation of activities
based on evidence
IEC material
Campaigns
22. Conclusions
• Existing HIV prevention services are
enriched and expanded, new ones
introduced, standardized, and set
number of members of the populations
at risk is reached
• Improved knowledge and skills for the
protection not only of HIV infection but
also from hepatitis and other sexually
transmitted infections
Improved knowledge about HIV project
target groups and the general population
The number of people counseled and
tested for HIV increased
Improved conditions for treatment and
the implementation of substitution
treatment in health care and in the
penitentiary institutions
Provided the continuous monitoring,
better planning and timely detection of
new infections, and therefore the quality
of treatment of PLHIV
Enhanced cooperation among
governmental and non-governmental
sector in the field of HIV prevention,
defined common objectives, cooperation
mechanisms and activities
It enables the delivery of health services
outside the health system
The status of NGO activists promoted
4 bio-behavioral surveys completed the
picture of HIV infection in Serbia ,
pointed out the problems and pave the
way towards the development of
programs to meet the needs
23. Sustainable Services
Out of numerous services partially/fully financed by GFATM the
following became sustainable (funded from the national budget):
- HIV preventive program in 12 prisons
- LSBE in institutions for children deprived of parental care
- Harm Reduction Programmes for drug users/substitution treatment
(methadone and buprenorphine) in 26 health centers and prisons
- HIV prevention among Roma (included in curricula with STIs,
performed by health mediators, and funded from the budget/other
donors)
Besides that, the following services are available:
- HAART for registered HIV positive patients in four AIDS clinics
- Testing for HIV positive patients (needs improvement)
- VCCT in 23 institutes of public health (need to be improved)
24. HIV PROGRAMME GAP - 1
- Outreach Voluntary and Confidential Counselling and Testing on HIV
In newly registered cases in 2014. every forth patient discovered his/her status in the
terminal clinical stage of HIV infection. It is important to enable counsellors to
“leave” their institutions and work in partnership with the civil sector organizations
in the field/ medical mobile units. It is desirable to increase use of rapid tests, to
provide (simultaneous) testing on Hepatitis B and C, and to make VCCT accessible
on the primary healthcare level
- Harm Reduction Programmes among drug users
Outreach work in drop-in centres is not performed within the health and/or social
systems. From 2004 to 2014 the programmes existed in continuity and they were
complementary with substitution therapy, which maintained HIV prevalence on a
low level (up to 1.5% in 2013). With the end of the GFATM programme the majority
of drug users not in treatment programmes, will be left with no support. There will
be an increased use of non-sterile injection equipment and other forms of risk
behaviour, increasing the prevalence of HIV and HCV infection among drug users.
25. HIV PROGRAMME GAP - 2
- Outreach/Mobile Medical Unit and Drop-in centres for the most-at-risk
populations (SWs, MSM, IDUs)
Outreach work and drop-in centres are not a part of the official healthcare and/or
social system, so that with the end of the GFATM programme the majority of
vulnerable individuals will be left without any support. Outreach work and
drop-in centres represent the most important prevention strategy in HIV
response. The lack of these strategies also excludes the possibility of any kind
of HIV monitoring, as well as the possibility to provide care for a number of
health disorders to vulnerable individuals and the rest of the population, who
have close ties with these individuals.
- Care and support programmes for PLHIV
Satisfaction with social relationships, provided support and inclusion in the
society was expressed by 41.6% of responders, while quality of life and health
was satisfactory for the 13.3% responders. Education, development of social
support systems, strengthening the capacity of NGOs and continuing fight
against discrimination are essential conditions for improving quality of life of
people living with HIV.
26. Partnerships
The purpose of co-ordination and partnerships is :
• to avoid duplication
• to identify gaps and needs
• to build upon one another’s abilities and skills
• to maximize coverage
There is little indication of well-functioning co-ordination structures in
the communities
Most organizations co-operate with a few organizations that they have immediate
and practical need to have contact with
Such contacts are usually not formalized and are sporadic rather than regular
Partnerships between community organizations
Competition between community organizations working in the same field
Competition for clients and territory
CBOs are often driven by a leading individual and such individuals are identified
with the organizations they start and support over the years
27. PLHIV associations
The fact that people involved in community organizations
are often directly affected by HIV/AIDS places considerable
pressure on them to respond
In this context opportunism and self-enrichment are
regarded with suspicion and tension emerges between the
‘opportunities’ offered by HIV/AIDS funding and the
humanitarian, community-motivated and philanthropic
motives for response
Such a backdrop provides a poor context for partnerships
28. Partnerships between CSOs and
government
60% of GFATM budget was disbursed to CBOs/NGOs. 40% to institutions
Little formal involvement of relevant community-based organizations in
planning new developments at local government level
No existing blueprint or published strategy for municipal-level HIV/AIDS
responses and the official Integrated Development Plans of the respective
municipalities are inadequate in their HIV/AIDS components.
Lack of involvement of community organizations in working within
government programmes is most notable in the case of the anti-retroviral
programmes which are largely hospital-based and which community
organizations have not as yet been formally drawn into, although they often
supply much-needed background support in an informal and unrecognized
way
There are also often insufficient linkages between public sector institutions,
such as IPHs that provide VCT, and community organizations such as support
groups, which provide on-going support to infected individuals in the
community itself
29. What do we have
Health Insurance Fund Ministry of Health
HIV treatment
Diagnostics
Surveillance in a small part
Not transparent system of
contracting and slow
procurement procedure
Health-care institutions (their own
sources)
„Programmes of general
interest“ covering prevention
and control, surveillance and
part of diagnostics
Provided by public health
institutes
Small grant for non-profit
organization
30. What do we have
Ministry of Youth and
Sports
Autonomous Province of
Vojvodina
Small grant for preventative
programmes targeted young
people
Provided by non-profit
organizations
Often do not fit the National
strategy for HIV Infection and
AIDS
Other ministries, agencies and
institutions at national level don’t
participate in financing of national
HIV response
Financing of small non-profit
organization projects through
Secretariat for health, youth and
education
Local Self Governments
• Only a few local self governments
financing HIV response identified
• Usually small grants for projects
for young people
• City of Novi Sad continuously
supports VCT and support for
PLHIV
31. Scenarios
Full integration – 2,620,000 EUR
Integration of only effective and
efficient programs – 1,020,000
EUR
Integration of only effective and
efficient programmes, but to
reach universal access –
2,160,000
Significant role of local self
government
Example of City of Novi Sad: in
2011 spending for HIV
programmes 0.052 EUR per
capita
Integrated approach –
participation of different
ministries in financing of
national HIV response
Besides MoH and MoY also
participation of ministries of
interior, defense, labor and
social policy, science and
education, regional
development, justice, culture
and information
For the national level it would
make 370,275 EUR yearly
In the case of 0.1 EUR spending
of local self-government for HIV
programmes, it would make
712.067 EUR