Tools and Guidelines

Now more than ever, greater attention to human rights and legal issues in the context of HIV/AIDS is needed. Universal access to prevention, treatment, care, and support will never be achieved unless we take concrete steps to put human rights at the center of the fight against HIV/AIDS. This guide has been prepared by the Law and Health Initiative of the Open Society Institute’s Public Health Program to highlight the many legal and human rights-themed sessions, presentations, and other events at the XVII International AIDS Conference and its satellite events in Mexico City, Mexico.

In order to be effective, HIV/AIDS prevention and care programmes must address the broader factors that make people vulnerable to HIV/AIDS. Human rights abuses, stigma, discrimination and marginalisation stand in the way of people obtaining HIV/AIDS-related information, the means to prevent HIV infection, as well as care, treatment and support.

Supervision is the process of directing and supporting staff so that they may perform their duties more effectively. There are many functions of supervision, including motivating and training staff; sharing data and guidelines; monitoring and evaluating staff performance; managing day-to-day challenges; and facilitating organizational support. This handbook provides a quick reference to the principles and processes of effective supervision. It is intended to help supervisors work together with the clinic staff to provide the best possible services for the key population.

The module is divided into seven units. The units are convenient blocks of material and should be studied in the order in which they are presented. In addition, there are several appendices at the end of the module. The last three appendices guide surveillance officers through the process of developing an action plan and operations manual for establishing and maintaining an HIV case-based surveillance system. Throughout the module, small group discussion questions are designed to assist in the development of the action plan and operations manual. The expected outcome from this module is an enhanced understanding of HIV case-based surveillance as well as a completed (or nearly complete) action plan and operations manual.

To introduce HIV-related services in health and community facilities, it is essential that a rapid and comprehensive process of appraisal and implementation planning occur for each site. This process includes several steps to ensure that the proper contacts are made, accurate data are gathered and used for program planning, and comprehensive program planning occurs. Participants from technical and program support areas should be involved in all aspects of the process. This manual outlines the rapid appraisal and implementation planning framework used to plan service delivery in FHI-supported sites and provides tools to be used along the way.

The World Health Organization (WHO) recommends that national programmes establish capacity to provide early infant virological testing for HIV given the high risk of death by 2 years of age for infected infants and the increasing availability of paediatric antiretroviral treatment in many resource limited settings. Currently available assays and diagnostic platforms that should be considered by MOH programs for early infant HIV diagnosis include appropriately ongoing externally validated commercially and non-commercially available tests for HIV DNA (PCR) or HIV RNA. This document is a guidance note on consideration of options for selection of technology for early diagnosis of HIV in infants in resource-limited settings.

The global recommendations and guidelines on task shifting propose the adoption or expansion of a task shifting approach as one method of strengthening and expanding the health workforce to rapidly increase access to HIV and other health services. Task shifting involves the rational redistribution of tasks among health workforce teams. Specific tasks are moved, where appropriate, from highly qualified health workers to health workers with shorter training and fewer qualifications in order to make more efficient use of the available human resources for health. The recommendations and guidelines on task shifting have been developed in the context of efforts to rapidly increase access to HIV services in order to progress as far as possible towards the goal of universal access to HIV services by 2010. However, the impact of task shifting would not be restricted to HIV service delivery. The implications for other essential health services, and the potential for wider health systems strengthening, are recognized throughout.

The purpose of this course is to improve the management of national AIDS programmes by presenting a systematic process for developing and managing a comprehensive national AIDS prevention, care and treatment programme; and providing an opportunity to increase the knowledge and practice skills needed to implement such a process. The primary audience for this training is AIDS programme managers – individuals who have the authority and primary responsibility for managing national AIDS programmes. The secondary audience includes people who can influence decision-making about the programme. This training course will be repeated periodically to take account of the turnover of people in these key positions. The training course will initially be provided at the regional level, and may then be tailored to national needs and provided within countries, for state or provincial AIDS programme managers.

The two overriding goals of national AIDS programmes are to reduce the transmission of HIV and to care for and mitigate the impact of HIV on those already infected. Achieving these goals requires an understanding of the extent of prevalence of HIV infection and also where it is spreading.

Policy plays an essential role in guiding an effective response to HIV and AIDS. Governments use policy to state their views on a particular issue and declare the approach they will take to resolve or respond to that issue. Organizations use policy to explain to their employees the modalities of executing their work as well as norms of behaviour. Community groups use policy to advocate for what the community needs.