Implementation Arrangements. Outcome III: Environment for effective AIDS Response is Enabled Strategic Outcome III supports both Strategic Outcomes I and II. Strategic Output 3.1 Enhanced use of strategic information to monitor HIV response coverage, quality and impact. Key Strategy 3.1.1: Monitoring & Evaluation system strengthened for improved programme implementation Key Implementation Strategies The PAS III Monitoring and Evaluation Framework was developed through consolidation of the Provincial AIDS Strategies M&E Frameworks and consensus among stakeholders on targets to be set in the Monitoring Framework. PAS III recommends enhanced use of strategic evidence to monitor service coverage, quality and impact. Many challenges exist in the current M&E system including incomplete data reports, lack of coherence among different MIS, lack of standardization of indicators across service providers, lack of age and sex disaggregated data, lack of systematic way to collate and validate data at the provincial level and absence of recent studies for key populations (except the IBBS 2011 and UNODC prison study of 2012). As a result, PAS III M&E Framework relies on various sources of data for baselines, target setting, monitoring and evaluation, while laying out concrete plans to strengthen a coherent MIS system. Effective implementation of the Pakistan AIDS Strategy depends on functional M&E Units at Federal and Provincial AIDS Control Programme levels staffed with an M&E Manager, Epidemiologist, M&E Officer and data entry operator. Similar units in private sector service providers will contribute towards a centralized MIS system collating and producing information at provincial and national levels. Output monitoring relevant to both programme monitoring and national level reporting will be done on quarterly basis and progress reports generated on quarterly and annual basis. Global reporting to UNAIDS is done on an annual basis through the Global AIDS Response Progress Report (GARPR). Most GARPR indicators are included in the PAS III Monitoring Framework, however, those we do not have information for will be reported on when and if information becomes available. Further, Integrated Biological and Behavioural Surveillance (IBBS) will be conducted every two to three years to monitor the trend and emerging threats. Periodic research (according to agenda), conducted at provincial level will also help in measuring outcomes and impact.
Provide support for approval of new laws and regulations at National level, if and when needed; Its members create enabling environment for implementation of the project. TACA Members include: 1. Minister, Ministry of NHSR&C Chairperson 2. Secretary, Ministry of NHSR&C Member 3. Secretary, Ministry of Finance Member 4. Secretary, Ministry of Religious Affairs Member 5. Secretary, Economic Affairs Division Member 6. D G,, Ministry of NHSR&C Member 7. Director General, Ministry of Technical Education & Training Member 8. Director General, Ministry of Overseas & HRD Member 9. Chief Health Planning and Development Member 10. Director General, Ministry of Information Member 11. Program Manager Provincial AIDS Control Program Punjab, Members 12. Sind, Baluchistan, Focal Person KP. Members 13. Country Representative UNAIDS, Members 14. Country Representative UNDP, Members 15. Country Representative UNICEF, Members 16. Country Representative WHO, Members 17. Country Director USAID, Members 18. Country Director DFID, Members 19. Chief Health Advisor, the World Bank. Members 20. Representative of PLHIVs. Member 21. National Program Manager Member Secretary National AIDS Control Programme The Provincial Steering Committees provide technical oversight and are responsible for overseeing the implementation of the PAS III. They will support in preparation of provincial operational plans, M&E Framework, development of guidelines and mechanisms for public private partnerships (based on lessons learnt) when services for KPs are outsourced, development of coordination mechanisms for working with PLHIV, CBOs, development partners, and public sector line departments, extend support to NACP for carrying out IBBS and other HIV-related research and development of standards, liaise with development partners funding agencies at both domestic and international levels, and help develop a risk mitigation strategy. District AIDS Councils Under GF Round 9 District AIDS Councils were initiated in five select districts by PR 1 for enhanced coordination with and among government departments at the local level for service provision to injecting drug users. Under PAS III DACs will be adapted to include representatives of other key populations in districts where they exist, and expanded to additional districts as needed. DAC support oversight by developing a coherent strategy and action plan to deal with HIV and AIDS in the district. They coordinate local efforts to ensure that services are properly delivered and to monitor effectiveness.
Facilitate strengthening of referral system for beneficiaries of HIV intervention for relevant services Ensure participation in multi sectoral meetings Ministry of Kashmir Affairs and Gilgit Baltistan Facilitate NACP and private sector organization(s) for HIV intervention in Gilgit/Baltistan and AJK Facilitate monitoring of HIV interventions in Gilgit/Baltistan and AJK Facilitate strengthening of referral system for beneficiaries of HIV intervention for relevant services Ensure participation in multi sectoral meetings National / Regional National TB Program Facilitate the revision of TB/HIV guidelines when required Facilitate provision of Anti Tubercular drugs and INH prophylaxis treatment for PLHIV, diagnosed with TB, in HIV clinics Ensure participation in multi sectoral meetings National/ Provincial Drug Regulatory Authority Facilitate inclusion of HIV related drugs in essential drug list Facilitate approval for manufacturing of oral substitute drugs suggested in National OST Strategy Ensure participation in multi sectoral meetings National Anti-Narcotic Force Facilitate OST intervention in the country Facilitate development of IEC material for OST strategy Joint monitoring of OST intervention sites including storage facilities Ensure participation in multi sectoral meetings National / Provincial Bureau of Employment and Overseas Emigration Facilitate development of IEC material for intending migrant workers Facilitate private sector organization on intervention for intending migrants National / Provincial
Provide technical assistance to NACP/PACP on HIV interventions and research on pre and postal management of HIV positive women Facilitate capacity building of identified divisional level hospitals in the country (with ART and paediatric treatment) Ensure participation in multi sectoral meetings UNODC Facilitate approval of National OST Strategy Facilitate in manufacture of oral substitute drugs in the country Participate in joint monitoring of OST service delivery sites and storage facilities Facilitate advocacy efforts to bring policy and legislations for relevant harm reduction interventions Ensure participation in multi sectoral meetings National/ Provincial UNDP Facilitate development /revision of relevant national HIV strategy and guidelines on MSM/TG interventions Ensure participation in sectoral meetings National/ Provincial UNHCR Facilitate private sector organization on intervention for refugees and internally displaced persons Facilitate strengthening of referral system for returned HIV positive refugees, internally displaced persons and their families Ensure participation in sectoral meetings National/ Provincial UNFPA Facilitate development /revision of relevant national strategy and guidelines on STI management Provide technical assistance to NACP/PACP on HIV interventions STI management Facilitate capacity building of identified divisional level hospitals in the country on STI management Ensure participation in multi sectoral meetings National/ Provincial
Bureau of Employment and Overseas Emigration Facilitate distribution of IEC material for intending migrant workers Facilitate private sector organization on intervention for intending migrants Facilitate strengthening of referral system for returned HIV positive migrants and their families Ensure participation in sectoral meetings Provincial CAA Facilitate complete and sustained coverage of HIV risk identification and referral information to airports with international flights (through Civil Aviation Authority) Ensure participation in multi sectoral meetings Provincial Health Care Commission / Health Regulatory Authority Facilitate policy introduction on regulating HIV testing in the Province according to WHO guidelines Ensure Blood Transfusion Authority is screening blood based on the WHO approved HIV Rapid testing kits Ensure Public and Private Laboratories/Health facilities are following the national VCCT guidelines for HIV testing Provincial Prevention and Control of Hepatitis Programme Contribute in development/revision of Continuum of Care guidelines for integration of Hepatitis Prevention and Control Programme with AIDS control programme in the Province. Contribute in clinical management of PLHIV for prevention and control of Hepatitis through provision of vaccines for Hepatitis B and Interferon for treatment of Hepatitis B and C to SDPs serving PWIDs and PLHIV on ART respectively Provincial Service Delivery Package implementers Manage the awarded HIV grant Establish fully functional Programme Management, Financial, PSM (where required) and M&E units Coordinate with relevant Provincial and District Provincial/ District
Every person has the right to marry and found a family People living with HIV are subjected to marital HIV testing in some countries, are denied access to reproductive healthcare services, pressured not to have children or to have sex, and even forcibly sterilized Denying people living with HIV access to marriage and family rights is unfairly discriminatory Education and training workshops on rights and law. Facilitated dialogue between affected populations, service providers and law enforcement officials. Involvement of people living with HIV and other key populations Every person has the right to fair labor practices People living with HIV are discriminated against and unfairly dismissed in the workplace on the basis of their HIV status Workplace discrimination denies employees with HIV the ability to earn a living when they may need income most. This increases the impact of HIV on their lives Does the implementing organization have an adequate policy on HIV in the workplace? Everyone has the right to freedom of assembly and association In some countries people living with HIV and other key populations are denied the right to organize and form support organizations Where laws or practices prevent key populations from organizing, they lose an important source of information and support to promote their health Does implementation plan reflect removal or amendment of such discriminatory laws? Every person has the right to freedom of movement HIV should not be treated differently from other diseases with regard to immigration, long-term residency or short-term visits to any country Countries that require information about HIV status, that deport people who are living with HIV, and who treat HIV differently from other diseases, can undermine access to healthcare, information and other human rights Any plans for bringing overseas ministry on board and sensitize them? Awareness raising and information kiosks at land, sea and air routes for passengers on HIV