Most At Risk Populations' Society in Uganda ( MARPS IN UGANDA) plan 2013-2030

MOST AT RISK POPULATIONS AS STAKEHOLDERS IN THE HIV RESPONSE AT NATIONAL LEVEL PLAN: 2013-2030

Theme: "Gauging our steps Post MDGs 2015’/Sustainable Development Goals With Emphasis On optimal ARV Adherence"

Objective 1:  Strengthen and consolidate implementation of strategies for the prevention and control of AIDS, TB and MALARIA targeting MARPs in Uganda

1. Define MARPs and risk factors e.g., : Young sexually active ( Negotiation Issues), Substance users (Risk impaired protection practices), Health Occupational workers ( exposure to TB and Hepatitis), People in long term relations (multiple partners) , PWD (negotiating issues) , MSM( Protection issues and exposure to Hepatitis,/Cancer), LGBTIQQ ( Protection issues and exposure to Hepatitis/Cancer), Sex-workers (Protection issues), PLHIV ( Co-morbidities’  issues), Fisher-folk ( Multiple partners), Uniformed services ( Multiple partners), in-mates (negotiation and protection), Mobile traders ( multiple partners), Truckers ( multiple partners) and Cleaners/Garbage  collectors ( exposure to medical waste ).
2. Outline services: Health, legal and other social services
3. Establish a country-specific profile of organisations targeting MARPs.
4. Strengthening and enlisting a buy-in by technocrats in recognizing needs of MARPs.
5. Support implementation of MARPs targeting Policies and Guidelines.
6. Establish sustainable mechanism for continual capacity building for providers to address MARPs issues
7. Establish strategies that improve awareness of MARPs needs to general community and stakeholders
8. Provision of adequate basic equipment and supplies such as sexual reproductive health ( SRH) commodities
9. Streamline services targeting MARPs 
10. Monitoring and evaluation of compliance to guidelines for providers.

Objective 2: Promote a non-discriminating/stigmatizing atmosphere for MARPs

2.1 Involve policy-making entities in providing a non-criminalizing atmosphere targeting MARPs.

2.2 Ensure linkages and referral systems through which MARPs issues are addressed are supported

2.3 Establishment of MARPs friendly services in all facilities.

2.3 Strengthen capacity for provision of PEP/PrEP and HPV vaccination services including provision of necessary SRH supplies and logistics

2.4 Mobilize MARPs to take up services

Objective 3: Promote Evidence Based Practices

3.1 Baseline survey for MARPs and MARPs targeting organisations.

3.2 Establish a harmonized service provision targeting MARPs

3.3 Support relevant research on contribution of MARPs to transmission of HIV

3.4 Establish mechanisms for prevention of anal sexual transmission of HIV/AIDS (PASTRA).

Objective 4: Enhance community systems to address MARPs issues

4.1 Build capacity of district level resource persons in the promotion of community interventions for services targeting MARPs

4.2 Mobilize public to participate in community interventions targeting eradication of violence, violations, abuse, discrimination and stigma

4.3 Develop and launch anti-HIV Campaign incorporating MARPs issues

4.4 Support community initiatives to enable MARPs become key actors in prevention and control

4.5 Establish and maintain Prevention Programmes targeting Most At Risk Populations –MARPs- (Encourage examination for cancer, HPV Vaccination, HIV-Education, Prevention and Management, PEP, PrEP, HCT, condom distribution, New Prevention Technologies, referral, Commodity supply chain management, and needle exchange programme.)

Objective 5: To ensure health facilities (hospital and health centers) have the capacity to provide quality services key to MARPs

5.1 Ensure compliance with Infection Prevention and Control procedures and guidelines during Medical Male Circumcision 

5.2 Ensure friendly cancer examination services

5.3 Ensure access to ART.

Objective 6: Monitor and evaluate MARPs targeting services

6.1 Institute a reporting, monitoring and evaluation mechanism of all organisations targeting MARPs.

No	Description	Indicators	Responsibility
	Objective 1:  Strengthen and consolidate implementation of strategies for the prevention and control of AIDS, TB and MALARIA targeting MARPs in Uganda
	Define MARPs as:  Substance users, Health Occupational workers , People in long term relations, PWD, MSM, LGBTIQQ, Sex-workers, PLHIV, Fisher-folk, Uniformed services, in-mates, mobile traders, Truckers and waste handlers/Cleaners.	No of organisations targeting particular MARPs and those facing low-targeting. Assess needs of at risk populations and key affected populations.  Stakeholder profile	IPs , Amicaall, Development Partners, UNAIDS, World Bank, MJAP,  Correctional facilities, Ministry of Justice, MoH, NDA,JCRC, MARPI/STD Clinic, Butabika,  UAC, MoGLSD, Ministry of Internal Affairs, Ministry of Transport/Communication, Ministry of Local Government, MARPS IN UGANDA, SMUG, UHMG, RHU, AIC, Cleaning firms, Marps Network, UNASO, TASO, Mild May, IRCU, MoES, other CSOs).
1.1.1	Support  organisations to access funding, establish a MARPs Coordination and Technical Group ( MCAT-G) /Teams to identify/fill gaps in order to improve best-practices in healthcare settings	-No of organisations registered and targeting MARPs ( Names, registration certificates, objectives, contacts) -No of organisations implementing integrated HIV/TB/Malaria programmes targeting MARPs.	Do
1.1.2	Profile of organisations registered to target MARPs	do	do
1.1.3	Establish and support organisations in form of trainings, harmonization and task identification	No of organisations supported	Do
1.1.4	Support organisations to develop annual work plans and roll them into the national work plans	No of  organisations with work plans	do
1.1.5	Establish a national surveillance and reporting point (Install  computers, accessories and install software programs for surveillance to improve data management and easy retrieval)	No of organisations contributing to this exercise.	Do
1.1.5	Train and support organisations in advocacy and self determination skills	No of organisations trained and supported	do
	Outline services: Health, legal and other social services	Organisations categorically addressing specific /various services	do
	Establish a country-specific profile of organisations targeting MARPs.	-No of organisations contributing to HIV response by MARPs - Established contacts and work plans	do
	Strengthening and enlisting a buy-in by technocrats in recognizing needs of MARPs.	No of stakeholders attending a national stakeholders meeting to deliberate on MARPs issues	do
	Support implementation of MARPs targeting Policies and Guidelines.	-Organisations supported and oriented through policy frameworks affecting MARPs programming - No of organisations introduced to establishing formal human resource policy, HIV Work place policy and Equal opportunities Policy.	Do
1.5.1	Establish an updating mechanism of MARPs issues into  various policy and Guidelines (PEP Policy Guidelines; Develop PEP Implementation Guidelines; and disseminate all policies, standards and guidelines )	Policies, guidelines updated or developed	Do
1.5.2	Procure commodities and supplies for adhering to standard prevention targeting all MARPs	No of organisations distributing Prevention and Control  supplies	IPs/NMS
1.5.3	Provide support to organisations to engage in widespread knowledge and awareness about standard precautions to improve demand creation for prevention prophylactics and adherence to Standard Prevention  Precautions	-Prevalence of tolerance campaigns through media and UPR at service points -Proportion of beneficiary population exhibiting appropriate knowledge, behaviour/practices that are risky and alternatives.	MoH/IPs
1.5.4	Auditing practices and giving feedback	No of organisations engaged in conducting auditing practices and giving feedback	All IPs
	Establish sustainable mechanism for continual capacity building for providers to address MARPs issues	No of organisations supported to implement continual  prevention and control training/coaching programmes for beneficiary actors ( e.g., integrated approaches to HIV/TB/Malaria Programming)	do
1.6.1	Establish and build capacity of National trainer Team from  various MoH departments and divisions in IPC	National Trainer Team established	MOH-ACP/C.S/Q/A
1.6.2	Train DHT/IPs in comprehensive Prevention and Control	No of DHTs and IPs trained in comprehensive  prevention and control	MOH-ACP/C.S/Q.A
1.6.3	Training of leaders in social services’ institutions in addressing MARPs issues	No of institutions with key leaders trained and able to mobilise MARPs to contribute to HIV response	All
1.6.4	Train organisations in comprehensive Prevention and Control to form peer trainer workforce	No of organisations whose key contact persons are trained in Prevention and control	All
1.6.5	Regular updates/circulars on MARPs issues	No of circulars/updates developed and sent No of organisations that received updates or circulars on MARPs	All
1.6.6	Establish focus days or events or fares for continuous personal development and Health Education for public on MARPs.	No of organisations engaged in focus days or events or fares	All
1.6.7	Induction courses for newly recruited staff	- No of organisations having and implementing an equal opportunities policy. -No of facilities conducting induction courses for new recruits - No of organisations having an HIV work place policy	All
1.6.8	Train all providers in prevention and control best practices such as report writing and analysis of records	Number of organisations sending a focal person who in turn has trained others in  prevention and control skills in the last 12 months	All
1.6.9	Support exchange visits and scholarships to centers of excellence and conferences	Number of organisations and persons supported and participated in study tours	All
	1.7 Establish strategies that improve awareness of MARPs needs to general community and stakeholders	No 0f organisations supported	All
1.7.1	Establish mechanisms for conducting community fares to promote awareness on MARPs issues	No of organisations engaging communities in talks and discussions on MARPs issues	All
	Provision of adequate basic equipment and supplies such as sexual reproductive health ( SRH) commodities	-No of established condom, lubricants, Various SRH Commodities and microbicide distribution points - No of organisations supported to mobilise MARPs to engage in prevention practices ( e.g., Medical circumcision,  cancer examination and HPV vaccination) - No of organisation trained in proper disposal practices	All/NMS/NDA
1.8.1	Mapping facilities with adequate basic equipment and supplies for implementing standard precautions.	No  of facilities with adequate basic equipment and supplies	MOH/Clinical Services
1.8.2	Forecast and budget  required for equipment and supplies	Budget for required equipment and supplies available	All
	Lobby funds to procure/procure required equipment and supplies	Funds available and equipment and supplies procured	All
1.8.3	Distribute basic equipment and supplies	Percentage of organisations that received basic equipment and supplies	NMS/IPs/NDA
	Streamline services targeting MARPs	No of organisations reporting about MARPs	All
1.9.1	Support organisations to implement work plans and be able to report about their progress	No of organisations supported	All
1.9.1	Advocacy meetings for  key stakeholders and partners	-No of meetings held -No of Partners supported -No of reports made -A directory of MARPs targeting organisations developed.	All
1.9.2	Regional meetings to establish Coalitions among Implementing Partners	Regional  coalitions established	All
1.9.3	Meetings of Regional Health Care Waste Management  Coalitions	No of regional meetings held	Chair of regional coalition /IPs
1.9.4	Build capacity of Implementing Regional Partners in handling MARPs	-No organisations supported to build capacity of regional coalitions	All
	Monitoring and evaluation of compliance to guidelines for providers.	-No 0f organisations compliant. - Reports highlighting best practices, challenges and practical suggestions.	All
1.10.1	Establish a national award / merit mechanism for best implementers	No 0f organisations engaged in this exercise. - Established progress indicators and categories for awards	All
1.10.2	Regular support supervision	Percentage of organisations given support supervision in prevention and control	Identified team
1.10.3	Award giving as a means of motivation	Percentage of organisations engaged in competitions for  awards	MoH/Quality Assurance
1.10.4	Assessment reviews in report form	Report of assessment review	MoH/Health Facility Managers/IPs
1.10.5	Benchmark  according to standards	Benchmark ratings	MoH/Q/A
	Objective 2: Promote a non-discriminating/non-stigmatizing atmosphere for MARPs
	2.1 Involve policy-making entities in providing a non-criminalizing atmosphere targeting MARPs.	No of meetings to clearly engage policy and programme actors in planning for a non discriminating and non-stigmatizing atmosphere in Uganda	All
2.1.1	Awareness meetings at national,  district and organisation level	No of meetings held No of actors met	All
	Identify/allocate resources	Resources allocated	All
2.1.2	Orient services providers in needs of MARPs and designing of means to inform policy and programme on these needs and effect of criminalization and stigma at national/Community grass-root level	-No of legal, health and social services providers involved and engaged -No of MARPs targeting organisations reporting an increase in demand of screening for HIV and TB , Immunization against Hepatitis B, cancer examination and anecdotal reports about UPR at points of  service delivery	All
2.1.3	Procure supplies for free screening and immunizing health workers( Cancer, TB and HIV screening;  Hepatitis B vaccine)	Supplies for screening and Hepatitis B vaccine procured	CDC/WHO/IPs
2.1.4	Mobilize health workers and MARPs  for Hepatitis B vaccination, screening for HIV, TB and cancer	Percentage of health facilities and organisations engaged in this mobilisation work	MoH/IPs
2.1.5	Nationwide Immunization uptake against Hepatitis B	No immunized against Hepatitis B Virus	Facilities/IPs
2.1.6	On-going confidential HIV counseling and testing; and screening of health workers against TB	No of health workers confidently counseled and tested for HIV and TB	Occupational Health Unit/IPs
	2.2 Ensure linkages and referral systems through which MARPs issues are addressed are supported	No of service provision points for MARPs issues identified and linked         (Legal, health and social services)	All
2.2.1	Ensure national stakeholders’ meetings are comprehensive in representation	Platform to strengthen linkages	All
	2.3 Strengthen capacity for provision of PEP/PrEP and HPV vaccination services including provision of necessary SRH supplies and logistics (  establish the PVC strategy and PASTRA strategies) * PrEP/PEP prophylaxis, Vaccination and SRH commodities* Prevention of Anal sexual transmission of HIV-AIDS	No of organisations supported and involved in this drive	All
2.3.1	Assess capacity  of health facilities to provide PEP services ( MARPS IN UGANDA HIV/TB/MALARIA Focal Person to provide progress report on this by end of November 2011)	No of sites assed for capacity to provide PEP services, No of sites with capacity to provide PEP services	All
	Identify PEP core team at PEP service sites	No of PEP service sites with core teams established	Health Facility managers
2.3.2	Establish 24 hr PEP service in all health facilities - Redesign premises where necessary, Procure furniture,  supplies and equipment, identify PEP core team, train PEP core team and all health workers on the host unit in PEP service provision and SGBV management	-No of health facilities providing  24hr PEP services - No of MARPs targeting organisations notified of these services	ACP/Health Facility Managers/IPs
2.3.3	Support to PEP core team	No of facilities with PEP core teams being supported by IPs	IPs
2.3.4	Distribution of PEP  IEC material – Documentation forms, PEP registers	PEP IEC materials at districts and health facilities	MoH/District/IPs
2.3.5	Train Health workers/IPs in PEP and general Infection Control	No of health workers trained in PEP	MoH/IPs
2.3.6	Provide PEP services to health workers, all survivors of rape and defilement	-No of survivors of rape and defilement that received timely PEP services - No of PWD organisations aware of PEP points ( affirmative action)	Health Facility managers/NGOs/IPs
	2.3 Mobilize communities to take up PEP services	- No of organisations conducting community awareness fares and drives	All
2.3.1	Awareness meetings with District and Community leaders, IPs, to establish buy-in for communities	No of districts meetings held	MoH/ACP IPs
2.3.2	Regional meetings with the law enforcement fraternity and judiciary	No of regional meetings held for law enforcement and judiciary	ACP IPs
2.3.3	-School, entertainment and sports centers sensitization meetings - Transporters’ facilities sensitization meetings - Hotel and hospitality facilities sensitization meetings	-No of schools sensitized -No 0f entertainment centers sensitized -No of Sports facilities engaged in this -No of transport, repair garages and parking facilities engaged in this -No of brothels and sex-work points engaged in this - No 0f Hotel and hospitality staffs aware of PEP points	Districts/IPs
2.3.4	PEP Radio/TV spots and talk shows	No of radio/TV spots and talk shows conducted	Districts/IPs
2.3.5	Participate in community meetings to create PEP awareness	No of facilities participating in community meetings	All, Health Facility Manager-PEP core team/IPs
2.3.6	Identify and Support to community PEP mobilizers among  the VHT	No of PEP mobilizers given support by PEP core team or IPs	PEP core team/IPs
	Objective 3: Promote Evidence Based Practices
	3.1 Establish a MARPs Surveillance System(MARPs SS)
3.1.1	Baseline Survey	Report of Baseline Survey	All
3.1.2	Installation of software for aggregating data in resource center	Soft ware installed	MoH-Resource Centre
3.1.3	Development and dissemination of definition of issues to be surveyed; standards to be observed in auditing	Definitions developed and disseminated	MoH/Q/A
3.1.4	Launch of MARPs SS home page	Home page launched	MoH-Resource Center
3.1.5	Recruit all actors to participate in MARPs SS	No of actors participating in MARPs SS	All
	Training all organisations in standardized auditing and  surveillance	No of facilities and organisations with trained staff sin auditing and surveillance	All
3.1.6	Quarterly joint support supervision	Reports of supervision	All
3.1.7	Stakeholders’  meetings on MARPs programming progress	Report of stakeholders’ Meeting	All
3.1.8	Generation/dissemination of Annual reports	Annual reports	MoH/Resource Center
	3.2 Establish a harmonized service provision targeting MARPs
3.2.1	Medical transmission in Labour suits	Establish infection control committees ( HIV in Work place)	MoH/ Health Institution Managers
3.2.2	Medical transmission in dental units	Establish infection control committees ( HIV in Work place)	MoH/ Health Institution managers
3.2.3	Nosocomial infections following elective surgery	Establish infection control committees ( HIV in Work place)	MoH/Health Institution managers
3.2.4	Neonatal sepsis in regional and district hospitals	Establish infection control committees ( HIV in Work place issues)	MoH/Health Institution Managers
3.2.5	Drug Resistance of commonly used antibiotics	Establish infection control committees  to ease procurement( HIV in Work place issues)	MOH/Health Institution managers
3.2.6	Needlestick management	Establish infection control committees  ( HIV in Work place issues)
3.2.7	PEP for other MARPs see objective 2.3. above	See objective 2.3	All IPs
	Disseminate study reports	No of districts/Organisations/facilities with study reports	MoH/UAC/UNASO/TASO/ UHMG
	3.3 Support relevant research on contribution of MARPs to transmission of HIV	No of organisations showing contribution of MARPs to HIV response	All
	3.4 Establish mechanisms for prevention of anal sexual transmission of HIV/AIDS (PASTRA).	Mechanisms to popularise protected sexual intercourse	All
	Objective 4: Enhance community systems to address MARPs issues
	4.1 Build capacity of district level resource persons in the promotion of community interventions for HIV prevention and Control with emphasis on MARPs ( district specific MARPs and MARPs targeting organisations linked)	-Profile of MARPs - Profile of MARPs targeting organisations	All
4.1.1	Print and Disseminate Prevention practices specific to risky behaviours	No of participants that attended the dissemination meetings	MoH
4.1.2	Distribute Manual  and other IEC  to community health workers, District Health Teams, CSO and IPs	No of districts/community health workers with manual	DHO/IPs
4.1.3	Orient DHTs/IPs on prevention of HIV and other infections in communities	No of districts oriented	MoH/ All IPs
4.1.4	Train District and IP Trainers to train community workers in infection control	No of district and IP trainers trained	MoH/All IPs
	4.2 Mobilize public to participate in community interventions targeting eradication of violence, violations, abuse, discrimination and stigma
4.2.1	Establish community based fares and talk points to eradicate violence, violation, abuse, discrimination and stigma ( VADS), share experiences,  and identify support needs to include MARPs in HIV response and mitigate effects of VADS.	Assessment report	All
4.2.3	Awareness meetings with community leaders- political, religious, traditional, educationists, Security organs and parents’ committees.	No of meetings held	MoH/IPs
4.2.4	Orient VHTs and other community voluntary organizations in community prevention practices	No of community resource persons oriented	IPs
4.2.5	Health Education provided and promotion commitments generated during community meetings	-No of community meetings. -Venues where conducted	IPs
	4.3 Develop and launch anti-HIV Campaign incorporating MARPs issues
4.3.1	Launch and commemorate annual campaign week  targeting MARPs	Campaign launched and ongoing	IPs
4.3.2	Build district capacity to conduct fares	No of districts conducting fares	MoH/IPs
4.3.3	Support organisations to carry out fares	No of districts/facilities supported to  conduct fares	MoH/IPs
4.3.4	Hold camps in public squares and health facilities	No of districts with fares held in public squares and at health facilities	Districts/IPs
4.3.5	Support local music, dance and drama artists to compose and perform arts to improve tolerance of MARPs	No of districts conducting fares and involving performing artists.	IPs
4.3.6	Develop IEC materials (pamphlets, leaflets, T-shirts, caps etc)	IEC materials developed	MoH/IPs
4.3.7	Development of films and film shows in market places and public squares	Developed films being screened in communities	MoH/IPs
4.3.9	MARPs articles in major news papers, TV/Radio programs	Articles cited in major news papers	MoH/IPs
	4.4 Support community initiatives to enable MARPs become key actors in prevention and control
4.4.1	Support VHTs and other community voluntary Organizations with transport to create awareness about their activities	No of districts providing transport to VHTs and voluntary organizations	District/IPs
4.4.2	Training informal sector stakeholders in prevention and control practices (e.g., hair salons, film kiosks, food kiosks, washing bays, cleaners/waste handlers..)	No trained in infection prevention and control	MoH/IPs
4.4.3	Training traditional healers in prevention and control	No trained in infection prevention and control	MoH/IPs
4.4.4	Training Traditional Birth Attendants in infection prevention and control	No trained in infection prevention and control	MoH/IPs
4.4.5	Training Private Medical/dental Practitioners in infection prevention and control	No trained in infection prevention and control	MoH/IPs
4.4.6	Procure and distribute prevention commodities and supplies to community initiatives	No of community initiatives that received commodities and supplies	DLG/IPs
4.4.7	Conduct communities/institutions meetings to identify and form prevention ambassador groups	Number of community/institutional with ambassador groups status formed	MoH/IPs
4.4.8	Support (Transport and lunch allowances) ambassador groups in communities and education institutions	No of community  ambassadors supported with transport and lunch allowances	Districts/IPs
	4.5 Establish and maintain Prevention Programmes targeting Most At Risk Populations –MARPs- (Encourage examination for cancer, Medical Male circumcision, HIV-Education, Prevention and Management, PEP, PrEP, HCT, condom distribution, New Prevention Technologies, Commodity supply chain, referral, and needle exchange programme.)
4.5.1	Promote Harm Reduction Programmes, Map IDUs locations, to identify factors affecting their access to HIV prevention, treatment, care and support	-No of organisations oriented and introduced to Harm Reduction Principles -No of IDUs locations identified	IPs/ Butabika
4.5.1	Procure commodities for the needle  exchange program (needles, syringes and safety boxes) for IUDs	Commodities and supplies for NSP procured and ready for distribution	MoH/IPs
4.5.2	Build the knowledge and capacity of IDUs to prevent transmission and access care, treatment and support to HIV services	Percentage of injecting drug users (IDU) reached with HIV prevention programmes in the last 12 months	MoH/IPs
4.5.3	- Empower  and support outreach to IDUs/Substance users ( Marijuana/Khat/Alcohol) -Establish needle and syringe program sites for every 1,000 IDUs	-Number of needle and syringe programme (NSP) sites established per 1000 injecting drug users (IDUs)	MoH/IPs
4.5.4	Distribute commodities and supplies for the needle exchange programme	Number of syringes/needles distributed per injecting drug user per year by NSP	MoH/IPs
4.5.5	Link and support IDU locations for capacity building, sharing experience as part of mitigating stigma and impacts of HIV/AIDS	No of IDU locations linked and networking	IPs
4.5.6	Distribute condoms, lubricants and microbicide commodities and supplies for the prevention of unprotected anal sex	Number of commodities distributed	MoH/IPs
	Objective 5: To ensure health facilities (hospital and health centers) have the capacity to provide quality services key to MARPs
	5.1 Ensure compliance with Infection Prevention and Control procedures and guidelines during Medical Male Circumcision and cancer examination
5.1.1	Support health facilities	No of health facilities supported	MoH/IPs
5.1.2	Forecast and budget for equipment and supplies	Forecasts and budget available	MoH/IPs
5.1.3	Procure distribute equipment and supplies	Equipment and supplies procured	NMS/I Ps
5.1.4	Accredit facilities for conducting services	No of facilities accredited	MoH/ACP
5.1.5	Build capacity of accredited health facilities to adhere to standard precautions	No of accredited health facilities trained in standard precautions	MoH/IPs
5.1.6	Train traditional/religious surgeons to observe infection control during circumcision procedures	-No of traditional/religious surgeons trained in infection control practices - No of private clinics trained in infection control practices	MoH/IPs
	5.2 Ensure friendly cancer examination services	No of service provision points accredited as friendly to MARPs.	do
	5.3 Ensure access to ART.	No of ART service provision points accredited as friendly to MARPs.	do
	Objective 6: Monitor and evaluate MARPs targeting services
	6.1 Institute a reporting, monitoring and evaluation mechanism of all organisations targeting MARPs.
6.1.1	Quarterly support supervision	4 quarterly reports	MoH/Facilities/IPs
6.1.2	Bi-annual stakeholder review meetings to find out the effectiveness of existing plans	2 meetings, reports	MoH
6.1.3	Conduct regular support supervision	No of facilities/organisations supported in MARPs related Programming   (Institutionalizing MARPs Targeting Services)	MoH/District/IPs
6.1.4	Assessment review of prevention practices	Report of assessment review	MoH/Facilities/IPs
6.1.5	Benchmark health facilities/organisations according to standards	Benchmark ratings	MoH

Check list:

Prevention targeting inclusion of MARPs issues

Percentage of health care facilities where all therapeutic injections are given with new, disposable, single use injection equipment

Percentage of health facilities and organisations promoting “PVC/PASTRA” services

Percentage of MARPs able to have access to prevention services without violence, abuse, discrimination and stigma

Disaggregated reporting targeting specific MARPs

Number of needle and syringe programme (NSP) sites per 1000 injecting drug users (IDUs)

Number of opioid substitution therapy (OST) sites per 1000 injecting drug users (IDUs)

Number of syringes/needles distributed per injecting drug user per year by NSP

Percentage of injecting drug users (IDU) reached with HIV prevention programmes in the last 12 months

Percentage of injecting drug users reporting the use of sterile injecting equipment the last time they injected

Percentage of injecting drug users reporting the use of a condom the last time they had sexual intercourse

Percentage of sex workers (SW) reached with HIV prevention programmes in the last 12 months

Percentage of MARPs reporting anal sex in the last 12 months

Percentage of MARPs reached with HIV prevention programmes in the last 12 months

Percentage of MARPs reporting benefits of inclusion in decision-making to engage in HIV response in last 12 months

Messages presented to inform public awareness on MARPs issues

NOTES:

*By protection is meant: Protection from stigmatizing effect as a result of the criminalizing context that this kind of sexuality, identity, behaviour may elicit.

* By negotiation is meant: All those skills, powerlessness, attitude, context and practices that may point towards utilization of prevention prophylactics against unplanned pregnancies, STIs and HIV.

*By impairment is meant: The context in which negotiation for use of prevention prophylactics is allowed.

* By exposure is meant: Situation that brigs one in proximity to bio/medical-hazards.

* By multiple partners is meant: Situation where there are multiple concurrent sexual partners and their HIV/STI status is [mutually] not known.

*By co-morbidities is meant: Situation where immunity being compromised gives way to other opportunistic infections.

TRMM & GS (Volunteer Consultants)