UNDP Uzbekistan

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Continuing Scale Up of the Response to HIV with Particular Focus on Most At Risk Populations and Strengthening System and Capacity for Universal Access to HIV Prevention, Diagnosis, Treatment and Care in Uzbekistan
Background

 

Responding effectively to the HIV epidemic remains a challenge for both the public sector and civil society in Uzbekistan. In 2010 and 2011 Uzbekistan has been awarded two grants of the Global Fund to fight AIDS, tuberculosis and malaria - HIV Round 3 Rolling Continuation Channel and Round 10 grants. In accordance with GF Policy the grants have been consolidated in a Single Stream of Funding. The consolidated project is implemented by UNDP as the Principal Recipient in close cooperation with governmental and non-government organizations.
The main goal of the project is to prevent the spread of HIV into the general population by reducing its impact on at most vulnerable populations and to strengthen health systems and national capacity for universal access to HIV prevention, diagnosis, treatment and care in Uzbekistan.

Objectives

The key objectives of the project are
1. To scale up coverage and increase quality and comprehensiveness of HIV prevention services for most-at-risk populations (MARP)
2. To scale up treatment, care and support for people living with HIV
3. To strengthen health system in Uzbekistan
4. To create an enabling environment for effective scale up of HIV prevention, treatment, care and support services
5. To strengthen infection control for prevention of HIV transmission
6. To strengthen systems for procurement, supply and management of necessary health products and consumables for HIV prevention, diagnosis and treatment
7. To facilitate decentralization and integration of services for sustained outreach and improved access.

 

Achievements & expected results
Objective 1: To scale up Coverage and Increase Quality and Comprehensiveness of HIV Prevention Services for Most-at-Risk Populations (MARP)

This component includes activities on the continued delivery of Harm Reduction Services for IDUs through Trust Points (TPs), support to ensure effective operations of the Trust Points, establishing and strengthening engagement in managing community based outreach activities in coordination with TPs, recruitment and training of SR outreach workers (IDU, SWs, MSM) and peer educators, development and distribution of IEC materials tailored to the need of IDUs, capacity and commitment building for the OST programme, procurement and distribution of HIV prevention commodities to MARPS, development and distribution of IEC materials tailored to the needs of SWs, delivery of outreach prevention services to MSM, development and distribution of IEC materials tailored to the needs of MSM, development and distribution of IEC materials tailored to the needs of young people, provision of STI diagnosis and treatment for MARP groups through Friendly STI cabinets.

Objective 2: To Scale up Treatment, Care and Support for People Living with HIV

This component includes activities to strengthen the capacity of medical professionals in delivery of ARV treatment for PLHIV, procurement and effective distribution of ARV drugs, provision of OI prophylaxis and treatment, training of health care providers in management of HIV/TB co-infection, procurement of medical products and consumables (CD4 and PCR supplies), strengthening of multi-disciplinary teams to provide services for treatment adherence, palliative care and psycho-social counseling, involving civil society and people living with HIV in the peer led adherence care and support activities, provision of basic support packages to PLHIV, building capacity of PLHIV for facilitating self-help groups and other peer based intervention, development and distribution of targeted IEC materials for PLHIV, development and printing of national PICT protocols and guidelines, training of health care staff in selected settings on national PITC protocols and guidelines, procurement of test kits and other commodities for PITC, provision of PMTCT services as part of antenatal, child birth and postpartum services, training for health care professional in all components of comprehensive PMTCT services, training for pediatricians, infectious disease specialists and social workers in care and treatment of HIV positive children, development and printing of educational materials for pregnant women and women living with HIV.

Objective 3: To Strengthen Health System in Uzbekistan  

The component includes activities to increase decision makers’ awareness of HIV related issues, standardisation of medical care,  support to the development of a new National Aids Programme, further improving and institutionalising educational programmes for health workers on HIV, developing and conducting special training on infection control and prevention of nosocomial infection by blood born viruses, provide the information materials and increasing access to advanced medical practices, develop a national M&E plan, and to improve data management capabilities, strengthening sentinel surveillance system and capacity.

Objective 4: To Create an Enabling Environment for Effective Scale up of HIV Prevention, Treatment, Care and Support

This component will include continued engagement of policy makers and implementers in facilitating Universal Access, implementing a National NGO forum for ongoing dialogue and advocacy on current emerging issues, empower PLHIV and strengthen their role in addressing stigma, sensitize opinion makers and community leaders, sensitize uniformed personnel, develop common skills and knowledge among project partners to jointly advocate for common issues, strengthen NGO partner capacity through exposure and cross learning.

Objective 5: To strengthen infection control for prevention of HIV transmission

This component will include promotion of safe use and disposal of equipment in healthcare settings to prevent transmission of HIV as well as other blood borne infections such as Hepatitis B and C. National guidelines and standards will be prepared on injection safety along with Standard Operating Procedures for effectively using and safely disposing a range of critical single use items for invasive procedures. While making necessary supplies of disposables to healthcare facilities across the project regions and training healthcare providers on their safe use, the project will also empower communities to make informed and rational use of invasive procedures. Systems for hospital waste management will be strengthened to respond to the expected increase in the amount of hospital waste generated.

Objective 6: To strengthen systems for procurement, supply and management of necessary health products and consumables for HIV prevention, diagnosis and treatment

This component will include promotion of safe use and disposal of equipment in healthcare settings to prevent transmission of HIV as well as other blood borne infections such as Hepatitis B and C. National guidelines and standards will be prepared on injection safety along with Standard Operating Procedures for effectively using and safely disposing a range of critical single use items for invasive procedures. While making necessary supplies of disposables to healthcare facilities across the project regions and training healthcare providers on their safe use, the project will also empower communities to make informed and rational use of invasive procedures. Systems for hospital waste management will be strengthened to respond to the expected increase in the amount of hospital waste generated.

Objective 7: To facilitate decentralization and integration of services for sustained outreach and improved access

The project will focus on operationalizing necessary systems to bring services within easier reach of the communities, benefiting particularly women, girls, MARPs and the rural population in general. Staff of the Rural Primary Healthcare Facilities (SVPs) will be trained to make necessary referrals for OI, STI etc. This will be backed up with instituting technical software and updating systems for ensuring referrals between key service providers are tracked and honored. In view of the growing detection of HIV among children, primary healthcare providers will also be provided training on IMCI/HIV course using the successful model developed by UNICEF, currently being implemented in 3 of the 5 project Oblasts. Responding to the growing need for home based care among PLHIV, including palliative care for the terminally ill, the project will train patronage nurses whose routine work involves home visits, to educate communities on HIV and train families of PLHIV on home based care. Emphasis will be laid use existing services as opposed to creating parallel systems at the community level. To ensure that the services are user friendly for the vulnerable and marginalised populations, the project will engage Civil Society Organizations for structured community based monitoring of the healthcare services.


Achievements and results in 2011

Over 24000 people of most-at-risk populations from all regions of the country have already benefited from HIV prevention, care and support services and were reached by prevention and advocacy services, aimed to reduce high risk behavior;
- Over 31000 young people received HIV prevention services through mini-sessions, provided by peer-to-peer educators and HIV related informational education materials;
- 3836 people, living with HIV (PLHIV) received antiretroviral therapy (ARVT); in order to ensure quality of decentralized ARV treatment 210 specialists from all regions of Uzbekistan received basic and advanced training in ARVT;
- Over 3500 PLHIV and their family members benefited from treatment, care and support services;
- 365 medical specialists, gynecologists, midwives, neonatologists, social workers, nurses and obstetricians were trained on Prevention of mother to child transmission and Pediatric AIDS,
- 485 pregnant women and 481 infants, born to HIV-positive mothers benefited from mother-to-child transmission prevention services;
- Over 7400 opportunistic infection treatment courses conducted in adults and children, living with HIV;
- 7824 treatment courses of sexually transmitted diseases were provided;
- 316 regional medical specialists were trained on infection control, aimed to ensure effective intra-hospital prevention and reduce the number of new nosocomial infections;
- Series of trainings and events, aimed to reduce stigma and discrimination organized for opinion makers, including journalists, religious leaders, and NGOs and PLHIV;
- At the National level, 350 regional specialist were trained on  starting up Sentinel Surveillance and HIV Sentinel Surveillances aiming at to ensure better tailored HIV prevention program in the country was conducted;
- 135 specialists, Trust point assistants, M&E specialists and representatives of NGOs received training on Monitoring Information Systems (MIS), this will enable to better monitor services, provided to clients;
- Over 300.000 copies of informational-educational materials printed and are being distributed among most-at-risk populations, young people and other project beneficiaries
Activities
Andijan; Bukhara; Djizak; Ferghana; Karakalpakstan; Kashkadarya; Khorezm; Namangan; Navoi; Samarkand; Surkhandarya; Syrdarya; Tashkent; Tashkent City
The project is contributing to achieving the goal of the National Strategic Programme on HIV of the Republic of Uzbekistan for 2007-2011 and the MDG # 6 target: stabilizing the epidemic at the concentrated stage by means of ensuring Universal Access to HIV prevention, treatment, care and support with specific focus on vulnerable populations. This will finally contribute to halt and reverse spread of HIV/AIDS in Uzbekistan. The Program’s goal is to prevent the spread of HIV into the general population by reducing its impact on at most vulnerable populations, including injecting drug users, sex workers and men who have sex with men and to strengthen systems and capacity for universal access to HIV prevention, diagnosis, treatment and care in Uzbekistan. Specifically, the main objectives of the project are to scale up coverage and increase quality and comprehensiveness of HIV prevention services for most-at-risk populations (injecting drug users, commercial sex workers, men having sex with men, youth especially young women); to scale up treatment, care and support for people living with HIV; to strengthen health system in Uzbekistan; to create enabling environment for effective scale up of HIV prevention, treatment, care and support services; programme support and M&E;  to strengthen infection control for prevention of HIV transmission, to strengthen systems for procurement, supply and management of necessary health products and consumables for HIV prevention, diagnosis and treatment.
Downloads
Project ID: 00080864
Status: Ongoing
Duration: 06/04/2011 - 31/12/2013
Management Arrangements: NEX

Budget
Total Budget: USD 23318843.71

Total Delivery:
Year Amount
(USD Thousands)
2011 3,219

Contributions by donors
Global fund USD 22,718,843.71
UNDP USD 600,000.00
Project Address
16 Tarobiy Str., Tashkent, 100100, Uzbekistan
Project Personnel
Zakir Kadirov
Project manager
Contact person in UNDP

Ms. Aziza Umarova
Head of Good Governance Unit
aziza.umarova@undp.org

Last update
21/01/2013
Focus area
2. Democratic governance

Sector and Sub-Sector
6.6 HIV/AIDS, tuberculosis, malaria and other major diseases

Geographic focus
Nationwide
Nationwide
Andijan
Bukhara
Ferghana
Djizak
Karakalpakstan
Kashkadarya
Khorezm
Namangan


UNDAF outcome
1. Economic well-being of vulnerable groups is improved. (residents of economically under-developed, mainly rural areas; women, particularly home-based workers; labour migrants and their families; children, particularly most-at-risk a

Expected outcome
1.1 Capacity of the central and local authorities enhanced to develop and implement economic and social security policies aimed at welfare improvement of vulnerable groups.


1.1.1. Strengthened government capacity at national and local levels to improve macroeconomic forecasting, innovation, and to collect, analyze and report data in line with the Millennium Development Goals and other international standards.

Implementing Agency / Main Partners