Dear MyGlobalFund.org Facilitation Team,
Below is the my answer to the asked questions.

Question. What are thé Most effective health and social interventions that link HIV/AIDS and sexual and reproductive health? Which ones should be supported by the Global Fund and which ones should not?
Sexual and reproductive health care represents an opportunity to expand HIV prevention and care for women. Similarly, services provided within HIV programs provide a potential platform for sexual and reproductive health care, such as prevention of sexually transmitted infections and family planning.

• Affirmative action should be put in place to increase éducation of girls in médical related course and subjects.
• Improved education of the girl child
• Improved nutrition so as to help people to couple with HIV/AIDS

• Increase health care facilities in a bid to increase accessibility and affordability.
• Conduct massive sensitization on women rights in order to break the strings attached to culture that marginalize women in access to health care services.
• Sensitize men in gender related issues in order to break patriachism in society.
• Economic empowerment of women
• Incorporate gender and women studies on the education curriculum of health education institutions.
The following should be funded by the global fund • Improved nutrition so as to help people to couple with HIV/AIDS.
• Increase health care facilities in a bid to increase accessibility and affordability • Conduct massive sensitization on women rights in order to break the strings attached to culture that marginalize women in access to health care services • Incorporate gender and women studies on the education curriculum of health education institutions

Training and intervention, not just focusing on those who are educated, but specifically focusing on those who are not educated, and are in rural areas.

Much education is done in urban areas, schools, colleges and universities.
Even companies are now exposing their workers to regular information sessions.  Unfortunately areas such as farms, rural areas, where there are truck stops, and people are not that well educated seems to have been forgotten.

It is important to note that, in many communities, women play a major role in any interventions.  Most of the education and training offered are attended by women, and this should be kept in mind when embarking on training sessions.

Yours truly,

Juan Claasen
Director
Nurture HIV/AIDS Services

• Country  regulatory, laws  and denayal of certain rights at the community, household levels.
• Lack of  awareness of the community members in handling issues related to sexual minorities.
• Weak health systems and social structures.
•  Gender activism is weak or no Competent gender activists
  
  Regards

many useful suggestions have been made. One important goal is pulling together of evidence on what works in a more scaled up way - there seem to be a lot of excellent programmes - how do they fare on a bigger scale? what would be needed to make them work? Some neglected areas are 1. programmes and services to prevent and treat the outcomes of intimate partner violence (there is an excellent public sector health initiative in Kenya on this which provides routine HIV prophylaxis) Violence can be a factor in HIV transmission. 2. Male sexual health and HIV. This is a really neglected area - men have few places to go with sexual health concerns (which are often psycho-social), and yet health male sexuality can play a really important role in prevention. 3. HIV and SRH educational programmes for younger adolescents (should ideally be starting by 10 or possibly even younger). it is this upcoming generation that badly needs the tools to protect itself, and data suggest that the age of sexual debut is extremely low in many countries. But this is a really hard one and so gets ignored. but it would be good to encourage creative thinking in this area and looking at what is effective.

I think that supporting NGO's that have as main goal to improve the condition of the women as a whole can be very effective. These organizations can reach large parts of their communities and are well respected. They have in many cases enough influence to change the social conditions of some communities, by teaching women professional skills that allow them some level of economic self-sufficiency. Once this starts to happen, women gain respect; they can then start challenging traditional sexual practices and change their partner behaviours. They can be encouraged to create specific sub-groups to address HIV prevention, and provide education. These groups can also develop specific educational programs for teenage girls. In general, I agree with one of the participants of this forum that programs that are holistic in nature are more effective and sustainable.

What are the most effective health and social interventions that link HIV/AIDS and sexual and reproductive health? Which ones should be supported by the Global Fund and which ones should not?

Any program is effective only if it has multi facets accommodating an integrated approach for a holistic development. Always, HIV/AIDS interventions can be looked as a part of integrated health care services that enhance sexual and eproductive health. Sexual and reproductive health care begins from childhood and runs through one’s adolescence period and become hectic during adulthood. A person needs attention right through these periods to improve his/her reproductive health.

An altogether independent and  individual health care program/ intervention would not bring in desired impact among the population to prevent HIV.  Two or three programs aiming at the community’s or populations’  multiple needs can be combined and integrated to the desired level. For example, education and health can gotogether among the children that can increase both the knowledge and health seeking behavior of the children in preventing HIV or promoting the sexual and  reproductive health. Interventions on life skills will be a major cementing factor here. Children at secondary, higher secondary, college level woudl get benefits  - where parents are also available to participate. 

Other possible multi sectoral interventions that would be most effective are :

Health and Benefit schemes – through community structures – stregthening the local bodies – SHGs/ panchayats / community associations

Both the school and non school where families and local leadership are available 

Repoductive health and HIV prevetion through workplace models -

Mostly unorganised and migrant population 

Such programs also help the organisors to broad base their access to resources both physical and financial.
 

Which one should not ?