Post on 22-Dec-2015
Ghana’s HIV Response
The Ghana Team:Richard N. Amenyah
Matilda Owusu-AnsahEvelyn Awittor
Lord DarteyMercy Bannerman
Background • 1985
– National Advisory Council on AIDS (NACA) – National Technical Committee on AIDS (NTCA)
• 1986- First AIDS Case diagnosed in Ghana
• 1987– National AIDS/STD Control Programme (NACP)
• Sept 2000 – Ghana AIDS Commission
Goals of the National ResponseTo achieve Universal Access, the goals of the
National Response as outlined in the NSF II are:
• Reducing new infections among vulnerable groups and the general population;
• Mitigating the impact of the epidemic on the health and socio-economic systems as well as infected and affected persons; and
• Promoting healthy life-styles, especially in the area of sexual and reproductive health.
Thematic areas
• Within the framework of Universal Access to prevention, treatment, care and support by 2010, the NSF II is programmed around 7 thematic areas:– Policy, Advocacy and Enabling Environment– Coordination and Management of the Decentralized
Response– Mitigating the Economic, Socio-cultural and Legal Impacts– Prevention and Behavioral Change Communication– Treatment, Care and Support– Research, Surveillance, Monitoring and Evaluation– Mobilization of Resources and Funding Arrangement
National HIV Prevalence
HIV Prevalence - HSS, DHS and National
0
0.5
1
1.5
2
2.5
3
3.5
4
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Year
Pre
vale
nce
National
HSS
DHS
Source: NACP-Ghana
2.9
3.4 3.6
3.12.7
3.2
0.00.51.01.52.02.53.03.54.0
2001 2002 2003 2004 2005 2006
Prevale
nce
Year
HIV Prevalence Trend 2001 - 2006
Median
Linear (Median )
2.3
1.9
2.0
0.8
1.4
4.0
3.5
2.7
2.4
2.9
4.5
4.44.5
3.6
4.24.3
4.7
4.4
3.2
3.73.5
3.0
2.5
1.9
2.5
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
2002 2003 2004 2005 2006
Mean
Preva
lence
Year
15 to 19
20 to 24
25 to 29
30 to 34
15 to 24
Ghana’s gains– Strategic planning [NSF I –(2001-2005) and NSF II-(2006-
2010), JPR (2004, 2007), 5-POW, APOW]– Policy formulation (National HIV Policy-2004)– Decentralized implementation of the National response– Prevention programmes (Near Universal awareness)– Treatment and care and support (5th year of ART)– Human rights issues (anti-stigma campaigns)– Monitoring and evaluation (M&E Plans for all Levels)– Increased participation of CSOs and GIPA (Partnership
Forum, TWG etc)– Impact mitigation (OVCs, NHIS for PLHIVs, IGAs)
UNIVERSAL ACCESS: NATIONAL TARGETS FOR GHANA
Programmatic area
IndicatorData
SourcesBaseline (year)
2008 2010 Data Collection Type
Impact targetNational HIV prevalence among people aged 15-49 GHS 2.20% (2003) 2.10% 1.90%
NACP Technical Report (HSS/GDHS/Programme Data)
HIV prevalence among young people aged 15-24 GHS 1.9% (2005) 1.4% 1.0% HSS
Prevention
Impact target % of HIV-infected infants born to HIV infected mothers GHS 30% (2004) 22% 15%[1] Routine data collection system
Process target # of centers providing PMTCT services GHS 135 (2005) 190 238 Routine reporting system
Impact target% of people aged 15-49 who both correctly identify ways of
preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission
GSSGHS
F-38%M-44%(2003)
F-46%M-54%
F-50%M-60%
GDHS(2008)BSS(2006)
MICS(2006)
Treatment
Impact target% of women, men and children with advanced HIV infection
who are receiving antiretroviral combination therapyGHS 6.5% (2005) 42% 66% Routine reporting system
Process target # of centers providing ART services GHS 5 (2005) 50 138 Routine reporting system
Process target # of centers providing VCT services GHS 145 (2005) 190 238 Routine reporting system
Process target# of clients tested for HIV at VCT sites and receiving their
serostatus results in the past 12 monthsGHS 42,206 (2005) 200,000 300,000 Routine reporting system
Impact target% of HIV positive pregnant women who receive a complete course of antiretroviral therapy to prevent mother to child
transmission in the last 12 months.GHS 0.45% (2005) 24.8% 47.6% Routine reporting system
Process target # of centers providing PMTCT services GHS 135 (2005) 190 238 Routine reporting system
Care and support
Impact targetRatio of current school attendance among orphans to that
among non-orphans, aged 10-14GSS 0.79 (2003) 0.9 0.95
GDHSMICS
National commitment
Impact targetAmount of national funds disbursed by government on
HIV/AIDSMoFEP
Cedi 97 billion (2003)
TBD TBD NASA[2]
[1] Impact target: UNAIDS estimated 50% reduction of the proportion of infants infected with HIV. [2] National AIDS Spending Assessment (NASA).Abbreviations: GHS –Ghana Health Service , GSS – Ghana Statistical Service, TBD- To be determined, MoFEP- Ministry of Finance and Economic Planning , MICS – Multiple Cluster Study, BSS-Behaviour Surveillance Survey, HSS-HIV Sentinel Survey, NACP- National AIDS Control Programme, GDHS-Ghana Demographic Health Survey
Key issues in HIV response• Prevention
– An increasing trend in HIV new infections– Slow rate of behavior change– Low risk perception
– Low uptake of prevention services– High levels of stigma– Weak link between community and health services
– Weak integration of HIV programs into sexual reproductive health programs
– Low priority for workplace HIV prevention programs– Inadequate Operational research on prevention
services
• Treatment care and support– 16% of adults who need HAART are on therapy– 10% of HIV infected children <15 years in need of
HAART are on HAART– 10% of HIV infected pregnant women have
received antiretrovirals to reduce the risk of mother to child transmission (past 12 months)
• New combination ARV prophylaxis introduced
– Weak Home Based care programs– Inadequate human resource to support services
Coordination/Management
• Weak Coordination of the multi-sectoral response
• Weak M & E particularly on Prevention activities