National policy on STI/HIV/AIDS control
The country has adopted policies, as demonstrated in frameworks, guidelines, and monitoring and evaluation (M&E) plans, that focus on the prevention of HIV infection, the provision of treatment, care and support for people living with HIV (PLHIV), and the mitigation of the social and economic consequences of high levels of morbidity and mortality due to AIDS (UNAIDS, 2009). National policies should reflect growing international consensus on HIV/AIDS policies detailed in number of goals and declarations, including the Millennium Development Goal #6 to combat HIV/AIDS, the United Nations (UN) General Assembly Special Session on HIV/AIDS (UNGASS) Declaration of Commitment on HIV/AIDS (UNGASS, 2001), and the UN Political Declaration on HIV/AIDS (UNAIDS, 2006), which calls for a global commitment to scaling up for universal access to HIV treatment, prevention, care and support.
Evidence of policies, frameworks, guidelines and M&E plans that focus on HIV/AIDS prevention, treatment, care and support. Supporting documentation should include copies of these policy components, where or by whom these were issued or published, and what the actual recommendations were. For countries that have signed on to the UNGASS declaration commitment and action plan and are collecting core indicators for their country progress reports, the indicator for a National Composite Policy Index (NCPI) will include the necessary information to determine the existence of a county policy and a range of policy components (UNAIDS, 2009). Note: the NCPI is cross-listed with the PEPFAR New Generation indicators as number H6.3.N (PEPFAR, 2009).
Surveys, reports, and interviews from Ministry of Health and collaborating programs (including private and non-governmental organizations) on written HIV/AIDS policies, frameworks, or guidelines. Where available, data collected for the NCPI can be used.
In order for HIV/AIDS prevention, treatment, care and support recommendations to be fully integrated into HIV/AIDS and reproductive health services and programs, they must be mainstreamed into polices, frameworks, guidelines, and plans for M&E. This outcome indicator measures the success of advocacy efforts to increase HIV/AIDS awareness and education among policy makers leading to the adoption and formalization of recommendations at the national, provincial, and district levels.
International and national policies and the resulting programs addressing HIV/AIDS generally focus on four primary areas: (1) prevention (e.g., PMTCT, IV drug use, male circumcision, pre- and post-exposure prophylaxsis, condom use, sexual and other risk reduction, testing and counseling, and targeting most at risk populations); (2) support care for people living with HIV/AIDs and orphaned and vulnerable children; (3) treatment with antitretroviral therapy, nutrition and related services; and (4) health system strengthening. Integration of HIV/AIDS services with maternal and child health, family planning, and related health programs is a growing collaborative effort that should be indicated in national-level policies (PEPFAR, 2009). Countries are expected to know the nature of their epidemics and to delineate and prioritize policies and programs based on this knowledge. If a country primarily has a concentrated epidemic among injecting drug users, the emphasized policies and programs will differ from a country with a generalized epidemic from largely heterosexual transmission.
Evaluators may have difficulty obtaining evidence that the range of recommended policies for a national HIV/AIDS program have been incorporated into government frameworks, guidance, and M&E documents. Once HIV/AIDS policies have been formally adopted, evaluators need to follow-up to verify how these recommendations are being operationalized. For example, if a country has a policy on PMTCT, linkages need to be made that can demonstrate if there are field programs that make quality services available to pregnant and post-natal mothers and infants and if sufficient numbers of women are using these programs to have an impact on the number of HIV-infected infants.
UNAIDS, 2009, Monitoring the Declaration of Commitment on HIV/AIDS: Guidelines on Construction of Core Indicator, Geneva: UNAIDS. http://data.unaids.org/pub/Manual/2009/JC1676_Core_Indicators_2009_en.pdf
Global Health.Gov Website, 2008, National Composite Policy Index Questionnaire, Washington, D.C.: U.S. Department of Health and Human Services, PEPFAR, 2009, http://www.globalhealth.gov/news/news/072908b.html
PEPFAR, 2009 The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR. https://www.k4health.org/toolkits/igwg-gender/president%E2%80%99s-emergency-plan-aids-relief-next-generation-indicators-reference
UNAIDS, 2006, Political Declaration on HIV/AIDS, Geneva: UNAIDS. http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/report/2006/20060615_hlm_politicaldeclaration_ares60262_en.pdf
UNGASS, 2001, Declaration of Commitment on HIV/AIDS, http://www.unaids.org/sites/default/files/sub_landing/files/aidsdeclaration_en_0.pdf
WHO, 2003, Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation, May 13-15, Geneva: WHO. http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf