scholarly journals Political and Governance Challenges to Achieving Global HIV Goals with Injecting Drug Users: The Case of Pakistan

2019 ◽  
Vol 8 (5) ◽  
pp. 261-271
Author(s):  
Hina Khalid ◽  
Ashley M. Fox
Keyword(s):  
Drug Users ◽  
Technical Assistance ◽  
People Living With Hiv ◽  
Political Commitment ◽  
Policy Actors ◽  
Governance Challenges ◽  
Scale Down ◽  
The Government ◽  
Opiate Substitution Therapy ◽  
Hiv Programs

Background: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently set the ambitious "90-90-90 target" of having 90% of people living with HIV (PLHIV) know their status, receive antiretroviral therapy (ART), and achieve viral suppression by 2020. This ambitious new goal is occurring in a context of global "scale-down" following nearly a decade of heightened investment in HIV prevention and treatment efforts. Arguably international goals spur action, however, setting unrealistic goals that do not take weak health systems and variations in the nature of the epidemic across countries into consideration may set them up for failure in unproductive ways that lead to a decline in confidence in global governance institutions. This study explores how policy actors tasked with implementing HIV programs navigate the competing demands placed upon them by development targets and national politics, particularly in the current context of waning international investments towards HIV. Methods: To examine these questions, we interviewed 29 key informants comprising health experts in donor organizations and government employees in HIV programs in Pakistan, a country where HIV programs must compete with other issues for attention. Themes were identified inductively through an iterative process and findings were triangulated with various data sources and existing literature. Results: We found both political and governance challenges to achieving the target, particularly in the context of the global HIV scale-down. Political challenges included, low and heterogeneous political commitment for HIV and a conservative legal environment that contributed towards a ban on opiate substitution therapy, creating low treatment coverage. Governance challenges includedstrained state and non-governmental organization (NGO) relations creating a hostile service delivery environment, weak bureaucratic and civil society capacity contributing to poor regulation of the health infrastructure, and resource mismanagement on both the part of the government and NGOs. Conclusion: Our findings suggest that in a context of waning international attention to HIV, policy actors on the ground face a number of practical hurdles to achieving the ambitious targets set out by international agencies. Greater attention to the political and governance challenges of implementing HIV programs in low- and middle-income countries (LMICs) could help technical assistance agencies to develop more realistic implementation plans.

Operations Research on the Female Village-Based Family Planning Worker Program of Pakistan

1998 ◽  
Vol 18 (3) ◽  
pp. 283-305
Author(s):  
Louisiana Lush ◽  
George P. Cernada ◽  
A. K. Ubaidur Rob ◽  
Mohammed Shafiq Arif ◽  
Minhaj Ul Haque ◽  
...  
Keyword(s):  
Family Planning ◽  
Operations Research ◽  
Technical Assistance ◽  
Field Studies ◽  
Family Planning Services ◽  
Training And Supervision ◽  
The Government ◽  
And Training ◽  
Broad Program

This article presents the results of a number of operations research studies (OR) of family planning services provided by a new cadre of female village-based family planning workers in Punjab Province, Pakistan. This cadre of workers, recruited nationwide, have been trained to visit women in their villages to provide information and family planning services. The studies were conducted as part of a broad program of technical assistance to the Government of Pakistan. Surveys investigated the quality of their training as well as attitudes among clients to the new program. They found that the program is developing well but there is room for improvement, particularly in counseling and training. Additional field studies are ongoing and recommendations for change have been incorporated in training and supervision. The program is expanding on a national scale.

A Policy Analysis Regarding Education, Career, and Governance of the Nurses in Bangladesh: A Qualitative Exploration

2021 ◽  
pp. 152715442098800
Author(s):  
Taufique Joarder ◽  
Md. Aslam Parvage ◽  
Lal B. Rawal ◽  
Syed Masud Ahmed
Keyword(s):  
Nursing Education ◽  
Stakeholder Analysis ◽  
The Body ◽  
Historical Factors ◽  
Governance Challenges ◽  
Directorate General ◽  
The Government ◽  
New Policies ◽  
Lower Castes ◽  
Qualitative Exploration

Nurses, short in production and inequitable in the distribution in Bangladesh, require the government’s efforts to increase enrolment in nursing education and a smooth career progression. Given the importance of an assessment of the current nursing scenario to inform the decision makers and practitioners to implement the new policies successfully, we analyzed relevant policies on education, career, and governance of nurses in Bangladesh. We used documents review and qualitative methods such as key informant interviews ( n = 13) and stakeholder analysis. We found that nursing education faced several backlashes: resistance from diploma nurses while attempting to establish a graduate (bachelor) course in 1977, and the reluctance of politicians and entrepreneurs to establish nursing institutions. Many challenges with the implementation of nursing policies are attributable to social, cultural, religious, and historical factors. For example, Hindus considered touching the bodily excretions as the task of the lower castes, while Muslims considered women touching the body of the men immoral. Nurses also face governance challenges linked with their performance and reward. For example, nurses have little voice over the decisions related to their profession, and they are not allowed to perform clinical duties unsupervised. To improve the situation, the government has made new policies, including upliftment of nurses’ position in public service, the creation of an independent Directorate General, and improvement of nursing education and service. New policies often come with new apprehensions. Therefore, nurses should be included in the policy processes, and their capacity should be developed in nursing leadership and health system governance.

Positive prevention by people living with HIV among injecting drug users, mashhad positive club

2007 ◽  
Vol &NA; ◽  
pp. S311 ◽  
Author(s):  
Vahid Nowbahar ◽  
Hamidreza Setayesh ◽  
Ali Feizzadeh ◽  
Mohammad Tavakkoli ◽  
Farhad Malekahmadi ◽  
...  
Keyword(s):  
Drug Users ◽  
Injecting Drug Users ◽  
People Living With Hiv ◽  
Positive Prevention ◽  
Living With Hiv

A Review of Hepatitis C Virus: Prevalence, Genotype, Risk Factors in Pakistan Last Quarter of Century

2021 ◽  
Vol 2 (01) ◽  
pp. 26-30
Author(s):  
Aetsam Bin Masood ◽  
Zain Ul Abideen ◽  
Muhammad Salman Anjums ◽  
Muhammad Irfan
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Prevalence Rate ◽  
Injection Drug Users ◽  
Drug Users ◽  
Educational Background ◽  
Healthcare Waste ◽  
Awareness Campaigns ◽  
The Government

Hepatitis C virus has infected over 200 million people worldwide and is the most common blood-borne disease. Pakistan has the HCV prevalence rate of over 8%. A literature search has been performed using different keywords in different databases i.e. PubMed, Google Scholar, and NCBI. 6.2% prevalence rate was found in the general population, 4.13% in healthcare workers and a higher prevalence rate was observed in injection drug users and multi transfusion population. Use of injection was very frequent among the Pakistani population, reuse and sharing of syringes have an association with HCV infections. In Pakistan most prevalent genotype of HIV was 3a. Knowledge about HCV and its risk factors also varies with the educational background. Blood donors should be screened for HCV, awareness campaigns about different risk factors should be initiated at the government level, and strict regulation on healthcare waste should be implemented, these might help in preventing its spread to healthy individuals.

Gender- and Poor-inclusive Community-managed Sanitation and Hygiene in Urban Indonesia

2010 ◽  
Vol 5 (4) ◽  
Author(s):  
R. Mozar ◽  
C. Sijbesma
Keyword(s):  
Technical Assistance ◽  
Solid Waste Management ◽  
Development Program ◽  
Action Planning ◽  
Project Planning ◽  
Community Empowerment ◽  
Management Support ◽  
Urban Sanitation ◽  
Sanitation And Hygiene ◽  
The Government

The Government of Indonesia executed the Indonesia Sanitation Sector Development Program (ISSDP, April 2006 - January 2010), with financial support from the Governments of the Netherlands and Sweden, as well as management support from the World Bank's Water and Sanitation Program (WSP). The program assisted a dozen cities to improve sanitation in a wider sense. It covered safe disposal of human excreta and waste water, local drainage, solid waste management and promotion of hygienic practices. The program was demand-based: the cities brought in their own human and financial resources, but got technical assistance for sanitation situation assessments and mapping, sanitation strategy and program development, and finding additional resources for increased implementation. The program had three major thrusts: (1) develop an enabling sanitation environment, (2) raise sanitation awareness and promote good hygiene, and (3) build city sanitation planning capacities and develop city sanitation strategies. The promotion component included development of poor-inclusive sanitation intervention, assisting men, women and children in the poorest neighborhoods to strengthen good and improve bad sanitation and hygiene conditions and practices. Community empowerment is important in urban sanitation development, but at the same time, requires that the social and technical institutions in charge of empowerment and sanitation adopt new skills and techniques for working with communities. Without the right skills to assist the communities, build their skills, and provide some minimal monitoring of performance afterwards, there is a risk of over-expecting what a community can manage. Community empowerment with gender- and poor-inclusive approaches must be integrated into all stages of urban sanitation development, i.e. (1) the organizational development, (2) review of related existing projects and services, (3) formulation of an overall city sanitation strategy and program, and (4) local project planning. Equitably attention for gender and poor is part of the overall organization, strategy formulation, local action planning, program and projects development and implementation, and monitoring and evaluation of outputs, outcomes and impacts.

scholarly journals Strategi Diversifikasi Atraksi Budaya Dalam Mendukung Pengembangan Wisata Desa Wakatobi

2020 ◽  
Vol 9 (1) ◽  
pp. 25
Author(s):  
Muhadjir Suni ◽  
Muh. Zainuddin Badollahi
Keyword(s):  
Local Government ◽  
Cultural Tourism ◽  
The Political ◽  
Political Commitment ◽  
Diversification Strategy ◽  
Political Will ◽  
Purposive Sampling ◽  
The Government ◽  
Active Facilitator

This study aims to determine and analyze the Diversification Strategy of Cultural Attractions in Support of Tourism Development in Wakatobi Village. This research method is qualitative research. The determination of the informants in this study was obtained by purposive sampling. The informants are community leaders and traditional leaders who are key informants. The results show that the opportunity for Wakatobi Regency to become a cultural tourism destination can be opened, because it is supported by the exoticism of local communities with their cultural diversity. The strategy that can be prioritized in the development of Wakatobi village tourism is the diversification of cultural attractions that are organized through institutions or Tourism Awareness Groups initiated by the community and funded by the local government and acting as an active facilitator. It seems that the political will and political commitment of leaders to maximize local government efforts need to be supported by tourism stakeholders from the government, private sector and the wider community, this is a weakness that needs to be covered so that the strategy in developing Community Base Tourism (CBT) tourism in Wakatobi provides a diversification of attractions. tour which is actually quite interesting to witness. Penelitian ini bertujuan untuk mengetahui dan menganalisa Strategi Diversifikasi Atraksi Budaya Dalam Mendukung Pengembangan Wisata Desa Wakatobi. Metode penelitian ini adalah penelitian kualitatif. Penentuan informan penelitian ini diperoleh secara Purposive sampling. Adapun informan yaitu tokoh masyarakat dan tokoh adat yang merupakan informan kunci. Hasil penelitian menunjukkan peluang kabupaten wakatobi menjadi destinasi wisata budaya dapat terbuka, karena didukung oleh eksotisme komunitas lokal dengan keberagaman budaya yang mereka miliki. Strategi yang dapat diprioritas dapat dalam pengembangan wisata desa Wakatobi adalah  diversifikasi atraksi budaya yang terorganisasi melalui kelembagaan atau Kelompok Sadar Wisata yang diprakarsai masyarakat dan didanai oleh pemerintah daerah serta berperan sebagai fasilitator yang aktif. Tampaknya political will dan political comitment pemimpin untuk memaksimalkan upaya pemerintah daerah perlu di dukung oleh stekholder pariwisata dari pihak jajaran pemerintah, swasta dan masyarakat luas hal merupakan kelemahan yang perlu ditutupi agar strategi dalam pengembangan wisata Community Base Tourism (CBT) di Wakatobi menyajikan adanya diversifikasi atraksi wisata yang sesungguhnya cukup menarik untuk disaksikan.

scholarly journals Sierra Leone

2019 ◽  
Vol 19 (218) ◽  
pp. 1
Author(s):  
Keyword(s):  
Sierra Leone ◽  
National Development ◽  
Education Programme ◽  
Solid Base ◽  
Political Commitment ◽  
Medium Term ◽  
Middle Income ◽  
Income Status ◽  
The Government ◽  
Capital Development

The Government of Sierra Leone’s new Medium-term National Development Plan (MTNDP) 2019–2023 has been founded on a strong political commitment to deliver devel-opment results that would improve the welfare of Sierra Leone’s citizens. The plan charts a clear path towards 2023 en route to the goal of achieving middle-income status by 2039 through inclusive growth that is sustainable and leaves no one behind. For the next five years, the Free Quality School Education Programme is the government’s flagship programme to provide a solid base to enhance human capital development and to facilitate the transformation of the economy.

scholarly journals Kebijakan Pengendalian HIV/AIDS di Denpasar

2013 ◽  
Vol 8 (1) ◽  
pp. 45
Author(s):  
Tri Rini Puji Lestari
Keyword(s):  
Local Governments ◽  
People Living With Hiv ◽  
District Health ◽  
Aids Epidemic ◽  
The Government ◽  
Living With Hiv ◽  
And Control ◽  
The City ◽  
Government Perspective ◽  
Hiv Aids

Secara nasional, Indonesia telah mengantisipasi epidemi HIV/AIDS, tetapi jumlah kasus HIV/AIDS di Provinsi Bali dari tahun ke tahun memperlihatkan peningkatan yang semakin mengkhawatirkan. Penelitian ini bertujuan untuk mengetahui perkembangan jumlah kasus dan kebijakan penanggulangan HIV/AIDS di Denpasar. Penelitian ini menggunakan metode kualitatif yang dilakukan di Denpasar pada tanggal 11-17 September 2011. Sampel penelitian ini menggunakan informan terpilih yaitu kepala bappeda, pejabat Dinas Kesehatan Kabupaten Denpasar, direktur rumah sakit, puskesmas, ketua komisi penanggulangan AIDS di kabupaten/kota dan pemerhati HIV/AIDS termasuk ODHA. Penelitian menemukan jumlah kasus HIV/AIDS di Kota Denpasar yang tertinggi dan penularan terbesarnya melalui hubungan seks. Namun, dukungan pemerintah daerah dalam upaya pencegahan dan penanggulangan HIV/AIDS terlihat belum maksimal. Padahal kebijakan penanggulangan HIV/AIDS sangat ditentukan oleh cara pandang pemerintah terhadap penyakit HIV/AIDS. Untuk itu, perlu peningkatan pemahaman tentang HIV/AIDS serta pencegahan dan penanganan semua pihak terkait sehingga penanggulangan HIV/AIDS dapat lebih efektif, efisien, dan tepat sasaran.Nationally, Indonesia anticipated HIV/AIDS epidemic, but the number of cases of HIV/AIDS in Bali province from year to year showed an increase in the increasingly alarming. This study aimed to determine the number of cases and the development of policies on HIV / AIDS in Denpasar. This research was conducted using qualitative methods in Denpasar on 11-17 September 2011. The study sample was selected using the informant is head of planning, Denpasar District health officers, the director of the hospital, health center, chairman of the commission on AIDS in the district/city and observer of HIV / AIDS, including people living with HIV. The study found the number of cases of HIV / AIDS in the city of Denpasar is the highest and greatest transmission through sexual intercourse. However, the support of local governments in efforts to prevent and control HIV/AIDS looks not maximized. In fact the policy of HIV/AIDS is largely determined by the government perspective on HIV / AIDS. To that end, should be an increased understanding of HIV/AIDS as well as prevention and treatment of all parties concerned. So that HIV/ AIDS can be more effective, efficient, and targeted.

POLA FRAUD PADA PENYELENGARAAN BIMBINGAN TEKNIS (BIMTEK) DI SEKTOR PEMERINTAHAN

2016 ◽  
Vol 4 (1) ◽  
pp. 46
Author(s):  
Indah Sri Wahyuni ◽  
Tarjo
Keyword(s):  
Qualitative Study ◽  
Technical Assistance ◽  
Work Unit ◽  
Implementation Phase ◽  
Real Cost ◽  
Government Sector ◽  
Three Phase ◽  
The Government ◽  
Reporting Phase ◽  
Local Work

<p class="Default"><em>This study is aims to determine patterns of fraud in the technical assistance implementation activities in the government sector that is in the local work unit in the district X. It’s descriptive qualitative study by interviewing several informants who where directly involved in the technical assistance.The aspects that will be analyzed include three phases: planning phases, implementation phases and reporting phase. The result of this study shows that the frauds in the  three phase of technical assistance implementation. There are mark up of the price and number of participants at the planning phase. In the implementation phase the fraud is within shortening timing and eventually there is technical assistance fictitious, and at the reporting phase found that the fraud pattern is a discrepancy between the letter of accountability with real cost.</em></p>

scholarly journals An Integrated Approach to HIV Disclosure for HIV-Affected Families in Thailand

2019 ◽  
Vol 18 ◽  
pp. 232595821983102 ◽  
Author(s):  
Jureeporn Jantarapakde ◽  
Chitsanu Pancharoen ◽  
Somsong Teeratakulpisarn ◽  
Pornpen Mathajittiphan ◽  
Rosalin Kriengsinyot ◽  
...  
Keyword(s):  
Family Relationship ◽  
Integrated Approach ◽  
Hiv Disclosure ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Knowledge ◽  
Group Education ◽  
Living With Hiv ◽  
Hiv Programs ◽  
The Impact

Disclosure of HIV status to family members could improve communication, relationship, and cohesion. We evaluated the impact of a family-centered program designed to increase the readiness/willingness of parents to disclose HIV status to their children. People living with HIV (PLWH) with children ≥8 years were surveyed regarding HIV knowledge, family relationship, attitudes, willingness/readiness to disclose, and they were then invited to participate in group education and family camps. Of 367 PLWH surveyed, 0.8% had disclosed, 14.7% had not yet disclosed but were willing/ready to disclose, 50.4% were willing but not ready, and 33.2% did not wish to disclose. The educational sessions and camps led to significant improvements of HIV knowledge and disclosure techniques, and readiness/willingness to disclose. Given the benefits of group education and family camps in supporting PLWH to improve their communication with their families and disclose their HIV status, these supporting activities should be included in HIV programs.

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