2013 IMPLEMENTATION STRATEGY

Based on existing data from the local epidemic appraisal, Nigeria’s HIV epidemic is mixed, with a considerable generalized component driven by behavioural patterns through concentrated high-risk sexual networks. The figures show that despite the decline in new infection among heterosexual partners, new infections prevail among classified groups of persons with behaviour patterns that pre-dispose them to higher risk of HIV infection than the general population. These groups are termed “Most At Risk Persons” (MARPS) – Female Sex Workers and their Clients, Injecting Drug Users and Men who Have Sex with Men. Addressing the HIV prevention needs of these groups will significantly impact on the national HIV incidence and prevalence within a short period of time.

Nigeria’s contribution to global burden of mother to child transmission of HIV is estimated at over 30%. This is in spite of the efforts made so far by Federal Ministry of Health (FMOH), NACA and development partners, following the launch of the National HIV/AIDS Strategic Plan (2010-2015) NACA prioritized Prevention of Mother to Child Transmission (PMTCT). The overall goal of the national PMTCT programme is to contribute to improved maternal health and child survival through accelerated provision of comprehensive PMTCT services. With technical and financial support of Donor Agencies such as WHO, UNICEF, UNAIDS, Global Fund, PEPFAR and others, the PMTCT programme is currently being implemented in tertiary, secondary and primary healthcare facilities. NACA is also scaling up PMTCT to additional PHCs with support from the Global Fund. PEPFAR II will also be scaling up PMTCT in line with the decentralization policy. Whilst these efforts on the supply side are commendable, NACA recognizes that commensurate efforts is required to strengthen the demand side and ensure available services are accessed by intended target population. This will be best addressed through effective community mobilisation interventions.

The potential of successes from community mobilization and support structures was further emphasized by the World Bank report.[1] The reports showed clearly that community based structures can enhance access and uptake of HIV related services especially in rural areas. The community based response will enhance the operationalization of the nodal approach to health care service delivery, which facilitates effective linkages between all the cadres of health care service delivery system designed in each geographical location.

In view of the foregoing paragraphs, NACA adopted the following strategies to facilitate effectiveness of project interventions.

  • Formative research (Surveys)
  • Capacity building including training of healthcare workers, CBOs and NGOs
  • Coordination of implementation of combination prevention using the Minimum Prevention Package strategy
  • Community mobilisation for service uptake, including HCT and PMTCT
  • Monitoring and Evaluation