IMPLEMENTATION STRATEGY

Nigeria’s HIV epidemic is mixed1 and is considerably driven by behavioral patterns through concentrated high-risk sexual networks. However, the main driver of the HIV epidemic in Nigeria is due to perceived ‘low risk sex’ with multiple sexual partners. There is still low condom usage even at last risk sexual encounter among the groups of persons with behavior patterns that pre-dispose them to higher risk of HIV infection compared to 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) and the Elimination of Mother to Child Initiative in 2014, eMTCT remains a national priority. With over 5000 facilities providing PMTCT services across the country, there are still observed gaps in women accessing these services2. This informed the need to still strengthen the demand side through community mobilization and demand creation strategies to ensure available services are accessed by intended target population.

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, the 2015 NACA/MDG Project adopted the following strategies to facilitate effectiveness of project interventions.

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

[1] National Agency for the Control of AIDS, Nigeria and World Bank. Evaluation of the Community Response to HIV and AIDS in Nigeria July 2011.