A fully functional health system is a prerequisite for delivering good quality health services. HIV Testing and Counselling is the entry point to HIV prevention, care, treatment and support. Knowledge of one’s HIV zero-status and successful linkages to other services are critical for access to effective treatment interventions. Cities and urban areas are engines of transformation. They are home to the largest and most dynamic economies and they are energized by young, mobile and diverse populations with talent, creativity and innovation.
Urban areas are also home to millions of people who have fallen through the cracks of social, political and economic life. People who lack access to education, health services and prevention measures face significantly higher health risks. Under these social conditions, many diseases, including HIV, spread more quickly. Additionally, poor sanitation and crowding foster the spread of tuberculosis, which is the leading cause of death among people living with HIV. This pillar will give space for cities to address their significant disparities in access to basic services, social justice and economic opportunities. This strategy will focus on among others the following key areas:
- Cost-effective solutions to improve nutrition in the 1,000-day window are readily available and affordable. They include:
- Ensuring that mothers and young children get the necessary vitamins and minerals they need;
- Promoting good nutritional practices, including breastfeeding and appropriate, healthy foods for infants; and
- Treating malnourished children with special, therapeutic foods including strengthening linkages with immunization and nutrition programmes. {See also nutrition under Economic strengthening)
Early Infant Diagnosis
- This strategy will improve the continuum of care from early infant HIV diagnosis, initiation on treatment and adherence;
- It will track loss to follow-up of HIV-exposed infants and link them to care;
Access to timely initiation of ART for infants living with the virus
Weak capacity for initiation and provision of antiretroviral treatment for children;
Increase HTC Services
- Increase HTC Services through mobile teams providing integrated HIV and health services including HTC at local levels including youths in and out of school;
- Increase young people’s update of HTC through integration with ASRH services, promote innovative HTC methods including self-testing.
Referral linkages and support
Poor follow up for clients who test positive to assess ART eligibility, as well as discordant couples; Strengthen referral and follow up of HIV positive clients and discordant couples to appropriate care and treatment services
Supporting HIV Negative Clients
Clients with HIV-negative results kept negative, HIV-negative clients receive post-test services and follow up that includes risk-reduction counselling, promotion and provision of condoms, referral to other interventions such as VMMC, youth activities and community mobilization programmes. Scale up comprehensive HIV prevention programmes for sex workers, adolescent and young people and other vulnerable populations, both by creating the specific context for facilitating behavior change and economic strengthening.
Churches present opportunities for a robust couple’s HIV prevention programme so that 80% of couples in JHWO`s area of implementation are reached with such a programme by 2018. Such a programme will focus on concordant negative and discordant couples, Components of it should include regular mutual HIV testing and disclosure of status, counselling and support services, earlier ARVs for those discordant couples who choose to have it, family planning services, cancer Screening, parenting, relationship and family skills building.
