From Evidence to Programming: GBV in the HIV and AIDS response Maureen Obbayi; Nduku Kilonzo PhD; Lina Digolo MbChB; Lilian Otiso MbChB The LVCT GBV/PRC team; The Division of Reproductive Health/Ministry of Public Health and Sanitation Trocaire; The Elton John AIDS Foundation; 1
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From Evidence to Programming: GBV in the HIV and AIDS response Maureen Obbayi; Nduku Kilonzo PhD; Lina Digolo MbChB; Lilian Otiso MbChB The LVCT GBV/PRC.
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From Evidence to Programming: GBV in the HIV and AIDS response
- LVCT Training Institute- Quality assurance of services- Programme data utilization- CSO coordination frameworks
- TIMISHA (LVCT South to south capacity building model) - Direct service delivery- Demand creation & advocacy
LVCT: an indigenous Kenyan NGO, country led, country managed, country priorities
Policy
Practice
Research
ACTION: HIV, SRH,
mental Justice
outcomes
Evidence to ACT:- Research- Piloting
LVCT’s GBV/ PRC action framework
Platforms to ACT:- Policy reforms - Systems
strengthening- Partnerships
Impetus to ACT:- Quality service
delivery- Client feedback
• Survivors of sexual violence?– VCT counsellors from Quality Assurance – Emerging PEP data
• Operational research study (2004-6) – Diagnosis: perceptions, priorities for service delivery– Intervention: standard of care, health provider training– Evaluation: uptake and delivery of care (prophylaxis,
examination, counselling)
Kilonzo et al, 2007; 2008; 2009 5
2003/4: HIV and SV?
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Diagnosis• No regulatory framework, standards or reporting
• Inconsistent service delivery, limited capacities
• Perceptions: “Lets say I have a boyfriend and am against the act, but you
can be forced. He will come at night when he knows I am there because he want to do …, and to make me to give him. He knows if he rapes me... and when others get to
know, they will reject and laugh at me saying I was raped – so I will give in” (adolescent female, 16yrs, Thika)
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Intervention• Stakeholder consultations: DRH, local HMTs• Standard of care: algorithm, protocols, procedures• Provider training• Community mobilization
CASUALTY/OPDEmergency management
PEP/EC, examination, PRC1 form STI drugs
Counseling - Trauma/crisis, HIV test,PEP adherence; preparation for
Justice system
Laboratory
HIV care: PEP management: Laboratory monitoring
PEP outcomes
on-going follow up 4/52
Evaluation in 2006 (n=386; >30% data rejected)
Data for programming..- median age - 16.5; 56%
children; 88% female- 55% - knew assailant, children
more likely (OR 6.2; p=0) - 82% EC delivery- 16% lost in client flow
Changes: - Child friendly services (Speight
et al 2006)- EC services at casualty- Social support & counselling- Strengthening referrals
from evidence to programming: research-policy-practice