Multisectoral HIV-Prevention in South Africa (MHIVP4)

laufendes projekt

ContextWith a prevalence rate of 20.4% among the population group of 15-49-year-olds, South Africa is among the countries most affected by HIV. In 2018, 7.7 million people were living with HIV in South Africa – the largest epidemic in the world. Women are disproportionally affected by HIV in South Africa: almost 63% of adults living with HIV are women. While the number of new HIV infections in South Africa has declined significantly from 340,000 in 2012 to 240,000 in 2018, the country still has an unacceptably high number of new infections. New infections remain alarmingly high in young men and women. A disproportionate number of new HIV infections occur among adolescent girls and young women (AGYW). Delivering services through the school health programme provides an effective opportunity for preventing HIV transmissions in this vulnerable population by increasing HIV awareness and risk-reducing behaviours among young people.In response, the South African government has issued the Integrated School Health Policy (ISHP) in 2012 and has since prioritized this policy, including in the National Strategic Plan for HIV, TB and STIs 2017-2022 (NSP). Despite efforts to improve school health service delivery, the implementation of the ISHP is still hampered by insufficient budgetary and third-party resources, is rendered inefficient by dysfunctional coordination mechanisms, and is challenged by lack of social acceptance among many "community gatekeepers"ObjectiveInter-governmental structures for implementing and financing the ISHP are strengthened.ApproachDuring the consolidation phase of the module, the capacity development strategy of the module aims at phasing out responsibilities, strengthening inter-governmental structures and securing financial sustainability from domestic and external resources for ISHP implementation. At the organisational level, better coordination between the relevant departments for school health service provision will be facilitated through the creation of integrated frameworks and processes, such as streamlining the budget process towards a comprehensive inter-departmental budget request and establishing and strengthening formalized inter-departmental task teams at the national and provincial levels. A coordinated inter-departmental school health budget contributes to financial sustainability and closing of the fiscal gap for school health services. At the individual level, public officials will be capacitated to better plan, budget and implement school health services at different levels. At the societal level, attitude changes towards a more favourable perspective on school health services are promoted.ResultsThe module will contribute to the reduction of the HIV infection rate and therefore help to improve the health of teenagers and young women in South Africa. The improved coordination of national structures for implementing and financing school health services will not only improve the health of learners but will also enable them to make informed decisions concerning their own risk behaviour and their sexual sovereignty. The outcomes have the potential to unlock substantially more funding for school health services and improve the accountability framework for coordinated service provision. Moreover, this approach will strengthen civil society in representing the interests of vulnerable groups, meaning that such groups will be taken into consideration in the new NSP and in applications for funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).

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