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1. Situation Analysis and Problem Statement
2. Vision, Mission, Goals and Guiding Principles
3. Strategic Issues
3.1 Capacity Building
3.2 Community Mobilization and Empowerment
3.3 Integration with Health Programs
3.4 Leadership and Mainstreaming
3.5 Coordination and Networking
3.6 Focus on Special Target Groups
4. Thematic Areas, Objectives and Strategies
4.1 Capacity Building
4.1.1 Health Sector
4.1.2 Education Sector
4.1.3 Community Capacity Building
4.1.4 HIV/AIDS Prevention and Control Office
4.1.5 Other Implementers
4.1.6 Legal and Human Rights Issues
4.2 Social Mobilization and Community Empowerment
4.3 Integration with Health Programs
4.3.1 Primary Health Care Units
4.3.2 Hospital Services
4.3.3 Safe Blood
4.4 Leadership and Mainstreaming
4.4.1 Leadership
4.4.2 Mainstreaming
4.5 Coordination and Networking
4.6 Special Target groups
4.6.1 Commercial sex workers, truckers, migrant laborers,
people in uniform, teachers, students and youth
out of school
4.6.2 People Living With HIV/AIDS, Orphans and other
Vulnerable Children
5. Comprehensive HIV/AIDS Strategic Plan Matrix
5.1 Thematic Area 1: Capacity Building
5.2 Thematic Area 2: Social Mobilization and
Community Empowerment
5.3 Thematic Area 3: Integration with Health Programs
5.4 Thematic Area 4: Leadership and Mainstreaming
5.5 Thematic Area 5: Coordination and Networking
5.6 Thematic Area 6: Special Target Groups
6. Budget Requirement and Justification
7. Governance and Institutional Arrangement
7.1 HIV/AIDS Councils and Executive Boards
7.2 The Ministry of Health
7.3 HIV/AIDS Prevention and Control Offices (HAPCOs)
7.4 Other Implementers
8. Monitoring and Evaluation
9. Challenges and the Way Forward
9.1 Challenges
9.2 Way Forward
10 Annexes
Annex 1
Minimum Service Delivery Package at Institutional Level
Annex 2
Role of Key Implementing Agencies and Stakeholders
Annex 3
Identified List of Policy Documents, Manuals and Guidelines
and their status
Annex 4
Acronyms
The ongoing multi-sectoral response to the HIV/AIDS epidemic is framed around the National policy and the Five-year Strategic Framework that were issued out in 1998 and 1999 respectively. Several independent attempts were undertaken to review and evaluate the performance and achievements of the ongoing interventions. These include:
All these discrete but participatory undertakings have generated a wealth of information on the situation of HIV/AIDS in Ethiopia including the prevalence rate, the major determinants, socio-economic impacts, and most vulnerable groups to HIV infection shed light on the major strengths/successes, limitations/gaps, opportunities and threats of the multi-sectoral response.
The exercise of developing a new and comprehensive Strategic Plan for the multi-sectoral HIV/AIDS response is based on these findings and is a logical continuation of the situation and response analysis undertaken earlier.
This Strategic Plan and Management (SPM) has been prepared mainly through desktop review. Critical analysis and synthesis of the relevant documents was carried out with the involvement of relevant individuals and institutions during regular consultation and brainstorming sessions. Among other documents, the Critical Review of the Original National Strategic Framework and the revised National Strategic Framework (NSF) have formed the basis for this exercise and have been meticulously reviewed.
Excluding the introduction and executive summary, this SPM has NINE major parts and important annexes. Part one covers a synoptic overview of the situation of HIV/AIDS in Ethiopia and the national response to date. Part two consists of the mission, vision, goal and guiding principles of the national response, while part three elaborates on the six strategic issues that the Government of Ethiopia has identified. Part four focuses on the six thematic areas along with their corresponding objectives and strategies (unless prevented by paucity/absence of reliable baseline data, objectives have been presented in measurable terms). The fifth major part of the SPM is the strategic plan matrix, which outlines selected strategy, major activities, indicators, means of verification and responsible body for the activities of the given thematic areas. Part six covers the budgetary requirements and justification. Part seven and eight cover governance and institutional arrangement, and monitoring and evaluation respectively. Part nine elaborates on the major challenges and the ways forward. The SPM is subsequently concluded with the annexes which include the minimum service delivery package by institutional level, role of key implementing agencies, list of policy document and acronyms.
This SPM covers four years (2004-2008). Its implementation process and performance will be closely monitored and evaluated. Based on their comparative advantage, multi-sectoral actors at all levels working on HIV/AIDS issues are expected to develop and implement their respective plans based on this SPM.
According to the Fifth AIDS in Ethiopia report issued by the Ministry of Health, the national HIV prevalence rate is estimated to be 4.4%. Currently there are more than 1.5 million PLWHA in Ethiopia of which 817,000 are women and 96,000 are children under the age of 14.(MoH 2003).
The government of Ethiopia has been steadfast in its response to the epidemic. In 1985, prior to the first laboratory diagnosis of HIV in Ethiopia, the government established a National HIV/AIDS Task Force within the Ministry of Health. In 1987-89 Short and Medium Term Plan were drawn out to respond to the budding epidemic. As the epidemic began to spread the government responded by issuing a national AIDS policy, the strategic framework and the establishment of a multi-sectoral and broad based National AIDS council (NAC) and the secretariat, which evolved to the current HIV/AIDS Prevention and Control Office (HAPCO). Despite these and other concerted efforts the epidemic still continues to grow steadily both in urban and rural settings claiming the lives of the most productive segment of the Ethiopian society. HIV/AIDS has now become one of the major challenges to the socio-economic development of the country.
The development of this SPM is geared towards enhancing and strengthening the
ongoing multi-sectoral prevention and control activities. The SPM outlines the
vision, mission, goals and guiding principles of the national multi-sectoral
response to the HIV/AIDS epidemic. After a thorough analysis of the limitations,
gaps and achievements of the prevention and control efforts thus far, the following
six strategic issues are identified and addressed in this document
Capacity Building: The health sector, the education sector and the community
are the three priority focus areas for capacity building. The health sector
shoulders the greatest responsibility in bringing a continued reduction in the
spread of HIV as well as the care and treatment of those infected and affected.
To this end the capacity of this sector has to be strengthened so that it can
effectively assume its leadership role. Strengthening the capacity of the education
sector and, integration of HIV/AIDS into the system would result in shaping
the future generation and ensure a sustained human resource development. In
order to realize the objectives of the multi-sectoral response against HIV/AIDS,
the capacity of the community to contain the havoc HIV/AIDS is causing amongst
individuals, families, and the community at large needs to be built.
Community mobilization and empowerment: Targeted prevention and care and support services cannot attain their maximum impact without community mobilization and empowerment. Community participation can be realized only when it is ignited from within and not imposed from outside. It is vital that the community is involved, and empowered in identifying its own problems and subsequently developing and implementing solutions for them. In this regard the involvement of the community including religious leaders, women’s groups, youth organizations, farmers' associations, council members, health extension workers, teachers, development agents, and NGOs will significantly contribute to the fight against the epidemic and will be enhanced.
Integration with Health programs: The current health policy, the decentralization of health governance to woredas and Kebeles and the focus on the health extension program, has created a favorable working environment for the prevention and control of HIV/AIDS. Hence HIV/AIDS related services will be integrated, strengthened and expanded.
Leadership and mainstreaming: Some Government Sectors have mainstreamed HIV/AIDS into their core policy and functions, however, HIV/AIDS is not yet mainstreamed as a priority development agenda by most sectors. Unless sectoral leaders at all levels provide the required guidance for mainstreaming HIV/AIDS in their program and are made accountable for ensuring its implementation, it will be impossible to curb the spread of the epidemic and mitigate its impact.
Coordination and Networking: Roles and responsibilities of the different actors in the multi-sectoral response of fighting HIV/AIDS needs to be clearly identified, clearly delineated and lucidly communicated to all involved. Lessons learned from the coordinating efforts of HAPCO, at different levels will be strengthened and built on to enhance coordination at all levels.
Targeted Response: Even though Ethiopia is in a state of generalized epidemic, it is important to give priority to selected vulnerable target groups. In line with the multi-sectoral response special attention will be given to the Youth, CSW, Mobile workers, uniformed people and teachers as there is demonstrable evidence for their vulnerability.
The SPM has dealt in detail with the aforementioned six strategic issues and identified thematic area within each issue. Subsequently, under each thematic area, specific components are identified for which an objective is defined and selected strategies are designed. Overall, under the six thematic areas, sixteen components are identified for which objectives are defined with their specific selected strategies.
Budgetary need for the implementation of the SPM is estimated to be around 6 Billion Ethiopian Birr.
Under the new implementation arrangement of the national response, at the federal
level HAPCO will be directly accountable to MoH and the RHAPCOs will be accountable
to their respective RHBs. Zonal and woreda health bureaus will be directly responsible
for coordinating HIV/AIDS activities in their respective areas.
