REQUEST FOR PROPOSALS-Surveillance workshops

STRENGTHENING SURVEILLANCE SYSTEMS FOR HIV AND AIDS IN PRISONS

Proposed Date: XX September 2009

Background

HIV and AIDS are serious threats in many countries and present significant challenges for prison and public health authorities and national governments. The levels of HIV infection among prison populations worldwide tend to be much higher than in the general population. Since it is acknowledged that prisoners and prison staff are part of the broader community, the health threat of HIV within and outside prisons are linked.  Therefore, it is a fact that most prisoners are in prison for only a short period of time, therefore HIV infections acquired inside can easily be transmitted outside. 

In 2008, UNODC’s Regional Office for Southern Africa launched a regional programme covering Mozambique, Namibia, Swaziland and Zambia. The main objectives of this programme: ‘HIV Prevention, Treatment, Care and Support in Prisons Settings in Southern Africa ’, are to:

1. To reduce the risk of transmission of HIV within prisons and;
2. To reduce mortalities related to HIV and AIDS in prisons.

These objectives are expected to be achieved through advocacy for improved prisoners’ and prison staff’s access to HIV and AIDS services by addressing structural issues such as rules and regulations, overcrowding, monitoring and improving general conditions of prisons at the same time supporting the operationalisation of national policies. The programme also extends technical capacity building to service providers as well as raising their awareness on HIV and AIDS in Prisons.

Surveillance refers to the many and varied systems used to track the incidence (new occurrences) and prevalence (total existing cases) of a particular disease. AIDS surveillance systems are used to track HIV infections, AIDS cases, opportunistic infections, and other data. The term is also often used to refer to policies and programs concerning the accessibility and requirements for HIV testing.  From almost the beginning of the epidemic, AIDS surveillance has been a complex and controversial subject, with advocates, public health officials, and government agencies often differing on such issues as named reporting for HIV infection, partner notification, and testing of pregnant women.

Until recently, data on levels of HIV infection for developing countries were not sufficiently voluminous to allow any but a one-time snapshot of the situation in a particular region or country. However, this picture is rapidly changing as repeated surveys and sentinel surveillance projects established over the past several years begin to use consistent methods of HIV serologic data collection over a period of years.

Often, national and regional responses to HIV/AIDS have been undermined by generic approaches, which do not address the major drivers of the epidemic to the specific, local requirements.  According to a recent study by the Commission on AIDS in Asia, effective prevention services for those groups most at risk of infection can avert 80% of new infections.  This reiterates the importance of accurate local data collection and analysis. In many countries in the region, critical data on the HIV epidemics is still limited or unavailable to the policy-makers. Without this information, national AIDS programs cannot identify the priorities, progress, and impact of interventions. Pivotal to a successful response is the availability of data. 

Data cannot be used well unless they are of high quality, also data should be collected with an idea of how they will be used in planning and evaluating HIV programmes or in advocacy. Surveillance data help us to understand the size and characteristics of the HIV epidemic as well as the opportunities to set up evidence-based HIV interventions. One of the primary areas of data use is to  estimate the number and distribution of those at higher risk as it enables to allocate resources effectively and plan such needs at the national scale. Understanding the sources of new infections enables programmes to refocus efforts to those groups at risk, including prisoners and prison staff.

Based on the above background, UNODC has realized the need to build capacity of prison staff, prison administration, health and statistics sections in prison settings on the basic principles of HIV surveillance,  with the objective of strengthening surveillance systems in prison settings. 

Purpose of the workshop

The main purpose of the proposed workshop is to build capacity of prison staff (administration, management, health and statistics) on the basic principles of HIV surveillance.  To review and discuss how HIV surveillance data can be used to guide National AIDS Programme decisions.

The workshop will outline the methods and principles of collecting high quality HIV surveillance data, as it is a prerequisite for effective data use. Sessions will address the measurement instruments i.e. laboratory tests used in surveillance as they are tools in obtaining surveillance indicators and help participants to understand the gaps in interventions.

Sessions on data use will be structured to explain different types of data use, such as for planning various prevention interventions, care and treatment, planning the size of interventions and targeting interventions to populations at risk. Exercises based on real surveillance data and case examples will be used to illustrate the challenges in data interpretation, and the advantages and disadvantages of different data sources.

During sessions on data presentation, participants will learn how to present data to different audiences such as programme managers, policy makers, communities and media. An important part of the workshop will focus on learning how to write-up a surveillance report. 

Key topics

 Key discussions will include, but not limited to:

• General Principles and key epidemiological issues in Public Health Surveillance
• Core elements of  HIV/AIDS surveillance
• Planning and Management of HIV surveillance
• Evaluating  an HIV surveillance system
• Indicator selection
• Ethical Considerations in HIV/AIDS surveillance
• Obtaining useful and high-quality data
• Data collection, analysis , dissemination and use
• Principles of effective data use
• Most common weaknesses in HIV surveillance data
• Case studies and exercises

Target Audience

The proposed workshop is intended to build capacity of the national prisons and correctional services.  Participants are expected to represent a multidisciplinary audience of prison administration, management, prison warders, prison nurses and other health officials, data managers (and statistics divisions representatives) as well as same categories data handlers from the public hospitals that serves the prison populations.

Expected Outcomes

Upon completion of the workshop, participants will be able to go back to their respective workplaces with concrete understanding and knowledge of principles of  HIV surveillance, with particular emphasis on prison settings.  They will have drafted guidelines to establish or strengthen surveillance systems,  drafted data collection tools an learned data management and dissemination techniques.

The outcomes of the workshop should have great impact on the general HIV data management in the prisons, an effect that should be noticed in the national HIV surveillance system.

This will lead to informed decision making and interventions for prison services programming.