Annex 2: Follow-up and implementation; an Extract from the Report: International consultation policy guidelines on improving health workers' access to prevention, treatment and care services for HIV and TB 14-16 September 2009, WHO/Geneva (pp 41-46)

General Results of Guideline Group discussions and agreements

There is consensus among members of the Guideline Group that there is a need for a policy guideline from WHO/ILO

In the end, participants reached consensus, accepting 14 statements as a policy guideline. Countries can take statements and create advocacy material or collaborate with existing strategies already in place to increase access for Health Care Workers (HCWs).

Proposal on implementation strategy from group work by partners and stakeholders

i) Issues and challenges related to policies and guidelines for health worker access to HIV and TB

  • Consultations
  • Advocacy and Adaptation on the use of the policy guideline
  • Dissemination and Implementation
  • Mobilization and Allocation of resources
  • Monitoring and evaluation
  • Modality/processes

ii) Consultations

By June 2010: HQ/Regional consultation

  • Regional Level
  • a regional advocacy meeting with WHO, ILO, ministries of health, finance and labour should occur
  • Country Level
  • with WHO, ILO, ministries of health, finance and labour should occur also with trade unions, professional associations, civil society and health workers Living with HIV/TB

iii) Advocacy and Adaptation

By December 2010: National Advocacy

  • With ministries of health, finance and labour should occur also with trade unions, professional associations, civil society and health workers Living with HIV/TB
  • Development of an implementation plan at the country level
  • focal point/leadership present existing guidance a realistic dissemination plan must be developed including training and orientation for health workers
  • guidance on how to use and how to involve health care worker committees
  • Utilization of existing mechanisms (e.g. Country Coordination Mechanisms (CCMs) )
  • invite parties not previously involved (such as occupational health)

iv) Dissemination and Implementation

  • virtual meetings and other innovative methods to prioritize funds for implementation (e.g. SharePoint, websites, etc.)

v) Mobilization and Allocation of resources

  • advocacy work with donors is necessary to make health workers a priority to establish the funds necessary for implementation
  • country ownership: governments themselves must also commit funds to provide these necessary services

a. Assisting countries to integrate TREAT policy guidelines with HRH policies and strategic plans , linkages with existing national financial mechanisms (MTEF & LTEF, SWAp, etc).

  • Other existing funding mechanism should be explored (Global Fund, PEPFAR...)

(e.g. a concrete proposal should be submitted to the Global Fund to ensure that health workers are a priority)

  • Global Fund: the activities of these proposed guidelines could fit within HIV and TB opportunities, best if integrated

vi) Monitoring and Evaluation

  • monitoring and evaluation group should be established within WHO/ILO specific to this initiative
  • work plan needs to be linked to target with measurable results of successes
  • Performance based implementation
  • Link to UNAIDS Programme Coordinating Board (PCB) 9 priority outcomes
  • Link to data gathering process of the national composite index on the UNGASS declaration

vii) Modality/processes

  • "pouch" or political mobilization
  • the political dimension is crucial (Issues of stigma, discrimination) Consultation/Planning— Implementation— Evaluation

Joint WHO/ILO responsibility

- e.g. advocate through existing global and regional forums: World Health Assembly (WHA), Regional Programme Meeting (RPM), International Conference on AIDS and STIs in Africa (ICASA), ILO international conferences etc.

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