Breaking the Silence -Fight against HIV/AIDS

"Pakistan has entered in to the stage of concentrated epidemic, where more than 5% prevalence is reported amongst at least one high-risk group". Since 1987, when the first case of HIV infection was reported, cases of AIDS and HIV infection have been steadily rising in Pakistan.

In May 2003, United Nations Fund for Population Assistance (UNFPA) awarded Greenstar Social Marketing, Pakistan a 20 month contract for an STI and HIV/AIDS prevention program in Hyderabad. The prime beneficiaries of the intervention were brothel-based female sex workers, singing and dancing girls in Serey Ghat, the 2nd largest red light area of the province after Napier Road of Karachi.

ACHIEVEMENTS

• Completed baseline research, mapping and need assessment exercise.

• Conducted sero-surveillance study in collaboration with Sindh AIDS Control Program. 158 Samples were collected form a total population of 170 FSW (aged 15- 49 years) after getting informed consent and pre test counseling

• Assessed health services and retail outlets available to target population (within 2 kilometers radius)

• Established a clinic/ resource centre with mini lab in the heart of the brothel and branded it by the name of Naya Aghaz Sehat Markaz

• Identified all medical service providers and chemists in the area, and trained them on standardized treatment procedures and referrals.

• Established linkages with public sector HIV surveillance center for referrals for HIV testing, counseling and care for PLWHA.

• Developed contacts with key influencers and internal stakeholders to enhance operational effectiveness and sustainability.

• Six Peer outreach workers identified and trained on delivering disease prevention messages and correct use of condoms.

• Developed Behavior Change Communication Strategy and interpersonal communication tools for addressing STI and HIV/AIDS.

• Conducted post intervention KAP survey to assess change in knowledge, attitude and practices regarding HIV/AIDS; treatment seeking behavior and condom use. The impact of peer outreach program was also assessed.

Scaling up the pilot intervention to cover larger segment of population at risk
Keeping in view the success of the project, Government of Sindh awarded a contract in 2006 to scale up the intervention to cover the whole city of Hyderabad targeting the Kothi khan-based and Street-based female sex workers in addition to continuing the brothel-based services.

 

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Greenstar TB Program

Pakistan has the seventh highest TB burden in the world, with an estimated prevalence of 177/100,000. Around 1.5 million people are living with the disease in the country. Despite the extraordinary efforts of the government and partners, case detection still remains at 39 percent, well below the global target of 70 percent.

In partnership with National TB Control Program (NTP), Ministry of Health, Greenstar (GS) is implementing one of the Global Fund Round 3 supported projects on TB.

Till the end of December 2006:

• 962 franchised clinics were providing treatment facilities

• 1010 private providers (doctors) were trained on TB DOTS protocol

• 10557 non-prescribing providers (including paramedics, LHVs, volunteers, treatment supporters and the project staff) were trained in their relevant areas like case identification, case referral for registration, case holding and treatment support under TB-DOTS etc.

• More than 9000 cases were registered. Around 78% of them were Sputum Smear Positive cases

• Around 1000 patients successfully completed their treatment.

The objective of this program is to create greater knowledge and provide increased access to high quality TB DOTS information, testing and treatment through a private sector clinic franchise - GoodLife Stop TB Network, in 5 major cities; Karachi, Lahore, Rawalpindi, Peshawar and Quetta.

The Greenstar,s public-private-partnership strategy appears to serve as a model in Pakistan to engage providers to deliver quality TB services accessible to vulnerable, low-income population. Through this strategy, GSM has improved access for TB diagnosis and treatment providing healthcare on "the doorsteps of patients."

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