Setting up and Managing Sexual Health Clinical Services in Resource-Poor Settings: A Comprehensive Programmatic Guide for NGOs

This 2-part manual was developed to support the provision of clinical services to key populations (men who have sex with men, people living with HIV/AIDS, sex workers and injecting drug users) in Andhra Pradesh as part of the India AIDS Initiative-Avahan (IAI-Avahan) programme and the Frontiers Prevention Project (FPP). A key lesson that has so far emerged from this multi-site project is that communication and participation are central to the HIV/AIDS response: "The most successful responses to HIV/AIDS are built upon local leadership, commitment and responsibility, and are supported by strong knowledge base. Local non-governmental organisations (NGOs) and community-based organisations (CBOs) are particularly well placed to facilitate community responses as well as to effectively bridge the needs and capacities of poor people and communities with broader health and development efforts."

The manual includes two volumes:

Setting up and Managing Sexual Health Clinical Services in Resource-Poor Settings: A Comprehensive Programmatic Guide for NGOs [PDF] - The main purpose of the first volume is to help NGOs design and implement strategies and workplans for sexually transmitted infection (STI) service delivery as part of a focused and comprehensive package of prevention interventions. In an effort to enhance the interface between clinical services and communities, the manual contains tools to enable community support services (provided by outreach workers and specialised technical support staff) to effectively cooperate with existing clinical services. For instance, Section 2 examines the steps involved in designing NGO-managed STI services and offers specific strategies for assessing organisational capacity to implement such services. The volume includes a variety of guidelines and tools (such as clinical reports and forms collected in various appendices) to facilitate this process.

Clinical Management of Sexually Transmitted Infections in Resource-Poor Settings: A Comprehensive Guide for Clinicians [PDF] - The second volume is primarily intended for clinical staff who will oversee and manage a variety of interventions, including the diagnosis and treatment of STIs, within specialised NGO clinics. It features a comprehensive approach for the effective management of STIs through service delivery, with a focus on referral pathways to services, including guidance on taking a patient's sexual history and the management and treatment of STIs. Tools which may be useful in implementing clinical services (e.g., syndrome codes to aid in monitoring and data collection, and information on generating patient-specific personal identification numbers) and participatory exercises (e.g., role plays) for those who wish to use this manual to assist in training are also offered.

The India HIV/AIDS Alliance (Alliance India) was established as a country office in New Delhi in 1999 and is part of the International HIV/AIDS Alliance. Its strategic goal is to increase community action for, and access to, prevention, care and impact mitigation efforts in India. The project from which this 2-part manual emerged is supported by the Bill and Melinda Gates Foundation and is being implemented by partner NGOs.