Program Title: Prioritized HIV prevention and treatment services for key populations in Bangladesh_FSWI

Introduction: The NFM 3 comprise of 2 services sector like [1] HIV Sector and [2] C-19RM. Considering the geographical presence, capacities of grant management and overall programmatic experience; Dhaka Ahsania Mission [DAM] Consortium, comprise with  i.e., Dhaka Ahsania Mission as Sub recipient (SR) along with two Sub Sub Recipient [SSR]: Young Power in Social Action (YPSA) and Nari Mukti Sangha (NMS) will implement the following activities under this sub grant agreement for 12 months where beign SR, DAM will be the lead agency. FSWs will receive a different service package (Intensive or Minimum), based on their vulnerability. Special attention will have focused on improving FSW’s access to SRH services and to reduce GBV and improve mental health

Ending AIDS, through reaching the 95-95-95 treatment targets and provides a moderate return on investment that would be a feasible investment option in terms of sustainability and program effectiveness.

Background and Rational for the project:
Bangladesh has maintained a low HIV prevalence of <0.01% among its general population since the first case was detected in 1989 however, it is one of seven countries in the region where the epidemic continues to increase. In the past 20 years, Bangladesh has developed from a low-level into a concentrated HIV epidemic, driven mainly by injecting drug use. Among other key populations (KP) defined in the 4th National Strategic Plan (NSP) HIV prevalence remains low: among female sex workers (FSW) prevalence was found to be less than 0.5%. The estimated sizes of the Key Populations (KPs) are 102,260 for female sex workers (FSWs) in Bangladesh.

In NFM3, the three PRs, ASP (Government), Save the Children (SC) and icddr,b will jointly implement the HIV program with SC focusing on PWID and FSW, icddr,b focusing on MSM and TG and ASP focusing on strengthening the enabling environment as well as gradually initiating HIV service delivery for PWID and FSW from selected government hospitals.

Goal/Aims:
[HIV Sector] To minimize the spread of HIV and the impact of AIDS on the individual, family, community, and society, working towards, ending AIDS in Bangladesh by 2030.

[C-19RM Sector] aims at community participation approaches translated into action during the pandemic through empowering community members, mobilizing resources, and strengthening the ownership among the local community to ensure effective advocacy, proper networking, and dissemination of information and, subsequently, actions at the level of the community

Objectives [HIV Sector]:

  • To increase coverage of services, to increase the identification of PLHIV and to prevent new HIV infections for 24.72% of MSM/MSW (from 21.30%), 49.02% of TG (from 39.83%), 81.76% of PWID (from 28.73%) and 30.6% of FSW (from 18.09%), considering the targets of the national size estimation 2015-16
  • To provide universal access to treatment, care and support services for the people living with HIV
  • To strengthen the coordination mechanisms and management capacity at different levels to ensure an effective national multi-sectoral HIV&AIDS response
  • To strengthen strategic information systems and research for an evidence-based response.

Objectives [ C-19RM]:

  • To provide nutrition support to FSW who are in need of the support
  • To provide additional allowances to field based staff of their facilities (25) in selected geographic areas
  • To learn regarding GBV and its related information, response & reporting
  • To provide guidance to FSWs on registration for vaccination and transportation support to complete the vaccination

Approaches:
The program has six main approaches; three are related to HIV service delivery, and three are related to creating an enabling environment. The program will:

  • Prevent new HIV infections and reduce incidence by improving and expanding access to combination HIV prevention (including comprehensive harm reduction) services for KP
  • Increase case-finding among KP by improving and expanding access to differentiated HIV testing services (HTS)
  • Improve access, adherence to and quality of ART services for KP in need, lowering HIV-related morbidity and mortality and reducing onward transmission of HIV
  • Strengthen community and government health systems, empower marginalized communities to claim their right to health in a stigma-free environment, and improve linkages and cross-referrals and build capacity to manage and deliver HIV services
  • Advocate for legal reform at the policy level and advocate and engage with local gatekeepers and law enforcement agencies to reduce stigma and enable implementation of HIV services for LP
  • Improve systems for M&E and strategic information (including updated IBBS data (ongoing under current grant), a revision of size-estimation data (using OP funds) and operations/implementation research)

Project Duration: 01 January 2023 to 31 December 2023 (12 months)

Total Project Budget:
HIV Sector: 72,739,106 [BDT], C-19RM Sector: 20,681,635 [BDT]

Main Scope of Assignments [HIV Sector]

  • Provide essential services to 30,000 FSWs
  • Operating 09 Drop-In-Centers (DICs) and 16 outlets
  • Condom Promotion, STI and HTS services for FSWs and their partners
  • Creating an enabling environment within local communities through advocacy meetings and distribution advocacy materials.
  • Monitoring and Coordination
  • Linkage with sex worker’s network

Main Scope of Assignments [C-19RM Sector]

  • Nutrition and social support for KPs
  • Providing additional allowances for the field staff under COVID-19 situation
  • Organize group education sessions on COVID-19 vaccination and GBV
  • Facilitate key population for vaccination

Project Area and Coverage:
The project under this service agreement will be implemented in the following in 13 Districts of Bangladesh. The Consortium will cover 30,000 FSWs during January – December 2023 through establishing 09 DICs and 16 outlets. Districts wise targeted coverage and number of DICs/outlets is given below:

Organization

Districts

No. of DICs

No. of Outlet

Population

Dhaka Ahsania Mission Dhaka, Rajshahi, Khulna, Jessore, Satkhira and Dinajpur

04

07

14,370

Young Power in Social Action Sylhet, Chattogram, Cox’s Bazar, and Cumilla

03

04

7030

Nari Mukti Sangha Dhaka, Tangail, Gazipur and Narayanganj

02

05

8,600

Total 13

09

16

30,000