APPENDIX A - National Composite Policy Index Questionnaire
I. Strategic Plan
1. Has your country developed a national multi-sectoral strategy/action framework to combat HIV/AIDS?
(Multi-sectoral strategies should include, but not be limited to, those developed by Ministries such as the ones mentioned below.)
No. The United States does, however, have a national plan for HIV prevention, developed by the Centers for Disease Control and Prevention (CDC) within the U.S. Department of Health and Human Services (HHS).
1.1 IF YES, which sectors are included?
Sectors included | Strategy/Action framework | Focal point/Responsible |
Health | Yes No | Yes No |
Education | Yes No | Yes No |
Labor | Yes No | Yes No |
Transportation | Yes No | Yes No |
Military | Yes No | Yes No |
Women | Yes No | Yes No |
Youth | Yes No | Yes No |
Others to specify | Yes No | Yes No |
1.2 IF YES, does the national strategy/action framework address the following areas, target
populations and cross-cutting issues?
Programme
a. Voluntary counseling and testing? Yes
b. Condom promotion and distribution? Yes
c. Sexually transmitted infection prevention and treatment? Yes
d. Blood safety? Yes
e. Prevention of mother-to-child transmission? Yes
f. Breastfeeding? Yes
g. Care and treatment? Yes
h. Migration? Yes
Target populations
i. Women and girls? Yes
j. Youth? Yes
k. Most-at-risk populations? Yes
l. Orphans and other vulnerable children? Yes
1.3 IF YES, does it include an operational plan? No
1.4 IF YES, does the strategy/operational plan include:
a. formal programme goals? No
b. detailed budget of costs? No
c. indications of funding sources? No
1.5 Has your country ensured “full involvement and participation” of civil society in the planning phase?
No.
1.6 Has the national strategy/action framework been endorsed by key stakeholders?
Yes.
2. Has your country integrated HIV/AIDS into its general development plans (such as: a) National Development Plans, b) United Nations Development Assistance Framework, c) Poverty Reduction Strategy Papers, and d) Common Country Assessments)?
No.
2.1 IF YES, in which development plan? Covering which of the following aspects?
N/A.
HIV Prevention
Care and support
HIV/AIDS impact alleviation
Reduction of gender inequalities as relates to HIV/AIDS prevention/care
Reduction of income inequalities as relates to HIV prevention/care
Others:
3. Has your country evaluated the impact of HIV and AIDS on its economic development for planning purposes?
No.
3.1 IF YES, how much has it informed resource allocation decisions? (Low to High)
Low High
0 1 2 3 4 5 6 7 8 9 10
4. Does your country have a strategy/action framework for addressing HIV and AIDS issues among its national uniformed services, military, peacekeepers and police?
Yes.
4.1 IF YES, which of the following have been implemented?
HIV Prevention Yes
Care and support Yes
Voluntary HIV testing and counseling Yes
Mandatory HIV testing and counseling Yes
Others to specify:
Overall, how would you rate strategy planning efforts in the HIV and AIDS programs?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
II. Political support
Strong political support includes government and political leaders who speak out often about AIDS and regularly chair important meetings, allocation of national budgets to support the AIDS programs and effective use of government and civil society organizations and processes to support effective AIDS programs.
1. Does the head of the government and/or other high officials speak publicly and favorably about AIDS efforts at least twice a year?
Head of government Yes
Other high officials Yes
2. Does your country have a national multi-sectoral HIV and AIDS management/coordination body recognized in law? (National AIDS Council or Commission)*
Yes. The President’s Advisory Council on HIV/AIDS
2.1 IF YES, when was it created?
1995
2.2 Does it include?
Terms of reference Yes
Defined membership Yes
Including civil society Yes
People living with HIV Yes
Private sector Yes
Action plan Yes
Functional Secretariat Yes
Date of last meeting of the Secretariat March 25-26, 2008
3. Does your country have a national HIV and AIDS body that promotes interaction between government, people living with HIV, the private sector and civil society for implementing HIV and AIDS strategies/programs?
Yes.
3.1 IF YES, does it include?
Terms of reference Yes
Defined membership Yes
Action plan Yes
Functional Secretariat Yes
Date of last meeting: March 25-26, 2008
Comment: The President’s Advisory Committee on HIV/AIDS (PACHA)
4. Does your country have a national HIV and AIDS body that is supporting coordination of HIV-related service delivery by civil-society organizations?
No.
4.1 IF YES, does it include?
Terms of reference
Defined membership
Action plan
Functional Secretariat
Date of last meeting
Comment: Not Applicable.
Overall, how would you rate the political support for the HIV/AIDS program?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
2007 0 1 2 3 4 5 6 7 8 9 10
III. Prevention
1. Does your country have a policy or strategy that promotes information, education and communication (IEC) on HIV and AIDS to the general population?
Yes.
1.1 In the last year, did you implement an active program to promote accurate HIV and AIDS reporting by the media?
Yes, when inaccurate or erroneous reporting on HIV/AIDS is brought to the agency’s attention, the HHS/CDC will contact the appropriate media outlets and provide factual corrections.
2. Does your country have a policy or strategy promoting HIV and AIDS related reproductive and sexual health education for young people?
Yes.
2.1 Is HIV education part of the curriculum in:
primary schools? Not Applicable
secondary schools? Not Applicable
2.2 Does the strategy/curriculum provide the same reproductive and sexual health education for young men and young women?
Not Applicable. Educational content and curriculum decisions are under the jurisdiction of U.S. States and localities.
3. Does your country have a policy or strategy to promote information, education and communication and other preventive health interventions for most-at-risk populations?
Yes.
3.1 Does your country have a policy or strategy for these most-at-risk populations?
Injecting drug users, including:
- Risk reduction information, education and counseling? Yes
- Needle and syringe programmes? No
- Treatment services? Yes
- If yes, drug substitution treatment? Yes
- Men who have sex with men? Yes
- Sex workers? No
- Prison inmates? No
- Cross-border migrants, mobile populations Yes
- Refugees and/or displaced populations? Yes
- Other most-at-risk populations? Please specify No
Comment: U.S. policy is that no Federal funds shall support needle-exchange programs.
4. Does your country have a policy or strategy to expand access, including among most-at-risk populations, to essential preventative commodities? (These commodities include, but are not limited to, access to confidential voluntary counseling and testing, condoms, sterile needles and drugs to treat sexually transmitted infections.)
Yes.
4.1 Do you have programmes in support of the policy or strategy?
A social-marketing programme for condoms? No
A blood-safety programme? Yes
A programme to ensure safe injections in health care settings? Yes
A programme on antenatal syphilis screening No
Other programmes? Please specify Yes
Comment: HHS/CDC supports voluntary HIV testing in collaboration with state and local health departments and community organizations. U.S. law prohibits Federal funds shall support needle exchange programs.
Overall, how would you rate policy efforts in support of prevention?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
2007 0 1 2 3 4 5 6 7 8 9 10
Comment: We decline to rank U.S. HIV-prevention efforts on a scale of 1 – 10. However, an independent assessment of HHS/CDC’s HIV-Prevention programs conducted by the U.S. Office of Management and Budget in 2007 awarded the agency the highest possible rating (Effective) given to Federal programs (see: www.whitehouse.gov/omb/expectmore/summary/10009017.2007.html). HHS/CDC is the lead federal agency for HIV prevention in the United States.
5. Which of the following prevention activities have been implemented in 2006 and 2007 in support of the HIV-prevention policy/strategy? (Check all programmes that are implemented beyond the pilot stage to a Significant portion in boththe urban and rural populations).
a. A programme to promote accurate HIV and AIDS reporting by the media reporting. No
b. A social-marketing programme for condoms. No
c. School-based AIDS education for youth. Yes
d. Behaviour-change communications. Yes
e. Voluntary counseling and testing. Yes
f. Programmes for sex workers. No
g. Programmes for men who have sex with men. Yes
h. Programmes for injecting drug users, if applicable. Yes
i. Programmes for other most-at-risk populations. Yes
j. Blood safety. Yes
k. Programmes to prevent mother-to-child transmission of HIV. Yes
l. Programmes to ensure universal precautions in health care settings. Yes
m. Other: (please specify)
Overall, how would you rate the efforts in the implementation of HIV prevention programs?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
Comment: We decline to rank U.S. HIV-prevention efforts on a scale of 1 – 10. However, an independent assessment of HHS/CDC’s HIV-Prevention programs conducted by the U.S. Office of Management and Budget in 2007 awarded the agency the he highest possible rating (Effective) given to Federal programs (see: www.whitehouse.gov/omb/expectmore/summary/10009017.2007.html). HHS/CDC is the lead federal agency for HIV prevention in the United States.
Care and support11
IV. Care and Support
1. Does your country have a policy or strategy to promote comprehensive HIV and AIDS care and support, with sufficient attention to barriers for women, children and most-at-risk populations? (Comprehensive care includes, but is not limited to, confidential voluntary counseling and testing, psychosocial care, access to medicines, and home and community-based care.)
Yes.
2. Which of the following activities have been implemented under the care and treatment of HIV and AIDS programs?
a. HIV screening of blood transfusion. Yes
b. Universal precautions. Yes
c. Treatment of opportunistic infections. Yes
d. Antiretroviral therapy (ART) Yes
e. Nutritional care. Yes
f. Sexually transmitted infection care. Yes
g. Family planning services. Yes
h. Psychosocial support for people living with HIV and their families. Yes
i. Home-based care. Yes
j. Palliative care and treatment of common HIV-related infections: pneumonia, oral thrush, vaginal candidiasis and pulmonary TB (DOTS) Yes
k. Cotrimoxazole prophylaxis among HIV-infected people. Yes
l. Post exposure prophylaxis (e.g., occupational exposures to HIV, rape) Yes
m. Other: (please specify)
Overall, how would you rate the efforts in care and treatment of the HIV/AIDS program?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
3. Does your country have a policy or strategy to address the additional HIV and AIDS-related needs of orphans and other vulnerable children (OVC)?
Not Applicable. There is no national policy of this type. U.S. States are responsible for policies and activities to meet the needs of all vulnerable children.
3.1 IF YES, Is there an operational definition for orphans and other vulnerable children in the country?
Not Applicable.
3.2 Which of the following activities have been implemented under orphan and vulnerable children programs?
School fees for orphans and vulnerable children
Community programmes
Other: (please specify)
Comments: Not Applicable.
Overall, how would you rate the efforts to meet the needs of orphans and other vulnerable children?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
Not applicable.
V. Monitoring and
Evaluation
V. Monitoring and Evaluation
1. Does your country have one national Monitoring and Evaluation (M & E) plan?
Yes. 1982-present.
1.1 IF YES, was it endorsed by key partners in evaluation?
Yes.
Comment: There are multiple monitoring-evaluation tools throughout the Federal Government.
1.2 Was the Monitoring and Evaluation plan developed in consultation with civil society, people living with HIV?
Yes.
2. Does the Monitoring and Evaluation plan include?
- a data collection and analysis strategy Yes
- well defined standardized set of indicators Yes
- guidelines on tools for data collection Yes
- a strategy for assessing quality and accuracy of data Yes
- a data dissemination and use strategy Yes
3. Is there a budget for the Monitoring and Evaluation plan?
Yes—In progress. Years covered: year to year.
3.1 IF YES, has funding been secured?
Yes.
4. Is there a Monitoring and Evaluation functional Unit or Department?
Yes.
IF YES,
Based in NAC or equivalent? No
Based in Ministry of Health? Yes
Elsewhere? Please specify
Comment: Monitoring and Evaluation is a regular function of operation of all Federal health programs.
4.1 If yes, are there mechanisms in place to ensure that all major implementing partners submit their reports to this Unit or Department?
Yes.
4.2 Is there a full-time officer responsible for monitoring and evaluation activities of the national program?
Yes. There is a full-time Monitoring and Evaluation Officer at the Centers for Disease Control and Prevention within the U.S. Department of Health and Human Services
4.3 IF YES, since when?
1994.
5. Is there a committee or working group that meets regularly coordinating Monitoring and Evaluation activities?
No.
5.1 Does it include representation from civil society, people living with HIV?
Not Applicable.
6. Have individual agency programmes been reviewed to harmonize Monitoring and Evaluation indicators with those of your country?
No. Not Applicable.
7. To what degree (Low to High) are UN, bi-laterals, other institutions sharing Monitoring and Evaluation results?
Low High
0 1 2 3 4 5 6 7 8 9 10
Comment: Not Applicable
8. Does the Monitoring and Evaluation Unit manage a central national database?
Not Applicable.
8.1 IF YES, what type is it?____________________
Not Applicable.
9. Is there a functional* Health Information System?
National level Yes
Sub-national* Yes
(*reporting regularly data from health facilities aggregated at district level and sent to national
level, analysed, and used at different levels)
10. Is there a functional Education Information System?
Not Applicable.
National level Not Applicable
Subnational* Not Applicable
11. Does your country publish at least once a year an evaluation report on HIV and AIDS, including HIV surveillance reports?
Yes.
12. To what extent is strategic information used in planning and implementation?
U.S. planning is based largely on the strategic information found in HIV-surveillance reports.
13. In the last year, was training in Monitoring and Evaluation conducted?
At national level? Yes
At sub-national level? Yes
Including civil society? Yes
Overall, how would you rate the monitoring and evaluation efforts of the HIV and
AIDS program?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
National Composite Policy Index Questionnaire – Part B
I. Human rights
1. Does your country have laws and regulations that protect people living with HIV and AIDS against discrimination (such as general non-discrimination provisions or those that specifically mention HIV, that focus on schooling, housing, employment, etc.)?
Yes.
2. Does your country have non-discrimination laws or regulations which specify protections for certain groups of people identified as being especially vulnerable to HIV and AIDS discrimination (i.e., groups such as injecting drug users, men who have sex with men, sex workers, youth, mobile populations, and prison inmates)?
No. Non-discrimination laws apply equally to all U.S. citizens.
IF YES, please list groups:
3. Does your country have laws and regulations that present obstacles to effective HIV prevention and care for most-at-risk populations?
No.
IF YES, please list groups:
4. Is the promotion and protection of human rights explicitly mentioned in any HIV and AIDS policy/strategy?
No.
5. Has the Government, through political and financial support, involved vulnerable populations in governmental HIV-policy design and program implementation?
Yes.
IF YES, please list groups: The U.S. has over 50 groups who represent vulnerable populations. Each of these organizations is involved in policy design and implementation. There are also U.S. State-level groups (HIV Care and Treatment Consortiums and eligible Metropolitan-Area HIV-Planning Councils) and local groups (Community HIV-Prevention Planning Groups) that participate in policy planning and program implementation with the Federal Government.
6. Does your country have a policy to ensure equal access, between men and women, to prevention and care?
Yes.
Comment: U.S. policies state organizations must provide interventions to persons with HIVAIDS without regard for race, gender, or national origin.
7. Does your country have a policy to ensure equal access to prevention and care for most-at-risk populations?
Yes.
Comment: The U.S. policies state that services must be delivered to persons with HIVAIDS without regard for race, gender, or national origin.
8. Does your country have a policy prohibiting HIV screening for general employment purposes (appointment, promotion, training, benefits)?
Yes.
9. Does your country have a policy to ensure that HIV and AIDS research protocols involving human subjects are reviewed and approved by a national/local ethical review committee?
Yes.
9.1 IF YES, does the ethical review committee include civil society and people living with HIV?
Yes.
10. Does your country have the following monitoring and enforcement mechanisms?
-- Collection of information on human rights and HIV and AIDS issues and use of this information in policy and program development reform
No.
-- Existence of independent national institutions for the promotion and protection of human rights, including human rights commissions, law reform commissions and ombudspersons which consider HIV- and AIDS-related issues within their work
Yes.
-- Establishment of focal points within governmental health and other departments to monitor HIV-related human rights abuses
Yes.
-- Development of performance indicators or benchmarks for compliance with human rights standards in the context of HIV and AIDS efforts
No.
11. Have members of the judiciary been trained/sensitized to HIV and AIDS and human rights issues that may come up in the context of their work?
Training of federal judges on HIV and AIDS issues is incorporated into training on broader issues, such as offender re-entry programs. Most judges in the U.S. are state court judges, due to our federal system of government. Training for judges at the state level is governed by state governments and varies from state to state.
12. Are the following legal support services available in your country?
-- Legal aid systems for HIV and AIDS casework?
Yes.
-- State support to private sector laws firms or university based centers to provide free pro bono legal services to people living with HIV and AIDS in areas such as discrimination?
Yes.
-- Programs to educate, raise awareness among people living with HIV and AIDS concerning their rights?
No.
13. Are there programs designed to change societal attitudes of discrimination and stigmatization associated with HIV and AIDS to understanding and acceptance?
Yes.
Overall, how would you rate the policies, laws and regulations in place to promote and protect human rights in relation to HIV and AIDS?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
Overall, how would you rate the effort to enforce the existing policies, laws and regulations?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
II. Civil Society participation
II. Civil society participation
1. To what extent civil society has made a significant contribution to strengthening the political commitment of top leaders and national policy formulation?
Low High
0 1 2 3 4 5 6 7 8 9 10
2. To what extent civil society representatives have been involved in the planning and budgeting process for the National Strategic Plan on HIV and AIDS or for the current activity plan (attending planning meetings and reviewing drafts)?
Low High
0 1 2 3 4 5 6 7 8 9 10
3. To what extent the complimentary services provided by civil society to areas of prevention and care are included in both the National Strategic plans and reports?
Low High
0 1 2 3 4 5 6 7 8 9 10
4. Has your country conducted a National Periodic review of the Strategic Plan with the participation of civil society?
Not Applicable.
5. To what extent does your country have a policy to ensure that HIV and AIDS research protocols involving human subjects are reviewed and approved by an independent national/local ethical review committee in which people living with HIV and caregivers participate?
Low High
0 1 2 3 4 5 6 7 8 9 10
Overall, how would you rate the efforts to increase civil-society participation?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
III. Prevention
1. Which of the following prevention activities have been implemented in 2003 and 2005 in support of the HIV-prevention policy/strategy?
(Check all programmes that are implemented beyond the pilot stage to a significant portion of both the urban and rural populations).
| 2006 | 2007 |
a. A programme to promote accurate HIV and AIDS reporting by the media. | a. ___x______ | x |
b. A social-marketing programme for condoms | b. __________ | b. _________ |
c. School-based AIDS education for youth | c. ___x______ | c. __x______ |
d. Behaviour-change communications | d. ____x_____ | d. __x______ |
e. Voluntary counselling and testing | e. ____x_____ | e. __x______ |
f. Programmes for sex workers | f. __________ | f. _________ |
g. Programmes for men who have sex with men | g. __x_______ | g. __x______ |
h. Programmes for injecting drug users, if applicable | h. ___x______ | h. __x______ |
i. Programmes for other most-at-risk populations[1] | i. _____x____ | i. __x______ |
j. Blood safety | j. ____x_____ | j. __x______ |
k. Programmes to prevent mother-to-child transmission of HIV | k. ___x______ | k. ___x_____ |
l. Programmes to ensure safe injections in health care settings | l. ___x______ | l. ___x_____ |
m. Other: (please specify) | m. _________ | m. _______ _________ |
Overall, how would you rate efforts in the implementation of HIV-prevention programs?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
IV. Care and support
1. Which of the following activities have been implemented under the care and treatment of HIV and AIDS programmes?
| 2006 | 2007 |
a. HIV screening of blood transfusion | a. _____x____ | a. __x______ |
b. Universal precautions | b. _____x____ | b. ___x_____ |
c. Treatment of opportunistic infections (OI) | c. _____x____ | c. __x______ |
d. Antiretroviral therapy (ART) | d. ____x_____ | d. _x_______ |
e. Nutritional care | e. _____x____ | e. ___x_____ |
f. Sexually transmitted infection care | f. ___x______ | f. _x_______ |
g. Family planning services | g. ___x______ | g. __x______ |
h. Psychosocial support for people living with HIV and their families | h. ____x_____ | h. __x______ |
i. Home-based care | i. ____x_____ | i. ___x_____ |
j. Palliative care and treatment of common HIV-related infections: pneumonia, oral thrush, vaginal candidiasis and pulmonary TB (DOTS) | j. ___x______ | j. ___x_____ |
k. Cotrimoxazole prophylaxis among HIV-infected people | k. ___x______ | k. ___x_____ |
l. Post exposure prophylaxis (e.g., occupational | l. ____x_____ | l. ___x_____ |
exposures to HIV, rape) | | |
m. Other: (please specify) | m. _________ | m. ________ _________ |
Overall, how would you rate the efforts to increase civil-society participation?
Poor Good
2006 0 1 2 3 4 5 6 7 8 9 10
Poor Good
2007 0 1 2 3 4 5 6 7 8 9 10
2. Does your country have a policy or strategy to address the additional HIV and AIDS-related needs of orphans and other vulnerable children (OVC)?
No.
2.1 Which of the following activities have been implemented under the orphan and other vulnerable children programmes?
Not Applicable.
-- School feeds for orphans and vulnerable children
-- Community programmes
-- Other
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