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Improving health and protecting human rights Improving health and protecting human rights for individuals, communities, and society Presenter: Dasha Ocheret.

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Presentation on theme: "Improving health and protecting human rights Improving health and protecting human rights for individuals, communities, and society Presenter: Dasha Ocheret."— Presentation transcript:

1 Improving health and protecting human rights Improving health and protecting human rights for individuals, communities, and society Presenter: Dasha Ocheret | Reaching the un-reached: communities as generators of demand, and complementary deliverers of services at local level and to remote and key populations Reaching the un-reached: communities as generators of demand, and complementary deliverers of services at local level and to remote and key populations Melbourne, July

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3 OST Program in Azerbaijan, 2013

4 Whom do we reach? How often harm reduction services analyze who their clients are and whom they do not reach? ‘Contacted’ = contacted once a year? once during the Global Fund program cycle? Contacted through secondary needle exchange?

5 Donor’s perspective EC-funded three year program in 6 countries of Eastern Europe Main objective: to enroll 4,000 women into harm reduction services Donor’s interest: high efficiency, low unit cost and clear reporting according to unified indicators 5

6 How did we involve the community to improve harm reduction programs’ efficiency? 90ies: as unpaid workforce for rapid situation assessments Beginning of 2000s: secondary needle exchange (unpaid outreach workers) Mid-2000s: paid outreach workers, case managers and peer educators for ART Late 2000s: monitoring of access to HIV services Since 2014: improving allocative and technical efficiency of harm reduction programs 6

7 Eurasian Network of People Using Drugs (ENPUD)

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11 Questions to be asked What services should be added on top of the standard WHO/UNAIDS/UNODC package to reach the unreached? What services should be removed? How to reduce costs of service provision? Operational management decisions (changing opening hours…), changing legislation framework (take-home methadone doses), negotiations with pharma (internazal naloxone), etc. 11

12 Case of Tajikistan New Funding Model as ‘safe’ platform to pilot drug user involvement in funding allocation decision-making Status quo: community leaders are asked which service they want Naloxone, hepC treatment, legal support, expansion of methadone programs Budget decisions are taken behind close doors As a result: expansion of methadone programs 12

13 EHRN regional program A.Community-based service monitoring: consultations with various sub-groups of PWID B.Costing exercise: how much does it really cost? C.Prioritization exercise: consultations with the community on D.Allocation exercise: explicit rationing of resource allocation in E.Advocacy for better service management and for supportive legal frameworks 13


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