Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 123

5 Clinical and Support Services Figure 5.1 Illustrative multi-level approach to acceptable, accessible and respectful clinical services Programme level Central State/Province District/County Programme role • Development of guidelines and standard operating procedures • Policy development for appropriate services and non-stigmatizing clinical environment • Advocacy for affordable, confidential, respectful sex worker services • Sex worker-specific pre-service training in health education institutions • Modules for sex worker issues incorporated into relevant ongoing in-service trainings • Work with professional bodies (i.e. nursing association, medical association) to incorporate relevant topics in routine communications with members • Coordination with national programmes to ensure links between clinical services and to establish referral networks • Training and sensitization of clinic staff on sex worker issues in relevant state-/ province-wide trainings; monitoring and supportive supervision of district-level clinic staff • Training and sensitization of state-/province-level programme managers and health officials on sex worker issues in clinical care • Advocacy for affordable, accessible, confidential, respectful sex worker services • Coordination with state-level health officials and authorities on ongoing issues of accessibility and acceptability, quality assurance and ensuring functional referral system • Training and sensitization of clinic staff on sex worker issues in relevant districtwide trainings; monitoring and supportive supervision of municipal-level clinic staff • Advocacy for affordable, accessible, confidential, respectful sex worker services • Coordination with district health officials and authorities on ongoing issues of accessibility and acceptability and ensuring functional referral system • Ensuring participation in quality-assurance programmes and activities Municipality/ Sub-municipality • Work with clinics to establish evening and weekend hours, mobile and fixed-time/ fixed-location satellite services • Work with clinics to ensure confidentiality of services • Training and sensitization of staff at key referral clinics; monitoring quality of clinical services • Regular meetings with staff at key referral clinics for feedback • Campaigns to inform sex workers of their right to confidentiality and the right to refuse services • Ensuring sex workers’ involvement in clinical services • Ensuring effective links to community-based services as well as quality assurance Frontline worker/ Community • Participation as trainers in clinical staff training and sensitization • Ensuring sex workers’ involvement in clinical services • Monitoring quality/respectfulness of clinical services • Participation in regular meetings with clinical and community-based staff 101