Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 158

6 Programme Management and Organizational Capacity-building

Part I: Programme Management
6.1 Introduction
This chapter explains how to establish a management system for an HIV and STI prevention and care
programme serving multiple sex work locations within a country and multiple sex work sites within
urban locations, with the goal of covering a high proportion of sex workers with at least minimal
services. Such a programme requires centralized management and, depending on the size of the
country, additional layers of management to support local implementing organizations.1
Comprehensive HIV/STI prevention and care interventions with sex worker communities2 are
complex and have many aspects that must be addressed simultaneously. For example, they require
regular outreach to sex workers and their clients, usually in settings with significant social, cultural,
religious and legal barriers. Sex workers’ needs may vary depending on their gender (female, male
or transgender), as well as the settings in which they work (indoors,3 outdoors or arranged via the
Internet or by mobile phone).
Many implementing organizations have little experience working with sex workers, while sex worker
organizations may have limited organizational capacity to implement and scale up programmes
themselves. Linking with existing clinical services often requires building the capacity of providers
to deliver services to sex workers in a non-stigmatizing way. Establishing services outside the
government or private sectors requires effort to build management infrastructure and processes.
Finally, funding often comes from multiple sources, with different reporting requirements for
government and other funders.
Management systems address all of these issues by:
• defining roles and responsibilities, providing oversight, managing relationships with external
partners, doing advocacy and coordinating with other programmes
• planning and administering the activities of multiple interventions at various levels in the overall
programme
• supporting the operational activities that support the work, including data reporting systems,
commodity procurement, quality monitoring and improvement, support and supervision, training,
etc.
• implementing financial procedures and controls.
This chapter is not a comprehensive strategic planning or management guide. Resources for
essential aspects of strategic planning and programme management that are not unique to sex
worker programmes are listed in Section 6.8. The chapter focuses on management approaches and
systems that address the unique needs of sex worker programmes and have been used in successful
programmes with a high degree of coverage. These unique aspects include:

1 An implementing organization is an organization delivering a prevention intervention to sex workers. It may be a governmental, nongovernmental, community-based or
community-led organization, and may work at a state, district or local level. Sometimes a nongovernmental organization provides services through sub-units at multiple
locations within an urban area, and in this case, each of those sub-units may also be considered an implementing organization.
2 In most contexts in this tool, “community” or “communities” refers to populations of sex workers rather than the broader geographic, social or cultural groupings of
which they may be a part. Thus, “outreach to the community” means outreach to sex workers, “community-led interventions” are interventions led by sex workers, and
“community members” are sex workers.
3 “Indoor” sex workers work in a variety of locations including but not limited to their homes, brothels, guesthouses, bars, clubs and other sex work venues.

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