PEOPLE WHO INJECT DRUGS PROGRAMME BRIEFING

FEBRUARY 2019

PROGRAMME OBJECTIVES

1. Prevent new infections of HIV and TB amongst people who inject and use drugs.

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3. Improve the 90 90 90 health outcomes for PWID by using combination prevention approaches.

4. Reduce human rights, social and structural barriers to HIV, Hepatitis, STI and TB prevention, care and impact among PWID.

5. Strengthen the advocacy and national commitment for PWID programming in South Africa.

* Programme based on international best practice (IDUIT), NSP and previous GF grant rounds.

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GEOGRAPHY & TARGETS

PROVINCE DISTRICT PSE Y1 TARGET Y2 TARGET Y3 TARGET

Eastern Cape Nelson Mandela Bay500 250 300 350

Gauteng

City of Johannesburg 6,827 3,414 4,096 4,779

Sedibeng (satellite)500 250 300 350

Ekurhuleni (satellite)500 250 300 350

Kwa-Zulu-Natal

Ethekwini1,245 623 747 872

Umgungundlovu (satellite)500 250 300 350

Western Cape City of Cape Town1,517 759 910 1,062

11,589 5,795 6,953 8,112

IMP

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PROGRAMME TEAM ARRANGEMENTS

Funded management and administration support staff include:

• Data capturer – capturing all programme data.

• Driver – tasked to support the team on outreach.

• An allocation towards M&E, financial and other senior management support.

Programme teams will consist of:

• Programme manager – leading the programme team.

• Site coordinator – tasked with leading the peer educators.

• Peer educators

Team supported by the following programme implementation personnel:

• NIMART nurse – tasked with providing clinical services, OST (where applicable), referral, tracking and tracing.

• Locum nurse (only OST sites) – tasked with supporting OST implementation over the weekends/public holidays.

• Locum OST doctor (only OST sites) – tasked with supporting OST implementation.

• Social Auxiliary Worker – tasked with supporting PWID with mental health, and OST support in relevant sites.

• HTS and linkage officers – tasked with providing HTS and linkage to care for PWID.

ACTIVITIES

Peer education

• Ex/current PWID/PWUD as peers with a ratio of 60 unique PWID per peer per month.

• NACOSA to train SRs on micro planning methodology.

• Peers to provide minimum package of services – harm reduction information and education, risk assessments, provision of harm reduction packs, mobilisation for clinical, OST or other services.

• Selected peers to provide human rights defense support.

NB:

• Linkages to SW, MSM & TG programmes important (GF and PEPFAR).

• NACOSA to train selected peers to provide specific support to young people who inject or use drugs in PWID sites.

• Special focus on finding women who inject drugs, provision of dignity packs.

• Provision of hygiene packs to PWID in need – identified by SR.

ACTIVITIES

Needle and Syringe Programme

• Distributed on outreach. NOT an exchange programme. Provided with harm reduction information/education.

Clinical services

• Wound care. HTS, ART, PEP (site specific), viral load testing (site specific).

• OST (COCT, COJ and Ethekwini only). Methadone provided to eligible PWID.

• STI and TB screenings, family planning, STI treatment, cervical and breast cancer screening, NCDs.

• Waste management.

• Overdose management.

• Appropriate referral and tracking.

• Hepatitis pilot (NACOSA part of the National Hepatitis Technical Working group)

ACTIVITIES

Psychosocial support

• Provided by SAW in each SR. Specific support for PWID on OST programme, as well as other PWID identified.

Human Rights defense

• NACOSA to train selected peers to provide HR defense and support to PWID.

• Appropriate referral and tracking.

• Interventions to tackle stigma, discrimination, violence in community perpetrated against PWID.

Sensitisation of stakeholders

• NACOSA to train SR to sensitise SAPS, DOH, DSD, shelters, religious sector etc. on PWID/PWUD.

ACTIVITIES

Advocacy for policy reform

• Working with SANPUD, each SR will need to support the existing district drug networks advocating for PWID rights and access to services.

• SANPUD to be funded by AFSA under the HR component.

• Work with Aurum on the prison population.

Networking and advocacy

• SR Local, district and provincial programme and stakeholder coordination.

• SR - coordination with district drug networks.

• PR- coordination with SANPUD.

CAPACITY BUILDING

• Peer educator training

• Site coordinator training

• Programme management training

• Human rights defenders training for peer educators

• Sensitisation Training of Trainers for SRs

• PSM for programme managers and nurses

• HIV Rapid Test Quality Improvement Initiative (RTCQI) for HTS counsellors and nurses

• Integrated Management of Childhood Illnesses (IMCI); SRH training; Basic Life Support; Primary Adult Care NIMART and dispensing; Infection Control; and Adult HIV training for nurses

• South African Addiction Medicine Society (SAAMS) training for nurses conducting OST (under review)

DIFFERENTIATED SERVICE DELIVERY MODEL

Model will be different based on the KP, context of the site, public services available, development level of the SR, district Department of Health and clinic facilities.

Service frequency: Regular contact and continuous re-engagement with PWID (at least quarterly) will be facilitated by peer educators doing outreach in a variety of field settings such as abandoned building, parks, train tracks and roads among other areas.

• New PWID will be seen weekly, or as often as they are available to receive harm reduction pakcs

• PWID initiated on OST will be seen daily, and provided psychosocial support when required or indicated by the social worker

• Stable PWID on ART will be seen quarterly

• Stable PWID on TB treatment will be seen monthly

• HIV negative PWID will be tested at least twice a year

Service Intensity: Core, layered and linkage services based on need.

SR SKILLS & EXPERTISE

• PWID/PWUD experience beneficial.

• Knowledge and experience of harm reduction.

• Clinical expertise.

• Outreach/peer education experience.

• Existing MOU/relationship with DOH.

SR QUALIFICATION CRITERIA

All applicants must have a broad-based black economic empowerment (B-BBEE)

level one (1) or two (2) only.

A valid B-BBEE certificate or sworn affidavit deposed by a director/board

member of the applicant confirming B-BBEE level is required. Organisations who

don’t have a B-BBEE Verification Certificate issued by an independent

verification agency must complete a sworn affidavit using the Department of

Trade and Industry (dti) templates for specialised entities on the Department of

Trade and Industry website.

SR EVALUATION PROCESS AND CRITERIA

SR Selection panel will:

• Stage 1: Assessment of compliance with pre-qualification criteria. Applications that do not comply will not be evaluated further.

• Stage 2: Assessment of compliance with administrative requirements (refer Annexure B). Applications that do not comply will not be evaluated further.

• Stage 3: Assessment of technical competency focusing on the ability to fulfil the requirements of an SR, experience and expertise of implementing similar interventions and presence in the selected district. Applicants need to achieve a score of at least 50 points of the technical competency requirements in order to progress further.

• Stage 4: On-site visit to SRs to clarify details about the applicant. This stage is optional and at the discretion of the SSP. No points are awarded.

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