Decentralization of AIDS policy in the state of Rio de Janeiro
S.D.L. Losekann, D. Pires, N. Zuccaro, S. Cabral, A. Chieppe, M. Melo, S. Aguiar
SESDEC (State of Rio de Janeiro Civil Defense and Health Department), Gerência de DST/AIDS, Sangue e Hemoderivados (STD/AIDS Programme), Rio de Janeiro, Brazil
Issues: Decentralization is a Brazilian public health policy's guideline. The Brazilian STD / AIDS Policy strove to follow this guideline by decentralization of resources destined to states and municipalities qualified by STD / AIDS Policy of Incentive. This process, however, stopped in 2003. The STD / AIDS Programme in the State of Rio de Janeiro, after concluding that the context has changed and progressing decentralization process was necessary, started the qualification process for other municipalities. The goal is to make the planning and executions as close as possible to the local reality.
Description: There were three criteria established: demographical, cumulative number of AIDS notified cases and the availability of antiretroviral distribution units. As a result, 17 municipalities have been mapped, and the choice of the demographical criteria was made due to the valorization of preventive actions, not excluding the importance of structuring HIV / AIDS patient care. The STD / AIDS Programme in the State of Rio de Janeiro selected 17 municipalities for qualification: 8 were qualified, 4 are still under review process, 2 demonstrated a desire to be qualified, but they would like to structure themselves first, and 3 did not present the project.
Lessons learned: The plan submitted by the selected municipalities, following a qualification management process, presented an analysis of local vulnerabilities to STD / AIDS due to people's reality, and the planned actions aimed at addressing such vulnerabilities, making an effective and efficient planning upon using the resource.
Next steps: In 2010 there will be continuity of the qualification process of new municipalities, and the implementation of them will be monitored more closely in order to provide technical support, as it was given in the planning process.
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