Abstract
The Ghana National Strategic Plan (NSP) for HIV and AIDS aims to reach 80% of all key populations by 2015 with a comprehensive package of HIV services, including prevention, treatment, and support. Under the strategy, a number of evidence-based services have been rolled out to key populations nationwide by the Ghana Aids Commission (GAC) and implementing partners. This evaluation, therefore, was conducted as a mid-point assessment in order to describe the achievements and challenges of the ongoing implementation of the National HIV Prevention Program for female sex workers (FSW) and men who have sex with men (MSM) in Ghana. This performance evaluation employed a mixed-methods approach in order to assess the following key study aims: (1) describe how services are being delivered; (2) document barriers and facilitators to accessing health services for MSM and FSW as well as the larger structural influences on sexual and health seeking behaviors such as stigma and discrimination; (3) assess whether organizations directly providing services to FSW and MSM have standard operating procedures, functional supervision mechanisms, monitoring and reporting systems, and administrative, management, and planning capacity; and (5) document efforts to increase stakeholder and organizational coordination and to address social, cultural, religious, political, and legal barriers to HIV prevention efforts among FSW and MSM. Study findings suggest that leadership provided by the GAC and the Technical Working Group (TWG) are strong, and while some greater capacity building and standardization could improve data collection and reporting and standardize service availability, organizations are striving to adhere to the service package and to provide a high quality product. This effort has resulted in high demand for services and a positive reputation for respectful treatment and confidentiality among FSW and MSM. Overall, recommendations focus on the ways in which the program can continue to be strengthened and expanded to better meet demand for services without sacrificing the reputation for service quality upon which that demand is predicated. (Excerpt, modified)