I-TECH began supporting the implementation of pre-exposure prophylaxis (PrEP) as part of Namibia’s combination HIV prevention strategy in 2017.
I-TECH’s support for PrEP in Namibia is focused on three key areas:
- site-level direct service delivery support for PrEP for adolescent girls and young women (AGYW);
- site-level technical assistance to strengthen facility-based delivery of PrEP for priority populations; and
- above-site level technical assistance at regional- and national-levels.
Direct Service Delivery Support for PrEP Delivery to AGYW in Khomas and Zambezi Regions
I-TECH supports direct service delivery of PrEP for AGYW through community-based delivery approaches linked with the DREAMS program in the Khomas and Zambezi regions. Since early 2018, PrEP education, counseling, and initiation services have been provided to AGYW aged 15-24 as part of the community-based DREAMS service package. Community-based services are provided at safe spaces as well as tertiary institutions including University of Namibia, Namibia University of Science and Technology, and NEUDAM. I-TECH also provides community-based PrEP monitoring and follow-up services through DREAMS in Zambezi and through the DREAMS program partner, Star for Life, in Khomas. As of May 2019, over 2,290 adolescent girls and young women have been started on PrEP across the two DREAMS regions.
Additionally, I-TECH supports awareness and demand generation through the development and distribution of fliers and informational sheets on PrEP for AGYW and their key influencers (e.g., parents, community, peers) and works to incorporate PrEP education into existing HIV prevention education programs, curricula, and health talks.
Technical Assistance for Facility-Based PrEP Delivery to Priority Populations
I-TECH also provides technical assistance for facility-based delivery of PrEP for priority populations including AGYW, sero-discordant partners, and pregnant and breastfeeding women. Since 2017, ongoing technical assistance is provided to the Ministry of Health and Social Services (MoHSS) health facilities in both DREAMS regions as well as the four additional regions supported by I-TECH’s HIV Care & Treatment program – Erongo, Karas, Otjozondjupa, and Kavango East. Site-level technical assistance includes the provision of on-site training and mentoring on PrEP guidelines, clinical service delivery, and monitoring and evaluation. In addition to provision of PrEP within the ART clinic, site-level technical assistance is focused on supporting successful integration of PrEP into antenatal care, family planning services, and primary health care services.
Above-site Technical Assistance
Since 2017, I-TECH has also supported PrEP implementation at regional- and national-levels to facilitate site-level success. I-TECH has worked closely with MoHSS and other partners to develop and implement national PrEP guidelines, national PrEP implementation standard operating procedures, national M&E and clinical tools, and a national PrEP training curriculum. I-TECH hosted a PrEP study tour to Kenya with key MoHSS regional and national staff and actively participants in the PrEP technical working group.