Recently, a new issue of the Journal of the International AIDS Society has been published. One of the articles using the implementation learning evaluation approach examined the implementation of the Breaking Down Barriers initiative targeting key and vulnerable populations in Ukraine.
Since 2017, as a part of the Breaking Down Barriers initiative of the Global Fund, Ukrainian organizations have implemented HIV-related human rights programmes which seek to increase access to prevention and treatment services for key and vulnerable populations.
The Breaking Down Barriers initiative provides technical and financial support for the implementation of rights-based HIV, tuberculosis and malaria interventions in 24 countries. These include programmes aimed at addressing stigma and discrimination and ensuring people-centred healthcare and law enforcement practices, as well as programmes aimed at mobilizing communities and increasing legal literacy and access to justice.
The evaluation of the Breaking Down Barriers initiative in Ukraine used an implementation learning approach drawing on a document review of programme monitoring documents alongside key informant interviews with implementers, government officials and human rights experts.
Based on the Eight rights-based interventions related to HIV were identified in Global Fund programme documents and key informant interviews as making up the core of the Breaking Down Barriers initiative in Ukraine.
These included programmes seeking to:
- eliminate stigma and discrimination;
- ensure the non-discriminatory provision of medical care;
- promote rights-based law enforcement practices;
- expand legal literacy (“know your rights”);
- increase access to justice; i
- mprove laws, regulations and policies;
- reduce gender discrimination, harmful gender norms and violence against women and girls;
- and mobilize communities for advocacy.
Key informants reported that significant progress had been made addressing human rights barriers and scaling up interventions, both before and after Russia’s invasion. Programme implementors adopted innovative approaches, including using paralegals, hotlines and other community-led interventions, to ensure that key and vulnerable populations, including displaced individuals, were able to access prevention and care.
The results of our evaluation found that Ukrainian organizations were successfully scaling up and adapting programmes addressing stigma and discrimination in communities and health settings; working to address harmful laws and police practices and increase legal literacy and access to justice; reducing gender discrimination and violence; and mobilizing communities affected. Ukrainian organizations responded resiliently to challenges, finding innovative solutions to reach those displaced and to ensure the continuity of HIV programmes.