Project Design Document (PDD) Template

Project Title: Clinical HIV and sexual health training and mentoring in PNG
Duration: 2 years
Country/Region: Papua New Guinea

Contents

............................................................................................................1
1. Background........................................................................................................................................2
2. Stakeholder Consultation..................................................................................................................2
3. Problem Description..........................................................................................................................2
4. Proposed Solution.............................................................................................................................3
5. Alignment to National Priorities........................................................................................................3
6. Implementation Arrangement...........................................................................................................4
7. Sustainability.....................................................................................................................................4
8. Workplan and Budget........................................................................................................................4

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1. Background
Write a small paragraph on why this project is important.
  
Across PNG, HIV and related health care services are provided by both government and faith-based
organisations. There is very limited capacity to deal with complex HIV cases, drug-drug interactions
or comorbidities beyond TB. The use of clinical guidelines varies between provinces, resulting in
inconsistent application of best-practice HIV, TB and STI clinical care and sexual health medicine
across the country.

Nearly half of all HIV related health care is provided by the Catholic Health Services. Community
health workers (CHW) within the Catholic Health Services provide a significant proportion of HIV and
related services in PNG. CHWs are an integral part of health care delivery and health system
strengthening in the country. Clinical training and mentoring and laboratory support were identified
as priority areas in the rollout of HIV treatment and care programsi,ii.   
 
There are very few occasions for HIV health workers in PNG  to assess and improve their knowledge
and skills in diagnosis, care and management of HIV, STI and related issues due to lack of access to
adequate training and ongoing mentoring support. HIV health care workers in remote provinces in
PNG  have limited access to important updates in national HIV epidemics, treatment guidelines and
national HIV policies and strategies.

2. Stakeholder Consultation
Who are the stakeholders you would include in this project and why. A few bullet points with a brief
explanation as to why.
 Funder – financial support of the project
 PNG Dept of Health – endorse the training and participation of doctors and nurses
 PNG HIV services/organisations – endorse the training and participation of doctors and
nurses. Willingness/buy-in to implement new models of care.
 PNG Sexual Health services – endorse the training and participation of doctors and nurses.
Willingness/buy-in to implement new models of care.

3. Problem Description
What is the problem that this project is trying to address? What is causing this problem and what are
the effects of the problem. 1-2 paragraphs.

Papua New Guinea’s national HIV prevalence in the general population is reported around
0.9%iii UNAIDS estimates higher rates among key populations and there is evidence of higher HIV
incidence in some provinces and urban areas. There are over 52,000 People Living with HIV (PLHIV)
across the country, with 62% of these on antiretroviral treatment (ART)iv. There is no data available
to identify how many PLHIV have suppressed viral loads v. Disaggregated paediatric data indicates
just 49% of children living with HIV were being prescribed ART at the end of 2019 vi. 81% of pregnant
women who are living with HIV receive ART for the prevention of mother-to-child transmission, with
22% of children born to mothers living with HIV diagnosed as HIV positive, either as a result of
vertical transmission or during breastfeeding vii.

There is limited data on the prevalence of STIs amongst the general population however the most
recent PNG Integrated Bio-Behavioural Survey (IBBS) survey provides data on the STI prevalence

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amongst priority populations. Amongst, women and girls who sell and exchange sex (FSW), men who
have sex with men (MSM) and transgender women (TG), the prevalence of
Sexual Transmissible Infections (STIs) is high. 52.1-60.8% of FSWs, and 34.0% of MSM/TG have been
diagnosed with one or more STI such including hepatitis B virus, syphilis, chlamydia, and
gonorrhoea at the time of the survey viii.  Condom use reported at last high-risk sex among adults
aged 15-49 is approximately 27.%ix.
 
HIV, along with co-morbid presentations including sexually transmitted infections (STIs) and
tuberculosis (TB), continue to present significant health, social and economic challenges in Papua
New Guinea. There is limited opportunity for the clinical workforce to access professional
development and clinical upskilling programs that enable reflective practice, support the
introduction of new clinical guidelines, guide advanced practice and promote evidenced-based
innovative approaches to HIV prevention, testing, treatment and management.  
 

4. Proposed Solution
What is the proposed solution to the problem? What is the goal and outcomes of the project/how
will this project solve the problem. 1-2 paragraphs.

The ASHM Master Mentor Training aims to strengthen the capacity of health care workers and
organisations to actively participate in developing and maintaining effective and efficient systems for
prevention, testing, treatment and management of HIV and STIs. This is achieved by equipping
Master Mentors with the knowledge, skills and capacity to provide training, education and
mentoring to healthcare workers.

The primary focus of the training is mentoring theory and practice, this is both a didactic and
practical aspect of the training that allows participants to apply and enact what they have learnt
through role-play and discussion. The principles of mentoring theory and practice are woven
throughout the training course, ensuring that the Master Mentors understand their relevance and
application regardless of the subject.

ASHM supports a long-term approach to health system strengthening, through continuous medical
education and capacity building of health workers in HIV and sexual health by incorporating on-going
clinical mentoring support alongside the delivery of trainings to build a sustainable workforce.
Clinical mentoring is provided face-to-face by ASHM Clinical Advisors, enabling longitudinal
engagement for coaching and mentoring to health workers that supports the application of learning
(from training) into practice.

5. Alignment to National Priorities

List the national strategies that this project aligns with.

Papua New Guinea National STI & HIV Strategy 2018–2022, is the strategic guide for the country’s
response to STI and HIV at both national, provincial and district levels. The strategy addresses the
drivers of the STI and HIV epidemic and builds on achievements of the previous country strategic
plans to achieve its goal of contributing to the country’s Vision 2050 through universal access to
comprehensive STI and HIV prevention, treatment, care and support.

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6. Implementation Arrangement
List any implementing arrangements that might be required. A few bullet points.

 Identification of a suitable training venue

 Participant travel and accommodation
 Trainers and ASHM staff travel and accommodation
 Implementation of the training (venue, catering, training resources, IT support)

7. Sustainability
Explain how project benefits and outcomes could be sustained after the project is completed. A few
bullet points.

 Master Mentor training encourages continuous medical education and capacity building of
health workers in HIV and sexual health by incorporating on-going clinical mentoring support
alongside the delivery of trainings to build a sustainable workforce.
 Clinical mentoring enables longitudinal engagement for coaching and mentoring to health
workers that supports the application of learning (from training) into practice.

8. Workplan and Budget

List what types of things you would include in your budget, e.g. travel to and from Australia. A few
bullet points.
 Clinical advisor time to develop the training
 Clinical advisor time to implement the training
 Travel to and from Australia for clinical advisors/trainers, ASHM staff to support the project
 Participant travel and accommodation
 ASHM staff and clinical advisor travel and accommodation within PNG
 Visa’s
 Venue hire and catering
 Staffing and overheads

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i
Heather Worth (2009). Review of the ASHM Clinical and Laboratory Mentoring Program 2008-2010, Clinical Mentoring Component
ii
CHSS, Anglicare, ASHM, Burnet Institute, Igat Hope (2017). Sexual and Reproductive Health Integration Project (SRHIP) Situation
Analysis (unpublished)
iii
UNAIDS (2019). Available at https://www.unaids.org/en/regionscountries/countries/papuanewguinea
iv
UNAIDS (2019). Available at https://www.unaids.org/en/regionscountries/countries/papuanewguinea
v
UNAIDS (2019). Available at https://www.unaids.org/en/regionscountries/countries/papuanewguinea
vi
UNAIDS (2019). Available at https://www.unaids.org/en/regionscountries/countries/papuanewguinea
vii
UNAIDS (2019). Available at https://www.unaids.org/en/regionscountries/countries/papuanewguinea
viii
Kelly-Hanku, A., Willie, B., Weikum, D.,A., Boli Neo, R., Kupul, M., Coy, K., Hou, P., Aeno. H., Ase, S., Gabuzzi, J.,
Nembari, J., Narakobi, R., Amos-Kuma, A., Gare, J., Dala, N., Wapling, J., Toliman, P., John, L., Nosi, S., Worth, H.,
Whiley, D., Tabrizi, S.N, Kaldor, J.M., Vallely, A.J, Badman, S.G. and Hakim, A., (2018) Kauntim mi tu : Multi-Site
Summary Report from the Key Population Integrated Bio-Behavioural Survey, Papua New Guinea. Papua New Guinea
Institute of Medical Research and Kirby Institute, UNSW Sydney: Goroka, Papua New Guinea.
ix
Papua New Guinea Demographic and Health Survey 2016-2018 (2019). Available at
file:///C:/Users/jessica.michaels/Downloads/Demographic-Health-Survey-2016-18-Report.pdf