2023 CLM Summary Findings

Indicator
Information about the facility services are disseminated outside the facility (catchment area). 

Providers are providing additional information about the service and the facility.

Findings
There were clients who did not know about the services of the facility before going to avail of the service despite living with the community around the facility.

Recommended Actions to Improve Awareness

In the facilities

1. 1. Display a giant signboard for passersby and the public to see the name of the facility and the services available.

   2. Identify specific ways to improve display and dissemination of information about the services within the facility (print brochure, print posters, TV display).

In the surrounding communities

1. 3. Conduct community awareness campaigns about the facility.

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 4. Use social media posts (facebook and whatsapp blasts) about the facility and its services.

Indicator
Clients did not wait for more than one hour before the service was provided. 

Clients did not hesitate to go to the facility (because of accessibility issues).

Findings
There were clients who waited for more than 1 hour or up to 4 hours before the service were provided. 

Recommended Actions to Improve Accessibility

In the facilities

1. 1. Identify actions how to reduce waiting time to less than one hour.

      • manage client flow (triage) 

      • improve access to entrance and exits 

      • extend opening hours (8 hours a day) 

      • identify specific time period for high volume services (eg 1pm-3pm dedicated just for ART resupply)

   2. Identify how to augment or improve number of staff and their capacity -  train more, hire more, etc.

In the surrounding communities

1. 3. TBD

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 4. TBD

Indicator
The intended service was available and provided. 

For services that were not available, clients were provided information where to avail it (or referred).

Findings
Some staff of the facility were unaware of the services available in the facility. For example, the HIV team were not aware if there are Xray services for TB diagnosis.

The printed profile of the facilities are outdated. Some services listed are no longer available.

Recommended Actions to Improve Availability

In the facilities

1. 1. Improve profile and directory of the facility (regularly updated).

   2. Conduct internal refresher orientation among staff on the profile of the clinic (services available, fees, etc)

   3. Regularly remind providers to provide referral slip to all clients referred (including clinic to clinic referrals)

In the surrounding communities

1. 4. TBD

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 5. Support regular updating of the printed profiles and directory of the facilities.

Indicator
Client did not pay for or did not use its own money for the services provided (on services that are free).

Findings
Some clients were required to pay for the service, despite of the expectation (general knowledge) that HIV tests, STI consultations, diagnosis, treatment and other services are supposed to be free.

Recommended Actions to Improve Affordability

In the facilities

1. 1. Publish or display services and its applicable fees – in a big signboard or prints.

   2. If some fees are needed to be collected, discuss ways of reducing burden from clients. Plan with management of the facilities or the organization.

In the surrounding communities

1. 3. Disseminate information about services available both with and without fees.

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 4. Help disseminate printed profiles of facilities which includes information on services available, both with and without fees.

Indicator
Services specific to KP were provided. 

Services specific to young person (24 and younger) were provided.

Findings
There were no services specific to KP and Young People. 

HIV, STI, TB services were provided to all who go to the facilities.

As an example, there are no KP youth peer counsellors,  no transgender-specific information or counselling services (to discuss TG-specific issues).

Recommended Actions to Improve Appropriateness

In the facilities

1. 1. Identify and develop/provide KP-specific services.

   2. Identify and develop/provide youth-specific services.

In the surrounding communities

1. 3. TBD

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 4. Support KP-specific services and youth-specific services.

Indicator
Client did not feel stigmatized or discriminated when the service was provided.

Client did not feel afraid to access the service (did not worry about other clients knowing its KP or HIV status).

Findings
There were clients who reported some experience of stigma or discrimination while receiving the services. They were:

• being shouted at by the providers

• were called publicly as KP

• their client books were left open at the counter and everyone can see their personal records

• they feel shame or afraid because of multiple people in the clinic (including friends or family) who may know them as MSM or as PLHIV

Recommended Actions to Improve Appropriateness

In the facilities

1. 1. Identify additional safe spaces (area) for clients within the facility.

   2. Continue internal sensitization forums about issues and need to provide quality and friendly services to KPs and Young People.

In the surrounding communities

1. 3. TBD

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 4. Continue conduct of sensitization forums for service providers.

Indicator
Client is aware of mechanisms to report complaints about the service.

Client feels confident that the provider made him/her fully aware of the service provided.

Findings
Multiple clients were not aware where to raise issues or report complaints about the service or the providers.

There were very limited client feedback mechanism as this is not part of the PHA and facility policy.

Recommended Actions to Improve Appropriateness

In the facilities

1. 1. Train staff to orient clients about mechanisms to provide feedback. For example, provide a feedback box with cards of happy or sad emojis and provide biro and small sheets of paper where clients can drop these feedback anonymously.

   2. Providers can encourage clients to use the feedback/ suggestion box.

   3. Providers can include client satisfaction questions (feedback) after the service

In the surrounding communities

1. 4. TBD

In partnership with KPAC and other organizations in the province (HWW, APNG, WVI, etc)

1. 5. TBD