Health Facility Staff: Enforcement of Institutional Policies (Tier 2)

One of the key actionable drivers of reducing stigma and discrimination in health facilities is provision of a health facility environment that supports staff to provide non-stigmatizing and discriminatory care. A critical first step in creating such a supportive environment is the presence of written guidelines to protect patients living with HIV from discrimination. A second step, critical for implementation, is that all facility staff know of the existence of the guidelines, as measured in Tier 1 indicator, 1.1a. The third step is enforcement of the guidelines. Therefore, this indicator measures enforcement of the guidelines, at the level of individual health facility staff, by asking staff if they think they will get into trouble if they discriminate against patients living with HIV. This indicator addresses an important institutional factor that helps to reduce HIV stigma and discrimination in a healthcare facility. The enforcement of written (formalized) guidelines that protect patients living with HIV from stigma and discrimination provides information about whether healthcare settings are working to create a safe environment for their patients. This indicator is a facility-level indicator.