Aid in Action
HIV/AIDS
|
Monday, May 05, 2008
New Approaches:
FY 2006
Photo: 2005 Helen Dombalis, Courtesy of Photoshare
Cluster Model. When AIDS programs are introduced into communities, donor-funded agencies generally identify or import a few better-known partners to implement interventions. This may enable programs to launch quickly but it can overlook and disempower local responses mounted by indigenous volunteer groups. This approach is also relatively unsustainable, as program activities often cease when funding ends. With few external resources, indigenous volunteer groups implement prevention, care and support activities of their own design. These activities are usually highly sustainable and responsive to community needs, though they tend to be ad hoc, uncoordinated, sometimes lacking technical know-how, and sometimes duplicative. The Regional Outreach Addressing AIDS through Development Strategies (ROADS) Project funded by USAID/East Africa works in highly vulnerable communities along the transport corridors of East and Central Africa. ROADS has developed a “cluster model” to maximize program reach by expanding participation and collective action of small, sustainable, indigenous volunteer groups with similar focus and interests. The steps include: 1) participatory assessment of community needs/resources; 2) community-wide stakeholder meeting to validate and prioritize needs; 3) individual meetings with like-minded groups at which they describe and map their existing activities, develop a plan and budget for joint action, and establish a management/governance structure led by a steering committee with representatives from each group member. In Mariakani, Kenya, for instance, the low-income women cluster has 35 groups and more than 1,000 active members providing community-based HIV prevention and care services. The model has facilitates open discussion of such taboo, long ignored but critical to addressing HIV and AIDS topics as cultural norms around gender, sexuality, incest and substance abuse. The cluster model was presented on a panel at the Implementing Partners Meeting in Kigali.
Creating Jobs as an HIV Prevention Strategy. Hotspot towns along major transport routes in East and Central Africa are sites of high un- or under-employment for women and older orphans/youth. It is critical to address their economic vulnerability to effectively address their HIV risk behavior. The ROADS Project created LifeWorks, a partnership with business to create jobs for at-risk populations in hot-spot communities. With a board co-chaired by the managing directors of General Motors East Africa and Unilever Kenya Limited, LifeWorks catalyzes the business sector to create small and medium-scale businesses employing women and older orphans. LifeWorks links with USG programs funded by PEPFAR and receives support from French and Japanese Cooperation. LifeWorks businesses receive ongoing mentoring in critical business areas (e.g., marketing, inventory control) through global development alliances with GM and Unilever. A unique requirement for LifeWorks companies is that they adopt HIV programming in their workplace and their corporate social responsibility platform. To date, LifeWorks has received orders for home and fashion accessories being produced by vulnerable women in Mariakani, Kenya, from the gift shops of a large East African hotel and resort chain. It also has a pledge of support from a high-end design house in the US. Core businesses being launched in Kenya include light manufacturing, home and fashion accessories, and agribusiness, which will directly employ over 250 women, orphans and youth by end 2007. At least 200 more will be employed in spin-off jobs (laundry, child care). Two LifeWorks papers were presented during a Global Health Council workshop on partnerships.
FY 2007
SafeTStop Community Branding Strategy. The ROADS Project has developed a unique community intervention social marketing concept known as “SafeTStop” in hotspots along regional transport corridors. In SafeTStop communities, local partners identify existing/potential entry points for HIV services, including volunteer groups, businesses, churches and mosques, pharmacies/drug shops, and health facilities. Through a participatory approach, the project strengthens these services, formalizes links among them, then brands service outlets (e.g., youth centers, businesses, FBOs, drugs shops, health facilities) with SafeTStop signs to visualize the SafeTStop community network. The project also establishes a central SafeTStop resource and recreation center as a hub for HIV information and skills-building, and as an alcohol-free alternative to bars and drinking dens. Through September 2007, ROADS has helped establish 29 SafeTStops in eight countries. This branding strategy was presented at the Kigali Implementing Partners meeting.
Integrating Other Health Services into HIV and AIDS Programming: The cluster model, which organizes myriad community groups into a coordinated local response to HIV and AIDS, offers strong opportunities to integrate other health services. In February 2007, the ROADS Project distributed 2,600 insecticide-treated nets through the PLHA, youth and low-income women clusters in Malaba, Uganda. The nets were provided by the World Health Organization with funding from USAID/East Africa. The initial consignment of nets was distributed to AIDS-affected families identified as the most vulnerable by the PLHA cluster and the Principal Health Inspector of Malaba Town Council. Home-based care volunteers trained by ROADS visited beneficiary households to demonstrate proper use and care of the nets. The goal is to improve overall health of PLHA and their families while dramatically reducing household expenditure on malaria treatment. This activity, which has expanded to Malaba, Kenya and other SafeTStop sites, is part of the project’s drive to integrate essential non-HIV services into programming, including malaria prevention, family planning and alcohol treatment.
Harnessing Cutting-edge Technology to Reach Low-Literate and Mobile Populations. Illiteracy is high in many communities along the transport corridors of East and Central Africa. In addition, many truck drivers and community members lack opportunities to participate in HIV and AIDS training and education sessions. The ROADS Project has introduced portable, solar-powered audio devices to reach long-distance drivers and community members with targeted HIV and AIDS messages. The oral communication strategy recognizes that: 1) mobile populations have difficulty accessing quality, consistent HIV messages and information, in their own language, when they travel from country to country; 2) illiteracy is a persistent barrier in impoverished communities; and 3) few community members have the time or opportunity to participate in extended off-site trainings. The user-friendly devices include hours of content on HIV prevention, care and treatment, including ART adherence and side effects for drivers on treatment who are far from home. The devices cannot be reprogrammed and have no re-sale value. ROADS has distributed 2,381 devices through transport companies and the SafeTStop HIV Resource Centres in Busia, Malaba and Mariakani, Kenya. The devices are numbered to track their movement and use along the transport corridor leading from Mombasa to the Great Lakes Region. The project trains facilitators to form and conduct listening groups, administer pre- and post-listening questionnaires, and use simple monitoring and evaluation tools.
Training and Future Meetings:
Contact Person:
Shelagh O’Rourke
Email: sorourke@usaid.gov
Wairimu Gakuo
Email: wgakuo@usaid.gov
Read Family Health International's Postcards from the Road with highlights from the Regional Outreach Addressing HIV through Development Strategies (ROADS) Project:
April 5, 2008 - Uganda
March 6, 2008 - Rwanda
February 15, 2008 - Burundi
February 8, 2008 - Kenya
Recent Articles Published in the African Journal of Drug and Alcohol Studies, Volume 5, Number 2, 2006
Three-Country Assessment of Alcohol-HIV Related Policy and Programmatic Responses in Africa
Summary of the Proceedings of Meeting on 'Alcohol, HIV Risk Behaviours and Transmission in Africa: Developing for AIDS Relief (PEPFAR)'
Summary of AfriComNet Practicum by Fungai Machirori