A4R HIV/AIDS Prevention Project

Last Updated on Sunday, 22 March 2009 16:01

    EXECUTIVE SUMMARY:

A4R focus on HIV/AIDS respond to pandemic in Rwenzori region in respect to youth and also to help mitigate the impact of HIV/AIDS among the vulnerable community groups especially youth and children.

A4R is registered with civil society organization (CSO) Network in the district and also registered at national level with the NGO Board and UNASO a networking AIDS organization nationally.

A4R responds to the HIV/AIDS pandemic in quite different approaches all aimed at contributing to the reduction of further spread as well as reducing the impact of the pandemic to the households in Rwenzori region.

A4R`s mission is to “Inform and support communities with quality care and support services”. This contributes to our vision, which states: “act local think global”.

   A4R OBJECTIVES:

• To Prevent and reduce the spread of HIV/AIDS infection.
• To contribute to the reduction of the impact of HIV/AIDS pandemic.
• To build capacity of local communities to ably undertake appropriate interventions aimed at HIV/AIDS prevention.
• To facilitate the proper implementation of HIV/AIDS related Policies, Laws and program and help to take action.
• To network with Government and other relevant actors in strengthening effective implementation of HIV/AIDS programs in Rwenzori region.

A4R has been implementing various activities under various projects, which include; Global Fund , UNASO and the summary of the various activities under various projects is included in A4r track record.

Rwenzori region Profile
Key Features:
Located in the West of Uganda and borders the democratic Republic of Congo its west. An aerial view of Rwenzori region, shows that the western half is mainly a mountainous terrain while the eastern half comprises the plain. Significant here is the Rwenzori mountain range, which is a result of faulting of the rift valley. Theres two national parks namely, Queen Elizabeth and Rwenzori which together cover 1537sq km or 57%. The two major lakes are lake George and Edward which together occupy another 15% of the area. In addition to this, the district also endowed with vast forest reserves and at least six river streams.

Health
The region has health units, hospitals and health centre. The region has medical doctors and health inspectors.
Malaria is the top disease followed by acute respiratory infections while the national level for HIV/AIDS stands at about 10%. Access to safe water / although in some areas low and many streams rives and lakes are contaminated making the water quality poor.

Background Information
Uganda has a predominantly young population.  According to the New Vision report dated 24th March 2005 there was an indication that Uganda’s current total population had reached 26.8million people according to the 2002 population and housing census report. Of these figures, the children(less than 18years) were 15.0million, yet the youth (18-30) claimed 6.0million people. Specifically adolescents, officially defined as those 10-19 years of age, comprise 24% of the total population and those defined as young people aged 10-24 comprises of 33% of the total population.

As a result of the growing population, the importance of addressing adolescent sexual and reproductive health and reducing HIV infection is ever increasing.

According to the 2000/2001 UDHS, 52% of girls aged 15-19 and 38.7% of boys 15-19 have had sex.
There is increasingly early exposure to the risk of sexually transmitted infections including HIV/AIDS.

The prevalence of STD and HIV is high among young people and it is estimated that 15-24 year olds comprise more than 50% of those infected with HIV.  In response to the above, a number of programs targeting young people have been implemented by a number of partners, including Ministry of Gender Labour and Social Development -MoGLSD, UNICEF, African Youth Alliance (AYA) through UNFPA, Save the Children in Uganda (SCiU), Program for Enhancement of Adolescent Reproductive Life (PEARL), International CARE and Relief (ICR) and CARE Uganda, all providing information and education through peer education in communities, and scaling up clinical reproductive health services to embrace young people in particular.

Similarly, in Rwenzori region, the tradition and culture of postponing first sexual intercourse is slowly being eroded especially among young persons. Adolescents lack access to factual information and rely on “false truths” from fellow peers who do not have access to any concrete source of information relating to sexual health, HIV prevention and other important information. Therefore adolescents/youth like nationally equally remain at risk of all forms of risky sexual related practices that have often led them into trouble of early pregnancies, contracting HIV/AIDS and other STIs that have drastically affected their livelihoods.

Therefore A4R to think of taking on a program that will enhance strategies for reducing the HIV infection, risky sex and early pregnancies as well as improving the knowledge of reproductive health and social participation and parenting skills among the adolescents/youth is paramount. And this explains why within the Frame work of the country program of cooperation of UNICEF and the Government of Uganda, UNICEF has compelling reasons for promoting Civil Society Involvement in programs of cooperation after recognizing that the Human Rights Based Approach to programming mandates the participation of youth that is often facilitated by local level organizations.


   PROBLEM STATEMENT:

HIV/AIDS continues to cause devastating impacts on to the households and communities with in Rwenzori region. It is quite undoubtedly now that this region exists with high HIV/AIDS rates of up to 12.6 % irrespective of the reduced National rate of about 6%. This is relatively a high rate compared to the National level rate.
While Uganda is to be praised for having reduced the HIV/AIDS prevalence rate fro 18.7% to 6% (UNAIDS REPORT) there is considerable delay before this will significantly decrease the impact it surpasses on to the children and the increasing the number of orphans in Uganda.

It is estimated that Uganda has not less than 2million orphans and this number is expected to grow given the prevailing context in Uganda where poverty, common infectious diseases, the HIV/AIDS pandemic and conflict remain in our midst.  Statistics have it that about half of the new infections every year in Uganda are among the adolescents and young people aged 15 to 24. It has further been found out that girls and young women are disproportionately affected as they comprise two-thirds of those newly infected youth between 15-24.

There have been some efforts by other institutions to try to build some structures on ground to assist the adolescents and youth including training some Youth Friendly service Providers especially by the Young and Powerful Initiative –YAPI that had support from African Youth Alliance, AYA under UNFPA.

There is limited accurate and update information on sexual and reproductive health, including HIV/AIDS among the youth in Rwenzori region. Most adolescents/young people in the target Sub-Counties do not recognize the need for knowing their health status with regard to HIV/AIDS and this makes them reluctant in seeking for even the would be accessible HIV Counseling and Testing Services. Above all communities around the region have been found to be more vulnerable to the HIV infection and have their families affected by the HIV/AIDS pandemic in one way or the other given the high risk and vulnerability to the infection these kind of communities face. Orphans and Vulnerable children are very vulnerable group to the HIV infection and the targeted Sub-Counties have limited and others even no intervention at all for reducing this vulnerability.

The sub-counties are also characterized with other vulnerable children whose situation is desperate for a variety of reasons and this making them even more vulnerable to HIV infection as they lack information relating to sexuality and reproductive health. There is limited access to health services by the adolescents/youth including access to HIV related services like HIV Counseling and Testing, condoms, care and support for those who test positive that are often limited to Health centre and yet these are very few in the region. It’s even currently hard for health service providers to accept extending the services right in the local communities because of limited facilities and insufficient supplies.

There is therefore need for building a supportive environment among health service providers to sustainably support the provision of youth friendly health services to the youth in the region and promoting efforts that are geared towards the promotion of access to and utilization of Youth Friendly Health services and as well enhance behavior change among the youth. This will help reduce chances of risky sexual behaviors and thus reduce chances for HIV transmission to the youth hence contributing to National goal of reducing the HIV prevalence.


  PROJECT JUSTIFICATION:

A4Rs previous experience in handling youth in the region /shown that empowering the youth to make their informed choices, build their levels of knowledge using participatory and interactive methodologies as well as liaising with the health service providers is one of the most best strategies for enhancing reproductive health promotion among the youth. Its true and past experience has shown that training out of school peer educators as Trainers of Trainees (TOTs) and community educators is a viable strategy for reaching big numbers of out of school youth and the community at large.

Peer educators’ sensitization activities in particular have generated increasing desire by adolescents to demand for a youth /adolescent related services which can provide young people with opportunities for accessing HIV Counseling and Testing (HCT) services that are less periodically rendered in these targeted region and Sub Counties.

Out of school youth will be trained as peer educators in the initial region and sub-counties. The key challenges of youth concerning sexual practices especially in so far served region and sub counties reveal that HIV/AIDS is a fast growing issue, requiring serious attention using multifaceted approaches.

The proposed interventions and the project goals are directly in line with Uganda’s revised National HIV/AIDS strategic framework which is aimed at reducing the HIV/AIDS prevalence rate and mitigating the health and socio economic effects of HIV/AIDS at the individual, household and community level among other interventions.


   A4R PROJECT GOAL:

To contribute to the prevention of HIV transmission, care and support among the youth by promoting community level sustainable participatory and innovative mechanisms for knowledge promotion on behavior change as well as enhancing timely access to and utilization of existing, affordable and appropriate health services for the adolescents/young people.


   A4R PROJECT SPECIFIC OBJECTIVES:

To increase knowledge and understanding of HIV/AIDS and other STDs risk factors through provision of  appropriate information among the youth.

• a)Conduct social mobilization for Youth Friendly Services (YFS) through music, dance and drama, Focus Group Discussions (FGDs), games, sports and specific debates. b)Conduct Focus Group Discussion, FGDs with youth to identify issues that make them vulnerable to HIV/AIDS.
• c)Liaise with partners to procure and provide Youth friendly IEC/BCC materials including posters, stickers, leaflets, T-Shirts, brochures and hold radio talk shows with specific messages.
• d)Conduct life choices and life skills video shows in the region.
• e)Conduct peer to peer interactive talks/discussion meetings with youth in the region and Sub-Counties.
  
  

Promote youths access to and utilization of Youth Friendly Services through effective linkages with community service providers through building capacity of community adolescent structures to act as reproductive health/HIV/AIDS prevention promoters among youth.

1. a)Liaise with the region TOTs in YFS to select and orient health service providers from the health centers in the region.
2. b)Form small out of school  peer groups that will be involved in continued participatory activities and discussions guided by the trained peer educators relating to adolescent needs and service requirements in areas of sexual reproductive health and other HIV/AIDS services.
3. c)Liaise with Health Units to conduct and link monthly community service provision outreaches with of youth through social mobilization events and recreational activities including sports, Drama, educative videos and indoor games. These events will thus require materials like balls, sets of drama costumes, art and craft materials, educative video tapes, and counseling services. Joint drama and sports competitions with key messages on youth Friendly Services will be conducted.
4. d)Conduct a one day joint meeting to develop a referral strategy together with service providers, trained peer educators and A4R staff.
5. e)Support trained peer educators to refer youth to health centers and community service provision out reaches to access services like STD care and management, HIV Counseling and Testing, free condoms, and other reproductive health/HIV/AIDS services.
6. f)Conduct experience sharing meetings among the peer educators to help them share experiences and review their strategies to continuously ensure access to appropriate and services among youth in the region.
7. g)Conduct joint quarterly meetings among the service providers and the peer educators to share experiences, lessons learnt and plan for the way forward.

Build the capacity of A4R to effectively implement and manage the project activities.

1. a)Conduct Monitoring and evaluation on the set targets.
2. b)Network and collaborate with key stakeholders in the area to enhance sharing of the similar experiences quarterly.
3. c)Conduct end of project joint review meeting with stakeholders including local leaders’ representatives.
4. d)Pay for project implementing personnel costs including Coordinator, Program Officer, a Field Officer and Finance Officer.
5. e)Procure some project implementation facilitating equipments like computers for documentation, and motorcycle.
6. f)Conduct quarterly  board project review meetings and retreats.
7. g)Maintain effective reporting to key stakeholders.
8. h)Pay project running costs.

  AN INCIPATED METHODOLOGY FOR IMPLEMENTING PROJECT:

The training methodology will be a mix of classroom-based learning and participatory on job training using participatory methodologies that will involve group formation of different youth age.  It will focus on a structured learning process that facilitates peoples’ critical analysis of their environment, identify problems, discuss them and come up with practical solutions or action for suiting their environment.

The specific practical skills application and follow up activities on the peer educators are among the strategy to be used in changing behavior of youth in relation to sexual practice. This methodology acknowledges the importance of shared participation and interactiveness meanwhile promoting innovativeness. Dialogue and interactive meetings will be used during project implementation to help youth identify and appreciate the problems, needs, capacities, expectations, priorities, resources and potentials through their formed groups in the different age groups.

In this intervention, this process will enable the youth and communities to identify risks and vulnerabilities in their environment and work towards addressing them. Also from the experience that factual information can be easily conveyed via role play and music, drama and dance performances, the peer educators will combine both  and offer them together with the young people from the formed  peer clubs at community level.

Follow-up of previously trained peer educators will be done using the similar participatory methodologies.  Strategic linkages and partnerships will be forged with health units to provide adolescent friendly health services (AFHS) for the young persons out of school.


  A4R KEY PROJECT STRATEGIES:

A4R focus on AIDS will employ the following strategies:

• a). Increasing access to adolescent Youth Friendly Health Services through training, referral and follow-up support/support supervision.
• b). Working closely with the respective local government departments (health, education and community development) to mainstream peer education skills and strengthen coordination.
• c). Promoting participation of out of school young persons and communities in project activities through regular dialogue meetings and training events.

   A4R PROJECT HUMAN RESOURCE REQUIREMENTS:

The planned program requires qualified human resource to ensure effective and quality implementation and follow up of set up project activities.

The following will be required:
The A4R Coordinator who in this case will work as the Program Manager and will be charged with a key responsibility of generally overseeing the intended program implementation strategies and as well ensuring that the anticipated impact is achieved. It will be the responsibility of the coordinator to ensure that the implementation is in line with the set work plan and ensure timely implementation to enhance timely realization of project impact. Together with the Organization Technical Advisor and other technical staff from UNICEF be charged with ensuring that field staffs are performing to the set expectations and standards.

One Program Officer and one Field Officers will be charged with ensuring effective day to day running of the project activities as set on work-plan. These will directly and closely wok with the peer educators and the youth Health Service Providers to ensure the services are appropriately accessed. They will directly work with the trained peer educators to organize special community Based Focus Group Discussions and other participatory sessions. They will ensure continuous and timely data collection from the peer educators organize this data for analysis and use by other project stakeholders.

Project Finance Officer who will entirely be responsible for ensuring proper management of project finances through accurate handling of project books of accounts. He or she will ensure timely preparation of monthly and quarterly financial reports with accurate accountabilities approved by the coordinator and a scented to by the Organization Technical Advisor. He or she will ensure that bank reconciliation and bank statements and financial variations are prepared on time and submitted to UNICEF.


   A4R Project Goal:

To contribute to the prevention of HIV transmission, care and support among the youth in the region by promoting community level sustainable participatory and innovative mechanisms for knowledge promotion on behavior change as well as enhancing timely access to and utilization of existing, affordable and appropriate health services for the adolescents/young people.
Specific Objective 1:

To increase knowledge and understanding of HIV/AIDS and other STDs risk factors through provision of accurate, updated and appropriate information among the youth.