HIV AND AIDS

hiv & AIDS

SDI mainstreams HIV/AIDS in all its programmes and activities with the specific aim of “empowering communities especially women and adolescents to lead self-determined, healthy and productive lives . Our key areas of intervention include; Early Infant Diagnosis (EID), HIV Testing and Counselling (HTC), Prevention of Mother to Child Trasmission (PMTCT ) and Sexual Reproductive Health and Rights (SRH&R). In our programmes we mainly target adolescents, young women and women. Male involvement is one of the key strategies used to achieve sucess. SDI has also implemented a number of HIV & AIDS specific projects as presented below;

Making follow up with a teen mother

Partnership Initiatian meeting with Health Facility

Community awareness carnival

Community meeting with teen mothers and sex workers

Pamodzi (Together) is a 2 year collaborative project being implemented by a collaboration of 3 local NGOs and 3 Government health facilities in Salima District in Malawi. The project aims at improving access and uptake of HIV prevention and treatment services by 22% (from 63% to 85%) among teen mothers and sex workers by December,2020 through enhancement of clinic to community collaborations(C3 methodology). Specifically the project addresses loss to follow-ups for infants born to sex workers and teen mothers, low uptake of PMTCT services, increased ART default rate and unfriendly spaces in the health facilities for sex workers to access services in the target area. Children born to sex workers and teen mothers are hard to reach and part of the missing group in PMTCT and EID. The project is implemented by Sustainable Development Initiative (SDI), Life Concern Organization (LICO) and Foundation for Community and Capacity Development (FOCCAD) with funding from Positive Action for Children’s Fund (PACF).A partnership was put into place which comprises the 3 local NGOs and 3 government health facilities of Lifuwu Health Center, Maganga Health Centre and Salima District Health Office ( DHO). The project also recruited and trained 15 mentor teen mothers and 15 mentor sex workers (aunties), who also formed part of the team as volunteers. The project have produced the below outcomes;

A total of 203 lactating teen mothers and 71 lactating sex workers were found and introduced into care
A total of 29 children born from both HIV positive sex workers and teen mothers have been traced, tested HIV+ and are now on treatment.
Introduced a referral system for teen mothers and sex workers in 3 health facilities (Maganga, Lifuwu and Salima DHO)
Through advocacy interventions the project was able to identity underlying issues that prevent teen mothers and sex workers from accessing ART such as long distances to health facilities, stigma, confidentiaty, life demands (sex workers prefer going to work than going to clinic), having different appointment dates for the mother and the baby). Following successful lobbying with DHMT and healthy facilities, the project has hence influenced the 3 health facilities to create safe spaces/policies and environment for sex workers and teen mothers. All 3 health facilities have trained all its staff on management of teen mothers and sex workers. The environment has tremendously improved, cases of hostility against teen mothers and sex workers are going down. Each of the three health facility have a vibrant teen club which serves as a platform of long-term engagement with teens within their geographical area. All 3 health facilities are providing integrated outreach services. This means ART services for teen mothers and sex workers can be accessed every day.
Established strong partnership linkages between NGOs , District Health Office (DHO), District Health Management Team (DHMT) and Health Advisory Committees (HACs), PMTCT support groups ,sex workers, teen mother and health facilities

HTC Counsellor interacting with a client

Clinic-CBO Collaboration (C3) Project: With support from PATA, SDI implemented the C3 Project. The collaboration was aimed at addressing lack of access quality and reliable HTS services at Chikowa Health Centre. This problem was due to shortage of trained full time HTC counsellors at the Clinic. The two conducted joint planning and implementation of activities. The collaboration achieved the following; a) Number of qualified HTC counsellors has doubled from 2 to 4 at Chikowa clinic; b) Number of hours for HTC services has been extended from Morning hours only to Morning and Afternoon at Chikowa Clinic; c)Number of days for HTC services has extended from 3days per week to 5 days per week; d) Community based HTS has been introduced ; e) Number of clients accessing HTC services has increased by over 100%. The project also resulted into improved data collection , management and reporting on HTS and HTC seeking behaviour among communities. By working together Chikowa Clinic and SDI increased efficiency and effectiveness in delivery of HTS. Both Chikowa and SRGDI have gained skills and experience on how best to work with /handle NGOs and Clinics respectively . More projects (e.g. Peers supporter programme & CTPT) have being introduced through the collaboration 8. Increased confidence from potential donors and partners (the partnership makes it easy for both parties to gain credibility and trust).

Project Reach: With funding from One to One children Fund through Pediatric AIDS Treatment for Africa (PATA), SDI implemented Project Reach in 2014 - 2016 in Partner-ship with Chikowa Health Centre in Blantyre. The purpose of the project was to expand the pediatric HIV work force and improve healthcare services and outcomes. The programme targeted adolescents living with HIV.SDI recruited, trained and supported adolescent peer supporters that were supporting other adolescents in the fol-lowing areas; a) Providing HIV/AIDS and SRH&R education b) Providing lay counseling d) Providing encouragement to other Adolescent HIV patients at the health center’s e) Helping Adolescent HIV patients learn how to self-manage their treatment f) Making follows up to Adolescent HIV patients that miss an appointment g) Helping Adolescent HIV patients cope with associated issues, such as stigma h) Collecting information on Adolescent HIV patients and i) Advocating for Adolescent / youth Friendly Services

Above: one of the peer supporters (in green blouse) with a client

Peer to Zero: SDI in partnership with Chikowa health centre implemented a Peers to Zero (P2Z) Programme in 2017. The programme was set up by PATA and African Young Positive Network (AY+) to bring together frontline healthcare providers and young people living with HIV (YPLHIV), creating a unique platform for advocacy and service delivery change. Through the programme, SDI worked with 3 peer supporters, Chikowa health centre practitioners and Chikowa youth group living with HIV. The peer supporters and the youth group aimed at supporting their peers to live positively without stigma and discrimination and to promote adherence to ART treatment.The program has ably created a safe space for the youths enabling them to access health services such as sexual and reproductive health services and ART treatment at the facility without reservations. During the implementation of the programme, the number of youths accessing services at the facility doubled. The facility empowered peer supporters great-ly to act independently by training them to provide HIV testing and counseling to clients, dispensing ART drugs and other services at the facility.

Above: Students pose for a picture after a training how to communicate HIV prevention messages using computer applications

Multimedia AIDS Communication Programme (MACP): SDI implemented MACP project in the year 2012 - 2013 in Blantyre, Zomba and Chikhwawa. The project was funded by PEPFAR – US Embassy and aimed at enhancing the accessibility of HIV/AIDS prevention information to the youth and adolescents through ICT. This was in recognition that in the current modern era, a good percentage of young people have access to ICTs by using different technologies such as listening to radios, watching TV, using cell phones, computers and other communication devices. Through the project, Over 1000 students from 30 schools is Blantyre , Chikhwawa and Zomba were linked and supported to use ICT to share HIV prevention infor-mation through media applications such as internet, Facebook and Whatsapp .

HIV Prevention Audio Books for Visual Impaired: HIV Audio-Books for the Blind (HAB4B) Project aimed at increasing access to HIV prevention and SRH information among the visually impaired students using ICT. The project was supported by PEPFAR – US Embassy and was part of the Multimedia AIDS Communication Programme (MACP). It targeted two schools Makande (Chikhwawa) and Nadzombe (Phalombe) for the Visual Impaired. The project was implemented in partnership with Digital Multimedia Solutions.

Combined Therapy And Physical Tracking (CTPT): Supported by VIIV Health Care, SDI implemented a PMTCT project called CTPT in Chikowa, Bangwe and Zingwangwa Health Centre from 2012 - 2016. The project aimed at increasing stable access to PMTCT services by pregnant women, new mothers and new babies. Its components included EID, HTC, ART, Tracking and follow up of patients, women empowerment and Male involvement.The project worked with 5 women to women groups and 3 men to men groups which had an average of 20 members each. The groups were met weekly and they were trained in PMTCT messaging, advocacy, gender and village savings and loan (VSL) methodology as a means to economic empowerment. Activities were implemented in collaboration with HSAs, the Health facilities, community volunteers and local leaders. The project trained 57 Outreach workers in EID. It conducted early diagnosis for Over 1,400 infants and about 30 infant were registered on ART. The project also identified 89 (20 male and 69 female) defaulters for ART of which 70 (14 male and 56 female) were tracked and followed up by the volunteers. More than 8000 men were reached with PMTCT messages through awareness campaigns. Women to women groups registered 45% household income level increment through engagement in Village Savings and Loan Associations