Total Control of the Epidemic

Transcription

1 Total Control of the Epidemic A strategy to reach every single individual in a community with HIV/AIDS education and mobilization for behavior change. A presentation to the World Bank 5 th December Humana People to People

2 List of Content Why TCE? The TCE Strategy as a Model. Where is TCE being implemented? The Results and Indications of Impact. The Operational Arrangements. The Challenges and Lessons learnt. The way forward.

3 Total Control of the Epidemic Why TCE The Rational

4 Why TCE The Rationale HIV spreads by human behavior and can therefore only be prevented by informed decisions by the people themselves. Awareness is not enough to change sexual behavior people need to talk about it, make decisions and take action. Because of the stigma connected to HIV/AIDS, people need help to overcome fear and denial to be able to take decisions.

5 Why TCE The Rationale cont. In most countries affected by HIV/AIDS, the large majority of people do not have access to trained HIV/AIDS educators / counselors. There are not enough professionals needed to respond effectively to the epidemic. People also need to be mobilized to utilize services that do exist.

6 Why TCE The Rationale cont. A possible and cost effective solution using trained lay people to respond to the needs caused by the epidemic is imperative. The community response to the consequences of the epidemic need to be strengthened and promoted.

7 Total Control of the Epidemic The TCE Strategy as a Model

8 The Idea and the Vision To achieve total control of the epidemic through a comprehensive and systematic intervention involving all people, local leaders, service providers, etc. To reach every single person with information, education, counseling and mobilization through interpersonal communication.

9 The Idea and the Vision cont. To achieve this through the recruitment and training of 50 local TCE Field Officers per people. One Field Officer in charge of the program in every Field of 2000 people. A three year action of door to door mobilization.

10 The Goals Empower every single person with knowledge and skills on how to prevent new HIV infections. Empower the individuals and their communities to mitigate the impact of the epidemic. Empower communities to sustain the response after 3 years.

11 The Planned Results Over 80% of people are TCE Compliant (they have taken control). Over 50% of people are mobilized to know their HIV status. Over 5% are active as Passionates (community activists). The program have reached all the schools, workplaces, churches and traditional healers.

12 The Activities Reach every single person through systematic and repeated house to house visits. Counsel and assist people to make an individual plan for how to be in control of HIV/AIDS. Educational sessions in schools, workplaces, churches, etc. Talk Shows and Rallies.

13 The Activities - continued Promote Government HIV/AIDS programs (PMTCT, HBC, ARV, etc.) Formation of clubs and groups engaged in prevention of HIV and care and support for people living with HIV/AIDS and orphans. Training and empowerment of community volunteers. Promoting partnership and networking on community level.

14 The Activities - continued Targeting all vulnerable groups in actions: Sex workers Truck drivers Youth Etc.

15 Total Control of the Epidemic Where is TCE being implemented?

16 Where TCE is being implemented Zimbabwe 3 TCE Areas with people Mozambique 2 TCE Areas with people Botswana 9 TCE Areas with people South Africa 1 TCE Area with people

17 Total Control of the Epidemic The Results and Indications of Impact

18 Results in Zimbabwe April 2000 October Activity One on one educational Sessions Number of people reached Active as Passionates People reached through group lessons Condoms distributed Results

19 Results in Mozambique September 2000 October Activity One on one educational Sessions Number of people reached Active as Passionates People reached through group lessons Condoms distributed Results 165,943 84,491 5,847 69, ,679

20 Results in Botswana January 2001 October Activity One on one educational Sessions Number of people reached Active as Passionates People reached through group lessons Condoms distributed Results

21 Results in South Africa August 2002 October August 2002 to October 2002 Activity One on one educational Sessions Results Number of people reached Active as Passionates People reached through group lessons Condoms distributed

22 Evaluation TCE Bindura 2002 A survey based on qualitative data was done in May 2002, by PSI Zimbabwe: TCE project appears to have had an impact on community s reaction to HIV Positive People There seems to have been a marked change in attitude towards terminally ill AIDS patients in the rural communities.

23 Impact Assessment Botswana 2001 A comparative survey based on quantitative and qualitative data was done in June 2000, by CDC, TCM communities were found to have a significantly: Larger number and increase in clients tested for HIV Larger number and increase in the number of condoms distributed to the community Higher level of knowledge about STDs and HIV/AIDS Lower level of misconceptions about STDs and HIV/AIDS

24 Impact Assessment Botswana 2002 Humana People to People made an internal Impact Assessment in July 2002 comparing households visited with households not visited: Positive Findings: Good Indications of behavioural change: 30 % of the persons visited by TCM FO s reported to be tested compared to 19% not visited 72 percent of people visited by TCM reported having changed their behaviour after learning about AIDS, compared to 58% not visited

25 Impact Assessment Botswana cont Higher reported condom use among persons visited by a FO, significant in rural areas. Significantly higher number reported sex with only one partner in the 3 oldest TCM Areas. Higher reported knowledge about and use of Government Services such as PMTCT and VCT among people visited.

26 Total Control of the Epidemic The Operational Arrangements

27 Operations The Management A management team of 3 for 250 Field Officers + 6 International Volunteers + 6 Local Counterparts as Special Forces. A local supervisor for every group of 50 Field Officers. A National Office provides administrative support and technical assistance

28 Operations Continuous Training Initial 4 weeks of training. One week workshop every quarter. Weekly meetings in the groups of 50 reporting & planning Lectures The Field Officer is trained as a lay counselor within the first year.

29 Operations The Manuals The TCE Field Officer Manual The TCE Field Officer as a Counselor The TCE Field Officer as an Educator The Perpendicular Estimate System The Passion for People Movement The Soy Manual Etc.

30 Operations The Tools The District Multi Sectoral AIDS Committees and the Village / Ward Dev. Committees. The Clinics, HBC and Social Workers. The Schools. The Traditional Healers and Church Leaders. The Traditional Leaders (Chiefs & Headmen). The Local Politicians (Ward Councilors). The local Business Leaders.

31 Operations The Partnerships The District Multi Sectoral AIDS Committees and the Village / Ward Dev. Committees. The Clinics, HBC and Social Workers. The Schools. The Traditional Healers and Church Leaders. The Traditional Leaders (Chiefs & Headmen). The Local Politicians (Ward Councilors). The local Business Leaders.

32 Operations - Monitoring Daily verbal report to local leaders. Community monitoring (Monthly meetings). Referral forms to service providers. Weekly written reports to management. Field Visits. Performance assessment - The SCORE. Survey of knowledge and attitudes among FO s. Annual impact assessment.

33 Total Control of the Epidemic The Challenges, The Best Experiences and The Lessons Learned

34 The Challenges Daily verbal report to local leaders. Community monitoring (Monthly meetings). Referral forms to service providers. Weekly written reports to management. Field Visits. Performance assessment - The SCORE. Survey of knowledge and attitudes among FO s. Annual impact assessment.

35 The Best Experiences The Field Officers develop skills and knowledge continuously and rapidly throughout the program. Sharing experiences at a weekly meeting is a precondition for this. TCE fulfills an enormous need for a dialogue and detailed knowledge about HIV/AIDS among people. The TCE program has big impact in individual levels of knowledge and attitudes.

36 The Best Experiences - continued Passionates are trained and empowered to take a leadership role in individual and community driven behavior change. TCE works well with and can play a role in promoting existing programs on field and district level. Formation of unplanned partnerships i.e. listeners groups to reinforce radio drama. Local community and their leadership has welcomed and is supporting the program.

37 The Best Experiences - continued Local leaders are inspired by the Field Officers to be in the forefront of the fight against HIV/AIDS. TCE builds capacity in communities to build social networks. Initial input to individual and groups leads to a heightened level of activity and decision making towards the same goal community driven fight against the spread of HIV/AIDS.

38 Lessons Learned There is need for daily monitoring of the Field Officers. It is necessary to involve the community leaders in the monitoring. Special strategies has to be developed to reach people in employment.

39 Lessons Learned - continued A variety of activities in addition to the door to door campaign are necessary to reach all people and to keep the Field Officers motivated. TCE can provide services according to local needs i.e. training of teachers, counseling at work places, start youth recreational structures, orphan programs, etc.

40 Total Control of the Epidemic The Way Forward - Possible Cooperation with the World Bank

41 Share Experiences Visit to countries with MAP funding present the TCE program. Share the TCE Tools and Manuals. World Bank evaluate the TCE Program. Experience sharing workshops/meetings. Conduct situational analysis to adapt the TCE strategy to local needs.

42 Share Experiences - continued TCE is developed as a model that can be scaled up from 1 or few Areas of people to entire Provinces, Nations and Regions to combat HIV/AIDS. TCE is developed with tools and manuals for all levels so that every individual know what to do and what is expected from them in the process.

43 Implementing Partners Instigate TCE as pilot projects within MAP. Humana People to People partner with a local NGO or other agency to implement the TCE Program. Humana People to People can provide its expertise and experiences in other forms of cooperation.