HOPE End of Year Program Report

Transcription

1 Development Aid from People to People HOPE End of Year Program Report January to December 2013 To U-landshjelp landshjelp fra Folk til Folk, Norge

2 Name of Program: HOPE ZAMBIA Implementing organisation: DAPP in Zambia Reporting Period: January 2013 to December 2013 PROJECT OF OPERATION Name of Project CENTRAL PROVINCE 1 HOPE Mkushi 2 HOPE Serenje 3 HOPE Chibombo and Chisamba WESTERN PROVINCE 4 HOPE Kaoma and Kaoma COPPERBELT PROVINCE 5 HOPE Ndola SOUTHERN PROVINCE 6 HOPE Monze Projects involved in the program HOPE Projects 2013 Ndola Serenje Mkushi Mongu Kaoma Chibombo Livingston Note: DAPP had planned to start operation in two new districts of Western Province being Lukulu and Shangombo. Starting of these districts delayed but activities will start in Sanombo in January Due to the delay in starting these projects they are not part of the program report. On the other hand DAPP in Zambia started operation 2 other new HOPE projects which were HOPE Chibombo and HOPE Monze. 1

3 1. INTRODUCTION The HOPE projects are aimed at stopping the spread of HIV and reversing its impact on those infected and affected by the HIV epidemic, with the main emphasis of training community volunteers as activists. The projects worked within target communities in the Copperbelt, Central and Western Provinces of Zambia. The Program activities were structured and implemented through the following key elements: 1. Health activities: - focused on reducing new infections and improving health for people living with HIV within the participating communities. 2. Opinion forming activities: - with interventions focusing on promoting behaviour change to form opinions that complement the health activities. 3. Outreach activities focused on mobilizing and capacity building trainings for community health service providers such as TB and ART treatment supporters, Health Workers, Community Counsellors and community structures such as Support Groups for people living with HIV (PLHIV), and youth clubs. The project activities were facilitated by DAPP staff with support from about 2500 community based activists and working with over 500 Support Groups for PLHIV and 128 Youth Clubs. The needs and priorities of the target groups remained diverse across the operational areas and this influenced the differences in focus: HOPE Ndola focused CT activities, as well as positive living training for people tested HIV positive and on improving economy for people living with HIV by increasing access to micro financial services and participating in small income generating activities. The health and nutritional status of PLHIV has greatly improved thanks to their participation in these interventions. Youth and school activities were also implemented during the reporting period as well as the distribution of condoms. TB and ART adherence supporters were instrumental in facilitating some of the planned activities within the communities in Ndola. HOPE Serenje and Mkushi facilitated interventions to improve the food security and nutrition status for PLHIV. Participating households were trained in improved farming methods and received small livestock and crop input loans. The project has further supported gardening, fish farming and banana plantations as a strategy for improving income and nutrition levels for PLHIV. HOPE Mongu and Kaoma built capacities of local organizations to effectively deliver services to their clients as well as counselling and testing and conducting positive living training. Other interventions included focusing on school and youth club Programs, community meetings, establishment of saving groups and activities to improve the livelihoods and food security for people infected individual or affected households. During he year the HOPE project in Kaoma took over operation of a big project supporting orphans and vulnerable children. This was in cooperation with World Vision which continued technical 2

4 support to DAPP. Main activities included working with care givers who carried out door to door support visits to households affected by the HIV pandemic. HOPE Shangombo and Lukulo did not start activities in the year as the major partner funding was not obtained. However activities wil start in Shamgombo in January DAPP started activities in three new districts, which had not been planned. This was HOPE Chibombo, Chisamba and HOPE Monze. The project activities was related to a big programme to support orphans and vulnerable children (same as mentioned for HOPE Kaoma) and included door to door support carried out by trained care givers to over 12,0000 orphans and 2464 people living with HIV in the 3 districts. DAPP was further appointed the lead agency for this programme in Chibombo and Kaoma districts providing sub-grants to smaller organisations. This report will focus on activities in HOPE Ndola, Mongu, Kaoma, Serenje and Mkushi which was the projects supported by member organisations of the Federation Humana People to People. DAPP Zambia has been partnering with the following key stakeholders on the HOPE Project Ministry of Health and other government line departments Network for Zambian People living with HIV/AIDS (NZP+); District and Community AIDS Task Forces (DATF and CATF); Support Groups for People living with HIV/AIDS; Youth Clubs; Community Based Organizations; Local leaders including the Traditional leaders. 2. ACTIVITIES CARRIED OUT A. Strengthen the economy, nutrition and food security for PLHIV and their families The HOPE project has been building the resilience of the vulnerable people living with HIV in support groups through strengthening their economy, improving their nutrition and increasing their food production levels to reduce dependency on external support. To address the food and nutrition needs of PLHIV the project has distributed farming inputs and conducted trainings in sustainable farming practices and food preparation methods. The input provided to the groups varies from project to project. In Mkushi and Serenje districts the project has distributed small livestock which are important household assets and also help in meeting their dietary needs. Benefits are also accruing from the fish farming, banana plantations and from the harvested crops grown from the inputs packages distributed to the participating households. HOPE Ndola has maintained its linkage with CETZAM Financial services where 184 support group members accessed loans for engaging in income generating activities. Trainings have 3

5 been imparted to support group members to enhance their business management skills. Some of the loan recipients who have repaid have made new applications for larger amounts which will be used to finance higher income performing activities. Apart from the micro-finance services, the project has distributed seedlings and seeds for backyard gardens that are meant to address the nutrition needs of households Establishment and running of saving groups became an important part of the HOPE program during 2014 in order to improve the economy of PLHIV and their families. Support Groups as well as other community members were mobilised to start saving groups in which the members contribute monthly and when a capital has been build the group member borrow for emergencies and income generation for a small interest of 10%. This activity was carried out in Mongu and Kaoma with 55 savings groups, Mkushi with 15 groups and Serenje with 20 groups bringing the total to 90 groups out of the 140 planned. However the idea is gaining ground and many more groups are expected to start in B. Strengthen the health for people living with HIV (PLHIV) and their families PLHIV were mobilised and trained to improve the living condition and health for themselves and their families and as well mobilised and organised to take part in the fight to stop the spread of HIV and to support those infected and affected by the virus. Positive Living Advocacy Training sessions have been conducted at support groups level in an effort to increase awareness to PLHIV on strategies for living longer. PLHIV are also provided with knowledge on where to access different services such as condoms, Male Circumcision, Prevention of Mother to Child Transmission (PMTCT), Counselling and Testing, etc. PLHIV are bouncing back to normal lives after adhering to Antiretroviral Therapy (ART) which is reducing opportunistic infections and other related diseases. During the year the groups were provided capacity building in organisational development, advocacy, governance and record keeping. The project also provided mentorship to the groups so that they are fully established to sustain activities in their respective groups. Groups have developed and documented organizational structures such as constitution, action plans and group calendars. They have elected leadership and are conducting meetings; make minutes and members understood their role and responsibilities. Furthermore, the Program in all the districts has been working closely with key partners such as the Network of Zambian people living with AIDS NZP+, Ministry of Community Development, Mother and Child Health, the department of livestock and fisheries and the department of agriculture. NZP+ coordinates the activities of support groups has been trained on how to conduct technical support to the groups. 4

6 C. Counselling and testing (CT) The Program carried out static and mobile HIV counselling and testing. HIV counselling and testing services have been provided to a total of 51,237 people using the mobile and stationary testing. D. Treatment related activities The project worked with 238 active TB Treatment Supporters from the support groups of people living with HIV. They assisted in TB screening and provided adherence counselling in taking the drugs. The supporters were helpful in tracking those that default the intake of drugs. These treatment supporters are volunteers attached to the clinics within the Programs operational areas are as well in contact with the HOPE project that mobilizes them to continue being active. Most of the TB and ART adherence supporters trained in previous years are still active. The volunteers assisted in screening patients and provided adherence counselling to patients newly enrolled on ART and those finding difficulties in coping with treatment. The treatment supporters were also instrumental in tracing those defaulting on treatment and mobilised patients for adherence. They also conducted client reviews on TB days. E. Condom Distribution Condom distributions and demonstrations were carried out for a total of more than 1,400,000 condoms distributed during the period through actions and established condom outlets. The distribution process also involved information dissemination on the benefits of using the condom and the recommended way of correctly using the condom. The project distributed both male and female condoms as an HIV prevention strategy. The condoms have been sourced from the Ministry of Health District Offices and from Society For Family Health offices F. Community awareness and opinion forming activities The project carried out campaigns and satellite activities in the communities and some of them were during the commemoration of the following events: World TB Day, International Women s Day, International Day of the Family, World AIDS Day and Youth Day. Messages during these campaigns included HIV/AIDS prevention and prevention of major common diseases, childcare, gender based violence, hygiene and the importance of clean water. Participants to the campaigns have increased knowledge and awareness on health related issues and the services available to them such as MC, PMTCT and ART as well as the partners providing these services. DAPP involvement in these events at national, district and community events has increased the visibility of the HOPE Program to the general public and other stakeholders. 5

7 G. Youth and School Programs The Project worked with 165 schools and 127 Youth Clubs, co-ordinating and mentoring AIDS Action Clubs. Pupils and out of school youths were educated in behaviour change, Gender-Based Violence, Post-Emergency Prophylaxis (PEP) including HIV and other related diseases. In schools, the Program worked through trained peer educators who carry out various activities on HIV prevention and water, sanitation and hygiene. The out-of school youths learned life skills so that they were equipped with knowledge in problem solving behaviour and use them appropriately and responsibly in the management of personal affairs to prevent against HIV infection. H. Mobilising and capacity building support structures for PLHIV HOPE program worked closely with Network of the Zambian People living with HIV/AIDS (NZP+), District AIDS Task Force, Community AIDS Task Force and the Clinics. The residence development committee (RDC), neighbourhood health committees (NHC) and the Health Zone Committees all participated in implementing activities in the community and at district level during the campaigns. I, Working with Caregivers HOPE in Serenje and in Mkushi trained 75 care givers in each districts in psycho social counselling of children as well as other ways to provide care and support to orphans and their families. The care givers conducted visits to households caring for orphans after the training. HOPE in Kaoma took over working with 375 care givers trained under the STEPS OVC project while the projects in Kaoma and Mongu continued to work with about 50 care givers previously trained by DAPP bringing the total number of care givers in Kaoma and Mongu to 425. A total of 4,484 orphans were supported by the care givers as well as 1,813 people living with HIV. Main activities carried out by the care givers during home visits include psyco social counselling of children and people living with HIV, providing guidance of ways to improve nutrition in the family, growth monitoring of young children, mobilising all children to go to school and monitor their performance in schools. 6

8 3. IMPACT OF THE PROGRAM Reduction in the spread of HIV/AIDS: Reduced cases of HIV infection were recorded at community level. The project formed youth friendly corners and youths were involved in giving out information in HIV and AIDS as well as distributing condoms in order to reduce the spread of HIV. Knowledge and awareness in HIV/AIDS has also improved and the impact the project activities had on the community is that people have knowledge about HIV and AIDS and new HIV infections have reduced in the community. Support members are now in the fore front to fight the epidemic. The graph shows the improvement recordedd in Ndola at household level of HIV prevention, 95% of surveyed households have reported an improvement in HIV prevention. Increased income and food security for support group members: The income, nutrition status and overall livelihood for people living with HIV and their families have improved. In Ndola, households are now able to have 3 meals a day. The graph also indicates improvements reported from the Ndola household survey and it represents improvements in cooking methods, nutrition and access to safe drinking water. This has been as a result of positive living lessons conducted and the back yard gardening activities the participants are involved in. Increased incomes have also been reported resulting from access to small loans which have been invested in income generating activities and other productive assets at household level. Through the farming inputs that were given to support group farmers managed to plant and harvested enough crops for selling and food. They managed to have food fair during under five clinic and created awarenesss for the mothers and their children on how to prepare nutritious meals. The incomes among support group members have increased. After the yields 7

9 support group members were able to sell some of the produce and they were able to take their children back to school for those whose children had dropped out of school due to financial constraints. The fingerlings and livestock which they were given has become the source of income for most households and they have enough fish to sell and eat. There is an increase in business opportunities at local level for support group members. Thanks to the savings that support group members are doing they have managed to come up with their own small businesses such as rearing broiler and village chickens and some are able to boost up their already existing businesses, their households have been economically strengthened. Improved health for targeted support group members and their families: Increased knowledge among community members in prevention, treatment, care and support for PLHIV has contributed to improved health and support. There are reduced AIDS death incidences at community level. The establishment of strong linkages in Ndola with the health service providers from the government departments and the civil society organizations in the district through the referral system ensures an easy access to health services. There are reduced cases of malnutrition reported at village level. There are reduced AIDS death incidences in Serenje District. PLHIV are no longer bed ridden as it used to be in the past. People go for VCT and if tested positive they are provided with art service. All those who used to be unproductive because of nursing the sick relative are now busy with other activities. 8

10 4. OUTPUTS FOR HOPE ZAMBIA 2013 Ndola Mongu and Kaoma Mkushi Serenje Summary Plan Ach Plan Ach Plan Ach Plan Ach Goal Ach +/- # of staff # of DI's #of activists and volunteers Objective One Improve Health and Welfare for People living with HIV/AIDS Number of People trained in Positive Living 2,600 2,705 1,000 1, , Number of PLHIV benefiting from pass on loans of livestock and gardening , Number of Saving groups Number of PLHIV that benefited from micro finance Objective Two Preventing the spread of HIV/AIDS Number of people tested for HIV Number of schools reached Number of out of school youth clubs Number of people reached with opinion forming activities 13,000 13, ,055 15,000 15,550 15,000 16, Number of men/ boys mobilised for male circumcision Number of Condoms Distributed Objective Three Mobilising people to take active participation in the fight against HIV/AIDS Number of Community AIDS Task Force trained (CATFs) mobilised and trained Number of Support Groups affiliated with HOPE Number of care givers trained and active TB treatment supporters/ ART adherence supporters active in the HOPE

11 5. ANNEXES - PICTURES FROM THE HOPE PROGRAM PREVENTION AND ADVOCASY Drum performance Youth club clu performing during Community campaign in Chipulukusu Radio awareness program in the making Youth participating in World AIDS day 9

12 STRENGTHEN THE ECONOMY, NUTRITION AND FOOD SECURITY FOR PLHIV AND THEIR FAMILIES Cooking demonstrations Fish farming 10

13 Improved gardening supporting household nutrition and income Saving group during monthly saving session in which each member bring their contribution 11

14 Chicken Pass on Loans Goat Pass on Loans 12

15 TRAINING OF CARE GIVERS IN MONGU AND KAOMA Training of Care Givers in Basic Care and Support Care givers with the certificates after training in Basic Care and Support Care givers with the visiting books 13

16 Annex 2: Success Stories SAVINGS CLUBS IN HOPE SERENJE Annie Chisenga is a member of Mwimbula support group in Serenje District. She HIV positive and encourages people to go for VCT. She was encouraged to join a support group and is happy that she did. Annie is also engaged in gardening, as an income generating activity to help sustain her family. In 2012 DAPP trained us in savings internal lending community (SILC). We were 10 in the group and we started saving and lending the savings to group members. We were saving between K50(US$10) to K1,000 (US$20) We have now a lending capital of K38,000 (US$7,600) she says. Annie got a loan from the saving group which enabled here to expand her business and garden. The income she made from gardening was invested in field crops and she started growing maize, beans, sweet potatoes and soya beans. This year I have managed to buy 32 bags of fertilizer and I plan to use 6 hectares of my land to plant maize, she says. She says the saving group has helped her so much as she is able to also do farming. I had land but I could not do farming because I had no money to buy farming inputs. We have come to learn to do business because when you borrow the money from the saving group you need to use it and repay it after a month with 10 percent interest. So it made me to explore what kind of business to do. I am now self-reliant and I no longer depend on my relatives, she says. Annie says she is now able to provide for her children with three nutritious meals per day. She says other community members have also formed saving groups after seeing Mwimbula support group s success. Annie thanks DAPP for the training in SILC. Many people in her area that do not belong to support groups have decided to join the saving groups. Annie says she is now happy with her life and appeals to those who have not joined the saving groups to do so, even if they are not HIV positive.. 14

17 BEADS MAKING A SOURCE OF SURVIVAL Just when people throw paper anyhow, Wiphan Support Group is using it to earn a living and sustain lives. The group members use it together with glue to make beads for sell. These fashionable beads of different designs (necklaces) and colors are sold at K15 (US$3) each. Picture showing the production of paper mash necklaces Dorothy Chanda attests that her life has changed and she is grateful to the HOPE Humana project. Dorothy of Nkwazi in Ndola is a widow with four children. Her health started failing after the death of her husband in 2007and her friend, who was a support group member, encouraged her to go for VCT. She was told the importance of knowing her HIV status and also the benefits of joining a support group. This was five years ago, when I had gone for VCT and the results were positive for HIV. After getting the results, I was a bit confused because I the sole bread winner who was looking after the children since the father had died a year before, she says. It took time for me to accept the results, but with the help of friend I managed to over come fear and I joined Wiphan support group, under the HOPE Humana project in Ndola. As a group we were trained in Horizon (positive living course). 15

18 She says life was difficult but eventually became better as the group got involved in beads making as a source of their survival. The beads are made from paper and glue and are sold at K15 (US$3) each. She says with the beads making business, life has become very easy and she is able to have three meals a day and also send her children to school. All my children are going to school with the money raised from the sell of beads. Taking the children to clinic has also not been a problem as am able to do so from the money I get from the sales. Life has really changed and happy with what HOPE Humana project is doing in helping change the lives of People living with HIV/AIDs, through the support group programme, she says. Dorothy says she has sold 74 beads and raised K1110 (US$222) in the last two months. She says she is humbled to be part of the support group. She is able to take care of two orphans for whom the group has given her responsibility. The group has also been given a house which belongs to the group due to her hard work and understanding of what needs to be done to people infected and affected by HIV/AIDS. I would like to pay tribute to HOPE Humana for the job they are doing in alleviating poverty among people living with HIV/AIDs through the various programmes they are running in the communities around Ndola, Dorothy says. 16

19 Annex 3: Reccomendation Letter 17