HIV/AIDS PREVENTIONS. A Community Based Organization Approach In Mgbala Agwa,, Nigeria By Nduka Ozor

Transcription

1 HIV/AIDS PREVENTIONS A Community Based Organization Approach In Mgbala Agwa,, Nigeria By Nduka Ozor

2 CONTENTS OF THIS PRESENTATION Objectives What Is CBO? Where Is Mgbala Agwa HIV/AIDS Prevention Strategies By MAYF Other Strategies Challenges /Constraints Strengths Monitoring And Evaluation Outcomes

3 Objectives The main objective of this presentation is to provide a preliminary overview of the suitability of community based organization (CBO) in Mgbala Agwa to contribute to HIV/AIDS preventions. The presentation will highlight the strategies adopted in the program, challenges and strengths. It will also discuss ways of overcoming the constraints in similar settings.

4 What is CBO? CBO- Community Based Organization, to us means organization working in the grass root areas to implement certain social services that has direct impact in the community e.g.mgbala Agwa Youth Forum(MAYF) Nigeria, IKU osttersund Sweden etc.

5 Where is Mgbala Agwa? Mgbala Agwa is a rural community in the Oguta local government area of Imo state, Nigeria with a population of over 100,000 people. 65% aged years.mgbala Agwa community depends on crude subsistence farming as its mainstay. It can best be described as a community in the dark era in the 21 st century. It has an un-investigated HIV/AIDS prevalence rate, this is due to lack of resources to conduct the survey, but deaths related to AIDS is adding up seriously, children orphaned by AIDS is also unestimated. HIV/AIDS prevention programs are implemented by Mgbala Agwa Youth Forum (MAYF) in partnership with IKU Sweden.

6 OUR Strategies HIV/AIDS massive awareness programs through street walk, distribution of Information and Educational materials, rallies etc. In-School Programs: Catch them young (CTY),peer education, Teachers training,anti -AIDS club,etc Behavioral change communication(bcc),condom education, village meetings, Voluntary counseling and Testing (VCTs), Prevention of mother to child transmission, (PMTCT), prevention of STI Community coordinating Mechanism: women organisations,age grades, youth association, traditional rulers, churches etc Out of school program: one-on on-one one peer education, female and male football competitions, artisans and housewives.

7 Strategies contd. Shift emphasis from individual to community level Identification of the risky groups and high transmission areas Information for a community profile Participatory Rapid appraisal Participatory Planning process for HIV/AIDS action committee Basic steps in AIDS education and training section Training for community health providers Pre-testing and using of picture code for children Monitoring and evaluation

8 Shift emphasis from individual to community level During the development and packaging of the intervention program for in-school, it was discovered that exclusive targeting of students without involving the teachers and parents will not produce effective result. We therefore decided to train teachers who will in turn train students and form anti-aids clubs in the schools. This is for sustainability. While parents were thought of the Basics of HIV/AIDS. The reaction of the town was positive; they requested that such programs be extended to other primary and post primary schools in the clan and sub-villages after the pilot project.

9 Identification of Risky group and high transmission areas The lifestyle of youths is a burden and their behaviors were extended to teenagers, youths were trained as peer Health Educators (PHE) for behavioral change. High transmission areas identified included schools,roadsides,private male houses and some drinking joints. Plans were made at these areas for private meetings

10 Information for a Community profile Demography: population, sex, age distribution, family sizes, migration patterns, other ethnic groups in the community were obtained Economy: economic activities, employment and unemployment, local bars, shops, palm wine tapers, etc were assessed History: History of community, issues of concern, history of wars, community actions, history of HIV/AIDS/information/campaigns/activities collated. Health and social services: number of health services available, chemist shops,vct programs, PMTCT programs, schools, market, churches, clubs, identify potential partners in these relevant sectors. Organisations: religious organisation, other youth organizations, women groups, NGOs, which of these are potential partners Power and leadership: Traditional institutions, influential leaders, local government officer, councilors, KAPB information for HIV/AIDS, gender specific perception, HIV and STD problems

11 Participatory and Rapid Appraisal Information were collected, working with smaller team like villagers, health workers and community development workers Participation from representatives from villagers in team was essential; village leaders, opinion leaders, women leaders and youth leaders Composition of team was balanced Daily team discussion in the field served to adjust guidelines Initial appraisal was for a short term A rapid appraisal was action-oriented; oriented; it was intended to provide a basis for program design and implementation

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13 Participatory plan process for AIDS action committee We mobilized a committee for action stimulating awareness of the problem of HIV infection Involved broad variety of community residents, analysed behaviours and problem base of the community Focused on the potentials for change, motivated actions Selected strategies that strengthen potentials and remove obstacles Choose actions that provided immediate success Did some basic trainings, prepared materials for work in the community Choose peer educators from vulnerable and risky groups for training

14 Steps taken in AIDS education and training sessions Assessed what the people already know about HIV and STD Build on what is known Stop and check people s s understanding often Build sessions around problem solving and decision making, involving everybody in both Plans in evaluation of education or training activities as part of the process.

15 Training for community Peer Health Educators Basic facts on HIV/AIDS and STDs, reproductive health and the relationship of HIV infection and TB Treatment of STDs Family planning methods Gender issues in behaviors change Care and support for people living with HIV/AIDS and the role of stigma, ways to promote positive living. Basic training in the principles of health, the use of picture codes c and short role play as discussion starters Monitoring and evaluation methods, including identification of risky r behaviors of peers, the role of alcohol and drug abuse, choosing evaluation questions and indicators of measuring success, and ways to monitor activities

16 Pre-test and using picture codes We adopted the following questions for pre-test picture codes: Who are the people in this picture? Are they from this village? What do you see happening in the picture? Why is it happening? Does this happen in real life? What problem does this led to? What are the root cause of this problem? What can be done about it

17 Challenges/constraints Poverty level of the community Farming/agricultural systems in the community. Illiteracy level Socioeconomic problems; gender related problems, traditional practices, complete lack of social amenities, social structures. Weak health institution Lack of resources: funds, materials, High level unemployment Denials and low level awareness Inadequate capacities

18 Strengths Availability of manpower or personnel Non language barriers Community ownership of the program Acceptance of youths as part of community decision making body. Knowledge of Community cultures Supports from the traditional rulers council Consistency in the mist of frustrations. Passion to bring about a change. Collectivism with open mindedness.

19 Monitoring and Evaluation Indeed monitoring and evaluation should be built into programs during their planning phases. It is very important to work with the community to determine what should be evaluated, how it should be evaluated and the expectations from the project. It is also very important to let the community know those who will be involved in the community evaluation process, this will help evaluators a lot. But we have not been able to do impact evaluation of this program due to funds.

20 Immediate Outcomes After the 12 months programme, children and other participants were better informed on the dangers of risky behavior which led to minimal incidence of unwanted pregnancies in the village Secondly, teachers were adequately trained on how to sustain the programme and continue to teach their students about HIV/AIDS, the schools now have one hour extra moral classes where HIV and sex are discussed with students. MAYF project also helped young people instigate life style changes to slow AIDS infection in the community and to improve understanding of people currently living with the disease, at least condom consumption increased based on our investigations from the patent medicine dealers

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34 Thank You