Sreyassu Action Plan:

Sreyassu Action Plan: 20 20 1. Summary of the Project Sreyassu is a community-based organization located in Chillakallu, Jagayyapeta Mandal in Krishna District of Andhra Pradesh State. It was started in 2006 as a Project to support the people living with and affected by HIV/AIDS (PLHIV). Slowly, the registered members in the Project were educated and empowered in a way that they grouped together and formed as a CBO and got registered as a statutory body. The Sreyassu since its inception registered 1279 beneficiaries infected with HIV. Presently following up 446 PLHIV, 28 Children infected with HIV/AIDS (CLHIV), 100 Children affected by AIDS (CAA). The Sreyassu aims to prevent mortality and morbidity among the followed up PLHIV and CLHIV by improving their quality of life. As the area is surrounded by Factories, the migrant labour exists. The truckers mobility is found as well. The need still exists to encourage prevention, promote care and support, treatment follow-up and grapple the issues related to human rights. With its intervention, it is planning to support the PLHIV in terms of improving their health; promoting higher education among the children infected/affected by AIDS, fostering the orphan and semi-orphan children thus aims to improve the quality of life. The Sreyassu CBO is being supported by IADHO (Indo American Development and Health Organization), THE KCP Cements Limited, The RAMCO Cements Limited and local donors. It works in close coordination with the District AIDS Prevention and Control Unit, DRDA, MEPMA, Women and Child Welfare Department at the district level. In the Mandal, it has developed strong linkages with the ART Centres, Link ART Centres, DMCs, CHC, Mandal Development / Revenue Departments and local cement Factories. Sreyassu utilizes a peer-education approach with local community PLHIV Groups for tackling the issues related to the project community partners (beneficiaries). The total estimated budget for 20-20 is 2. Background The health department of the Andhra Pradesh government has been working towards bringing down HIV rates and a marginal drop has been recorded. The latest data put out by the daily shows that Guntur, Krishna and East Godavari districts have a high number of HIV cases but the new cases that are emerging are worrying. HIV tests were conducted on 4.9 lakh people in the state between April and September 1

2015. The daily reports that 12,742 people were found to be HIV positive and 42% of these cases were in Guntur, Krishna and East Godavari districts. In 2015-16, 24,957 new HIV cases came up in the state. Of these new cases, 3,781 were recorded in Guntur, 3,538 in East Godavari and 2,693 in Krishna district. There are more than 5 lakh people in the state with HIV, of which information regarding 1.5 lakh patients are currently not available with the government. The LEPRA Society initiated Sreyassu Project and developed it as a Community Based Organization by empowering the people living with HIV/AIDS. The Organization under its one of the strategic priority Empowering the People we work with will supports the CBO and capacitate them in Project Management, Fund Raising, Financial Management and acquiring CBO statutory requirements. The Opportunities for the CBO is to tap the resources by influencing the stakeholders. It can generate a demand for accessing the schemes and services for the people who are in need. One of the key constraints is that the Operational Mandal, Jagayyapeta is a border to Andhra Pradesh and Telangana, the System administration of Govt.delays (state bifurcation) in terms of accessing resources from Khammam and Vijayawada (E.g. ART Medication and the Pensions) and affects the people living with HIV. The Sreyassu CBO compliments the NACP IV of NACO where the main objectives are to reduce new infections and provide comprehensive care and support to all PLHIVs and treatment services for all those who require it. The main strategies include intensifying and consolidating prevention services, increasing access and promoting comprehensive care, support and treatment. 2.2 Project Rationale The Sreyassu has registered 1279 beneficiaries infected with HIV in Jagayyapeta Mandal and in and around areas. Presently following up 446 PLHIV, 28 Children infected with HIV/AIDS (CLHIV), 100 Children affected by HIV/AIDS (CAA). The PLHIV and CLHIV on ART treatment are #239 (PLHIV =223; CLHIV = 16). They are in need of follow up towards treatment adherence. In addition to this, the nutritional factor has its significance for being healthy. In the project, keeping track on the health condition of beneficiaries, ensuring prompt treatment impacts in early identification and management of OI s thus reducing mortality and morbidity among these populations. Among the beneficiaries of the CBO, more than 70% of them are linked up with at least one eligible social entitlement, where for the rest it has to be done. 80% of the Project beneficiaries belong to the below poverty line. 2

Among followed up beneficiaries of the Project, the women living with HIV/AIDS comprises 62% (275). Among these, 40% of the women lost their husband in the early 30 s. These women to be supported by facilitating the Government schemes and services, treatment follow-up aspects. Out of the 28 children living with HIV/AIDS (7 children are orphan: 25%; 14 children are semi-orphan: 50%). The Orphan children are living with the extended family members. The Children are in need of continuation of their schooling, reducing the dropout rates due to the financial problem. Also, children interested to pursue higher education to be identified and supported. The Project addresses the health, social and economic aspects of these populations in order to improve their quality of life. In the project, towards the children the basic rights enshrined in UNCRC (Right to live, Right to Education, Right to Participation and Right to Protection) are met among children living with HIV/AIDS and Affected by HIV/AIDS. 2.3: Project Duration The Project is proposed for a year (April 20 March 20) 3. Intervention 3.1 Goal or overall objective To improve the quality of life among PLHIV in terms of their health, social and economic aspects 3.2 Objectives 1. To reduce the morbidity and mortality among the PLHIV 2. To reduce the dropout rate and facilitate the education support among the children affected by and infected by AIDS 3. To reduce the stigma and discrimination associated with the disease 4. To increase access to social entitlements among the needy PLHIV 3.3 Results: 1. Improved health condition and increased man-days among the registered beneficiaries of the project 2. Eligible Children continue their higher education and children in need meet basic needs 3. Leadership is promoted among people living with HIV/AIDS by strengthened support groups and issues related to stigma and discrimination are addressed 3

4. Increased accesses to social services and entitlements by people living with HIV/AIDS 3.4 The Key assumptions are Philanthropists may involve in the Project for supporting the beneficiaries Good Cooperation and support from Government Departments is expected Support Groups strengthened at community level involve actively in the advocacy initiatives and access the services available at GO s and NGO s 3.5 Approach or strategies Peer Education Approach is followed to identify, counsel, refer the PLHIVs to the need-based services. Strengthening the support groups and the CBO results in the empowered community members for promoting and protecting their rights Direct Service Delivery in terms of medical aid, nutrition support, foster care and the education support helps the beneficiaries to improve their quality of life. 4. Component wise Proposal 4.1 Clinical Support Clinical Support is one of the major components in the Sreyassu Project. PLHIV needs a regular diagnosis of their health status. The Clinical Support includes medical counselling, health check-ups, Medical aid and Follow up services. The clinical support improves the health status of the PLHIV. On monthly basis, the clinics are organized with the support of Medical Officer. The Patient Cards are maintained and regular track of client health status is recorded. The Health Screening shall be done for the attendees of the clinic and medical aid is provided. On an average per clinic 50-60, PLHIV attends the clinic. The Opportunistic treatment is also provided for skin infections, Urinary tract infections, PID, Dysentery, Oral Candidiasis, Respiratory tract infections etc. The referrals are done from the weekly clinic and follow up is made by the outreach team for needed clients. The clinical support played a significant role in Reducing the death rate from 15% to less than 2%. Resulted in reduced Opportunistic Infections among the PLHIV Increased HB% from 8-10%, 4

Increased health condition among the PLHIV Resulting in early detection of infections associated with and to initiate immediate treatment. Expected Results: 1. Improved Health Status among PLHIV 2. Reduced Death rate 3. Reduced Opportunistic Infections Proposed Clinics: 12 Per Year 4.2 Nutrition Support Poor nutrition increases susceptibility to opportunistic infections and may accelerate the progression of HIV/AIDS. In this context, Sreyassu observed that most of the persons who are accessing the services are suffering from malnutrition and opportunistic infections. They belong to BPL Families (below poverty line). The project encourages the affected persons to have a minimal nutritional intake to cope up with the health situations and develops a system which is cost effective and locally relevant. HIV and TB coinfection cases, HIV infected persons, who are put on ART, Infected pregnant women and mal-nourished HIV infected persons will be supported under the Nutrition component. Expected Results: 1. Improved Health Status and reduced Mortality among PLHIV Proposed Number of Beneficiaries: 30 Per Month 4.3 Education support To support the children living with HIV/AIDS and affected by HIV/AIDS (on need-based) for continuing their education, the project is proposing education support. 1. Higher Education Support the Higher Education support aims to sponsor a child who is interested in higher education with limited options for continuation due to their family economic status. From last three years project supported 8 members under education support. This resulted to get employment among three children who completed their course (Polytechnic, ITI, Ag. B.Sc.). Expected Results: 1. No dropouts among the children for schooling 2. Continuation of Higher Education among children from PLHIV households 5

Proposed Number of Children for Education support: 5-8 Members per year based on need 4.4 Foster / Emergency Care Foster/ Emergency needs ensure a child to have supplementary nutritive diet and need-based support in particular. The foster children are the CLHIV, orphan and semi-orphan children living with Grannies and extended family members. The children in foster care are supported individually based on their immediate needs. The project provides needy and emergency support to meet the basic needs of the child. Foster care is designed to ensure the children to enjoy the child rights. The amount proposed for Foster care is used to provide supplementary nutrition two nutritive meals a day; provide tuition fees to children below 10 th class; meeting emergency medical needs for those children whose parents/caregivers not afford. Expected Result: 1. The orphan and semi-orphan children living with HIV/affected by HIV meet their basic needs. 6

5. Sreyassu CBO - Results matrix with outcome and output levels Results Indicator Target Means of verification Outcome 1: Reduced morbidity and Patient records mortality among the PLHIV Output 1: Improved health condition and increased man-days among registered beneficiaries of the project Outcome 2: To reduce the dropout rate and facilitate the education support among the children affected by and infected by AIDS % of deaths reported among the followed up beneficiaries % of OI s reported and Managed timely No. of PLHIV attended the clinics and followed up No. of PLHIV are tracked for CD 4 No. of PLHIV Kept on ART Treatment are followed up No. of Co-infection cases are registered and followed up No. of man-days increased among PLHIV % of eligible children completed their higher education % of children facilitated for employment opportunities % of death rate reduced compared with Last Year (From 3% to less than 1%) PLHIV 150 CLHIV 28 ART PLHIV 100 ART- CLHIV - 16 Foster Care = 6 Children Patient records GIS Information Education support Register and Education records of the children (Academic records and Certificates) Output 2: Eligible Children continue their higher education and children in need meet basic needs Outcome 3: To reduce the stigma and discrimination associated with the disease No. of Eligible Children identified and supported with Higher Education No. of Children provided with Foster Care support % of support groups with the persons living with HIV/AIDS are active Increased knowledge levels among the trained members in support groups Target = 5-8 Children 80% of the formed support groups 30-40% increase in knowledge levels among the trained CBO Members CBO Resolution for supporting needy children children Academic records and Certificates Support Group Meeting register Enrollment Details 7

Results Indicator Target Means of verification Output 3: Leadership is promoted among No. of Monthly Meetings At least 60% of the identified Support Group meeting people living with HIV/AIDS by strengthened conducted in support groups issues are resolved through the register support groups and issues related to stigma and discrimination are addressed No. of support groups strengthened No. of issues resolved related to stigma and intervention Outcome 4: Increased access to services and entitlements by people affected by leprosy and LF discrimination % of empowered support group members accessing the schemes and services At least 60 % of empowered support group members (new)accessing the schemes and services in this year Increased livelihood options through income generation support = 6 Members Support Group meeting register Livelihood Supported documents 5.1 Implementation Plan 20-20 Sreyassu CBO- Activities planned for the period of April 20 - March 20 # Activity Annual Target Apr Result 1: Improved health condition and increased man-days among the registered beneficiaries of the project 1.1 Conduct Clinics in Sreyassu for management of OI s 12 1 1 1 1 1 1 1 1 1 1 1 1 1.2 CD4 Testing (New and Follow up) x x x x x x x x x x x x 1.3 Provide Counseling on Treatment 100 ART follow up and Treatment Clients Adherence x x x x x x x x x x x x 1.4 Provide Psychosocial support to PLHIV through door to door visits and group counseling sessions 150 PLHIV, 29 Children infected with HIV/AIDS Mar Jun Jul Aug Sep Oct Nov Dec Jan Feb x x x x x x x x x x x x Mar 8

Sreyassu CBO- Activities planned for the period of April 20 - March 20 # Activity Annual Target Apr Mar (CLHIV) 1.5 Provide Nutrition support to the needy beneficiaries of the project Jun Jul Aug 30 Members x x x x x x x x x x x x Result 2: Eligible Children continue their higher education and children in need meet basic needs 2.1 Facilitate Higher Education Support to the needy children 5-8 Members x x 2.2 Foster Care support / Emergency Need to children 6 Children X X X X X X X X X X X X Result 3: Leadership is promoted among people living with HIV/AIDS by strengthened support groups and issues related to stigma and discrimination are address 3.1 Monthly Support Group Meetings 6 Support at community level Groups X X X X X X X X X X X X Identify and support the PLHIV 3.2 issues related to stigma and discrimination As per need X X X X X X X X X X X X Result 4: Increased access to social services and entitlements by people living with HIV/AIDS Identify the Eligible Persons for 4.1 social entitlements with the support of CBO Members As per need X X X X X X X X X X X X Facilitate the access of Schemes 4.2 and Services from the GO s and Minimum 75 NGO s for improving their social Members X X X X X X X X X X X X and economic status Sep Oct Nov Dec Jan Feb Mar Staff /Human resources: 1 Office Assistant, 2 Outreach Workers will lead the Project. The Staff of LEPRA Society will provide technical assistance in terms of Programme and financial aspects. The documentation will be done by the local consultant on a Weekly basis. 9

4.3 Monitoring, Reporting and Evaluation Periodicity Activity Methods/Tools Monthly Clinics Clinics Monthly Monthly Foster Care Nutrition Support Direct Service to needy Direct Service to needy Submission dates 15 th of every month 1 st week of every month 1 st week of every month Yearly Education Support Direct Service July 20 Monthly Quarterly Annual Organize support group meetings Quarterly Review meetings Annual review meetings Who is responsible Medical Officer; ORWs with the support of Medical Officer ORW s along with the CBO Board Members ORW s Participatory 2 nd Week ORW s ORW s along with the CBO Board Members Reports 1 st Week Sreyassu Staff Reports Last Week of March 20 President CBO Budget: Attached the Budget sheet: INR 5, 42,0 Factors ensuring sustainability of the project 1. Involving the community members in the project activities and their increased participation ensures the project sustainability 2. Strategic relationships with the Corporates and working towards establishing tie-ups with the CSR department results in increased funding sources to CBO s 10