2016 YEAR REPORT FOR THE PERIOD JANUARY TO DECEMBER 2016 TCE YUEXI IN PARTNERSHIP WITH U-LANDSHJELP FRA FOLK TIL FOLK, NORGE HUMANA PEOPLE TO PEOPLE CHINA
The project at a glance 1 Project name TCE Yuexi 2 Operation area Yuexi County, Liangshan Prefecture, Sichuan Province, China 3 Project Leader Agen Riga 4 Physical address and contact details 5 The project idea and the people it reaches 6 The people at the Project 7 The history in brief 342 Xining Road, Yuexi Town, Yuexi County, Liangshan, Sichuan Province, China Postal code: 616650 Email: agen.riga@hppchina.org.cn The idea of the project is during a 3 years campaign to achieve total control of the HIV/AIDS epidemic in 5 high risk townships of Yuexi County among a population of 20,000 people. This is done with one-on-one door-to-door visits to all resident villagers with health education, mobilization and voluntary home-based counselling and testing. Further it is done through a Passionate network and training of local leaders and influential people who will support the information and mobilization work. The project focuses especially on prevention of Mother-to-Child transmission and improvement of hospital delivery rates. The project comprises of 1 Troop Commander, 8 Field Officers, Yuexi Women Federation and 20 000 community people. HPP China has worked in Liangshan on HIV prevention and control since 2010 and has good relations to the local health system. With this as background we managed in 2014 to get a 1 year grant from the Population and Reproductive Health Capacity Building Program from the World Bank. After this program was finished in mid 2015 AIDS Healthcare Foundation was mobilized to engage in Yuexi through a small pilot program in one township From October 2015 to September 2016. Yuexi County is among the 7 counties in Liangshan with a growing HIV epidemic. This is caused by trafficking of drugs through that area with many farmers and young people involved in injecting drugs and sharing needles, this also combined with severe poverty and the low education level of the Yi minority. This situation is further enhanced by Yi minority who support pre-marital sex, and therefore awareness about HIV/AIDS is low, the population is very vulnerable to HIV/AIDS. The TCE project is the first pilot project in this county with focus on prevention of Mother-to-Child transmission and improvement of hospital delivery rates. In 2016 China Association of STD and AIDS Prevention Control offered a grant to run a one year program starting in May 2016 to 31st of March 2017. The program activities covers 5 Townships in Yuexi County. 2
Project activities January - December 2016 Trainings The Field Officers provided trainings to villagers through various approaches such as door to door visits and organized group trainings. Exclusive trainings basically targeting women were also carried out. The trainings involved topics such as Basic knowledge of HIV/AIDS, Sexually Transmitted Diseases (STD) and drug abuse. The Troop Commander provided training for the local Women Federation cadres on basic HIV/AIDS knowledge, mobilization and management skills during his visits when carrying out Monitoring & Evaluation. Capacity building for project team When the program started in May 2016 the newly recruited Field Officers received initial training which focused mainly on theoretical knowledge followed later by practical training in the field. Yuexi County Health Department in coordination with Yuexi Center of Disease Control (CDC) also gave both theory and practical training to Field Officers, covering topics such as HIV/AIDS epidemic, prevention, rapid testing and how to mobilize and educate pregnant women about the importance of giving birth at the hospital. Every month the Troop Commander organized training for the project team. The training consisted of HIV/AIDS issues, planning, data collection, keeping records, dangers of drug abuse etc. During such sessions Field Officers also presented the challenges they faced in the field, discussed them and found solutions with help from the team. Field visits including monitoring and evaluation Field Officers carried out door to door mobilization and a total of 14,385 people were reached on first time visits (covering 5388 Households). The Field officers organized 32 group trainings in the field. During the door to door educational visits the field officers were teaching about the Basic facts about HIV/AIDS. They also mobilized people for testing and those who consented got pretest counseling and rapid test was carried out. 5,961 people received rapid test and were informed of the results. The Field Officers managed to mobilize the community about condom use and 16,554 condoms were distributed during visits and trainings. The Field Officers conducted 136 door to door educative visits mainly targeting pregnant women. Basic knowledge about ante natal care and prevention of mother-to-child transmission (PMTCT) was given to the women and they were mobilized to give birth in hospitals. The Field 3
Officers also provided couples with counseling and training on Reproductive & Maternal Health. 496 couples were reached with individual counseling services. 162Training times were conducted to Women Federation cadres, who were trained on how to mobilize and support women to give birth in hospital. The Field Officers also visited a total of 112 households with People Living with HIV (PLHIV). During these visits the families got knowledge on treatment and care, medical compliance and referrals were also made. Field Officers made individual visits to People Living with HIV and they reached out to 219 individuals where they rendered support and guidance on how to stay healthy by following the treatment plan, avoiding drugs and doing exercise. The Troop Commander on the other hand supported the project team on a monthly basis by visiting the Field Officers in the field where he offered on site training on how to carry out effective door to door mobilization, carrying out rapid testing and how to record data correctly. The Troop Commander also checked on the Field Officer s records to make sure data was properly and correctly entered and also provide on the spot advice. In this way the Troop Commander assisted the Field Officers to increase their capacity thereby improving their mobilization skills. Passionate mobilization 52 active villagers were successfully mobilized to be Passionates whose duties includes mobilization of other villagers to attend trainings and meetings, identifying pregnant women, identifying People Living with HIV and to coordinate some of the TCE activities and events to prevent the spread of HIV. 8 trainings were held to build the capacity of the Passionates. They were trained on advocacy for the fight against family violence, furthermore about woman s rights, Basic HIV/AIDS facts, treatment and care and taking up responsibilities as Passionates.. Effects of the project activities There is a vast change in people s attitude towards the program, at first they were shunning any information about HIV/AIDS, but due to the Field Officers diligence and continuous visits and education now they understand about HIV/AIDS. Women are empowered and now take an active role in the community where they now speak openly about HIV. Couples are now open in discussing and sharing about family issues in relation to reproduction, maternal health and testing for HIV. Pregnant women go for ante natal clinic and to hospital for delivery 4
Stigma and discrimination has reduced and now the community accepts both the infected and affected in the social activities and gatherings within the community. Primitive and traditional beliefs reduced since everyone now understand what HIV/AIDS is and how it is transmitted from one person to another. General health conditions improved in terms of hygiene and now the community understands that the earlier the virus is detected the better possibility of getting treatment. The consciousness and knowledge of the community about HIV increased Family members, relatives and friends know how to take care of the infected and to take measures on prevention and control. Integration of people living with HIV/AIDS into the community has improved, for example those who are infected can now be seen at community gatherings. People now actively participate in meetings and trainings and are able to speak openly about HIV/AIDS. The HIV home-based rapid testing and counseling in Yuexi County gets popularized and is well accepted by Yi Society (Yi minority). The Local Government and other organizations learnt project implementation from the HPP model. They stated that the project model of providing house to house education and testing was advantageous in that it provided more interaction with individuals. Secondly they said individual discussions could help to build trust. In addition to that they said it was possible to reach the villagers who were reluctant to group training or meetings due to being shy or busy. The local authorities learned from this unique HPP model and also highly praised it. The government has started to consider how to spread this idea to community approach. China Association for the Prevention and Treatment of HIV / AIDS, Liangshan Prefecture Center for Disease Control and Prevention, Liangshan Prefecture Association for the Prevention and Treatment of HIV / AIDS, Yuexi Public Health Bureau, Yuexi AIDS Prevention Bureau, Yuexi People s Hospital and AHF Representatives appreciated and valued the HPP project model. 5
Attachment number 1: Project in numbers Indicators Goals Results Number of People first time visited and registered 3,000 14.385 Number of HH first Visits to inform people about TCE&HIV 900 5 388 Number of People second time visited 1,875 0 * Number of People tested by a Field Officer 750 5 961 Pregnant women tested for HIV 15 120 Train WF to mobilize and support women to give birth in hospital 75 163 Couple counseling on Reproductive & Maternal health 150 496 Male and female condoms distributed 3,750 16,554 Women Self Help groups formed and trained 15 26 Passionates in the TCE Program 15 52 HIV Prevention events (villages) 15 108 HIV Prevention events (schools) 3 0 * Women federation key women training time 4 10 County Level Workshops 1 0 * Number of positive house hold visited 15 112 Number of positive people visited 22 219 Number of ARV Trio formed 7 0 * Number of trainings carried out for field officers 7 108 Training of women cadres at township and village level for 4 time 15 10 *) The project decided to focus on 1st time visits, testing, condom distribution and on pregnant women and reproductive health, so after the original application made for 2016 those 2 goals were omitted in the work plan. 6
Attachment 2: Project photos Project staff meets every month for both training, submission of statistics and discussions about work in the field. After much education and mobilization many villagers agree to be tested for HIV. 7
Different approaches were utilized to make sure information reached every single person in the community. Field officers reached out to couples with Maternal Health education and mobilization for HIV test. 8
Attachment 3: Case story Story from Field Officer Liu Min In July 2014, I was assigned to participate in Humana People to People TCE Project (TCE Yuexi) by the local Women s Federation (WF/Yuexi ). I decided to accept it with a strong will despite the disagreement from my family, relatives and friends. Although it might be a road filled with thorns, I would make it a smooth road by myself. I will never change my mind after I made a decision, and I won t let my superiors down. More than one year has passed, the work was very difficult and I met many challenges, but I always told myself that perseverance means victory. The door-to-door health knowledge promotion and education and family counseling and testing played an important role in my outreach work. I met lots of things which made me sigh. When I saw villagers who had never received any education and could not read any word, I thought it would be great if there was a literacy class; I felt sorry for the women who suffered from domestic violence but didn t know how to use law as a weapon to protect them; and I respected the young man with physical disabilities who developed animal breeding with a strong will; I felt sad to tears when I saw the HIV/AIDS orphans leading hard lives; I also felt upset when I saw the school-aged children staying at home and living in unenlightened environments. During the door-to-door training and consultation, based on the local situation, I helped the villagers to cultivate a better habit of personal hygiene, mobilized them to do premarital check-up and pregnancy checking to ensure the health of the next generation. I taught the villagers how to use condoms correctly and told them how dangerous it was to take drugs. I especially focused on explaining HIV/AIDS prevention and control. I was glad that after more than one year of efforts, the villagers started to support my work and no longer refused me to help them with counseling and testing. It is an encouragement and appraisal to my work and I will work harder to benefit more and more villagers. As a rural female official, my work is very ordinary but I believe that with my hard work I can help to advocate for the good policy which will benefit the villagers and help to safeguard the legitimate rights and interests of women and children. Although I m busy with my work every day, I feel fulfilled and happy. 9
Attachment 4: Training record list 10
Attachment 5: Weekly Field Officer Report 11