|Maasai||Education||Poverty||HIV/Aids||Water||FGM||HumanRights/ GoodGovernance||Cultural Citizenship||Gender Issues|
simanjiro district HIV /Aids project
The pilot project developed initial contacts to communities and institutions through their local leaders and administrative officials. Deliberate efforts were made to involve the grassroots communities through awareness raising and training of peer health educators reflecting on the traditional set up of the Maasai community who are the main ethnic group in the district. Other main achievements in the same period were: starting of the workplace intervention with the Simanjiro district council who is the main regular employer in the district, facilitation of anonymous HIV and syphilis testing and conducting of a baseline research of KAPB on HIV/AIDS.
General background information
Afya Bora approaches develop critical health HIV/AIDS awareness for individuals, groups and general public. Afya Bora promotes and encourages public participation in decision making at all levels of society in regards to health education.
CUSO is a Canadian international non-governmental organization committed to global social justice. To reach this goal CUSO works in partnership with groups and organizations searching for alternative to the unjust social, economic, and political order that limits peoples` freedom, foster inequality, threatens cultures and communities and degrades the environment.
The Simanjiro HIV/AIDS project marked the beginning of Afya Bora and CUSO collaboration on HIV/AIDS intervention. The Memorandum of Understanding was signed for the project duration of one year lasting from November 2002 to October 2003.
The Simanjiro HIV/AIDS project aimed at contributing to the efforts of the district council in prevention and control of HIV/AIDS by working with community groups both formal and informal.
Specific objectives of the project were:
To determine perceptions, cultural factors that inhibit behavior change or accelerates HIV transmission in Simanjiro district
To collaborate with the district council on establishing protocol for anonymous HIV and syphilis testing of ante natal women
To increase knowledge about, promote appropriate attitude and improve skills among trainers
Promote workplace HIV/AIDS intervention in Simanjiro district
The internal review workshop has recommended the continuation of the project and stressed the need to focus the interventions in areas of prevention, care and support and impact mitigation in accordance to the National priority areas as per TACAIDS. In this regard therefore the proposed main objective is to:
Develop community-based interventions within the context of sexual and reproductive health in order to prevent HIV/AIDS transmission, care and support for PLWHA and to mitigate the impact of HIV/AIDS.
Key results from each key activity area and conclusions of the pilot project
The Simanjiro HIV/AIDS pilot project employed a multi-sector approach with a strong blend of baseline research, intervention development and community involvement. Its strategic intervention areas were: communities, workplaces and baseline research. The district council, workplaces and community are the principle entry points in addressing the HIV/AIDS epidemic in the district.
3.1 Community intervention
The community intervention took place through a range of adult facilitation techniques that were used in training of mobile teachers and community leaders from one of the six division of Simanjiro district. The training workshop lasted for five days from 22nd -26th September 2003. The topics covered during this workshop were: Peer Health education, HIV/AIDS/ STDs, Gender and HIV/AIDS. Other topics were on behavior change, negotiating safe sex and condom use, and family planning. It is envisaged to link the trained mobile school teachers and community leaders with community age set leaders in order to establish Peer Health Education in the Maasai community as the traditional set up is favorable.
3.2 Workplace intervention
Afya Bora was able to initiate a workplace intervention already a total of 20 Peer Health Educators were trained from the district council and District Commissioner` office. The emphasis is on behavior change, Information Education Communication (IEC) and Sexual Transmitted Diseases (STD) control within the workplace. The Peer Health Educator at the respective workplace is used as backbone for the implementation of other components of the workplace intervention such as: Peer Health Education, Condom promotion through education and social marketing, STD case management and Care and Support including provision of Antiretroviral. Other components are workplace HIV/AIDS policies, voluntary counseling and clubs, workers health insurance schemes and establishment of AIDS committees. Combinations of stepping stone approach and Peer Health Education model from the MOH were used during this training.
3.3 Baseline research
In order to know where we begun, Afya Bora facilitated the Simanjiro district council in carrying out anonymous HIV and Syphilis testing among ante natal mothers and other volunteers. In the three months of testing (October to December 2003) 330 cases were tested among them 66 or 20% were HIV positive. Furthermore Afya Bora in collaboration with Simanjiro district council conducted a KAPB baseline survey. Some of the important findings as per consultant reports were as follows: A total of 609 individuals participated in the study these included 523 who participated in the questionnaire interviews, 9 heads of departments, 20 key informants and 57 participants of the eight FGD sessions.
Generally findings suggest low insight (among most participants) as far as HIV/AIDS is concerned. Only 2% were able to give correct definition of HIV. The rest either gave responses close to correct one (20%), while (46%) gave a far-fetched response while (33%) knew nothing about it.
A multi-sectoral community facilitation approach to HIV/AIDS prevention, care and support and impact mitigation of the effects of HIV/AIDS in Simanjiro district.
As already noted HIV/AIDS epidemic is the leading cause for rising morbidity and mortality in the country and has impacted negatively on the process of human development. H.E President Benjamin W Mkapa declared HIV/AIDS a national disaster. The president called upon all stakeholders to participate in the fight against the pandemic. Afya Bora in collaboration with the Simanjiro district council recognizes the need for effective interventions that address the underlying causes for continued spread of HIV.
Over the past decade Simanjiro district witnessed increasing urbanization and influx of large number of peoples in search of minerals especially Tanzanite. The illiteracy rate among women is higher than that of men. Health facilities in the district are inadequate resulting into poor MCH services. All these pitfalls compounded with strong conservative sexually tailored traditions means a growing inequality between men and women and further contributing to high transmission of HIV in Simanjiro district.
Finally only the district council has focused on the district coverage on her HIV/AIDS interventions, other NGOs and Faith Based organizations have limited their interventions in some localities within the district. It is therefore imperative to compliment the district council efforts in this endeavor.
Afya Bora adopts strategies in line with the national guiding principles as well as best practices promoted by international bodies such as UNAIDS. The project enhances community participation and involvement, respect for PLWHA and multi-sectoral approaches, all this in view of promoting and protection of health as a basic human right.
This project collaborates with groups and organizations within both the government and non- governmental sector to contribute toward community facilitation and empowerment.