Improving community driven support systems for total prevention of HIV infection for children, women and persons living with HIV/AIDS in Meme Division
It has been observed that most HIV/AIDS services have been implemented by government officials without limited involvement of PLWHA and local populations in the past years, and PLWHA in Meme Division are expressing disagreements and looking for solutions. The project will focus on community interventions addressing loss to follow-up on PMTCT, and to keep HIV negative women negative.
In this regard, we propose to: organize 5000 families into 12 PMTCT areas; carry out capacity building for government officials, PLWHA, families and community members; expand and optimize PMTCT services in communities; strengthen the capacity and commitment of the existing community health systems; and promote local government officials to consider the voices of community members in health support systems. The project will eventually lead to sustained relationships between local duty bearers and community members to improve support systems for preventing HIV infections. This project is proposed for 36 months.
The expected number of beneficiaries of this project are :
The expected targeted beneficiaries of this project are :
Indirect: 25,000 community members, 12 Traditional Leaders from 12 villages, 100 Community health workers, 2000 others in the neighbouring villages who will copy best practices.
Direct: 1200 children, 1200 women living with HIV/AID, 12 women trained as PMTCT Ambassadors, 12 Women trained as PMTCT Mentors, 1076 people living with HIV/AIDS, 1500 youths.
Why is this project needed - what problem is it expected to address?
Cameroon’s population (20 million) faces one of the most severe HIV epidemics in West/Central Africa, with an adult HIV prevalence of 4.3%. HIV prevalence in south west region 5.7% (population of 1,516,079) is higher than the national average, which has impacts on higher HIV (6.1%) in Meme division. CAPEC, The Ministry of Public Health, Baptist Health Board, and private individuals are contributing to the availability/coverage of PMTCT programmes in Health Centres of the 5 districts in Meme. A meeting was organized with 156 PLWHA to identify programme challenges in communities in the division; five district medical officers (DMOs), ten Chief of Centres and ten nurses were also consulted. According to PLWHA, “…community-driven health support systems are very limited and less than 10% of us and members of our communities were trained and involved in PMTCT programme interventions to overcome loss to follow-up of PLWHA and to keep HIV negative women negative.”
DMOs testified that this problem is worse in this division than in other divisions of the region coupled with low lliteracy rate (less than 10%) for women. The project will build capacities of PLWHA and provide support to promote their participation in PMTCT programmes. In addition, networks with health practitioners, PLWHA, their families and communities will be established to increase collaboration between them in the prevention of HIV infection. We expect that after three years of project implementation, community health systems will be led by communities to totally prevent HIV infection for children, women and PLWHA in Meme Division.
How does this project respond to the needs and the specific PACF 2012 Call for Proposals topic(s)?
The 12 PMTCT ambassadors and 12 Mentors will collaborate with health practitioners in all health centres in PMTCT areas to ensure that all infected persons get quality access to treatment and form support systems to eliminate HIV infection. The project will:
- Strengthen PMTCT support system through an integrated approach to community HIV/AIDS education, prevention and awareness activities.
- Strengthen community-based health care system and promote greater community mobilization and involvement of PLWHA.
- Provide psycho-social support to encourage HIV-sero-status disclosure within couples and address stigma/discrimination.
- Establish methods to follow-up HIV-exposed infants, women and children who have abandon treatment.
- Strengthen the capacities of health practitioners in providing quality PMTCT and paediatric care services.
- Form TRIOs to encourage patient focused and family-centred support. TRIOs comprise of a patient on treatment and two supporters, preferably family members or close friends. Each PMTCT Ambassador will establish at least 600 TRIOs in three years. The TRIO is a functional structure that continues to be there after the PMTCT Ambassador finish their three years of mobilization and engagement of PLWHA.
- Facilitate early infant diagnosis and promote continues care of infants and young children of HIV+ parents, follow up on infants who go undiagnosed or who are diagnose too late and referred for care and treatment.
- Strengthen information system and enhance monitoring, evaluation and operational research.
Overall Objective: To mobilize and empower 5,000 families (about 25,000 people) in Meme Division to lead the elimination of HIV/AIDS in their lives, that of their families and in communities. More specifically:
- To establish a patient-focused and family-centred PMTCT support system.
- To follow-up on all loss cases of pregnant mothers and breast feeding mothers receiving antiretroviral prophylaxis.
- To alleviate the impact of HIV/AIDS on women and children’s health.
- To strengthen referral systems and linkages between individuals, communities and PMTCT programmes.
- To establish a community information system for documentation, sharing and adoption of best practices.
- Organize person-to-person and door-to-door mobilization, awareness and counselling.
- Organize PLWHA, women, local leaders and community members to volunteer in the PMTCT programmes and also facilitate follow-up of loss cases.
- Build capacities of PLWHA and community-based organizations to provide quality home-based care services to mothers and children living with HIV/AIDS.
- Create support groups for PLWHA and build their capacities to alleviate impact of HIV on their lives, families and communities.
- Build capacities of health practitioners in providing quality PMTCT and paediatric care services.
- Organize discussion meetings between health practitioners, support groups for PLWHA, women groups, Faith-based associations, community-based organizations,and community leaders.
- Create and support community mobile clinics.
- Establish community social marketing teams.
- Train women to be PMTCT ambassadors and mentors in their communities.
- Organize communication campaigns to reduce stigma and discrimination.
- Produce referral cards to enable the control of the pregnant women in the PMTCT programme.
- Organize pregnant women to give testimonies on TV, radio or written. It is documented to be use in promotion in other villages.
- Organize experience sharing events within and between communities for PLWHA.
- Mobilize for VCT and training pregnant women in PMTCT.
- Implement the orphan support programme to deal with the problem of the increasing number of children orphaned by HIV/AIDS.
- Create community health information system to strengthen programme M&E.