Network Of Organizations of/for the Visually Impaired and the Blind (NOVIB)

1. Network Of Organizations of/for the Visually Impaired and the Blind (NOVIB)

2. Presentation Title Best Practices of a Collaborative Project on the Promotion of Disability Inclusive HIV/AIDS Response in Ethiopia The Case of NOVIB and Seven Implementing Affiliates

3. Title of the collaborative HIV/AIDS project:The Inclusion of Persons with Disabilities (PWDs) in Local HIV/AIDS Program Interventions Project implementation period: October, 2008 December, 2010 Funded by: Foundation Dark and Light (renamed Light for the World Netherlands) Coordinated/facilitated by: Network of Organizations of/for the Visually Impaired and the Blind (NOVIB)

4. Collaborating/implementing Network members • Salu Self-Help Blind and Handicapped Association (Salu) • Help for Persons with Disabilities-Organization (HPDO) • Addis Hiwot Center of the Blind (AHCB) • Ethiopians for Ethiopians (EFE) • Ethiopian Women with Disabilities National Association (EWDNA) • Oasis Blind Support Association (OBSA) • Attention to Persons with Disabilities-Organization (APDO)

5. Major stakeholders involved: • Federal HIV/AIDS Prevention and Control Office (FHAPCO) • City Administration, Regional and Sub-City level HIV/AIDS Prevention and Control Offices (HAPCOs ) • Federal Ministry of Health (MOH) • City Administration and Regional Health Bureaus • Federal Ministry of Labor and Social Affairs (MOLSA) • City Administration and Regional Labor and Social Affairs Bureaus • Local Government (Kebele) Administrations • Disabled persons organizations (DPOs) • Coalitions/Associations of Persons Living with HIV

6. Special Needs Education Departments at the Ministry of Education and Addis Ababa University, and a Deaf School in Addis Ababa • Light for the World County office -Ethiopia • STICHTING DIR/DIR Foundation • Brothers of Good Works (Former MMM) • Cheshire Foundation • Faith-Based Organizations (FBOs) • Funeral Associations (Ider) • Health Institutions and VCT centers in the intervention areas • Schools and community centers in the intervention areas • Relevant NGOs in the intervention areas

7. Implemented in two metropolises (Addis Ababa and Dire Dawa) and eight towns/cities in three regional states (Oromia, Amara and Southern Nations Nationalities and Peoples Region)

8. Project Objectives:Facilitate access to basic HIV/AIDS services for persons with disabilities, and immediate family and community members;Broaden public awareness regarding the relationships between disability and HIV/AIDS;Popularize the inclusion of persons with disabilities in the national response to HIV/AIDS;

9. Main Planned and Implemented Activities • Conducting awareness raising and training workshops for persons with disabilities on HIV/AIDS prevention and reproductive health issues; • Providing VCT and referral service to the target groups; • Making available HIV/AIDS focused information to the visually impaired in accessible (Braille and audio) formats; • Training HIV/AIDS service providers in sign language, to enable them communicate with and properly serve the deaf;

10. Delivering home-based care to persons with disabilities living with HIV; • Training and deploying peer educators to enhance awareness on HIV/AIDS and disability issues; • Assisting school clubs and community centers with technical and material support, to accommodate disability issues in their HIV/AIDS-related activities; • Undertaking a base line survey on the knowledge, attitudes and behavior of women and girls with disabilities toward HIV/AIDS, disseminating the findings by all available means;

11. Carrying out disability and HIV/AIDS public awareness raising through various means including: • Public gatherings, community conversations, youth dialogues, musical shows, stage dramas, billboards, posters and radio programs; • Organizing joint project monitoring and progress review meetings, to facilitate experience sharing and peer evaluation among the collaborating and stakeholder organizations; • Mobilizing and sensitizing the concerned government sector offices, local administrations, community-based structures, health institutions and non-government stakeholders for the inclusion of persons with disabilities in the HIV/AIDS policy and program agenda.

12. Project Achievement • Over 400 persons with and without disabilities trained and deployed as peer educators on disability, HIV/AIDS and reproductive health issues. • Over 4000 persons with and without disabilities reached by the peer educators with the information; • 2,500 persons with disabilities and their family members provided with VCT service; • 1,115 visually impaired persons received HIV/AIDS and related IEC materials in Braille and audio formats; • Nearly 13,000 persons with disabilities and community members attended community conversation sessions on disability, HIV/AIDS and RH awareness raising ;

13. 3000 people reached with an open air disability and HIV/AIDS awareness raising musical show staged by visually impaired performers; • 1,700 stakeholders (PWDs, family and community members, service providers, program implementers and decision makers) participated in various workshops conducted on issues related to disability and HIV/AIDS awareness raising, and the promotion of inclusive response to HIV/AIDS; • Home-based care and medical treatment given to 636 PWDs living with HIV; • 95 HIV/AIDS service providers trained in sign language and disability issues;

14. 12 editions of radio programs broadcast on disability and HIV/AIDS awareness raising, and disability inclusive HIV/AIDS practice; • Baseline survey findings on HIV/AIDS KABP of women and girls with disabilities disseminated by means of IEC/BCC materials, documentary film, TV and workshops; • 4 billboards reflecting the relationships between disability and HIV/AIDS, constructed and put up for public display in three cities/towns; • 9 school, community and workplace HIV/AIDS clubs strengthened with technical and material support, to include disability issues in club activities; • As part of project coordination and facilitation process, NOVIB conducted a series of stakeholder meetings, field monitoring visits and supervision of organized events and performed activities.

15. Challenges Encountered • The failure of stakeholders including medical practitioners and service providers to treat PWDs as HIV risk groups; • Inadequate attention given by the concerned authorities and other development actors to disability issues in general, and from the HIV perspective in particular; • Long-prevalent negative social attitudes regarding disability, and the resultant neglect, stigma, discrimination and denial experienced by PWDs; • The non-inclusion of the disability agenda in the relevant government policy, program and legal documents at national and regional levels; • Minimal attention given by the research community to the subject of disability and HIV/AIDS. For this reason, a broad knowledge gap exists on HIV prevalence among PWDs in the country;

16. The ill design of infrastructural facilities and health institutions preventing PWDs from access to HIV/AIDS services; • Health practitioners and service providers inadequately trained in regards to the treatment and care of PWDs; • The cumulative negative impacts of these challenges on the implementation of the collaborative HIV/AIDS project, in the form of reduced workshop attendance and participation, and insufficient response to training offers by stakeholders; • Limited available Braille transcription and audio recording services, hindering the accessibility of HIV/AIDS IEC/BCC materials to the visually impaired in adaptive formats;

17. The high percentage of PWDs relative to the total population of the country, which accentuates the existing policy and program gap, and the need for urgent response; • Not much work done in popularizing and implementing HIV/AIDS and Disability mainstreaming; • The non-allocation of sufficient resource (financial, material and human) to support PWD organizations involved in integrating disability and HIV/AIDS interventions; • The difficulties experienced in ensuring the sustainability of the project and the achievements made.

18. Lessons Learned • Collaboration under the umbrella of a Network enables organizations of PWDs to speak in collective voice, and draw attention to their situation ; • With properly managed sensitization and awareness raising work, stakeholders can effectively be trained, informed and brought on board to include disability agenda in HIV/AIDS response interventions; • Concerted and consistent efforts are required to bring about lasting and sustainable positive changes in attitudes and practices, concerning the inclusion of PWDs in HIV/AIDS and other development policies and programs;

19. The last few years, during which the collaborative HIV/AIDS project was under implementation, have witnessed increased emphasis on the inclusion of PWDs in HIV/AIDS interventions, as can be observed in public HIV discourse and program planning. This shows that sustaining the effort and momentum is likely to produce far-reaching and enduring outcomes in the right direction; • In view of the encouraging results obtained in a short period, and with the investing of limited funds, it can be anticipated that committing additional resource and partnering with NOVIB and member organizations will move forward the practice of inclusive HIV/AIDS response, which is presently at an early stage.

20. Recommendations for Further Action • Extensive research should be conducted on HIV prevalence among PWDs and a wide range of associated issues, to objectively inform and direct disability inclusive HIV/AIDS response in the country; • The principles and significance of inclusive development exercise including HIV/AIDS response need to be widely popularized among policy and decision makers, program planners, service providers and other stakeholders through various means; • Stapes should be taken to consult international experience in respect to the concepts and practice of disability inclusion, and adapt the lessons learned to local context;

21. The Federal Ministry of Health, Federal HAPCO and other sector ministries and line offices, among others, need to include/mainstream the disability agenda in their HIV/AIDS and development policies and programs in general, and take the lead in initiating and promoting the practice; • Disabled persons organizations (DPOs) should work together in partnership to voice their common interests and stimulate proper and consistent response; • Funding partners and the government should ensure that a fair amount of resource is pumped in to the planning and management of disability inclusive HIV/AIDS response, and strengthening the capacity of organizations of PWDs involved in the process; • The collaborative HIV/AIDS project will need to be replicated and up-scaled to consolidate the achievements made, use the experience to reach thousands more in need, and realize sustainability and community ownership of the intervention.

22. Thank You!