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REGIONAL DISABILITY & HIV PROJECT « Strengthening local initiatives related to the AIDS response for persons living with disabilities in Burundi, Mali and Senegal ». Regional HIV/AIDS workshop: Africa and South East Asia Bujumbura 21–25 February 2011.
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REGIONAL DISABILITY & HIV PROJECT « Strengthening local initiatives related to the AIDS response for persons living with disabilities in Burundi, Mali and Senegal » Regional HIV/AIDS workshop: Africa and South East Asia Bujumbura 21–25 February 2011 Dr. Almouner TALIBORegional coordinator Email : regional-vihsida@hi-sen.org Bujumbura 21 February 2011
Project teams / COUNTRY : Mali • Caroline BOLTZ : Health coordinator • Mamadou KEITA: HIV project manager Senegal • Dr. Aïda ZERBO : HIV project manager Burundi • Côme NIYONGABO : Inclusion coordinator • Fulgence NDAGIJIMANA: HIV project manager
Main donors: MAE France/AFD Big Lottery Fund World Learning USAID HCNLS HI Total Budget : € 1,988,290, including: MAE France 50% 50% HI and other donors
Start: March 2008 End: February 2011 Request for an extension pending: June 2011 Location: Burundi : 17 of the country’s provinces (129 communes) Mali: districts of Bamako and Koulikoro Senegal : 4 departments in the Region of Dakar, 3 regions in Casamance (Ziguinchor, Kolda and Koulikoro) IMPLEMENTATION PERIOD AND LOCATION
General objective : Reduce the impact of HIV and AIDS on persons with disabilities in Burundi, Mali and Senegal, through strengthening of local actors Specific objective: Facilitate the access of persons with disabilities to systems of prevention, care and treatment, and encourage their participation in HIV response plans OBJECTIVES
EO 1 : Persons with disabilities have access to health facilities, care services and information on HIV prevention adapted to their disability. EO 2 : Persons with disabilities are involved in seeking sustainable HIV response strategies and actions adapted to their needs EO 3 : The lessons learned from innovative community-based actions contribute towards improving the competencies of actors working on HIV response initiatives for persons with disabilities EXPECTED OUTCOMES
1. Direct beneficiaries: Persons with disabilities Active members of national and local DPOs Persons living with HIV HIV response associations / Civil Society Organisations (CSOs) VCT and Treatment Centres staff 2. Indirect beneficiaries : Families of persons with disabilities National and local political authorities General population BENEFICIARIES
MAIN PARTNERS • Supervisory institutions in charge of the HIV response (ministries, national programmes, etc..) • HIV/AIDS-response CSOs • Associations of persons living with HIV • Local, national and regional DPOs • Specialised centres for persons with disabilities • HIV and AIDS treatment services
MAIN ACTIVITIES 1. Preliminary activities: • Organisation of a national HIV & Disability forum • Setting up of project steering bodies 2. Activities for EO 1 : • Implementation of activities that increases the accessibility of persons with disabilities to HIV response actions • Support to local initiatives (LI) focusing on the accessibility of persons with disabilities
MAIN ACTIVITIES / cont. 3. Activities for EO 2: • Initiation Actions enabling persons with disabilities to be involved in the HIV response • Strengthening the capacities of civil society actors • Support to LIs enabling persons with disabilities to be involved in the HIV response • Implementation of activities to include persons with disabilities in research 4. Activities for EO 3: • Develop local knowledge sharing on Disability & HIV • Production and dissemination of information • Organisation of meetings and seminars between Disability & HIV stakeholders
MAIN ACHIEVEMENTS • Organisation of a national HIV & Disability forum / country • Setting up of project steering committees (National Disability & HIV platform, Technical Committee / Steering Committee and LI project selection committee) • Organisation of advocacy and awareness-raising sessions (public authorities, elected representatives, CSO, technical and financial partners) to ensure disability issues are taken into account in AIDS policies and Programmes • Accommodations made to improve the physical accessibility of treatment services : 1 ambulatory care centre (Senegal), 8 VCT centres (4 in Burundi and 4 in Mali) and 7 treatment centres (4 in Burundi and 3 in Mali) • Equipment of VCT and treatment centres (Burundi and Mali): wheelchairs, audiovisual equipment, lab equipment, chairs, walking sticks, crutches, etc.
MAIN ACHIEVEMENTS / Cont. • Training of VCT/treatment centres’ staff on the Disability Creation Process, disability rights, Psychology related Disability and quality approach (52 in Burundi, 15 in Mali and 55 in Senegal) • Training: 14 national trainers on HIV & Disability (6 Senegal and 8 Mali); and 9 counsellors on Sign Language (SL) • Training on SL and HIV of Peer Educators who are active in the field (516 in Burundi, 65 in Mali and 18 in Senegal) • 320 CSOs trained on disability inclusion, 136 of which have introduced concrete measures on behalf of persons with disabilities • 198 member associations of the ABS have inclusive action plans • 516 peer educators are active in the field • 46 080 disabled persons informed about HIV and 4729 tested for HIV • 617 HIV + disabled persons taken care of by the partner associations
MAIN ACHIEVEMENTS /Cont. • Development/adaptation, production and dissemination of IEC tools on HIV & Disability • 61 LIs financed, reaching 24,913 persons • Support for advocacy actions (organisation of debate-related conferences and open door days) • Experience sharing meetings between project stakeholders (Peer Educators, Trainers, VCT and treatment centres Staff) • Support for the inclusion of disabled persons living with HIV in existing networks • Identification by HIV response stakeholders of the issues and consequences of not including persons with disabilities as a vulnerable population group in the HIV response (in all three countries) • Setting-up of a team of facilitators at DPO level (Constellation)
MAIN ACHIEVEMENTS / Cont. • Inclusion of Disability in data collection tools • Participation by DPOs in the HIV response alongside HIV-related CSOs • Accessibility of treatment centres • Participation in the revision of HIV National Strategic Plans • Inclusion of persons with disabilities as a vulnerable group to HIV • Mainstreaming of disability issues into HIV policies, programmes and actions • Involvement of the supervisory institutions, technical and financial partners and other actors in the inclusion of disability in the HIV response • Ownership of disability issues by some actors • Awareness-raising of actors at international level : • ICASA (10,000 people, inclusion of Disability & HIV by the community programme, drafting of recommendations) • Francophone conference on HIV/AIDS (5,000 participants) • 3rd GA of the African Disability & HIV Campaign • Mid-term evaluation : drafting of recommendations for actors in the Disability & HIV fields
MAIN BARRIERS 1. OPERATIONAL • Activities unequally distributed between countries • Incoherence between the time and means provided and ambitions to implement specific activities • Lack of advocacy on Disability & HIV issues at community level • Social perceptions of disability (socio-cultural context) • Poor knowledge of HIV among DPOs • Absence of basic HIV-related data on persons with disabilities • Reliability of statistics on the disabled population • Weak management capacity of DPOs • Problems of governance within DPOs and some CSOs • Problems in understanding the notion of partnership by actors • Late implementation of project in some countries 2. Human resources • Delays in staff recruitment • Mobility of HR and some positions remaining vacant for some time (resignation of a project manager)
MAIN BARRIERS / Suite 3. FINANCIAL • Funding will soon come to an end. This might have consequences for results obtained so far • Problem of financial monitoring at regional level (no compilation of year 1) • Lack of financial resources for implementing the partners’ action plans : no resources planned for needs generated by the project • Management of co-financing of donors • Little funding mobilised to strengthen activities 4. Communication • Problem for programmes in thinking “regionally” • Difficulties in communication between the Regional Coordination and country teams • Insufficient sharing of good practices between actors • Lack of synergy and competence in the field of disability on the part of actors
MAIN BARRIERS/ Cont. 5. Proposed solution • Strengthen advocacy • Strengthen the capacities of DPOs and CSOs through training • Conduct studies to build a database • Set up communication channels • Step up fund-raising • Funding of community actions through the LIs • Much more advocacy action needed
Lessons Learnt • Ownership of the project by key players • Impact of the quality of the initial assessment on the project’s implementation • Relevance of the project : geographical coverage, level of intervention, activities, thematic areas, choice of partners • Involvement of key players in a participative process and operating of the project’s steering frameworks: guarantees of success • The use and integration of existing frameworks/networks facilitates the implementation of new projects in new thematic areas
Lessons learnt /Cont. • Ensuring the inclusion of disability in existing policies/Plans requires both the adoption of a specific approach and time • Support of known and recognised actors for advocacy and awareness-raising among decision-makers • Effectiveness of the Peer Education approach • LIs proven to be effective in community activities that address the community’s needs • The Consortium Approach (DPOs/ HIV CSOs) proven to be relevant in the implementation of LIs
MAIN DOCUMENTATION BURUNDI • Baseline study (KAP) on persons with disability and HIV (in French, 2008) • KAP study at the end of the second year of project implementation (in French, 2010) • Mid-term evaluation (in French, 2009) • Final evaluation of the BLF component (in French, 2010) • Guide on BCC (in French, Kirundi, Braille and Sign Language, 2008) • Documentary on the project (in French, 2010) • Awareness-raising tools : posters, CD of songs and sketches (in Kirundi, 2008 - 2009) MALI • DVD 2009 : « HIV and AIDS in Malian sign language » • DVD Documentary 2010 : « We are all concerned» • Adaptation of AIDS card game, 2010 • Brochure on knowledge on HIV and AIDS Adaptation, 2010 • Ambiguous scenarios game, 2010
MAIN DOCUMENTATION / Cont. SENEGAL • Interim project report, May 2009 • Leaflet, guide in French, 2009 • Inclusion of 3 disability-related images in the national AIDS awareness-raising tool box (2009) • Glossary and Messages (interactive DVD interpreted in SL and translated in Braille), 2010 • Collection of audio messages on HIV and Disability (CD) 2010 • Recordings of awareness-raising radio programmes • Disability & HIV picture boxes in Braille 2010
LOOKING FORWARD • Fund-raising for a new phase (by country or at regional level will depend on opportunities) • Inclusion of the Reproductive Health dimension (SRH) • Advocacy for the definition of specific national actions targeting persons with disabilities