PEPFAR TASO Presentation to the Satellite Session on Community Participation during the 2012 IAS Conference in Washington DC, USA. Robert OchaiExecutive Director The AIDS Support Organization (TASO) Uganda. 22nd July 2012
TASO’s Mission and Vision • TASO is an indigenous Ugandan NGO deeply involved in the fight against HIV/AIDS with a vision to see “A World Without HIV” in our lifetime. • It was formed 25 years ago by people affected by HIV/AIDS and its mission is to “contribute to a process of preventing HIV infection, restoring hope and improving the quality of life of persons, families and communities affected by HIV infection and disease.” • TASO provides a wide range of community based services including combined HIV prevention interventions, treatment, care and support services for PLWHA, Advocacy and promotion of Positive Health Dignity and Prevention (PHDP), Advocacy.
Key TASO Activites • TASO provides treatment, care and support to 100,000 clients (PHAs) annually through its 11 service centres across country. • It trains over 2,500 health workers (including community volunteers) annually through its 4 regional training centres. • It provides training and technical support to various Community Based Organisations in Uganda. • It acts as a channel thought which resources are passed on to the communities.
The Intervention Strategy • Working with community leaders through the existing administrative , cultural and social structures to build momentum for action against HIV/AIDS. • Building the capacity of community volunteers through training, mentoring, and ongoing support supervision to enhance service delivery. • Training community leaders to provide effective leadership and oversight over HIV/AIDS programs. • Regular reviews to enhance learning and adaptation.
Interventions Cont’d • Proactive engagement with PLHIV throughout out the project planning, implementation, and review cycle. • Providing critical infrastructural support that may be necessary to ensure success; such as bicycles for transport, a microscope for the local community heath centre, etc. • Community based provision of critical services including ARVs through appropriate distribution mechanisms.
Results: Capacity Enhanced • Over the years, TASO has trained 6,000 community volunteers round the country; these provide voluntary services to their community members. • Each year, up to 300 members of Village Health Teams (VHT) benefit from improved capacity. • At least 250 health workers in various health facilities benefit each year from various capacity building interventions including training, mentoring, support supervision, etc.
What has worked? • Involving the communities in the design and implementation of prevention and care services. • Community based delivery of HIV prevention, care and treatment services has enhanced community access and uptake of those services. • Involvement of people living with HIV helped turn the tide; especially in fighting stigma, and educating the public, and mobilizing community volunteers. • Task shifting to well trained lay service providers has “boosted” the workforce. • Engaging the community leaders enhanced services.
People living with HIV at the forefront of community sensitization There is greater empowerment and awareness in communities benefiting from TASO’s community interventions compared to those not being served. There is reduced stigma Improved skills and capacity to respond to various emergencies.
Community based HIV Counseling and Testing This service is provided both at the fixed service delivery points and at the communities; the uptake at community level is over 95%!
Impact: Good Health (comparing medical complaints between Clients receiving ART at Community Vs Facility outlets)
Impact: Better Adherence to ART (Comparing Adherence Levels of the Clients Receiving ART at Facilities Vs Community outlets)
Data Issues • There are inadequate national systems for collecting, analyzing, disseminating, and store community level data in our program areas. • Some baseline data is obtained from the Census and DHS surveys as well as specific surveys and modeling. • We use PRA techniques and work with the communities to collect, analyse, report and disseminate the baseline data specific to their area. • Evaluation is done using the same PRA tools. • Routine program implementation data is used to track progress and refine the interventions as necessary.
Critical Success Factors • Buy-in and support from the national and local leaders. • Involvement of people living with HIV/AIDS. • Full engagement with the communities in defining their priorities, agreeing action plans, implementing and monitoring strategies. • Providing appropriate training for all categories of community volunteers and support groups. • Legal framework for (or at least no objection to) task shifting; this facilitates community involvement. • Establishing a sustainable mechanism for the motivation of community volunteers.
Key Partners • The Government of Uganda provides an enabling environment, good will, and other support through MOH, MOFPED, UAC, and other agencies. • The donors; i.e. PEPFAR (USAID & CDC), and others. • PLWHAs volunteer their time, energy , experiences, and emotions into the fight against AIDS. • The CSOs do a great job in reaching out to the people. • Community Volunteers including the Village Health Teams are a wonderful resource. • TASO staff for all the great work; thank you all.