Training and Research Support Centre (TARSC),

1. Participatory Reflection and Action (PRA) community groups in ‘Community based systems in HIV Treatment’ Training and Research Support Centre (TARSC), With African, Caribbean and Pacific Group of States (ACP Secretariat) In Zimbabwe, Malawi, Namibia, Botswana, Mozambique and Tanzania Fortunate Machingura TARSC Zimbabwe Kick-Off meeting - Lilongwe

2. TARSC’s role in the wider objectives of the consortium Agreement speaks to the following objectives • to empower local communities fighting HIV/AIDS; through participatory research and action programme (PRA) within the identified target areas • to generate evidence to support learning on community based and patient centered approaches to HIV treatment from target areas with high endemic HIV infection Kick-Off meeting - Lilongwe

3. The Specific objectives of WP2 in the research • Map the social economic differentials within the communities that affect risk and vulnerability to HIV and AIDS, and that may have an impact on uptake of available services for prevention, treatment and care of AIDS • Using this, identify the nature of the epidemic in the community in terms of risk groups and environments, the public health stage and burdens of the epidemic and discuss the nature of the responses needed for key social groups. • Map the resources, institutions and actors available at community and primary care level to  respond to the epidemic. Kick-Off meeting - Lilongwe

4. The Specific objectives of WP2 in the research continued…. • Identify for key social groups the priority social and economic determinants at individual, household, community and system level  that facilitate and block access, uptake and adherence to the resources above for prevention, treatment and care for HIV and AIDs (including  community knowledge on social rights) • Review the evidence to assess the opportunities and mechanisms to enhance facilitators and overcome priority blocks to access, uptake and adherence: (e.g. opinion leader and health worker attitudes and practices; communication processes and skills, mechanisms for social dialogue and communication;  resource transfers, service organisation and so on) • Identify strategies for strengthening these opportunities and mechanisms as recommended by communities, health authorities, opinion leaders and key stakeholders, the actions that can be taken in the medium and long term for these strategies and the progress markers for these action. Kick-Off meeting - Lilongwe

5. Tasks of WP2 • Task 1: Formulation of a detailed Activity Plan for each PRA Meeting Group in each country • Steps:a) already developed a draft overall PRA protocol detailing activities and will solicit input from partners involved • The protocol gives an outline of its mandate as a methodology in accessing data for the research at primary care level including from the community and health services • It provides a profile on the staging of the methodology on how the aims will be addressed • Gives objectives and an overview of the specific objectives of each PRA meeting (2 meetings 1.5 days long) and a detailed layout of the activity guideline of each meeting • Gives a collective understanding of the terms used in the project such as community, Coverage, health systems, community systems ,uptake, Adherence etc • It briefly provides an outline of existing knowledge in the context of 1)the differences in communities that affect uptake of AIDS services from the literature 2) How the PHC level of the health system responds to AIDS prevention, treatment and care 3)The disaggregations that need to be taken into account in the organization of the process. 4)The household differences that need to be taken into account and 5)How these differences will be handled in this protocol. Kick-Off meeting - Lilongwe

6. Tasks of WP2 continued… • Task 2: Empowerment of Focus Groups • Steps:b) Train partners involved on the use of the PRA Protocol in Harare • The meeting will be a two day meeting that will be aimed at building capacities of CoBaSys partners in using PRA techniques at community level to collect the evidence needed for the research • Participants for the meeting will be drawn from project partners that are responsible for implementation of the PRA protocol c) identify and approach key stakeholders in the target area and inform them about the PRA meetings and invite them: this may include Chiefs, councilors, Health facility committees, Health workers, PLWHA support groups, CBOs, opinion leaders etc d) set up a half day sensitization meeting on what the project is about and seek their input, schedule dates and timings of the 2 PRA meetings with them (inculcate a sense of ownership) e) Use the PRA protocol to guide activities at the meetings and schedule for feedback and other work f) minutes of each meeting should be comprehensively outlined by the researcher and his/her team using a GUIDELINE on reporting and will be sent to TARSC Kick-Off meeting - Lilongwe

7. Tasks of WP2 continued… • Task 3: Mentoring, review and synthesis of findings • Steps: g) TARSC/WP2 will agree with partners the time at which PRA meetings will be held in each country. This is enable mentoring, follow up and to ensure quality of work. h)TARSC will visit at least once in each country’s PRA meetings for mentoring and support i) TARSC will review, consolidate and synthesize the findings vis the objectives Kick-Off meeting - Lilongwe

8. TARSC/WP2 Deliverables; results and indicators of success • Deliverables • Overall PRA Meeting Protocol • Minutes of PRA meetings for each target area, drafted by project partners and available on the project website; • Final publication concerning the activity results’ available on the project web-site 2. Results • Strengthened community participatory research processes in community based systems in HIV treatment 3. Indicators of success • A tangible pool of regional partners trained to use PRA Research methodologies in community based HIV treatment • Local evidence used to define people centered policies on community based HIV treatment • Widely disseminated, useful and relevant evidence from communities on community based systems on HIV treatment (publication) Kick-Off meeting - Lilongwe

9. Our involvement with other Project partners • While TARSC will work with country partners in Tanzania, Mozambique, Namibia, Botswana, Malawi it will also implement country work in Zimbabwe vis WP2 • Liaise and link up with WP1: budget ; Information dissemination, strategic alliances and networking; scientific and co-ordination issues • Liaise and link up with WP3: • to organize local stakeholders advocacy at national level (national roundtables) founded on evidence from the PRA meetings in Zimbabwe; • input in the formulation of a patient centered model for community based systems in HIV treatment founded on evidence from the PRA work at community level; • hold a community anti-stigma awareness campaign in Kariba and Goromonzi District and or • organise a local radio broadcast on HIV treatment at community level in Shona and Ndebele in Zimbabwe Kick-Off meeting - Lilongwe

10. Our involvement with other Project partners continued… • Liaise and link up with WP4 to: • Use the evidence from the communities (PRA meeting groups) to shape the strategic and technical reasons for regional alliances • Define the strategic links starting from existing links and networks e.g work in EQUINET, SEAPACOH, ECSA HQ, SADCPF and line Ministries at national level to engage regionally and globally • Liaise and link up with WP5 to: • Input to the web dissemination strategies that are useful, relevant, widely accessible to encourage interregional collaborations • Input in the next stages of proposal development and areas of capacity and skills building • Liaise and link up with WP6 to: • Input in the development of monitoring indicators (process, outcome etc) • Liaise and link up with WP7 to: • Access knowledge generated by other partners • Input in the development of IEC materials • Participate in conferences Kick-Off meeting - Lilongwe

11. Thank you www.cobasys.eu With the support of the ACP Science and Technology Programme. A Programme of the ACP Group of States with the financial assistance of the European Union. ACP S&T Grant Contract N° FED/2009/217058. Contact details: Thank you for your kind attention Kick-Off meeting - Lilongwe