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A Project on Establishment of Jousing Flats Voluntary Counselling and Testing Centers in Njoro Area to Reduce Prevalence of HIV/AIDS and Provide Nutritional Support Among the Youths Aged Between 16-35 Years Report

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Updated: May 15th, 2019

Background Knowledge

According to UNAIDS (2008), “The / epidemic’s spread through the countries of is highly varied.

Although it is not correct to speak of a single African , Africa is without doubt the most affected by the virus. Inhabited by just over 12% of the world’s population, Africa is estimated to have more than 60% of the AIDS-infected population. Much of the deadliness of the epidemic in Sub Saharan Africa has to do with a fatal synergy between HIV and , though this synergy is by no means limited to Africa…” (UNAIDS, 2008).

To reduce the HIV/AIDS prevalence, the government of Kenya has established Voluntary Counseling and Testing centers in all the provinces. This is although not sufficient for the rising number of new infections. The British government has agreed to finance and support this program.

The VCT centers are approved by National Aids Control Council and the Ministry of Health. The Njoro area which is within the Rift Valley province has three VCT centers that are: Njoro health center, P.C.E.A Njoro local church VCT center and Egerton university center (MOH, 2008).

These centers may not be enough to serve the rising population especially after the post election violence whereby many families moved to the area to seek refuge majority being 45years and below. It has also been noted that 64.1% of the population in this area have never been tested for HIV and 78% are ready to have Voluntary Counseling and Testing (BHA, 2009).

Some of the victims have been neglected by their families and have ended up living by the road sides. Others have been displaced after the 2007 country’s general election. Therefore the proposed project is aimed at establishing housing to victims and more VCT centers within Njoro area so that the services can be available to a high percentage of the population within the area and thus reduce the rate of HIV prevalence which is one of the Millennium Development Goals to be achieved by 2015.

Target population

The targeted population is the youth in Njoro area aged between 15 and 40 years.

Statement of Problem

According to research findings it has been noted that 60% of Kenyans do not know their HIV status. It has also been noted that the living conditions of the victims is poor thus access to health related services is limited .This has led to an increase in the rate of new infections and a high rate of spread of HIV (UNAIDS, 2007).

The above problem has been cited as a hindrance to the war against HIV/AIDS mainly because those who have not been tested tend to be potential victims of infection and re-infection thus delaying the application of the appropriate measures to HIV/AIDS intervention through nutrition support.

The proposed project is aimed at increasing delivery of VCT services by establishing housing for severely affected AIDS patients and three more VCTs in the Njoro area which will be operating for 24 hours. This will enhance counseling and testing of those youths who are still stigmatized but would like to know their status; services will be provided even at night.

Nutritional support will be given to those clients with signs of malnutrition i.e. those with BMI of less than 18.5. Community members will also be educated on the importance of counseling and testing through churches and demonstrations during barazas.

Justification

The Njoro area has a large number of youth who settled in the area after a recent post election violence. Their living condition is poor and most of them usually engage in casual labour to earn a living. Those who fail to get a chance in the available labour market tend to engage in commercial sex work especially women and girls and women. These prevailing conditions usually put the youth at risk of contracting HIV/AIDS.

According to research, 64.1% of the population in this area has never been tested but is readily willing to be tested. With HIV/AIDS continuing to be a major public health concern in Kenya and the world, the issues surrounding acceptance and use of VCT need to be addressed. Enhancing community awareness of the benefits of early HIV diagnosis, providing couple-based VCT as an integral part of VCT and increasing access to VCT testing sites may enhance utilization of VCT services.

HOUSING PROJECT will embark on serious mobilization and then on counseling and testing of the people in the Njoro area. This will be done through collaborations with other community based groups, churches and youth groups within the area. Using this approach the project will make sure that maximum numbers of people are reached before counseling and testing activities start.

Goal

To reduce HIV prevalence among youths aged between 15-40 years in Njoro area by 15% by the year 2015.

Objectives

  1. Provide residence to HIV victims and other individuals living in poor conditions.
  2. Provide cleanliness and sanitation measures within the residential flats.
  3. Increase awareness of the importance of counseling and testing services through community mobilization.
  4. Increase uptake of counseling and testing services among the community members and other referral services such as medication and support in the next one year.
  5. To reduce stigma and discrimination through psychosocial support among the community members.
  6. To provide nutrition counseling and assessment to the infected clients.

Expected Results/Outcomes

HOUSING PROJECT is planned to run for three years after which some changes are expected to occur among the primary stakeholders. They include;

  • At least 80 % of the HIV victims will be provided with a residence.
  • Access to VCT services will be effective.
  • Monitoring of the rate of spread of HIV will be easily done.
  • More than 75% of community members particularly the youth will be aware of their HIV/AIDS status.
  • De-stigmatization of people living with HIV/AIDS and increased support by their family members and friends.
  • Reduced spread and effect of HIV/AIDS within the community as majority will be aware of their status and hence positive living behaviors among the youth.
  • Reduced rates of Mother to Child Transmission among the pregnant mothers within the community as they will receive specialized care and medication to protect the unborn baby.
  • Improved quality of life of those people living with HIV/AIDS through provision of nutritional support and access to ARVs

Project Implementation Plan

HOUSING project strives to achieve its objectives through the following strategies;

  • Construction of 6 residential flats at specific points in the area
  • Construction of 3 VCT centers in Njoro area. Each VCT center will have one nutritionist, one VCT counselor and two social workers.

Activities to be carried out include;

  • Provision of organized cleanliness and sanitary services within the residence.
  • Provision of voluntary counseling and testing services to the community members.
  • Allocation of rooms to the needy and sick.
  • Referring the HIV infected clients to the PGH-Nakuru and Molo District Hospital for medication.
  • Providing fortified blended flour to underweight clients.
  • Provide nutrition assessment and counseling to the clients.
  • Use of puppetry and drama in community mobilization and enhanced information dissemination.
  • Carrying out of road shows to encourage the community members to visit the VCTs.
  • Promoting use of condoms and safe sex.
  • Psychosocial counseling and support to the clients.

Activity Schedule

The activity schedule is attached in a separate MSproject format named residence project.

Table 1: Stakeholder’s Analysis

HOUSING PROJECTS’ success will depend on various factors, one of them being the level of stakeholder contribution to the project. They will be classified as primary, secondary and key stakeholders depending on their impact on the outcome of the project.

STAKEHOLDER TYPE OF STAKEHOLDER CONTRIBUTION TO PROJECT HOW TO BE INCLUDED
Youths Primary They are the targeted group whose behavior is expected to change Will be involved in every stage of the project
Churches Secondary Dissemination of information to the youth in the church To be included in the implementation stage
BAF Key Donor of the project To be included in every stage
World vision Secondary Providing education & psychological support to the OVC’S Monitoring and evaluation stage
Provincial hospital Secondary Providing medical services to those clients who have been referred there Implementation stage
Agricultural firms Secondary Manage the farm for the production of food for the clients Management of cropping systems
Architects Secondary Construction of the flats and the VCT centers Design stage
M.O.H Key Providing test kits

Providing ARVS

Implementation stage
Colleges Secondary Allow the use of demonstrations & mobile VCTS in college premises.

Allowing poster to be placed inside the colleges

Implementation stage
County council Secondary To permit posters within the town Licensing
NASCOP Secondary Provision of test kits Implementation stage
Global Fund Key Main donor All the stages of the project
HOUSING AGENCY Key Implementing All the stages of the project

Sustainability

HOUSING PROJECT will be involved in provision of housing to approved persons who may or may not be required to pay a certain amount and provide Voluntary Counseling and Testing services, psychological support and nutritional support to the members of the community for the proposed 3 years. It will also work together with other organizations involved in the fight against HIV/AIDS within Njoro area.

In order to ensure sustainability of the project, the following activities will be done:-

  1. Those found needy will be provided with housing
  2. Those who will be found HIV positive after testing will be referred to PGH-Nakuru and Molo District Hospital; where they will be given a card number to be accessing ART services.
  3. The house resident and HIV-infected clients will be trained on income generating activities such as cake-making, yoghurt making, soap-making which will generate money to purchase food and thus prevent food insecurity in their households in future.
  4. Volunteers trained on home based care will be enrolled into the Ministry of Health to continue supporting and caring for the bed ridden clients within Njoro area.
  5. The newly established VCTs will be registered with the MOH and NASCOP for continued supply of test kits after the completion of the project.

Monitoring

This will be done to ensure that the proposed project is achieving its objectives .The monitoring team will consist of a member from the funding agency, NASCOP and implementing agency.

The performance of the project will be monitored every month through the following ways:

  • Use the records to determine the number of people benefiting from the housing project.
  • Using the records used in room allocation to know the exact number considered for allocation
  • Using the daily attendance list to estimate the number of people that visit the VCTs in every month.
  • Reviewing records to determine the number of people who have been referred for treatment in the Provincial General Hospital Nakuru.
  • Using a questionnaire during households’ visits to identify those people who have not been tested and for what reasons.
  • Using a questionnaire to determine people’s attitude towards the housing program, counseling and testing services and existence of stigmatization.
  • Checking the records to determine the number of people who have been given nutritional support in every month.
  • Household visits to identify the clients who have started income generating activities.

Evaluation

The evaluation process will be conducted by a team from the USAID main offices in Nakuru. This will be done quarterly every year. They will evaluate:

  • Allocation of funds for each activity and verification will be done by use of receipts where necessary
  • House allocation list
  • Attendance lists
  • The state of ongoing activities.

Formulation evaluation- will be done before the designing of the project to assess its economic feasibility

Process evaluation- will be done during the implementation stage to assess whether the project is geared towards achieving the objectives that have been set. It will be conducted after every three months. Factors such as inputs (e.g. test kits, flipcharts), procedures, personnel and timeliness in delivery of materials will be evaluated.

Outcome evaluation- will be done after completion of the project to assess if the objectives were met i.e. the percentage of people that have been housed counseled and tested.

Impact evaluation- will be done a few years after the completion of the project process whether the goal was met that is, reduction in HIV/AIDS prevalence by 15% within Njoro area. This will also involve a community survey and use of records to determine the number of people who were tested and given nutrition support as well as referred for medication to hospitals

Appendices

Appendix 1: Logical Framework Matrix

Narrative summary Objectively verifiable indicators Means/sources of verification Assumptions/risks
Goal:

To reduce HIV/AIDS prevalence in Njoro area by 15% by the year 2015.

Solve the housing problem for the HIV victims and other needy members of the society.

Reduced number of deaths and new HIV infection cases by 10%.

Reduced housing problem in the area

  • Survey
  • Records
  • Funding will be available
  • That the outcome will be as a result of the intervention.
Purpose:
  • Reduce the number of people who are homeless
  • To increase awareness and provide counseling and testing services to the community members.
  • To provide nutritional support to the HIV positive community members.
Reduced number of homeless people

50% of the members of the households in the area tested.

100 households provided with flour, vegetables and eggs.

30 households provided with planting seeds.

  • Records
  • Household visits.
A peaceful political environment will be present.

Members of the households will cooperate.

Output/outcomes:

A good residential design

Nutrition counseling

Purchasing land

Construction of VCT centers

Demonstrations

Training of the youths.

A well drawn design of the buildings

200clients counseled

5 acre piece of land bought

3 VCT centers built within the area.

50 youths trained.

  • Records
  • Reports
The designers will complete their work on time.

Members of the community will utilize the counseling lesions in their day to day lives.

The youth will make use of the acquired skills to earn a basic living.

Inputs:

House keepers

Nutritionists

Test kits

Flipcharts

Food models

Books, pens

Puppetry group

Facilitators

2 housekeepers per flat

3 nutritionists in the area

3000 test kits supplied.

5 bundles of flipcharts

2 dozens of A4 books

3 trainings on drama done.

2 facilitators

Records Funds will be available

Appendix 2: Monitoring and Evaluation Framework

Project profile M&E Indicators Information to be collected Methods for collecting information Tools for collecting information Methods for data analysis Tools for data analysis
Goal

To reduce HIV/AIDS prevalence in Njoro area by 15% by the year 2015.

Reduced number of deaths and newly HIV infected cases by 10% What is the % reduction in HIV prevalence in Njoro area? Survey Questionnaire Descriptive statistics e.g. percentages SPSS
Objectives

To increase awareness and provide counseling and testing services among the community members.

To provide nutritional support to the HIV-infected clients.

75% of the community members tested.

100 households provided with food.

What percentage of people has been tested within one year?

How many households have been given nutritional support?

Survey

Records from the VCT centres

Individual household visits

VCT attendance list Descriptive statistics e.g percentage SPSS
Output

Nutrition counseling

Road shows

Training of the youths

Continuous

5 road shows done

50 youths trained

How many clients have been counseled per month?

How many road shows have been carried out within one year?

How many youths have been trained?

Review of records

-Video Recording

VCT attendance list.

Records

Records

Inputs:

House keepers

Nutritionists

Test kits

Flipcharts

Food models

Books, pens

Puppetry group

Facilitators

3 nutritionists in the area

3000 test kits supplied.

5 bundles of flipcharts

2 dozens of A4 books

3 training sessions on drama done.

2 facilitators

CVs of the employed staff

Records of purchases

records records

Appendix 3: Budget Plan for Three Years

BUDGET
ITEM UNIT COST (Kshs) TOTAL COST (Kshs)
CAPITAL EXPENDITURES
construction of 6 flats and 3 VCTs
construction of 6 flats 3,500,000.00 21,000,000.00
Construction of 3 VCTs 500,000.00 1,500,000.00
2 4WD cars 4,500,000.00 9,000,000.00
3 motorbikes 80,000.00 240,000.00
3 computers 35,000.00 105,000.00
2 photocopying machines 80,000.00 160,000.00
3 TV sets 15,000.00 45,000.00
6 office desks 10,000.00 60,000.00
12 benches (4 per VCT) 1,000.00 12,000.00
3 filling cabinets 15,000.00 45,000.00
12 office chairs 4,000.00 48,000.00
1 public address system 50,000.00 150,000.00
5 acre piece of land 500,000.00 2,500,000.00
Sub Total 34,865,000.00
RECURRENT EXPENDITURES
Staff and Rent
1 Project Manager 60,000.00 2,160,000.00
2 Project Co-ordinators 40,000.00 2,880,000.00
3 Nutritionists 30,000.00 3,240,000.00
3 VCT Counselors 20,000.00 2,160,000.00
6 Volunteer Social Workers 10,000.00 2,160,000.00
3 Facilitators 15,000.00 135,000.00
2 Drivers 15,000.00 1,080,000.00
Rent 10,000.00 360,000.00
Sub Total 14,175,000.00
MATERIALS AND SUPPLIES
Fuel 50,000.00 1,800,000.00
Stationaries 10,000.00 360,000.00
Flipcharts 3,000.00 108,000.00
Food materials 10,000.00 360,000.00
3 weighing scales 10,000.00 30,000.00
puppetry materials 10,000.00 500,000.00
3 microtoise 3,000.00 9,000.00
Sub Total 3,167,000.00
TRAINING
50 Youths 3,500.00 17,500.00
Cake-making 1,000.00 3,000.00
Yoghurt-making 500.00 1,500.00
Soap-making 2,000.00 6,000.00
Sub Total 28,000.00
Contigencies 10% 5,223,500.00
Auditing 5% 2,611,750.00
GRAND TOTAL 60,070,250.00

Bibliography

“Global AIDS epidemic.”, UNAIDS Epidemic update. 10 May 2010. Web.

John, Liffe, The African AIDS Epidemic. Oxford: Oxford publishing, 2006.

Kenya National HIV and AIDS Communication Strategy for Youth “Report on the global AIDS epidemic”, Nairobi: Macmillan publishers, 2008.

Raymond, Allen. Social, Political, Cultural, and Scientific Record of the HIV Epidemic, Encyclopedia on AIDS, Penguin books, 2008.

Tony, Whiteside. AIDS in the 21st Century: Disease and Globalization. Palgrave: Macmillan, 2003.

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