A Project on Establishment of Housing Flats Voluntary Counselling and Testing Centers in Njoro to Reduce Prevalence of HIV/AIDS Report

Background Knowledge

According to UNAIDS (2008), “The HIV/AIDS epidemic’s spread through the countries of Sub-Saharan Africa is highly varied. Although it is not correct to speak of a single African epidemic, 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 tuberculosis, 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 centres 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 centres 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 roadside. 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 centres 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 counselling 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 counselling 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 counselling 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 behaviours 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 centres in Njoro area. Each VCT centre will have one nutritionist, one VCT counsellor 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 counselling to the clients.
• Use of puppetry and drama in community mobilization and enhanced information dissemination.
• Carrying out of roadshows to encourage the community members to visit the VCTs.
• Promoting use of condoms and safe sex.
• Psychosocial counselling and support to the clients.

Activity Schedule

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

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.

Table 1: Stakeholder’s Analysis.

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 residents and HIV-infected clients will be trained on income-generating activities such as cake-making, yoghurt making, and 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 bedridden 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 counselled 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

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.