Practical Experience Combating

Transcription

1 Practical Experience Combating HIV/AIDS in Rural Roads Construction Projects in Cambodia Global Development Learning Network Dr. Chea Samnang Director, Department of Rural Health Care Ministry of Rural Development Royal Government of Cambodia

2 General Information about Cambodia Population: millions Land: 181,035 Sq km; 24 provinces, 162 urban areas, 185 districts, 1,621 communes, 13,890 villages. Crude Birth rate: 1.96 % per year. CMR ( < 5 ) is 83 deaths per 1,000 live births, 20 % of children under five suffering diarrhea, Adult (male and female) Literacy rate is 73.6 %, and 83.4 % of youth (male and female) are literate..

3 Mandates of Ministry of Rural Development 1. To improve the quality of life of the rural people by encouraging and facilitating their economic self-sufficiency and social welfare, rather than building and promoting dependency on assistance from the government and aid agencies; 2. To try and solve the urban human congestion problems which were caused by migration from rural areas to the cities during the wars and after that due to other reasons; 3. To encourage and assist rural people to participate more in the improvement of farm and rural industrial produce and marketing; this in turn would improve the national economy; 4. To empower the rural people to rely on themselves and to play an active role in solving their own community problems, rather than wait for the central Government - or other rural development agencies to initiate assistance programme.

4 Context of HIV/AIDS situation in Cambodia Cambodia has been severely affected by the HIV epidemic over the past decade. In 2006, the HIV prevalence was estimated at 0.9% among the Cambodian population aged between 15 and 49, a decline from 1.2% in Mobile and migrant populations appear to be at increased risk of HIV infection. The Law on Prevention and Control of HIV/AIDS, enacted in 2002, created a favourable environment for prevention, care and support, and in recognising the human rights of vulnerable communities as well as infected and affected individuals. However, enforcement of the law remains a challenge. New prevention approaches for other vulnerable groups such as Male Sex Male, drug users and street children, were developed and are now ready to go to scale. Many NGOs developed services for orphans and families affected by HIV/AIDS, but the need for more support remains high Several non-health ministries started to address HIV/AIDS through HIV/AIDS policies, strategies and action plans, but capacities and funding remain limiting factors for an enhanced multi-sectoral response Cambodian people 97 percent understand about HIV/AIDS infection. Condom use 95 percent in brothel

5 HIV/AIDS Coordination Structure Council of Ministers Office National AIDS Authority Line Ministries Development Partner Agencies AIDS committee in respective ministry

6 Vision of Strategic Plan for Comprehensive Response to HIV/AIDS in rural community This vision calls for a holistic people centered and gender sensitive approach, which focuses on bottom up development for the people, by the people with the aim to empower individuals, households and communities in increasing their preventive and coping capacity, and creating enabling environments

7 Objectives of Strategic Plan To contribute to reducing HIV infections by addressing individual and socio-economic variables, which determine vulnerability and behaviors of rural populations, To mitigate the impact of HIV/AIDS on rural communities, households and individuals, especially rural women and children, and to provide support to PLWA.

8 Strategic Plan for Comprehensive Response to HIV/AIDS in Rural Community of Cambodia First Strategic Plan : Second Strategic Plan :

9 Structure of First Strategic Plan, Situation and Response Analysis Vision of Strategic Plan Objectives of Strategic Plan Strategic Plan Strat 1: Enhancing Policies and Guidelines Strat 2: Empowerment individual, families,communities Strat 3: Advocccy at all levels Strat 4: Strengthening existing structure and Capacity building Strat 5: Follow up, Monitorirng and Evaluation and Information Management

10 HIV/AIDS Infections in Asia HIV is going down HIV stability HIV is going up Cambodia Source: NAA meeting, 17 Jan 2008

11 HIV/AIDS Awareness and Prevention Activities in Rural Transport Sector in four provinces 1. Conducted Field Assessment at target communities living along the construction roads; 2. Established a team work at National and Provincial level 3. Organized Orientation Training Workshop for the team member; 4. Prepared design HIV/AIDS Education IEC materials and action plan development; 5. Conducted HIV/AIDS Awareness raising and Prevention Education; 6. Reviewed meetings of sharing experiences.

12 1 - Field Assessment at target communities living along the construction roads General information about road construction workers, including male and female, working hours; Number of villages located along the construction roads and number of families and population living in those villages; Existing NGOs and its field work in those villages; Number of entertainment shops such as Karaoke, Drinking shop, Brothel at those area; Location of HC, OD and VCCT/Counseling center; HIV/AIDS information that people have ever heard; HIV/AIDS Suspected Cases died in the villages

13 2 - Established a team work at National and Provincial level National Team was established which consisted of staff from different department within MRD structure as the members of MRD-AIDS Committee, Provincial Team in each target province of rural road construction project was organized, which consisted of PRIP Staff and Provincial Office of Rural Health, Roles and responsibilities between National and Provincial Team on HIV/AIDS project was developed in close consultation with Provincial Team during the orientation workshop on the start up project; Field Supervisor-AIDS National Team Agreeable roles and responsibilities of the team work based on the structure below. PRIP Team/WB Prov T. 1 Prov T. 2 Prov T. 3 Prov T. 4

14 3 - Organized Orientation Training Workshop for the team members Orientation workshop for start-up project in the province, and all Provincial and National Team were participated. The contents of this workshop were included 1. HIV and AIDS situation in Cambodia; 2. Impacts of HIV/AIDS infection; 3. Basic knowledge about STI, HIV and AIDS infections; 4. Condom use and its importance; 5. Voluntary Blood Testing and counseling; 6. Care and Support to the people living with HIV/AIDS (PLWA); 7. Life skills; 8. Development Workplan for implementing HIV/AIDS awareness and preventive program in target areas

15 4 - Prepared design HIV/AIDS Education IEC materials

16 5 - Conducted HIV/AIDS Awareness raising and Prevention Education; Provide knowledge and life skills on AIDS and STI to the constructors' employees, local community who is living along the constructed roads, including some local entertainment places; Provide IEC materials, including condoms distribution and condom use education by using the participatory approach in education sessions on HIV/AIDS awareness and preventive program Provide counseling and advising the constructors' employees, high-risk groups of local community, direct and indirect commercial sex workers at the local entertainments to consult with HC, OD and other NGO's centers, including VCT; Closely follow up and supervision by project team and supervisors to the implementation activities on HIV/AIDS and STI awareness and preventive program at target areas in PRIP Project.

17 Subjects of HIV/AIDS Awareness raising and Prevention Education - 3 to 4 hours (Maximum) HIV/AIDS Situation in Cambodian Reality of HIV/AIDS infections Basic knowledge STDs Condom use Voluntary Blood testing Life Skills/Information for PLWA Posters, Question &Answer Game, Q & A, Poster presentation, Poster/ leaflets distribution Game, Q &A, Poster presentation Demonstration, Q &A, Poster/leaflet Presentation, Q &A, Poster/leaflets Video show, Q &A 15 min 40 min 30 min 30 min 30 min 90 min

18 Activities of HIV/AIDS Education

19 Activities of HIV/AIDS Education

20 Most Frequent Q & A from Participants 1. Where they can buy the condoms? 2. If they would like to have blood tested to check HIV epidemic, where they should go? 3. If the mosquito bites the HIV/AIDS person and bite the others (No HIV/AIDS), is there the contamination of HIV? 4. If the pregnant woman have AIDS or affected by HIV, will her child be infected by HIV? 5. Is there medicine treating this HIV/AIDS? 6. Overhearing that khmer traditional physician can treat HIV/AIDS, is it true? 7. If there are HIV/AIDS people at their villages and, there is discrimination to those people, how to solve it? 8. Etc.

21 6 - Reviewed Meetings of Sharing Experiences Basic Schedule: twice a year Discuss about the key lessons learned and improvements

22 Output Indicators to monitor the progress of HIV/AIDS education Number of HIV/AIDS material dissemination Number of condoms distribution Number of VCT sites established along side the construction project Number of people attended VCT for pre-test consulting services, Number of people attended VCT for post-consulting services Number of people tested for HIV/AIDS and STD at these VCT Number of people diagnosed with HIV/AIDS and STDs at VCT Percentage of people tested with diseases, Local residents identified with HIV/AIDS not directly associated with project; Number of construction sites have been visited for workshop and information dissemination purposes Percentage of construction sites have been visited for workshop and information dissemination purposes Number of road workers and administrative staff who attended training workshop Percentage of road workers and administrative staff are involved in the construction project participating in educational programs Number of villages have been visited for workshop and information dissemination purposes

23 Key Lessons Learned 1. In general, we lack of budget to implement HIV/AIDS awareness in rural road construction projects. One percent policy from road construction cost is not success to mobilize in the other rural road projects; 2. The best time that community people can participate in HIV/AIDS education is only in the morning. We may need to design HIV/AIDS education in the evening session; 3. Some provinces have a lot of target villages and families living along the road construction s site, and we need more times to conduct HIV/AIDS education sessions; 4. Need to encourage more men to participate in the HIV/AIDS education sessions;

24 Key Lessons Learned (Cont.) 5. Video show is more attractive session than poster show / demonstration. We should use more time for film presentation (video show); 6. More condom should be available to distribute to the attended people, 7. Road constructor/manager seems not happy to let the workers attend education session. They think that it may lost their time to finish the construction on time in the contract workplan; 8. Local authority has a good collaboration with HIV/AIDS education team.

25 THANK YOU FOR YOUR ATTENTION!