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® © 2005, CARE USA. All rights reserved. A Partnership Model with Civil Society Organizations to Expand Care & Support Services to Hard to Reach PLHIV Uganda HIV Implementer’s Meeting Sara Nieuwoudt, MPH Health Program Officer CARE International in Vietnam Co-authors: Nguyen Thanh Van Nguyen Thi Anh Nguyet
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Civil Society Contributions to HIV Care and Support

Nov 19, 2014

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Health & Medicine

Sara Nieuwoudt

Presention given at the HIV Implementers Meeting held in Uganda (2008)
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Page 1: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

A Partnership Model with Civil Society Organizations to Expand Care & Support

Services to Hard to Reach PLHIV

Uganda HIV Implementer’s Meeting

Sara Nieuwoudt, MPHHealth Program Officer

CARE International in Vietnam

Co-authors: Nguyen Thanh Van

Nguyen Thi Anh Nguyet

Page 2: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Overview: “Same Same but Different”

Different epidemic

Different civil society

(Mostly) same partnership strategy

Challenges and Successes

Recommendations

Page 3: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

a concentrated HIV epidemic

0.53%

Ministry of Health, Viet Nam (2005): HIV/AIDS estimation and projection in Vietnam for 2005 – 2010 period .

Page 4: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Drug Users: 34%

‘Prostitutes’: 6.5%

Public Billboard: “AIDS. Drug use. Prostitution.

Road to Death”

a concentrated HIV epidemic…

that is not concentrated for

hard to reach

Source: MoH (2005): HIV/AIDS estimation and projection in Vietnam for 2005 – 2010 period.

Page 5: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Vietnam’s Civil Society: “Same Same but Different”

The Party

National

Provincial

District

Commune

The Ministries

Mass Organizations

National

Provincial

District

Commune

National

Provincial

District

Commune CSOs

Page 6: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

independent civil society & HIV

Self-help groups

Faith-based

Community-based

Bright Futures NetworkThe Network (HCMC)AIDS Program Green Bamboo

Tue Tinh DuongDieu Giac PagodaPastoral Care Center

Action for DevelopmentXuan VinhEmpathy clubsAn Giang & Can Tho groups

Examples:

Page 7: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

challenge for independent civil society

complicated & restrictive registration process

Page 8: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

STRONGER Project

Timeline: 2005 to present Funded by: PEPFAR & USAID through Pact Partners: civil social organizations

Stronger Organizations, Networks, & GIPA for an Empowered Response to

HIV/AIDS

Page 9: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

partnership model: EMPOWERMENT!

grants

management &technical skills

PLHIV better served in community

PLHIV networks strengthened

CSOtraining

Public Health System

Page 10: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Key to partnership

Women’s Union(a mass organization)

CSOs

Page 11: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Different care & support | Same monitoring

care & support specific to each group

monitoring methods developed jointly

•home visits & care

•OI diagnosis

•Relapse prevention

•ARV adherence support

•counseling support

•OVC care & support •guides, e.g. cue cards

•data entry forms

Page 12: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

success in scale-up: acceptance leads to growth

6 to 11 CSO grantees per year

3 to 5 provinces

5000 to 48,000 grant range (USD)

13 CSO grantees total (2 self-sufficient)

Page 13: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

success in numbers and GIPA

100+ CSO members trained

10,657 reached through CSOs Beneficiaries

Providers

Leaders13 CSO managing programs

national advocacy

“I thought that death was waiting for me. I did not think that I could lead such a life like today …”

~ HIV positive Empathy Club member

Page 14: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Challenges faced

Poor health

Complex M&E

Short grant timelines

Legal

Photo credit: Lesley is a Gem Girl (Flikr, 2008)

Staff turnover

Stigma and Discrimination

Page 15: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

key lesson: empowerment takes time

Realistic capacity assessment

Realistic estimate of resources

Realisticexpectations

Success benchmarks should account for time

Page 16: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

programming recommendations

support civil society&

invest in building capacity

monitor & evaluate impact &

invest based on evidence

Photo credit: citybumpkin (Flikr, 2008)

Page 17: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

government recommendation: policy change

Simple registration

Legal recognition

Direct support

Page 18: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

Thank You!

Our Donors: Pact & PEPFAR

Our CSO Partners: •Tue Tinh Duong•The Network (HCMC)•Action for Development•Bright Futures Network•Pastoral Care Center•Xuan Vinh•AIDS PROGRAM•Can Tho Group •Empathy Club•Dieu Giac pagoda•Green Bamboo•An Giang Group•Shield Club

Vietnam Delegation

Page 19: Civil Society Contributions to HIV Care and Support

®

© 2005, CARE USA. All rights reserved.

our inspiration

“[This] is the first time we participated in the whole process of

project management and we are very happy and proud to

see CARE look at us positively. They acknowledge us as

capable, and believe that we can change our lives and

encourage people like ourselves to be more optimistic. All

our project activities are completed with quality.”

~group leader of Bright Futures Network (2003)