UNICEF, SFH, HIV AYP Programme and the Success Story in Kaduna Communities
By ALEX UANGBAOJE
Recently, the United Nations Children’s Fund (UNICEF) and Society for Family Health (SFH) with the supervision of Kaduna State AIDS Control Agency (KADSACA), recorded a huge success inAdolescents and Young People (AYP), HIV service delivery and prevention programme, in both Jama’a and Jaba Local Government Areas of Kaduna State.
The eighteen months (18) programme which started October 2014, was conceptualised and designed by UNICEF and SFH because of the alarming increase in HIV prevalence in the two LGAs according to available data in the state ministry of health.
According to the state ministry of health report, Jama’a and Jaba LGAs has the highest HIV prevalence of 9.2% in 2011 and 7.7, 7.0% in 2012 respectively, which necessitated the pilot of HIV comprehensive service uptake for AYPs in the two LGAs.
In the course of the 18 months period of the programme, discoveries were made during counselling and testing. For instance, the perception that created fears in the minds of AYPs in the two LGAs, and has over time restricted them from knowing their status, that is; the believe that almost everybody was HIV positive changed.
This is because at the end of the programme, the new findings shows a drastic reduction in HIV prevalence rather than the increase as presented by the state ministry of health.
Speaking of the decline, AYP programme manager, Barnabas Anthony, field officer, SFH Kaduna Field Office, said that what’s on ground is far different from the records of paper.
According to him, “at the end of March 2016, we tested about 57,000 people and out of the 57,000 we only got 125 people who were tested positive, which suggest that some of the findings we have seen from surveys which says that Jama’a and Jaba have increasing prevalence rate might not be to correct.
“What we saw from the field was not really so, but again we try to find out what exactly is responsible for this survey, sometimes you test about 100 people you hardly get 2 or 3 positive. But some of the argument the Demand Creators and Counsellor Testers presented is that it could be that when these surveys were done then, probably the AYPs that were there then might have gone to the city for greener pasture, so they are no longer on ground.
“Secondly, what they also mentioned was that some of the AYPs already know they are positive as a result refused to turn up for testing, they also mentioned that some of the people that still come out to test, as you know in this part of the world, some people believe in prayers for healing. So after they may have gone to prayer houses and are declared free, now they want to know their current status.”
This new revelation was what prompted a traditional chief at the close out meeting of the AYP programme in Kwoi, Jaba LGA, to ask the organisers a passionate question, which is; “what is the current status of HIV/AIDS in our community now in percentage, can you please us?” this Barnabas said the programme can not be an authority to determine the current percentage as there are authorities saddled with that responsibility.
But worthy of note is the fact that UNICEF and SFH committed their resources to a programme directly targeted at AYPs a feat the Jaba LGA, Caretaker Committee Chairman, Hon. Ben Kure admitted has never happened in the LGA since creation.
Kure who was represented by his Vice, Hon. Kennedy Dsuwa noted that “before the intervention of UNICEF and SFH there has never been partners supporting the LGA in the area of youth HIV programme.
“Indeed the youths are the backbone of every society, this inform the need for them to be targeted with appropriate HIV interventions to protect the future generation. Successive LG administrations did not give this programme the much needed support to ensure sustainability.
”Let me use this opportunity to commend UNICEF and SFH for deeming it fit to initiate this laudable programme in order to reduce the spread of HIV among AYPs in Jaba LGA.
“I have no doubt in my mind that many of our youths got to know their HIV status and are now adopting appropriate behaviour to remain HIV free while those that are infected now have access to treatment. This has indeed averted uncountable, untimely and unnecessary deaths.”
Another area of commendation for organisers of the programme is the impact made on the behavioural pattern of the AYPs. For example, in a brief discussion with one of the beneficiaries, 18years Adams Mercy who before the commencement of the programme was involved in multiple sexual relationship said she discovered the danger in having sexual relationship before marriage.
She expressed satisfaction in the services of both the Demands Creators and Counsellor Testers whom she said has made health facilities in their areas youths friendly.
According to her, before now, it was difficult for an AYP to walk up to a health facility for the purpose of knowing his or her HIV status. But she did not just know her status but also know what measures to take to avoid been infected with HIV and that she has already taken steps to avoid sex until she is married.
Another AYP, 16years old Hamani Yusuf agreed that knowing his status is not enough for him, but that there’s need for him to take the message to his friends in order to reduce the HIV prevalence in his community.
The objective of the programme was to ensure that the proportion of AYP that have been tested and known their HIV status and accessing appropriate services is increased by 25 % in the two LGAs.
The project was an integrated, comprehensive and community based HIV prevention programme that provided quality services with guarantee improved service delivery and data quality assurance and untimely programme goal achievement.
At the lunch of the programme 18 months ago, about one hundred thousand (100,000) AYPS were targeted to be reached, but that Barnabas said was suppassed as organisers were able to reach about 169, 675 AYPs, that is 93,675 males and 76,260 females with HIV knowledge, while 56, 986, that is 29, 326 males and 27, 660 females accessed HIV counselling and testing as against the 40,000 target.”
Knowing what impact this programme has made in the lives of AYPs in the two pilot LGAs, the big issue now is the question of sustainability as mentioned by Jaba LG Caretaker Committee Chairman and demands of extension by stakeholders who were present at the close out ceremony.
A traditional ruler, Kpop Kham, HRH Danladi Moude, in commending the brave initiative by UNICEF and SFH for choosing Jaba and Jama’a LGAs as pilot for the programme, made a passionate appeal for extension and expansion of the programme.
Noting the impact of the programme on his community, HRH. Danladi said “Through out this period of 18 months many young people now have the boldness to approach health facilities for HIV test and counselling and they are now aware of their status.”
Kpop Kham who was represented by the District Head of Duya, His Highness, Iliya Bako Byung, called on both the state and LGAs to join forces with UNICEF and SFH to ensure sustainability and extension of the programme to other parts of the state and country in general.
The programme according UNICEF cost it about $380, 000 for the 18 months but has since been extended for another 3 months with additional N3.3 million to enable UNICEF buy time to renegotiate with the new government on how to take over the project.
In his submission, Dr. Idris Baba, HIV/AIDS Specialist, UNICEF Kaduna Field Office, explained that, the idea was for the state government to take over the project after 18 months so it can be sustained but for the change of government which is a little setback to the initial arrangement.
He added, “what we are doing now is to keep it running until the end of June, hoping that by the end of June we might have reach certain level of agreement to enable the state government take over the programme and run it by themselves. The money for the additional 3 months extension has already been released to KADSACA.”
He said with the success recorded so far, UNICEF will summon a meeting of all stakeholders before the end of the year so as to discuss the findings and how the programme can be expanded to Kagarko, Lere, Birni Gwari, Ikara and Chikun LGAs.
Dr. Idris noted that taking charge of the programme has no cost implication for the state as all the facilities needed has already been put in place and the health workers in the center are state government workers.
The programme manager, however, commended the communities for their response to the programme during the 18 months period.
Beneficiaries of the programme also thank the Demand creators and the Counsellor Testers for their understanding and approaches which they said gave them confidence to overcome the earlier fears of knowing their status.
One strategy that gave credence to the programme was the community mobilisation, a process that helps the communities identify their needs and also respond to and address those needs. Gaining the participation of members of the community helped health care service provider to raise awareness and got across the the hard to reach areas of the two LGAs.
The fact that the programme was initiated for the community, managed by members of the same community for the benefit of people of the community, explains why the response and participation of the people will forever remain a mystery to organisers of such programmes.