Regional Workshop for Costing eMTCT National
Strategies:
Understanding Community Engagement in eMTCT
Community Engagement Working Group
Lucy Ghati, NEPHAK/GSG Representative
3 September 2012
Overview
I.
II.
III.
IV.
V.
VI.
Who We Are
Who is the “Community”?
What is Community Engagement
Why is Community Engagement Important
How to Engage Communities
How to Include Community Engagement in
National eMTCT Plans
VII. Who Can Provide Technical Support?
VIII.Questions
1
Who We Are: Community
Engagement Working Group (CEWG)
• Recently formed IATT Working Group
• Co-Chaired by GNP+ and CDC
Workgroup Objective
To provide Global Plan countries with (1) practical tools and (2)
technical assistance for developing, implementing, managing,
and monitoring community engagement programs addressing
the Global Plan goals and objectives.
2 Who is the “Community”?
Communities are groups of people linked by
common ties.
Within the HIV response these communities
include:
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networks of people living with HIV,
community leaders, service users,
faith-based organizations,
advocacy groups
men, women, boys and girls
actual communities – towns, villages, groups of people
living together
3 What is “Community Engagement”?
Community engagement is a process by which
the community is engaged to:
work collaboratively with national and local health
authorities, facility and community based medical
service providers, legislators, advocacy groups,
donors and others engaged in efforts to develop,
implement and evaluate Global Plan related care;
empower women and their communities to access
health care and hold those who provide it
accountable.
4
Why is Community Engagement
IMPORTANT?
Community Engagement is important
because it:
Increases demand for services,
Improves client retention,
Improves uptake of and adherence to interventions that will achieve
Global Plan goals and objectives,
Addresses HRH/HSS issues by engaging a massive potential workforce
by enlisting communities in the provision of care,
Builds strong linkages between health facilities and communities,
Brings men and families into comprehensive eMTCT care and ensures
that they also get the services they need,
 Improves equitable outcomes and reaches underserved populations.
5
How Can our Communities Engage in
this Work to Achieve Rapid Scale-up?
Communities can:
 Improve the supply and quality of services
 Increase the uptake of services, including ARV
adherence and facility delivery and follow-up
 Create an enabling environment
Improve supply & quality of services
Communities can improve the supply and quality of
services by:
 Supporting front-line health care workers e.g. community based
distribution of family planning
 Serving as extension workers
 Having peer educators and mentor mothers in health facilities
provide education and support where there are too few
doctors and nurses (HSS/HRH/Task shifting and sharing)
 Creating links between community- and faith-based
organizations and facility-based services
 Community workers reach into communities to link individuals
into services and trace those lost to follow-up
 Monitoring governments and health facilities to hold them
accountable for providing services that suit the needs of
women, men and children
Increase uptake of services
Communities can increase the uptake of services
(including ARV adherence and facility delivery and
follow-up) by:
 Participating in campaigns for behavior change and
reduction of discrimination
 Providing peer support
 Maximizing the use of community assets and resources
 Creating demand through treatment literacy and
awareness of availability of services
 Supporting community led health promotion campaigns to
create demand and increase uptake
Create an Enabling Environment
Communities can create an enabling
environment by:
 Advocating for scale-up and the right to sexual and
reproductive health,
 Promoting community engagement in policies and strategies.
 Addressing HIV related stigma and discrimination and gender
inequalities
 Participating in technical working groups
 Reducing stigma and discrimination
6
How To Include Community
Engagement in National eMTCT Plans?
Include & budget for the following:
1. Establish and strengthen community-based support services
(including FBOs and PLHIV )
2. Train community workers (e.g. people living with HIV, mentor
mothers, community health workers, peer educators, etc.) to
deliver comprehensive prevention of vertical transmission services
3. Community-based support for linkages to and retention in facilitybased services
4. Support and provide community education and awareness
5. Strengthen and encourage community-led program
accountability
Positive aspects of Community
Engagement in Plans
 Gender-sensitive approaches for engaging both men and
women e.g. health development army and women’s
coalitions in Ethiopia
 Strategies for reaching underserved populations e.g. Ghana
and Zambia financial reimbursements for poor women
accessing PMTCT services
 Peer support groups e.g. Kenya and Mozambique
 Community distributors of family planning services e.g. Malawi
and Mozambique
 Health management committees with community
participation e.g. Kenya
 Building capacity of community support groups including
PLHIV to support treatment adherence including through
home based care e.g. Nigeria
Areas for strengthening
community engagement
 Budgets for CE do not reflect narrative e.g. lack of budget for
capacity building of CBOs to provide outreach to households affected by HIV
 Limited focus on local accountability mechanisms to
support planning, implementation and monitoring of
EMTCT response
 Limited consideration of community based structures
outside of the health sector (faith based organisations,
social welfare structures etc)
 Lack of clarity on role of PLHIV in planning and
monitoring responses
 Limited focus on activities to reduce HIV related stigma
and discrimination
7 Who can provide Technical Support?
IATT Community Engagement Work Group
 Brochures
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“Supporting and Strengthening community engagement towards achieving
zero new HIV infections among children and keeping their mothers alive” –
Introduction to Community Engagement
“Communities taking action for women, mothers and children” – Suggestion of
Promising Practices
Checklist of Minimum Community Engagement Activities
GSG Civil Society Representatives
UNAIDS Community Mobilization Team
Community groups working locally, in particular networks
of women living with HIV and service providers working
directly with mothers living with HIV
Most Importantly…
 We need to allocate a budget that will meet the full costs of
community engagement.
 NACC/NACA should work with development partners to roll
out a national plan that will implement revised WHO
guidelines and reduce stigma in health care facilities
 NACC/NACA, in collaboration with community groups, should
develop strategies to keep women engaged in follow-up
treatment and care services
 We need to wholeheartedly involve women groups in mother
and child health care
 Women’s groups must be represented in the national eMTCT
platforms and relevant advocacy discussions
Questions?
We are ready and able to help.
Email:
Georgina Caswell gcaswell@gnpplus.net
Amy Medley igm8@cdc.gov
(Co-chairs of CEWG)