MAKENI ECUMENICAL CENTRE HIV/AIDS PREVENTION PROJECT PROPOSAL 1. INTRODUCTION Makeni Ecumenical Centre is an NGO founded in 1971, Limited by Guarantee. It is situated 10km South of Lusaka on a 15 acres plot. The Centre has five settlement villages namely: Kafue 40km south west of Lusaka, consisting of 50 acres, 20 families, Mwembeshi 54 km west of Lusaka, consisting of 1000 acres, 86 families, Kalwelwe 130km north of Lusaka consisting of 630 acres, 42 families, Chisamba 120km north of Lusaka consisting of 3100 acres, 66 families and Mwomboshi 130km north of Lusaka consisting of 1265 acres, 55 families. The Centre also serves the population surrounding these five settlement villages through the provision of education, clinics, churches and other social amenities. The Centre has since built up substantial educational health and community projects. These include: Adult Education Courses (Home Economics, Tailoring, Nutrition, Carpentry & Joinery, Agriculture and Electronics), General Clinics in (Makeni, Mwembeshi, Mwomboshi and Kalwelwe), Family Planning Clinics in (Makeni, Mwembeshi, Mwomboshi and Kalwelwe), Pre and Primary Schools in (Makeni, Mwomboshi, Mwembeshi and Kalwelwe), So far the creation of the five settlement villages in the rural areas has enabled Makeni Ecumenical Centre Establishment to settle 270 families, a population of about 2000 people. The General Clinic at the Centre (Makeni Clinic) now serves a catchment population of about 21,000 people. 20% of the population are children under the age of five and attend under five clinic. The clinic also attends to about 10,221 people on average per month. The average expected pregnancies are 5.4%, average expected births are 5.2%, average women in child bearing age is 22% average population below 15 years is 48% and the average population above 15 years is 51.2%. The Family Planning Clinic (Makeni) too serves the same catchment population of 21,000 people. The Static clinic attends to 600 clients per month on average. Mainly the use of injectables is on the increase as compares to the pill. Condoms are not a preference apart from a small percentage of the clients, hence few clients on double protection. The Centre also has an Orphanage Project (St. Nicholas Orphanage) taking care of children whose parents have died of AIDS. The number of the children kept at the orphanage is 30. The 30 children are totally dependent on the Centre for everything in their livelihood. 2. STATEMENT OF NEED HIV/AIDS prevention within the communities has become very critical especially in each and every household in the society. Issues of concern pertaining to this problem situation are safe-motherhood, Family Planning, Sexuality, Sex Education for Adolescents, Venereal Diseases, HIV/AIDS Counseling, Prevention of Sexual Violence and the Provision of Support to such victims. IN any case, even with the existence of Makeni and Family Planning Clinics and the other clinics in the rural areas with the Makeni Ecumenical Centre, most people are not adequately catered for on most aspects of HIV/AIDS prevention due to limited health services and high catchment population. It is therefore proposed that a Peer Educators training course be conducted as soon as possible so that most members of the communities will be better catered for in the promotion of effective health services and in turn enable them to move from being simply passive recipients of care to more active participants in such health programmes through empowerment. It is also hoped that as part of their process of empowerment, some Peer Educators will be able to train fellow community members in their communities as peer educators too. More still, the Family Planning Clinic at the Centre is not able to cope with the pressure of work due to inadequate staff. The inadequate staffing is due to lack of funding as the clinic is purely dependent on the Centre for all its operations. There are only two nurses to run the project and carry out field work too. One nurse remains to run the static clinic while the other goes on mobile. Once a week a Medical Doctor comes to the clinic to attend to contraceptive complications, infertility problems and any other gynecological problems. Also evident is the crude deathrate which has increased very considerably over the past one year. Average deaths range from those aged between 1 – 35 years. The catchment population of Makeni alone dropped from 36,000 in 2000 to 21,000 in 2001, and one of the major contributing factors to the deaths being AIDS related complex. It is therefore very apparent that most communities in whatever set up in Zambia should have a well tailored programme on HIV/AIDS prevention implemented which will ensure an anticipated reduction in their crude death rate. 3. PROJECT PROPOSAL GOALS i) ii) iii) 4. 5. To identify members of the public from the communities to do Peer Education training on matters related to HIV/AIDS prevention (Reproductive Health Care). To create more awareness among the communities on the prevention measures of the killer HIV/AIDS pandemic. To empower every member of the community through Makeni Ecumenical Centre conduct Community Based Care Services on HIV/AIDS prevention. OBJECTIVES i) To equip the Peer Educators with technical teaching skills in order for them to facilitate Health Education and Focus Group Discussion Sessions at community level related to: a) Family Planning and Contraceptive Services b) Sex Education for adolescents c) STDs/HIV/AIDS d) Maternal Care e) Sexual and Gender Violence f) Gynecological Services ii) To equip the Peer Educators with counseling skills in order for them to deal with problems to HIV/AIDS prevention in the communities. ACTION PLAN i) ii) iii) To conduct a course on HIV/AIDS prevention at basic level to Peer Educators. The Course will cover main aspects of Reproductive Health Care. To carry Focus Group Discussions in order to sensitize the communities on matters related to HIV/AIDS prevention. a) Practical skills on Focus Group Discussions in relation to Sexual Health Care. It is anticipated that with the creation of the HIV/AIDS Prevention Project at the Centre, the target groups i.e. adolescents, women etc will on weekly basis conduct Focus Group Discussion Session on Reproductive Health Care to interested parties from the various communities within the Makeni Ecumenical Centre and the rural areas. To provide counseling sessions to needy parties on matters related to Reproductive Health Care/HIV/AIDS Prevention. iv) Considering how essential counseling services are to particularly the needy groups in the communities, it is abundantly clear that the HIV/AIDS Prevention Project will have the immediacy the communities to persons in need of such services. To evaluate the impact of Peer Educators on HIV/AIDS Prevention Project Services in the communities at the end of the programme. Three types of evaluation methods will be used for the many target groups to assess the real problem situation among the beneficiaries of the Peer Educators on HIV/AIDS Prevention Project. Both qualitative and quantitative methods of evaluation will be used. However an impact evaluation will be conducted too. 6. MONITORING Both Peer Educators trained and the programmes they will be involved in will be regularly monitored. In this regard on-going assessment will be conducted. The two activities will be assessed thus: a) TRAINING FOR PEER EDUCATORS All trainee Peer Educators will be assessed at the end of the training programme. The assessment is expected to cover both the knowledge and the communication skills they possess in conducting sessions on HIV/AIDS prevention. B) PROGRAMME ACTIVITIES The Peer Educators will be required to fill in a form detailing their monthly activities or sessions conducted on HIV/AIDS prevention. The form filled in will address the following: i) KNOWLEDG - Acquired by clients ii) ATTITTUDE - Negative/Positive Observed iii) BEHAVIOUR - Any Positive Change Towards HIV/AIDS Prevention. It is expected that the HIV/AIDS Prevention Project Manager will be conducting field trips in the communities around Lusaka and the rural areas where the Peer Educators will be conducting sessions. By conducting such visits, the Project Manager will then be in close touch with some clients encountered by Peer Educators who may need immediate attention. As a way of strengthening the referral system, Peer Educators will through their Project Manager refer cases to the nearest clinics within the catchment areas of their operations. Monitoring forms of HIV/AIDS Prevention Project Peer Educators activities will be submitted twice a month to Makeni Ecumenical Centre HIV/AIDS Prevention Project. However, all programmes will coexist with the other projects to ensure an easy monitoring system. The HIV/AIDS Prevention Project Manager will be required to implement his/her activities at the same hieracal level as the rest of the other managers and should therefore report to the Makeni Ecumenical Centre Personnel and Administrative Manager who later reports to the Executive Committee who report to the donors. Hence the monthly progress reports on HIV/AIDS Prevention Project activities will be submitted once a month to the Makeni Ecumenical Centre Personnel and Administrative Manager. 7. THE BUDGET A. Training course for Peer Educators i) Stationery @ 50,000 ii) Transport @ 4,000 iii) Food for 42 Participants iv) Guest Speakers @ 30,000 B. X X X 10,000 X 10 Days X 15 Sessions X 10 Days Sub Total Agency Operational support for Peer Educators at Community Level i) Educational Materials for 4 months ii) Communication Costs for 4 months iii) Stationery for 4 months = = = = = 500,000 1,680,000 4,200,000 4,500,000 10,880,000 = = = 1,100,000 1,070,000 1,150,000 iv) 8. Purchase of Handouts for the Chronically ill for 4 months Sub Total Sub Total (A) + Sub Total (B) 10% to cover Institutional Overheads + Grand Total = = = = = 2,000,000 5,320,000 16,200,000 1,800,000 18,000,000 PROJECT SUSTAINABILITY Given that the project will be implemented with the established system of the Makeni Ecumenical Center, and that the Peer Educators themselves from the communities will be key players in the implementation of the HIV/AIDS Prevention services, this particular project is viable and sustainable.