AIDS Widows and orphans Education Support Organization is a Christian child focused relief and development non - governmental organization working with communities in Uganda to promote social transformation, human dignity and self reliance. AIDS Widows and orphans Education Support Organization is registered as a Community Based Organization (CBO) in the districts of Kamuli and Buyende. AIDS Widow
s and orphans Education Support Organization has Magada Ronald as its founder in 2003. Actual operations started in 2004. AIDS Widows and orphans Education Support Organization -AWOESO began as a simple act of compassion which has become one of the national voluntary organizations. In early 2000’s they were moved by increased number of marginalized children in Uganda as a result of AIDS scourge and poverty. He established AIDS Widows and orphans Education Support Organization to assist the children in cooperation with some churches in Uganda
With a vision of “securing a future for the most vulnerable children”, the following have arisen as the core values of the organisation:
• We are committed to the poor
• We are responsive
• We value people
• We are stewards
• We are Christians
As such the mission of the organisation is to contribute to the economic growth of Uganda through orphan education support and self sustenance skills provision, Transform and Change the lives of Marginalized children. In order to attain the aforementioned mission, the following are our corporate objectives:
To help children who are marginalized by HIV/AIDS, conflicts, domestic violence and abuse of their rights. To assist children who Are members of AWOESO to acquire skills, knowledge and resources to enable them to take care of their mental, physical, reproductive and nutritional health. To provide basic necessities of life to the AWOESO children
To provide counseling services to mentally and physically traumatized children. To develop appropriate health education programs and facilities for members and potential members of AWOESO. To care for the HIV/AIDS orphans by providing the basic necessities of life. To set up income generating projects for AWOESO children. To fight and protect the rights of the Ugandan children. To sensitize Ugandan parents to raise their children as responsible people and to give them the respect they deserve
AIDS Widows and orphans Education Support Organisation recognizes children as a gift and heritage of communities. Children however, are the most vulnerable victims of underdevelopment, conflict and disasters. AIDS Widows and orphans Education Support Organisation believes that the most way to care for children is through their families and communities. Long term solutions to poverty enables local people take responsibility for the future of their children. AIDS Widows and orphans Education Support Organisation supports communities to establish long term community based area development programmes that benefit children and families and entire communities. AWOESO’s approach is to work in partnership with people in communities themselves to realize their skills, resources and potential to overcome the forces of poverty and underdevelopment. Community development workers are catalysts living within the community and support the process of change towards a better life. Through community meetings, they enable the people to identify their most critical problems and find the most critical problems and find other most practical and sustainable solution. The aim is to increase the capacity of the people to be self reliant by dealing with the causes of poverty as well as the symptoms. As a child focused organizations, AIDS Widows and orphans Education Support Organisation recognizes that every child regardless of s*x, race and creed has certain basic rights. These included the right to education, health care, safe water, safety and security, childhood etc. AIDS Widows and orphans Education Support Organisation plays a very important role of advocating for the rights and the protection of the vulnerable and voiceless children in Uganda. This is done in close collaboration with the government, communities where we work and other NGOs. AIDS Widows and orphans Education Support Organisation recognizes that there are tremendous resources available in Uganda. Through the national resource development programmes AIDS Widows and orphans Education Support Organisation aims at empowering communities to recognize and enhance other resources available and utilize them for sustainable development. Resource development is an important development tool that AIDS Widows and orphans Education Support Organisation believes can be used to encourage the creation of wealth to the advantage of all people regardless of their stars. AIDS Widows and orphans Education Support Organisation believes that all people have an important contribution. AIDS Widows and orphans Education Support Organisation started its official operation in Uganda in 2003 at a community level and the organization is now supporting over four projects in Kamuli Districts. Due to the increased number of marginalized children in Uganda, the organization has also started its extension in her services to Jinja. AIDS Widows and orphans Education Support Organisation is involved in Health care related programmes which serve to reduce child mortality through immunization against killer diseases, providing public health education and training community health workers and traditional birth attendants, HIV /AIDS education, awareness, training, counseling and prevention. Supporting community based interventions for orphans by providing agricultural rehabilitation, counseling, and skills training. Skills training for women and youth to enable them increase incomes and become self reliant. These are skills of tailoring, carpentry, crafts making, brick making, brick laying and other small scale cottage industries. Environment conservation education and activities including tree planting, improved cooking facilities and conservation friendly agricultural practices.
1.1.4 Situation analysis and problem statement
Uganda faces a generalized HIV epidemic. Since the onset of the epidemic in the late 1980s, a cumulative total of over 2 million people have contracted HIV. An estimated 900,000 Ugandans have died as a result of the disease. Prevalence is higher in urban areas (10.7%) than in rural areas (6.4%). In regard to the epidemic, Uganda has a very high level of political commitment and awareness at all levels and the comprehensive national response has led to a reduction in HIV prevalence from 18% in 1992 to 7.0% in 2005. The government has provided free antiretroviral drugs (ARVs) through the public sector since 2004. Yet, of the estimated 114,000 people who need immediate access to ARVs, only 63,896 are receiving them.1
Whereas the Ugandan government and civil society has made tremendous progress in combating the epidemic, the impact of the scourge is extremely hard on the individuals affected and their families. The actual services provided to Children Living with HIV/AIDS (CHA) are mainly centered in the existing health care facilities and the few NGOs in the Districts. Access to these facilities by the population is low due to their scattered nature with big gaps of non-coverage. Interventions in this area need to be supported and made more accessible uniformly throughout the country.2
It is widely recognized that grater involvement of CHA results in more appropriately designed and relevant programs and policies, greater access to services for those infected and affected by HIV/AIDS and decreased stigma and discrimination through improved understanding of the CHA experience. Greater involvement of CHA also results in decreased isolation, peer support and increased knowledge of – and ability to cope with – one’s condition, greatly improving the quality of life of HIV + individuals. Re-integration into society as a productive and contributing member is facilitated through better knowledge of and access of material, economic and educational support specifically targeting CHA and their families.3
It is for the above reasons that AWOESO intends to establish the “Rejuvenating the voice of People Living with HIV/AIDS (PHA)” project. The project is essential to enhance amelioration of the plight of the vulnerable patients. AWARE: of the scope of work ahead of us and the enormous challenges posed;
REALISING: that it is through collaborative efforts that we can save the rest of the human kind;
COGNISANT: of the fact that our relationship with nature and the rest of mankind is a stewardship;
RECOGNISING: the meager resources at our disposal;
BELIEVING: that the contribution of people and organizations of good will in general can ameliorate the situation;
AWOESO launches an earnest appeal for funding in order to make a tailor-made holistic intervention of building a process of involving all measures set and sustained at the community level to improve the quality of services provided to CHA so as to ascertain life longevity, achieve independence, social integration and a better quality of life for HIV/AIDS patients.
2.0 PROJECT LOCATION & JUSTIFICATION
Target population
This project is targeting CHA in our operational district of Kamuli. The project is justified by the following reasons:
Office:
AWOESO has its headquarters in Kamuli and field offices in most of our operational areas(Jinja inclusive) that shall help in ensuring proper and effective co-ordination of all the project activities. Effective supervision and monitoring shall be ensured since proximity to the target community and consequently the beneficiaries is very easy. Suffice to note that this location is part and parcel of the catchment area targeted by this project. Goodwill:
From the preliminary surveys done, AWOESO enjoys the goodwill of the public owing to the corporate image we have created for the little time we have been in operation. The implication here is that we have the support of the local population, the local council executives and the district administrations in the proposed project areas. These structures are very crucial in the implementation of any development intervention. Letters of support are indicated in the annexes. (iv) Call for humanity:
Based on the principle of humanity, AWOESO finds it appropriate to respond to the needs of the needy in the aforementioned districts with a view of alleviating their suffering as mentioned earlier. AWOESO was born of a desire to provide assistance to the very needy people affected by HIV/AIDS and alleviating their plight. It is for this reason that the organization establishes links with organizations of goodwill in order to package the livelihood of the very needy. Complementing efforts:
AWOESO is cognizant of the role other stake holders including the central government, local authorities and other agencies have played in addressing the AIDS pandemic in the country. Besides, given the gaps that have appeared (as has been mentioned in the situation analysis), AWOESO justifies this project as a means of providing a unique intervention to compliment efforts of other stake holders in order to ensure a holistic strategy towards improved health conditions of the people in the district. (vi) Strong organizational base:
AWOESO is a strong organization, with management structures in place, a technical team based in Kamuli and clear separation of powers. In field offices, technical officers and locally elected community members shall comprise the management organs of the organization, which shall ensure collective responsibility in any management decisions made. (vii) Collaborative network:
As already noted, AWOESO enjoys a good collaborative network with the local folks, LCs and the district administrations. Further collaboration exists with the Ministry of Health and other relevant agencies. This network shall ensure successful implementation of the project activities.
3.0 DEVELOPMENT OBJECTIVE
To build a process of involving all measures set and sustained at the community level to improve the services provided to CHA so as to ascertain life longevity, achieve independence, social integration and a better quality of life for HIV/AIDS patients.
4.0 IMMEDIATE OBJECTIVES
To conduct baseline surveys for the people and households affected by HIV/AIDS in the operational areas;
To undertake training of trainers as well as developing a well co-coordinated programme to improve the quality of life of HIV/AIDS patients;
To strengthen coordination and linkages among stakeholders and implementing agencies in the management of HIV/AIDS;
To mobilize and allocate adequate resources for management of HIV/AIDS and ensure judicious utilization of such resources;
To develop through community awareness positive attitudes towards HIV/AIDS patients;
To promote self reliance and integration of HIV/AIDS patients in the mainstream of community life, particularly targeting the nutritional aspect in the management of HIV/AIDS;
To develop a referral network within the existing systems so as to avail services to HIV/AIDS patients;
Building the capacity of home based care providers and community health care providers in care techniques and strengthening collaboration among service providers at all levels;
Reviewing and disseminating guidelines for home-based care and clinical management of HIV/AIDS and monitoring implementation on an on-going basis;
Building the capacity of health training institutions in providing HIV/AIDS management, education and training;
Promote palliative care;
Research and development;
Institutional development;
Monitoring and evaluation.
5.0 STRATEGY
5.1 General strategy
The general strategy for implementing this collaboration is further reduction of self, family and societal stigma through individual, couple and family counseling, promotion of counseling in all sectors of society, Voluntary Counseling and Testing Services, dissemination of clinical case definition for AIDS, dissemination of HIV associated risk factors and referral for VCT as well as equipping workers in government and private institutions with knowledge and skills in HIV diagnosis (clinical, laboratory and epidemiological). Palliative care will be promoted at the community and family level coupled with management of opportunistic infections and mother to child HIV infection.
5.2 Technical Approach
The "Rejuvenating the voice of children living with HIV/AIDS" (RVCLHA) program is an innovative model designed to increase access to HIV/AIDS prevention, care, and treatment through the strengthening of networks of service providers and PHA (Persons Living with HIV/AIDS) associations. The RVCLHA project will strengthen the "network model" of HIV/AIDS services currently used in Uganda. The "network model" utilizes central medical centers (CMCs) staffed by doctors and nurses as hubs which support satellite centers and mobile units, with varying levels of medical expertise as treatment moves from urban to rural communities. The model employs prevention, care, and treatment components and taps networks of government hospitals and clinics, non-governmental organizations, and faith-based organizations (FBO). The RVCLHA project will assess, capacitate, and provide resources to networks of PLWHAs and associations. AIDS Widows and orphans Education Support Organisation (AWOESO) is the primary management and implementing organization. The National Forum for People Living with HIV/AIDS is a primary partner in the RVCLHA project. AWOESO has provided services in Uganda since 2001.
5.3 Strategic actions
5.3.1 Conducting a baseline survey for the people and households affected by HIV/AIDS in the operational area
Proper service delivery ought to be preceded by having accurate data and information as pertains to the needs and priorities. Besides having the general situation analysis, it is important to identify families affected by the HIV/AIDS pandemic such that service delivery is holistic and tailor made for the target beneficiaries. Their own participation in the design of the intervention mechanism is crucial. Key activities shall include:
Designing the terms of reference
Selecting the lead investigators
Developing the research instruments
Training research assistants
Conducting field surveys
Holding participatory workshops
Analyzing data
Dissemination of findings
Using the findings to refine the mitigation strategies
5.3.2 Undertaking training of trainers as well as developing a well co-coordinated program to improve the quality of life of HIV/AIDS patients
Key actions shall include:
Training needs assessment and designing of trainers manuals
Development of HIV/AIDS kits
Holding training of trainers programs
Supporting local trainings
5.3.3 Strengthening coordination and linkages among stakeholders and implementing agencies in the management of HIV/AIDS
There are many institutions and organizations that provide HIV/AIDS programs both in management and prevention. There is latent potential for the involvement of many more, as the response becomes broader. However the problem is inadequate coordination among stakeholders on issues of programme planning, implementation and monitoring to optimize resource utilization and improve the impact of programs. Major Actions
Establishing an effective machinery to coordinate the work of stakeholders in the management of HIV and AIDS at all levels. Strengthening, in particular, the coordination of Health care delivery institutions and organizations at grassroots levels, including community groups and individual efforts. Instituting policy and mechanisms for referral arrangements between hospitals and community groups in the management of HIV/AIDS.
5.3.4 Mobilize and allocate adequate resources for management of HIV/AIDS and ensure judicious utilization of such resources
Care for the sick always leads to depletion of resources in the family including those belonging to the sick. The caregivers also experience physical and psychological fatigue and hence give reduced attention to other economic activities, which would boost the depleted resource base. Major Actions
Develop guidelines for allocation and utilization of resources for HIV/AIDS management activities. Develop capacities of communities and institutions to mobilize and allocate resources for HIV/AIDS management. Empower national, district and area level structures to support facilitate and monitor the process of resource mobilization and utilization at community level. Advocate for resource support from public, private, NGO, religious and other institutions to support HIV/AIDS management efforts at individual, family and community levels.
5.3.5 Develop a referral network within the existing systems so as to avail services to HIV/AIDS patients
The potential of this project rests in building a strong collaborative network to execute the assignment. Key actions include:
Facilitating stakeholders meetings/workshops/seminars
Developing a framework of operation
Establishing a follow-up mechanism
Dissemination of lessons learnt using a multimedia approach
5.3.6 Involve HIV/AIDS patients, their relatives and the community in planning and implementing HIV/AIDS mitigation programs
Major actions
Support the establishment of Community Care Committees
Facilitate the operations of the committees
Develop a strong collaborative network for purposes of sharing information and building expertise in care and management of HIV/AIDS
Support and strengthen community self help groups to provide services to other people living with HIV/AIDS (PLWHA), act as an intermediary between the PLWHA and relatives, conduct HIV prevention and mobilization among non – infected and non – affected people, ensure proper division of labour with health care professionals and for advocacy and lobbying.
5.3.7 Promoting self reliance and integration of HIV/AIDS patients in the mainstream of community life, particularly targeting the nutritional component in the care and management of HIV/AIDS
The major strategy adopted in this regard is to economically empower the families affected. We propose a revolving loan scheme that supports the development of Small Medium Enterprises (SMEs). The loan shall help these families have some income security to cater for expenses related to caring for the patients. Major actions
Product development to operationalise the loan scheme, particularly targeting food security and proper nutrition in the management of HIV/AIDS
Management of the scheme at cost recovery basis
5.3.8 Build the capacity of home based care providers and community health care providers in care techniques and strengthening collaboration among service providers at all levels
The quality of care of patients is a major factor in impact mitigation. The current problems include lack of capacity, negative attitudes towards CLWAs, inefficient referral systems and inadequate resources including essential drugs and related supplies. Major Actions
Support the development of positive attitudes among clinical and home-based care-providers towards HIV positive persons and AIDS patients as a basis for effective care and support. Develop mechanisms that ensure availability of drugs, protective materials and other essential facilities for effective management services. Training on HIV/AIDS Comprehensive care package. Train locally available medical personnel on current HIV/AIDS therapy. Provide the rapid screening Kits
Hire a consultant to develop the customized care packages & treatment guidelines
Provision of treatment guidelines for ARVs, treatment of opportunistic infections.
5.3.9 Review and disseminate guidelines for home-based care and clinical management of HIV/AIDS and monitoring implementation on an on-going basis
Major Actions
Hire a Consultant to develop the dissemination guidelines and clinical management notes
Support the production of the final documents
Produce translated copies of the said documents
Conduct workshops and seminars for the dissemination campaign
5.3.10 Build the capacity of health institutions in providing HIV/AIDS management education and training
Major actions
Hold courses of clinical management of HIV/AIDS
Provide financial and logistical support geared at promoting training and supervision
Support the establishment of a referral web
5.3.11 Promote palliative care
The major strategy will be to integrate palliative care with other home based care approaches in order to achieve the best quality of life for patients (and their families) suffering from HIV/AIDS. Crucial elements are the relief of all pain – physical, psychological, spiritual and social and enabling and supporting caregivers to work through their own emotions and grief. Key actions include:
Pain relief
Treatment of other symptoms such as nausea, weakness and fatigue
Psychological support
Spiritual support and help with preparation for death
Support for families and carers-help with nursing and infection control.
5.3.12 Undertake community led OVC services
The overall goal of this component is to provide protection, care and fulfillment of the rights of orphans and other children made vulnerable by HIV/AIDS in Northern Central Uganda.
5.3.12.1 Objectives
To ensure that education and learning opportunities are provided to orphans and vulnerable children
Improve food security and nutrition as well as energy/cooking security in the households of Orphans and Vulnerable children
To improve health and social services for Orphans and Vulnerable children
Increase access to adequate shelter to Orphans and Vulnerable children
To train all teenage Orphans and Vulnerable children in Life Skills
To protect Orphans and Vulnerable children from all forms of abuse
To ensure that Orphans and Vulnerable children have access to psycho-social support systems
5.3.12.2 Broad Activities
Education: Covers areas of advocacy for registration of Orphans and Vulnerable children, access to education, including inclusive education; provision of bursaries, scaling up of the school-feeding programme; and create a conducive environment to attract and retain children in school as well as their teachers. Food Security and Nutrition: Addresses nutrition and related education, procurement of garden tools and seeds for home gardening, and mobilization and training of communities on crop sharing
Access to health services: Establishment of health insurance system for Orphans and Vulnerable children. Adequate Shelter: Addresses mobilization, sensitisation and training of communities on orphan care and support; construction of facilities that will temporarily provide relevant and appropriate options and arrangements that will cater for orphan shelter, protection and care. Procurement of energy saving cooking devices and training on their proper use. Life skills training: Empowerment of teenage Orphans and Vulnerable children to make informed choices and decisions about life. Child protection: Covers children and community sensitization, and establishment of support groups for counseling. Psychosocial needs: Covers training of community based personnel and agencies on counseling. Support to carers, including extended families looking after orphaned children. Home visits to OVC households. Youth-to-youth counseling and support. OVC support integrated into home-based care for the sick. Gardening, for nutrition and social integration of OVC. Material support provided by neighbours and other community members. Spiritual support and counseling. Income-generating projects. Provision of school fees, uniforms and school supplies. Establishment of community schools. Life skills education, including HIV/AIDS/STI information and awareness. Referral services to public sector agencies - such as social welfare and health. Advocating on behalf of children - such as on issues of school fees, rent, legal issues, s*xual and physical exploitation, involvement of the police. Assistance with 'succession planning' - such as memory books, wills and inheritances.
