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(i) PROGRAMME ACHIEVEMENTS
(a) Project Management and Financial System
Most Provinces have put administrative systems in place. Provincial HIV/AIDS offices have been established with HIV/AIDS Programme Coordinators. Programme structure and implementation have been institutionalised in most of the Provinces.
(b) HIV/AIDS Strategic Plans
Most of the Provinces have developed and are implementing National HIV/AIDS Strategic Plan. Some have their strategic plans printed and distributed while a few are yet to do this. Some Provinces are in the process of renewing their strategic plans for another period. The strategic planning process has enhanced programme ownership within the Provinces.
The Episcopal Church of Sudan on the other hand has yet to start their HIV/AIDS programme as a Province. Sudan will need help from coordinators of closer Provinces like Uganda and Kenya to support them in programme implementation.
(c) Programme Activities
HIV/AIDS intervention has expanded within the Provinces during the last four years (2002-2005). There is significant increaase in the number of Dioceses actively involved in HIV/AIDS activities. Some of the activities the Provinces are implementing include:
- Prevention through youth programmes and community awareness;
- Leadership training at various levels of the Provinces;
- Care and support for PLWHA/PABA, referral for ARVs, treatment of opportunistic infections, VCT services and home-based care for OVC and PMTCT services;
- OVC activities such as material provision, education support and vocational skills.
(d) Leadership
Over the period of 2001 to 2005, there has been an increase in Church leadership involvement and commitment in HIV/AIDS activities as well as ownership of the programme. This is attributed to National/Provincial leadership meetings, conferences and training on HIV/AIDS. Some Provinces have held conferences on the role of Bishops and their wives in HIV/AIDS intervention.
Most Provinces have also held trainings for Diocesan coordinators of various departments, which include Sunday school and brigade, youth and mothers union. Many of these are mobilizing community members to utilize their local resources to support PLWHA. Some are engaged in working on reducing stigma and discrimination. As a result there is increased capacity on both Diocesan and Parish levels. Some Anglican clergy and church workers have started to come out to share their experience of living with HIV.
Knowledge of Church leaders on HIV/AIDS has built and increased leadership commitment on the fight against HIV/AIDS. The Church is now working with PLWHA to break the silence on HIV/AIDS in most provinces. Sermons are being preached on HIV/AIDS in various Provinces.
(e) Human Resources
CAPA has a pool of very experienced professional human resource as programme coordinators. The wealth of skills and experiences in each Province should be used to encourage and facilitate other Provinces who may be struggling especially those whose situation is exacerbated by years of unrest and war like Burundi, Congo, Rwanda and Sudan.
(f) HIV/AIDS Prevention
Training geared towards HIV prevention has been given to women, youth and PLWHA for dissemination and sensitisation of others. Youth programmes for peer educators, HIV/AIDS committees, focal persons and puppeteers have been started.
(g) Care and Support
Community volunteers and caregivers have been trained and are engaged in Home Based Care (HBC) activities. There are more volunteers coming up for training to work with the church on HIV/AIDS. Some of the activities in this area include:
- Care and support for orphans and vulnerable children;
- Training of PLWHA, medical staff and caregivers has been done;
- Training of focus groups including women, youth and PLWHA are done;
- Established of support groups for PLWHA;
- Increasing the number of community care and support groups;
- Work has been done in pastoral care, IGAs, and empowerment of women and orphans.
(h) Voluntary Counselling and Testing
- Voluntary Counselling and testing (VCT) centres are established;
- Training of Diocesan staff to provide VCT services is being done;
- Increasing the number of people visiting VCT centres.
(i) Partnership and Networking
Various Provinces work closely with other bodies and national governments and especially departments of health as well as some UN bodies in the fight against HIV/AIDS. Partnerships and networking provides opportunities for sharing, mutual learning and consultation. This reduces overlaps of activities and utilises lessons learnt from other implementers.
This has helped to achieve the following:
- Strong partnerships have been established with opportunities for sharing and learning from each other;
- Increased conversation around stigma and discrimination;
- New partnership have emerged such as between Anglican Province of Kenya and St. Paul Theological College where ACK clergy and church workers are encouraged to join a Masters Programme in Community Care and HIV/AIDS;
- Increased collaboration with other organizations with similar goals like MAP International.
(ii) PROGRAMME CHALLENGES
(a) National Context
Each of the Anglican Provinces operates in a unique and complex context. This context must be appreciated and understood in order to provide focused and relevant interventions. National contexts include varying cultures, traditions and practices, numerous languages, poor social-economic status and histories of conflicts and war. All these issues impact on the HIV/AIDS situation.
The settlement of returnees of young and unskilled people displaced by war must be carefully planned. This often results in massive displacement of people within the country who need support and basic services.
Other challenges that exacerbate the HIV/AIDS situation include:
- Long distant to services, inadequate or non-available services like in Sudan;
- Rape perpetrated by armed people or peace-keepers fuel the spread of HIV;
- Inadequate Government commitment n the fight against HIV/AIDS;
- Programmes in different dioceses and in different countries make programme implementation, monitoring and evaluation difficult;
- Rapid urbanization with the proliferation of slums exacerbates the situation of HIV/AIDS.
(b) Leadership
Some of the issues in leadership include:
- Lack of or varying commitment and involvement among Church leaders;
- Changes in leadership often interrupts programme continuity;
- Low level of involvement of Church leaders;
- Religious leaders are often reluctant to talk about sexuality and HIV/AIDS;
- Some Church leaders remain detached, silent, and inactive in addressing HIV/AIDS issues.
(c) Programme Funding and Sustainability
- Resource mobilization is difficult and funding for the different programmes is a big problem. Strategies should be put in place for sufficient funds especially in the face of growing number of Dioceses and need;
- Late disbursement of funds makes it difficult to monitor implementation and progress;
- High cost of control interventions, makes it difficult to sustain gains;
- The fluctuations in the foreign exchange rates;
- Inadequate funds paused a great challenge such as inability to provide food supplement to clients who needed nutritional support;
- Sustainability of programme due to short duration of programmes funding;
- Sustainability of the Diocesan HIV/AIDS desks;
- Unstable funding led programme avoiding long-term commitments.
(d) Human Capacity and Programme
- Deficiency in management practices (e.g. financial & record keeping);
- Major donors not funding Church initiatives to scale up their efforts for fear of inadequate accountability;
- Some Dioceses do not have skills for proposal writing and professional programme management;
- Inadequate manpower at the sites leading to increased clientele caseload;
- Inadequate capacity and skills among
- Clergy to effectively address HIV/AIDS.
(e) Documentation and Information
The capacity of the Church to respond effectively to the challenges of HIV/AIDS is depended on right and accurate information.
Challenges identified in this area include:
- Inadequate documentation and communication skills;
- Poor documentation of activities of the churchs HIV/AIDS activities;
- Lack of proper policies makes it difficult to influence government decisions on HIV/AIDS;
- Lack of guidelines on scaling-up of activities;
- Clash in timing and policies of churches and funding partners.
(III) LESSONS LEARNT
- The commitment of the clergy and Church leadership is crucial for scaling-up of HIV/AIDS activities;
- The success of Church based HIV/AIDS work is highly dependent on the involvement and support of Church leaders for programme ownership;
- Church leadership, programme staff and other stakeholder should be involved from the beginning of HIV/AIDS work. Enhancing ownership includes regular communication and updating stakeholders at all the levels of the programme;
- Involvement of HIV positive clergy helps to break the silence in the church while involvement of PLWHA in HIV/AIDS work at all levels contributes to the success of programmes;
- Policy development and Strategic plan for HIV/AIDS processes takes time;
- Understanding the cultures and traditional practices is essential for effective HIV/AIDS programme;
- Partnerships and networking opportunities within churches and other agencies in the field of HIV/AIDS are important for sharing and mutual learning;
- Need for comprehensive care approach i.e. medical and pastoral care as part of the essential needs for OVC;
- Anglicans go to other areas rather than their churches for VCT for fear of discrimination. The church should help to build trust and confidentiality with its members by addressing stigma and discrimination;
- There is need to continuously advocate for increased resource allocation for the development of church capacity and implementation processes;
- People going to VCT centres need assurance that they will receive care, support and treatment, which include drugs and nutritional support.
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