engagement of recipients of care -...
TRANSCRIPT
Engagement of Recipients of Care
Stella Kentutsi
Executive Director, NAFOPHANU
National Forum of People Living with HIV/AIDS Networks in Uganda
March 29, 2019
Lusaka, Zambia
• RoCs-centered
• Meaningful
• Consistent
• Transparent
• Structured
• Equity
• Supported
• Practical
• Accountability
The CQUIN Learning Network 2
Principles of Community Engagement
A structured, supported, meaningful and accountable process that ensures that people living with HIV have a seat and a voice in decision-making, planning, implementation, monitoring and evaluation in order to achieve access to and utilization of quality HIV care for all.
The CQUIN Learning Network 3
Definition of Community Engagement
• Following GIPA/MIPA principles✓ Greater involvement of people living with HIV&AIDS
✓ Meaningful involvement of people living with HIV&AIDS
• Following national, sub-national and community levels
• Following DSD context
The CQUIN Learning Network 4
Levels of Engagement
The CQUIN Learning Network 5
Levels of Engagement
• Community/sub-national/national involvement has both bottom-up and up-bottom approaches
• The CQUIN dashboard community engagement domain gives the highest score to countries in which RoC belong to the national TWG, have a seat and a voice... is this sufficient?
The CQUIN Learning Network 6
Involvement: Community and DSD
Representatives from the community of people living with HIV (PLHIV) and civil society organizations (CSO) are not involved in any activities related to DSD and there are currently no plans to engage these groups
PLHIV and CSO are not currently engaged in DSD activities, but engagement is planned or meetings and discussions are ongoing
PLHIV and CSO are meaningfully engaged in DSD implementation
PLHIV and CSO are meaningfully engaged in implementation and evaluation of DSDmodels
PLHIV and CSO are meaningfully engaged in implementation and evaluation of DSD, as well as oversight of DSD policy (e.g., via inclusion in DSD task force or other group) 7
The CQUIN Dashboard: Community Engagement Domain
• How
• Why
• When
• What
• To what extent?
The CQUIN Learning Network 8
How engagement has been and what’s needed
• Community resource persons, known by different names, are volunteers at facility and
community levels (buddy system). Play various roles.
✓ Receiving and registering peers at facilities
✓ Stigma reduction, as peers are more comfortable dealing with each other
✓ Follow up on colleagues, returning lost to care, home visits, referrals and linkages
✓ Counselling
✓ Health education talks
✓ Drug distribution at facility and community refills
✓ Adherence/treatment buddies
✓ Screening for TB
• Need formal recognition and support both financial and technical to facilitate their work
The CQUIN Learning Network 9
Community Engagement through Peer-to-Peer Support
The CQUIN Learning Network 10
Investing in RoCs
IPs MOH
Funding has been largely to MOH and IPs, creating a disconnect between the two and the RoCs who just remain beneficiaries.Deliberate funding for ROCs must be undertaken.
ROCs
MOH
IPs
Now What we want to see
2-way to meaningfully contribute to DSD
• Have formal structures from village to district level for partners to find a stable team to work with and irrespective of DSD model, fall-back for people living with HIV at community level to belong
• Coordination meetings that bring all RoCs together at community, district and national level, part of feedback mechanism
The CQUIN Learning Network 11
Coordination
The CQUIN Learning Network 12
Advocacy
Who is going to make noise for
you?
• Most of the trainings have been dedicated to health workers,
so targeted capacity building for RoCs to support DSD
service delivery needed
• AIDS/TB competency training, to address their knowledge
gaps to serve RoCs better. • Could use the Support Appreciate, Learn and Transfer (SALT) model;
stage by stage appreciation and scoring of how much one knows and does
The CQUIN Learning Network 13
Capacity-Building
Community dialogues have brought together people
living with HIV and those affected; duty bearers,
service providers, beneficiaries, CSOs/CBOs,
FBOs, cultural leaders at decentralized and national
levels
The CQUIN Learning Network 14
Community Dialogues
• RoCs need simplified tools to monitor service delivery• For instance, NAFOPHANU and members monitor stock
levels/stock-outs on a monthly basis
• Should be part of teams to supervise and share experiences of what they go through
The CQUIN Learning Network 15
Monitoring, Evaluation, Tracking
• RoCs should actually carry out research and should not be just subjects of research!
• In Uganda and other countries, RoCs have provided data to guide planning through the PLHIV Stigma index and Community score card (beneficiary satisfaction surveys)
• Knowledge dissemination
• Message development
The CQUIN Learning Network 16
Implementation Research
• Participation in Policy formulation, implementation
and review, e.g. in Uganda, supported Uganda AIDS
Commission to develop the first ever national Anti
HIV stigma and discrimination policy
• The development of other guidelines, SOPs and other
manuals targeting PLHIV as RoCs must involve them
The CQUIN Learning Network 17
Policy Issues
• We want to see a more resilient constituency of PLHIV, placed at the center of the
response, if we are to close the gaps
• A complete strategic framework for PLHIV involvement, at the epic of the
decision making, at all levels
• Challenges affecting PLHIV must be addressed; drug stock outs, stigma &
discrimination, rights’ violations, poverty, nutritional gaps
• Integration and alignment must be seen (walk the talk!)
• Involvement as programme designers, planners, implementers and evaluators
• Investment that is deliberate to make RoCs strong partners in the HIV/TB
responses
The CQUIN Learning Network 18
Moving Forward / Next Steps
The CQUIN Learning Network 19
Thank You!