Shaloom Care House
webmaster 4. August 2012
INTRODUCTION
1.1 Background information
The project will be implemented by SHALOM CARE HOUSE of the Catholic Archdiocese of Mwanza, a faith based organization based in Mwanza-Tanzania
Shaloom Care House (SCH) is a faith based organization, operating under the Health Department of the Archdiocese of Mwanza. It was established in 1992 under the HIV prevention programme of the Archdiocese following the 1987 declaration of the Tanzania Episcopal Conference (TEC) to combat HIV/AIDS.
Shalom Care House provides services in Mwanza City for all, regardless of creed, nationality, tribe or color. Services offered by Shaloom Care House are extensive and include psychosocial support, health care, education and legal support to people living with HIV/AIDS (PLHA) and Orphans and Vulnerable Children (OVCs) and their families.
1.2 Vision Statement
A community free of poverty and HIV/AIDS, that respects, promotes and protects human rights including caring for people living with and affected by HIV/AIDS
1.3 Mission Statement
To bring a positive change in the lives of orphans and most vulnerable children and people living with HIV/AIDS through improving the quality of their lives and social-well being, facilitating the communities to provide care to OVCs and PLHA and recognizing the needs and rights of those already affected by HIV/AIDS
1.4 Core Values of Shaloom
Shaloom is guided by the central belief that reducing the spread HIV/AIDS and its impact on the livelihood of people is extremely important in helping AIDS-related orphans and PLHAs and their poor families to meet their fundamental rights and needs and become good members of the society.
1.4 Development Goal of SCH
To contribute towards reduction of poverty and the spread of HIV through working with the communities to develop and implement programme activities and strategies that prevents and mitigate the impact of AIDS epidemic in Ilemela and Nyamagana District of Mwanza Region in Tanzania
- PROBLEM STATEMENT
HIV continues to spread around Sub Sahara African. It has become increasingly apparent that the epidemic does not follow the same in all societies. It affects different sub-groups in different ways at different times. Tanzania has been struggling against HIV infection and AIDS for almost a quarter of a century while Shaloom Care House has been struggling for almost 21 years, but HIV has continued to spread and there was a dramatic increase in the number of AIDS cases as more HIV infected people succumbed to opportunistic infections arising from suppressed immune system. As in other sub- Saharan countries, HIV infection is spread predominantly by heterosexual contact
By the end of 2012 SCH was providing service to 1300 people living with HIVAIDS and more than 700 orphans and vulnerable children. The number of clients cared by SCH has been increasing daily due to the wide spread and high impact of HIV/AIDS in Ilemela and Nyamagana Districts of Mwanza city.
Special factors contributing to the wide spread and high impact of HIV and AIDS in Ilemela and Nyamangana District of Mwanza city include both social and economic factors. Economically, Mwanza as a fast growing city in Africa is a busy city with high mobile population due to petty trading, cotton farming, fishing industry, job opportunities, buses and trucks stop and many markets. Because of these factors there is a considerable level of migration for trade within the city and to the surrounding trade centers identifies as high HIV – Transmission area. These centers have increased social interactions and hence accelerated HIV and AIDS infections.
Furthermore, the growth in bars and entertainments in the city, trade centers and hardship life has encouraged the growth of prostitution. Traditional practices that encourage polygamy, early marriage and widow inheritance are among the additional factors promoting a wide spread of HIV and AIDS in the project operational areas. The results from the 2011-2012 Tanzania HIV/AIDS and Malaria Indicator Survey show that the HIV prevalence in Mwanza region is 4.2.
Overall, 5.1% of Tanzanians age 15-49 are HIV-positive. HIV prevalence is higher among women (6.2%) than among men (3.8%). HIV prevalence is higher in urban areas for both women and men than in rural areas.
A comparison of the 2007-08 THMIS and 2011-12 THMIS HIV prevalence estimates indicate that HIV prevalence has declined slightly from 5.7% to 5.1% among adults age 15-49. Similarly, HIV prevalence has declined among women, from 6.6% to 6.2%, and among men, from 4.6% to 3.8%. Therefore more effort is required to stop new infection through community mobilization, care and treatment for people living with HIV.
-
PROJECT RATIONALE
Much of the care for people with HIV and AIDS is provided at home by immediate family and friends, as well as by home based care organizations. Providing care for people with HIV and AIDS in the home has many potential benefits for both HIV infected and affected people, yet there are many failings in the support given to caregivers.
The core project activities at Shaloom Care House are Home based care service, care and treatment, prevention and care and OVC support program which include education support and health care for orphans and vulnerable children.
Shaloom Care House provides services to 1300 HIV and AIDS clients in the above list children are 101. The population of the clients cared is not proportional to the caregivers, the centre has only two nurse counselors who are permanently employed and 56 community care givers known as home based care volunteers. The guidelines of the Ministry of Health and Social Welfare of the United Republic of Tanzania state that each caregiver should not care for more than 15 clients. For the statistics given above the home based care volunteers for Shaloom Care House care for more than 20 clients.
Currently SCH hires a Medical Doctor from Sekou Toure hospital, the doctors comes only two times a week and he works only for four hours a week.
A potential benefit of home based care is that sick people are surrounded by people they love and are familiar with, so they can also receive more flexible and nurturing care. They will also not be exposed to hospital-based infectious diseases. As people with terminal illness generally spend their final moments at home, improving the quality of their care at home also removes the cost and distress of traveling to and from the hospital when they are weakest.
Furthermore, in being cared for at home, a person with HIV may be in a more ready position to work or look after family members for short periods of time while the primary earners work. The time the family would otherwise use traveling to and from hospital can instead be spent on house work and looking after other family members. Expenditure on transport and hospital costs is also reduced.
Home based care organizations in Tanzania are the other important care providers and consist of trained health workers or volunteers linked to a hospital, NGO or faith group, for example SCH make visits to people’s homes for perhaps one or two hours. We assist the client with much of the care provided by families including household chores and providing and cooking food, as well as performing more clinical tasks such as administering pain relief or medication. We also make referrals for more professional medical help.
Care and treatment is very important because without treatment nearly everyone with HIV will get AIDS. Currently Antiretroviral therapies have brought renewable hope for many people living with HIV. However they do not offer a cure. In this project effort will be put in treating opportunistic infections because when the HIV client is free from OI’s he/she may live longer because he/she will not get AIDS easily. Care and treatment is done at our centre or at patient’s home during home visiting.
The common opportunistic infections in our community includes; Pneumonia, skin infections, heperszoster, arthritis, bronchitis, UTI, worms, fungal infections, tonsillitis and STI’s
Despite of tremendous advances in care for human immunodeficiency virus (HIV) infection and AIDS treatment, morbidity and mortality due to HIV/AIDS in Tanzania remains unacceptably high. For example in 2012 the mortality rate for AIDS patients cared by SCH increased by approximately 100% .The reported death increased from 6 patients in 2011 to 14 patients in 2012. High mortality rate for HIV and AIDS patients in Tanzania is contributed by various factors including inadequate food supply contributed by climatically changes and economic instability which lead to food inflations. Most of our patients are just eating a single meal a day meanwhile they take ARV.
The study shows that food insecurity in Tanzania contributes to ARV non-adherence and treatment interruptions or to postponing ARV initiation: ARVs increased appetite and led to intolerable hunger in the absence of food, side effects of ARVs were exacerbated in the absence of food, some of AIDS patients believed they should skip doses or not start on ARVs at all if they could not afford the added nutritional burden and competing demands between costs of food and medical expenses led people either to default from treatment, or to give up food and wages to get medications.
One day I visited one of our clients who were serious sick; I asked her if she takes ARV regularly. She said “The most difficult or painful thing that I find about taking my medicine is when the time for taking medicine approaches and I don’t have something to eat. If I don’t have something to eat, then I don’t take my medicine until I have what to eat”
Therefore Shaloom Care House is seeking funds from different partners to improve our services we offer to our poor clients that we help in order to provide holistic and quality services to the clients. In this project emphasis will be put in;
-
Home based care
-
Care and Treatment
-
Mobile VCT
-
Technical support and human resources empowerment
-
PROJECT DESCRIPTION: PROJECT GOAL, OBJECTIVES AND LOGICAL FRAME WORK
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Project goal
To contribute toward reduced spread of HIV and AIDS through working with the community to develop and implement programme activities and strategies that mitigate the impact of AIDS epidemic in Ilemela and Nyamagana Municipalities of Mwanza city and to achieve the millennium Development Goals (MDGs) by 2025.
-
-
Project objectives
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To strengthen access and referral of appropriate health and other support services to PLHIVs around project area.
-
To reduce new HIV infections and HIV relates stigma through community mobilization around the project area.
-
To strengthen capacity of the Organization to implement and manage project activities effectively.
Activities
Shaloom Care House will implement activities to reach out to different audiences with different messages targeting PLHIV cared by the centre. This intervention will consist of integrated strategies such as service provision, referrals, and social support. Knowledge of status through counseling and testing will be an immediate goal of the PLHIV activities so as to ensure all those who test positive receive the required support in order to reduce the rate of new infections and improve quality of life by enrolling in appropriate treatment and support programs.
The projected timeline for implementation will be as from September 1, 2013 to August 30, 2014.
Objective 1: To strengthen access and referral of appropriate health and other support services to PLHIVs around project area.
-
Stakeholders Meeting: To introduce the new partners to the community, and seek their support and involvement in the planned activities, the project will hold a one day meeting of at least twenty (20) community members and stakeholders including but not limited to the local authority at village and ward level, HIV/AIDS committees (VMAC and WMAC) representatives, religious and community leaders, CBOS, NGOs, Health center/hospital leadership, community health workers and any other stakeholders in Mwanza city. A specialist in HIV/AIDS and stigma and discrimination from district medical department and the SHALOOM CARE HOUSE Coordinator will facilitate the one day workshops, to create awareness among the community on the project, and the planned activities.
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HBC refresher training: SCH has 56 trained home based care providers who need refresher courses to improve their performance. Therefore there will be a 5 day training facilitated by the Mwanza regional home based care coordinator from the Department of Social Welfare in collaboration with National AIDS Control Programme will facilitate the training. The training will focus on communication skills, adherence on ARV, Home based care service provision, management of opportunistic infections, knowledge of status through testing and counseling, nutrition, provider initiative testing and counseling (PITC) and stigma and discrimination education. The aim of the training will be to provide a refresher to the home based care volunteers , remind them of their roles and responsibilities to the community in order to provide holistic and quality services to the people living with HIV and AIDS in Mwanza.
-
HBC Service Provision: The trained HBC providers will provide care to bedridden PLHIV in accordance with Ministry of Health and Social Welfare guidelines. To ensure the HBC providers provide quality services to their clients, they will be facilitated with PHDP kits which contain protective gear, hygiene items, basic medication (following the national guideline), and these kits will be replenished as appropriate. To facilitate effective and efficient HBC provision and timely submission of reports to the project coordinator without distracting HBC provider’s day to day businesses. The project will purchase umbrellas, T-shirts for all the HBC volunteers. During home visits the HBC volunteers will keep and maintain proper documentation of their clients and items provided to clients during each visit. The project, therefore, will purchase counter books and adapt the visit record sheets for record keeping.
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Food and material support provision: The project will identify 200 people living with HIV cared by SCH who are absolutely poor to access this support. The identified clients will be given 5 kg of beans, 20kg of maize flour/rice and bars of laundry soaps, the program will be for monthly bases. To facilitate effective and efficient program the project will establish a data base for the beneficiaries.
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Home Based Care Monthly Meeting: The HBC volunteers will meet on a monthly basis to discuss their activities, the challenges faced, the successes they have had and plan for subsequent monthly activities. During these meeting, they will be required to submit their dully completed monitoring tools to their supervisors, who will use the data to compile HBC reports. The home based care monthly meetings will be conducted by the supervisors who will also use the time to provide technical assistance in identified areas of service delivery. The monthly meetings will also be used for provision of best practice, new information in the care and support setting, in order to increase the HBC provider’s knowledge and skills for addressing various technical issues pertaining to PLHIV. Some of the topics to be discussed will stem from questions raised by HBC providers during meetings, in order to be responsive to immediate needs of their clients. The home visit record sheets will be submitted to Shalom Care House staff during Home-based care volunteer’s monthly meetings. The project will develop monitoring tools including printed registers.
Objective 2: To reduce new HIV infections and HIV relates stigma through community mobilization around the project area.
6. Outreach HIV testing and counseling (HTC): The project will carry out mobile testing and counseling at fixed outreach locations to be determined by the management. The project will also encourage provider initiated testing and counseling (PITC) at the Centers. Mobile HTC will be conducted twice a month along the streets of Ilemela and Nyamagana Districts. The clients who test positive will be referred to the nearest CTC for further investigations and management and followed up by HBC care givers to ensure they receive the required services such as CD4 count, ART and home based care if needed.
The project will hire a nurse who will be in charge of the HTC services at the site and procure necessary equipment to facilitate mobile HTC such as field tents and a PA system to mobilize and entertain the audience during mobile testing and create a an enabling environment to encourage people to consider testing.
The project will prepare and procure VCT cards, Referral forms, and Registration book. The project target is to reach 3500 clients by the end of August 2014.
7. Care and Treatment. The Clients diagnosed HIV positive will be attended for further investigations and management. ARV will be administered to the clients with CD4 counts below 350 the rest will be given close follow up to insure they attend clinic regularly to check for CD4 counts and treating opportunistic infections.
The project will hire a Medical Doctor who will be a doctor in charge of the CTC services and procure necessary medications for opportunistic infections.
8. Community sensitization and mass education provision. The Project team will identify 6 people living with HIV who are very open about their sero status to be involved in this program; these PLHIV will be the role models. The identified clients will be contacted to seek their will of being the key resource persons of the program. These people will be providing HIV education by exposing their sero status publically. They will be visiting in schools, churches, and mosque and in public meetings. They will be in groups of two individual regarding to gender therefore there will be three groups each group will be having two resources persons, Male and Female. The project coordinator will be working together with each group in preparing meetings and visits, each group will conduct four meetings a month, targeted number of meeting is 130.
Objective 3: To strengthen capacity of the Organization to implement and manage project activities effectively.
9. Institutional capacity building: The Project Coordinator will provide ongoing technical and program support to all project activities. The project will offer a refresher training courses for home based care volunteers. The project coordinator will also facilitate recruiting of two medical personnel, a clinician and a nurse. The project will also be flexible to accommodate volunteers from abroad who medical specialists.
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Logical frame work
Project goal
Outcomes
Activities
Outputs
Time frame
To contribute toward reduced spread of HIV and AIDS through working with the community to develop and implement programme activities and strategies that mitigate the impact of AIDS epidemic in Ilemela and Nyamagana District of Mwanza city and to achieve the millennium Development Goals (MDGs) by 2025.
Strengthened access and referral of appropriate health and other support services to PLHIVs around project area.
-
Stakeholders meeting.
The stakeholder meeting which involved 20 participants has been conducted..
1st week of October 2013
-
HBC refresher training
5 days training has been conducted for 56 HBCV
1st week of November, 2013.
-
HBC service provision
HBC service has been provided to the targeted group.
October 2013 to September 2014.
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Food and material support provision
Food and other materials such as soap has been provided the targeted clients
Every month 1st of October to September 30th.
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Home based care monthly meeting.
HBC monthly meeting has been conducted.
Every month 1st of October to September 30th.
Reduced new HIV infections and HIV relates stigma through community mobilization around the project area.
-
Outreach HIV testing and counselling (HTC)
HTC has been conducted to 3500 clients.
October 2013 to September 2014.
-
Care and treatment
Care and treatment has been done for all registered PLHIV.
October 2013 to September 2014
-
Community sensitization and mass education
The community has been sensitized and mass education has been provided around the project area
Every month from October 2013 to September 2014
strengthened capacity of the Organization to implement and manage project activities effectively
-
Institutional capacity building
Institutional capacity building has been done.
1st to 2nd week of October 2013.
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PROJECT MANAGEMENT
Project management as perceived by the organization is a process through which project management team makes a stream of decisions and actions that lead to the development of realistic strategies, which guide the project to achieve its pre-determined objectives. The well balanced management team and proper management decisions are then seen as means to achieve planned project objective and activities.
The organization will manage the project. The management is very crucial since it enables managers to anticipate changing conditions, provide clear project objectives, co-ordinate well project activities and allocate limited resources, correctly.
The project management focus will be to identify PLHIV and provide them with psycho-social support, food, materials, health care, monitoring, co-ordination and integration of project activities and services with Government plans. The project management as its strategies, will constantly review progress of the project activities and make decisions and actions to redress noted inconsistencies and weaknesses
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MONITORING AND EVALUATION
The project monitoring and evaluation plan aims at proposing ways through which long-term and short-term changes in the lives of PLHIV will be tracked or measured. Long-term changes are the changes related to quality of life among PLHIV and their family members. Short-term changes are changes related to access to education and health care services, quality of care, capacity of PLHIV and access to psychosocial support among PLHIV and the community. The plan also aims at suggesting how the project will gather information and measure each of the quantified outputs/ progress indicators of the project. It will also suggest who will be involved in monitoring and evaluation.
5.1: Technical Monitoring and Evaluation of the Project:
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Conducting base-line surveys to collect data and information to establish a baseline status and bench mark that can be used in the mid-term and end of project evaluation.
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Routine Data Collection tools (with details of what information will be gathered, when and by whom) will be put in place and used by the project staff and trained home based care volunteers to collect relevant data and information on each of the quantifiable project output and progress indicators.
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Daily project activities will be monitored on a monthly basis; feedback sharing and planning meetings will be conducted to share information on the performance of the project.
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Monthly meetings with home based care volunteers will be conducted to collect information on the performance of the project.
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Quarterly and annual project review meetings will be held with key stakeholders including the health secretary of the Archdiocese of Mwanza to up-date each other and share data and information on the progress of project activities and plan for next quarter or next quarter another year.
5.2: Financial monitoring:
Good governance, financial accounting and monitoring systems will be put into place to ensure high quality financial management. To enhance this, the following will be done.
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The project budget monitoring and trucking sheets will be put in place to truck the records related to the project budget and expenditure on a monthly basis.
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The Project coordinator will ensure that the project expenditures are always related to the Project budget and are accounted for within seven days.
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The Project coordinator will ensure the best practices in project budget management, accounting, reporting and forecasting.
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Monthly meetings among project staff to discuss equitable and transparency issues related to allocation of financial resources to the intended target groups of people.
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The accountant will provide the project budget and expenditure accounts to the Project coordinator on a monthly basis.
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Monthly, Quarterly and Annual financial reports will be prepared by the project accountant and shared with the donor and key stakeholders.
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Ensuring project funds are utilized correctly, safeguarded and reported timely and accurately to donors and other key stake holders.
webmaster 4. August 2012
INTRODUCTION
1.1 Background information
The project will be implemented by SHALOM CARE HOUSE of the Catholic Archdiocese of Mwanza, a faith based organization based in Mwanza-Tanzania
Shaloom Care House (SCH) is a faith based organization, operating under the Health Department of the Archdiocese of Mwanza. It was established in 1992 under the HIV prevention programme of the Archdiocese following the 1987 declaration of the Tanzania Episcopal Conference (TEC) to combat HIV/AIDS.
Shalom Care House provides services in Mwanza City for all, regardless of creed, nationality, tribe or color. Services offered by Shaloom Care House are extensive and include psychosocial support, health care, education and legal support to people living with HIV/AIDS (PLHA) and Orphans and Vulnerable Children (OVCs) and their families.
1.2 Vision Statement
A community free of poverty and HIV/AIDS, that respects, promotes and protects human rights including caring for people living with and affected by HIV/AIDS
1.3 Mission Statement
To bring a positive change in the lives of orphans and most vulnerable children and people living with HIV/AIDS through improving the quality of their lives and social-well being, facilitating the communities to provide care to OVCs and PLHA and recognizing the needs and rights of those already affected by HIV/AIDS
1.4 Core Values of Shaloom
Shaloom is guided by the central belief that reducing the spread HIV/AIDS and its impact on the livelihood of people is extremely important in helping AIDS-related orphans and PLHAs and their poor families to meet their fundamental rights and needs and become good members of the society.
1.4 Development Goal of SCH
To contribute towards reduction of poverty and the spread of HIV through working with the communities to develop and implement programme activities and strategies that prevents and mitigate the impact of AIDS epidemic in Ilemela and Nyamagana District of Mwanza Region in Tanzania
- PROBLEM STATEMENT
HIV continues to spread around Sub Sahara African. It has become increasingly apparent that the epidemic does not follow the same in all societies. It affects different sub-groups in different ways at different times. Tanzania has been struggling against HIV infection and AIDS for almost a quarter of a century while Shaloom Care House has been struggling for almost 21 years, but HIV has continued to spread and there was a dramatic increase in the number of AIDS cases as more HIV infected people succumbed to opportunistic infections arising from suppressed immune system. As in other sub- Saharan countries, HIV infection is spread predominantly by heterosexual contact
By the end of 2012 SCH was providing service to 1300 people living with HIVAIDS and more than 700 orphans and vulnerable children. The number of clients cared by SCH has been increasing daily due to the wide spread and high impact of HIV/AIDS in Ilemela and Nyamagana Districts of Mwanza city.
Special factors contributing to the wide spread and high impact of HIV and AIDS in Ilemela and Nyamangana District of Mwanza city include both social and economic factors. Economically, Mwanza as a fast growing city in Africa is a busy city with high mobile population due to petty trading, cotton farming, fishing industry, job opportunities, buses and trucks stop and many markets. Because of these factors there is a considerable level of migration for trade within the city and to the surrounding trade centers identifies as high HIV – Transmission area. These centers have increased social interactions and hence accelerated HIV and AIDS infections.
Furthermore, the growth in bars and entertainments in the city, trade centers and hardship life has encouraged the growth of prostitution. Traditional practices that encourage polygamy, early marriage and widow inheritance are among the additional factors promoting a wide spread of HIV and AIDS in the project operational areas. The results from the 2011-2012 Tanzania HIV/AIDS and Malaria Indicator Survey show that the HIV prevalence in Mwanza region is 4.2.
Overall, 5.1% of Tanzanians age 15-49 are HIV-positive. HIV prevalence is higher among women (6.2%) than among men (3.8%). HIV prevalence is higher in urban areas for both women and men than in rural areas.
A comparison of the 2007-08 THMIS and 2011-12 THMIS HIV prevalence estimates indicate that HIV prevalence has declined slightly from 5.7% to 5.1% among adults age 15-49. Similarly, HIV prevalence has declined among women, from 6.6% to 6.2%, and among men, from 4.6% to 3.8%. Therefore more effort is required to stop new infection through community mobilization, care and treatment for people living with HIV.
-
PROJECT RATIONALE
Much of the care for people with HIV and AIDS is provided at home by immediate family and friends, as well as by home based care organizations. Providing care for people with HIV and AIDS in the home has many potential benefits for both HIV infected and affected people, yet there are many failings in the support given to caregivers.
The core project activities at Shaloom Care House are Home based care service, care and treatment, prevention and care and OVC support program which include education support and health care for orphans and vulnerable children.
Shaloom Care House provides services to 1300 HIV and AIDS clients in the above list children are 101. The population of the clients cared is not proportional to the caregivers, the centre has only two nurse counselors who are permanently employed and 56 community care givers known as home based care volunteers. The guidelines of the Ministry of Health and Social Welfare of the United Republic of Tanzania state that each caregiver should not care for more than 15 clients. For the statistics given above the home based care volunteers for Shaloom Care House care for more than 20 clients.
Currently SCH hires a Medical Doctor from Sekou Toure hospital, the doctors comes only two times a week and he works only for four hours a week.
A potential benefit of home based care is that sick people are surrounded by people they love and are familiar with, so they can also receive more flexible and nurturing care. They will also not be exposed to hospital-based infectious diseases. As people with terminal illness generally spend their final moments at home, improving the quality of their care at home also removes the cost and distress of traveling to and from the hospital when they are weakest.
Furthermore, in being cared for at home, a person with HIV may be in a more ready position to work or look after family members for short periods of time while the primary earners work. The time the family would otherwise use traveling to and from hospital can instead be spent on house work and looking after other family members. Expenditure on transport and hospital costs is also reduced.
Home based care organizations in Tanzania are the other important care providers and consist of trained health workers or volunteers linked to a hospital, NGO or faith group, for example SCH make visits to people’s homes for perhaps one or two hours. We assist the client with much of the care provided by families including household chores and providing and cooking food, as well as performing more clinical tasks such as administering pain relief or medication. We also make referrals for more professional medical help.
Care and treatment is very important because without treatment nearly everyone with HIV will get AIDS. Currently Antiretroviral therapies have brought renewable hope for many people living with HIV. However they do not offer a cure. In this project effort will be put in treating opportunistic infections because when the HIV client is free from OI’s he/she may live longer because he/she will not get AIDS easily. Care and treatment is done at our centre or at patient’s home during home visiting.
The common opportunistic infections in our community includes; Pneumonia, skin infections, heperszoster, arthritis, bronchitis, UTI, worms, fungal infections, tonsillitis and STI’s
Despite of tremendous advances in care for human immunodeficiency virus (HIV) infection and AIDS treatment, morbidity and mortality due to HIV/AIDS in Tanzania remains unacceptably high. For example in 2012 the mortality rate for AIDS patients cared by SCH increased by approximately 100% .The reported death increased from 6 patients in 2011 to 14 patients in 2012. High mortality rate for HIV and AIDS patients in Tanzania is contributed by various factors including inadequate food supply contributed by climatically changes and economic instability which lead to food inflations. Most of our patients are just eating a single meal a day meanwhile they take ARV.
The study shows that food insecurity in Tanzania contributes to ARV non-adherence and treatment interruptions or to postponing ARV initiation: ARVs increased appetite and led to intolerable hunger in the absence of food, side effects of ARVs were exacerbated in the absence of food, some of AIDS patients believed they should skip doses or not start on ARVs at all if they could not afford the added nutritional burden and competing demands between costs of food and medical expenses led people either to default from treatment, or to give up food and wages to get medications.
One day I visited one of our clients who were serious sick; I asked her if she takes ARV regularly. She said “The most difficult or painful thing that I find about taking my medicine is when the time for taking medicine approaches and I don’t have something to eat. If I don’t have something to eat, then I don’t take my medicine until I have what to eat”
Therefore Shaloom Care House is seeking funds from different partners to improve our services we offer to our poor clients that we help in order to provide holistic and quality services to the clients. In this project emphasis will be put in;
-
Home based care
-
Care and Treatment
-
Mobile VCT
-
Technical support and human resources empowerment
-
PROJECT DESCRIPTION: PROJECT GOAL, OBJECTIVES AND LOGICAL FRAME WORK
-
Project goal
To contribute toward reduced spread of HIV and AIDS through working with the community to develop and implement programme activities and strategies that mitigate the impact of AIDS epidemic in Ilemela and Nyamagana Municipalities of Mwanza city and to achieve the millennium Development Goals (MDGs) by 2025.
-
-
Project objectives
-
-
To strengthen access and referral of appropriate health and other support services to PLHIVs around project area.
-
To reduce new HIV infections and HIV relates stigma through community mobilization around the project area.
-
To strengthen capacity of the Organization to implement and manage project activities effectively.
Activities
Shaloom Care House will implement activities to reach out to different audiences with different messages targeting PLHIV cared by the centre. This intervention will consist of integrated strategies such as service provision, referrals, and social support. Knowledge of status through counseling and testing will be an immediate goal of the PLHIV activities so as to ensure all those who test positive receive the required support in order to reduce the rate of new infections and improve quality of life by enrolling in appropriate treatment and support programs.
The projected timeline for implementation will be as from September 1, 2013 to August 30, 2014.
Objective 1: To strengthen access and referral of appropriate health and other support services to PLHIVs around project area.
-
Stakeholders Meeting: To introduce the new partners to the community, and seek their support and involvement in the planned activities, the project will hold a one day meeting of at least twenty (20) community members and stakeholders including but not limited to the local authority at village and ward level, HIV/AIDS committees (VMAC and WMAC) representatives, religious and community leaders, CBOS, NGOs, Health center/hospital leadership, community health workers and any other stakeholders in Mwanza city. A specialist in HIV/AIDS and stigma and discrimination from district medical department and the SHALOOM CARE HOUSE Coordinator will facilitate the one day workshops, to create awareness among the community on the project, and the planned activities.
-
HBC refresher training: SCH has 56 trained home based care providers who need refresher courses to improve their performance. Therefore there will be a 5 day training facilitated by the Mwanza regional home based care coordinator from the Department of Social Welfare in collaboration with National AIDS Control Programme will facilitate the training. The training will focus on communication skills, adherence on ARV, Home based care service provision, management of opportunistic infections, knowledge of status through testing and counseling, nutrition, provider initiative testing and counseling (PITC) and stigma and discrimination education. The aim of the training will be to provide a refresher to the home based care volunteers , remind them of their roles and responsibilities to the community in order to provide holistic and quality services to the people living with HIV and AIDS in Mwanza.
-
HBC Service Provision: The trained HBC providers will provide care to bedridden PLHIV in accordance with Ministry of Health and Social Welfare guidelines. To ensure the HBC providers provide quality services to their clients, they will be facilitated with PHDP kits which contain protective gear, hygiene items, basic medication (following the national guideline), and these kits will be replenished as appropriate. To facilitate effective and efficient HBC provision and timely submission of reports to the project coordinator without distracting HBC provider’s day to day businesses. The project will purchase umbrellas, T-shirts for all the HBC volunteers. During home visits the HBC volunteers will keep and maintain proper documentation of their clients and items provided to clients during each visit. The project, therefore, will purchase counter books and adapt the visit record sheets for record keeping.
-
Food and material support provision: The project will identify 200 people living with HIV cared by SCH who are absolutely poor to access this support. The identified clients will be given 5 kg of beans, 20kg of maize flour/rice and bars of laundry soaps, the program will be for monthly bases. To facilitate effective and efficient program the project will establish a data base for the beneficiaries.
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Home Based Care Monthly Meeting: The HBC volunteers will meet on a monthly basis to discuss their activities, the challenges faced, the successes they have had and plan for subsequent monthly activities. During these meeting, they will be required to submit their dully completed monitoring tools to their supervisors, who will use the data to compile HBC reports. The home based care monthly meetings will be conducted by the supervisors who will also use the time to provide technical assistance in identified areas of service delivery. The monthly meetings will also be used for provision of best practice, new information in the care and support setting, in order to increase the HBC provider’s knowledge and skills for addressing various technical issues pertaining to PLHIV. Some of the topics to be discussed will stem from questions raised by HBC providers during meetings, in order to be responsive to immediate needs of their clients. The home visit record sheets will be submitted to Shalom Care House staff during Home-based care volunteer’s monthly meetings. The project will develop monitoring tools including printed registers.
Objective 2: To reduce new HIV infections and HIV relates stigma through community mobilization around the project area.
6. Outreach HIV testing and counseling (HTC): The project will carry out mobile testing and counseling at fixed outreach locations to be determined by the management. The project will also encourage provider initiated testing and counseling (PITC) at the Centers. Mobile HTC will be conducted twice a month along the streets of Ilemela and Nyamagana Districts. The clients who test positive will be referred to the nearest CTC for further investigations and management and followed up by HBC care givers to ensure they receive the required services such as CD4 count, ART and home based care if needed.
The project will hire a nurse who will be in charge of the HTC services at the site and procure necessary equipment to facilitate mobile HTC such as field tents and a PA system to mobilize and entertain the audience during mobile testing and create a an enabling environment to encourage people to consider testing.
The project will prepare and procure VCT cards, Referral forms, and Registration book. The project target is to reach 3500 clients by the end of August 2014.
7. Care and Treatment. The Clients diagnosed HIV positive will be attended for further investigations and management. ARV will be administered to the clients with CD4 counts below 350 the rest will be given close follow up to insure they attend clinic regularly to check for CD4 counts and treating opportunistic infections.
The project will hire a Medical Doctor who will be a doctor in charge of the CTC services and procure necessary medications for opportunistic infections.
8. Community sensitization and mass education provision. The Project team will identify 6 people living with HIV who are very open about their sero status to be involved in this program; these PLHIV will be the role models. The identified clients will be contacted to seek their will of being the key resource persons of the program. These people will be providing HIV education by exposing their sero status publically. They will be visiting in schools, churches, and mosque and in public meetings. They will be in groups of two individual regarding to gender therefore there will be three groups each group will be having two resources persons, Male and Female. The project coordinator will be working together with each group in preparing meetings and visits, each group will conduct four meetings a month, targeted number of meeting is 130.
Objective 3: To strengthen capacity of the Organization to implement and manage project activities effectively.
9. Institutional capacity building: The Project Coordinator will provide ongoing technical and program support to all project activities. The project will offer a refresher training courses for home based care volunteers. The project coordinator will also facilitate recruiting of two medical personnel, a clinician and a nurse. The project will also be flexible to accommodate volunteers from abroad who medical specialists.
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Logical frame work
Project goal
Outcomes
Activities
Outputs
Time frame
To contribute toward reduced spread of HIV and AIDS through working with the community to develop and implement programme activities and strategies that mitigate the impact of AIDS epidemic in Ilemela and Nyamagana District of Mwanza city and to achieve the millennium Development Goals (MDGs) by 2025.
Strengthened access and referral of appropriate health and other support services to PLHIVs around project area.
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Stakeholders meeting.
The stakeholder meeting which involved 20 participants has been conducted..
1st week of October 2013
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HBC refresher training
5 days training has been conducted for 56 HBCV
1st week of November, 2013.
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HBC service provision
HBC service has been provided to the targeted group.
October 2013 to September 2014.
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Food and material support provision
Food and other materials such as soap has been provided the targeted clients
Every month 1st of October to September 30th.
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Home based care monthly meeting.
HBC monthly meeting has been conducted.
Every month 1st of October to September 30th.
Reduced new HIV infections and HIV relates stigma through community mobilization around the project area.
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Outreach HIV testing and counselling (HTC)
HTC has been conducted to 3500 clients.
October 2013 to September 2014.
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Care and treatment
Care and treatment has been done for all registered PLHIV.
October 2013 to September 2014
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Community sensitization and mass education
The community has been sensitized and mass education has been provided around the project area
Every month from October 2013 to September 2014
strengthened capacity of the Organization to implement and manage project activities effectively
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Institutional capacity building
Institutional capacity building has been done.
1st to 2nd week of October 2013.
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PROJECT MANAGEMENT
Project management as perceived by the organization is a process through which project management team makes a stream of decisions and actions that lead to the development of realistic strategies, which guide the project to achieve its pre-determined objectives. The well balanced management team and proper management decisions are then seen as means to achieve planned project objective and activities.
The organization will manage the project. The management is very crucial since it enables managers to anticipate changing conditions, provide clear project objectives, co-ordinate well project activities and allocate limited resources, correctly.
The project management focus will be to identify PLHIV and provide them with psycho-social support, food, materials, health care, monitoring, co-ordination and integration of project activities and services with Government plans. The project management as its strategies, will constantly review progress of the project activities and make decisions and actions to redress noted inconsistencies and weaknesses
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MONITORING AND EVALUATION
The project monitoring and evaluation plan aims at proposing ways through which long-term and short-term changes in the lives of PLHIV will be tracked or measured. Long-term changes are the changes related to quality of life among PLHIV and their family members. Short-term changes are changes related to access to education and health care services, quality of care, capacity of PLHIV and access to psychosocial support among PLHIV and the community. The plan also aims at suggesting how the project will gather information and measure each of the quantified outputs/ progress indicators of the project. It will also suggest who will be involved in monitoring and evaluation.
5.1: Technical Monitoring and Evaluation of the Project:
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Conducting base-line surveys to collect data and information to establish a baseline status and bench mark that can be used in the mid-term and end of project evaluation.
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Routine Data Collection tools (with details of what information will be gathered, when and by whom) will be put in place and used by the project staff and trained home based care volunteers to collect relevant data and information on each of the quantifiable project output and progress indicators.
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Daily project activities will be monitored on a monthly basis; feedback sharing and planning meetings will be conducted to share information on the performance of the project.
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Monthly meetings with home based care volunteers will be conducted to collect information on the performance of the project.
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Quarterly and annual project review meetings will be held with key stakeholders including the health secretary of the Archdiocese of Mwanza to up-date each other and share data and information on the progress of project activities and plan for next quarter or next quarter another year.
5.2: Financial monitoring:
Good governance, financial accounting and monitoring systems will be put into place to ensure high quality financial management. To enhance this, the following will be done.
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The project budget monitoring and trucking sheets will be put in place to truck the records related to the project budget and expenditure on a monthly basis.
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The Project coordinator will ensure that the project expenditures are always related to the Project budget and are accounted for within seven days.
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The Project coordinator will ensure the best practices in project budget management, accounting, reporting and forecasting.
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Monthly meetings among project staff to discuss equitable and transparency issues related to allocation of financial resources to the intended target groups of people.
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The accountant will provide the project budget and expenditure accounts to the Project coordinator on a monthly basis.
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Monthly, Quarterly and Annual financial reports will be prepared by the project accountant and shared with the donor and key stakeholders.
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Ensuring project funds are utilized correctly, safeguarded and reported timely and accurately to donors and other key stake holders.