Mbn hiv/aids evaluation final report Team of consultants

Integrated AIDS work (#8)
External mainstreaming (#4*)
Youth behaviour change N=10	SACBC Plan Malawi Arise Plan India	CRD SCLC Mulanje hospital ASHA	NISAA APSA
Awareness building N=15	SACBC Plan Malawi Arise Samuha/Samraksha Plan India	ASHA INSA SWEAT The Black Sash Jekesa Pfungwa CRD SCLC	BERDO (JOPM) NISAA SEF
VCT and counselling N=6	SACBC Plan Malawi Arise	Mulanje hospital ASHA	BERDO (through partnerships)
HBC (including counselling) N=10	SACBC LL diocese Plan Malawi Arise Samuha/Samraksha	CRD (training of volunteers) SCLC (training of volunteers) INSA (training of community health care workers) Mulanje hospital (training and supervision of volunteers by PHC staff)	BERDO (training of volunteers, through partnerships)
Support to peer groups N=5	SACBC LL diocese Plan Malawi Samuha/Samraksha	Mulanje Hospital
Treatment N=4	SACBC Samuha/Samraksha	Mulanje hospital	BERDO (facilitating access by paying transport costs)
Palliative care (n=2)	SACBC	Mulanje hospital
Income generating activities N=7	SACBC LL diocese Plan Malawi	Jekesa Pfungwa SCLC	BERDO
Support of OVCs N=4	SACBC LL diocese Arise	Mulanje hospital (OVC centre where they train guardians)
Humanitarian aid N=3	SACBC Plan Malawi		BERDO (food parcels from own communal gardens for HBC clients and OVCs)

(*)Remark: NESA has not been included in this overview as they are a network of organisations and networks. Hence these organisations can be AIDS specific (ex. Samuha/Samraksha that is a NESA member), or generalists including at different extent HIV/AIDS activities in their core business.
The counterparts, that have mainstreamed HIV/AIDS through the implementation of a separate HIV/AIDS programme, develop all kind of HIV/AIDS related activities, covering the whole range of the prevention to care continuum. Hence the assessment of these activities has been included in evaluation question 3, which deals with the HIV/AIDS focussed organisations. These 5 counterparts are analysed in evaluation question 3 and will not be taken up further in the assessment of evaluation question 4 (which will further relate to 14 generalist counterparts visited).

The counterparts that implement HIV/AIDS activities, along with or as part of their current work (9 out of 14 generalist counterparts), are mainly conducting awareness raising activities directed to their constituencies and many of them, in particular, challenge attitudes of denial and discrimination. These activities are an obvious extension of their current business, be it primary health care or community development.

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  Mulanje hospital, INSA and ASHA (and Plan India) include HIV/AIDS in their health services: information on HIV/AIDS prevention (Mulanje, ASHA, INSA), access to VCT services (Mulanje and ASHA), access to ARVs (Mulanje) and training of community health workers (INSA, ASHA, Mulanje hospital).
  
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  CRD, SLCL, Jekesa Pfungwa are mainly involved in community building and include HIV/AIDS activities in their training and support activities to community groups or members. Focus is on awareness building and prevention and where relevant volunteer community care givers and counsellors are trained. Income generating activities are part of the core business of Jekesa Pfungwa and SCLC and hence have become even more relevant in a HIV/AIDS context, offering HIV/AIDS affected and infected people the possibility¹⁸ of an income.
  
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  The core business of SWEAT (empowerment of sex workers, defending the rights of sex workers) and of The Black Sash (facilitating access to social grants) is evidently relevant in an HIV/AIDS context, hence some specific HIV/AIDS activities have been developed to enhance the current business (HIV/AIDS included in safer sex workshops and condom distribution (SWEAT) and monitoring of and research on the importance of accessing social grants by PLWHA, the importance of a basic income grant for the lives of infected and affected people (The Black Sash).
  

The counterparts that are going through an external mainstreaming process did investigate the link between every programme component and adapted their core programme work (based on research or development of new methods) in order to challenge the vulnerability to HIV/AIDS of their constituencies:

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  NISAA (South Africa) investigated the impact of HIV/AIDS to all programme components (shelter for abused women, counselling services related to violence against women, awareness raising activities) and modified every programme component (ex. red and white ribbon campaign linking domestic violence (white ribbon campaign) and HIV/AIDS (red ribbon campaign)
  
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  BERDO (Malawi) did investigate the impact of HIV/AIDS in the communities they work for, adapted its strategy (classification of vulnerable households and elaboration of appropriate strategies to strengthen coping mechanism of these households) and started to include extra HIV/AIDS related activities in their programme (referring constituencies to VCT and ARV sites, bringing VCT services to the communities, facilitating access to ARV sites by paying transport costs). They were supported by the Joint Oxfam Programme in Malawi (through research and extra funding).
  
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  The Small Enterprise Foundation (South Africa) investigated the impact of HIV/AIDS on SEF clients and on micro finance in general and started a pilot project “Intervention with Micro finance for AIDS and Gender Equity” with the aim of (1) developing an innovative approach to the prevention of HIV/AIDS, by integrating a training program of gender awareness and HIV education into the TCP program of SEF and (2) to evaluate the potential for the combined intervention strategy to reduce vulnerability to HIV infection and gender based violence. The project is now in an extension phase trying to integrate the developed model into all SEF’s micro finance activities and to generate a model approach for HIV/AIDS mainstreaming within the micro finance sector which can be adapted and replicated in other settings, nationally and internationally.
  
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  APSA (India) participated in a research project, conducted by NISSO (Nederlands Instituut voor Sociaal Seksuologisch Onderzoek) in collaboration with the National Institute of Mental health and Neuro sciences and the department of child psychology in Bangalore. This research analysed the vulnerability to HIV infection of street children (and slum children) and developed an appropriate methodology to reach out these kids and address issues of violence in the society. The pilot project needs now to be translated to and implemented in the whole core business of APSA.
  

All of these “generalist” organisations (n=14) play an important role concerning awareness building and HIV/AIDS education using their current activities as an entry point for HIV/AIDS prevention and awareness building. All generalist organisations did train their staff to increase their HIV/AIDS competence. A few partnerships were established especially when a counterpart wanted to offer more HIV/AIDS specific services such as VCT or counselling.

All generalist counterparts (n=14) visited are gender sensitive (according to the appraisals of the CFAs), only a few amongst them (SWEAT, NISAA) tend to go beyond gender sensitivity emphasising the empowerment of women and trying to transform gender relations. Three out of the 14 generalist organisations are women – or women support - organisations (Jekesa Pfungwa, INSA and NISAA).

Table 28: Overview of gender strategies of counterparts visited in the four countries (n=13 – Plan India is not included in this overview – see remark under the table)