Community Based Care
- April 28, 2017
The overall picture for PLHIV is not a bright one. The following summarizes several significant areas where
PLHIV face serious challenges. Income - Both women and men reported significant (47%) drops in income after the diagnosis of HIV; men reported a 54% drop in income. Women living with HIV were more likely to be widowed or unemployed compared to men living with HIV. In general, 14% of HIV-affected household members reported being too sick to perform their regular activities in the previous four weeks, compared to 8% of non-HIV- affected households. Workers in HIV-affected households were more likely to miss a day of work with 57% of employed household members reporting having missed a day of work in the previous 3 months, compared to less than 49% of non-HIV- affected household members. People living with HIV reported selling land and other assets, cutting into savings and taking on debt, in order to cover costs associated with prolonged illness prior to diagnosis. Internal stigma was high with 16% of people living with HIV reporting suicidal thoughts and 65% reporting low self-esteem. 23% of women living with HIV reported being been verbally attacked and 7% had been physically threatened or attacked, because of their status. Therefore, CHEC has determined that creating better income generation potential for PLHIV is an essential goal. Health & Wellbeing - Healthy lifestyles are also essential but generally elusive for PLHIV. Changes in sanitation and nutrition are critical to improving the life of this vulnerable group, which require education, awareness, understanding of and access to healthy food, and support from the community and local authorities. These will be addressed by CHEC in the project, targeting women in their important roles as homemakers, and youth in their roles of peer influencers and future community leaders, to encourage change in culture and behaviors. Education - HIV continues to negatively impact access to education. Girls and older children living in HIV- affected households reported lower school attendance rates than those in non-affected households. Severe differences were seen between older girls (15-17 years of age) in secondary school, and particularly in upper secondary school, where the net attendance rate for non-HIV- affected households was almost twice that of HIV-affected (16% compared to 9%). (Report on the HIV/AIDS Sensitivity of Social Protection Nov, 2012). Orphaned and vulnerable children are even more likely to miss out on education opportunities. Basic Rights - Stigma and discrimination continue to exist in the context of HIV/AIDS in the rural community, as the administration of HIV/AIDS laws are not strong enough to protect PLHIV and reduce human rights violations against them. In particular, there is still inequality of women regarding property and marital relations and access to employment and economic opportunities. In addition, there is a substantial challenge to reduce the vulnerability, stigmatisation and discrimination that surround HIV/AIDS and promote a supportive and enabling environment, by addressing underlying prejudices and inequalities within societies and a social environment conducive to positive behavior change.
According to the 2012 Stigma Index survey:
1. 79% of women living with HIV were advised not to have children.
2. 73% women feel guilt, have low self esteem and 20% feel suicidal.
3. 39% experienced physical harassment due to HIV status.
4. 89% of the harassment was perpetrated by those living in the same house.
5. 45% of women suffered psychological pressure from their spouse.
6. 14% who were pregnant were strongly advised to terminate pregnancy.
Source: Stigma Index, CPN + 2012
Addressing these issues requires a combined understanding HIV/AIDS and gender, which will be a focus
during the upcoming project period. It is essential that PLHIV, particularly women, have access to activities
related to creating the tools and confidence to achieve self-sufficiency, and activities that are sustainable in
the existing community structures.
CHEC Community Based Care project has improved the overall capacity building of members of affected
communities, particularly women and girls, encouraging them to be confident enough to contribute
effectively to programs addressing their community and bettering their personal and familial situations. In
addition, partnerships with networks has been expanded to include all sectors and strengthen linkages with
human rights organizations to address the gender-based violence underlying gender issues and HIV related
CHEC has been directly responsible for the provision of information on HIV/AIDS to many hundreds of
people, and indirectly to many thousands. This information is also of vast significance to the community, and
has been designed to be built upon over time, as demonstrated in the activities by education and information
sharing on gender and legal issues and HIV/AIDS.
CHEC will step up its efforts in mobilizing technical input and services provided by other partners, both from
the government and non-governmental organizations, to support PLHIVs, their families and OVCs. The
outcomes/impacts include the following:
- Improved quality of life
- Increased gender equality
- Increased adequate income among PLHIV
- Improved knowledge of HIV/AIDS among Commune Council
- Increased serviceable skills among PLHIV
- Increased community and self acceptance of vulnerable people
- Increased confidence of vulnerable people
The beneficiaries of the project have been selected as vulnerable target groups since the start of the project in April 2006 and some are newly recruited into this current project cycle. Currently, CHEC work with Community leaders and local authorities targeted as key support mechanisms for PLHIV in their communities. Their awareness of issues facing PLHIV and integration of activities required to improve the quality of life, including income generation, is essential.
CHEC community based care program staff and field officers take care 1,977 of PLHIV and OVC as target
groups for CHEC given the investment made to date in the provision of care and support in 5 Operational
District target areas.
Outcomes and impacts:
|Indicators (Information differntiated by sex or one indicator for gender dimension)||Baseline August 2013||Impact Monitoring in Nov.2014||Changed Rates from August 2013 to June 2015|
|60% of 613 families affected by HIV and reached by the project show increased gender-eqitable behavior (i.e.. rights of girls & women protected)||41%||68%||92.6%|
|Percentage of target families (female and male members of target families) living with HIV/AIDS increase their confidence to have conversation about their daily living conditions.||N/A||76.25%||88.2%|
|60% of 732 people living with and affected by HIV have an improved realtionship with their community (parents, friends, relatives, and religious leaders) and local authorities.||N/A||73.74%||66.40%|
|Number of female and male living with HIV/AIDS reported satisfication with support from community networks||73%||75.53%||97.9%|
|Number of female and male living with HIV/AIDS reported being supported from community members and local authorities||57%||75.53%||79.3%|