1. 1 THE AFRICA LOCAL GOVERNMENT ACTION FORUM (ALGAF) PHASE IV MODULE I Local Government Responses to HIV/AIDS SESSION I PRESENTATION BY THE HARARE CITY TEAM 7 November 2003

2. 2 THE HARARE CITY TEAM Mr. Madenyika M. Magwenjere (Team Leader) Assistant Town Clerk & Provincial AIDS Committee Chairperson, City of Harare. Mrs. C. Mutiti Chief Health Education Officer (Focal Person), City of Harare Mrs C. Majoni District Health Education Officer, City of Harare Mrs. P. Samuriwo District Health Education Officer, City of Harare Mrs. D. Gwati District Health Education Officer, City of Harare

3. 3 SUMMARY OF ONGOING ACTIVITIES TO ADDRESS HIV/AIDS IN THE CITY OF HARARE Prevention Care Mitigation Research

4. 4 PREVENTION Community programmes for men, women and children. -Awareness programmes -Communication done at all levels -Promoting the use of condoms -Talk shows

5. 5 PREVENTION (Continued) Workplace Programmes -Preer education -Literature on HIV AIDS -Clubs on HIV/AIDS -Training of HBC volunteers -Dramma groups -Truck drivers to travel with spouses

6. 6 PREVENTION (Continued) Youth Programmes -Youths are the windows of hope -Intensified IEC programmes in schools, clubs, churches, etc -Friendly youth corners -Youth friendly nurses -Youths trained as IEC officers -Literature distribution -Youth Forum and Task Force for Harare

7. 7 PREVENTION (Continued) VCT Centres -Several in Harare -Councillors being Trained in Churches, schools, hospitals etc. PMTCT -Training of all nurses is ongoing -Training of grass root workers

8. 8 CARE Home Base care -Training of health promoters -Kits for HBC produced under DAACs -Dietary and Vitamin supplements -Treatment of opportunist infections Institutions - Several institutions look after the terminally ill.

9. 9 MITIGATION Food assistance School fees and uniforms provided by DAAC Legal assistance is available to children abused or raped Counseling services for children under difficult circumstances (Child friendly clinics and chat line) Community fostering is provided PLPWAS, their plight is addressed

10. 10 RESEARCH Research Carried our in all 9 districts Situation and response analysis done Enumeration of beneficiaries Monitoring and evaluation tools developed Monitoring and evaluation done on a monthly basis

11. 11 DEPARTMENTS CO-ORDINATING HIV/AIDS ACTIVITIES AND THEIR LEVEL OF LEADERSHIP National AIDS Council under the Central Government Multisectoral Provincial AIDS Committee District AIDS Action Committees (DAACs) Ward AIDS Action Committees (WAACs) NGOs (ACT, UNAIDS,KAPNICK, Mashambanzou) Hospitals, Clinics Private Doctors

12. 12 PROGRAMME CO-ORDINATION AND MANAGEMENT LOCAL AUTHORITY Councillors – Ex officio members of DAACs (Mayor – Town Clerk) Assistant Town Clerk (PAC Chairperson) Director of Health Services, (NAC Board Member) Chief Health Education Officer (Harare Focal person) District Health Officer (District Focal person) District AIDS co-ordinator

13. 13 Summary of Tool 5.5 Informed by an understanding of local realities and trends Situational and response analysis done and reveled the following: -High death rate, increase in number of orphans, street kids, widows. -Women, children and orphans more at risk -Poverty a universal problem among all groups -Knowledge gaps in the districts.

14. 14 Summary of Tool 5.5 Findings from the Response analysis revealed the following -A number of organizations and community organizations responding to the HIV/AIDS Pandemic -City of Harare responding through Health institutions. -Prevention of HIV/ AIDS given first priority followed by mitigation, care and research -NAC disbursed funds to LA for use by DAACs -District Capacity Building for DAACs and WAACs conducted in 2002 -Planning and review meetings are held quarterly -Programme monitoring and evaluation tools and indicators were developed beginning of 2003.

15. 15 SUMMARY OF TOOL 2.6 Conducting a LGA Self Assessment: Survey Clarity of Mandate in terms of Service delivery –Mandate is very clear –Directive from Central gvnt for LAs to come up with relevant programmes to tackle HIV/AIDS –Memorandum of understanding between the Central Government and the Local Authority –Mandate for LA is to mobilise, co-ordinate, facilitate and monitor the multisectoral response to HIV/AIDS.

16. 16 SUMMARY OF TOOL 2.6 Conducting a LGA Self Assessment: Survey Limitations of Powers to Make Decisions – There are no limitations of power. –All areas are funded by central govnt. –Local authority provides human and material resources.

17. 17 Summary of Tool 2.6 (Continued) Overview of Opportunities and Constraints Opportunities -Standard guideline in the form of a National HIV/AIDS Policy Document exists, for all to use in response to the challenges of HIV/AIDS. -LGA has mandated functions which it is expected to fulfill in areas of prevention, mitigation, care and research -By using the existing structures within LGA, the NAC strategy allows an opportunity for consultation among stakeholders in development of quarterly, ½ yearly or yearly plans.

18. 18 Summary of Tool 2.6 (Continued) Overview of Opportunities and Constraints Constraints Problem of split functions of government e.g VCT, PMTCT, Social welfare grants results in non-holistic care being given to clients or patients in need sometimes. There was some resistance to integration into LGA framework but the multisectoral / interdepartmental structures such as the WAACs, DAACs at community implementation level have largely resulted in integrated planning. Memorandum of understanding between NAC and LGA could go along way towards improved relations and clarification of co-operation between split functions of government. The prioritization of funding for the different requirements in the response to HIV/AIDS challenge was not autonomous, e.g. addressing the need for drugs, yet funds are there in LGA from NAC.

19. 19 Summary of Tool 2.6 (Continued) Overview of Opportunities and Constraints Possible Solutions Leadership of the LGA to be strongly supportive of the HIV/AIDS response, both internally and externally. -This is possible by LG leadership linking with other local leaderships such as Traditional authorities, Youth organizations,Churches, in building frameworks for responses. LGA should attempt to raise resources externally from local institutions and businesses. An impact evaluation survey needs to be carried out so that gaps in the implementation process are identified and the appropriate interventions instituted. LGA should be involved in coordinating local response to HIV/AIDs LGA should work towards strong partnerships with AIDS service organizations. Capacity building should be ongoing.

20. 20 THANK YOU