REGIONAL DISABILITY & HIV PROJECT « Strengthening local initiatives related to the AIDS response for persons living with disabilities in Burundi, Mali and Senegal » Regional HIV/AIDS workshop: Africa and South East Asia Bujumbura 21–25 February 2011 Bujumbura 21 February 2011 Dr. Almouner TALIBO Regional coordinator

Project teams / COUNTRY : Mali - -Caroline BOLTZ : Health coordinator - -Mamadou KEITA: HIV project manager Senegal - -Dr. Aïda ZERBO : HIV project manager Burundi - -Côme NIYONGABO : Inclusion coordinator - -Fulgence NDAGIJIMANA: HIV project manager

15th ICASA, Dakar 2008

Main donors:   MAE France/AFD   Big Lottery Fund   World Learning USAID   HCNLS   HI Total Budget : € 1,988,290, including: - -MAE France 50% - -50% HI and other donors

IMPLEMENTATION PERIOD AND LOCATION   Start: March 2008   End: February 2011   Request for an extension pending: June 2011 Location:   Burundi : 17 of the country ’ s provinces (129 communes)   Mali: districts of Bamako and Koulikoro   Senegal : 4 departments in the Region of Dakar, 3 regions in Casamance (Ziguinchor, Kolda and Koulikoro)

OBJECTIVES General objective :   Reduce the impact of HIV and AIDS on persons with disabilities in Burundi, Mali and Senegal, through strengthening of local actors Specific objective:   Facilitate the access of persons with disabilities to systems of prevention, care and treatment, and encourage their participation in HIV response plans

EXPECTED OUTCOMES EO 1 : Persons with disabilities have access to health facilities, care services and information on HIV prevention adapted to their disability. EO 2 : Persons with disabilities are involved in seeking sustainable HIV response strategies and actions adapted to their needs EO 3 : The lessons learned from innovative community-based actions contribute towards improving the competencies of actors working on HIV response initiatives for persons with disabilities

BENEFICIARIES 1. Direct beneficiaries:   Persons with disabilities   Active members of national and local DPOs   Persons living with HIV   HIV response associations / Civil Society Organisations (CSOs)   VCT and Treatment Centres staff 2. Indirect beneficiaries :   Families of persons with disabilities   National and local political authorities   General population

MAIN PARTNERS   Supervisory institutions in charge of the HIV response (ministries, national programmes, etc..)   HIV/AIDS-response CSOs   Associations of persons living with HIV   Local, national and regional DPOs   Specialised centres for persons with disabilities   HIV and AIDS treatment services

MAIN ACTIVITIES 1. Preliminary activities: - -Organisation of a national HIV & Disability forum - -Setting up of project steering bodies 2. Activities for EO 1 :   Implementation of activities that increases the accessibility of persons with disabilities to HIV response actions   Support to local initiatives (LI) focusing on the accessibility of persons with disabilities

MAIN ACTIVITIES / cont. 3. Activities for EO 2:   Initiation Actions enabling persons with disabilities to be involved in the HIV response   Strengthening the capacities of civil society actors   Support to LIs enabling persons with disabilities to be involved in the HIV response   Implementation of activities to include persons with disabilities in research 4. Activities for EO 3:   Develop local knowledge sharing on Disability & HIV   Production and dissemination of information   Organisation of meetings and seminars between Disability & HIV stakeholders

MAIN ACHIEVEMENTS   Organisation of a national HIV & Disability forum / country   Setting up of project steering committees (National Disability & HIV platform, Technical Committee / Steering Committee and LI project selection committee)   Organisation of advocacy and awareness-raising sessions (public authorities, elected representatives, CSO, technical and financial partners) to ensure disability issues are taken into account in AIDS policies and Programmes   Accommodations made to improve the physical accessibility of treatment services : 1 ambulatory care centre (Senegal), 8 VCT centres (4 in Burundi and 4 in Mali) and 7 treatment centres (4 in Burundi and 3 in Mali)   Equipment of VCT and treatment centres (Burundi and Mali): wheelchairs, audiovisual equipment, lab equipment, chairs, walking sticks, crutches, etc.

MAIN ACHIEVEMENTS / Cont.   Training of VCT/treatment centres’ staff on the Disability Creation Process, disability rights, Psychology related Disability and quality approach (52 in Burundi, 15 in Mali and 55 in Senegal)   Training: 14 national trainers on HIV & Disability (6 Senegal and 8 Mali); and 9 counsellors on Sign Language (SL)   Training on SL and HIV of Peer Educators who are active in the field (516 in Burundi, 65 in Mali and 18 in Senegal)   320 CSOs trained on disability inclusion, 136 of which have introduced concrete measures on behalf of persons with disabilities   198 member associations of the ABS have inclusive action plans   516 peer educators are active in the field   disabled persons informed about HIV and 4729 tested for HIV   617 HIV + disabled persons taken care of by the partner associations

MAIN ACHIEVEMENTS /Cont.   Development/adaptation, production and dissemination of IEC tools on HIV & Disability   61 LIs financed, reaching 24,913 persons   Support for advocacy actions (organisation of debate-related conferences and open door days)   Experience sharing meetings between project stakeholders (Peer Educators, Trainers, VCT and treatment centres Staff)   Support for the inclusion of disabled persons living with HIV in existing networks   Identification by HIV response stakeholders of the issues and consequences of not including persons with disabilities as a vulnerable population group in the HIV response (in all three countries)   Setting-up of a team of facilitators at DPO level (Constellation)

MAIN ACHIEVEMENTS / Cont.   Inclusion of Disability in data collection tools   Participation by DPOs in the HIV response alongside HIV-related CSOs   Accessibility of treatment centres   Participation in the revision of HIV National Strategic Plans – –Inclusion of persons with disabilities as a vulnerable group to HIV   Mainstreaming of disability issues into HIV policies, programmes and actions   Involvement of the supervisory institutions, technical and financial partners and other actors in the inclusion of disability in the HIV response   Ownership of disability issues by some actors   Awareness-raising of actors at international level : – –ICASA (10,000 people, inclusion of Disability & HIV by the community programme, drafting of recommendations) – –Francophone conference on HIV/AIDS (5,000 participants) – –3rd GA of the African Disability & HIV Campaign   Mid-term evaluation : drafting of recommendations for actors in the Disability & HIV fields

MAIN BARRIERS 1. OPERATIONAL   Activities unequally distributed between countries   Incoherence between the time and means provided and ambitions to implement specific activities   Lack of advocacy on Disability & HIV issues at community level   Social perceptions of disability (socio-cultural context)   Poor knowledge of HIV among DPOs   Absence of basic HIV-related data on persons with disabilities   Reliability of statistics on the disabled population   Weak management capacity of DPOs   Problems of governance within DPOs and some CSOs   Problems in understanding the notion of partnership by actors   Late implementation of project in some countries 2. Human resources   Delays in staff recruitment   Mobility of HR and some positions remaining vacant for some time (resignation of a project manager)

MAIN BARRIERS / Suite 3. FINANCIAL   Funding will soon come to an end. This might have consequences for results obtained so far   Problem of financial monitoring at regional level (no compilation of year 1)   Lack of financial resources for implementing the partners’ action plans : no resources planned for needs generated by the project   Management of co-financing of donors   Little funding mobilised to strengthen activities 4. Communication   Problem for programmes in thinking “regionally”   Difficulties in communication between the Regional Coordination and country teams   Insufficient sharing of good practices between actors   Lack of synergy and competence in the field of disability on the part of actors

MAIN BARRIERS/ Cont. 5. Proposed solution   Strengthen advocacy   Strengthen the capacities of DPOs and CSOs through training   Conduct studies to build a database   Set up communication channels   Step up fund-raising   Funding of community actions through the LIs   Much more advocacy action needed

Lessons Learnt   Ownership of the project by key players   Impact of the quality of the initial assessment on the project’s implementation   Relevance of the project : geographical coverage, level of intervention, activities, thematic areas, choice of partners   Involvement of key players in a participative process and operating of the project’s steering frameworks: guarantees of success   The use and integration of existing frameworks/networks facilitates the implementation of new projects in new thematic areas

Lessons learnt /Cont.   Ensuring the inclusion of disability in existing policies/Plans requires both the adoption of a specific approach and time   Support of known and recognised actors for advocacy and awareness-raising among decision-makers   Effectiveness of the Peer Education approach   LIs proven to be effective in community activities that address the community’s needs   The Consortium Approach (DPOs/ HIV CSOs) proven to be relevant in the implementation of LIs

MAIN DOCUMENTATION BURUNDI   Baseline study (KAP) on persons with disability and HIV (in French, 2008)   KAP study at the end of the second year of project implementation (in French, 2010) Mid-term evaluation (in French, 2009)   Final evaluation of the BLF component (in French, 2010)   Guide on BCC (in French, Kirundi, Braille and Sign Language, 2008)   Documentary on the project (in French, 2010)   Awareness-raising tools : posters, CD of songs and sketches (in Kirundi, ) MALI   DVD 2009 : « HIV and AIDS in Malian sign language »   DVD Documentary 2010 : « We are all concerned»   Adaptation of AIDS card game, 2010   Brochure on knowledge on HIV and AIDS Adaptation, 2010   Ambiguous scenarios game, 2010

MAIN DOCUMENTATION / Cont. SENEGAL   Interim project report, May 2009   Leaflet, guide in French, 2009   Inclusion of 3 disability-related images in the national AIDS awareness-raising tool box (2009)   Glossary and Messages (interactive DVD interpreted in SL and translated in Braille), 2010   Collection of audio messages on HIV and Disability (CD) 2010   Recordings of awareness-raising radio programmes   Disability & HIV picture boxes in Braille 2010

LOOKING FORWARD   Fund-raising for a new phase (by country or at regional level will depend on opportunities)   Inclusion of the Reproductive Health dimension (SRH)   Advocacy for the definition of specific national actions targeting persons with disabilities

Thank you