1. LOCAL GOVERNMENT RESPONSE TO HIV/AIDS Taking the Lead in Coordination and Action: Strategy and Partnerships ALGAF IV Session III By the Harare City Team (Mr. Magwenjere, Mrs. Mutiti, Mrs. Samuriwo, Mrs Dewa, Mrs. Dupwa, Mrs. Andifasi, Mrs. Majoni)

2. SESSION OBJECTIVES To emphasize the importance of co-ordination, integration and partnerships in developing an HIV/AIDS strategy To provide an overview of the concepts of mainstreaming and functional integration (with examples) To present some of the advantages and challenges of partnerships

3. PURPOSE OF A STRATEGY The purpose of a strategy is to provide a framework for how the LGA will address HIV/AIDS in its locality This framework should identify the objectives of the strategy, how these objectives will be met and who will be involved in the process.

4. Importance of Mainstreaming of LGA HIV/AIDS Response The local authority can identify areas which are neglected, overlaps, and duplications and where there are possibilities for collaboration.

5. RESPONSIBILITY FOR COORDINATION OF HIV/AIDS PARTNERSHIP NETWORK IN HARARE LGACoordination, IEC, Care, Mitigation services MashmbazhouHome Based Care (HBC) Chiedza home of hopeIEC & HBC ZAPSOVCT WASNGender Issues WAGWomen & IEC Island HospicePalliative Care PSIVCT, IEC, Family Planning

6. RESPONSIBILITY FOR COORDINATION OF HIV/AIDS PARTNERSHIP NETWORK IN HARARE (continued) SAfAIDSResearch ACTCounseling, IEC HOPEHBC & IEC Sports CommissionYouth Education Through Sport (YES) MayorCommunity mobilization against HIV/AIDS CouncilorsCommunity mobilization against HIV/AIDS DAACPrevention, Care & Mitigation WAACsPrevention, Care & Mitigation ZNNP PlusCare of PLWHA PadareMen and HIV/AIDS MAGsMen living with AIDS

7. RESPONSIBILITY FOR COORDINATION OF HIV/AIDS PARTNERSHIP NETWORK IN HARARE (continued) Traditional Healers Support Groups Moving on Club Youth Forum AIDS Clubs Ministry of Youth and Gender Medical director of Health District Health education Officer Chief Health education Officer Department of Works Health Department

8. SERVICES RELATING TO HIV/AIDS PREVENTION, CARE AND MITIGATION IN HARARE LGA CLINICS HOSPITALS VCT CENTRES HEALTH PROMOTION IN HIV/AIDS SOCIAL SERVICES

9. CLINICS Treatment of opportunistic infection IEC Condom Distribution Referral for supplementary feeding PNTCT Counseling Follow up of home based care patients Referral to social welfare for psychological support or care

10. HOSPITALS Management of affected patients VCT Management of opportunistic infections Implement discharge plan IEC

11. VCT CENTRES VCT support groups

12. HEALTH PROMOTION IN HIV/AIDS Youth corners / centres IEC Activities YES Programme Training of Community health workers Technical support Kurai Netsika Programme (Community Based Education Programmes for Children under 16 years)

13. SOCIAL SERVICES Assistance with food and medical treatment, school uniforms, fees, etc.

14. GAPS IN HIV/AIDS SERVICE DELIVERY a) Mitigation b) Prevention c) Care d) Research e) Other gaps

15. Mitigation Food Packs not consistently supplied Those in dire need of school fees and uniforms sometimes do not benefit due to limited funds

16. Prevention Not all groups in communities actively participate in educational programmes Inadequate information material at grassroot level e.g. posters, leaflets, video tapes to suite different target groups Conflicting messages on condom use which may impact on prevention strategies Some people still not keen to know their HIV status PMTCT uptake is low

17. CARE There are many organizations carrying out Home based care but they bare fragmented and with allegiance to different donors with little interaction with LGA. Gaps in meeting social needs by affected families which impacts on LGA Some drugs to treat opportunistic infections in short supply and ARVs not implemented in Local Authority Institutions Home based care kits not always available Lack of clearly laid out Policy on co-ordination, networking and management of the Home Based Care Programme in the City.

18. RESEARCH This is an area that needs strengthening by the local authority

19. OTHER GAPS NGOs Private Organizations identified as working in the area of HIV/AIDS are not co- ordinated by the Local Government Authority. There is no co-ordinated planning, implementation monitoring and evaluation of programmes and activities, by the LGA task force team

20. MAINTREAMING ACTIVITIES DEPARTMENTACTIVITIES City TreasuryHIV/AIDS messages through water bills, rate bills and other print outs Community ServicesHIV/AIDS education through sport (e.g YES programme, youth education through sport Department of WorksCondom use and disposal education( sewerage, water works) Community LeadersHIV/AIDS messages at gatherings and meetings

21. FUNCTIONAL INTEGRATION Gaps Identified There are some missing links in service provision – not well linked / co-ordinated Resources not well utilised There is an overwhelming demand for other resources (e.g food for the need

22. LGA RESPONSE HIV/AIDS task team needs to be strengthened in order to co-ordinate all ASOs in LGA Strengthen HIV/AIDS multisectoral committee (sharing information and resources) Focal person to strengthen public relations and social marketing of services Provide supermarket approach to HIV/AIDS service delivery

23. LGA RESPONSE (continued) Increase production of HIV/AIDS information leaflets and ensure access by community groups at all levels Co-ordinated approach to information development on condom use and promotion to be encouraged Co-ordinated approach to planning implementation and evaluation of programmes at all levels for LGA needs to be laid out for practical guidance of beneficiaries at all levels Research on impact of HIV/AIDS information and programmes within the LGA communities is suggested