TEA-CCRDA Narrative Report

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Overall Project title: Enhance CSOs Capacity and Advocacy Skills to Contribute

to the National Reduction of New HIV Infection and AIDS Mortality


Project title for the Implementing Partner /IP: -
Name of the project Implementing Partner: Tiruzer Ethiopia for Africa (TEA)
Reporting Period: October 2022 to March 2024
Contents
1. General information
2. Executive Summary of the Action
3. Major Activities implemented
4. Analysis of implementation
5. Planned activities vs. Achievement
6. Deviation from the plan and reason for deviation
7. Major challenges faced and actions taken
8. Lessons learned and recommendations
9. Cross cutting issues
10. Other information
11. Annex
ANNUAL NARRATIVE REPORT
I. General information
1. Name of the Organization: Tiruzer Ethiopia for Africa (TEA)
2. Name of the Project Coordinator/ Responsible Person for the report: Mohammed Hassun
3. Reporting Period: October 2022 to March 2024
II. Executive Summary of the Action

Straining from October 2022, Tiruzer Ethiopia for Africa (TEA) has been implementing the CRDA-funded
HIV-Project "Supporting the Reduction of New HIV-Infections and AIDS-Related Deaths". The objective
was to reduce new HIV infections and AIDS-related deaths by 2025 by reducing the risk of exposure or
transmission of HIV and sexually transmitted infections (STIs) among children and youth (KPPs). To increase
the participation of government and influential stakeholders in HIV services, it also organized advocacy
workshops such as peer teacher training, peer education group formation and peer education promotion. The
project includes GBV prevention workshops, establishment of joint GBV monitoring committee at district
level and dissemination of information on law enforcement measures. From our journey, we learned lessons
that were not specifically included in the main project, but that should be taken to make the results of our
project sustainable.

Over all summary of the report, capturing HIV prevention activities as mentioned in the indicator, and
highlighting key accomplishments, challenges, and lesson learned.
The Enhance CSOs Capacity and Advocacy Skills to Contribute to the National Reduction of New HIV
Infection and AIDS Mortality project is a regional project that covers 6 kebeles in Mile Woreda is funded by
CCRDA through the Global Fund. It is implemented by TEA in collaboration with key stakeholders, Mile
Woreda HAPCO and Mile woreda Health office, Youth association and PLHIV Associations etc. Targets sex
workers and the approach utilizes peer educators recruited from the target population of sex workers, to carry
out social mobilization among their peers, in HIV/AIDS/STI prevention. Once identified and trained, the peer
educators try to
Community-based HIV dialogues in Mile woreda to address HIV-attitude change, which addresses the high
level of stigma and discrimination associated with HIV, the major human rights abuses of people living with
HIV, and the issues that make women more vulnerable to HIV. Thus, a total of 808 people (W: 345 M: 463)
participated and benefited from HIV awareness session. It included basic facts, myths, misconceptions about
HIV and AIDS, stigma and discrimination of people living with HIV and AIDS, and social/cultural factors
that make women especially vulnerable to HIV infection. HIV and gender issues are often taboo subjects but
there are ongoing community discussions that are creating changes in social attitudes and behavior by
identifying and discussing social norms and values around HIV and gender.
By providing refresher training, conducting continuous peer education sessions, discussions with influential
leaders, voluntary HIV testing, medical treatment to prevent transmission of the HIV/AIDS from mother to
child. By a continuous Meeting of Task Force Committees to avoid exclusion and discrimination the youth
and women faced at health center, hotels, police station and kebele level.
Therefore, it was possible to see the following results;
Beneficiaries attended Community Conversation and peer education session on HIV/AIDS.
Beneficiaries affirmed that their knowledge on HIV and AIDS increased.
Beneficiaries believe they are giving them a chance to express themselves.
Beneficiaries believed that HIV/AIDS knowledge of people around them has increased.
Beneficiaries believed that people in their environment are more likely to be tested for HIV/AIDS after
Community conversation and peer education sessions.
Peer educators, youth association members, community members think after continuous peer
education sessions that people know the rights of people living with HIV/AIDS.

III. Major Activities implemented


List activities performed. Please make sure you link the activities performed to the expected
indicators mentioned and attached here with contributing to the outputs and impacts of the project.

The goal of the project is to contribute to efforts being made by the National AIDS and STIs control
Program, by encouraging prevention of new HIV/AIDs and STIs by brining positive sexual behavior
change by sex workers or SWs.
In order to achieve the above project goal, the project has laid out a number of activities. These include
training of peer educators, organizing of education and information activities, distribution of condoms, and
referral to STI management and voluntary counseling and testing centers.
Refresher Training for peer educators
A refresher training was given for 27 peer educators using the training manuals we had previously used in
the first quarter. The training is also geared towards providing these girls with skills to motivate their peers
to protect themselves by using condoms, how to teach their peers by using the peer education session
manual, showing them how to use the condoms and getting them to make use of health services to manage
STIs and attend HIV voluntary testing centers. Providing this training will strengthen Output 1.2 Increased
HIV prevention awareness among workers in a hotspot area and connect them to HIV services accessible
water and output 2.1: Strengthened CCC implementation in the project areas.
Periodic Peer education session
At the end of the refresher training, the peer educators conducted a four periodic peer education session.
The plan includes two group discussions and four counseling sessions per week. The group discussions are
communication activities on average in groups of five, aimed at behavioral change. The counseling
sessions, on the other hand, are individual activities. During these activities, peer educators inform their
peers about the means of transmission, the methods of prevention and treatment of STI/HIV/AIDS, the
referral centers and services available, and the negotiation tactics to make their clients use condoms. They
also give demonstrations on how to use the male and female condoms.

The peer educators are supervised by community facilitators, sex workers who have acquired a solid
experience in peer education through several years of practice and Mile Woreda Health Center HIV/AIDS
case managers. The HIV/AIDS case managers from referral health centers, who handle STI management.
They conduct supervision visits to sex work sites twice a week. Each technical supervisor supervises about
five peer educators. The peer education equipment called "IEC kit" has a brochure, a demonstration
mannequin, a wooden penis, condoms, spermicides, picture boxes, etc. The internal supervisors keep this
equipment and the peer educators can obtain their supplies for them.
Voluntarily HIV Testing and counseling
HIV testing is not common in the Afar community, but after extensive awareness creation, young people
say they plan to get tested voluntarily and get tested before they start friendship or engagement. More than
200 workers at Mile Customs Station are living with HIV/AIDS. They established an Association called
People Living with HIV/AIDS and making themselves expose to the community, they are acting as if
transmission HIV is enough for me. Engaged people with HIV (PLHIV) who are already on ART and
were also identified among key populations as mobilizers to intensify social network HIV testing by them
taking a lead in identifying follow key population (KPs) not tested to be tested and know their HIV status.
This will significantly contribute to the strengthening of Output 1.1: KPPs (FSWs and adolescent girls and
young women) are integrated with health facilities to provide effective HIV/AIDS services through peer
education.

Distribution of condoms
The condoms are ordered through the woreda HAPCO office, which delivers them to hotels or peer
educators. During counseling sessions, peer educators actively ask about symptoms of STIs among their
peers. They check the monthly check-up form and convince SWs to do their check-ups or go for voluntary
HIV testing. Depending on what is found, SWs are referred to the health centers for management of their
STIs or for routine check-up, and to the VCT centers for HIV testing. The SWs are given a referral slip,
which they show to the PE, who is based at the referral center. The PE receives the referred SWs and
introduces them to the health workers. In addition to the referral activities of the Pes, run by a voluntary
HIV case manager, conducts regular visits to the sex work sites in Mile to provide care and monitor sex
workers who refuse to or who cannot go to the appropriate health care center.

Following this, we were able to effectively implement the following activities and achieved results .

 Organized a workshop involving hoteliers, police stations, women, children and social affairs offices
and regional HAPCO/health offices with a total of 45 participants to strengthen coordination and
information sharing to improve client referral relationships and provide high quality services.
Thus, KPPs used a comprehensive strengthening approach that trained health providers and peer service
workers to identify and respond to gender-based violence (GBV) at risk of contracting or transmitting
HIV and STIs. This comprehensive approach allowed KPPs to access support from multiple entry points,
promoting a more comprehensive and integrated response to GBV issues. By improving coordination
between sectors such as health, law enforcement and social services, the referral network has become
stronger and more responsive to the needs of KPPs with GBV, ultimately improving the overall quality of
care and contributing to a safer environment for KPPs.
 We held discussion forums with 51 participants to establish partnership and information exchange
agreements between police stations, women and social affairs offices and health centers. This allows
health centers to serve as a gateway to abuse-related assessments and support, especially for clients who
have been abused. Staff at the police station, women's and children's office and health center were able to
discuss and support clients using STI/HIV services. These services lead to access to related health
services, including HIV testing and sexual assault prevention. By organizing an advocacy workshop
under the coordination of the HIV Prevention Coordinating Committee, in which 40 participants
participated, it was possible to create awareness and impact on the 2 percent of the district government's
annual budget for HIV prevention. Thus, strengthening the capacity of community actors has improved
HIV prevention and the GBV response. Peer mobilization of KPPs-friendly bar and hoteliers helped to
identify and support violent cases. This strategy has been useful for other CBOs, but requires sustained
discussion of realistic expectations in collaboration with KPPs and community actors to identify potential
actors.
 Reinforcement GBV focused Training was provided to 38 participants on GBV for hotel and restaurant
owners, implementation of reporting procedures to law enforcement, and legal avenues for sexual
assault cases. Through joint activities with KPPs, peer educators, community activists and service providers,
he was able to ensure responsive referral networks. Regular meetings and activities with KP members and
referral points have strengthened positive partnerships and expanded the referral network.
 Capacity building training was provided to 39 different service providers in the district, working on
HIV and GBV prevention, providers (health providers, Sharia and other legal professionals etc.) to
ensure that they are aligned with the actual needs of KPS, explained what it is. The services they provide,
and consultation to address service barriers. Therefore, it was possible to create awareness of the importance
of action for KPPs by influential leaders in HIV, STD and GBV prevention and response mechanisms through
comprehensive community consultation. GBV-related training sessions for health service providers and CBOs
are frequent, focusing on relationships with service providers and creating an opportunity to develop specific
risks and challenges.

Review meeting
In General, the review meeting focused what changes were observed in the following areas periodic peer
education session status, voluntary counseling and testing (VCT) practices, sexually transmitted infections
(STI) diseases awareness, prevention of mother-to-child HIV transmission (PMTCT) testing and care and
treatment (C&T). The peer moderators’ commitments, Islamic Sherea Court, the police and hotel owners’
collaboration and that they are performing their significant role for the project and for the protection of
women's rights. This will play a significant role in the strengthening of the result mentioned in Output 2.2:
Established community-based service monitoring committee at Woreda levels; It creates an environment
for continuous support and monitoring activities to be strengthened.
IV. Analysis of implementation
Critical section of analysis based on the organizational objective. Cleary show how the implemented
activities contributed to the achievement of the objective.

TEA key programmatic areas of prevention support for those affected by HIV and AIDS, care and
treatment, Stigma prevention and health systems strengthening. Orphans and vulnerable children are at
increased risk for neglect, abuse, malnutrition, poverty, illness and discrimination, and as they get older,
they are more vulnerable to HIV infection. In response, TEA prioritizes linking HIV-positive and young
people to treatment centers that build on community and family support structures to care for and track the
welfare of affected youth. TEA works with the line Government structures to provide comprehensive and
coordinated quality services for vulnerable youth and females.
The implementation of these activities will contribute to the strengthening of Outcome 1: The risk of
KPPS contracting or transmitting HIV and STIs reduced through advocacy and support organizations and
to Outcome 2: Increased participation of the government and influential leaders in HIV service of KPPs
through community-based monitoring.

V. Planned activities vs. achievement


Describe planned activities and achievement in short narration (write about the implemented
activities) and quantitative form (in quantitative form it should include the plan and
accomplishment to date column)

Peer-to-peer discussions, refresher training for peer trainers and moderators, assessment meetings with
adolescent girls and young women, preparation of referral formats, regular discussion sessions and regular
monitoring are some of the activities carried out during the quarter. Their performance in terms of the plan is
compared as follows. Conducted a regular service monitoring at the health facility level.
Se Indicators Target Achievement % Reason For
r for this Deviation
No quarter

1 Percentage of sex workers reached 489 500 102.2494888 The difference is due
with HIV prevention programs - to extensive
defined package of services awareness creation
(Major area of the Intervention) work.
2 Percentage of sex workers that 342 87 25.43859649
have received an HIV test during
the reporting period and know
their results (Major area of the
Intervention)
3 Percentage of other vulnerable 300 200 66.66666667 1 positive
populations (Daily Laborers)
reached with HIV prevention
programs - defined package of
services. (Major area of the
Intervention)
4 Percentage of other vulnerable 400 250 62.5 It is because there is
populations that have received an an attitude that it will
HIV test during the reporting not be investigated
period and know their results because there is fear.
(Daily Laborers) (Major area of
the Intervention)
5 Percentage of HIV-positive 10 9 90
pregnant women who received
ART during pregnancy
6 Percentage of HIV-exposed 7 0 0 No case come to the
infants receiving a virological test health center
for HIV within 2 months of birth
7 Percentage of people living with 75 245 326.6666667
HIV currently receiving
antiretroviral therapy
8 Percentage of people living with 50 30 60
HIV newly enrolled in HIV care
started on TB preventive therapy
9 Percentage of people living with 10 9 90 6 free from TB
HIV in care (including PMTCT)
VI. Deviation from the plan and reason for deviation
Description of major changes observed as a result of the activities accomplished during the reporting
quarter and in the previous quarters.
The commitment of the established task force of influential leaders (kebele, Hotel owners, Clan and
Government institutions and Health center leaders etc. are:

The youth group commitments and behavioral changes towards HIV prevention
Compassion and support from taskforce members towards people living with HIV/AIDS during their
testimonies;
Commitment by the taskforce members to create awareness in public events, mosques, Christian churches,
Sharia courts, kebele, hotels etc. are;
Effective participation of the taskforce members in the Gender based Violence (GBV) prevention through
the function of their organizations and through specific activities;

The established task force of influential leaders: - This task force enforces the law in the Mile town and the
woreda; By doing justice; they have started to play an important role in stopping the new spread of HIV by
contacting and creating awareness for the community directly. Therefore, we will continue to strengthen this
work to bring results. This is the main contribution of Output 1.3: he incidence of GBV cases decreased.

Major challenges faced and actions taken

The implementation of this project was faced with some challenges. These include:
 Due to the cost of life and lack of jobs, young peoples are discouraged and they become carelessness
 Refusal by Female sex workers go to STI and voluntary testing health centers
 Inconsistent use of condoms with customers or regular partners
 Refusal to go for voluntary HIV testing for fear of stigmatization, and
 Illiteracy among a greater majority of sex workers
 Hotel owners After taking condoms for free from the government, they sell to SWs who work in their
hotels.
Action taken
The fact that peer educators, who are SWs themselves handle the condom distribution through their
network, has helped to build trust within the group.
The influential leaders became more committed after being encouraged and trained by the Project. We
used participatory strategies on training, outreach and advocacy. The influential leaders task force
established. This taskforce can be effective in the fight against the epidemic. Through
 Strengthen the synergy between the various religious denominations;
 Strengthen the leadership of religious leaders in the face of HIV/AIDS;
 Contribute to decreasing the spread of HIV/AIDS
 Build the capacities of religious leaders with reference to prevention and psycho- social and
spiritual care in the context of HIV/AIDS.
VII. Lessons learned and recommendations
We have learned that all stakeholders are critical to the effectiveness of the work by strengthening
coordination and regular awareness creation sessions with the active participation of the tribal leaders,
religious leaders, Kebele administrations, health officers, youth associations, Customs office, Federal
Police and Defense Camps, it is possible to bring about change. We were also able to realize that there is a
high prevalence of HIV in these military camps.

Integrated data collection systems, including the use of agreed indicators, are a priority for all stakeholders.
Different stakeholders may have different information needs to some extent, but in DCC. Having a
coordinated process between stakeholders reduces confusion about what is communicated, increases the
accuracy of the information and ultimately allows any stakeholder to use the information.

Therefore, GBV prevention and response efforts must be aligned with national and regional government
structures. Since there are many pastoralist people living in Ethiopia, it is necessary to develop a data
collection system to understand and respond to the scope of the problem, and there should be mandatory laws
or decrees for the concerned parties to pay attention. Partners with other ministries should ensure that data
collection is aligned with government systems and facilitate institutional capacity building of relevant
government structures (eg institutional capacity assessment, identification of gaps and action plans to address
gaps).

Investments in the health sector in areas such as Afar, pastoralists and war-torn areas must continue,
but multisectoral collaboration at all levels will improve integration of GBV prevention and response
with HIV services. We have been doing work focused on integrating GBV in the health sector, especially
GBV prevention and response with the HIV service platform, and this needs to be strengthened. Although this
is a natural and effective approach to GBV prevention in Ethiopia, future GBV prevention and response
interventions should include other sectors to translate clinical investments into quality services for GBV
survivors. For example, GBV should facilitate the development of a GBV service mapping tool, but the
quality of services provided in non-health sectors (eg legal services, socioeconomic support and psychological
counseling) is in some cases very limited. In designing and implementing multifaceted GBV prevention and
response interventions, donors and policy makers must ensure that the needs of GBV survivors are fully met.

VIII. Cross cutting issues


In the district, there is no food support for the families exposed to the disease, so their children are
becoming vulnerable to food shortages. Especially since there is no support given to those people who are
not Afar ethnicity, it has made the problem difficult. In connection with the war, many of the pastoralist
are armed, and women are being raped and forced to sex without using condoms. We are working with
influential leaders to solve these and similar problems.
IX. Other information

The business not active like as before and there is a severe food shortage, so it is good if there is an option to
provide immediate food support to mothers and their children who are affected by the HIV/AIDS and STIs
disease.

Annex

Financial Report Attached separately.

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