ADVOCACY PLAN: GOALS AND OBJECTIVES

GOAL

The ultimate goal of the advocacy plan is to reduce HIV prevalence among the newly born children through provision of information on sexual and reproductive health amongst youth especially Young People Living with HIV and AIDS.

OBJECTIVES

1. Prevent unintended pregnancies by encouraging the dual approach that is the use of condoms and contraception by HIV young positive women.
2. Encourage participation of HIV positive male to provide greater opportunity for communication about condom use between partners and assist young women in adopting contraception.
3. Integrate Anti-Retroviral Treatment and sexual and reproductive health amongst HIV positive young people to reduce mother to child transimmission and HIV transmission in general.
4. Strengthening sexual and reproductive health education in schools targeting adholescent girls and boys as an approach to reduce risk behaviour.

JUSTIFICATION

With growing numbers of people aware of their status and on anti-retroviral treatment (ART), it is critical to respond to their sexual and reproductive needs and rights, including HIV prevention needs. HIV positive young women, and men, need to be able to make informed sexual and reproductive health choices and have access to sexual and reproductive services such as family planning advice. HIV prevention programs aimed at young people living with HIV are a critical component of HIV prevention efforts. HIV and sexual and reproductive health are closely linked hence imperative to integrate the two aspects. A vacuum exists in the access to both information and services on sexual and reproductive health amongst young people living with HIV in the rural areas of Zimbabwe despite its positive contribution to the fight against the further spread of the pandemic.

There is no single approach which can hollistically fight HIV hence also the need to target adholescent people within schools to reduce new infections. Encouraging safer sexual behaviours in adolescents within schools is an important aspect in reducing risk behaviour. Education of sexual and reproductive health in secondary schools is an important aspect as it recognises the sexual development of these young people which, if not properly guided put them at risk to HIV infection.

NB-On young people living with HIV the project will utilise those whom are in the Support Groups of PLWHA of Rozaria Memorial Trust(the organisation i work for). Also RMT has in-school activities on HIV and AIDS so the avocate plan will utilise that existing platform but at the same time complimenting the work in another useful dimension. 'If you want to walk fast, walk alone but if you want to walk further, walk together'. Indeed by joining hands with Rozaria Memorial Trust we can walk further in the fight against HIV

MODULE 2: ASSIGNMENT 2--PHOTOVOICE PROJECT

PARENTS AND GUARDIANS OF CHILDREN LIVING WITH HIV/AIDS RECEIVING PYSCHO-SOCIAL SERVICES ON POSITIVE LIVING

26/03/2010, Magaya Village, Murewa, Zimbabwe

The two pictures above show parents and guardians of children living with HIV and AIDS participating in a local meeting on pscho-social suport issues on positive living. These are child psychologists at home they need to provide undivided love and help the child to overcome feeling of resentement and self denial. Without proper guidance and support this sometimes its a daunting task to many parents and guardians as most of them lack the skill and knowledge on how to best disclose the HIV status to the child. Also, it is important to note that some of these guardians are living with HIV/AIDS and still at denial then found themselves having to provide care for a positive child. This really inhibits effective support to the child.

From the analysis of the picture, there is clear indication that issues of care are centered on women, very few men are involved in the HIV care and support. HIV and AIDS is not merely a health issue but it further aggravates the social-economic vulnerabilities of women in society.

PROVIDING A SUPPORTIVE ENVIRONMENT FOR CHILDREN LIVING WITH HIV/AIDS

26/03/2010, Magaya School, Murewa, Zimbabwe


This is an informal group interaction of Children Living with HIV and AIDS and the facilitor of the meeting with the parents and guardians. This social interaction help to diminish the sense of isolation and improves the self esteem of the child. It is designed to encourage normal growth and development of the child and at the same time help to prevent psychological consequenses.

HIV positive children should be afforded equal opportunity to go to school and actively participate in all activities. Like on this particular day, the children were at school which means that although a child's status should be kept confidential because of fear of stigmatisation consideration should be made of informing those who need to be aware like school teachers who spends the invaluable time with the children. This can help to administer Anti-Retroviral medication at school level.

The most difficult part is that most of these children do not know their HIV status.

BRINGING THE COMMUNITY WOMEN VOICES IN FIGHTING HIV AND AIDS: DZEPFUNDE IN ACTION

27/11/09, Marumisa Village, Murewa, Zimbabwe

Music is a powerful way of information dissemination! The picture above shows the Dzepfunde group perfoming at Rozaria Memorial Trust organised village meeting on the consequenses of Violence Against Women and Girls to the spread of HIV and AIDS. Dzepfunde is a 20 member women only traditional performance group. Dzepfunde plays Jerusarema and Jiti with lyrics string with behaviour change messages that integrates HIV and Violence Against Women.

Their lyrics are cross cutting, they touch on both adults and children whist at the same time they remain modern, tackling issues mainly to do with stigma and discrimination and delivering key messages on positive living.

This community centred initiative demostrates that communities can create a shared vision in the fight against HIV and AIDS of an equitable and sustainable future through locally initiated and managed projects.Such initiatives need compliment through capacity building at village level taking into consideration the dynamism of HIV and AIDS; this enables the communities to measure progress towards the vision of fighting HIV and AIDS.

FIGTING HIV AND AIDS IN SCHOOLS THROUGH TRADITIONAL MUSIC AND THEATRE

28/11/2009, Zhombwe Primary School, Murewa, Zimbabwe

This was part of events during a price giving ceremony on essay competition on HIV and AIDS in schools hosted by Rozaria Memorial Trust, the organisation i work for.

This traditional lyrics called Jiti provides entertainment but at the same time they are educative and informative; it gives a relaxed atmosphere in disseminating various messages on HIV and AIDS. The schools are an effective platform to provide both primary and secondary school-aged children and adolescents with specific, gender sensitive and age appropriate information on HIV and AIDS prevention.
Such initiative shows that if school children are properly organised, they can be effective agents of change within the communities they live in. It encourage community and action orientated research by children to accelerate response to HIV

KNOW YOUR EPIDEMIC: THE ZIMBABWEAN HIV AND AIDS CONTEXT

ZIMBABWE AND HIV/AIDS
HIV and AIDS was first reported in Zimbabwe in 1985. In the early 1990's about 10% of the adult population were estimated to be living with HIV and AIDS It rose dramatically to about 29% by 1997. But since then the prevalence has declined to the current estimate of 13,7% according to Ministry of Health (2009). Zimbabwe has a population of 12 million people and the number of people living with HIV and AIDS is estimated to be 1 300 000. The HIV pandemic has disproportionately affected women with 680 000 of them living with it and the children with HIV and AIDS are 120 000. The age group with most People living with HIV and AIDS is between 15-45 years.

The decline in the HIV prevalence rate has been to some positive changes in sexual behavior due to increased awareness of HIV and AIDS. The Zimbabwe Demographic and Health Survey showed that around 76% of women and 81% of men know that condoms can reduce the risk of HIV infection. Also there is an increase in the number of young people delaying the debut sex encounters. Also there is reduced sex partners amongst both the married and those still single.

THE GOVERNMENT AND CIVIL SOCIETY RESPONSE
The Zimbabwean government was slow to acknowledge the problem and take appropriate action when HIV and AIDS first emerged in Zimbabwe. National Aids Co-ordination Programme (NACP) was set up in 1987 and several short and medium term AIDS plans were carried out in the preceding years but the country's first HIV and AIDS policy was announced. NACP was replaced by National AIDS Council (NAC) in 1999 and in the same year the government introduced AIDS levy on all taxpayers to fund the work of the NAC.

These measures have had a positive impact, the political will towards fighting HIV and AIDS is there in Zimbabwe but other issue have led to a situation where the government is unable to adequately address the crisis. The government response to HIV and AIDS have been compromised by other political and social crisis that have dominated political attention and negatively affected the implementation of the National AIDS policy. National AIDS Council is also poorly organize and lack the resources to effectively respond to HIV and AIDS in the country.

Some political tension between Zimbabwe and some western countries has decreased aid or at other times halted altogether thereby negatively affecting the responses to HIV and AIDS by both the government and Civil Society Organizations. Although, Zimbabwe is still receiving a substantial amount on HIV and AIDS, these donations are not as much as other Sub-Saharan African countries are receiving. For example Zambia, a neighboring nation with a similar HIV prevalence rate, was reported in 2008 to be receiving $187 per HIV positive person annually from foreign donors and in Zimbabwe the figure was estimated to be just $4 per person

THE EFFECTS OF HIV AMONGST WOMEN AND CHILDREN
It is estimated that 680 000 women and 120 000 children are living with HIV and AIDS in Zimbabwe. There are large social and economic gaps between women and men in Zimbabwe, and these inequalities have played a central role in the spread of HIV. Constrictive attitudes towards female sexuality contrast with lenient ones towards the sexual activity of men, resulting in a situation where men often have multiple sexual partners and women have little authority to instigate condom use. W omen's roles and their biological vulnerability to HIV infection have been a major driver of HIV infection amongst women in Zimbabwe. According to UNAIDS estimates, almost 60% of Zimbabwean adults living with HIV at the end of 2006 were female. This gender gap is even wider amongst young people – women make up around 77% of people between the ages of 15 and 24 living with HIV.

As the rural Zimbabwe remains a fertile ground for the spread of HIV and AIDS, women in this area face a multiple HIV induced problems. Most of them they lack access to facilities such as post-exposure prophylaxis and adequate maternal health attention because they have limited access to information on these. However, because of limited human resources and poor infrastructures, many women are still not receiving these drugs others have to walk for distances of more than 20km to reach the next clinic or hospital. This has increased mother to child-transmission although most of the hospitals in the country have drugs to prevent such incidences.The provision of drugs to prevent mother to child rose from 4% in 2006 to about 35% in 2009. Although this is an encouraging scale-up, access to nevirapine remains low especially in rural areas.

Prevention campaigns that emphasise safe sex and abstinence often fail to take into account these realities, and are more applicable to the lives of men than those of women. Women are likely to be poorer and less educated than men, exposing them to HIV infection and making it harder for them to access treatment, care and information.

On palliative care, current statistics indicate that more than two third of all Home Based Care giving for People Living with HIV and AIDS are women. These women often struggle to bring in income whilst providing care therefore many families affected by AIDS suffer from increasing poverty. Also young girls are greatly affected where both parents are ill from HIV and AIDS as they become the main carers at other times even foregoing their school education. When both parents die she becomes the head of the family; this scenario also applies to young boys who found themselves in the same predicament.

YOUTH AND HIV/AIDS
Young people in Zimbabwe are much more vulnerable to HIV/AIDS than older people are. Because their social, emotional and psychological development is incomplete, they tend to experiment with risky behavior, often with little awareness of the danger. In fact, risky sexual behavior often is part of a larger pattern of adolescent behavior in the country, including alcohol and drug use, delinquency, and challenging authority

Nevertheless, most young people have only limited knowledge about HIV/AIDS—largely because the society make it difficult for them to obtain information especially in the rural areas. . Because adolescents are in a period of transition, in which they are no longer children but not yet adults, public health responses to their needs are often conflicting and confused. At the same time, social norms and expectations, along with peer opinion, affects young people's thereby exposing them to risk behavior.

AIDS deaths have forced many adolescents to take on adult roles in Zimbabwe, the transition from childhood to adulthood is disappearing. Often, children must leave school to care for a dying parent or relative. Because AIDS consumes family budgets, fewer funds remain available for children's education, health care, and other needs. Moreover, children who care for relatives with AIDS but who remain in school are often older than their classmates and thus more likely to drop out of school early Some strategies being proposed to alleviate the impact of HIV/AIDS on children include subsidizing school expenses such as school uniforms and school fees.

Also young girls are greatly affected where both parents are ill from HIV and AIDS as they become the main carers at other times even foregoing their school education. When both parents die she becomes the head of the family; this scenario also applies to young boys who found themselves in the same predicament.

With the Anti-retro-viral drugs prolonging the life of people living with HIV and AIDS, young children are graduating into adolescence but there is lack of knowledge and guidance on these children on how to deal with their developing sexual life, there is no sexual and reproductive education amongst the youth.

CONCLUSION

The Zimbabwean government and Civil Society organization response to the AIDS crisis has been commendable given the limited resources under which they are operating. Prevention and treatment initiatives have been scaled up and the national HIV prevalence seems to have declined.

Despite this, HIV prevalence is still one of the highest in the world and the majority of those in need of antiretroviral treatment are not receiving it. A prevalence rate of 13,7 remains high therefore its not a time to relax; there is need to reinvigorate and scale up prevention and awareness programming on HIV/AIDS in Zimbabwe.

About Kudakwashe Dizha

My name is Kudakwashe Dizha and i am 24 years old. I am from Zimbabwe which is in the Southern part of Africa and also falls under the Sub-Saharan Africa which is a home to the two third of people living with HIV and AIDS in the world. Zimbabwe has only three major languages namely Shona, Ndebele and English which is the official language. My mother language is Shona and for you to have a taste of it follow the following transaction "KUENDESA MWANA MUSIKANA KUCHIKORO KUNO DEREDZA KUPARIRA KWE HIV/AIDS" in english it means "sending a girl child to school reduce her vulnerability to HIV/AIDS". Nonetheless, its country with less ethical and religious friction as most of the people believe in Christianity.

Currently, i am working for Rozaria Memorial Trust which is a Non-Governmental Organization which is based in Murewa District, Zimbabwe and i am studying towards a degree in Office Administration and Technology with Chinhoyi University of Technology. Rozaria Memorial Trust work is rooted on care and support for people living with HIV and AIDS. Also we do prevention and awareness in schools and the rural communities on HIV/AIDS and Violence Against Women.I have been involved in HIV programming for Rozaria Memorial Trust from 2007 up to now as the Coordinator. For more information on the work of Rozaria Memorial Trust you can visit our website:http://www.rozariatrust.org

My community has been deeply affected by HIV and AIDS, with the current statistics from existing work of my organization depicting an average of 15 people per village who are living with HIV and AIDS openly; most of the rural villages on average have of about 100 households. At national level the prevalence rate is 13,2% and the rural areas continue to be the fertile grounds for the spread of HIV and AIDS as there is limited awareness on HIV and AIDS especially amongst the youth. Also the patriarchal nature of the society has contributed to the vulnerability of girls and women to HIV and AIDS.

The e-course its a unique programme which will deepen my knowledge on HIV/AIDS and also help me to strengthen the already existing work of Rozaria Memorial Trust on HIV and AIDS thereby making the e-course to be more practical as possible.