REVIEW OF IRISH AID PROJECT Michael McCarthy November 2007
Contents Introduction
3
General Findings
7
Detailed findings in relation to each Support Group 12 Recommendations
29
1. Introduction This report seeks to assess the impact of a 3-year Capacity Building Project funded by the Irish Government (Irish Aid) and facilitated by Skillshare Ireland and implemented by SWANNEPHA. This project aims to: ‘To strengthen the capacity of Community Support Groups (CSG) and the National PLWHA Networks.’ The report will document activities of the project to date, identify barriers to its implementation and provide a clear strategy for the project for the final 2 years.
Swaziland and HIV/AIDS The Sentinel Surveillance of 2006 reflects that Swaziland has an HIV prevalence rate of 39.2% amongst pregnant women, which is amongst the highest in the world. About two hundred thousand and twenty thousand people (220 000) are believed to be living with the virus. More than thirty thousand (30 000) people are believed to be in need of antiretroviral therapy. To date it is reported that about twenty three thousand (23 000) PLWHA have been on record to have started receiving treatment, about six thousand (6 000) people have been lost for reasons not known. This is attributed to lack of information on issues of positive prevention, treatment, care and support for people living with HIV and AIDS and poor tracking systems. The rollout of the Antiretroviral Therapy (ART) and Prevention of Mother to Child Transmission (PMTCT) programmes through the public health system in Swaziland has created a great need for information on living with HIV and AIDS, prevention, treatment, care and support, particularly from the point of view of people infected or affected by the virus.
SWANNEPHA The Swaziland National Network of People Living with HIV and AIDS (SWANNEPHA) is an umbrella body of organizations of people living with HIVAIDS. Since its inception in November 2004, with a membership of 43 support groups and organization, SWANNEPHA has had a 435% growth rate to 187
groups by December 2006, some with a minimum of 25 and a maximum of 1000 members. SWANNEPHA is a non-profit making National Network promoting unity among its members to strive for the greater involvement of people infected and affected by HIVAIDS (GIPA) in Swaziland. The Network considers the GIPA concept as its guiding principle and, therefore, reaffirms the key role PLWHA play in the national response to this epidemic. SWANNEPHA coordinates the PLWHA Support Groups to mobilise at a community level to prevent new HIV infections, support care of the infected and affected and design impact mitigation projects to counter the effects of the epidemic. The Network strengthens advocacy issues surrounding PLWHA, supports capacity building, skills sharing and information generation. SWANNEPHA is an infra-structural body ideally placed between the statutory sector, Community Support Groups and Associations to support the development of systems that will ensure quality of life for all people infected and affected in the country.
SWANNEPHA Community Support Groups Support groups (SG) are community based public interest, non profit making organizations formed by community members to serve them. Support groups are not owned by one person or founder that is why services revolve around the needs of the people. The aim of PLWHAS support groups was formed with purpose of providing prevention, care and support to those people infected and affected by HIV/AIDS. They help PLWHAS and community to mitigate socialeconomic impacts created by HIV/AIDS. One of the key functions of support groups is to educate the people and create awareness of HIV/AIDS, and work towards reducing new infections, stigma and discrimination of PLWHAS SWANNEPHA membership encourages formal leadership structures and openness about ones HIV positive status. Main activities include, education of general public on HIV and AIDS and positive living, home-based care, counseling and income generating projects such as farming.
Irish Aid Capacity Building Project In 2006 SWANNEPHA commenced implementing a Capacity Building Project funded by the Irish Government (Irish Aid) and facilitated by Skillshare Ireland. This project aims to: ‘To strengthen the capacity of Community Support Groups (CSG) and the National PLWHA Networks.’
This is a regional Project working in 4 countries, Swaziland, Lesotho, Mozambique and Botswana. The Project aims to be able to support 20 CSG in each country to increase their capacity to develop responses to issues relating to HIV/Aids in their community. SWANNEPHA is the implementing agency in relation to Swaziland and oversaw the selection of 20 SG to participate in the projects that were equally spread among the 4 regions of Swaziland. Please see overleaf for the activities that have taken place to date under the projects 5 Objectives:
Irish Aid Capacity Building Project (IA Project) Objective 1 To strengthen Institutional and Organisation Capacity of PLWHAs Training workshops provided in1. Human rights & legal rights (Family law, Constitutional Law, Swazi law & customs) 2. Social mobilization & peer education 3. ART& PMTCT, Referral System and Adherence monitoring Objective 2 To strengthen advocacy and influencing policy of PLWHAs and their institutions 1. 2.
100 T-shirts with Advocacy Messages developed and distributed to 20 support groups-conducted on World AIDS Day 100 PLWHAs wore these t-shirts with the message" Stop AIDS and Keep the promise�
Objective 3. To facilitate sharing learning and experiences No work undertaken to date Objective 4. To develop support for psycho-socio and livelihood support for PLWHA 1. 2. 3.
10 sewing machines procured for 10 PLWHA groups. 36 PLWHAs from 10 support groups were trained in nutritional gardens from Hhohho and Manzini regions. 20 people trained in Entrepreneurship skills & business management
Objective 5 To pilot a holistic approach towards providing support to orphans and vulnerable groups
1.
10 support groups trained in income generating activities to support community orphanages 20 people trained as model mothers & to provide psychosocial support to OVCs
2.
Methodology The Objective in undertaking this research was to obtain the following: -
Assess impact and issues relating to the implementation of the Irish Aid Capacity Building Project Identify where SWANNAPHA can strategically intervene and support the Support Groups (SG) to the best effect Assess current capacity of SGs Identify gaps and barriers to be addressed Identify Local resources and Agencies Develop relationships with SGs
Methods A Questionnaire was developed and piloted on a number of Support Groups. The final questionnaire was translated to SiSwati as was a brief document explaining the purpose of the Irish Aid Project. This questionnaire was used for a semistructured interviews with each support group, with the assistance of a translator. Field visits took place from October 12th –October 29th 2007.
2. General findings Role of SG in sensitizing the community in relation to HIV/AIDS All the Support Groups in the project play a central role in their community in educating, supporting and counseling members about HIV/AIDS. Some of the areas covered by groups include; General information about HIV/AIDS and its effects, Adherence Counseling, Positive living, Preventive measures (such as condom distribution), and promoting the value of VCT. However it was beyond the scope of this research to asses the quality and effectiveness of this information provision. The groups almost always originated as peer support groups and this coupled with training they have received from this project and other agencies has ensured that they are a valuable resource for the community in this area. While some groups have been quite innovative, using drama, poetry, holding workshops, others have faced difficulties in terms of stigma and lack of support from local leaders and lack of resources which has reduced their effectiveness. Also it seems that the groups success in this area is dependant on having a good relationship with local leaders and state agencies (usually health facilities) working in the community. Some groups have become a referral point by clinics and local leaders to provide counseling and support to those who have recently tested positive or are having problems with some aspect of their status. However the groups do not have the resources to fulfill this role as completely as they would wish.
Home-Based Care Provision Nearly all the groups are providing Home-based Care (HBC) to sick and bedridden members of the community. However they are facing many challenges in this work. Most of the communities are dispersed rural settlements. As none of the groups have access to their own transport (not even bicycles), which means that many members are not reached in a timely manner. And undertaking HBC can be debilitating for members of the group who are themselves not in the best of health. Moreover there was no evidence of systematic relationship between health authorities and SG, and many groups had no materials (gloves, soaps, napkins) to undertake their work. Their also seemed to be a lack of willingness
amongst health authorities to recognize the groups role in HBC, because they are not trained to a professional or certified level in this work.
Internal Governance and development of Support Groups All support groups had a clear constitution and officer roles. However some groups had taken a more sophisticated approach than others in relation to their work, having a well thought-out structure for the group and a clear vision and strategy. Every group’s remits have rapidly expanded since they formed as a peer support group to now becoming implementers for various different projects relating to HIV prevent and impact mitigation. It is clear that most of the group need support in identifying clear strategic goals within their current capacity and in identifying, mobilizing and managing additional resources. There is the potential that groups may quickly become overstretched if their management capacity is not developed.
Support from local leaders A key determinant in a group’s success is support and co-ordination with local leaders. Some groups have developed strong links with the local Chieftaincy and Inkhundla, receiving resources, especially land, others have received little or no support. A common reason for this has been the absence of strong leadership in the group and the discrimination or suspicion from local leaders and ignorance as to the group’s role.
Barriers to positive responses to HIV/AIDS Groups have been successful is spreading information about HIV and advocating for positive living among the community. However there are a number of barriers to this work being successfully embedded in the community. Many of the communities are not located beside a clinic dispensing ARVs (distances vary between 3-15km). Few members of the community have their own transport, getting to the clinics can be a significant problem and has led to adherence not being met. Most the groups are based in impoverished, self-reliant agricultural areas which have been suffering serious droughts with food production being severely effected, again resulting in low adherence to medicines. There has even been reports of some people selling their medicines for food. Combined with the fact that most communities had no piped water supply meant that the groups’ promotion of healthy nutrition as a way of slowing the development of HIV was not always possible to implement. The WFP does operate in the Lubombo and Shiselweni areas but they were some examples of distribution problems and groups from the other 2 regions didn’t have the WFP to rely on.
Income Generating Activities (IGA) Through the Irish Aid Project (IA Project) and other agencies, support groups have begun to develop IGAs with a view to increasing the groups resources and also to bolster individual members income. Although training in business planning was undertaken as part of the year 1 activities of this project, it was very obvious that groups need a lot more support in developing their IGAs. There were mixed results in relation to the sowing projects. The largest single challenge was the sourcing of market for the groups’ products. Most of the groups could only manage to sell products in the local community where there is a limited market due to population sizes and poverty. This approach to supporting IGAs in the community requires significant strategic review in terms of their long-term sustainability.
Co-ordination with other agencies It is evident from the research that many of the support groups have been successful in sourcing the support of other NGOs and Government Agencies. However these agencies are often working in an isolated and haphazard fashion, with much duplication evident and opportunities for productive partnerships approaches not being explored. This is particularly inefficient as some of the agencies working with support groups are also SWANNEPHA members (SASO and SWAPOL).
Advocacy Support groups have been strong advocates for PLWHA in their communities with varying success. The full potential of this advocacy has yet to be fully harnessed by SWANNEPHA at a regional or national level (where a lot of the policy changes need to be made). The most significant barrier to this happening is the absence of a regional structure within SWANNEPHA. SWANNEPHA is opening a regional office for Lubombo in Siphofaneni, Lubombo. A systematic process for communicating issues from the grassroots to the Board and secretariat and a strategic advocacy framework to respond to these issues, needs to be developed. To date there has been no formulised sharing of learning or experience among the 20 groups and as of yet, no formal mechanism for sharing experiences among the 4 countries involved in the project.
Monitoring and Evaluation There has been very poor record-keeping during the first year of the project and no systematic user friendly monitoring and evaluation system has been developed for SG, due to unforeseen staff turnover within SWANNEPHA. Many of the groups fill out more than one monitoring form, however a number keep no records of their activities. A user friendly monitoring and evaluation system needs to be developed. All groups must be supported to maintain records of their
activities and the administrative burden for groups must be kept realistic and not involve unnecessary duplication
Training There has been confusion among participants that the intervention training provided as part of this project is not the same as certified vocational training for employment purposes, especially in relation to peer counselling. Also it was difficult to ascertain how the training was being systematically used by the group as a whole. It would be helpful if clear practical follow-ups and monitoring of learning form the training was included as part of training workshops.
Gender Issues Most members of support group are women as they are often most affected by the impact of HIV. Also the prevalence of deeply rooted gender bias in Swazi culture can prove detrimental to the efforts to prevent HIV spread, promoting HIV testing, treatment literacy and adherence. The current gender makeup of many of the support groups can also mean the SG not being accepted by community leaders. However the work of many of the groups has shown that these issues are not insurmountable and many of the female group members identified that support groups were a safe and nurturing space for them to discuss their issue. However it was notable that the participation of men as support group members was very low and this is worrying due to their influence in the community but also due to the support needs that men with HIV also need.
Orphans and Vulnerable Children (OVCs) and Young People All the groups identified a high number of OVCs in their community who were facing many difficulties such as no proper parental/family support, lack of money to pay for school and limited support to help them deal with treatment if they are infected. Moreover very few of the groups have young people involved. In fact most young people identified that they would be more comfortable forming a separate group linked to the support group so they could discuss issues affecting them without adult or family members present.
Support Group Resources Participants raised concerns over working space. Activities are coordinated from individual’s homes and as there is often no office space to work from and a consistent central place to provide information or assistance.
Role of SWANNEPHA Although SWANNEPHA has shown leadership in developing this project, there is a danger that the learning from this project may not be easily incorporated into
the organization work as a whole. There is a need to evaluate the Network’s implementation of its current 5-year plan, with a view to developing clear annual implementation plans for the organization as a whole. Also SWANNEPHA’s administration capabilities need to be developed especially in terms of information retention and organisation, internal communication mechanisms and office management to ensure it is position to support its membership more effectively.
3. Detailed findings in relation to each Support Group Hhohho region 1. Asphile Nalo Mkhuzweni Support Group General. This is a new Support Group started in 2005 and has 28 members. It meets every 2 weeks, and has clear officer roles and group structure. However like most of the groups visited, although they were undertaking a number of activities, they need support to develop a clear plan to guide their work. The group’s preventative work concentrates giving awareness talks at local the Chieftain meeting. In terms of support and collaboration the group felt they had received some support from the chieftaincy. They have approached Red Cross for help in terms of food parcels but had heard nothing back. They also mentioned trying to contact the Director of the Disaster Task Force. They confirmed that they monitor their activities and fill out the SHAPMoS forms for NERCHA. They are affiliated to SWANNEPHA but wished to have more contact and understanding of the organization. Projects In terms of impact mitigation, like most Community Support Groups, this group originated as a peer support group for its members and continues to do so. It also is developing a number of projects to reduce the impact of HIV/AIDSA. Nutritional Gardens- Members of the group have had training in Nutritional gardens as part of the Irish Aid Project, but never received adequate seedlings (they did mention that the Chieftains KaGoGo centre did have seedlings for OVCs but didn’t elaborate on how they were to be used.) They are proposing to start the gardens on an individual basis in their own homesteads for their own consumption. They mentioned that sourcing water was a potential barrier to these plans as they were dependant on
Boreholes (within 3-5 Km of each homestead) and none of the group had any water tanks to collect rain water. B. Sewing IGA Project-This SG was one of the 10 who had received a sewing machine (as well material and training) as part of the Irish Aid Project. They seem to have some success so far in that they have been successful in selling the dresses in the local community for a total profit of 500 rand and have used this to buy further raw material and to support 10 OVCs. They are in the process of opening a bank account. However they are been asked to leave the Government Offices where the sowing project is based due to lack of space and are looking at re-housing options (they mentioned the local school). They were frustrated that there was a new craft enterprise center built in the community, but nobody was able to access due to what they saw as ‘Government Administration problems.’ They expressed a wish to receive training in how to develop their IGA. They also wish for advice on how to get new designs for their dresses and maintenance of their sowing machine. C. Poultry farming- They expressed an interest in developing a poultry farming project but had not developed the idea in any detail. 2. Nhlanguyavuka Support Group General This group was only formed last year and has 24 members. As well as SWANNEPHA it has received some support from World Vision in terms of food aid and the Red Cross in terms of candles and soaps. Although having a clear group structure it does no monitoring or reporting of its work at the moment. The group undertakes preventive and educational work around HIV/AIDS, for members of the group and also to the general community and Chieftaincy community meetings. It provides counseling to individual members of the community as the need arises. Projects The group has also developed 2 projects, with the help of Irish Aid, to mitigate the impact of HIV/AIDS on the community. A. Nutritional Gardens- The group has 1 large garden from land donated from a member of the group. (They have asked the local chief for their own land and he is in the process of investigating this). They sell the products from the garden and use the profits to support OVCs in the community. The group has used the skills they have learnt to develop nutrition gardens in their own homesteads as well. The main barrier in this area is the lack of proper fencing, as although they use the traditional method of using trees and hedges but unfortunately this doesn’t prevent chickens and goats from eating the produce. They fetch water from taps
where the water is pumped from bore holes in the vicinity. However sometimes the boreholes run dry. The group was interested in obtaining water tanks to alleviate this problem. B. Sewing Project- The group received a sewing machine and dresses from the IA Project. They are producing dresses for sale in the local community (so far have sold 5). They use the house of a member to do this. They requested training in how to develop this IGA.
3. Litsemba Liyaphilisa (Mpolonjeni) Support Group General This group has been existence for 2 years and has 106 members and meets twice a month. Unlike most other support groups, membership is open to infected and effected as an effort not to increase isolation and discrimination. The group also has a youth group which uses drama to sensitize both the youth and the wider community to HIV issues. It has developed a good relationship with the local chieftaincy, where they speak every week at Chieftaincy meetings about various aspects of AIDS/HIV. This has been very successful at sensitizing the community in relation to HIV/AIDS. The Chief will consult and refer people to the group if he comes across a case he deems they could be of help with. Members undertake home visits on a rota basis providing advice, encouragement and care and support to infected people who are sick/bed-ridden. This work has helped reduce stigma and discrimination in the community. The group doesn’t fill out any reporting forms for SHAPMoS (they were told they didn’t qualify to fill out SHAPMoS forms as they weren’t an official service agency) or SWANNEPHA but has developed its own monitoring forms to record its work. The group identified transport costs- people have to travel to Mbabane or Methane Clinic for ARV’s and tests- as a barrier to adherence. They identified that a large number of people also have TB and that this is as serious problem as HIV. The group (like many of the others) identified that having no materials (gloves, napkins, soaps etc) to undertake Home-based Care. They were initially supplied with materials from the Hospital in Mbabane but when they returned for more they were told that SWANNEPHA has to put in an order on their behalf. Unfortunately nothing has been clarified in this regard to date. Projects A. Development of Office- The group has also built an adobe office in the traditional fashion on land donated by the chair. The Chief has guaranteed that ownership will remain in the hands of the group. The group uses this space for information and counseling, but due to other demands on group members times mean it can’t be done on a drop-in basis.
B. Nutrition Gardens- The Group has developed a garden on their land whose produce is used for their own nutrition and it is also used to supplement the food of the bed-ridden. They have use traditional forms of fencing and have trouble keeping out some animals. Water is not a serious problem- it’s collected from a stream 1km away and there are plans being developed in the community to develop a project to bring piped water to the community. The group is trying to support members to develop gardens in their own homesteads but the major barriers here are lack of fencing, tools and seeds. C. Sewing Project. This is another of the 10 groups which received a sewing machine as part of the IA project. They are developing a room in their office as the home of the sewing project with electricity being piped in from a member’s generator. The group has been sowing t-shirts and getting a printing company to print HIV/AIDS messages on them. While the group feels there will be a large demand for such t-shirts the printing costs have proven exorbitant so they are reviewing the project. They have requested support in relation to this. D. Beads & Ribbons- Members of the groups skilled in crafts have also developed AIDS ribbons and beads. However they have been only able to sell a few locally and have had trouble receiving payment from organizations (including SWANNEPHA) that purchased larger orders. 4. Siyabonelela Support Group General This group is two years old and has 10 members. The group provides peer support and awareness around HIV. It also provides inputs about HIV at community meetings. The group has provided some Home-based Care and provides food for HBC the sick from their own pocket. They have been able to obtain materials from the local clinic in Ntfonjeni, with which they have a very good relationship. The group felt that current membership of the group was low due to so many a people becoming sick. There is a high level of stigma and discrimination in the community which led to difficulties in recruiting new members. They suggested that SWANNEPHA could have a role in educating local leaders about the SG and their role in dealing with HIV as a means of mobilizing local leaders to work with and support the SG, as they had little or no contact or support with local leaders. They fill out both SHAPMoS and SWANNEPHA monitoring Forms. Projects A. Nutritional Gardens- The group received seedlings and training from the local clinic. They have received fencing from Red Cross but are 3 rolls short. They also have obtained land for their communal garden from a member of the group. There is a river located next to the proposed garden
and they are interested in developing irrigation methods. They have shared the knowledge they have gained as part of this project with the wider community about the value of good nutrition. B. Sewing Project. Another of the SG to receive training and sowing machine. They are sewing school uniforms (have sowed 7 already) from a members home. But unfortunately the material arrived after the school year started so they won’t be able to sell any other uniforms until next year. They requested help in developing this project. 5. Asiphile Mantabeni Support Group This group is in existence for 3 years and has 42 members. They have received support from Ammical and the Red Cross in terms of funding/resources. They use the local Neighborhood Care Point (NCP) for holding meetings/workshops and as an office space. They provide information to the community about HIV at community meetings, undertake HBC (they were trained and are supplied with materials by Red Cross), and like all groups provide mutual support to each other. However like other groups transport costs for trips to Mbabane (about 15km away) to collect ARVs and have checkups can be a barrier for a lot of members’ strict adherence. As they are so close to Mbabane they don’t receive any food parcels from WFP but they are having similar crop failures as other parts of the country due to water shortages (they get water from a nearby dam 2km away) They also felt they could receive more support from community leadership. There are significant trust issues to be alleviated with the Chieftaincy, as the group was adamant they did not want resources channeled through the chieftaincy but directly to the group. The group fills out reports for SWANNEPHA. A. Nutritional Garden- IA provided training and seedlings and members of the group have developed their own gardens in their homesteads. The vegetables from these gardens are used for nutrition supplements but are also sold and some even given out free to members who can not afford to buy any B. Vaseline and Fabric Softener sales. The group developed this IGA project by saving their own capital. They have made profits from selling both products but have had to use some of the income to pay for members travel and other health expenses. This seems is a common dynamic among support groups. C. Sewing Project- the group has been able to use some of the income from the above project to buy a sewing machine and material and start a sowing project in the NCP. However this project is just in its infancy and the group has recognized the need for a clear business plan.
6. TALASO (Lobamba) Support Group (This group was originally designated as being in the Manzini region but the group clarified that it was based in the Hhhohho region.)
General It has been in existence since 2000 but only joined SWANNEPHA in 2005. The group provides HBC, Counseling and education around HIV. They have a written plan but recognized it was out of date and would need revisiting. Volunteers from the group attend the local clinic (Lobamba) twice a week to give advice about to clients attending the clinic. They have asked to be given space to speak at community meetings but there has not been time for this to happen yet. The Inkhundla has agreed to give the group a container to be used as an office and the chief has agreed to provide land to house it when it arrives. However they have nothing to equip the office with. They report to SHAPMoS and SWANNEPHA. Projects A. Nutritional Garden- This is a communal garden on land given by to the group by the Inkhundla. They have got fencing from Moya centre. There is a tap beside the garden that they use for water but as they will have to pay for this they are contemplating whether using a water tank would be more cost effective. They wish to develop gardens in individuals’ homesteads but the lack of fencing is a barrier. They also wish to explore the possibility of setting up a poultry project. They have been advised by Mantibeni SG in terms of their learning from developing Vaseline and Fabric Softener.
Manzini 7. Nigasecwayi Support Group General In existence since October of 2006 and now have 39 members. They have been given land by the chief. They have been visited by Red Cross but haven’t had a return visit as Red Cross wanted the SG to register as member at E20 Per person. They provide adherence support and provide awareness about HIV to groups members and to the wider community- they staged a drama about HIV and used this also to promote the group. They also provide support to families where a member has recently died. They have an unwritten plan and would like to have some help to develop it into a written plan. Poverty and lack of food is a big barrier to the group- they are not in the WFP catchments area. They don not fill out any monitoring forms at the moment. Projects A. Sewing Project- Received machine as part of IA Project but had to buy their own materials as they never received any from the project. They use
the head woman’s house at the moment to sow dresses. The project in its early stages. B. Other Plans- They also have plans to develop poultry project and goat project. They have skills in gardening (but no seedlings) and land from the chief but need money to get water tap (there is a water scheme in the community). They also wish to develop an office on their land.
8. Sigwaca (Maliyaduma) General This group is a year old and has 20 members, most of whom are women. This is a pattern common among all groups. They provide information and advice around HIV to group members and at church and community meetings. They work closely with Community Health Motivators in terms of encouraging testing and counseling and HBC. The local clinic at Mkhumin refers people to the group for support). They feel this has reduced stigma a little but that people are still quite reluctant to reveal their status. The community also faces a large challenge of having not enough food- they are not currently served by WFP because of their closeness to Manzini. The group has very few resources and meet in a local church, they wish to have their own physical structure to meet in. In terms of reporting the group does fill out SHAPMoS forms but have had trouble sending them in on time due to them not being collected. They also complained that they received the same form in relation to REMSHAC from both NERCHA and SWANNEPHA. Projects A. Sewing Project- The group received a sewing machine from the IA Project. They have used it to sow school uniforms but like other groups have found out, they only have a market for them once a year. They use a local church of the White Ministry to do the sowing but have to pay rent. (This is paid by monthly subscription by group members). As profits had to be used for essential expenses of group members there are no funds to buy more material. B.
They wish to develop other IGA by using the handicraft skills that some members have and they would also like to get young people involved but don’t have the initial capital to start anything. They also mentioned an interest in developing an indigenous Chicken Project.
9. Vulamehlo Velezizweni Support Group General
This group formed in 2004 and has 21 members. They promote positive living among their members and undertake HBC. They group has no resources- it has visited and asked for support from the Chief and Inkhundla but has not received a positive response. This group identified many serious challenges that they are facing. Hunger is a big problem (there is no WFP help) and this is causing problems with people’s adherence. Travel costs to the local clinic in Mgamina for medicines and check-ups is a serious barrier. They reported that some people have to walk 20km round trip to collect medicines. They have started collecting medicines for each other but they still have to attend quarterly check-ups. They reported that this was an especially serious problem and had led to a lot of early deaths. They do work with Rural Health Motivators (RHM) but RHM can’t give out ARVs. It is also difficult to persuade people to go for VCT because of travel costs. The group fills out monitoring forms for SWANNEPHA, but felt they weren’t receiving adequate support in return from SWANNEPHA. Projects A. Poultry Project- They had been promised chickens from IA Project but have received nothing yet. They have no land or structure to house the chickens. They started to make their own bricks for the chickens on one homestead but this is not completed. They now propose to divide chickens among members and house them in each homestead. B. Nutrition Garden- The group received training as part of IA Project but never received any seedlings. There is a river close by but there is no irrigation system to alleviate drought conditions in the area. As the group has no land it is proposing to develop nutritional gardens in each homestead. 10. Siniala Etsembeni Mafutseni Support Group General This group is 3 years old and has 45 members. As well as support from SWANNEPHA it receives support from SWAPOL. It provides counseling, support and advice for members and community around HIV on a one-to one basis rather than in a larger meeting. It provides HBC, but has had trouble getting materials from the local Clinic, who does not recognize them as qualified Home Carers or Health Motivators. The number of OVCs in the area is a major problem and many are not going to school or not getting proper treatment. The Chair and one other member of the group are trained as model mothers and provide some support to OVCs and the group mentioned that ADRA was working in the area but had heard nothing specific from the group. Another big problem is the bed-ridden not having any food to eat due to drought and being too sick to work the land. However the area has received some food parcels from World Vision. They feel they have got very little support from local leaders and wish to launch the group publicly to emphasize the work they do. However they did mention that they Chief had promised them land but none has been forthcoming yet. In terms of
increasing the water in the area the group is looking at digging a bore-hole but they have no resources at the moment to do this. They fill out regular reports for SWANNAPHA. Projects A. Nutrition Gardens- They Received training and seedlings from IA Project. However because of inadequate water and lack of proper fencing (they used traditional fencing but this was not strong enough to keep out animals) has not been a success. B. Poultry Project- The groups plans to bring chickens from each homestead together and develop a poultry project. They have developed a budget but wish to have support in turning it into a business plan and getting extra resources they need. They also have the idea to develop a piggery project.
Lubombo 11. Ngcina Support Group General This group was formed 3 years ago and now has 45 members. As well as SWANNEPHA the group has received support from the Good Shepard Hospital in terms of a water tank (which was not functioning at the time of the visit), World vision (Workshop on small business operations), and fencing for 6 members gardens from Red Cross. They also have 2 Peace Corps Volunteers working in the community which help the group. They provide peer support to members and undertake HBC. They do also provide general information to the community and people are referred to them by local leaders. A big challenge that they face is not having a formal document or certificate from SWANNEPHA to help ensure they are recognized by the Chief and local leaders. They also felt SWANNEPHA could have a role to play in educating the local leaders in the role of the Support Group and providing legitimacy for the support group. This was their biggest priority at the moment as they felt they couldn’t really develop or deal with stigma and discrimination issues until local leaders were more supportive. However having said this, the community has given them some land to develop an office. They report to SWANNEPHA. Projects A. Nutritional Garden- the group uses a large plot of community land where they have planted a garden. The plot is subdivided into subplots for each member. Training and seedlings for this was provided by the IA project. They have been given a water tank by Good Shepherd but it is not operational to collect water. They also identified that due to low rainfall it would have to be supplemented by deliveries from Swaziland Water &
Sewage Co. However they do not have the funds to initiate this at the moment. B. Self-Help Credit Project- The group was also in the process of developing a project whereby members would save money together and this money would be used for loans for individual’s business ideas.
12. Phumele Eboleni Support Group General This group is less than a year old and has 20 members. The group members provide care and support to each other. They also provide inputs to chieftaincy meetings about the role of positive living in relation to HIV. They have been given a plot of land by the local chief. They have also been visited by World Vision to assess their needs but there has been no return visit so far. They fill out SHAPMoS reports. Projects A. Nutritional Garden- The Group hopes to use their land for a nutritional garden but they have no fencing, no supplies and water is 6/7km away. They think a water tank is their best option. They were trained by Red Cross in developing the Garden but received no tools or seedlings. The group is also interested in developing a Poultry IGP but as of yet this is just in the idea stage. 13.SWEEP Support Group General This group has been in existence for 4 years and has 14 members. As well as support from SWANNEPHA it has received some funding from the Lutheran Development Society (LDS). They provide HBC, provide each other with peer support and give awareness talks at community meetings. They felt they were getting no support form the Chief and local leaders and were in fact on very bad terms. It was indicated that this was due to the Chief not being happy that the group were filling out SHAPMoS recording OVCs in the community rather than going through him. They felt they could do with support from SWANNEPHA in mediating this issue. They were also concerned in relation to WFP food packages. LDS used to distribute food to all those on treatment but as the numbers on treatment have increased this is now done only on a priority basis. Projects
A. Nutritional Gardens-The group has received training, fencing and seedlings (for 10 individual homestead gardens) from LDS. However due to very low rainfall the gardens have been struggling. They get their water from a well but also filter washing water with sand to use on the garden. B. Sewing Project- Another of the groups to receive a sewing machines. They have sown school uniforms but are now faced with the challenge of having a product that be only sold once a year. They also didn’t raise enough income to buy more material. They are interested in developing a poultry project. 14.Sinceni Support Group General This group has been in existence for 5 years and has 42 members. Its main activity is providing peer support. They also give awareness talks at chieftaincy meetings, provide HBC and support caregivers in relation to taking care of OVCs in KaGoGo centers. They have also received food packages from ACET but on a priority basis. In terms of monitoring they provide information on HBC to World Vision and the local clinic. The group is a member of SWANNEPHA but was not fully clear as to SWANNEPHA’s remit. Projects A. Nutritional Garden- They received training and seeds as part of IA Project and secured use of land of local clinic. Challenges they are facing is in terms of not having adequate fencing and either a water tank or piping to transfer water from the hospital water system. Despite this they have successfully harvested one seasons worth of vegetables and recently resown the garden. However they had hoped to sell the produce locally but as World Vision was giving out food parcels at the time this didn’t work so the group consumed the food themselves or gave it way. B. Poultry Project.-The group had also received their own plot of land from the chief where SWAPOL has built a chicken hut for them on it. They have raised some capital themselves to buy the chickens but don’t have enough money saved for all the supplies they need (food, medicines etc.) They hope to use the local community as their market. However they haven’t developed a business plan and would like support in this area. 15. Sitsatweni Litsemba Lekuphila Support Group General They have been in existence for 4 years and started off with just 6 members and have grown to 48 who provide care and support to each other. They provide information on HIV to wider community (by drama and poetry), and encourage people to get tested. They have also held workshops in the community with
support from SASO. They provide HBC and feel that their large membership has helped reduce stigma in the community. 20 members of the group have been given training and materials (including drip irrigation) for setting up backyard gardens in their homesteads by Red Cross. The group has been trained and fills out SHAPMoS. They haven’t been given any training in relation to reporting to SWANNEPHA. The group also indicated that they had filled out a small grant application to SWANNEPHA a few months back but have heard nothing. They also were having difficulty obtaining WFP packages with their ARVs due to the closure of the distribution point at Kalanga. WFP now distributes in the community but is refusing to register those on ARVs as it claims that they should get food with their ARVs (which is no longer the case).
Projects A. Sewing Project. The group has set-up a committee to oversee this project. They were trained by World Vision and given 5 machines (including 1 overloader which needs electricity). 18 members of the group (all women) are involved in this project. The group is yet to obtain any materials and wish to sow school uniforms. B. Poultry Project. This also has a committee overseeing it made up of 14 men. They received training from World Vision. The group has got land from the chief and with grant from US Embassy and their own contributions have built a chicken shed. However they have no resources for chickens or medicines or feed as of yet. The group is also interested in developing a candle-making project for older members of the group 16. Asihlangane Zombodze Support Group General This group has 34 members and meets every week. They work closely with Rural Health Motivators in sensitizing the community in relation to HIV. They have held workshops on various topics including Behavioral Change and Treatment Literacy. They have undertaken a mapping exercise identifying their potential resources and the group needs. They have formed a youth group who uses drama to spread information about HIV to the youth. They undertake HBC and receive materials through Inkhundla but can’t always be guaranteed that they will receive supplies from Ministry of Health (they have gone months without supplies at times). They have received a lot of positive support from the Bandlancane (Chiefs Inner Council) and are currently in negotiations with the Chief for the group to receive its own plot. Like other groups transport costs to the hospital is a big problem for many people. Currently they undertake no monitoring of the groups activities but would be very interested in receiving training to do so. They hope to obtain t-shirts for the group to increase awareness and recognition of the group.
Projects A. Sewing project- They received a machine and materials as part of IA Project. They are no longer able to use the building they are in so are looking to re-house the project. They are sowing school uniforms and looking at items they could supply to the health centre. They hope to distribute profits among members, and those who are bedridden and OVCs. B. They are looking at developing a Nutritional Garden, they have secured fencing and seedlings from FAO, and are just waiting to be given land by Chief. They hope to use Farrow Irrigation. They are also looking at developing poultry project but need diamond fencing. C. Candle-Making- The group members have donated money to buy wax to train young people in candle making. They need a start-up grant. 17. Lilungelo Lami (Lavamisi) Support Group General This group is only one year old and has 30 members. They give out information on positive living and speak about HIV at community meetings. They also undertake HBC. They have received some support from the Lutheran Development Services and Rural Health Motivators. Like other groups members have difficulty collecting ARVs from the nearest clinic in Mutfuseni. Hunger is also a difficulty as it is an area of very low rainfall; there is one bore-hole for the whole community. This has made it difficult for members to develop their own nutritional gardens. They have got little support from local leaders (the group felt they were being discriminated against.) However there was a representative of the Chief at the meeting and he indicated that requests for support were being considered. They use a church shelter for their meetings. They send reports to SWANNEPHA. Projects A. Sowing Project- The group sows dresses from a member’s house, and has sold some locally and is opening a bank account. However they recognized that there wasn’t a large market for these products locally. They are also interested in developing a poultry project. 18. Gege Support Group General This group is only 6 months old and has 20 members. They provide inputs to chieftaincy meetings twice a month. They identified there was a large number of OVCs in the area (over 500) who had serious difficulties paying for food and schooling. They mentioned that Nercha had built a Kagogo centre that is used by
OVCs. Again distance to the local clinic is a problem and a barrier to adherence. The members pool any spare monies to pay for members who can’t afford transport. They want to develop a nutritional garden and office on land given by the chief but have no resources to do so. This is one of the fee groups who don’t have a problem with water as there is piped water in the community. They fill out no monitoring forms and weren’t very familiar with SWANNEPHA’s role.
Projects A. As the group is so new they haven’t been able to develop any projects so far. They have received training in sowing from Red Cross but were given no equipment or material. 19. Sambulo Semphilo Support Group General This group is 2 years old and has 73 members. The group members volunteer in the local Hospital in Nhlangano who support patients referred to them after they have been tested positive. They also provide information at community meetings. They also provide HBC (but they don’t have any materials) to members but distance between houses can be a barrier (this was mentioned by a number of groups as they have no transport, not even a bicycle). They have gone to the Inkhundla for support but have not received any (they felt that they were not understood.) Projects A. Sewing- Have been given Sewing Machine but no material. (They were told they would receive material on production of quotes but this never happened.) They wish to produce school uniforms and materials for the Hospital (towels, bandages, bed linen etc). Would like support from SWANNEPHA in drawing up an agreement for this. They don’t have their own place to do the sewing in. They plan to temporally use the hospital dining room. B. Nutrition Garden- They have been given land by the Hospital on which they have sowed their garden. They get water from the hospital but the piping they use is quite old. They sell the produce and also give it out to clients of the hospital. 20.
Matsanjeni Support Group
General This group is 4 years old and has 30 members. The group provides education and counseling around HIV to the community in an effort to tackle ignorance and stigma. They also provide HBC to sick members of the community. They identified water shortages and the lack of an office to work from (they have been
given land by the chief but as not have no building on it.) The group submits monitoring reports to SWANNEPHA and SWAPOL. Projects A. Poultry Project- The group received funding from World Vision to develop this project. They have built a chicken coup and they are currently selling the eggs locally and they plan to be in a position to sell some of the chickens soon. B. Nutritional Gardens-.The group has developed trench gardens in their homesteads for their own nutritional purposes.
4. Recommendations General As part of Irish Aid Project
SWANNEPHA to form Irish Aid Country Project Steering Committee to oversee the recommendations of this report. This committee to include relevant partner’s organizations, especially those who are members of SWANNEPHA, to facilitate better collaboration can be developed in relation to this project. SWANNEPHA to devise a system of certification/identification of Support Groups so they can present their legitimate bona fides to any agencies they are dealing with. SWANNEPHA to meet with NERCHA/MOHSW to explore what solution can be developed into making ARVs more accessible and providing materials for HBC SWANNEPHA to develop clear and monitoring and evaluation for the project. SWANNAPHA to explore, with relevant partners, solutions to water issues being faced by SG.
As part of SWANNEPHA’s development SWANNEPHA to develop a clear strategy of engagement with all support groups in the Network, and so the approaches undertaken in this project can be sustained and transferred to work with other support groups. SWANNEPHA to continue to develop Partnership with WFP to ensure that those on ARVs get supplementary food packages, especially in Manzini and Hhohho regions. SWANNEPHA to continue to pursue its efforts to obtain resources for developing response to Youth and OVC SWANNEPHA to explore responses to the various gender issues relating to HIV/AIDS, in conjunction with relevant partners. SWANNEPHA to develop annual plans for the organization and a regional structure SWANNEPHA to develop its administration supports (databases, transport system, office management etc)
Specific Project Objectives Objective 1 To strengthen Institutional and Organisation Capacity of PLWHAs
Ensure there is practical follow-up system for all training Host the following training workshops for Support Groups
1. 2. 3. 4. 5. 6.
Proposal Writing/Resource mobilization Monitoring and Evaluation Methods Impact Mitigation Training on palliative care, HBC & Lay Counseling Prevention training- on PMTCT Strategic Planning and organizational development Lay Counseling
Objective 2 To strengthen advocacy and influencing Policy of PLWHAs and their institutions
Facilitate participation of SG in World AIDS Day and candle light campaign Develop regional structure within SWANNEPHA to ensure issues from the ground can be dealt with effectively SWANNEPHA to host a meeting between local leaders from all 20 communities (both at Chieftaincy and Tinkhudala level) to explain SWANNEPHA’s and Support Groups role and the purpose of this project, with a view to reducing stigma and obtaining better co-operation with SG, especially in accessing local resources and facilities. Explore with Skillshare Swaziland the development of Rights advocacy plan
Objective 3. To facilitate sharing learning and experiences Develop system of sharing information and learning with other countries involved in the project. Organise coming together of 20 support groups to share learning and plan for final year at the end of year 2. Explore with Skillshare about developing Newsletter or other methods of documenting and sharing best practice.
Objective 4. To develop support for psycho-socio and livelihood support for PLWHA
Sign MOU with Imbita and implement system for distributing start-up capital loans based on submission of business plan form SG, including training and support in Business Planning in relation to IGA. Review approaches to IGA Distribute monies relating to start-up of Poultry farms based on receipt of business plans from SG Establish how door to door peer supportive counseling money to be used
Objective 5 To pilot a holistic approach towards providing support to orphans and vulnerable groups
Develop process for giving money to IGA for community orphanages Agree process for distributing for School uniforms and food supplements Provide training on model mothers