Country: Tajikistan || Duration: 2006-2009; 2009-2011 || Donor: Oxfam Novib || Budget: € 750,000
In an effort to establish a network of essential public health services in the Gorno-Badakhshan Autonomous Oblast (GBAO) of east Tajikistan, AFEW initiated the ‘Pamir against AIDS Project: HIV Prevention & Care in GBAO, Tajikistan’. By building the local capacity of service providers in the GBAO region, this project effectively addressed the growing HIV epidemic among vulnerable populations (that is, people who inject drugs and highly vulnerable women, including sex workers), as well as supporting those individuals already living with HIV. The focus was on involving all sectors of society in building a client-centred continuum of care that includes prevention, treatment and support.
This project was implemented in two phases between July 2006-June 2009 and October 2009-December 2011.
PHASE I: 2006-2009
Specifically, AFEW carried out the following activities:
Ultimately, these activities increased the availability of services among those most vulnerable to HIV, including access to medical, social, educational, psycho-social and harm reduction services, as well as self-help group initiatives.
A project truly inspired by local ‘grassroots’ organisations
The project evolved out of a request to AFEW from community organisations in Pamir who were seeking support from an international organisation in growing the region’s health and social services for women in risk categories (including sex workers), people who inject drugs and people living with HIV/AIDS. Through the project Steering Committee (PSC) all project activities, themes and processes were designed in partnership with these local organisations.
Creation of a region-wide client management network that is equipped to offer comprehensive care to key populations
Altogether, 42 governmental and non-governmental service providers adopted AFEW’s client management system: the services of these organisations were linked up in the partner network. The state departments of Health, Internal Affairs, Drug Control Agency, AIDS and TB centres, infectious disease clinics and narcology clinics started coordinating their activities with those of local NGOs through this network.
Four social bureaus were established that operate a client management referral system providing vulnerable people with access to medical, psycho-social, legal and harm reduction services. During the project, 2 214 people accessed approximately 53 different types of services through these bureaus. Additionally, the opening of a voluntary counselling and testing service on the premises of the region’s AIDS Centre, provided a crucial entry-point to services for hard-to-reach populations.
Improved quality of services and professional support for vulnerable people
AFEW conducted a programme of training, education and the dissemination of professional guidance to staff from partner service providers. Altogether, 595 of these frontline professionals took part in 60 skills-building workshops, capacity-building trainings, conferences and other events that aimed to increase their knowledge of HIV and related areas. In addition, through annual events, such as AFEW’s Summer School 2008 and Spring School 2009, partner organisations received in-depth training, became connected to national and international networks of service providers.
More than 15,000 copies of informational and educational materials (on health promotion, voluntary testing and counselling, HIV/AIDS, TB and other diseases prevention and treatment) were developed and distributed through the partner network.
Finally, the establishment of a Training Resource Centre on the premises of the Regional AIDS Centre ensures that materials, guidance, training and meetings will continue beyond the project end-date.
Events that raised public awareness of HIV and drugs-related issues
AFEW and its partner organised mass media, advocacy and public awareness events in the region around key dates such as World AIDs Day (December 1), where around 2,500 members of the public participated in activities and received information about healthy living, HIV and infectious disease prevention.
PHASE II: 2009-2012
From October 2009-September 2012, AFEW and its local partner NGO ‘Volunteer’ continued to build on the results of the first ‘Pamir against AIDS’ project. In this second phase of activities, they increased the focus on HIV prevention and sexual health education among women.
By concentrating efforts on women, the project aimed to prevent the further feminisation of the HIV epidemic in this region. While most HIV cases are still identified among men, there is an emerging growth in the number of cases reported among women. The risk factors for a female HIV epidemic are high in this region: mass labour migration (women can be exposed to the risk of contracting HIV from husbands who have spent long periods abroad), meanwhile gender inequalities mean low access to sexual health education for women, negative attitudes towards condoms and the perpetuation of myths about HIV.