The report outlines the background, achievements and lessons learned during the start up, implementation and close out of the project, which ended in July 2009. It aims to support learning across the Alliance’s programmes and the wider HIV response.
The project’s main objective was to use networks of people living with HIV to increase access to HIV and wrap-around services. The project did this by building the capacity of groups of people living with HIV (PLHIV groups) to link communities and people living with HIV with their local health services. It also gave people living with HIV an important role in supporting the delivery of HIV services in health facilities and the community.
During its three-year life, the project dramatically increased access of people living with HIV to prevention, care and support services. Over 1.3 million people accessed HIV services through the project.
Emilly Katamujuna, Programme Manager of Alliance Uganda commented: ‘We often hear arguments from policymakers and donors that community based organizations are not able to deliver national scale services that will sufficiently impact the epidemic. This report documents how the Networks Model Project proved that a coordinated community based response can have an impact at a national level.’
The project originally started in seven districts of Uganda but rapidly expanded to cover 40 districts nationwide, and was replicated in a further 12 districts by Alliance partners.
An external evaluation of the project undertaken by JHPIEGO on behalf of USAID found that the Network Support Agents - trained people living with HIV (PLHIV) to work as community volunteers - was one of the most successful components of the project:
“The [NSA’s] have been able to mobilize PLHIV to utilize existing services, including health facility-based services and wraparound services provided by community-based organizations (CBOs) and non-governmental organizations (NGOs). They compensate for a shortage of staff at health facilities, where they direct and counsel clients. They also play a critical role in tracking and following up clients.”
Monica is a Network Support Agent for Namungalwe Village, Iganga district in Uganda. The impact of her work is clearly described by one member of the community who wished to remain anonymous: ‘Monica has been of great support to me and my husband with regard to adhering to treatment and I am doing well. She has supported us to disclose to our parents and my brother our HIV status because most of our relatives initially thought that it was witchcraft. Disclosing has helped us to get care and support from the family.’
The report provides convincing evidence of the need for and effectiveness of investing in community HIV responses lead by people living with HIV. International donors and the Government of Uganda need to act soon to follow up the achievements of the Networks Project, otherwise the human capacity built by the project is in danger of being lost. Without continued financial and personal support it will be hard for the Network Support Agents to survive – with a detrimental impact on community cohesion and the loss of an important pillar of support for over-stretched health workers.
Lynette Lowndes, Alliance Director of Field Programmes said: ‘By documenting the lessons learned, we hope that this report will be an inspirational aid to those working on community responses to HIV in Uganda and elsewhere.
‘We also urge donors and policymakers to act on the evidence of the success of the Networks Project in realising national targets by putting people living with HIV at the heart of service delivery.’