Lessons learned: the case of SKOWA
A recent review of SKOWA helped staff and volunteers to reflect on their progress, and to identify some key lessons:
- The take-up of voluntary counselling and testing was higher among women and young girls than that of men and boys. This may be in part because women are keener to seek medical care, counselling, information and support. However, this can complicate decision making in a family and, for women especially, can lead to blame, stigma, rejection and violence.
- Many people in rural areas want to have voluntary counselling and testing, but the facilities are not available.
- Transport for staff and peer educators to cover hard-to-reach areas remains a challenge.
- The referral and follow-up of prevention of mother-to-child transmission and voluntary counselling and testing services needs to be strengthened and refined.
- Commercial sex workers are highly mobile. This makes it almost impossible to follow up with contacts made.
- Building trusting relationships with a highly mobile population is challenging, offering little time to interact with outreach workers.
- Establishing trust is crucial if clients are to disclose personal details such as their safer sex practices. Changes in behaviour and attitude in the target group increase with regular communication.
