1. Mobilizing Community Groups
to Access Comprehensive
care;
The Coast Province Example

2. RATIONALE
A WAY OF PROMOTING THE USE OF
ART
 The community is your most important
stakeholder
 It has the power to kill any of your initiatives
 The community has a very great interest in it‟s
own health and well-being

3. Involving the community in matters related to
HIV makes people feel responsible for the
outcome of HIV related issues
Therefore the community becomes your key ally
and partners in the management of HIV.

4. COMMUNITY INVOLVEMENT IN ART
 „Your health is your responsibility‟
 Therefore a community‟s health is it‟s
responsibility
Therefore it is through the community that you
are best placed to;
 Advocate for prevention of new infections.
 Advocate for a health seeking behavior
amongst individuals of that community and
the community as a whole (public health)

5. “A communities health is it‟s
responsibility”
 If you involve the community in all phases
of ART/Tb treatment provision you
empower them and the benefits are
…..and because they are in control of the
situation…

6.  Stigma reduces .Fear and hopelessness is
replaced by positive community activity
 Promotion of adherence to medication
because there is motivation through
community approval ,support and
encouragement.

7. PROCESS
 Identify a community group already
involved in care e.g.
 Community Health group
 Home based care
 Welfare (funeral) group
 People at high risk CSW, Widows
 PLWA
 Unions and other collective agreement groups

8.  Mobilisation process- making yourself known who are you? What do you
want?

9.  An entry point takes into consideration the community priorities-IGA

11. PROCESS
 Tell them what the problem is exactly
 Tell them what needs to be done to solve
it
 Define the community role after the necessary
negotiations
 Define your role
 Define how your role links with their role
 Capacity build them in areas they are deemed
deficient

12. ROLE OF THE HEALTH PROVIDER
 Create awareness of the availability of the
service
 Show them how to access it
 Teach the group about the benefits they will
derive from it
 Encourage them to use it make it accessible
 Negotiate with them on compliance issues
 Ask them to spread the word to others

13.  Organizing the interaction- the power of the uniform

14. ROLE OF THE COMMUNITY GROUPS
 To identify the sick and the appreciate extent of
the problem
 To encourage their own to seek to know if they
are also infected and if they need to seek
treatment (VCT,PMCTC)
 To empathize with those that are sick and
affected.
 To support the patients physically and
emotionally during diagnosis and treatment
 Then help them back into mainstream society

15. EXAMPLES
 Bangladesh ,Likoni, Kisauni,Bamako
 Kenya Red-cross community volunteer
groups Majengo
 Kenya Street traders
 Commercial Sex workers
 MAWEO
 COPE
 St Josephs Shelter

16. BANGLADESH-
A slum community
 Located in Changamwe , Bangladesh is a
typical urban slum settlement with a
 Community health centre Bamako that
takes care of:
 Malaria, immunisations ,family planning etc
 Home based care, orphans
 Community T.B. DOTS
 Feeding program

17.  Bangladesh Bamako- Community health centre. Using
existing systems to add value

19. Bangladesh Bamako
 The Bamako was initially only a
community Health Initiative that;
1.Took on the role of HBC
2.Then we introduced T.B. community
DOTS
3. Now HBC is being replaced by ART and
community ART

20.  Advantages
 Social cohesion makes follow up and
adherence issues easy
 In an informal settlement people are easily
lost to follow up

21. COMMERCIAL SEX WORKERS
Community group at high risk
Kisauni CSW group Rationale:
CSW have the potential to act as a reservoir and a
vector at the same time.
 Peer education, group support and influencing
amongst the CWS affords an opportunity
 PROCESS-
 Group support -VCT-From VCT to ART
 Benefits include curbing further spread through their
line of work
 They are able to do something about their
occupational hazard

22. Coast People living with HIV
COPE a community group
 They have been very instrumental in
lobbying for development of ART services
 They highlight deficiencies in our program
 Act as a checks and balances-

23. Kenya Street traders
- the informal sector
 RATIONALE This is a difficult to reach
group and can easily fall through the
gaps. They are also a very powerful
group.
 Kongowea Market
 Encourage each other to go for VCT, capacity
build themselves now looking forward to
working with NHIF
 Reduction in funerals already noted due to
their actions.

24. Community programs by large
estates
 Rea Vipingo – an NGO-GOK-Private sector
partnership
 Community outreach program doing VCT and
referring patients for treatment
 Management support the process

25. ST.JOSEPHS SHELTER OF HOPE-
community support by an FBO
 St. Josephs Shelter of Hope
 Started as a health clinic with an orphan
support program
 Went on to treat residents from the area with
T.B. and opportunistic infections.
 Coordinates with Voi District hospital which
provides a clinical officer and drugs
 Ready for ART
 Social /FBO/Government partnership

26. MAWEO
Women‟s group Kwale District
 Educated (read empowered) community
women group
 Difficult District with bad stigma issues
 Lobbying the community to accept HIV
and go for VCT and treatment
 Latest figures >80% acceptance of PMCT
by women visiting ante-natal clinic
 Those positive will enroll for PMCTC+

27. KENYA REDCROSS
MOMBASA HOMEBASED CARE PROGRAM
organized volunteer community groups
 YOUTH
 Majengo slum
 Linkages are well developed between the
community volunteers, CHW, and local
health institutions
 Clear example of how to move from
Volunteerism- HBC-ARV with the desired
linkages.
 Adherence issues are simplified.

29.  Our concern- How are communities coping on their
beach plot

30.  They are helping themselves on their own…but how ?

31.  Tell them the problem –show them a solution give them control

32.  If the neighbours are willing….

33. Show them how -Kenya Red cross/neighbour

35. Community interaction-training

37. CWS can take care of themselves

39. LINKAGES
 Do not try to do everything yourself you
are not taking over the community
responsibility
 NGO/CBO with community HBC
 Community HBC with Community Health
worker
 Community health worker with
Government/other clinic
 Clinic Links with and is answerable to DMOH