A Partnership Model with Civil Society Organizations to Expand Care & Support Services to Hard to Reach PLHIV Uganda HIV Implementer’s Meeting Sara Nieuwoudt, MPH Health Program Officer CARE International in Vietnam Co-authors : Nguyen Thanh Van Nguyen Thi Anh Nguyet

Overview: “ Same Same but Different” Different epidemic Different civil society (Mostly) same partnership strategy Challenges and Successes Recommendations

Different epidemic

Different civil society

(Mostly) same partnership strategy

Challenges and Successes

Recommendations

a concentrated HIV epidemic 0.53% Ministry of Health, Viet Nam (2005): HIV/AIDS estimation and projection in Vietnam for 2005 – 2010 period .

Drug Users: 34% ‘ Prostitutes ’: 6.5% Public Billboard: “ AIDS. Drug use. Prostitution. Road to Death” a concentrated HIV epidemic… that is not concentrated for hard to reach Source: MoH (2005): HIV/AIDS estimation and projection in Vietnam for 2005 – 2010 period .

Vietnam’s Civil Society: “Same Same but Different” The Party The Ministries Mass Organizations CSOs National Provincial District Commune National Provincial District Commune National Provincial District Commune

The Party

independent civil society & HIV Self-help groups Faith-based Community-based Bright Futures Network The Network (HCMC) AIDS Program Green Bamboo Tue Tinh Duong Dieu Giac Pagoda Pastoral Care Center Action for Development Xuan Vinh Empathy clubs An Giang & Can Tho groups Examples:

Self-help groups

Faith-based

Community-based

Bright Futures Network

The Network (HCMC)

AIDS Program

Green Bamboo

Tue Tinh Duong

Dieu Giac Pagoda

Pastoral Care Center

Action for Development

Xuan Vinh

Empathy clubs

An Giang & Can Tho groups

challenge for independent civil society complicated & restrictive registration process

complicated & restrictive registration process

STRONGER Project Timeline: 2005 to present Funded by: PEPFAR & USAID through Pact Partners: civil social organizations Stronger Organizations, Networks, & GIPA for an Empowered Response to HIV/AIDS

Timeline: 2005 to present

Funded by: PEPFAR & USAID through Pact

Partners: civil social organizations

partnership model: EMPOWERMENT! grants management & technical skills PLHIV better served in community PLHIV networks strengthened CSO training Public Health System

Key to partnership Women’s Union (a mass organization) CSOs

Different care & support | Same monitoring care & support specific to each group monitoring methods developed jointly home visits & care OI diagnosis Relapse prevention ARV adherence support counseling support OVC care & support guides, e.g. cue cards data entry forms

care & support

specific to each group

home visits & care

OI diagnosis

Relapse prevention

ARV adherence support

counseling support

OVC care & support

guides, e.g. cue cards

data entry forms

success in scale-up: acceptance leads to growth 6 to 11 CSO grantees per year 3 to 5 provinces 5000 to 48,000 grant range (USD) 13 CSO grantees total (2 self-sufficient)

3 to 5 provinces

5000 to 48,000 grant range (USD)

success in numbers and GIPA 100+ CSO members trained 10,657 reached through CSOs Beneficiaries Providers Leaders 13 CSO managing programs national advocacy “ I thought that death was waiting for me. I did not think that I could lead such a life like today …” ~ HIV positive Empathy Club member

100+ CSO members trained

10,657 reached through CSOs

13 CSO managing programs

national advocacy

Challenges faced Poor health Complex M&E Short grant timelines Legal Photo credit: Lesley is a Gem Girl (Flikr, 2008) Staff turnover Stigma and Discrimination

key lesson: empowerment takes time Realistic capacity assessment Realistic estimate of resources Realistic expectations Success benchmarks should account for time

Realistic capacity assessment

programming recommendations support civil society & invest in building capacity monitor & evaluate impact & invest based on evidence Photo credit: citybumpkin (Flikr, 2008)

support civil society

&

invest in building capacity

government recommendation: policy change Simple registration Legal recognition Direct support

Simple registration

Legal recognition

Direct support

Thank You! Our Donors : Pact & PEPFAR Our CSO Partners: Tue Tinh Duong The Network (HCMC) Action for Development Bright Futures Network Pastoral Care Center Xuan Vinh AIDS PROGRAM Can Tho Group Empathy Club Dieu Giac pagoda Green Bamboo An Giang Group Shield Club Vietnam Delegation

Our CSO Partners:

Tue Tinh Duong

The Network (HCMC)

Action for Development

Bright Futures Network

Pastoral Care Center

Xuan Vinh

AIDS PROGRAM

Can Tho Group

Empathy Club

Dieu Giac pagoda

Green Bamboo

An Giang Group

Shield Club

our inspiration “ [This] is the first time we participated in the whole process of project management and we are very happy and proud to see CARE look at us positively. They acknowledge us as capable, and believe that we can change our lives and encourage people like ourselves to be more optimistic. All our project activities are completed with quality.” ~ group leader of Bright Futures Network (2003)

“ [This] is the first time we participated in the whole process of project management and we are very happy and proud to see CARE look at us positively. They acknowledge us as capable, and believe that we can change our lives and encourage people like ourselves to be more optimistic. All our project activities are completed with quality.”

~ group leader of Bright Futures Network (2003)