Chad, December 14, 2007 - The prevention and treatment of HIV/AIDS and sexually transmitted diseases (STDs) have been quite successful in the Western Logone region in the southern part of the country. A decentralized and integrated approach to HIV/AIDS and STD prevention has been implemented under the World Bank’s Population and AIDS Control Project. An assessment of the strategy indicates satisfactory results for this year. The project, which relies upon local grassroots, community associations, has distinguished itself through an approach utilizing people from a given social and professional category to provide outreach to their own peers. This so-called ‘peer-to-peer’ education has enabled the project to achieve educational and outreach coverage levels of 63 percent in Moundou and 66 percent in the capital. The most edifying result has also been the incorporation of STDs and HIV/AIDS into its screening component. During the first three quarters of 2007, the virus screening centers tested a total of 15,761 people, or 120 percent more than during the same period in 2006. The number of persons living with diagnosed HIV increased over the same period, from 1,866 to 3,536, an increase of 90 percent. In its management of the local response to STD/HIV/AIDS treatment, the project is also focused specifically, in its support to the public sector, on a so-called “Lead Ministry” component targeting seven ministries, i.e., Defense, Education, Health, Public Safety, Social Welfare, Justice, and Communications. The achievements of the Ministry of Education involve the distribution of disease prevention manuals and teachers’ guides: - During the first three quarters of this year, 190,000 HIV/AIDS prevention manuals were distributed to primary schools and 105,000 to secondary schools.
- Teachers received 16,500 copies of the guides.
- Training activities produced some impressive and unexpected results: the project trained 2,842 people, for an implementation rate of 185 percent. In addition, 73 percent of health club facilitators and peer educators were also trained.
- A total of 745 primary and secondary schools are dispensing HIV/AIDS education, for a coverage rate of 116 percent in terms of training.
The results obtained by the Ministry of Social Welfare are primarily associated with the Project’s “Orphans and Other Vulnerable Children” component: - Support for school enrollment for this category of children achieved an implementation rate of 130 percent in Moundou and N’Djamena, or 1,314 children compared to the 1,000 originally projected. - The project provided professional training to 49 foster families, or 75 percent of the target. Another interesting aspect of prevention is the involvement of the Ministry of Communications, in collaboration with 10 radio stations, six private radio stations, the national television network and three newspapers. This year’s results indicate that 40 radio, television and print media journalists were trained between September 2006 and September 2007. The immediate impact of this training was felt in the production of 533 programs broadcast by the radio stations involved in the Project. Beyond these satisfying results, it is important to highlight this Bank project’s support for community interventions. In the context of its second component, the Fund for the Support of Population Activities and AIDS Control (FOSAP), the Project supported 94 prevention-oriented sub-projects implemented by local associations; 16 impact-reduction sub-projects carried out with associations of persons living with HIV; 11 social welfare sub-projects in nine social centers in N’Djamena and the two Logone regions; and, finally, two legal assistance sub-projects in N’Djamena and Moundou. Results as of the end of the third quarter of 2007 were positive: - Ninety-four local grassroots associations had provided peer-to-peer education to 72,281 vulnerable persons, for an implementation rate of 77 percent of the annual target.
- These same associations had directed 12,200 vulnerable individuals towards screening centers and 6,540 to health centers for treatment of STDs. Of the people receiving screening guidance, 44 percent went on to be tested, and 36 percent of those in the second group were treated at health centers.
- For the first time within the framework of the project, the associations have also succeeded in selling 50,000 condoms, thereby achieving 88 percent of the sales target established for the year.
Despite these welcome results, the availability of cost-free anti-retroviral (ARV) treatment remains low at the regional level. The lack of physicians qualified to issue drug prescriptions is likewise a basic constraint limiting easy access to ARVs in the regions. The PPLS2 acknowledges that further efforts are needed to improve the quality of peer-to-peer education aimed at behavioral change. Project officials feel that additional funding will help make it possible to achieve these goals. Edmond Bagdé Dingamhoudou, World Bank, Chad |
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