Brent Matthysen , Phiwa Sondhlane, Babalwa Fede and John Imrie
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Transcript of Brent Matthysen , Phiwa Sondhlane, Babalwa Fede and John Imrie
Combining community-based organizations’ local knowledge, participatory and
GIS mapping approachesto improve condom availability in
Gert Sibande District, South Africa -
Lessons from a pilot intervention
Brent Matthysen, Phiwa Sondhlane, Babalwa Fede and John Imrie
July, 21 2014
Sexual HIV Prevention Programme (SHIPP) Futures Group International
Background• Condom use remains a core sexual HIV prevention
intervention globally
• However, ensuring the quality, quantity, distribution continuity & equity of freely-available condoms presents substantial challenges
• Erratic & inequitable condom distribution, particularly in poor rural & hard-to-reach areas, results in poor uptake, inconsistent usage & an unwillingness to adopt condoms as a primary HIV prevention strategy
Policy Context1) South African National Department of Health is the main provider of freely-available condoms in the country
Male Condom Distribution
Rates by District (2012-13)
and Scale-up Targets
J T Gaetsewe DMFrances Baard DM
Ekurhuleni MMSiyanda DM
Johannesburg MMBuffalo City MM
eThekwini MMPixley ka Seme DM
Cacadu DMTshwane MM
Dr K Kaunda DMMangaung MM
Amathole DMN Mandela Bay MM
A Nzo DMVhembe DM
Umkhanyakude DMiLembe DM
Namakwa DMBojanala Platinum DM
RS Mompati DMSedibeng DMNkangala DM
Ugu DMWest Rand DM
Joe Gqabi DMUthungulu DM
Fezile Dabi DMT Mofutsanyane DM
G Sibande DMO Tambo DM
Gr Sekhukhune DMSisonke DM
Capricorn DMZululand DM
C Hani DMXhariep DM
Waterberg DMMopani DM
Lejweleputswa DMEhlanzeni DM
Ngaka Modiri Molema DMCentral Karoo DM
Overberg DMCape Winelands DM
Eden DMUmzinyathi DMWest Coast DM
uMgungundlovu DMCape Town MM
Amajuba DMUthukela DM
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.05.55.66.37.1
8.99.0
9.911.812.212.612.712.8
13.814.414.614.915.115.115.515.915.916.116.816.917.517.618.118.218.319.119.319.8
22.523.123.2
24.324.624.725.225.2
27.027.9
30.839.1
42.642.743.0
49.155.3
63.769.369.6
Current average: 22 condoms
Mid target: 36
Final target: 50
Gert Sibande
19.1
2) Condom distribution has been variable &
erratic
Source: Health Systems Trust, 2013. District Health Barometer
19
Policy Context (cont.)• South African NDoH is the main provider
of freely-available condoms
• Condom distribution across the country has been variable & erratic
• 3) National plan aims to supply 1 billion condoms annually
50 male condoms per male aged ≥15 years
Mpumalanga Province (South Africa)
PRETORIA.
. Cape Town
. Durban
Johannesburg .
Pilot Site - Gert Sibande District
Methodology
Methodology – Step 1Geospatial analysis of antenatal HIV rates
prevalence, 2011
Methodology – Step 2• Collaborative systems review of condom supply,
management & distribution system
– Poor:• condom supply• distribution coverage• monitoring (data recording)• data flow• reporting (NOT feeding the DHIS)• data analyses • information sharing
Methodology – Step 3Capacity-building workshops with SAG partners
– District & Local Municipalities & CBOs
1. Know Your Epidemic & Response
2. Drawing of maps by hand:• mapping of infrastructure &
services (107 CBOs & 242 persons)
• plotting of hot spots & primary & secondary condom distribution points
Methodology – Step 4 Plotting of sites using Global Positioning System
hand-held devices
Mapped & Plotted Potential Hot Spots & SCDPsHot Spots Social, Health, Safety, Security &
Civil Services InfrastructureTuck Shops, Stores, Supermarkets & Markets Public Primary & Secondary Health FacilitiesTaverns, Bars & Shebeens (unlicensed) CBOs (nonSHIPP-funded)Hair Salons Police StationsIndustry, Mines, Farms & Timber Sidings Libraries, Community & Information CentersGas Stations Municipal OfficesTruck Inns, Truck Stops & Taxi Ranks Social Development Services OfficesInformal Settlements Other Government Department OfficesTelecommunication Booths Post Offices
Lodges, Guest Houses, Hotels & Inns Condom Warehouses / DepotsLiving Compounds & HostelsCar Wash Sites (informal) 1,800 sites mapped & plottedBrothels (all are illegal)PrisonsPower Stations
Methodology – Step 5 Creation of electronic maps using:
− stored GPS coordinates− freeware Geographic Information Systems (GIS)
software applications
Collaborative amendment of condom distribution data collection tool used by the condom warehouse & other primary distribution points− auto-aggregation by week, month & quarter
using MS Excel formulas
Combining community-based organizations’ local knowledge and GIS mapping activities to improve condom availability
Methodology – Step 6 Dissemination of e-maps to stakeholders for use
in condom distribution scale-up planning & distribution activities
Gert Sibande Condom Distribution Rates (Number of male condoms per male aged ≥15 years)2013-14
Apr-13
May-13
Jun-13Jul-1
3
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
0
10
20
30
40
50
60
19.4
28.325.1 25.8 27
40
53.8
34.7 32.2
25.7 27.1 28.2 27.6 25.6
• Participatory approaches ensure CBOs acquire in-depth understanding of mapping that is easily replicable without need of advanced additional technical support
• Combining participatory approaches, GIS technology & CBOs’ indigenous knowledge can fast-track equitable condom distribution & coverage, & reach key populations such as rural communities
Lessons Learned
Thank Youwww.futuresgroup_shipp.com
The Sexual HIV Prevention Programme (SHIPP) is a United States Agency for International Development (USAID) – PEPFAR funded initiative in South Africa (SA) to galvanize and support combination HIV prevention activities. •Implementing partners include Futures Group, the Centre for AIDS Development, Research, and Evaluation,
EngenderHealth, and Futures Institute.