Towards comprehensive and sustainable workplace hiv & aids p

NAT IO N A L O R GAN IZ AT IO N OF PEER ED UC ATO R S

Innovative Options for Behavior Change

Towards comprehensive and Towards comprehensive and sustainable workplace HIV & sustainable workplace HIV &

AIDS programming AIDS programming

NOPE Experience in NOPE Experience in Workplace ProgramsWorkplace Programs

NATIO NAL O RGANIZ ATIO N OF PEER EDUC ATORS


NOPE BackgroundNOPE Background• A local NGO established in 2001 by Peer Educators A local NGO established in 2001 by Peer Educators

within IMPACT project regions of Rift Valley, Coast within IMPACT project regions of Rift Valley, Coast and Rift Valley. Our Mandate lies within expansion and Rift Valley. Our Mandate lies within expansion of the Behaviour Change Communication of the Behaviour Change Communication strategies. This includes moving Peer Education strategies. This includes moving Peer Education from isolated projects to expanded comprehensive from isolated projects to expanded comprehensive HIV and AIDS programs at the workplaces and HIV and AIDS programs at the workplaces and community levels. Currently working with over 40 community levels. Currently working with over 40 workplaces; private and public sectors in Kenya, workplaces; private and public sectors in Kenya, South Sudan and Tanzania. South Sudan and Tanzania.



SUMMARY OFSUMMARY OFBEST PRACTICES BEST PRACTICES



As an organization we believe in comprehensive As an organization we believe in comprehensive programming based on proven steps towards HIV and programming based on proven steps towards HIV and AIDS programming in the Workplaces ( Tea Farms, AIDS programming in the Workplaces ( Tea Farms, Flower Farms). The ‘must- follow’ steps Flower Farms). The ‘must- follow’ steps that have that have borne fruits include:borne fruits include:

a.a. Entry assessment before program formulationEntry assessment before program formulationb.b. Advocacy for Management buy-in of the program and Advocacy for Management buy-in of the program and

steering by the Human Resource Department steering by the Human Resource Department c.c. Management Sensitization of top and middle line managersManagement Sensitization of top and middle line managers

d.d. Identification, recruitment, orientation prior to and training Identification, recruitment, orientation prior to and training of Peer Educators of Peer Educators

e.e. Feedback to the workplaces with program implementationFeedback to the workplaces with program implementation

1. Creating effective socio-ecological 1. Creating effective socio-ecological environment for programming environment for programming



Involvement of top and middle line managersInvolvement of top and middle line managers

Oserian ED leading at the 2005 WAD

Sher Peer Educators, HRM With The Executive Director during the launch of Sher HIV and AIDS Policy in 2005



2. 2. Addition: Expertise in workplace policy formulationAddition: Expertise in workplace policy formulation • NOPE has added a feather to the project by availing tact NOPE has added a feather to the project by availing tact

and the required level of expertise in Policy formulation and the required level of expertise in Policy formulation for workplaces to eliminate going into program without for workplaces to eliminate going into program without policy and vice versa. The workplaces that have benefited policy and vice versa. The workplaces that have benefited so far are many but the ones in the region include:so far are many but the ones in the region include:

WorkplaceWorkplace Type of AssistanceType of Assistance11 KWSKWS Policy design and Formulation Policy design and Formulation

Undergoing ratification for approval Undergoing ratification for approval 22 Oserian Oserian Policy, Formulation, Design and Policy, Formulation, Design and

Dissemination Dissemination 33 Sher Sher

AgenciesAgenciesPolicy Formulation, Design and Policy Formulation, Design and dissemination dissemination



3. 3. Limiting costs to the workplaces Limiting costs to the workplaces and the project in program and the project in program implementationimplementation

• This forms a main aim of NOPE while assisting the This forms a main aim of NOPE while assisting the workplaces. The strategies put in place to facilitate this workplaces. The strategies put in place to facilitate this includeinclude Ensuring minimal cost to production time by peer Ensuring minimal cost to production time by peer

educators during Peer Education activities. They are educators during Peer Education activities. They are trained in identifying the most appropriate timings for trained in identifying the most appropriate timings for activities activities

Facilitating cost-sharing between the project and Facilitating cost-sharing between the project and workplaces. Example include the Peer Education workplaces. Example include the Peer Education training at Oserian and Unilever Tea Kenya training at Oserian and Unilever Tea Kenya

Facilitating linkages between workplaces, GOK and the Facilitating linkages between workplaces, GOK and the project. E.G, referral for training of W/Place service project. E.G, referral for training of W/Place service providers in PMTCT and Counseling supervision by GOKproviders in PMTCT and Counseling supervision by GOK

Sourcing for alternative funding by the companies ie Sourcing for alternative funding by the companies ie from NACCfrom NACC



4. 4. Enhancing ownership and strategic Enhancing ownership and strategic management of the program by the management of the program by the workplacesworkplaces • NOPE has been doing this by NOPE has been doing this by

– Enhancing ownership and leadership of the Enhancing ownership and leadership of the programs by the workplaces (Committes, Focal programs by the workplaces (Committes, Focal Persons)Persons)

– Giving constant feedback to the workplaces on the Giving constant feedback to the workplaces on the TA areas of program assistance they get from TA areas of program assistance they get from NOPENOPE

– Taking action on the information needs and Taking action on the information needs and facilitating similar action by the workplaces (E.g. facilitating similar action by the workplaces (E.g. Thematic approach to coordinators quarterly Thematic approach to coordinators quarterly meetings and specific workplace programs) meetings and specific workplace programs)



Case study: Case study: The realized low participation of women in access to The realized low participation of women in access to and utilization of services in one of the flower farmsand utilization of services in one of the flower farms

There was a realization that more men were There was a realization that more men were accessing HIV testing and care services at one accessing HIV testing and care services at one workplace from the Peer Education referral workplace from the Peer Education referral facilities and the coordinators reports. During the facilities and the coordinators reports. During the monthly zone-leaders meeting with the monthly zone-leaders meeting with the coordinator and the TA provider, a theme was coordinator and the TA provider, a theme was coined: Women; our mothers, our sisters and our coined: Women; our mothers, our sisters and our daughters. Lets care for them!daughters. Lets care for them!

This deliberate theme led to realization that led to:This deliberate theme led to realization that led to:i.i. Special focus on women and access to services by peer Special focus on women and access to services by peer

educators and identification of barriers educators and identification of barriers ii.ii. Improvement of attitude by service providersImprovement of attitude by service providersiii.iii. Eventual increase in VCT and PMTCT uptake by women Eventual increase in VCT and PMTCT uptake by women iv.iv. More women being trained in Community and More women being trained in Community and

Bereavement counseling to handle their specific issuesBereavement counseling to handle their specific issues



5. Enhancing the capacity of Peer Educators to 5. Enhancing the capacity of Peer Educators to move beyond HIV and AIDS education onlymove beyond HIV and AIDS education only

• The current curriculum we are using goes beyond The current curriculum we are using goes beyond the medical perspectives of HIV and AIDS hence the medical perspectives of HIV and AIDS hence encompassing:encompassing:– Values based approach e.g. Relationship Vs PreventionValues based approach e.g. Relationship Vs Prevention– Sexuality Vs Abstinence and faithfulness Sexuality Vs Abstinence and faithfulness – Gender dimensions in HIV and AIDSGender dimensions in HIV and AIDS– 52 week guideline for workplace Peer Education (implying 52 week guideline for workplace Peer Education (implying

active Peer Education for over 2-3 years): Tools for active Peer Education for over 2-3 years): Tools for implementationimplementation

– Alternative problem posing techniques (training in using Alternative problem posing techniques (training in using video, fish bowl, bridges of hope, power walk etc relevant to video, fish bowl, bridges of hope, power walk etc relevant to WorkplacesWorkplaces



6. Documentation of workplace 6. Documentation of workplace initiativesinitiatives • NOPE has managed to workplaces in NOPE has managed to workplaces in

documenting workplace programs efforts documenting workplace programs efforts and achievements. This culminated in and achievements. This culminated in – Development of a Management Advocacy Development of a Management Advocacy

Package for workplaces to enhance program Package for workplaces to enhance program adoption and adaptation adoption and adaptation

– Development of 54 week guide for workplace Development of 54 week guide for workplace Peer Educators Peer Educators

– Continuous monitoring and documentation of Continuous monitoring and documentation of specific workplace efforts, internet/intranetspecific workplace efforts, internet/intranet



7. Peer education as part of the larger programming 7. Peer education as part of the larger programming puzzlepuzzle

• Earlier realization: Most workplaces and TA Earlier realization: Most workplaces and TA providers have based the outcome of program providers have based the outcome of program on the outcome of Peer Education initiatives. on the outcome of Peer Education initiatives.

• Current positionCurrent position: Peer Education forms part of : Peer Education forms part of the puzzle towards improving qualities of lives the puzzle towards improving qualities of lives at the workplaces. NOPE deliberately assists at the workplaces. NOPE deliberately assists workplaces to have peer education function workplaces to have peer education function within larger policy environments, health care within larger policy environments, health care services, psychosocial support and other areas services, psychosocial support and other areas of interventions-Company policies, FKE, ILO and of interventions-Company policies, FKE, ILO and the National strategic plans the National strategic plans



8. Peer education as part of the programming 8. Peer education as part of the programming puzzle 2….puzzle 2….This can be seen in:This can be seen in:

WorkplaceWorkplace Other interventionsOther interventions LinkagesLinkagesOserianOserian Policy, PMTCT, STI mgt, OI & Policy, PMTCT, STI mgt, OI &

TB mgt, ART, Community TB mgt, ART, Community Counseling, HBC, HIV Counseling, HBC, HIV testing, FBO interventions, testing, FBO interventions, YIS interventions YIS interventions

GOK,FHI, GOK,FHI, SWAK, YMCA, SWAK, YMCA, KGGA, KGGA, NACOHAGNACOHAG

SherSher Policy, PMTCT, STI mgt, OI & Policy, PMTCT, STI mgt, OI & TB mgt, ART, Community TB mgt, ART, Community Counseling, HIV counseling Counseling, HIV counseling and testing, FBO and testing, FBO interventions, YIS interventions, YIS interventions interventions

GOK,FHI, GOK,FHI, SWAK, YMCA, SWAK, YMCA, KGGA, KGGA,

UTKLUTKL Policy, PMTCT, STI mgt, OI & Policy, PMTCT, STI mgt, OI & TB mgt, ART, Community TB mgt, ART, Community Counseling, HBC, HIV Counseling, HBC, HIV testing, FBO interventions, testing, FBO interventions, YIS interventions YIS interventions

GOK,FHI, GOK,FHI, Walter Reed, Walter Reed, KTGAKTGA



9. Creating Linkages and Net Working9. Creating Linkages and Net Working

• Workplace Coordinators are regular Workplace Coordinators are regular participants in workplace forums; Nairobi, participants in workplace forums; Nairobi, Central and Rift Valley. Central and Rift Valley.

• ConferencesConferences• Linkages to external sources of services, Linkages to external sources of services,

where applicablewhere applicable



10. Identification of unique program 10. Identification of unique program needsneeds• VCT needs- VCT needs- • Consumption of the existing servicesConsumption of the existing services• ConfidentialityConfidentiality

• Service provider needsService provider needs• Youth needsYouth needs• Management supportManagement support• M&EM&E• Documentation needsDocumentation needs• RejuvenationRejuvenation



Lessons learnt Lessons learnt 1.1. TA provision has to be strategic. There needs to TA provision has to be strategic. There needs to

be (a sort of) MOU between workplaces and the be (a sort of) MOU between workplaces and the TA providers for sustainability of such programs TA providers for sustainability of such programs and eventual exit plan and eventual exit plan

2.2. Proper orientation of peer educators prior to a Proper orientation of peer educators prior to a training is essential for result-oriented training is essential for result-oriented approaches and sustained intrinsic motivation approaches and sustained intrinsic motivation among peer educators among peer educators

3.3. Entry to workplaces has to be strategic and Entry to workplaces has to be strategic and systematic as some players do not have systematic as some players do not have capacity to implement comprehensive programs capacity to implement comprehensive programs yet preferred by the workplaces yet preferred by the workplaces



Lessons learnt contd…..Lessons learnt contd…..4.4. Enhancing ownership of programs by workplaces is Enhancing ownership of programs by workplaces is

the only way to sustainable programs. They have to the only way to sustainable programs. They have to see themselves as the implementers and Project as see themselves as the implementers and Project as TA providers and part of strategic linkagesTA providers and part of strategic linkages

5.5. Magnet Theatre and Peer Education can compliment Magnet Theatre and Peer Education can compliment one another especially at the agricultural estates: The one another especially at the agricultural estates: The estates have static populations and peer educators estates have static populations and peer educators have high information base. The theatre training also have high information base. The theatre training also acts a motivation to peer educators and adds variety acts a motivation to peer educators and adds variety to facilitation techniques peer educators have. E.g. at to facilitation techniques peer educators have. E.g. at Sher Sher

6.6. There are workplaces in Nakuru that have been doing There are workplaces in Nakuru that have been doing

something in their own ways and what they need is something in their own ways and what they need is strategic support mechanismsstrategic support mechanisms

7.7. With reduction of Peer Education activities, other With reduction of Peer Education activities, other program components are also likely to suffer. A program components are also likely to suffer. A realization from Naivasha w/place program initiativesrealization from Naivasha w/place program initiatives



Lessons learnt… 3Lessons learnt… 38. 8. It is easier to work in workplaces that have clear structures It is easier to work in workplaces that have clear structures

to integrate HIV and AIDS programming. to integrate HIV and AIDS programming. FactorFactor Workplace A e.g. Workplace A e.g.

Oserianl Celtel Oserianl Celtel Other workplacesOther workplaces

Clear Clear managemenmanagement structures t structures and and functionsfunctions

It is easy to fit HIV and It is easy to fit HIV and AIDS programming as AIDS programming as part of HR functionpart of HR function

HR head might be having HR head might be having other functions hence HIV other functions hence HIV unlikely to be given the unlikely to be given the priority it deserves priority it deserves

Existing Existing budget budget allocationallocation

With existing Budget With existing Budget allocation e.g. training allocation e.g. training budget, it is easy to budget, it is easy to carry out activitiescarry out activities

Policy Policy dissemination dissemination and and application application

It is vital t disseminate It is vital t disseminate HIV and AIDS policies. HIV and AIDS policies.

The policy application is based on The policy application is based on each individual's supervisor or each individual's supervisor or manager’s interpretation manager’s interpretation



Providing Providing controlled controlled housing to staffhousing to staff

The Staff are easily The Staff are easily reached and reached and monitoring the reach monitoring the reach and outcome is and outcome is easier easier

Without housing or Without housing or controls, the reach is not controls, the reach is not strategic hence we might strategic hence we might assume that the workers assume that the workers are reached as are reached as bandwagon/blanket in the bandwagon/blanket in the communitycommunity

Program Program ownership hence ownership hence sustainability sustainability

Easier as the Easier as the management management structure makes it structure makes it easier for buy-in and easier for buy-in and feedback feedback mechanisms towards mechanisms towards sustainability sustainability

Not easy. Staff likely to Not easy. Staff likely to compare themselves with compare themselves with other community based other community based interventions and place interventions and place more demand on the more demand on the project TA providersproject TA providers

Conclusion:There is no magic bullet towards targeting and managing each workplace program. Blanket or bandwagon approaches hence cannot apply equally in all workplaces



To be continued…..To be continued…..



Challenges and constraints Challenges and constraints 1.1. Receiving feed back, still a challengeReceiving feed back, still a challenge2.2. Harmonization of feedback in the Harmonization of feedback in the

workplacesworkplaces

3.3. Who owns the information in Peer Who owns the information in Peer Education initiatives? Is the Peer Education initiatives? Is the Peer Educator a postbox or the recipient Educator a postbox or the recipient of the mail of behaviour change?of the mail of behaviour change?

4.4. Time Time



Future…..? Future…..? 1.1. The workplace policies will have a statement on The workplace policies will have a statement on

the roles and responsibilities of employees unlike the roles and responsibilities of employees unlike the current ILO and FKE guidelines that have little the current ILO and FKE guidelines that have little emphasis on the role of employees in prevention, emphasis on the role of employees in prevention, service utilization, care to stakeholders and fellow service utilization, care to stakeholders and fellow employees, treatment care and support activities employees, treatment care and support activities other than stigma and discrimination other than stigma and discrimination

2.2. We will emphasize on strategic orientation of Peer We will emphasize on strategic orientation of Peer Educators on one-one and as a group to limit fast Educators on one-one and as a group to limit fast rate of drop-outs that we have witnessed at places rate of drop-outs that we have witnessed at places where these steps were not followed. This implies where these steps were not followed. This implies slowing the pace between identification, slowing the pace between identification, recruitment and eventual training of Peer recruitment and eventual training of Peer Educators Educators



Future…..2?Future…..2?3.3. Workplace policies covering the informal sector Workplace policies covering the informal sector

workplaces…”everywhere is a workplace…workplaces…”everywhere is a workplace…including NGOs and our own houses….including NGOs and our own houses….

4.4. MOUs with workplaces to avoid situations where MOUs with workplaces to avoid situations where they see the project as the end consumer of they see the project as the end consumer of results…”this your project syndrome” results…”this your project syndrome”

5.5. Enhance Technical assistance in BCC and Enhance Technical assistance in BCC and programming in the workplacesprogramming in the workplaces

Towards comprehensive and sustainable workplace hiv & aids p

Health & Medicine

Transcript of Towards comprehensive and sustainable workplace hiv & aids p