HISTORY AND IMPACT OF THE PROGRAMMES & PROJECTS OF LIFT ABOVE POVERTY ORGANISATION (LAPO) IN TARGET COMMUNITIES OVER THE YEARS
1. Promoting Sexual and Reproductive Health and HIV/AIDS Reduction (PSRHH)
Promoting Sexual and Reproductive Health and HIV/AIDS Reduction (PSRHH) project was implemented in partnership with Action Aid International Nigeria and the Society for Family Health (SFH). The project commenced in 2003 in yearly cycles and ended in 2008. The goal of PSRHH was the reduction of Sexually Transmitted Infections and HIV/AIDS among vulnerable groups like Transport workers, Uniform Service Men, Sex Workers, Out-of-School Youths i.e. Female-Out-of-School Youths (FoSY) & Male-Out-of-School Youths (MoSY) through behavioral change communication and Peer Education Programme (PEP).
PSRHH as implemented through the PEP Model had three principal phases - the entry phase, intensive phase and exit phase. The entry and intensive phases were aimed at behavioural change while the exit phase was aimed at ensuring behaviour maintenance, community ownership & programme sustainability. Activities carried out through PSRHH include Advocacy Engagements, Peer Education Training, Sensitization of community members and leaders/influencers through Interactive Forums, Inter-Personal Communication (IPC) with target groups and general population. Special events were also held during festive periods and special commemorative days like World AIDS Day (WAD) andWorld Malaria Day (WMD). Through the PSRHH project, LAPO was able to train 200 peer educators among out-of-school youths, transport workers and artisans in target sites around Benin City, Edo State.
With the support of EED, Germany from 2007, LAPO was able to expand the programme to Female Sex Workers (FSW) in Lokoja, a major junction and transit community in Nigeria and In-school Youths of selected primary and secondary schools in Benin City. In-school and FSW programme were expanded to Lagos and Delta states in 2009.
2. Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTC)
PMTCT activities were implemented in Edo State in 2004 in partnership with Pathfinder International Nigeria. With the support of Cordaid, Netherlands, LAPO scaled up the intervention in Delta and Rivers states as well as Nasarawa and Kogi states with the support of Novib, Netherlands in 2006. The programme was extended to Lagos and Rivers States with the Support of EED of Germany. LAPO’s PMTCT project is aimed at increasing HIV/AIDS awareness amongst the general population; encourage HIV counseling and testing (HCT), especially amongst pregnant women; access pregnant, positive women to ART; provide care and feeding for infants of positive mothers as well as provide care and support for HIV-positive individuals and their family members. Various community members were reached through advocacy/sensitization meetings, rallies and health fair. Through the upgrading of health facilities for HCT, training of Community Health Workers and Traditional Birth Attendants, mobilization of community members and home-based care, pregnant women were reached with HIV counseling and testing during antenatal care while those who tested positive were referred to designated PMTCT treatment facilities.
3. Care and Support for People Living with HIV (PLHIV) in Edo State
NECAIN-NELA Consortium on HIVAIDS (NECAIN) is a USAID-supported project implemented by LAPO from 2008 to 2010 in partnership with NELA and CiSHAN North Central. The project targeted PLHIV across the three senatorial districts (Edo South, Edo Central and Edo North) of Edo State for palliative care and support services. The LAPO/NECAIN project was aimed at facilitating easy access of PLHIV to palliative care; enhance linkages of PLHIV to comprehensive treatment and other support services; and reduce HIV-related stigma and discrimination. Project activities included advocacy meetings and sensitization seminars with stakeholders, training of caregivers on Home Based Care (HBC) and provision of palliative care services for PLHIV, formation of support group, referral services for PLHIV to access treatment, skill acquisition/ microcredit and nutrition support. Through the project, PLHIV had access to HBC/palliative care and support services through support to trained caregivers/ providers and enhanced linkages of PLHIV to treatment and other support centers. The project also contributed to the reduction of HIV-related stigma and discrimination among PLHIV and their families.
4. Community Action for Social Justice and Health (CASH)
The implementation of CASH project commenced in 2007, in partnership with Oxfam Novib. The purpose of the project, amongst others, was to prevent the transmission of HIV/AIDS in rural communities; improve the quality of life of persons living with HIV/AIDS; promote sexuality education in schools; promote access to safe water in rural communities; and reduce incidents of malaria in rural communities. The goal was to promote healthy living amongst vulnerable groups. LAPO implemented the CASH project across Edo, Delta, Kogi and Lagos targeting women (80%), men (20%) and youths.
In order to achieve the goal and objectives of the project, LAPO organized community health discussions, created awareness on HIV/AIDS and other community health issues, formed support groups for PLWHAs and trained them on positive living and HIV/AIDS programming. The organization equally provided them psycho-social and economic empowerment support as well as grant them access to treatment services. LAPO also promoted gender equity, social justice, sustainable livelihood and youth empowerment through the CASH project.
With the CASH project, LAPO was able to promote healthy living and improved quality of life of vulnerable people through enhanced health seeking behaviour, HIV/AIDS prevention and impact mitigation; reduction in stigma and securing livelihood of 100 households through the creation of 100 new jobs. Nutritional quality of 100 households was also improved through agricultural extension services and skills acquisition for youths in Edo and Nasarawa states.
5. Economic Empowerment of PLWHAs and PABAs.
LAPO commenced the Economic Empowerment for PLWHAs and PABAs project in 2006. This World Bank-assisted HIV/AIDS Fund (HAF) project was implemented in collaboration with the Edo State Action Committee on AIDS (SACA). The goal of the project is mitigating the effect of HIV/AIDS on PLWHAs and PABAs by providing access to micro-business management training and flexible micro-finance services for income generation activities (IGA). Under the project, 132 PLWHAs and PABAs benefited from pre-loan training on credit/micro-business management, positive living and microfinance for business start-ups or expansion between 2006 and 2007. The economic empowerment for PLWHAs/ PABAs was expanded to Delta and Kogi states in 2008 with the support of EED Germany and Novib, Netherlands and is currently sustained through integration with existing flexible LAPO micro-financial services.
6. Universal Access to Female Condom (UAFC) 2009 – Date
UAFC project promotes family planning, STIs and HIV prevention and control and makes women have greater control over their own protection against diseases. The implementation of the 3-year project commenced in 2009 in partnership with Oxfam Novib, Netherlands. The project’s pilot states are Lagos, Edo and Delta. LAPO is collaborating with the Society for Family Health (SFH) to create community-level awareness and develop enabling environment aimed at increasing demand for and access to Elegance® Female Condom in Edo State.
Under the project, LAPO carries out advocacy visits to opinion leaders/policy makers, engages in community mapping and health facility assessment in various communities in Edo State. From year 2009 till date, LAPO has carried out training of Master Trainers as well as sensitized over 10,000 participants drawn from community-based organizations/associations (CBOs), support groups of People Living with HIV/AIDS, trade associations including market unions, motorbike transport workers, community members, youth bodies and selected officers/men of the Federal Road Safety Commission and the Nigeria Police. Through this intervention project, members of target groups and communities/LGAs are now aware of the importance and correct usage of Elegance® Female Condom. Demand for the product has further increased.
7. Integration of Social/Health Education with Microcredit Services (Since 2006 to date)
In order to boost the impact of microcredit on poverty, Lift Above Poverty Organisation (LAPO) has been providing clients of LAPO Microfinance Bank social and health education services during union meetings since 2006. Under the programme, clients are sensitized on social issues including gender rights, domestic violence, rape and its consequences and participation in decision making, etc.
They are also sensitized on malaria prevention and control, modern family planning methods, pregnancy care, cervical cancer, hepatitis B, child immunization, diarrhea, HIV/AIDS and the dangers of self-medication, etc. Comprehensive health screening and referral services are provided to reduce self medication, promote preventive health care and utilization of quality health care services. Beneficiaries are usually screened for malaria, blood sugar, blood pressure and HIV/AIDS while breast and cervical cancer screening are organized quarterly for LAPO MfB clients and interested community members in collaboration with the Edo State Cancer Control Programme.
8. Capacity Building for Malaria Control
Since 2010, LAPO has been collaborating with ACOMIN (Network of Civil Society Organizations on Malaria in Nigeria) to build the capacity of member organizations in Edo State, Nigeria. The goal of the Global Fund R8 project is to reduce by 50%, the 2,000 malaria morbidity and mortality figures by 2013 and minimize the socio economic impact of the disease. The objectives include:
To contribute to the rapid scale up of universal coverage of the population at risk of malaria in 2010 through 100% coverage and 80% use of Long Lasting Insecticide-treated bed nets (LLINs) and sustaining this through 2013, to contribute to prompt and effective treatment of malaria using Arteminsine-based Combination Therapy (ACT), to scale up parasitological diagnosis of malaria in patients above five at health facilities to 80% by 2013; to reach at least 80% of the population at risk (communities, families, care providers and health workers) by 2010 through Behavioral Change Communication (BCC) for awareness and appropriate action on malaria prevention and treatment and sustaining this through 2013; and to contribute to health systems strengthening (including community systems strengthening through malaria control activities.
In 2010 and 2011, LAPO organized seven training sessions for over 300 target persons including Local government primary health care coordinators and nursing personnel, local and state malaria control officers, community health workers, youths, NGOs/CBOs members, young/pregnant women and mothers of under-5 children. The training developed their capacity for the delivery of malaria control programme towards achieving the objectives of the global fund malaria project.
The training built their capacity in following areas:
1. Social mobilization on activities targeted at bringing about increased and informed demand and use of malaria prevention and treatment products and services in all South-South states.
2. Using relevant community mobilization channels to expand informed demand, uptake and use of appropriate malaria prevention and treatment products as well as deepening community information resources.
3. Promotion of better and more informed community ownership of their health status through enhancement of community-driven strategies for uptake and usage of all health supporting services.
4. Promote partnerships and linkages for community-level sustainability.
In 2012, LAPO organized capacity development training for selected Civil Society Organizations (CSOs) in Edo state on community mobilization for malaria control. The training focused on the strategic use of community drama for promoting awareness on malaria prevention, importance of diagnosis before treatment, use of treated bed net and appropriate drugs for malaria treatment which is Artemisinin-based Combination Therapy (ACTs). Beginning from 2012 till date, LAPO has been engaged by ACOMIN/SFH to carry out community mobilization activities using community drama and Interpersonal Communication (IPC) in many rural communities in Edo Central Senatorial District.
9. Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS)’s Project
Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) is a community prevention and impact mitigation services is the key integration of other medical and social service programme, such as PMTCT, RH-HIV, OVC care, high-risk prevention, HIV/AIDS prevention, care and support programme and linkages with existing orphan care and youth intervention programme.
It is a USAID-funded project with the following objectives:
1. To strengthen the capacity of local CBOs and its collaborating partners to effectively implement integrated community-based prevention and mitigation activities by June 2016.
2. To increase community involvement, capacity and participation in maternal health, HIV/AIDS, STI and TB, Sexual and medical prevention, OVC, care and support by June 2016.
3. To build the capacity of CBOs in fostering innovation and local solutions for stemming the spread of HIV/AIDS and non-communicable diseases as well as mitigate their effects in communities through its consortium partners by June 2016.
Strategies of the project include:
Advocacy and partnership building; Sensitization and community awareness campaign; Technical, organizational and financial capacity building; Strategic behaviour communication including demand creation activities; Outreach community-based provision of services; Referrals, facility mapping and linkages to HIV/AIDS, OVC, TB, STI treatment, care and support services; and Monitoring and Evaluation (M&E).
Lift Above Poverty Organisation (LAPO) signed a contractual agreement with the Association for Reproductive and Family Health (ARFH) to carry out community-based intervention across Edo Central Senatorial District from April 2014. The project is a family-centered, community-led multi-sectoral intervention that engages communities to take action to prevent the spread of HIV/AIDS; care for and track the welfare of PLHIV including OVC and enable greater access to care and support at all levels from home to health facilities. The project is designed to holistically reduce the health, economic and social consequences caused by the proliferation of STI, TB and HIV/AIDS in communities, including capacity building through training and information, peer education, school and community-based prevention outreach for youths, voluntary counseling and testing (HCT) service and community home-based care (CHBC) for people living with HIV/AIDS.
10. Prevention of New HIV Infection among FSW and PMTCT Project
The LAPO intervention project on the Prevention of Mother to Child Transmission and New HIV Infection amongst Female Sex Workers (FSW) in Edo State is supported by Edo SACA through the World Bank’s HIV/AIDS Fund (HAF). The project was implemented between June 2014 and December 2015 in Ovia North East, Esan West and Esan Central Local Government Areas to increase knowledge and attitude conducive to HIV prevention practices among pregnant women and FSWs; and increase access of target beneficiaries to ANC, HCT, RH and PMTCT services. Key project activities include:
- Advocacy meetings with stakeholders such as brothel owners, community leaders and Local government policy makers.
- Training of FSW as peer educators and community volunteers as IPC conductors among young/pregnant women
- Peer Education sessions among cohort members of Female Sex Workers (FSWs) in Ovia North East.
- Interpersonal Communication (IPC) session among young/pregnant women in Esan Central and Esan West LGAs.
- HIV Counselling and Testing (HCT)
- Condom distributions and establishment of distribution outlets
- Community dialogue sessions
- Training of key stakeholders such as Traditional Birth Attendants (TBA), religious leaders and community volunteers
- Referrals for PMTCT, antenatal, family planning and STI treatment.
11. HIV Prevention among Patrons of High Risk Spots in Lagos State
HIV/AIDS Programme Development Project (HPDP II) is an intervention focusing on HIV prevention using Structural, Behavioural and Biomedical intervention approaches called Minimum Prevention Package Intervention (MPPI). LAPO partnered with two organizations; Health Awareness and Gender Advocacy Initiative (HAGAI) and Eagle Eye Behavioural Initiative to carry out HIV prevention activities among people who visit brothels and drinking spots where female sex workers ply their trade. The project was implemented in eight Local Government Areas of Lagos state, Agege, AjeromiIfelodun, Alimosho, Apapa, Surulere, Eti-Osa, Ojo and Badagry with LAPO assigned Alimosho and Ojo Local Government areas.
Objectives of the Project
- To contribute 50% to the targeted reach of the 30% vulnerable key population with comprehensive HIV /AIDS prevention services by the end of 2014 in Lagos State
- To reach 40% patrons of high risk spots in the intervention LGAs with comprehensive HIV Counseling, Testing and referral services by the end of 2014 in Lagos State.
- To reach 40% patrons of high risk spots in the intervention LGAs with comprehensive knowledge, and to ensure consistent condom use and other HIV prevention methods by the end of 2014 in Lagos State.
- To reach directly 70% patrons of high risk spots in the intervention LGAs with comprehensive HIV knowledge, information and education about HIV prevention intervention services by the end of 2014 in Lagos State.
Activities under the project include advocacy visits to stakeholders and behavioral change communication at various hotspots in Alimosho and Ojo Local Government Areas. The outreach was a moonlight activity where Venue Activators used comedy as a strategy to get the attention of the audience and passed vital messages and facts about HIV/AIDS, which helped in assessing their knowledge and views on HIV/AIDS. Other activities include:
- Administration of HIV/AIDS Knowledge Questionnaire to 34 patrons at the hot spots
- Distribution of printed IEC materials to clients of hot-spots across the local government areas
- Distribution of male condoms among target persons
- Provision of HCT services to patrons during outreach activities
Over 30 hot-spots were reached for various health interventions. A large number of patrons had the opportunity to know their HIV status while those who tested positive were referred to Ojo PHC.