DEFEATING CANCER IN NIGERIA
Cancer mortality remains the highest in Africa and among the highest in the world, according to the World Health (2016). The LAPO Community Campaign for Cancer Control (LAPO-C4) was initiated by Founder, Dr. Godwin Ehigiamusoe in 2016 with a determination to address increasing cancer morbidity and mortality in Nigeria.
LAPO believes that poverty is further reinforced by ill-health with cancer and other chronic ailments linked to the increasing level of household poverty in Nigeria. Tackling the cancer behemoth would indirectly address other related challenges like children dropping out of school, household social insecurity and poverty. The LAPO-C4 project is therefore one of the holistic measures aimed at achieving our mission of improving the lives of poor and disadvantaged populations in Nigeria.
The project is being implemented in collaboration with Community-Based Organizations (CBOs) drawn from Lagos, Rivers, Edo and Imo and the Federal Capital Territory (FCT), Abuja including JAKIN NGO (Lagos State), Bella Foundation for Child and Maternal Care (Edo State), Willi Johnson Foundation (Edo State), Partnership For Survival (Edo State), Initiative for the Development of the Next Generation (Edo State), Rehabilitation Initiative for Counselling and Healthcare (Edo State), Care and Development Centre (Rivers State), Rivers of Hope and Humanitarian Initiative (Rivers State), Better Community Life Initiative (Imo State), Our Lady of Perpetual Help Initiative (Imo State), Friends for Community and Youth Development (Imo State), Women Friendly Initiative (FCT-Abuja) and Yes to Life for Women and Children, (FCT-Abuja), Heartwells Complementary Services (Lagos State), Support Initiative for Sustainable Development (Rivers State) and Nativity Roma Cancer Support Centre (FCT- Abuja).
In 2017, LAPO advocated for policy change and improved access to cancer control services in collaboration with health institutions and other stakeholders in development. We also conducted mass enlightenment campaign and rapid screening, as well as referred those with health conditions to diagnostic and treatment centres in target states in partnership with partner CBOs. These activities were tailored toward reducing cancer-related deaths in Nigeria.
INTEGRATION OF HEALTH EDUCATION AND MICROFINANCE SERVICES (SINCE 2006 TO DATE)
In order to boost the impact of microcredit on poverty, LAPO has been providing social and health services to LAPO microfinance clients during their credit group meetings. Under the programme, clients were sensitized on social issues including gender rights and participation in decision making processes. They are also sensitized on malaria (in children and pregnancy), modern family planning methods, pregnancy care, cervical cancer, hepatitis-B, child immunization, diarrhea in children prevention, 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 screened for malaria, blood sugar, blood pressure and HIV while breast and cervical cancer screening programmes are organized quarterly in collaboration with Edo State Cancer Control Programme for LAPO clients and interested members of their communities.
STRENGTHENING INTEGRATED DELIVERY OF HIV/AIDS SERVICES (SIDHAS) PROJECT
In April, 2014, LAPO signed a contractual agreement with the Association for Reproductive and Family Health (ARFH) to carry out community-based interventions on Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) in Edo Central Senatorial District.
SIDHAS is a USAID-funded, family-centered, community-led intervention project that engages communities to take action to prevent the spread of HIV/AIDS; care for and track the welfare of People Living With HIV (PLHIV) including Orphaned and Vulnerable Children (OVC) and enable greater access to care and support at all levels of care from home to health facilities and other supports.
• To strengthen the capacity of local Community Based Organizations (CBOs) and its collaborating partners to effectively implement integrated community-based prevention and mitigation activities by June 2016;
• To increase community involvement, capacity and participation in maternal health, HIV/AIDS, Sexually-Transmitted Infections (STI) and Tuberculosis (TB), Sexual and medical prevention, OVC, care and support by June 2016;
• To build the capacity of CBOs in fostering innovative and local solutions to stem the spread of HIV/AIDS and non-communicable diseases and mitigate its effects in communities through its consortium partners by June 2016.
• The activities of LAPO in Edo Central Local Government Area under the project include the following:
· Referral of young and pregnant women for ANC, HCT and PMTCT services;
· Provision of PHDP – Positive Health, Dignity and Prevention (PHDP)/ chronic care to PLHIV;
· Tracking of Defaulters receiving ART, PMTCT and other HIV/AIDS-related Services in activated facilities.
· OVC Enrollment and provision of services to young/ older OVCs;
· Facilitation of 250 Caregivers monthly on gender issues and community integrated management of childhood illness(C-IMCI) in five LGAs of Edo central.
· Facilitation of 5 Child protection committee meetings monthly in the five LGAs of Edo central
Advocacy and partnership building; sensitization and community awareness campaign; Technical, organizational and financial capacity building; Behavioral Change Communication including demand creation activities; 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).
Advocacy meetings with community leaders, health facilities, school authorities and policy makers across the 5 Local Govt. Areas in Edo Central.
Training of 30 Community Volunteers (CVs) in Edo Central to carry out home visits to vulnerable households and children
Establishment of Child Protection Committees (CPCs) in each of the 5 LGAs of Edo Central
Enrollment of over 40,000 children from most vulnerable households into project services
Provision of services (psychosocial, health education, HCT, education, growth monitoring, nutrition counselling, birth registration) to over 40,000 vulnerable children to care
Establishment of 3 Kids Club (Iruekpen, Igueben and Uromi)
Establishment of 5 groups of 50 OVC Caregivers each, one per LGA for Cooperative Society formation and facilitates access to IGA support grant.
Provision of income generation activity support to 28 older children and caregivers of vulnerable children in the communities.
Testimony by SIDHAS Project Beneficiary Mrs. Okon Franca
Mrs. Okon Franca (08160514208) is a widow residing in Igueben and caring for six children. She lost her husband 7 years ago through a motor accident. She was a petty trader in provision and food stuff before the death of her husband. She became a subsistence farmer and engaged in menial jobs after losing her means of income soon after the death of her husband. She and her children lived in a dilapidated building with a leaking roof with the children not attending school.
In January, 2015 she was trained on how to make snacks and provided with SIDHAS grant of N15,000 to buy flour, sugar, egg, baking powdered yeast, groundnut oil and butter.
She currently sells snacks like chin-chin, poff-poff, doll-nut, meat pie and egg rows in schools, markets and banks in Igueben. Today, Madam Franca’s snacks are popular in schools, among market women and bankers in Igueben. Mrs. Franca has relocated from her dilapidated rented apartment to a better building and her children are now eating well and regular at school.
The project achieved increase in the uptake of HIV/AIDS and related services and enhanced adherence of target persons living with HIV to treatment regimen. It has also ensured general improvement in the level of community awareness on HIV/AIDS prevention, treatment, care and support issues like stigma and discrimination, HCT, PMTCT, Home-based Care and Referrals and dangers of social neglect of vulnerable children.
PREVENTION OF NEW HIV INFECTION AMONG FSW AND PMTCT PROJECT
Intervention Project on Prevention of Mother to Child Transmission and New HIV Infection among Female Sex Workers in Edo State is supported by Edo SACA through the World Bank’s HIV/AIDS Fund (HAF). The project is been 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 NE
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), religion leaders and community volunteers
Referrals for PMTCT, antenatal, Family planning and STI treatment.
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). In this project, LAPO is a partner in the consortium of three Organisations namely Health Awareness and Gender Advocacy Initiative (HAGAI), Eagle Eye Behavioural Initiative and Lift Above Poverty Organization (LAPO) to carry out HIV prevention activities among people who visit brothels and drinking spots where Female Sex Workers operates. The project is implemented in eight Local Government Areas of Lagos state. These Local Governments are Agege, Ajeromi Ifelodun, Alimosho, Apapa, Surulere, Eti-Osa, Ojo and Badagry Local Government Areas.
Objectives of the Project
To contribute 50% to the targeted reach of 30% of other 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 (Venue) 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 (venue) in the intervention LGAs with comprehensive knowledge of, and 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 (venues) 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 carried out by LAPO through the project include advocacy visits to Alimosho and Ojo Local Government areas of Lagos State; Open Community Meeting/Dialogue held at Ojo LGA secretariat to ensure that the stakeholders and the target population were aware and engaged for the intervention; Behavioural Change Communication outreaches 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 pass message on facts about HIV/AIDS which helped to assess and increase their knowledge of risk and transmission of HIV.
Other activities carried out include:
Administration of HIV/AIDS Knowledge Questionnaire to 35 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
HCT services were rendered to patrons during outreach activities and lots of patrons had the opportunity to know their HIV status. Those tested positive were referred to Ojo PHC
Over 30 hot-spots were reached for project interventions
CARE AND SUPPORT FOR PEOPLE LIVING WITH HIV (PLHIV) IN EDO STATE
NECAIN – NELA Consortium on HIVAIDS (NECAIN) is a USAID-supported project being implemented by LAPO since 2008 to date, in partnership with NELA and CiSHAN North Central. The project targets 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 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 include advocacy meetings and sensitization seminars with stakeholders, training of caregivers on 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 have 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.
ECONOMIC EMPOWERMENT FOR PEOPLE LIVING WITH HIV (PLHIV) IN EDO STATE
LAPO commenced Economic Empowerment for PLWHAs and PABAs project in 2006.
The project, a World Bank HIV/AIDS Fund (HAF) project, was implemented in collaboration with the Edo State Action Committee on AIDS (SACA).
The goal is to mitigate the effects 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). 132 PLWHAs/ PABAs benefited from pre-loan training
(on credit/ micro-business management and positive living training) and flexible microfinance for business start-up or expansion between 2006 and 2007.
The economic empowerment for PLWHA/ PABA was expanded to Delta and Kogi in 2008 with the support of EED Germany and Novib,
Netherlands and is currently sustained through the programme integration with existing LAPO flexible micro-financial services.
PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV/AIDS (PMTCT)
PMTCT activities were implemented in Edo State in 2004 in partnership with Pathfinder International Nigeria.
With the support from Cordaid of Netherlands, LAPO scaled up the intervention in two additional states (Delta and Rivers) in 2006 and into two additional states (Nasarawa and Kogi) with the support of Novib, Netherlands. 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 among general population; encourage HIV counseling and testing (HCT), especially among pregnant women; access pregnant, positive women to ART; provide care and feeding for infants of positive mothers; provide care and support to 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 tested positive were referred to designated PMTCT treatment facilities.
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH AND HIV/AIDS REDUCTION (PSRHH)
PSRHH project was implemented in partnership with Action Aid International Nigeria and Society for Family Health (SFH). It commenced in 2003 in yearly cycles and ended in 2008. Its goal is 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. the Female – Out – of – School Youth (FoSY) & Male – Out – of – School – Youth (MoSY) through behavioral change communications and Peer Education programmes. PSRHH as implemented through the PEP Model has 3 principal phases – the entry phase, intensive phase and phase down. The entry and intensive phases were aimed at behavior change; the phase down was aimed at ensuring behavior maintenance, community ownership & program sustainability. Activities carried out through PSRHH include Advocacy, 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) and World Malaria Day (WMD). Through the PSRHH project, LAPO has been able to train 200 PEs among the youth (out-of-school), transport workers and artisans in target sites around Benin City, Edo State.
With the support of EED, Germany, LAPO expanded this program to Female Sex Workers (FSW) in Lokoja, a major junction and transit community in Nigeria and In-school Youth of some selected primary and secondary schools in Benin City since 2007. In school and FSW program was expanded to Lagos and Delta states in 2009.
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