Capitalisation of good practices on HIV programming for persons with disabilities in Rwanda from 2008 to 2013

Muriel Mac-Seing and Elie MugabowishemaHandicap International

Background on the HIV and disability project

Title: Strengthening communities to integrate persons with disabilities in the HIV and AIDS response in Rwanda

Period: 2008 to 2013 Funding: Health Resources and Services Administration (HRSA)

of the US Government (New Partner Initiative) Technical assistance from: JSI and CDC Rwanda Main partners: Seven disabled people’s organisations (DPOs),

two CBOs, the Rwanda Biomedical Centre (RBC) and the Ministry of Health

Location: 19 of 30 districts of Rwanda

Expected project results ER1: The national AIDS programme, Umbrella of People with

disabilities in the Fight of HIV/AIDS (UPHLS), seven DPOs and CBOs and five health facilities/VCT centres are capacitated and their involvement in the national response to HIV increased

ER2: HIV prevention services are scale up to include at least 65,700 persons with disabilities and 187,570 family members

ER3: HIV care and support to people living with HIV is strengthened and scaled up to include at least 2,200 persons with disabilities infected and affected by HIV

ER4: Sexual and gender-based violence (SGBV) services are accessible to 6,000 women and men with disabilities and 70 persons with disabilities who are SGBV survivors have appropriate care and treatment

Main achievements• 93,393 persons with disabilities (57% women) and 246,100

community members (69% women) have been sensitized on HIV prevention

• 2,090 persons with disabilities living with HIV (61% women) received care and treatment services

• 4,903 persons with disabilities (54% women) and 8,715 community members were sensitized on SGBV

• 53 persons with disabilities (56% women) received SGBV care and treatment services

• Nine DPOs and CBOs received organisational development strengthening

• Three national forums on HIV and disability have been co-organised with the Rwanda Biomedical Centre and UPHLS.

Good practice 1: Strengthening of disabled people’s organisations

The process Technical and

organisational capacityassessment

Technical and organisational capacity

assessment

Technical support from JSI and follow-up from Handicap International

Technical support from JSI and follow-up from Handicap International

Increased institutional capacity of DPOs and

CBOs

Increased institutional capacity of DPOs and

CBOs

The results

Increased coverage

in selected districts

Increased coverage

in selected districts

Ownership and empowerment

of PWD

Ownership and empowerment

of PWD

Set up of association and support groups

for PWD

Set up of association and support groups

for PWD

Reinforced relationship between

organisations and their constituency

Reinforced relationship between

organisations and their constituency

Good practice 2: Involvement of persons with disabilities as peer educators in HIV prevention

The process

TOT of DPOs and CBOsTOT of DPOs and CBOs

Training of peer educators

Training of peer educators

Peer education to people, families and

community members

Peer education to people, families and

community members

The results

Family level

•Decreased stigma and discrimination•Increased knowledge•Formation of support groups•Increased involvement of CHW

Family level

•Decreased stigma and discrimination•Increased knowledge•Formation of support groups•Increased involvement of CHW

Individual level

•Increased demand for inclusive health services•Increased knowledge•Increased self-esteem and confidence•Sense of ownership

Individual level

•Increased demand for inclusive health services•Increased knowledge•Increased self-esteem and confidence•Sense of ownership

Good practice 3: Use of tailored advocacy to include disability at national level

The process Close collaboration with

RBC and UPHLSClose collaboration with

RBC and UPHLS

Technical working group of HIV and disability

Technical working group of HIV and disability

National forums on HIV and disability

National forums on HIV and disability

Training workshops at national and district

levels

Training workshops at national and district

levels

The results

Advocacy Advocacy

Production by RBC of disability sensitive IEC

material (sign language, images, large fonts)

Production by RBC of disability sensitive IEC

material (sign language, images, large fonts)

Disability inclusion

guideline in health

system at community

level

Disability inclusion

guideline in health

system at community

level

Inclusion of disability in national policies, e.g.

most recent NSP on HIV

Inclusion of disability in national policies, e.g.

most recent NSP on HIV

Inclusion of disability type in VCT registry

books

Inclusion of disability type in VCT registry

books

Good practice 4: Mainstreaming of disability at HIV service provision level

The process Disability accessibility audit with corrective

measures

Disability accessibility audit with corrective

measures

Training of health staffTraining of health staff

Adaptation of IEC material accessible to

PWD

Adaptation of IEC material accessible to

PWD

Support groups of PWD at health facilities

Support groups of PWD at health facilities

The results

Advocacy Advocacy

More PWD seeking HIV and SGBV services

More PWD seeking HIV and SGBV services

Increased knowledge

and changed attitudes among

health staff

Increased knowledge

and changed attitudes among

health staff

Identification of PWD by CHWs and follow-up

Identification of PWD by CHWs and follow-up

Mobile VCT services for

PWD

Mobile VCT services for

PWD

Selected health

facilities accessible to

PWD

Selected health

facilities accessible to

PWD

Good practice 5: Integration of SGBV protection in HIV programming

The process Participation in the MOH

SGBV technical groupParticipation in the MOH

SGBV technical group

Peer education and mass awareness

creation

Peer education and mass awareness

creation

Training of service providers and institutional

strengthening of CBOs

Training of service providers and institutional

strengthening of CBOs

District monthly consultative meetings

District monthly consultative meetings

The results

Advocacy Advocacy

Improved coordination and working relations among HIV and SGBV

actors

Improved coordination and working relations among HIV and SGBV

actors

Increased SGBV

seeking services

from PWD

Increased SGBV

seeking services

from PWD

Integration of SGBV in UPHLS’ HIV programming

Integration of SGBV in UPHLS’ HIV programming

Increased knowledge

among health staff, CHWs, police and

judiciary staff for providing

services to PWD

Increased knowledge

among health staff, CHWs, police and

judiciary staff for providing

services to PWD

Thank youMurakoze