Place of implementation:           BUGESERA DISTRICT 

NGERUKA HEALTH CENTER 

Project title:                                   GILS GET EQUAL CAMPAIGN: “Girls and young people living with HIV get respect” 

Period of implementation:         July 2019

1.                   BACKGROUND

Kigali Hope Organization (KHO) is a Rwanda Civil Society Organization whose members and beneficiaries are young people living with HIV. KHO activities have been targeted towards advocacy, HIV prevention, Mobilizing YPLWH to form support groups to improve their livelihoods and there by actively participating in the HIV response through different programs including: Primary prevention, Human rights promotion and AIDS impact mitigation.

Plan International Rwanda, a development and humanitarian organization that advances children’s rights and equality for girls will launch a new campaign dubbed ‘Girls Get Equal’ aimed at increasing girls’ and young women’s power, voice and leadership as a way of advancing their equality. It is using this approach to transform unequal gender power relations and bringing about significant and sustainable change so that girls can learn, lead, decide and thrive. The campaign was initiated and launched last year 2018 by Plan International globally to address the root causes of gender inequality by focusing on how and where discrimination and stereotyping hold women and girls back in different areas like education, health, economic participation and opportunity as well as political empowerment.

It will empower girls and young women to move with confidence to make crucial decisions affecting their lives, freedom to move, live and speak up without the threat of violence and harassment as well as storytelling to share diverse stories of Girls’ power. The social change campaign slogan is ‘We won’t stop until girls are seen, heard and valued”.

It is in that regards Kigali Hope Organization was selected to implement some activities targeting young people living with HIV in Begesera District at Ngeruka Health center specifically.

2.                   ACTIVITIES OBJECTIVES 

“Girls Get Equal Campaign: Girls and young women living with HIV get respect” PROJECT was conducted to attain the following objectives:

ü  Girls and Young people living with HIV  get power to make crucial decisions about their lives 

ü  Girls and young people living with HIV get freedom to move, to live and to speak up without stigma and discrimination 

ü  Girls and young people living with HIV get the ability to share stories of Girls’ power and be role models for HIV+ peers and get ability to advocate for the improvement of lives of other vulnerable young people 

ü  Girls and young people living with HIV get ability to work for their future as citizens of our country.

3.                   IMPLEMENTED ACTIVITIES

ü  Training on Sexual reproductive health and rights

ü  Training in how to fight and deal with stigma and discrimination (testimonies sharing was the strategy)

ü  Workshop on financial fitness

4.                   STRATEGIES USED DURING THE IMPLEMENTATION

ü  Testimonies sharing

ü  Focus group discussion

ü  Story telling

5.                   IMPLEMENTATION OF PLANNED ACTIVITIES

The conducted activities were in general successful and it took us 3 days for realization. All planned activities were conducted with and at Ngeruka Health Center. In total 20 girls and boys aged between 15-25 years old was present and among them 13 girls.

The training was starting each day of the 3 days from 8 AM in the morning to 4pm evening.

Opening remarks was delivered by KAYUMBA AIME, the legal representative of KHO. He talked about the organizing organization (PLAN International and KHO) and particularly about the project “Girls Get Equal”. He stressed on the importance of the training and the role of participants as well as their involvement for the success of the training.

Two days Training include Topic /Sessions on Sexual, reproductive health and rights, testimonies exchanges. And the third day we had a workshop on financial fitness.

DAY 1: 18^th July 2019:

SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS SESSION

This topic was new to the participants, as it was never discussed before. Participants was excited to hear and understand  all about Sexual Reproductive Health and Rights , as revealed that they still have and believe in false information and taboos (a young girl can only be pregnant after 7 days of menstruation, men become sexually impotent because of their sperm stolen by women, etc). The trainer disclosed all information regarding to SRH, and remove all false believes by deep explanation, examples and teaching materials demonstrations and provided answers to the asked questions. 

At the end of this session it was noticed through a quick evaluation, that at least 14 out of 19 trainees had well understood the themes developed on ASRH.

WOMEN AND GIRLS PERIOD CYCLE (MENSTRUAL CYCLE):

No information ever discussed before, about Menstrual Cycle, it was just new topic, Participants was introduced the significance and use of awareness of this by using examples, group exercise and presentation. 

It was noted that only young people who went to school were able to understand how to calculate their menstrual period.

DAY 2: 19^th July 2019

CONDOM USE (WITH DEMONSTRATION): 

Youth are mostly vulnerable in sex intercourse, most of the time they involve in non-protect sex intercourse that lead to unexpected pregnancies, new HIV infections as well as other STIs. 

Participants were very eager to learn as it was the first time aware of condom demonstration, usage, and how it protects in sexual intercourse. The session was practical demonstration by using teaching materials and mostly engages girls in practical exercises.

HIV ADHERENCE AND POSITIVE LIVING TESTIMONY:

There are a number of key issues in the follow up of patient (or young people living with HIV) on adherence to antiretroviral therapy, including accurate measurement of adherence, assessment of the impact of adherence on viral load and clinical outcome, determination of the factors that affect adherence, and the development of interventions. Addressing these issues may provide valuable information about which patients are most at risk for non-adherence and about how adherence might be improved. The critical factors that influence adherence fall into 4 main groups: (1) patient factors, such as drug use, alcohol use, age, sex… (2) Medication regimen, such as dosing complexity, number of pills, or food requirements; (3) the patient-health-care provider relationship; and (4) the supportive care system.

Testimony sharing makes youth living with HIV have attention in decision making, and make a comparison between himself / herself with someone who is giving testimony through inspiring story. The young person is motivated to choose the winning way (manner, methods…) and do whatever it takes to suppress viral loads. Self-development, fight with stigma and discrimination and have a positive mind lead always to positive living.

ENTREPRENEUR MIND SET:

Having entrepreneur mind set is a key for positive living of the youth living with HIV, most of participants are in agriculture domain, they do it for survive, not for business. This session focused on boosting youth mind set by starting small business using available startup capital, either thinks about cultivating for the business purpose or livestock business. 

BUSINESS IDEAS STIMULATION:

This session also helped for ideas stimulation, where each participants start thinking about the small business he/she can start by using surrounded opportunities and available resources, market study and innovation. This session was very practical with small group discussions and presentations. 

DAY 3: 25^th JULY 2029

FINANCIAL FITNESS

On this day, the participants had a chance to discuss about how they can improve their lives and at the same time their adherence to HIV treatment. The trainer tried to motivate them into forming a saving group as a starting point. In the past young people living with HIV at Ngeruka Health Center have never met before for any reason may it be for treatment or any other. So, forming a saving group may be a catalyzing step for them to meet regularly for a continued social supporting initiative that could lead to good adherence to HIV treatment, for instance.

Consequently the participants came up with an idea of saving the money that were given to them as transport during the training and use it for their development. 17 young people of them decided to start immediately and even we helped them to acquire information on how they can open a bank account at SACCO Ngeruka. At the moment the account is opened and 170,000RWF has been deposited on that account. Young people are now getting prepared to have an income generating activities.

This account will be used as saving tool, management of the fund, accuracy of transaction done, avoid fund embezzlement and safety. The deposits and withdrawal will be done based on consent of each member through written meeting resolutions.

CONNECT GROUP TO HEAD OF H.C FOR FUTURE ASSISTANCE, SUPPORTS AND ADVICE:

The head of health center promised to the group good cooperation for much need advices and guidance, opportunities sharing and keeping the recording materials of the group and its safety inside the health center where the group will operating.

CHALLENGES

ü  A the beginning of the training, young people were very shy because it was for most of them the first time to see each other so it was impossible for them to open up themselves for a constructive discussion

ü  To connect with local authorities was not easy for us as an organization because the communication about the collaboration with PLAN Rwanda was not communicated to the local leaders before the start of the implementation

RECOMMENDATIONS AND WAYFORWARD

ü  Adherence to treatment among young people living with HIV is still a challenge. And at Ngeruka health center young people should be encouraged to have good adherence.

ü  It has been noticed that young people have difficulties to access condoms (at Ngeruka Health center) and in order to meet this need, it would be necessary for KHO to regularly supply condoms to young corner at Health center level.

ü  We noticed that in health centers (in rural areas) are more likely to ignore the needs (need of information about sexual and reproductive health, about how to cope with stigma and discrimination, HIV treatment adherence, unwanted pregnancies,…) of young people living with HIV

ü  To reinforce knowledge gained on SRH, training refresher should be organized after at least three months.

ü  Young people will be  messengers among their peers to help reduce or stop HIV transmission

ü  There should be more initiatives that involve all health centers where PLAN International Rwanda operate in Rwanda (Bugesera, Gatsibo, Nyamagabe…) because as from the experience we had during the last month at Ngeruka Health center, young people living with HIV are neglected in terms of providing them the very much needed information about Sexual and reproductive health and rights, unwanted pregnancies, the role of young boys in the fight of HIV and new infections (As girls and young women infected with HIV are 5 times many than their brothers)

ü  Formed saving group needed the basic assistance and advice  include guidance in group development, the significance of joining forces, the better way to choose the sustainable business idea, group management and member’s future outcomes

PLAN Rwanda needs in the future to organize a coordination meeting with local leaders including District representatives and other decision makers in order to inform them about new collaboration about other project implementers in the District.