Building Capacity in the S&D response

The initial review of the pilot activities of the RSDU has demonstrated their effectiveness in improving self esteem and advocacy skills of PLHIV, empowering PLHIV towards GIPA, involving marginalised groups in evidence based programming (from research to project implementation), and improved collaborations between affected and stigmatized groups using a building blocks approach. The proposed strategies for implementation have built upon these emerging good practices; regional initiatives that have demonstrated success in reducing stigma and discrimination and approaches consistent with global best practices.

 

Initial assessments of organisations working in the HIV response highlighted a dearth of skills in addressing stigma and discrimination. Moreover, lack of understanding of the impact of S&D by practitioners had the potential to hamper HIV prevention efforts of some organisations. The RSDU addressed this knowledge gap through community level capacity building which provided pivotal community actors with the requisite skills in research, a deeper understanding into the causes and context of stigma and discrimination; and support in the development of tools for addressing S&D. Furthermore, the participatory and peer approaches used, involved translating knowledge into action to ensure long term sustainability. The capacity building sessions were focused around:

1. Leadership development: empowerment, partnership building, advocacy action, human rights and public speaking

2. Skills building in stigma and Discrimination BCC Approaches, including research evaluation and program design

 

Some emerging outcomes include:

 

  • Sustainability through collaboration and partnership building

RSDU supported the development of partnerships and networks at the local and regional levels through participatory planning and collaborative initiatives.

 

  •         Support to national planning by building an evidence base for programming

The RSDU provided support to strategic planning for anti-stigma and discrimination

programmes in inception phase countries through the rapid needs assessments and operational research, which were followed by dissemination forums and participatory project design workshops. The project design workshops served as an opportunity for stakeholders to design S&D programmes that were consistent with the country level strategic direction (as outlined in their NSPs) and based on emerging evidence and identified programme needs presented by the RSDU.

 

The rapid assessments, the dissemination forums and sub-project workshops therefore served as decision support and capacity built for the National AIDS Programmes and community groups seeking to streamline their S&D initiatives the priorities outlined in the National Strategic Plans. In instances where the new plans were being developed, the assessments gave guidance on the S&D components of the nascent strategic plan.

 

  • Empowerment, influential speaking, human rights and advocacy action
  •       Empowerment, a prerequisite for greater (more meaningful) involvement of PLHIV

An essential element of successful HIV programming entails involving affected communities in the design and implementation of initiatives. Working with persons living with HIV (PLHIV) is crucial to achieving success and sustainability of efforts to reduce community-based and institutional stigma and discrimination. Meaningful involvement of PLHIV can only be fully operationalised when they are empowered with the necessary skills to lead and participate in programming. A clear priority in the pilot countries was the need to provide stigmatized groups with self- esteem and capacity building to overcome their self stigma and internal stigma which presented barriers in the application of the GIPA principle. To respond directly to this identified need, PLHIV recruited through support organisations and local clinics participated in

1) BCC stigma and discrimination sessions, which focused on exploring and teaching the concepts of stigma and discrimination further elucidating the impact

S&D had on their lives

2) Empowerment for Leadership training sessions which challenged participants to greater levels of self awareness and sought to overcome low self esteem and built trust and cohesion within the group and

3) Influential speaking which focused on building oral communication skills which would augment the advocacy skills of participants. These sessions were supported by trained psychologists, counsellors and a peer counsellor who were able to provide psychosocial support and guidance to participants.

 

The stigma and discrimination session helped me to overcome my self stigma and also helped

me to cope with stigma inside the group. My attitude has changed and I learned to accept people

for who they are. It taught me to deal with the ‘outside world’. The empowerment and influential

speaking sessions worked hand in hand and help me to realise my purpose is in advocacy. I have

seen that when I speak out I can make a difference. Right now I volunteer doing advocacy and

VCT – I would not have done this if I did not go through the training…I have realised this is

my purpose and will continue to do it for a while.’’ PLHIV Participant

 

  • BCC Peer Education Sessions with Faith Based Leaders

This intervention focused on raising awareness of the context and consequences of stigma and discrimination. As religion plays a central role in the motivation of the community and faith leaders have a platform to influence community members, participants were encouraged to recognise the strategic role that they play in influencing the attitudes and behaviours of their constituents. These interactive workshops were also opportunities to pre-test components of the CARICOM antistigma and Discrimination toolkits.

…“this is an urgent issue as in most small islands pervaded by stigma and discrimination”…they (PLHIV) are neither enabled nor empowered…they are unable… and underground”

Key stakeholder St. Lucia.

 

The peer education and emotional intelligence approaches used have improved participants’ understanding of stigma and discrimination. Notably, a number of FBO participants cared for family members who were HIV positive and others prior to the sessions failed to realize they discriminated in their actions. The outcomes included greater commitment and motivation of participants to become more involved in HIV programming.

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