Category: all

The Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs (CCP) highlighted the PANCAP Knowledge for Health (K4Health) project as a best practice during its “Knowledge Management for Effective Global Health Programs” course in June.

The course was geared primarily toward professionals who work or aspire to work in international or domestic public health and Knowledge Management (KM) and Learning. It was facilitated by Dr Tara Sullivan, Project Director at Johns Hopkins Bloomberg School of Public Health and Ms Sara Mazursky, Deputy Project Director, Knowledge SUCCESS.

Dr Shanti Singh-Anthony, Coordinator, Knowledge Management and Mr Timothy Austin, Senior Project Officer, Communications, PANCAP Coordinating Unit, were invited to share success stories from the K4Health project.

Dr Singh-Anthony highlighted the project’s successful KM initiatives, including the use of Share Fairs and “peer assist” to foster effective and strategic collaboration between the Region’s National AIDS Programme (NAP) Managers and civil society organisation (CSO) representatives. She also spoke of the PANCAP Treat All Knowledge Suite and Roadmap, which provided the Region with essential information on the World Health Organization’s recommendation that all People Living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage.

Dr Singh-Anthony provided details on the project’s success in sharing best practices through South-South Knowledge Exchanges to Barbados, Dominica Republic and The Bahamas on Treat All, Pre-exposure prophylaxis (PrEP) and successful HIV testing strategies for key populations.

She shared PANCAP’s experience in applying the HIV knowledge management approaches to address the knowledge needs related to the COVID-19 pandemic and posited that these knowledge management approaches could be applied to other health and development issues.

Mr Austin illustrated how online engagement via the redesigned PANCAP website and social media platforms effectively established PANCAP as the knowledge hub for HIV in the Region with over 10 000 website users per month. He elaborated on the PANCAP Integrated Marketing and Communications (IMC) Strategy, which was utilised to elevate PANCAP’s visibility in the Region and effectively share updates on the Region’s HIV response with stakeholders, including CSOs, National AIDS Programmes, youth, policymakers, etc.

Mr Austin emphasised the importance of synthesising information to effectively communicate on complex public health topics using animated videos, infographics, podcasts and other KM and media products.

Dr Sullivan hailed the project as a best practice for effective use of KM for building collaboration and fostering knowledge sharing among distinct groups of people. She spoke of the value of the project in establishing common ground among NAP Managers and CSOs, which enabled increased cooperation in vital areas of HIV prevention, treatment and care.

The project’s success resulted in KM being a permanent part of the PANCAP Coordinating Unit’s operations and increased use of KM techniques in the Region for capacity building and learning for better health outcomes.

Image: Dr Shanti Singh-Anthony, Coordinator, Knowledge Management, and Mr Timothy Austin, Senior Project Officer, Communications, PANCAP Coordinating Unit

The Civil Society Hub Organization (CSO-Hub) Secretariat, with technical support from the United Nations Development Programme (UNDP) and the University of Belize (UB), hosted an HIV Rapid Testing and Counselling Training for civil society stakeholders from 17 – 21 May 2021 in Belize City.  The training focused on building capacity to implement rapid HIV testing interventions with limited human resources.

The course was designed to provide guidelines and skill-building opportunities to potential HIV testers.  This involved training participants in identifying strategies to support clients in making behaviour changes that would reduce the risk of acquiring or transmitting HIV.

Participants were also involved in practical sessions on the six (6) steps of prevention counselling.

Capacity building was also provided on HIV counselling, the HIV rapid test algorithm, finger prick and blood collection, safety at the HIV testing site, record keeping, quality assurance of HIV rapid testing, quality control, proficiency testing and professional ethics.

The initiative forms part of Belize’s National AIDS Programme, which aims to significantly reduce HIV infections among the most vulnerable populations.

Image: Executive Director, National AIDS Commission (NAC) Belize, Enrique Romero, delivering opening remarks during the HIV Rapid Testing Workshop

Gender-based violence (GBV) is recognized as one of the most severe forms of human rights violations and public health challenges. It occurs at home, the workplace, schools, political circles, prisons, and health institutions, to name a few. Perpetrators can range from intimate partners, family members, employers, co-workers, and state officials[1].

In the Caribbean, societies are organized around hierarchical gender power relations with male domination, reducing women’s economic and emotional independence.

According to UN Women Caribbean, 1 in 3 women in the Caribbean experience domestic violence, and over one-third of the region’s women report intimate or sexual violence incidents[2].

While there have been numerous workshops, panel discussions, and calls to action on GBV and gender equality, men and boys’ engagement in the discourse has been limited. Men and boys need to become more visible as integral partners in tackling sexual/gender-based violence and gender inequality. There is the need to engage boys and men as agents of change in the prevention and response, not just perpetrators or bystanders.

One of the National Gender-based Violence Action Plan outcomes calls for men and boys’ increased understanding of the dynamics of gender and violence and their active involvement in reducing GBV in Belize.

As a result, the Spouses of CARICOM Leaders Action Network (SCLAN) and the National Women’s Commission of Belize, with support from the Spotlight Initiative, implemented the “Engaging Men and Boys” project.

The initiative included a “Training of trainers” programme, workplace training, a peer education toolkit, school training and a public awareness campaign.

The objectives of the project encompassed identifying strategies for men and boys to understand the dynamics of GBV and commit to helping to end all forms of violence utilizing the positive deviance approach; challenging views about masculinity using role modelling and the positive deviance approach to transform attitudes and beliefs which contribute to family violence.  The project also aimed to equip men and boys with tools and strategies to help prevent GBV in their personal lives and community.

SCLAN plans to expand the project regionally in 2022.

Image:

“Belmopan Active Youths” (Belize) participating in a workplace session implemented under the “Engaging Men and Boys” Project.

###

[1] National Gender-Based Violence Action Plan: A Multisectoral Plan to Prevent and Respond to Gender-Based Violence in Belize 2017 – 2020; Ministry of Human Development, Social Transformation and Poverty Alleviation

[2] Violence Against Women in the Caribbean: A Critical Analysis

The National AIDS Commission (NAC), Belize, in partnership with the Caribbean Regional Network of People Living with HIV/AIDS (CRN+), hosted a virtual Public-Private Partnership (PPP) Forum with the participation of fifty (50) members of various sectors of society, including members of the public, private, and government sectors.

The Forum was facilitated by local consultant Dr Minerva Pinelo from “Rights Insights”. Presenters included Ms Eva Burgos, Executive Director, Gojoven Belize and CSO Hub, Mr Enrique Romero, Executive Director, NAC Belize, and Mr Jason Shepperd, Senior Programme Officer, CRN+.

The event, which was open to the public, provided the platform for participants to learn more about Belize’s HIV response.  The event also focused on the Caribbean’s HIV experience and, more significantly, the revised HIV workplace policy. The primary goal was to fuel engagement around the acceptance, development, and implementation of workplace-specific HIV policies.

The Primary objectives of having businesses and organizations formulate their own HIV workplace policy include but are not limited to creating an environment that is conducive to openness and acceptance among employees, ensuring confidentiality and non-discrimination, promoting awareness and prevention training programmes to reduce the possibility of contracting HIV and improve care, treatment, and support services.

Other objectives include promoting access to treatment and reducing new infections, limiting the impact of HIV and AIDS in the workplace at the individual level for employees, their families, and communities and ensuring a healthy workforce and long-term production sustainability.

The Forum also provided an opportunity for participants to engage in interactive discussions through a question-and-answer session and receive clarification on areas of interest related to HIV and AIDS.  The topics discussed included stigma and discrimination, the effects of COVID-19 on People Living with HIV (PLHIV) and the overall economy.  Participants also discussed ways to ensure mutually beneficial partnerships for progress, the need for increased technical support from the private sector to Civil Society Organizations (CSOs) and increased outreach support from the CSOs to the private sector.

Participants were provided with a brochure that included a roadmap in preparation for the development and design of an HIV workplace policy. The brochure can be accessed via the NAC’s website (www.nacbelize.org).

Dr Ruth Ramos Gonzalez-Ram is a Cuban born, Guyanese-trained physician who has made significant contributions in HIV medicine, patient care and services provided in Guyana. On the occasion of her retirement, I sat with her to find out a little more about her journey and her experiences over the years.

Dr Ramos graduated from the University of Guyana School of Medicine in 2000 and started to work at Georgetown Public Hospital Corporation (GPHC). In her days at the Internal Medicine department, Dr Ramos recalls that she was always attracted to what was referred to as the “back cubicle”- where all the AIDS patients were placed. At that time, knowledge of HIV and AIDS was minimal, there were no antiretroviral drugs available, and there was little one could do to help these patients.

Fast forward a few years, and in 2002, she was asked to be a substitute doctor at the Genito-Urinary Medicine (GUM) Clinic at a time when they anticipated they were going to be short of staff. She worked at the GUM clinic initially for two months, but her interest was solidified in working with infectious diseases and HIV medicine during this time. Upon her return to GPHC, she requested to be permanently transferred over to the GUM Clinic.

Dr Ramos recalls that there were many challenges in the early days: delayed HIV results, unavailability and limitations with regards to treatment options and lack of knowledge on HIV management. She said there were many times when improvisation was necessary, especially when treating children, but that they always worked to make the most of what they had in every situation to do the best for patients.

Dr Ramos says there have been many improvements and she has been a first-hand witness to these as they have happened over the years. Presently, HIV testing is available across the country, care and treatment have been de-centralized, and people can access both antiretrovirals and treatment for opportunistic infections at many locations. She says human resources have significantly increased. More doctors, counsellors, outreach workers, and nurses have been properly trained and equipped to manage HIV. Literature has become widely available, and the country has developed its guidelines and protocols for HIV management. Dr Ramos is proud to have witnessed this transformative period and to have played a role in making it happen.

When asked to share some of the key things she has learnt over the years, Dr Ramos says that working with HIV patients, at the time when she did, introduced her to a virgin field in medicine in Guyana. She enjoyed growing and learning with the development in the field; discovering new diagnostic methods, new therapies, understanding management of opportunistic infections. However, above all, she says that the most important thing she learnt was to “be less of a doctor and more of a human”. She said some of the most important things she learned were to be a better listener, more patient, less judgmental, more compassionate, and overall, her experiences have made her a better person.

Dr Ramos’s most significant achievement over the years has been having the privilege of motivating and supporting patients in some of the darkest moments of their lives, giving them hope and reassuring them. This has given her great joy, to see many of her patients lead productive lives and have undetectable viral loads. She said, “To see little children, now grown up, having healthy children of their own, that gives me great satisfaction, and I call it success!”.

Dr Ramos hopes that HIV can be integrated into healthcare as just another chronic disease in the future. She hopes that stigma and discrimination will be eliminated from both the medical community and society at large. She hopes that there will be better treatment options developed and that maybe one day, we will even have a vaccine to prevent HIV infection and relegate HIV to the history books.

Dr Ramos says to young doctors thinking about entering the field of HIV medicine, “If you want to be challenged every day, to keep exercising your brain and never be bored, go for it!”. She says that because HIV and infectious diseases are continuously evolving, it is imperative to keep updated.

Dr Ramos stresses the importance of staying humble as no one person will live long enough to understand all the mysteries of the human body and the diseases that can affect us. She says that she has had a most rewarding career and “I could never regret the day I decided to become an HIV physician!”

Youth in the Caribbean will benefit from Comprehensive Sexuality Education (CSE) activities launched by the UNFPA in a virtual webinar in February. CSE programmes enable young people to protect their health, wellbeing and dignity and are a strategic vehicle for promoting gender equality and human rights. The activities will be conducted under the Spotlight Regional Programme for the Caribbean which is part of the wider Spotlight Initiative (SI), a global, multi-year partnership between the European Union and the United Nations to eliminate all forms of violence against women and girls by 2030.

The webinar provided an outline of the CSE activities to be implemented, and participants were allowed to provide inputs in accelerating the planned efforts. The effects of COVID-19 in the education sector that might also put at risk the continuity of the CSE delivery through Health and Family Life Education (HFLE) were also discussed.

Director and Representative for the UNFPA Sub-Regional Office of the Caribbean, Alison Drayton, who welcomed participants to the launch, highlighted that Caribbean youth’s growth and development continued to be undermined by what she called “new manifestations of age-old threats”. She identified several CSE challenges being faced by Caribbean youth. She expressed that vulnerability to all forms of violence, particularly bullying, sexual violence, abuse and exploitation and adolescent pregnancy rates remained very high.

Highlighting the role of the CSE initiatives in addressing these issues, the Director explained that strengthening regional capacities to advocate for and deliver quality CSE for in and out of school youth in the Caribbean was at the heart of the Regional Spotlight Programme. “The Comprehensive Sexuality Education interventions, through the Spotlight Initiative, are informed by robust evidence and aim to contribute to the collaborative efforts in preventing violence against women and girls in the Caribbean,” she said.

The CARICOM Secretariat is one of the organisations that has partnered with the UNFPA on this initiative and is playing a significant role in implementing the Spotlight Regional Programme for the Caribbean.

Helen Royer, Director, Human Development, CARICOM Secretariat, said the implementation of a regional HFLE curriculum, the creation of resources and toolkits, training of teachers to communicate the curriculum, and improved coordination among all the agencies at the regional and national levels are among the outcomes of CARICOM’s efforts at strengthening HFLE. Despite those investments, she was concerned that the key messages of HFLE were still not being converted into measurable behaviour change.

Against that backdrop, Ms Royer said CARICOM welcomed the Spotlight Initiative to enhance regional capacities to advocate and deliver quality Comprehensive Sexual Education.

“The interventions are aligned with the hopes for healthy and contributing Caribbean citizens, as outlined in the CARICOM Human Resource Development 2030 Strategy and are also in support of the recently launched Road map by PAHO for promoting the health and wellbeing of adolescents and youth in the Caribbean which received CARICOM’s support and endorsement,” Ms Royer stated.

UNFPA works with governments, civil society and other partners to implement CSE. UNFA also promotes policies for and investments in comprehensive sexuality education programmes that meet internationally agreed standards. This initiative is financed through funding from the European Union and UN agencies through the Spotlight Initiative.

The COVID-19 Pandemic has resulted in a surge in cases of violence against girls and women in the Region.  In response,  the Centro de Orientación e Investigación Integral (COIN) with support from the U.S. Department of State’s Bureau of Western Hemisphere Affairs has launched “Caribbean United against Gender-based Violence – GBV”.

The goal of the project is to address the root causes of GBV in the Caribbean and to contribute to the end of violence against women and promote equitable environments.

Santo Rosario, Executive Director, COIN expressed that “One of the biggest problems in the international framework has its roots in the cultural and educational processes of our societies, which place women in a situation of vulnerability compared to men. Gender inequality is a structural problem that requires that all the structures of the state and civil society recognize the implicit bias as well as the explicit discrimination that exists and promote laws and mechanisms that transform the way women are seen and treated. We must do segmented politics, as GBV is reflected in each one of the segments: at work, in politics, and relationships, as women are vulnerable in all these spheres. Policies, mechanisms and sanctions must be developed that accompany a new educational perspective that places women in a position of equality.”

The project will support the creation of an enabling environment through a series of community-level small grants that will include four types of interventions:

• Change social norms: baseline surveys, training for men and boys that address socio-cultural attitudes that lead to GBV and social-emotional learning programmes.
• Build institutional capacity and alliances: training with civil society organizations as well as with government entities, the establishment of multi-stakeholder discussion spaces and participation in networks.
• Empower youth: empowerment and leadership training and direct involvement in local project activities as advocates against GBV.
• Improve availability and access to services: mapping of existing services, securing MOUs among project sub-recipients and service providers, the establishment of a referral system and multi-stakeholder case management system.

In particular, these interventions aim to strengthen the capacity of local actors to provide GBV prevention and response services to survivors of abuse, improve available data on the services that are already put in place and reduce socio-cultural attitudes that lead to GBV.  The project also aims to strengthen civil society and local governments’ abilities to improve access to GBV services and address GBV issues that result from the COVID-19 Pandemic.

The project will be implemented through small grants to local organizations in twelve Caribbean countries, namely:  Antigua and Barbuda, The Bahamas, Barbados, Dominican Republic, Dominica, Grenada, Haiti, Jamaica, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Saint Lucia, and the Republic of Trinidad and Tobago.

Editor’s notes:

In the Caribbean, available data shows a troubling panorama: three of the top ten recorded rape rates in the world occur in the Caribbean^[1] , and in nine Caribbean countries, 48% of adolescent girls’ sexual initiation was forced or “somewhat forced”^[2]. Some examples include the Dominican Republic and Haiti, which, according to the UNDP, are among the four countries with the most significant gender inequality in the Region. Kay Fanm, a Haitian women’s rights organization, has estimated that 72% of Haitian girls have been raped. In the Dominican Republic, there is an average of 177 femicides (killing of a woman or girl, in particular by a man and on account of her gender) per year since 2005.

[1] 2007 report by the United Nations Office on Drugs and Crime and the LAC region

[2] According to a survey that was pointed to in the 2007 report aforementioned.