Project for Developing Health Policy
at Medical Care Service Places for PLWHA
September 2013 – October 2016
Those involved and working in the field of HIV still face major challenges which require intensive efforts in order to overcome them and achieve success, namely: –
Second: The establishment of human rights principles for people living with HIV/Aids
Third: The establishment of the values â€‹â€‹of tolerance in the community towards people living with HIV
Fourth: Modify trends of medical providers to accept people living with HIV and their families
Since the Egyptian AIDS Society has been working in this field,ever since its establishment in 1992,through a variety of programs and activities, which began to crystallize and intensify its focus on issues of stigma and discrimination and establish the human rights for people living with HIV through the project, which began in 2011 in collaboration with Ford Foundation (support and promote the health policy at service centers providing medical care services for people living with (HIV / AIDS), several activities were undertaken, most notably
– Change of attitudes by medicalservice providers to accept people living with HIV.
– The development of medical protocolsin order to provide medical care for people living with HIV and their families without stigma or discrimination and to ensure respect for their feelings.
– The Establishment of human rights principles for people living with HIV at medicalservice providers with emphasis on the value of tolerance.
– Assisting people living with HIV and their families to enhance their feelings of self-worth and to eradicate self-stigmatization and help integrate them into the community.
A wide range of activities have been implemented with three health institutions, covering several medical services needed by people living with HIV and their families. This in the end, helped achieve a comprehensive model for the provision of medical services for people living with HIV and their families, without stigma or discrimination.
These institutions are: –
(Alexandria Fever Hospital), a specialized medical institution providing comprehensive medical services for people living with HIV
(Dental Research Center Smouha), a specialized medical establishment for dental treatment
(El Amrawi Family Medical Center), one of the largest medical centers in Alexandria, which provides comprehensive medical services in all areas of health services; it includes laboratories, x-ray and analysis as
well as a cultural center, etc…
Through the implementation of a range of training programs or a group of medical service providers working in the field (doctors/nurses/technical workers/receptionists), the society managed to provide accurate information on the disease, develop the skills of the trainees and modify employees’ attitudes toward people living with HIV and their families. The society applied new protocols for providing the following services; (testing /counseling/therapy/instill the value of tolerance/taking into account the human rights of people living with HIV. The training programs showed tangible results that reflected on the development of services provided for people living with HIV.
The following are the preliminary results for the project’s activities:
•6 focus groups were organized: (2) focus groups for medical providers (16 participants), (4) focus groups for people living with HIV and their families (30 participants) to get to know their opinions on the health services and social programs provided as well as the performance of medical service providers.
The study conveyed their full dissatisfaction with the services provided and the method of delivery; they aspired for more medical services to be provided, taking into account their human rights in services provided without stigma or discrimination. On the basis of this study, the topics of the training course were identified.
We monitored the policies and protocols followed in the targeted institutions in order to identify the aspects that need to be developed to meet the needs and requirements of people living with HIV. We also assessed the medical providers’ knowledge and skills to be able to identify the aspects that need training, in order to develop programs and a training package that would increase their efficiency, as well as modernize and develop the protocols applied in dealing with people living with HIV, which have been applied in executed activities.
(22 workshops were held for 200 medical providers): Part of the results achieved is that participants received correct and up to date information about HIV, the issue of stigma and discrimination, the human rights for people living with HIV, counseling and voluntary testing. This in turn promoted and supported their skills in providing services for people living with HIV and their families without stigmatizing or discriminating against them, while taking into account their human rights, which were monitored through supervisions, polling people living with HIV and follow-ups with the trainees.
Trainers (16 TOT) used the knowledge and skills gained to educate groups of workers at the relevant institutions.
8 support group meetings for people living with HIV were held (90 PLWHA), during which the typical method used for support group meetings was revised, which resulted in the satisfaction of a large proportion of people living with HIV at these meetings. They acquired new information and benefited from sharing their experience as people living with HIV as well as escaping isolation. That was at rates ranging between 65% to 85%.
There was full cooperation by the Ministry of Health, the Directorate of Health Affairs in Alexandria and institutions involved in the project. Medical service providers were eager to join the training programs, which resulted in the success of the project as planned, which will support the application and continuity of newly updated policies and protocols.
Success in this regard has encouraged the Society to come forward with a project that would complete earlier stages to ensure the establishment of the rules and protocols that have been applied and to continue this program which is considered one of the most important achievements in this field. It also enhances the value of partnership between civil society organizations and the Ministry of Health and Population which has provided all facilitations needed to ensure the continuity of the project.
The overall objective of the project:
To establish the rights of people living with HIV and their families to receive comprehensive medical, social and psychological care without stigma or discrimination and to eliminate the self-stigma and the community’s stigma towards them.
Goals related to medical services and their expansion
Rehabilitating a team of trainers to become qualified activists so as to assume their roles in the field, within their medical institutions and other medical institutions in order to extend the services at new sites.
Increase the efficiency of health service providers at selected institutions to improve the quality of their performance.
Using topics from the training package in the training programs that are implemented to make any adjustments or updates.
Adding 2-3newmedicalinstitutions,to be selected according to the criteria that will be developed by the Advisory Committee for the project.
Applying the updated protocols in providing medical services at the new selected site
Objectives related to support programs for people living with HIV
Training a team of activists of people living with HIV so that they can be responsible of the support programs for people living with HIV, and they could represent an example of an individual living with HIV without self-stigma or discrimination from the community and how they can go on with life normally.
Training a team of managers and facilitators of support programs and support for people living with HIV, in order to improve their competence and ability in managing meetings.
Objectives related to communication, evaluation and dissemination of the experience
Motivate and cooperate with media organizations and other civil society organizations to promote the principles of human rights of people living with HIV and to show case successful experiences.
Print and apply the training package and finalize it, in order for it to be to be accessible to everyone.
Presenting the comprehensive study, this includes all the steps, procedures and the results of the project, to be published in order to expand its benefit.
Operational procedures of the project
Operational procedures related to consultation and planning services
Hold regular work sessions with the consultative group on the project to determine the mechanisms of implementation, monitoring and strengthening the project
Hold two meetings for employees at the medical institutions that recently joined the project to discuss the project and to exchange information and opinions.
Prepare a study using a quick search tool for the institutions that recently joined the project to identify performance gaps and to establish the operational programs that fulfill the requirements.
Operational procedures related to medical services
Implement the operational plan for training activities for health care providers at target locations as follows
Convening of five workshops for 100 trainees, in order for participants to graduate (TOT)
Organizing 15 training courses for 300 employees at medical institutions involved in the project to ensure the implementation of the updated medical protocol that was developed by the institutions’ policies.
Experiment with the training package developed so that when it is presented in its final form, it would be an example in this field and it should be printed and distributed to the various sites so they can benefit from it.
Review and determine health policies within the institutions that recently joined the project and identify performance gaps/development required.
Operational procedures related to support programs for people living with HIV
Applying updated protocols at the relevant institutions that are involved in dealing with people living with HIV and their families, which have been recorded and approved by the specialized management in the institution.
Holding 5 workshops for 25individual activists who are living with HIV and participating in the project, to train them to be responsible for the support and assistance for people living with HIV(TOT).
Holding 10 support meetings for 100 individuals living with HIV and their families, by following the updated protocols that have been developed and implemented in the project to prepare them to integrate within the community and to eliminate the stigma that is either self-imposed or imposed by the community.
Implementing the training program TOT for people living with HIV and participating in the project in accordance with the schedule and specific topics assigned to each workshop.
Holding 2 workshops for10 of the managers and facilitators of the support and assistance programs for people living with HIV to improve their competence and abilities in managing the meetings.
The operational procedures related to communication, evaluation and dissemination of the experience
Implement monitoring program and evaluation of the activities carried out.
Prepare the final evaluation of the project.
Hold meetings to present valuable lessons learnt from the project to media organizations, civil society organizations and international organizations interested to share the benefits.
Organize a conference featuring national and international bodies to present the final results of the project.
Publish the results in Scientific Journals
Information about the disease – counseling – Development stages of the disease – Patient mother to Child Transfer – stigma and discrimination – human rights of people living with HIV – Support and assistance for people living with HIV and their families – Infection Control – communication skills – follow-up and evaluation tools
The geographical scope of the project:
Alexandria (Geographical scope of the institutions selected for the project)
Alexandria Fever Hospital
Dental Research Center of Alexandria-Smouha
El Amrawi Family Medical Center
Smouha or Raml Family Medical Center
Specialized center for the treatment of sexually transmitted diseases
September 2013 – October 2016
People living with HIV and their families
Medical providers(doctors -nurses–technical employees
Facilitators of support and assistance programs
Quantitative criterion: includes:
– Programs: Have the planned programs for the project been implemented?
Did we achieve the target number of trainers(TOT)and trainees as planned in the project of medical providers?
Did we achieve the objective of supporting and helping people living with HIV in terms of
number of training courses(TOT)and diversity/number of beneficiaries
number of support and assistance programs/number of beneficiaries
Qualitative criterion: includes:
Achieving the overall objective of the project:
The extent of achieving the overall objective of the project in terms of providing medical care services and social care for people living with HIV and their families without stigma or discrimination and respecting their human rights and instilling the value of tolerance.
The satisfaction of peopling living with HIV:
The extent of satisfaction of the beneficiaries,(people living with HIV and their families) with the performance of employees after the development of the services provided.
Applying the policies within the institution:
Did the institution commit to applying the updated standards and protocols that have been agreed upon?
The extent of improvement in the quality of performance:
Evaluating what the medical providers acquired in the form of information and skills through the workshops implemented in the project.
The extent to which training benefits are applied to enhance the quality of work performance in the institution
The possibility of applying this project with other organizations and indifferent countries.
How to circulate the benefits from this project.
Monitoring and evaluation methods:-
Monitoring sheet on the status quo at medical institutions.
Questionnaire to gather information and expertise of employees at targeted institutions.
Assessment sheet to monitor changes in the performance of the service during the implementation of the project according to the revised protocols.
Assessment sheet to monitor the changes in the institution after the implementation of the policies that have been adopted.
Questionnaire for trainees before workshops.
Questionnaire for the trainees after workshops.
Assessment sheet including observations and comments on performance.
Convening of a focus group meeting for a team of trainees to measure the impact of the training courses.
Convening of a focus group meeting for a group of people living with HIV benefiting from the services provided to measure the impact.
Evaluation of the achievements of the project.
Assessment of the lessons learnt
President and Project manager
Sawsan El Sheikh