A significant portion of my experience in Africa thus far comes through my interaction with participants in the Management Development Institute (MDI). As their teaching associate, I have helped each of them develop Community Health Improvement Plans (CHIPs) so that they may improve their organizations and/or the impact they have on their communities. I have been inspired by their passion, stories and ambitious plans for change.
The projects that have been developed here are dramatically different than those that were developed by the community health clinics that we worked with in the United States. During our Los Angeles programs, we saw CHIPs that largely focused on improving profitability, operations and infrastructure. In Africa, the projects go to a very basic level of educating communities about HIV/AIDS and extending testing, counseling and treatment services to those that need them. These are the stories of the participants I worked with during from the first MDI in Nairobi, Kenya (stay tuned for more about my Ghana participants).
Dr. Ssali and Dr. Kawooya represented the Uganda Cares initiative. They face a rural community where the HIV/AIDS prevalence continues to soar, especially among young people. Many infected youth do not know their status and continue to unknowingly spread the disease to others. At the MDI, Dr. Ssali and Dr. Kawooya set an ambitious goal to double the number of people being tested in their region from 125,000 to 250,000 annually. In order to achieve this they will initiate a public awareness campaign to mobilize the community around the importance of “knowing your status.” They also have plans to implement mobile testing clinics so that access to testing from rural areas is no longer an excuse for not being tested.
Andrew and Diana represented the Northern Uganda Malaria, AIDS & Tuberculosis Program. Northern Uganda has endured intense armed conflict for the last two decades. Although the situation is improving, the HIV/AIDS prevalence rate in the region is the remains over 8% (over 250,000 people). Post-conflict, the region has limited resources for the care and treatment of people living with HIV/AIDS (PLWHA) – there are currently only four CD4 machines in the entire region (used to monitor T-Cell counts in PLWHA). At the MDI, Andrew and Diana built a strategy to maximize the capacity of the CD4 testing machines in order to reach to 13,000 additional PLWHAs in Northern Uganda. Their project will begin with an assessment and evaluation of the cost effectiveness and performance indicators of various models of care.
Maryam represented the Benjamin Mkapa HIV/AIDS Foundation in Tanzania. The Benjamin Mkapa Foundation works to build the capacity of health workers that provide HIV/AIDS care and treatment in Tanzania. Many areas of Tanzania are very remote and the people in these areas have poor knowledge about HIV/AIDS, how to prevent it or how to treat it. Furthermore, many HIV/AIDS infected pregnant women in the region deliver their children at home instead of established health facilities. This results in increased rates of women passing HIV/AIDS to their newborns, as they are not aware of preventative measures they can take to protect their children. Upon her return to Tanzania, Maryam will institute a program to better train community health care workers so that they may conduct outreach activities to engage rural pregnant women and educate them about the benefits of delivery in health facilities. Though this program, she hopes to reduce the transmission of the virus from mothers to child by 20% in one region of Tanzania.
Samali and Henry represented the AIDS Information Centre Uganda. There is increased HIV/AIDS awareness in their region and they have found themselves inundated with demand for HIV/AIDS counseling and treatment services. With limited resources, they must find new, innovative methods in order to meet the demand for their services. After the MDI program, they believe they can reach 200,000 more clients through programs designed to mobilize the local communities including home to home care, community camping and couples campaigns (to engage the male head of household in counseling and care).
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