Toll free call centres a preferred option for HIV/AIDS information in highly stigmatised Somalia. ICASA Nov, 2015 Abstract no: THUAD 1301 Mr.Anwar Abdirahman Warsame SAHAN Executive Director Somaliland/Somalia

Background Somaliland is an independent State which break away the rest of Somalia in 1991 which is in the northwest part of Somalia and boarders with Ethiopia and Djibouti and Somalia Federal Government (Somaliland has not get international recognition since last 25 years ) The country has an estimated population of 3 million people and has enjoyed relative stability for more than two decades The country is predominantly Muslim

HIV/AIDS Situation Somaliland has a prevalence rate of 1.15% and this is among the antenatal care (MCHs) at last survey prevalence earlier 2015 (WHO) The first cases of HIV/AIDS were diagnosed in 1992 in Berbera from a returnee Somali from Djibouti and other cases where among the IDPs This due to lack of knowledge and information fueled a blame it on the foreigners situation and stigma to HIV in Somaliland The most at risk populations in Somaliland include youth, sex workers, cross boarder truck drivers and refugees from neighbouring Ethiopia and Southern part of Somalia (SFG)

Current responses The country thanks to development partners such as UNAIDS, UNICEF the Global Fund has established response mechanisms to combat HIV in Somalia/Somaliland The Global Fund helped set up and support HIV testing and TB screening centers in the country Civil society organizations with support from various partners are undertaking behavior change and communication interventions to raise the much needed awareness on HIV/AIDS ARVs are provided to infected persons and MTCT interventions are being supported at most of the health care facilities across the country. The number of people living with HIV (PLHIV) is increasing and estimated at 35,000 in 2014 (UNAIDS). The adult HIV prevalence rate in 2014 was 0.55%.

A brief about SAHAN Somaliland HIV/AIDS Network(SAHAN) is a network of more than 100 local NGOs and CBOs in the country who are responding to HIV/AIDS The Network was formed to coordinate the responses of its member organizations The network seek to set standards, provide information and build members capacity to effectively manage HIV/AIDS programmes The network also is active in advocating for resources and polices for prevention and care and support of people living with HIV

Hotline as a source of information HIV/AIDS is still highly stigmatized in the country and this deters many people from accessing services such as HIV Counseling and Testing, and seeking openly HIV/AIDS/STI information. Somaliland HIV/AIDS Network (SAHAN) developed and is implementing a hotline call centre for HIV/AIDS information. This is a first such call centre in Somaliland and is an innovation which has been tested in other countries. The call centre since its inception in June 2014 has provided to about 8,500 anonymous callers comprehensive information on HIV/AIDS and other related social issues and linked the callers to services.

How the centre works

The organisation trained 12 dedicated counsellors in comprehensive HIV/AIDS information. Callers call anonymously and request for information on a range of issues pertaining to health and sexuality An efficient referral system to services which is hinged on strict adherence to confidentiality was established with health care service providers. Access to information by callers is key and the centre approach seeks to have information available 24 hours a day.

Nutrition Family Planning HIV/AIDS Drug Abuse FGM Last Three Months Report

Lessons learnt The project used a comprehensive consultative process before its establishment which enabled the buy in from stakeholders and community members. The project learnt that communities are willing to get information on HIV/AIDS if it is provided in a safe environment which is not stigmatising and confidential. To date 8,500 callers have accessed the call centre with an average of 32 callers per day this is encouraging in a society where HIV/AIDS and sexuality issues are a taboo. Multi sectorial engagement is key to providing a comprehensive HIV/AIDS response in emergency settings. The project benefits from a wide range of supporters from government and private institutions. Cooperate social responsibility from telecommunication companies which provide the telephone facilities has been instrumental in providing the platform for the clients at no cost.

Challenges Demand for information is overwhelming sometimes as the call centre is considered to be the safest source of information. On average 32 callers per day call to get counselling and information. This results in burnout on the limited numbers of trained counsellors. Training of more counsellors is needed to increase the human resource base for the call centre. Call centres are costly to maintain and this project is donor dependent (at least 85%)

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