1. Burkina Faso: HIV/AIDS Disaster Response Project
--A Community Driven Approach--
Miriam Schneidman
MAP Local Response Workshop
December 2002

2. The Gaoua District Scheme: Phase I
Initiated by UNAIDS in late 90s & supported by multiple donors
Yielded good results in terms of promoting participatory approaches
Generated huge frustrations, as resources failed to reach beneficiaries
Initiated in 1997; spearheaded by UNAIDS and supported by other donors
Strategic planning process assisted to mobilize local community to analyze their problems & identify solutions– process lasted about 2.5 years
Community representatives demonstrated strong leadership and staunch commitment to tackling AIDS

3. The Gaoua District Scheme: An Innovative Community Approach to AIDS– Phase II
- To test a bottom up approach for empowering local communities to assume a greater role in the fight against the epidemic
- To determine feasibility of getting financial resources quickly to a large number of stakeholders
WHY GAOUA?
Zone of high migration
Commitment of local authorities
Favorable environment– solid foundation (strategic planning; training)
Differences with Gaoua I
Broader in scope, aiming to reach the entire province.
Greater reliance on local actors for the provision of training and technical support.
Shift in emphasis towards getting the money out rather than on a formal strategic planning process.
Reliance on working directly with community representatives rather than through local associations.

4. Key Milestones Supported broad based consultations
Carried out training for change agents
What is AIDS? – How to avoid it? –What can be done?
Adopted a locally driven planning process
Mobilizing stakeholders -Analyzing risks -Determining priorities
Identifying solutions -Elaborating sub-projects
Introduced an effective financing mechanism
Funds flow directly into local accounts – Funds controlled locally
Communities held accountable for results -Periodic financial audits
Consultations w/ Community
Social Mobilization
1 CPLS, 10 CDLS, 572 CVLS, and 20 Sectoral Technical Committees formed
Training of trainers
(2,500 trained)
Development and implementation of sub-projects
544 approved (out of 614 submitted)
30 associations approved
96% IEC; 3% care; and 0.8% testing

5. Pilot showed feasibility of mounting major
initiative on a large scale, in a relatively short time, and at a reasonable cost
In nine months, the pilot project has funded close to 600 micro-projects worth roughly US$175,000. Close to 95% of all villages in Poni province have been reached.

6. Elements of Success
Massive social mobilization of all segments of society
Strong political commitment at central & local levels
Community involvement in planning & oversight
Reliance on existing structures
Autonomy & flexibility in use of financial resources
Strong leadership & dynamism of project management team

7. Social Mobilization
Allow sufficient time in order to adapt activities to pace of life
Take into account social & cultural characteristics
Promote use of local radio that is a powerful tool for reaching illiterate people
Avoid pitfalls of ‘commando type approaches’
Key Social & Cultural Factors
Traditional power structures
Customs
Religious factors
Traditional languages
Role of women
Education levels
Pitfalls of Commando Approaches:
Displace other key activities by taxing limited capacities at community level
Create perverse incentives to the extent that they bring financial resources quickly to people who are desperately poor

8. Training
Use of local experts enhances success--- trainers can serve as role models
Quality of training and its adaptation to local culture is essential
Training is critical for improving knowledge & raising awareness
Use of participatory diagnostic techniques is essential
Quality & adaptation of training:
Pitch materials to audience (avoid a one glove fits all approach)
Translate materials into local languages
Ensure that trainers are fluent in local languages

9. Micro-Projects
Provide assistance in designing standardized micro-projects
Shift focus from awareness raising to care, treatment & support
Integrate HIV/AIDS interventions into other local activities
Integrate HIV/AIDS into local activities:
Health District Plans, with a particular focus on treatment of opportunistic infections, STI screening and treatment, TB treatment, family planning
Other community activities

10. Flow of Funds Facilitate flow of funds directly to beneficiaries
Elaborate an operational manual with clear procedures for accessing funds
Simplify reporting requirements
Integrate HIV/AIDS into local activities:
Health District Plans, with a particular focus on treatment of opportunistic infections, STI screening and treatment, TB treatment, family planning
Other community activities

11. Monitoring & Evaluation
Important for policy makers and funders to know how much things cost and what is being attained
Simple process indicators need to be used to monitor micro-projects
Essential to monitor and assess impact of interventions
Mapping of high transmission areas
Second generation surveillance
Integrate HIV/AIDS into local activities:
Health District Plans, with a particular focus on treatment of opportunistic infections, STI screening and treatment, TB treatment, family planning
Other community activities

12. An approach to scale up?
Initial results are promising in terms of process (preparing micro-projects; getting money out)
Further planning is required to:
Broaden community participation by involving women
Develop a home-based care model; a system for support of orphans; counseling program
Clarify roles & responsibilities of NGOs & associations
Reap synergies between HIV/AIDS & other activities
More time is needed to assess the effectiveness and impact of interventions
Does increased awareness lead to behavioral change?

13. “LA COMMUNAUTE S’ENGAGE”