1. HEARING IMPAIRMENT/ DEFICIENCE AUDITIVE: Group Members: Vivath Amadou Nimo Belete Issack; Aimable; Approach to our intervention: Mainstreaming Partnership Involvement of DPOs Peer

2. COMMUNICATIONPHYSICALENVIRONMENT Prevention: (IEC/BCC, Awareness, Training, VCT/PMTCT Mass Events); BarriersSolutionsBarriersSolutionsBarriersSolutions -Invisibility of the impairment; -Illiteracy (No inclusive school &/or special schools); -Self stigma in using Hearing Aid (in some countries); -Hearing Aid and Technologies not accessible; -No services available in Sign language; -Interpreter (thus no confidentiality); -No Sign language/HIV terminology; -Lack of adaptation IEC tools; -No Hearing Impairment- friendly media; -Lack of Peer educator among Hearing Impaired; -No means to convey result of Testing; -Awareness regarding impairment among all; -Inclusive/Specialized institutions; -Appropriate, accessible and affordable technology (Cell phone, internet); -Develop dictionary in sign language; -Capacity building to services providers -Inclusive media programs; -Adaptation and development of IEC Tools with involvement of DPOs (Pictures/images, visuals); -Training peer educators and capacity building; -Appropriated tools to communicate the test result; -Limited access of outreach services toward deaf persons; -No Signalization at the health facilities; -Low access to condom; PEP; -Limited access to Mobile Phone (expensive); -No access to internet; -Promote inclusive interventions; -Improving the stand of signalization and making more inclusive; -Condom integrated in the generic package of services; -Including PEP in the HIV/AIDS guide line. -Lack of understanding on deaf culture; -Invisibility of the impairment; -Lack of Knowledge/ skills to work with People with Hearing Impairment; -Existing policy doesn’t include their needs; -Over protection by the family. -Awareness raising; -Advocacy and lobbing for policies’ change;

3. COMMUNICATIONPHYSICALENVIRONMENT BarriersSolutionsBarriersSolutionsBarriersSolutions Treatment: (ARV,CD4, OI, Adherence) -Service Providers lack Sign language; - Confidentiality issues; -No Peer communicator -Training Medecine/health providers in sign langage; -Inclusion of peer communicator (counsellor); -Centres located far from their community; -Complexity of the ARV regiment (depends from country to country); -OI charged (in some country); -CD4 count machines are limited -Promote outreach services; - Home visit; -Awareness and lobbying for free charge of ARVs and OI. -Lobbying and advocacy in networking with Civil Society Org including DPO for policy enforcement -No client friendly behaviour of service provider; -ARV/ART illegally charged; -Non treatment adherence. E.g.: abandonment of ARV treatment due to quarrelling with the husbands -Awareness among services providers.

4. COMMUNICATIONPHYSICALENVIRONMENT BarriersSolutionsBarriersSolutionsBarriersSolutions Care and support: Psychosocial, Personal/Environment, Hygien, Social, Economic, IGA, Spiritual) -Service Provider lack sign language -Training Medecine/heal th providers in sign langage; -Inclusion of peer communicator (counsellor); -Less number of visits due to limited resources; -Work fatigue of service providers. -Proper resources allocation (financial and human); Guideline/policy non- inclusive; Lack of skill and knowledge among service provider regarding working with people with hearing impairment; Economic dependency High drop-out from the service; Lack of knowledge/ skills of peer family member on HBC; Non inclusion of PWHI in SHG. -Advocacy and lobbying; -Skill/capacity Building; -Proper Support tools, guidelines for service providers; -IGA/ families as unit of intervention.

5. COMMUNICATIONPHYSICALENVIRONMENT BarriersSolutionsBarriersSolutionsBarriersSolutions Rehabilitation: Psychological (emotional support, counselling), Social reintegration, Legal support (inheritance rejection from family) No Knowledge about services; No Sign language for service provider. Awareness creation Services available only at Province and National levels; HIV not mainstreamed into existing services. Increase service points in communities Guideline and policy non inclusive; Non availability of services; Non friendly client services; No information on rehabilitation. Package is not included under IEC; No training provider to family member of basic rehabilitation; Increase awareness Advocacy and training

6. Thank you/Merci!