| The Stephen Lewis Foundation

Association Centro Aberto Emaanuel

Mozambique attained independence in 1975 and experienced 16 years of civil war that destroyed the fledgling country’s infrastructure and economy. Virtually the only civil society left functioning was the country’s churches, many of which have now become involved in fighting a new war — against the HIV virus. Nowhere is this truer than in Mozambique’s smaller cities and rural areas, such as those that dot the commercial roads of Manica province en route to the Zimbabwe border.

The SLF currently supports the Association’s Interfaith Action Against HIV/AIDS that targets both church leaders and congregants for training on counselling skills, knowledge of children’s rights (including trafficking and abuse), and livelihood skills for women and youth. Additional treatment literacy training is provided to people living with HIV, with a special focus on treatment access and adherence. To carry the “lessons learned” into the community at large, the project offers outreach education through collaboration meetings with other stakeholders and public presentations. SLF funding also provides funding for a protected water well to assist 2,700 community members and it offers some administrative support.

Kindlimuka Association

Kindlimuka recognised very early in Mozambique’s AIDS pandemic that a meaningful response depends upon a partnership with people living with HIV and AIDS. Kindlimuka has since become Mozambique’s largest NGO combating HIV, and it employs a rights-based approach in designing, implementing and evaluating its activities. Kindlimuka puts a lot of emphasis on community mobilisation and organization, and promotes home-based care and counselling, orphan-support programmes, income-generating activities to help reduce poverty, and nutritional programmes to promote good health and offset malnutrition.

The SLF support is designed to help Kindlimuka strengthen its home-based care and counselling activities. Home-based care kits are provided as well as medicine for opportunistic infections. To ensure local ownership, plan and oversee activities and promote sustainability, Kindlimuka regularly holds community mobilization and coordination meetings with local government, NGOs and community stakeholders. To motivate these efforts and also ensure a high quality-of-care, SLF support pays for the cost of these meetings. It also provides for refresher training to Kindlimuka’s Community Care providers on home-based care, counselling and treatment literacy. Finally, SLF support pays for several salaries, administrative costs, and the cost of implementing a good monitoring and evaluation system.

Kubatsirana

In 1995, 35 churches came together to respond to the challenges of HIV/AIDS in the Manica province of Mozambique. They started Kubatsirana, an ecumenical organization that works to reduce the number of new HIV infections and improve the quality of life for people affected by the virus. Through a participatory community approach, Kubatsirana develops the capacity of churches and other Christian groups to provide HIV prevention and care. The organization’s Home-Based Care and Livelihood Project reaches vulnerable children, widows and people living with HIV and AIDS (PWLHA), supporting 36 volunteer caregivers. Home-based care volunteers work in the community providing basic health, food, and educational support to households affected by the virus. Kubatsirana is also working to increase food security by providing clean water (through a community water pump) and farming. The organization’s latest initiative works to train volunteers and counsel couples to prevent the vertical transmission of HIV to babies.

Kukumbi Organization for Rural Development

If one doesn’t live in Africa, one tends to forget that many poor and vulnerable children don’t even have a birth certificate, without which they can’t access government support including an education. Because this often happens in Mozambique, however, one service Kukumbi offers is to help caregivers secure the proper documentation for the orphans they support, thus allowing access by the children to other services.

As a rural development organization that works in 11 districts within the Zambezia Province of Mozambique, Kukumbi aims to strengthen the resilience of vulnerable groups affected by HIV. SLF funding empowers orphans and vulnerable children, grandmothers and people living with HIV and AIDS, in partnership with government, other stakeholders and local development committees. Thus, Kukumbi provides their beneficiaries with psychosocial support, supplementary food for people receiving antiretroviral treatment, educational materials including uniforms and shoes for school-going orphans, and shelter improvements for child-headed households and needy grandmothers.

With the assistance of local community based groups, Kukumbi also helps children without proper documentation to get birth certificates and, as needed, the death certificates of their parents. In line with the Government of Mozambique’s HIV/AIDS Strategy, they encourage communities to exercise neighbour-to-neighbour care, prevent vertical transmission of HIV, correctly adhere to antiretroviral treatment, and make use of voluntary HIV Counselling and Testing Centres. Finally, SLF funding ensures that home-based care volunteers receive small incentives and administrative expenses are covered.

Mozambican Treatment Access Movement

Mozambican Treatment Access Movement (MATRAM) works nationally to promote knowledge about HIV prevention and care, increase the uptake of treatment by people living with HIV, identify bottlenecks that inhibit the diagnosis and treatment of children, highlight human rights issues related to health care, and promote the meaningful participation of people – especially women – who are living with or affected by HIV/AIDS. Their strong focus on women is because, in Mozambique, on average 13 women are HIV-infected for every 10 infected men. Moreover, this gap continues to widen as women are more susceptible to HIV and become infected earlier than their male counterparts.

The SLF helps MATRAM develop and implement various media outreach and community education campaigns that focus on treatment and adherence issues. A cascading approach is utilized whereby a select number of Treatment Literacy and Prevention Practitioners are trained to conduct the outreach education using locally produced videos, information exchanges, workshops, printed materials, and community policy dialogues. In turn, these practitioners train others, including local volunteers, who are expected to go door-to-door in their catchment area to conduct question and answer sessions, provide treatment counselling, and promote HIV-testing. Because many of MATRAM’s methods are new to Mozambique, the organization aims to carefully evaluate and document their initiatives, thus contributing to an overall treatment literacy strategy for the country.