KAKUMA REFUGEE CAMP- PILOT BCC STRATEGY


Draft 1

THE INTERNATIONAL RESCUE COMMITTEE – KENYA

KAKUMA REFUGEE CAMP- PILOT BCC STRATEGY

REPORT ON DISCUSSIONS WITH COMMUNITY LEADERS

 

  1. Background

The IRC has implemented programs in Kenya since 1992 initially focusing on health related outreach activities in Kakume Refugee Camp (KRC).  The IRC started a comprehensive HIV/AIDS prevention and care program in Kakuma in September 2001 and spread out to neighboring host community areas of Lokichoggio and Kalokol in February 2004 and October 2005 respectively.

Behavior Change Communication (BCC) is a core component of the HIV/AIDS Program.  The beneficiary population in Kakuma Refugee Camp consists mainly of Refugees from South Sudan 70%, other nationalities represented include Somalia, Burundi, Democratic Republic of the Congo, Eritrea, Ethiopia, Rwanda and Uganda. The complex mix of ethnic groups, cultures and languages requires a carefully planned and targeted communication strategy, particularly in relation to behavior change in sensitive issues related to sex and HIV/AIDS.

The IRC has recognized the importance of a detailed, structured process in the design of an effective communication intervention and has developed a 12 –step approach to creating a BCC project. A thorough understanding of the audience and analysis of the context are the foundation of this approach. Community involvement and participation has its benefits for the success of a BCC strategy that include:

  • Identification of risk behaviors

 

  • Selection of the target group

 

  • Identification of communication activities and methods

 

  • And facilitating commitment to and support of the BCC process.

 

The IRC BCC Pilot strategy led by the IRC BCC Advisor started mid September 2007 to strengthen HIV BCC roll out activities started by the HIV/AIDS program Team after a BCC training workshop in July 2007.  The pilot strategy has identified Community Leaders in the Kakuma Refugee Camp as an important stakeholder for the implementation of the BCC approach to increase its chances of success and sustainability.

 

2. Community Leaders’ Discussions – Purpose, Objectives and Methods  

2.1 Purpose

The primary purpose for holding discussions with Community Leaders was to involve them in describing the problems and needs that expose Kakuma Refugee Camp Community to HIV infection.  Community Leaders would shed light on groups at risk and risk behaviors that need to be addressed. They would discuss availability and access to HIV preventive services provided in the camp including voluntary counseling and testing (VCT) services, condom distribution, STI treatment and stigma reduction.  The discussions would also explore types of existing Information Communication and Education (IEC) activities on HIV/AIDS and to what extent they have served to promote positive behavior change. The information gathered through the discussions will be used to guide the choice of an appropriate target group for the IRC BCC strategy in the refugee Camp.

 

2.2. Specific objectives for holding discussions with Community Leaders

 

  1. Assess problems and needs that expose camp residents to HIV infection.

 

  1. Identify groups at high risk and risk behaviors to be targeted with Behavior Change Communication (BCC).

 

  1. Establish the status of HIV prevention services in the Camp and what could be done to improve utilization of these services.

 

  1. Obtain data to support choice of an appropriate target group for the IRC’s BCC project.

 

2.3. Methods

Community Leaders’ discussions took place within the Kakuma Refugee Camp comprising of 8 Zones.

The UNCHR provided a list of Community Leaders from all community groups represented in the camp. These included refugees from Sudan believed to be 70% of all refugees, Somali, Ethiopian, DR Congo, Burundi, Rwanda, Uganda and Eritrea. There are also sub-groups among the major refugee groups like the Sudanese, Somalis and Ethiopians, these were identified and included for discussions.

Table 1-  Population Groups and Sub-Groups interviewed 
 

Sudanese

The Dinkas, Nuers, Equartorials, Darfur, Nubians

Ethiopians

Ethiopia Anyuak

Ethiopia Nuer

Ethiopia Oromos

Somali

Somali Bantu

Somali Madiban

Somali Yibre

Somali Banadir

Somali Digil

Uganda

Burundi

Rwanda

DR Congo

Eritrea

 

 

2.3.1 Composition of Field Team, Training and Data Collection

 

 The BCC Advisor planned to work with the HIV/AIDS team in data collection and subsequently in data analysis.  The BCC Officer joined the team from the IRC Lodwar office where he is based and participated in leading discussions with community leaders in the Refugee Camp.

A letter describing the purpose, objectives and dates of the discussions with Community Leaders was distributed to sampled Community Leaders in the Camp a week before. Community leaders who were found to have relocated or were out of the office at the time of the discussions were represented by their deputies in the discussions. Discussions were individually conducted with each Chairman and Chairlady representing the community group.

 

2.3.2        Constraints

  • Two national supervisory staff from the HIV/AIDS program that would have benefited from participation in the discussions left the program due to staff rationalization a month before.
  • Time was lost translating and explaining items for discussion to low literacy Community Leaders who could not read or speak a foreign language apart from their own mother tongue.
  • Some respondents were hesitant to disclose information on sex life in the community insisting that cultural practices were observed by all (Eritrea), so that HIV infection was not a problem for them.
  • There were days that other NGOs had called leaders to meetings that coincided with our schedule forcing us to postpone discussions to a later date.
  • Some leaders were also working for IRC or other partner NGOs as incentive staff and so it was conflicting to schedule discussions with them during working hours.

 

2.3.3. Data Analysis

The BCC advisor undertook the data entry and analysis in word document.  The items on the discussion guide were summarized under 6 topics to ensure information required was adequately captured; these were summarized under topics as follows:

  • Problems and needs that expose camp residents to HIV/AIDS infection
  • Groups at risk and behavior exposing them to risk of infection
  • HIV/AIDS Information
    • Information providers/channels of communication
    • Locations where information is provided; gaps and how communities could be motivated to take up services
  • Management of stigma and discrimination
  • HIV/AIDS prevention services
    • VCT services
    • Awareness campaigns
    • STI Management
  • Recommendations for enhanced and effective services

For the purpose of this report, findings are pooled together for all camp Zones because numbers of specific community leaders are too small to justify disaggregating data provided by variables of interest. The focus of the analysis was to examine common risk factors and behavior among different communities so as to guide the choice of a group to be targeted with behavior change messages that will be meaningful in all communities.

 

3. FINDINGS

3.1. Demographic and Social Characteristics of discussants  

3.1.1. Geographic Distribution and Coverage– Overall, a total of 28 community leaders participated in the discussions.  Community leaders were evenly distributed in all 8 Zones in the camp. In each community, gender balance was taken into account where a chairman and lady equally participated in the discussions. The larger the number of refugees from each community the more leaders were interviewed. Fortunately, it so happens that sub-groups from each community live together in a cluster complete with an administrative office. This is the point at which all communication to the group is distributed and received; most of the discussions took place at these centers.

 

 3.1.2 Age and Sex – The gender representation of discussants was equal i.e. 50% male and 50% female.  The majority (50%) of discussants were in their 30s, 25% were aged between 25 and 29 years while the remaining 25% were in their 40s. One participant was 54 years old.

 

3.1.3 Educational Attainment –

It was important to establish the level of education of Community Leaders in order to plan the best way to communicate with them in future regarding BCC implementation.   It was comforting to note that only 3 out of the 28 (11%) community leaders sampled had no formal education (NFE).  The level of education of those who participated in the discussions is outlined in the chart below.

Table 2.    

Community Leaders Level of Education

Community

 

NFE

Primary

Secondary

Tertiary

Adult Education

Grand total

Sudanese

 

2

 

3

 

2

 

Ethiopians

 

 

1

 

3

2

 

Somalis

 

1

   

1

1

 

Congolese      

2

     
Rwandese              
Burundi    

1

1

2

2

 

Uganda      

1

1

   
Eritrea    

1

 

1

   
Total

 

3

3

6

8

7

28

  

Key: NFE- No formal Education

 

 

3.2            HIV threat and associated factors

 

3.2.1        HIV risk factors as perceived by community

The first objective was meant to explore community leaders’ perceptions of the problems and needs that expose camp residents to HIV/AIDS that they would wish to see addressed.  Two problems were repeatedly mentioned by the majority of leaders as priority problems that must be addressed if HIV/AIDS transmission in the camp was to be contained. Close to 93% (26 out of 28) of discussants identified vulnerability of single mothers and widows to sexual exploitation due to poverty in the camp as a major problem. Single women and widows agree to have sex with men who either pay for it or provide means of livelihood for the family in exchange for sex. Considering that condom use has been found to be low in the camp by previous surveys, (KAPB May 2007 and BSS 2004), it follows that such women are exposed to HIV infection each time they consent to unprotected sex.

Similarly, 78%  (22 out of 28) of the discussants identified alcohol abuse in the camp as the second most important threat to spreading HIV/AIDS among camp residents. Brewing of illicit alcohol is common in the camp as an economic activity mostly among the Sudanese sub-groups.  Alcohol consumption is common among adult men, women and idle youth in the camp. The high numbers of drunken people has not only led to increased cases of irresponsible sex but also rape and insecurity due to fighting.

Low knowledge and awareness about HIV transmission was mentioned as a contributing factor to the spread of HIV infection in the camp by 21% (6 out of 28) of the discussants. Other problems mentioned appeared to stem from the three main problems mentioned above, examples are infidelity and wife inheritance among Sudanese sub-groups.  Sex with many partners coupled with low condom use expose many to HIV infection, these issues can be addressed through increased awareness and use of HIV/AIDS risk reduction measures.

 

3.2.3. Groups at risk and risk behaviors

78% of the discussants identified single mothers and widows who are forced by circumstances to exchange sex for means of livelihood for their families as one of the high risk groups. Similarly, many youth out of school follow in the high risk category with an equal percentage points at (78%). Others mentioned include people who get drunk and orphans who without parental guidance are exploited for sex by unscrupulous people at 25% and 18% respectively. Men who have sex with many partners and women in polygamous unions were considered to be at risk each by 14% of the discussants.

Several types of behaviors were mentioned as those that are likely to put most people at risk; at the top of the list is commercial sex at 46%, this is the risk factor mostly affecting single and widowed women in nearly all communities.  Following closely is drunkenness that sometimes leads both women and men to engage in unprotected sex. At the same time, 28.5% of discussants mentioned inconsistent and selective use of condoms among sexual partners as high risk behavior as far as HIV transmission is concerned.

Youth out of school were said to be engaged in sexual activity through different roots; among the influences mentioned are:

  • Early sex debut mentioned by 28.5% of the discussants
  • Peer pressure by 21.4 %
  • Idleness leading to irresponsible sexual activities by 17.8%
  • Young girls’ vulnerability to men who lure them with gifts in exchange for sex by 14.4%
  • Watching phonographic movies by 10.7%

Rape of women when they go out to fetch firewood was mentioned by one discussant.

 

3.2.4. Data that support choice of a BCC target Group

Discussants identified two groups to be at most risk of contracting HIV infection due to their vulnerability to circumstances within the community. Equal numbers of discussants mentioned single women/widows and youth out of school as the two target groups at most risk, each at 78.5%.  Other vulnerable groups mentioned by discussants included people who are always drunk mentioned by 27% of the discussants, youthful orphans without parental care being exploited for sex by 18% while men who have many sexual partners were mentioned by 14.2%.  Other categories of people at risk mentioned by one discussant each (3.5%) were women in polygamous unions and single adult men.

 

From the above discussions, it was clear that single women/widows and youth out of school were the two most vulnerable groups for consideration as target groups for the BCC strategy. IRC’s choice of a target group for BCC pilot strategy would however be determined through a stakeholder agreement and in consideration of resources available to implement activities necessary for behavior change.

 

3.3 HIV prevention programs in the Camp

As mentioned earlier, the IRC started a comprehensive HIV/AIDS program in the Kakuma refugee camp in 2001.  This included HIV/AIDS prevention activities, treatment, care and support both based in IRC health facilities and in the community. Discussions with community leaders were aimed at exploring the current situation with regard to problems and needs that increase the risk of contracting HIV infection among camp residents.  At the same time it was a good opportunity identified both to get relevant data to guide the choice of a suitable target group while at the same time being used as platform to involve communities in program decision making.  The findings would be used in the BCC program to address the root causes of the problems through community involvement in changing identified risk behavior that increase vulnerability to HIV infection.

 

3.3.1 Awareness campaigns

Although discussions with community leaders did not dwell on details of perceptions of achievement in the HIV awareness campaigns, it was clear that HIV/AIDS was a concern for all camp residents.  It was noted that there is high level of awareness of the existence of HIV/AIDS among the refugee communities in Kakuma.  Most discussants mainly mentioned transmission through the sexual route.  The Sudanese sub-groups however demonstrated the lowest level of awareness of HIV transmission as most of the discussants recommended that those found to be positive should be isolated so that they do not infect others. It was encouraging to note the smaller camp communities like the Rwandese, Burundis and the Congolese were well conversant with the mode of transmission and prevention of HIV.  From further discussions with other community representatives (Somalis, Eritreans) the message came through that most incentive staff employed by IRC and other partner agencies were from the minority groups.  Discussants from the Eritrean and the Equatorial Sudan sub-group came close to saying that their communities would be better informed in HIV prevention if some of their own people are hired as incentive staff to spread the preventive message in their communities.

Generally, there was a common feeling that the awareness program should be revitalized and more regular than it has been in recent months. The discussants recommended showing more videos and movies on HIV/AIDS and promotion and demonstration of condom use.  They pointed out that these activities would increase the number of people seeking counseling and testing services.

 

3.3.2 VCT services

Nearly all discussants identified a VCT center within walking distance to the community they represented.  It was clear however that the VCT centers’ attendance by the same communities was generally low.   Asked why the community was not fully utilizing the services at the VCT centers, two issues came through as having contributed to the low turn out at the VCT centers. First was the issue of declining awareness campaigns that served to motivated people to seek the services and second was the perception that confidentiality was compromised if one had counseling and testing at the Counseling and Testing Centre where they are known to staff.  Discussants pointed out that staff at the VCT could not be trusted to keep HIV testing results confidential.  The fact that one is seen seeking the CT services is construed to mean that one has reason to suspect they could be HIV positive, a pointer to their moral standing.

 

24.4% of the discussants were in favor of mobile VCT services where those who choose to be counseled and tested for HIV can do so soon after the awareness sessions. The opportunity provided by this arrangement may increase the numbers of those willing to be tested because of the neutral environment the chance provides. Similarly, 39% of the discussants were in favor of the IRC HIV Program’s recently introduced house to house counseling and testing saying it provides privacy that is lacking at the VCT centers.  Nonetheless, one community leader (Sudanese) disapproved of house to house counseling and testing saying it would appear one community is targeted in suspicion that they have high rates of HIV infection. (IRC HIV Program launched the house to house voluntary counseling and testing in the refugee camp last October (2007) to bring the service closer to the people, some communities have not been reached by the service as yet causing some to fear that they are being targeted as mentioned above).

Confidentiality in HIV counseling and testing is paramount and can be improved through more staff training, important too is the need for more community awareness to counter the notion that those who seek services at the VCT are of loose morals and suspect that their behavior may have led to infection with HIV.

 

3.3.3 Management of STI

Treating STI can minimize the spread of HIV by reducing the amount of HIV virus shed in the genital tract of those infected and therefore reducing susceptibility to HIV infection among those not infected.  Through discussions with community leaders, it became clear that the relationship between STI and HIV infection was not well understood.  Close to 43% of the discussants admitted that most people were not willing to discuss STI with friends or relatives.  25% of the discussants thought STI were not a major problem in their communities and believed that those affected get treatment at the clinics. Yet, 10% of the discussants said those affected were unwilling to disclose their problem to health workers for fear of referral to the Diagnostic Counseling and Testing (DCT) clinic.  (All clients found to have STI at the outpatient clinic are referred to the DCT clinic without prior warning or consent).

Another 10% of the discussants believed there might be more STI cases in the community and wondered why STI tests at the clinics turn negative but are positive on testing during repatriation. One discussant (from Sudan) believed there are many cases of STI as he observed, “There is an increase in cases of abortion, people complain of lower abdominal pain and passing of yellow urine”. One community leader who had worked as an incentive staff at the Ante Natal clinic said he had seen many cases of STI and had associated these with the low condom use in the community.

The above disclosures from community leaders indicate that there is need to increase awareness regarding relationship between STI and HIV/AIDS including signs and symptoms of the common STI.

 

3.3.4 Condom Distribution

Discussions with community leaders also revealed that there is widespread knowledge (82%) of how to access condoms both at community level and from health facilities and that people can protect themselves from HIV by consistently and correctly using condoms.  The finding is suggestive of possible success of the HIV/AIDS activities implemented separately by IRC, NCCK, Film AID, LWF and other partners, to distribute condoms and raise awareness on the benefits of the condom use in the prevention of HIV.  Still, despite demonstrated high awareness, the use of the condom is relatively low in the refugee camp.  28% of the discussants said that condom use does not appear to be consistent, implying the condom was only considered for use for sex with a non regular sexual partner.  It is of interest that the principal reason for condom use among sexually active people was because of concerns about contracting HIV/AIDS (61%), rather than concerns about preventing STI and unintended pregnancy only mentioned by 35% of the discussants.  25% of the discussants recommended wider promotion and demonstration of condom use to dispel some expressed fears that the government provided condom is not as efficient in preventing HIV when compared to the market based Trust condom.

3.3.5 Reduction of Stigma and support to PLWHA

Community leaders gave different accounts of their experiences with People living with HIVAIDS (PLWHA) in their communities.  Most discussants (35.7%) agreed that relatives were very supportive and cared for PLWHA but other people were likely to avoid those suspected to be PLWHA. 11% of the discussants feared that they could be infected by PLWHA if they interacted with them. Yet another 25% of the discussants mentioned that a good number of people regard HIV/AIDS as just another chronic illness like diabetes and so did not discriminate PLWHA. Close to 11% of the discussants had a feeling that PLWHA preferred not to disclose their status for fear of discrimination.  A smaller number (7%) however thought that PLWHA isolated themselves from other people and therefore invoked stigma on them.  Two discussants both from the Sudanese sub-groups described those infected with HIV as cursed and deserving to be isolated from the community.

There was noteworthy regard for PLWHA among two communities in the refugee camp that must be commended and emulated by other communities. The Ethiopian community showed concern and organized contributions for the support of PLWHA in their community. Similarly the Congolese community PLWHA has formed a support group and receives visits and encouragement from members of their community.

Lack of knowledge about other routes of HIV transmission can fuel stigma leading to negative attitudes towards PLWHA. When communities acquire comprehensive knowledge about how HIV is/is not transmitted, they are more likely to emphasize with PLWHA.  With necessary support and understanding, PLWHA can play a very important role in a HIV prevention program and contribute to lowering the rate of new infections.

 

4.1 Community Leaders’ perceptions of risk reduction measures

From the findings outlined above, it is easy to conclude that community leaders are well aware of the challenges facing their communities with regard to management of HIV/AIDS.  Overall, the population groups repeatedly mentioned as being at most risk of contracting HIV are single women/widows and youth out of school. The behaviors that cause the two groups to be vulnerable are known and need to be addressed.  It is also clear that knowledge of HIV/AIDS prevention among community groups in the camp has not translated into use of the same services by those who need them.   The community leaders’ perceptions of options available for overcoming the HIV/AIDS challenge amongst the camp community are described below.

 

4.1.1 Strengthen awareness campaigns

The most important need identified by community leaders was to step up HIV/AIDS awareness campaigns that appear to have slowed down in recent months. They observed that camp life is dynamic and refugees come and go through repatriation, new arrivals will need HIV/AIDS awareness to be at par with other refugees.   Public awareness used several months ago has become boring and people are not motivated to participate in them. The need to step up HIV/AIDS awareness and employ more exciting methods may revitalize the awareness campaign and result in behavior change. The urgent need for awareness was further confirmed by a number of misconceptions noted during the discussions; examples are described below:

  • Those who do not use condoms regularly fear that condoms are used by prostitutes.
  • One community leader (from the Somali community) said women are worried that the condom might get lost in the abdomen and make them sick.
  • The issues around the efficacy of the condom provided by Government need to be clarified to promote condom use, although the condoms available at the clinics are the best available on the market and are free (cost paid by Government) the packaging is different from those sold at the market making them appear as inferior.
  • One community leader suggested that female condoms should be made available to empower women where the partner declines to use the male condom.
  • The Eritrean community was categorical that HIV is not a problem for their community because they adhere to cultural norms regarding sexual engagement.  This clearly shows that there is little understanding of other routes that transmit HIV besides the sexual contact.
  • One community leader said, “This survey should not end here, we need people to come out in the community to raise awareness about HIV/AIDS”.

 

4.2.2 Address factors that increase vulnerability to HIV in the Refugee Camp

  • Community Leaders described public community awareness sessions over loud speakers as conducted earlier as ineffective because much of what is heard is easily forgotten a few weeks later. Awareness for HIV can further be enhanced through provision of IEC materials and pamphlets translated into each community’s local language and training of community based persons who would then follow through the material with discussions.
  • More knowledge about HIV/AIDS for Community Leaders including teachers through workshops should be considered to enable them guide communities to adopt behavior that reduce risk of HIV infection.  The two groups of leaders could be encouraged to emphasize positive and culturally accepted behavior such as abstinence from sex and being faithful to one partner.
  • A common thing among the camp residents is the use of drama, folk dances and songs to pass information on cultural norms and mores. When well structured, these can be used to convey messages for the prevention of HIV. Also related to these is the use of sports, competitions and intercommunity events to keep idle people, especially the youth, busy in a positive way.
  • Support income generating (IGAs) for single women/widows, PLWHA and alcohol brewers so that they can earn much needed income through productive ways instead of them reverting to behaviors that make them vulnerable to HIV infection.
  • Acquire and show more videos and films on HIV/AIDS, first, to increase HIV awareness and second as a means of countering watching of phonographic material by the youth.
  • Use existing clubs and encourage formation of new ones where such do not exist.  Support the clubs to get involved in HIV prevention activities among peers.
  • Promote formation of post-test support groups that include all those who have undertaken the HIV test. This group can inspire others to take the HIV test especially when members demonstrate increased change in positive sexual behavior. The PLWHA will be part of the post test clubs and because of the confidentiality observed, their status will not be known to others without their consent.

 

5. CONCLUSION

Discussions with community leaders revealed that squalid live at the camp was leading single mothers and widows to turn to sex as a way of earning some means of livelihood for the family. To improve their means of livelihood, other members of the community have turned to selling local brew as an economic activity.  At the same time, idleness has led out of school youth to engage in behavior that exposes them to HIV infection.

Discussants identified two groups of people in the community as the most vulnerable to the risk of contracting HIV infection posed by the problems identified above.

Community Leaders mentioned single women/widows and youth out of school as the two groups at most risk, each.  Other vulnerable groups mentioned included people who are always drunk, youthful orphans without parental care being exploited for sex and men who have unprotected sex with many partners.

 

Behaviors that were mentioned as those most likely to put most people at risk of contracting HIV in order of importance were commercial sex commonly practiced by single and widowed women in nearly all communities.  Following closely is drunkenness that sometimes leads both women and men to engage in unprotected sex.  Other behavior mentioned was the inconsistent and selective use of condoms among sexual partners.

Youth out of school were said to be engaged in sexual activity due to idleness and peer pressure and negative influences in the community including watching phonographic videos.

Most HIV preventive services are readily available in the Kakuma Refugee Camp including prevention, treatment, care and support services. However, discussions revealed that the knowledge of existence of HIV/AIDS services in Kakuma does not translate into utilization of services by an equal percentage of those who knew of their existence.  The uptake of HIV services among the residents is low, a situation that calls for a change in strategy to motivate communities to seek services.

The two most mentioned vulnerable groups for consideration as target groups for the BCC pilot strategy were single/mothers and youth out of school. IRC’s choice of a target group for BCC pilot strategy would however be discussed with all stakeholders to reach agreement and in consideration of resources available to implement activities necessary for the behavior change.

 

6. RECOMMENDATIONS

 

  1. Revitalize and strengthen the HIV/AIDS awareness campaigns through the development of IEC materials and pamphlets translated into each community’s local language; train community based resource persons to follow through the material with discussions.
  2. Diversify HIV/AIDS communication strategies that will catch the attention of the community and motivate them to change from negative to positive sexual behavior. Some strategies that have worked elsewhere include creative theatre such as drama, folk dance, road shows, competitions and sports. This can be used along locally developed IEC materials in local languages and with images recognizable by communities.
  3. Promote formation of post-test support groups that include all those who have undertaken the HIV test. This group can inspire others to take the HIV test especially when members demonstrate increased change in positive sexual behavior. The PLWHA will be part of the post test clubs and because of the confidentiality observed, their status will not be known to others without their consent.
  4. Confidentiality in HIV counseling and testing has been put into question and needs to improve.  This can be achieved through regular staff updates and training, important too is the need for more community awareness to counter the notion that those who seek services at the VCT are of loose morals and suspect that their behavior may have led to infection with HIV.
  5. There is good justification to explore provision of youth friendly health services to take into account the need for health providers to provide condoms to those who are shy to ask for the condoms.  Staff will be trained to counsel youth in a friendly atmosphere, provide STI treatment and condoms.
  6. If at all possible, micro-finance schemes may be considered to support income generating (IGAs) for single women/widows, PLWHA and alcohol brewers so that they can earn much needed income through productive ways instead of them reverting to behaviors that make them vulnerable to HIV infection.

ANNEX 1

 

IRC Kenya HIV/AIDS BCC Strategy Pilot Project

Community Leaders’ Discussion Guide

 

KAKUMA REFUGEE CAMP

Introduction

 

We appreciate your time to participate in this discussion. Your participation is voluntary and we in turn will maintain confidentiality in whatever we discuss. As a community Leader in this Zone, we encourage you to share with us information that will enable IRC serve the community better and achieve better results in the fight against HIV/AIDS. The more IRC understands the community’s needs/challenges the better it will assist in addressing priority needs that can reduce the rapid spread of HIV/AIDS in and outside the camp.

 

The discussions will take from 30-45minutes in a question and answer session, please contribute fully and ask for clarification for questions that may not be clear to you.

 

There will be two facilitators; one will ask questions and the other will translate words and phrases that may need to be understood better in a more familiar language.

 

We request to record your details separately to assist in the analysis of this information.

 

Do you agree to take the interview with the understanding explained above.

 

Signature:


The interviewer signature implies interviewee has consented to the interview.

 

Demographic Data

 

Date _________________________________________

 

Age _________________________________________

 

 

Sex__________________________________________

 

 

Education_____________________________________

 

 

Occupation____________________________________

 

 

Location (KRC Zone) ____________

 

 

Community (Sudanese, Somali Ethiopian, Ethiopian, DR Congo etc)

 


 

Length of stay           Years_________ Months__________

 

 

Questions for Community Stakeholders in Kakuma Refugee Camp

 

1. What problems/needs expose people in your community to HIV infection that need to be addressed? Explain.

 

Answer








 

2. Which group(s) of people in your community have a greater risk of contracting HIV and why?

 

Answer








 

3. What behaviors contribute to these groups of people being at higher risk of contracting HIV/AIDS?

 

Answer









 

4. Which group of people in the community should be targeted with behavior change awareness to reduce their chances of getting infected with the AIDS virus?

 

Answer






 

5. Where do people in your community get information about HIV/AIDS?

 

Answer








 

6. What are the methods used to raise awareness about HIV/AIDS?

 

Answer







 

7. In your opinion what information should be provided to motivate people in your community to avoid getting HIV/AIDS?

 

Answer








 

8. What more could be done to motivate people to avoid behavior that may result in contracting HIV/AIDS?

Answer








 

 

9. How are people living with HIV and AIDS (PLWHA) treated in your community?

 

Answer









 

10. What HIV/AIDS prevention services are available in your community?

Answer








 

11. What is your suggestion for improving utilization of HIV/AIDS prevention services in your community?

 

Answer







 

12. When and where is it convenient to distribute condoms for:

 

Answer

Young people?

 





Adults?






 

13. When and where is it convenient to make STD treatment services available?

 

Answer








14. When and where is it convenient to make counseling services available?

Answer





15. What other services or supplies do members of your community need to reduce their risk of getting HIV/AIDS?

Answer






!6. Is there anything else you would like to talk about with regard to HIV/AIDS in your community?

 

Answer






 


ANNEX II

        Rose Wahome (BCC Advisor) Interviewing one of the Somali leaders

 

     

   Kizito Mukhwana (BCC Officer) interviewing a Dafurian leader looking on is the translator. Venue: at the Reception Centre


 

Interview with one of the Chairladies at the camp reception centre

 

Interview with Sudanese (Equatorial) community leader at the administration centre

 

Interview with the Oromo chairlady at the administration centre office

 

Interview with the Ethiopian chairlady – looking on is the interpretor

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Posted on March 2, 2012, in Categorized and tagged , , , , , , , . Bookmark the permalink. Leave a comment.

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