Joy Mukaire of the Christian Health Association of Sudan discusses the organization's approach to encouraging HIV testing in the Western Equatoria and Lakes States of South Sudan.

1. Christian Innovations in HIV/AIDS
Prevention and Care
Increasing Demand for HIV Testing
in South Sudan
Joy P. Mukaire
CCIH Annual Conference
June 2012

2. Christian Health Association of
Sudan
 Shared Vision:
“All CHAS member
organizations visibly and
effectively participating in
health service delivery and
contributing to the
attainment of health
outcomes for South Sudan”

3. CHAS Mandate
Facilitate organizational
development of its members
and actively advocate, foster,
promote and support creation
of partnerships among member
organizations, the public sector
and other development partners
operating in Sudan

4. CHAS Strategic Focus Areas
There are four (4) programmatic
strategic focus areas:
 Health Systems strengthening
CHAS members
 Community systems
strengthening
 Scaling-up coverage of priority
health interventions for South
Sudan
 Advocacy and creation of
partnerships

5. CHAS Membership
 CHAS has 73 members drawn from:
 Episcopal Church of Sudan -
 Catholic Church –
 African Inland Church -
 Presbyterian Church –
 Pentecostal churches –
 Sudan Presbyterian evangelical Church -
 Muslim faith groups –
 PLHIV Network

6. HIV/AIDS in South Sudan
 According to UNAIDS estimates HIV prevalance
among adult population in South Sudan s 3%
 South Sudan shares borders with countries
reported to have high rates of HIV/AIDS
(Uganda 6.5%, Kenya, 6.3%, Ethiopia, 1.1%, DRC
3.4%, Central African Republic 4.9%)
 Since the signing of the CPA there is increased population
movement and interaction across boarders such that there
is potential for the epidemic to blow-up
 The nature of the epidemic is generalized low although
there are “hot spots” where it has matured and is
grounded

7. HIV/AIDS Prevalence by
Surveillance ANC Site

8. HIV/AIDS Prevalence by
State

9. Key Determinants of the
Epidemic
Knowledge about HIV/AIDS is still extremely
low:
Sudan Household Survey 2010 showed that only 11%
of southern Sudanese women aged 15-24 years are
knowledgeable about three ways of preventing
transmission of HIV.
Only 53.8% among women aged 15-49 years have
heard of HIV/AIDS
41.1% of women and 58.1% of men know can avoid the
AIDS virus by using a condom correctly every time

10. Key Determinants of the
Epidemic
 Multiple concurrent sexual partners coupled with low
levels of condom use
 High levels of stigma, discrimination, and denial regarding
HIV/AIDS and rudimentary health care systems.
 Massive population movements (IDPs relocation, refugees
influx, repatriation, ex-combatants transition to civilian life,
and commercial transporters travel)

11. Key Determinants of the
Epidemic
 Poverty, desperately low school enrollment, high levels of
stigma, discrimination, and denial regarding HIV/AIDS and
rudimentary health care systems.
 Cultural norms such as tribal marking practices, polygamy
and widow inheritance are also ingredients for rapid
spread of HIV.

12. National Prevention
Strategy
Given the nature of the epidemic and the post conflict context
South Sudan HIV/AIDS Strategic Framework includes seven
thematic areas: Enabling environment; Prevention; Treatment,
care and support; Capacity building; Post conflict ; and
Monitoring & Evaluation
The Prevention strategy includes
6. Awareness raising and community education
7. HCT
8. Promotion of condom use
9. PMTCT
10. Blood safety

13. CHAS Engagement
 Awarded a service agreement to provide technical leadership
and management of South Sudan HVI/AIDS project supported
by Multi Donor Trust Fund [MDTF]
 Two states: Western Equatoria and Lakes States
 Sub-contracted and strengthened capacity of 35 implementing
partners
Western Equotoria Lakes
• 15 FBO 7 8
• 6 CBO 3 2
• 11PLHIV Associations 10 1
• 2 Local government departments 1 1

14. The role of FBOs
 Communities prefer to seek HIV/AIDS related
information and services from FBOs
 They have been a source of comfort and compassion time
in memorial. A source of spiritual and other emotional
support
 Command authority in making HIV/ADS an issue for public
dialogue
 Supported creation & operations of PLHIV support groups
 Link with and work in partnership with traditional
health care systems to increase access to PMTCT

15. The role of FBOs
 Building an interface between facilities and the community
 Health service promotion in churches and on Christian FM radios
 Disease prevention
 Promote care seeking & compliance with treatment practices
 Supporting specific models for creating evidence in
priority setting and target prevention, care and support
 Participatory statistical methods like LQAS to collect evidence
 Cost effective home-care models – target primary care givers
 Outreach service systems
 Linking and working with traditional health care systems

16. Taking Lead
 World AIDS Day
events

17. Strategies Used
 Building capacity through training and empowering
over 800 church leaders and church workers in
HIV/AIDS awareness raising and education – a brief
session per church service
 Reaching out by initiated care & support structures
– PLHIV associations and service centers
 Trained community mobilizers and counselors and
established outreach service teams with support
from ministry of health. – 36 locations

18. Strategies Used
 Upgraded church
facilities
 Linked up with
traditional health
systems
 Attracted 80-100
clients per
session once a
month

19. What was Unique?
Churches participated
visibly in big events like
World AIDS Day
Campaigns. Supporting
positives and taking
lead in public debates
 Facilitating first
public testimony by
a young man in
Rumbek

21. Results
• Trained and supported 44 counselors trained under this
project
• Sixteen [16] FBO sites targeted by this project were
upgraded and supported to carry out HCT sessions on a
weekly basis.
• VCT services initiated at 7 sites in Western Equatoria
[Yambio, Nzara, Ibba, Ezo counties] and 9 in Lakes [Rumbek
Central, Rumbek East, Cueibet, Yirol West and East,
Wulu ]
• VCT services combined with advocacy reduced stigma in
areas considered difficult due to strong culture

22. Results
• Services were provided in 7 locations in Western Equatoria
[blitz sessions] and 18,232 people were served.
• Services were provided in 9 locations in Lakes [blitz sessions]
and 7,951 people were served.
• Forty three [43] TBAs in Nzara and in twenty four [24]
Rumbek were trained to promote access and utilization of
PMTCT
• Organized HCT sessions for CSWs: 66 in Yambio and 38 in
Rumbek
• Trained 78 Home Based care Facilitators who support
primary care givers