Sauti Moja-Tanzania is working closely with communities to mobilize them, build capacity among leaders, develop good knowledge about health issues, and stimulate community driven responses to confront health inequities.  The Sauti Moja-Tanzania Health Program consists of activities geared toward addressing the issues of HIV/AIDS and reproductive health.

The Challenge

• HIV/AIDS is devastating communities all over the world and Tanzania’s pastoralists are no exception. Furthermore, poor cultural practices make Maasai especially vulnerable to HIV transmission. In addition, due to the remoteness of these areas, most are not provided with adequate health and educational services.
• In Tanzania, up to 8% of the population is infected with HIV and subsequently, millions are facing the consequences of death, illness, and the incredible costs (financial and otherwise) incurred when sick or caring for sick family members.
• For pastoralists, like the Maasai, livelihoods fundamentally depend on adults and youth who are healthy enough to care for the livestock, which often includes walking long distances to find grazing land and water.  HIV/AIDS has the potential to eliminate these essential members from the productive workforce, thereby endangering the livelihoods of entire families.

Our Response

HIV/AIDS Community Conversations:  Community Conversations (CC) is an innovative methodology developed by the UNDP (United Nations Development Program) to enhance the capacity of the communities to generate a response to HIV/AIDS. Using participatory learning methods, the community group progresses through a six stage cycle of discussion during which they identify and solve their own problems. This response integrates individual and collective concerns, values and beliefs and addresses attitudes and behaviours embedded in social systems and structures.

Six Steps of the CC Method

• Relationship Building:  Building trust with the community is the most important element in ensuring success of subsequent steps.
• Identification of Concerns:  Facilitate discussions and activities to identify the local factors contributing to the spread of the disease.
• Exploration of Concerns:  Communities must deeply understand the factors with a focus on getting at the roots of the problems.
• Decision Making & Planning:  The community prioritizes and plans activities to alleviate or resolve the concerns they’ve discussed.
• Action:  Leaders and community members volunteer their time to implement their plans relating to prevention, testing, care and treatment.
• Reflection and Review: Ongoing acknowledgement and discussion of progress being made helps communities improve their plans and projects and also serves to motivate continuing community engagement in the process.

Getting Started

SM-TZ has started CC groups in two villages in Longido District: Mairowa (started in 2007) and Oltepesi (started in 2010).  In order to start the Community Conversation approximately 20 community members are identified to be a part of the CC Executive Committee (EC).  This group meets weekly along with the SM-TZ CC facilitator.  The facilitators have been trained in CC and facilitation skills and they are also from and live in the villages where the CC is taking place, meaning they are in a position to BUILD RELATIONSHIPS necessary to encourage involvement.  The goals of the meetings are to use participatory methods to build understanding of the disease and its impacts, IDENTIFY AND EXPLORE CONCERNS as well as to MAKE PLANS for addressing these concerns within the community.

The Actions

During the ACTION phase, the EC group implements micro-projects to address the identified concerns.  Sauti Moja-Tanzania supports these micro-projects with financial resources and technical support.  Each microproject is overseen by members of the Executive Committee.

1. School education. The community identified that no education about HIV/AIDS was being provided in the local schools, so now, EC members are conducting HIV and health education every week in Engarenaibor Secondary School for form I and II students.
2. Resource Center.  The community identified a gap in reliable sources of HIV and health information and their plan to solve this was to open a Community Resource Center.  The Resource Center is staffed twice a week and serves as a place for community members to get reliable information, counselling, and also obtain condoms.
3. Clinic Counselling.  A few women spend two days a week at the Mairowa clinic, counseling women, especially those who are pregnant, about the disease, its treatment, and care for those infected.  They also provide the much needed service of assisting Maa speaking women with translation.
4. Home-based care.  Three EC members have been trained as home based care workers. Every month they visit households of people living with HIV.  Their support has resulted in many people accessing counseling, social support, healthcare, and ARV treatment.
5. Livelihood support.  Those living with HIV/AIDS require better nutrition and sufficient food to order to take ARVs.  However, they have less energy for work such as farming and livestock raising.  Recently, at their request, SM-TZ has started to assist members of the HIV + group with agricultural activities.  SM-TZ has provided interest free loans to pay for ploughing of fields and purchase of seeds.  Conservation Agricultural training was also provided in order to maximize crop yields.
6. HIV+ Support Group.  Since the inception of the CC program, many people have come forward willing to disclose their status.  This has resulted in the formation of an HIV+ support group which now has 14 members. Many of these members are also assisted with financial support to access healthcare.
7. Moran training.  The SM-TZ community facilitator trains Morans in HIV/AIDS.  This is an important project as many Morans work in urban areas as security guards.  When they return home there is a danger of introducing HIV/AIDS into their families.
8. Traditional Birth Attendants (TBAs).  It was identified that TBAs did not have sufficient knowledge on how to protect themselves from HIV while caring for their patients.  A nurse from the Longido District Hospital has been training the TBAs to protect themselves as well as advise the mothers on the importance of testing.

If you would like to support the Community Health Project and help continue provide a platform for HIV/AIDS and reproductive health awareness, please click here and head to our Donations page!