Exceeding targets and saving lives

Mon, 7 November 2011

• ‘I would like to say thank you to Lifeline/Childline staff for their support. When I tested positive for HIV, they helped me through it and now my baby is HIV negative after taking the treatment… I am so happy today.' - Project Beneficiary in Khayelitsha

REPORT 2: Lifeline/Childline Western Cape – Addressing the HIV and AIDS Epidemic in Khayelitsha

The LifeLine/Childline Western Cape’s HIV and AIDS programme is a holistic intervention which aims to mitigate the effects of the HIV and AIDS epidemic in Khayelitsha. This is an ongoing programme, and is being implemented in close partnership with the Western Cape Provincial Department of Health. The programme activities are carried out by 54 specially trained and selected lay counsellors, who receive regular mentoring, supervision and debriefing from programme management and professional psychologists. This programme operates from 15 government clinics and hospitals in Khayelitsha and is providing a comprehensive HIV and AIDS voluntary counselling and testing (VCT) service and PMTCT programme to its beneficiaries.

The project runs from October 2010 to November 2011. This report covers the period between April 2011 and November 2011.

Activities and Outcomes

All the planned project activities have been implemented. Through the work of the 54 lay councillors at 15 clincs and day hospitals in Khayelitsha, the following results were achieved from the start of the project in November 2010 up to March 2011:

• 14 413 mothers benefitted from the Prevention of Mother-to-Child Transmission Programme, which was conducted at clinics and Maternity Obstetric Units (MOUs) in Khayelitsha. Given that each mother has at least one baby, this intervention has prevented thousands of children from being born with HIV.
• 43 241 new clients were counselled through Lifeline’s VCT services in Khayelitsha. These services include pre- and post-test counselling and HIV/AIDS health education.
• 7 271 clients received follow-up supportive counselling after having been tested as well as on-going support services which included participation in 317 support groups.
• 13 443 people received adherence counselling (to prepare them for admission into an ARV programme), while 6 167 of these clients participated in adherence support groups.
• 648 people living with HIV/AIDS, primarily women, benefitted from participation in the food garden and beading making income generation projects. • 43 791 people were informed and educated about HIV/AIDS through community outreach, educational activities, awareness raising and media campaigns. This included talks and presentations at schools, community groups and clubs, baby clinics and MOUs, and local taxi ranks.

Expenditure

The total cost of this project was R4 291 853. R200 000 was requested from SASIX, which has been paid in full.

Description	Total Budget (as per budget approved by SASIX)	Total Expenditure to date
Lay Counsellor costs	35 661	35 661
Food Garden Project Co-ordinator	21 816	18 142
Management Time (10% of Executive Managers salary)	28 800	26 400
Bead-making Project Co-ordinator	27 573	24 001
Bead Starter Kits (300 kits @ R 20 per kit)	6 000	5 488
Seedlings, Compost & Basic Garening Supplies (350 aspirant gardeners @ R 25 each)	8 750	4 389
Lay Counsellor Uniforms (R250 each)	13 500	13 500
Mentoring and Supervision of Lay Counsellors	38 400	7 730
Admin Costs (Audit, Banking, Insurance, Affiliation Fees)	19 500	19 500
TOTAL	200 000	154 811

This expenditure table above does not reflect expenditure for November 2011. However, the large under-spend on mentoring and supervision is because additional funding was made available by the Department of Health. Lifeline/Childline have indicated that they will use the extra allocation to contribute to the cost of paying lay counsellors to keep providing these services.

Challenges

The LifeLine/Childline’s HIV and AIDS Programme manager did not reported any major problems or challenges during the programme. All of the planned activities were carried out and the project targets were exceeded.

Monitoring and evaluation

Monitoring activities were conducted as planned. The programme manager, who is based in Khayelitsha, conducted site visits to all the clinics to provide technical support for programme implementation as well as providing monitoring and support services to the staff.

Additional monitoring systems which were in place during the reporting period included:

• Weekly team meetings between the programme manager and programme coordinators
• Fortnightly individual supervision sessions for programme coordinators by the programme manager
• Individual consultations by programme coordinators with the lay counsellors
• Individual and group clinical supervision with registered psychologist for lay counsellors
• Monthly statistical report capturing outputs (such as the number of beneficiaries served)
• Programme progress reports (two quarterly progress report prepared for the Department of Health)

An extensive year-end programme evaluation and assessment will be conducted in December 2011.

Conclusions

The LifeLine/Childline’s HIV and AIDS Programme in Khayelitsha operated smoothly during the period under review. It has exceeded all of the targets that it set for itself during this time and continues to play a vital role in Khayelitsha. It has won wide recognition for its work, including an acknowledgement by the Western Cape Department of Health for ensuring that a record number of clients adhered to their ARV regime at Khayelitsha day hospitals.

As a result of this programme, thousands of people now know their HIV status – a crucial first step in halting its spread. Many have also benefitted from education and counselling services. And perhaps most impressive among all the achievements of this project is that thousands HIV positive mothers have given birth to HIV negative children after benefitting from the prevention of mother-to-child transmission programme.

HIV/AIDS testing and counselling underway

Mon, 23 May 2011

• ‘I would like to say thank you to the staff of Lifeline. I feel as if I’m given a second chance. I even forget at times that I am sick. The staff of Lifeline looked beyond my sickness and they treated me like a person which felt good to me and made me regain my confidence’ - - Project Beneficiary in Khayelitsha

REPORT 1: Lifeline/Childline Western Cape – Addressing the HIV and AIDS Epidemic in Khayelitsha

The LifeLine/Childline Western Cape’s HIV and AIDS programme is a holistic intervention which aims to mitigate the effects of the HIV and AIDS epidemic in Khayelitsha. This is an ongoing programme, and is being implemented in close partnership with the Western Cape Provincial Department of Health. The programme activities are carried out by 54 specially trained and selected lay counsellors, who receive regular mentoring, supervision and debriefing from programme management and professional psychologists. This programme operates from 15 government clinics and hospitals in Khayelitsha and is providing a comprehensive HIV and AIDS voluntary counselling and testing (VCT) service and PMTCT programme to its beneficiaries.

The project runs from October 2010 to November 2011. This report covers the period between October 2010 and March 2011.

Activities and Outcomes

All the planned project activities have been implemented. Through the work of the 54 lay councillors at 15 clincs and day hospitals in Khayelitsha, the following results were achieved from the start of the project in November 2010 up to March 2011:

• 7 166 mothers benefitted from the Prevention of Mother-to-Child Transmission Programme, which was conducted at clinics and Maternity Obstetric Units (MOUs) in Khayelitsha. Given that each mother has at least one baby, this intervention has prevented thousands of children from being born with HIV.
• 21 318 new clients were counselled through Lifeline’s VCT services in Khayelitsha. These services include pre- and post-test counselling and HIV/AIDS health education.
• 4 609 clients received follow-up supportive counselling after having been tested as well as on-going support services which included participation in 126 support groups.
• 4 234 people received adherence counselling (to prepare them for admission into an ARV programme), while 2 913 of these clients participated in adherence support groups.
• 295 Men and women living with HIV/AIDS benefitted from participation in the food garden and beading making income generation projects.
• 20,567 people were informed and educated about HIV/AIDS through community outreach, educational activities, awareness raising and media campaigns. This included talks and presentations at schools, community groups and clubs, baby clinics and MOUs, and local taxi ranks.

Expenditure

The total cost of this project was R4 291 853. R200 000 was requested from SASIX, of which R100 000 was paid in the first tranche.

Description	Total Budget (as per budget approved by SASIX)	Total Expenditure to date
Lay Counsellor costs	35 661	12 691.15
Food Garden Project Co-ordinator	21 816	8 141
Management Time (10% of Executive Managers salary)	28 800	12 000
Bead-making Project Co-ordinator	27 573	13 838.15
Bead Starter Kits (300 kits @ R 20 per kit)	6 000	1 789.73
Seedlings, Compost & Basic Garening Supplies (350 aspirant gardeners @ R 25 each)	8 750	1 670.74
Lay Counsellor Uniforms (R250 each)	13 500	-
Purchase of new computer and printer	-	4 337. 77
Mentoring and Supervision of Lay Counsellors	38 400	450
Admin Costs (Audit, Banking, Insurance, Affiliation Fees)	19 500	12 847.20
TOTAL	200 000	67 765.74

This expenditure covers the first five months of the project, and excludes the figures for April 2011 as these had not been finalised at the time of reporting.

The budget items have changed slightly, in that the mentoring and supervision of the lay counsellors has already been covered by funding from the Department of Health. This allocation will now be used to pay for a professional psychologist to provide advanced counselling training to the 54 lay counsellors. This training will be useful as the programme is intending to expand their counselling service to include couples’ counselling for their clients, which has been identified as an important need in the area. The estimated cost of this is R32 740. The balance of this allocation was used to purchase a new computer and printer for the Khayelitsha office.

The uniforms for the lay counsellors will be purchased in June 2011.

Challenges

The LifeLine/Childline’s HIV and AIDS Programme manager has not reported any major problems or challenges during the programme thus far. All of the planned activities have been carried out and the project targets are being achieved.

Monitoring and evaluation

So far, the project monitoring activities have been conducted as planned. The programme manager, who is based in Khayelitsha, has conducted site visits to all the clinics to provide technical support for programme implementation as well as providing monitoring and support services to the staff.

Additional monitoring systems which were in place during the reporting period included:

• Weekly team meetings between the programme manager and programme coordinators
• Fortnightly individual supervision sessions for programme coordinators by the programme manager
• Individual consultations by programme coordinators with the lay counsellors
• Individual and group clinical supervision with registered psychologist for lay counsellors
• Monthly statistical report capturing outputs (such as the number of beneficiaries served)
• Programme progress reports (two quarterly progress report prepared for the Department of Health)

The Department of Health has said that the Khayelitsha sub-district has already reached 85% of the target for the number of people who need to be tested through this project, and is thus well ahead of schedule. This means that more people are now aware of their status and can receive appropriate counselling.

An extensive year-end programme evaluation and assessment will be conducted in December 2011.

Conclusions

The LifeLine/Childline’s HIV and AIDS Programme in Khayelitsha has operated smoothly in the last few months. As a result, the intervention was acknowledged in 2010 by the Western Cape Department of Health for ensuring that a record number of clients adhered to their ARV regime at Khayelitsha day hospitals.

In the next six months, Lifeline/Childline aims to strengthen the support groups and food/income generation activities for people living with HIV and AIDS by approaching the Cape Crafts and Design Institute, who develop and support craft making as an economic activity in the Western Cape. In addition, the programme’s lay counsellors will receive advanced training on how to conduct counselling for couples.

Given Lifeline’s efficient management of this project and proactive approach to monitoring the changing environment and needs of their clients, SASIX is confident that this project will remain on track and achieve its desired impact.