Title: Providing comprehensive HIV service delivery in hard-to-reach communities
Background:
Many hard-to-reach communities constitute underserved populations in terms of HIV services. These areas often face challenges such as inadequate road networks, high transportation costs, and risks associated with mobility within the communities. Some are situated along water bodies, further complicating movement. In pursuit of combating the spread of HIV and AIDS and providing care and support to foster healthier individuals for a brighter future, the West Africa AIDS Foundation, through the USAID Strengthening the Care Continuum Project, implemented significant initiatives in hard-to-reach communities within the Western Region of Ghana, specifically in communities within the Ellembelle, Jomoro, and Nzema East districts.
Description:
In an effort to reach hard-to-access communities, the project team identified peer mobilizers within these areas. The mobilizers chosen were influential individuals who were regarded as opinion leaders among different social groups and some individuals from various social groups, including the hairdresser’s association, ‘keke’ drivers’ association, long truck drivers’ association, boat riders’ association, men and boys, and faith-based organizations, were actively involved in the project.
Additionally, community information center operators played a role in making announcements and disseminating HIV messages.
Through engagement meetings with influencers, dates were scheduled to connect with their respective members. The availability of motorcycles facilitated an increase in the demand for HIV services.
At scheduled meetings with the groups, community members received education on HIV as well as HIV testing services offered by trained community health nurses, acting as case managers, ensuring confidentiality, and providing pre-test and post-test counseling. All Reactive clients received additional counseling and were guided to health facilities for enrollment in Antiretroviral Therapy (ART) whilst those testing negative to HIV tests were introduced to Pre-Exposure Prophylaxis (PrEP), with eligible individuals successfully enrolling in the program.
Lesson Learned:
- Utilizing community information centers for announcements and the dissemination of HIV messages yielded enhanced participation in HIV activities such as outreach testing, showcasing the importance of leveraging existing resources for communication and awareness creation especially in hard-to-reach communities.
- Actively involving various social groups, such as the hairdresser’s association, ‘keke’ drivers’ association, long truck drivers’ association, boat riders’ association, men and boys, and faith-based organizations, supported reaching a wide network of community members despite their hard-to-reach locations.
- Involving influential peer mobilizers in hard-to-access communities who are recognized as opinion leaders in various social groups, played a crucial role in facilitating engagement and ultimately acceptance and patronage of services.
- The availability of motorcycles facilitated an increase in the demand for HIV services. highlighting the significance of adequate transportation support in reaching remote areas.
- Offering comprehensive education on HIV during engagements was important for community members to make informed decisions.
- The involvement of trained community health nurses as case managers ensures a professional and confidential testing process.
Conclusion: To leave no one behind in the HIV fight requires reaching those in hard-to-reach communities which can be achieved by engaging community members themselves via their ‘social’ networks as well as leveraging existing resources such as community information centers.