WOMEN GROUP AGAINST HIV AND AIDS IN KILIMANJARO REGION (KIWAKKUKI)

 

FIVE YEARS STRATEGIC PLAN

2017-2021

 

Contents

LIST OF ABBREVIATIONS. iii

EXECUTIVE SUMMARY. v

1.0 INTRODUCTION.. 1

1.1 VISION, MISSION, CORE PURPOSE AND GOAL. 1

1.2 KIWAKKUKI’s CORE VALUES. 1

1.3 PROGRAMME STRATEGY. 2

1.4 PROGRAM APPROACH.. 3

1.5 GEOGRAPHICAL AREA OF FOCUS. 3

2.0 SITUATION ANALYSIS. 4

2.1 SOCIO-ECONOMIC ANALYSIS. 4

2.1.1 GLOBAL CONTEXT. 4

2.1.2 ECONOMIC SITUATION IN TANZANIA.. 5

2.2 HIV AND AIDS SITUATION IN TANZANIA.. 7

2.2.1 HIV Prevalence in the Country. 8

2.2.2 HIV Prevalence by Regions in Tanzania. 8

2.2.3 Orphans and Most Vulnerable Children. 9

2.2.4 Early Sexual Practices. 10

2.2.4 Gender Based Violence (GBV). 10

2.2.5 Risky Traditional Practices. 11

2.2.6 HIV Prevalence among Key Populations. 11

2.2.6.1 Sex Workers. 12

2.2.7 Mobility and Migration. 13

2.2.8 Stigma and Discrimination against PLHA.. 14

2.2.9 Enrolment in Care and Treatment Centers. 14

2.2.10 HIV Policy and Legal Environment. 15

3.0 STRATEGIC PRIORITIES. 15

4.0 PROGRAMME DESCRIPTION.. 17

   4.1 COMMUNITY ECONOMIC EMPOWERMENT. 17

   4.2 Awareness rising about HIV, AIDS and STIs prevention. 18

   4.3Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination. 19

   4.4 Most Vulnerable Children (MVC) support. 20

5.0 BUDGET PROJECTION (US$). 21

6.0 SWOT ANALYSIS. 22

   6.1 Organization strength. 22

   6.2 Weaknesses. 23

   6.3 Opportunities. 23

    6.4 Threats. 23

7.0 RESOURCE MAPPING.. 23

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE. 24

9.0 PROGRAMME MONITORING.. 26

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF ABBREVIATIONS

AIDS                             Acquired Immune Deficiency Syndrome

ART                              Antiretroviral Therapy

ARV                             Antiretroviral drugs

CTC                              Care and Treatment Centre

DHS                             Demographic Health Survey

FDI                               Foreign Direct Investment

FYDP                            Five Years Development Plan

GDP                             Gross Domestic Productivity

GBV                             Gender Based Violence

HAPCA                         HIV Prevention and Control Act

HBC                             Home-Based Care

HDI                              Human Development Index

HIV                              Human Immunodeficiency Virus

HMIS                           Health Management Information System

IGA                              Income Generating Activity

ICDP                            International Child Development Programme

KIWAKKUKI                  Kikundi cha Wanawake Kilimanjaro Kupambana Na Ukimwi

MDGs                          Millennium Development Goals

MVC                            Most Vulnerable Children

MW                             Megawatts

MKUKUTA                   Mkakati wa Kukuza Uchumi na Kupambana na Umasikini Tanzania

M & E                          Monitoring and Evaluation

MSM                           Men who have Sex with Men

MoHSW                       Ministry of Health and Social Welfare

MTCT                          Mother to Child Transmission

NGO                            Non- Governmental Organization

PHLA                            People Living with HIV and AIDS

PMTCT                                    Prevention of Mother to Child Transmission

PWID                           People Who Inject Drugs

SAM                             Social Accountability Monitoring

RACC                           Regional AIDS Control Coordinator

STI                               Sexually Transmitted Infection

SDGs                            Sustainable Development Goals

TACAIDS                      Tanzania Commission for AIDS

TDV                             Tanzania Development Vision 2025

THIS                             Tanzania HIV Indicator Survey

THMIS                         Tanzania HIV and Malaria Indicator Survey

VCT                              Voluntary Counseling and Testing

VAC                             Violence Against Children

VICOBA                       Village Community Bank

VSLA                            Village Saving and Credit Association

UNICEF                        United Nations Children Education Fund

UNAIDS                        Joint United Nations Programme on AIDS

UNDP                           United Nations Development Programme

 

EXECUTIVE SUMMARY

KIWAKKUKI is a nongovernmental organization founded in 1990 by women group to fight against HIV and AIDS in Kilimanjaro. The organization is based in Moshi Municipality and operates in all seven districts of Kilimanjaro region.

The current strategic plan will expire on December 2016. This has prompted us to design a new plan for the next five years. The new Five Years Strategic Plan has taken into consideration the achievements and challenges that we went through while implementing the previous 2012-2016 strategic plan. Thorough analysis of the success and challenges enabled the stakeholders to come up with priorities for the coming five years 2017-2021. The strategy is also aligned with the broader international and national development plans and policies which include; Sustainable Development Goals, Tanzania Vision 2025, National Five Years Development Plan II, and HIV and AIDS Policy of 2012.

Despite the fact HIV prevalence has fallen in Tanzania over the past decade, tens of thousands of people become infected with HIV every year. Stigma against HIV positive people and human resource shortages are among the obstacles to ensuring a sustained reduction of new HIV infections and to providing care and treatment to those already infected. However, Kilimanjaro region where KIWAKKUKI runs her programs is among the regions where HIV prevalence has increased from the average of 1.9% of 2008 to 3.8% in 2012. It is the responsibility of every one of us, individually and collectively, to prevent new HIV infections. We therefore appeal to the country as whole to ensure that the next generation is free from HIV, through prevention measures, regular testing and treatment in the case of infection to eliminate mother to child transmission. Sustaining this effort will also require investing in the skills, systems, and infrastructure until Tanzania is able to realize an AIDS free generation.

Although Tanzania has long been a popular country with foreign donors, in a strained financial climate, the current levels of funding are by no means guaranteed. Increased funding for HIV and AIDS from the Tanzanian government and commitment to prevention efforts will be necessary if Tanzania is to overcome the debilitating effects of HIV epidemic on its economy and the society.

Due to reduced donor funding on various developmental plans including KIWAKKUKI’s HIV and AIDS interventions, our stakeholders have taken this into consideration and proposed to focus more on economic empowerment to the communities for sustainable HIV and AIDS services. Thus, in the coming five years KIWAKKUKI will target the projects that will enhance economic capacity of the beneficiaries. However, whenever service delivery projects are secured will also be accepted but the mode of service delivery to beneficiaries will be modified for sustainability interests and approaches.

For the coming five years KIWAKKUKI will run a programme with four components namely: Community Economic Empowerment; Awareness rising about HIV and AIDS, and STIs prevention; Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination; and support for Most Vulnerable Children (MVC). The main approach that is going to be used is to empower the beneficiaries with knowledge, skills, and information so that actively they take roles and responsibilities towards securing economic power for improved livelihoods. The budget estimated for the organization to be able to carry out the planned activities for five years is $2,315,000 which is equivalent to TZS …………………..

KIWAKKUKI is currently facing some challenges including shortage of financial and human resources. However, as we begin implementing this plan we are going to work hard to ensure the challenges are minimized and our passion to fight HIV and AIDS is realized. Individual and collective efforts are required to fulfill our goal.

……………………………

Dr. Adela Materu

Executive Coordinator

KIWAKKUKI

1.0 INTRODUCTION

KIWAKKUKI is a Kiswahili acronym (Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI which means Women Group Against AIDS in Kilimanjaro region. It was founded in 1990 and in 1995 was registered as an NGO with the goal of enhancing women’s access to information on HIV and AIDS and empowering them with skills essential for fighting HIV and AIDS in their communities. In those years the pandemic was a scaring threat for people, with high prevalence rate accompanied by high levels of stigma, various misconceptions and beliefs about the disease. On the other hand the communities had limited access to information, and some cultural norms posed challenges to fight AIDS. Thus, the organized group of women (KIWAKKUKI) was formed to help the communities deal with such challenges.

 

1.1 VISION, MISSION, CORE PURPOSE AND GOAL

KIWAKKUKI’s vision is having a responsible community taking appropriate measures to fight against HIV and AIDS, poverty and contributing efforts to mitigate AIDS impact.

KIWAKKUKI’s mission is to integrate holistic programs that focus on HIV and AIDS prevention and increased community empowerment to support those infected and affected by HIV and AIDS with conscious gender mainstreaming

KIWAKKUKI’s Core Purpose is to mobilize women and the wider community by empowering them with knowledge and skills towards sustainable livelihoods particularly HIV and AIDS affected households

KIWAKKUKI’s Goal is to contribute towards sustainable community empowerment to respond and fight against the causes and effects of HIV and AIDS in Kilimanjaro region.

 

1.2 KIWAKKUKI’s CORE VALUES

KIWAKKUKI members and staff are linked, to live and cherish the following values;

5. God fearing
5. Voluntarism
5. Integrity and Honest
5. Love and Care
5. Unity
5. Respect
5. Sharing and Cooperation
5. Teamwork
5. Transparency
5. Accountability
5. Recognition of talents

 

1.3 PROGRAMME STRATEGY

KIWAKKUKI is always up-to-date with relevant knowledge regarding HIV and AIDS information locally, nationally and internationally. Furthermore, we are constantly in a search for current knowledge and information regarding international, regional and national plans, policies, Acts, regulations and laws that have a bearing on HIV and AIDS so as to align our programs and activities.  Then through program activities we ensure that the communities that we serve receive correct information and use it accordingly, the main aim being reducing HIV infections, improved home based care, improved support to most vulnerable children (MVC) and improved community livelihoods both socially and economically.

This strategic plan is expected to guide the organization operations for the next five years. The decision to develop this plan was prompted by several reasons, one of which is the Tanzania government has formulated a new National Five Years Development Plan 2016/17 – 2020/21; the second reason is the reviewed MDGs performance which led to the formulation of Sustainable Development Goals; the third is the reviewed national HIV and AIDS policy.  The fourth are the reports that are regularly and annually produced by different national and international organizations whose recommendations are very useful for us to adjust our work towards achieving KIWAKKUKI’s goal.

THEORY OF CHANGE

 

KIWAKKUKI  Empowerment base with Knowledge, skills and information

Target beneficiaries PHLA KIWAKKUKI groups Youth VSLA/VICOBA groups MVC Wider Community

Expected Change Improved Socio-economic wellbeing Enhanced food security Enhanced MVC social services Improved HBC to PHLA Reduced risky behaviors, traditions and practices Reduced stigma to PHLA

 

1.4 PROGRAM APPROACH

The broader aim of our mission, vision and the overall goal is to build knowledge competent communities concerning HIV and AIDS prevention and the appropriate measures to mitigate the impact of AIDS. In the coming five years KIWAKKUKI intends to build economic power of communities by encouraging KIWAKKUKI grass root working groups to incorporate income generating activities (IGAs) in their current and future plans. As they gain economic power they will also be encouraged to establish formal Village Saving and Loan Associations (VSLA) which will enable them to have better access to credit facilities.  In the past two years KIWAKKUKI has started an agricultural project in Moshi rural which involves new technologies in food crops farming and livestock keeping. The groups which are involved in the project get nutritious foods for their families especially AIDS affected households. The surplus farm production is sold for income for carrying out home based care to AIDS patients, and support MVC with basic needs particularly education.

Thus the major approaches that are going to be used by KIWAKKUKI are the following;

 

1. Building the capacity of the communities with correct information on HIV and AIDS and   the current disease trends locally and globally. 
2. Facilitating and securing good empowerment interventions for improved livelihoods in the face of the socio-economic challenges facing the communities.
3. Building the capacity of the communities to develop approaches that will mitigate the impact of the disease. 
4. Empowerment of women and youth on awareness of human rights so that they can realize and claim their rights, as well as be part of decision making

 

1.5 GEOGRAPHICAL AREA OF FOCUS

Program interventions and VCT, will continue in Kilimanjaro region covering all the seven districts. According to this strategic plan about 70% of time and interventions will focus on   promoting community economic empowerment. The rest of the time will be spent on other programs particularly MVC support and home based care coordination.  However, education and advocacy materials like posters, brochures, CDs and some publications are made available to interested partners and people beyond the focused geographical area.

 

2.0 SITUATION ANALYSIS

Our situation analysis begins with the key sectors that are closely related with HIV and AIDS.

 

2.1 SOCIO-ECONOMIC ANALYSIS

2.1.1 GLOBAL CONTEXT

 

MDGs progress report on poverty eradication indicates that the target of reducing extreme poverty rates was met five years ahead of the 2015 deadline. The global poverty rate at $1.25 a day fell in 2010to less than half the 1990 rate. 700 million fewer people lived in conditions of extreme poverty in 2010 than in 1990. However, at the global level 1.2 billion people are still living in extreme poverty (UNDP, 2014) This imply that, majority of people living in extreme poverty are found in developing countries and the conditions are worse to the poor who are HIV infected in poverty stricken areas particularly rural localities in Tanzania. Poverty has also led to HIV infection particularly women and girls who exchange sex with money to support their lives, children or families.

Globally, there are plans that were put forth for poverty reduction and improving people’s socio-economic well being. Sustainable Development goals (SDGs) particularly goal 1 and 2 aim at ending poverty in all its forms everywhere and hunger while goal 3 aims at ensuring healthy lives and promote wellbeing for all at all levels. Extreme poverty has been cut by more than half since 1990. However, more than 1 in 5 people live on less than $1.25 a day. Poverty is more than lack of income or resources; it includes lack of basic services, such as education, health, hunger, social discrimination and exclusion, human rights lack of participation in decision making. Gender inequality plays a large role in the perpetuation of poverty and its risks; it leads to potentially life-threatening risks from early pregnancy, and often lost hopes for an education and a better income. Age groups are affected differently when struck with poverty; its most devastating effects are on children, to whom it poses a life threat. It affects their education, health, nutrition and security. It also negatively affects the spiritual, emotional, and social development of children.

The aim of SDG goal 2 is to End hunger, achieve food security and improved nutrition and promote sustainable agriculture. Globally, about 842 million people (1 in 9 people) are undernourished; more than 99 million children under five age group are undernourished and underweight. The vast majority of these people live in developing countries. Agriculture is the single largest employer in the world, providing livelihoods for 40 per cent of today’s global population. It is the largest source of income and jobs for poor rural households. Women comprise on average 43% of the agricultural labor force in developing countries, and over 50% in parts of Asia and Africa, yet they only own 20% of the land. Poor nutrition causes nearly half (45 per cent) of deaths in children under five – 3.1 million children each year.

 

Goal 3 aims at Good Health and Well-being - Ensure healthy lives and promote well-being for all at all ages. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality, and major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV and AIDS.

             MDGs progress report indicates that new HIV infections continue to decline in most regions. The number of new infections per 100 adults (aged 15-49) decline by 44% between 2001 and 2012. An estimated 2.3 million cases of people of all ages are newly infected and 1.6 million people died from AIDS-related causes. Comprehensive knowledge of HIV transmission remains low among young people, along with condom use. On the other hand, about 210,000 children died of AIDS –related causes in 2012 compared to 320,000 in 2005

 

 2.1.2 ECONOMIC SITUATION IN TANZANIA

Tanzania is among the poorest countries in the world with a per capita Gross National Income of US $ 550. Tanzania is ranked at position 152 out of 187 countries on the Human Development Index (UNDP 2011). The economy depends heavily on agriculture, which accounts for more than one-quarter of GDP, provides 85% of exports, and employs about 80% of the work force. Macro-economic performance in Tanzania has been resilient to shocks with an estimated real GDP growth of 6.4% in 2012. Furthermore, GDP is projected to remain buoyant, increasing to 6.9% in 2013 and projected to 7% in 2014, creating opportunities for financing key social sectors, such as health, including HIV, TB, and malaria programmes (Tanzania Country Notes, 2013).Despite the impressive GDP growth, poverty remains persistent and has been at the centre of the development debate. The gap between the rich and the poor has continuously widen to date. It was against this background that the new national development agenda, MKUKUTA II, was designed with a greater focus on making growth more broad based and pro-poor. Under the food and nutrition security anti-poverty strategy, the government rolled out the “Kilimo Kwanza” or “Agriculture First” initiative, designed to reduce poverty through increased productivity in agriculture, which has been an integral part of the overall development strategy. This strategy was targeted to reduce poverty from the 2012/2013 level of 34% to 24% by 2015 – still higher than the MDG target of 19.3%. Priorities include clean water provision and irrigation, financial and insurance services, value addition, trade and exports development. Unemployment also remains a concern with nearly 2.4 million people unemployed as of 2011. Most of the unemployed are young and urban-based, representing 10.7% of the population. A lack of sufficient employment opportunities for young women, in particular, exposes them to risky behavior with incumbent dangers of HIV infection. Recognizing the challenges posed by Tanzania’s economic climate, and the social and economic vulnerability of a significant part of the national population, the government of Tanzania has put in place Vision 2025 (TDV 2025) plan, the second National Five Years Development plan (FYDP II 2016/17-2020/21), and has ratified the Sustainable Development Goals (2015-2030). 

 

2.1.2.1 The Tanzania Vision 2025

The utmost goal of TDV 2025 is that, by 2025 Tanzanians will be living in improved conditions and by then will be a substantially developed one with a high quality livelihood. This plan also expects to eradicate abject poverty. In other words, it is envisioned that Tanzanians will have graduated from a least developed country to a middle income country by the year 2025 with a high level of human development. The economy will have been transformed from a low productivity agricultural economy to a semi-industrialized one led by modernized and highly productive agricultural activities which are effectively integrated and buttressed by supportive industrial and service activities in the rural and urban areas. A solid foundation for a competitive and dynamic economy with high productivity will have been laid. Consistent with this vision, Tanzania of 2025 should be a nation imbued with five main attributes; high quality livelihood; peace, stability and unity; good governance; a well educated and learning society; and a competitive economy capable of producing sustainable growth and shared benefits.

2.1.2.2 National Five Years Development Plan 2016/17-2020/21 (FYDP II)

In line with the TDV 2025, the Five Years Development Plan II theme is “Nurturing Industrialization for Economic Transformation and Human Development”. Plan is projected to raise annual real GDP growth to 10 percent by 2021 (from 7.0 percent in 2015), per capita income to US$ 1,500 (from US$ 1,043in 2014) and reduction of the poverty rate to 16.7 percent from 28.2 percent recorded in 2011/12. The Plan also envisages raising Foreign Direct Investment (FDI) flows from US$ 2.14 billion in 2014 to over US$ 9.0 billion by 2021; increase electricity generation from 1,501MW in 2015 to 4,915MW by 2020 and improving electricity connections to 60 percent of the population, up from 36 percent in 2015. On average, manufacturing sector will grow by over 10 percent per annum with its share in total exports increasing from 24 percent in 2014/15 to 30 percent in 2020. An under- five mortality rate reduction from 81 deaths per 1000 live births recorded in 2014/15 to around 45 deaths per 1000 live births; maternal mortality reduced from 432 per 100,000 in 2014/15 to below 250 deaths by 2020/21. Also, access to clean and safe water in rural areas improved from 72 percent recorded during 2014/15 to 85 percent by 2020/21 and in urban areas to more than 90 percent. As a result, there will be improvement in national Human Development Index (HDI) from the value of 0.52 (2014) to 0.57 by 2021. However, fiscal performance continued to exhibit “stresses” due to faster rates of expenditure compared to domestic resource mobilization, despite revenue collection generally improving. Revenue to GDP ratio increased modestly from 11.6 percent during 2010/11 to 12.4 percent during 2014/15. The ratio was, however, well below FYDP I target of 14.4 percent.

Just as it was for the Arusha Declaration, Good Governance is essential for successful realization of expected economy level. There must be integrity and strong accountability systems for fiscal control. “For Tanzania to achieve development we need Good Politics, Good Leadership, Land and People” J.K. Nyerere. Economic growth and stability will provide relief to PLHA and to AIDS affected households.

 

 HIV AND AIDS SITUATION IN TANZANIA

 

 

 

 

 

 

 

 

 

 

Since the first three AIDS cases were reported in Tanzania in 1983, infections have spread rapidly leading to a generalized epidemic, with some areas more concentrated with the epidemic, and a devastating impact on social and economic development. The predominant mode of HIV transmission is heterosexual contact between HIV-infected and uninfected individuals, with sexual transmission accounting for approximately 80% of infections. Mothers to newborns transmission account for about 18% of infections and medical transmission through unsafe blood for approximately 1.8%. TDHS (2010) reported that Mother to Child Transmission (MTCT) is the second most common cause of HIV transmission within the Country. There are two notable gaps; these include low levels of attendance of ante-natal clinics (out of the 4 recommended visits) and lack of full integration of Prevention of Mother to Child Transmission (PMTCT) services in Maternal and Child Health services. Approximately, 24% of HIV positive pregnant women that attended antenatal clinics were not reached by PMTCT services and 43% of HIV exposed infants who needed ARVs to prevent MTCT did not receive it due to limited access to treatment, stock outs of commodities, or attrition from the program (TDHS, 2011). By the end of 2012, Tanzania had an estimated 1.5 million people living with HIV and approximately 86,000 new HIV infections (Spectrum, 2013). This can be attributed in part to widespread risky behaviors, inconsistent and incorrect condom use, inadequate numbers of eligible individuals on antiretroviral therapy, increased gender-based vulnerability, and some risky, traditional cultural practices.

2.2.1 HIV Prevalence in the Country

Although HIV prevalence in Mainland Tanzania has declined from 7.0% to 5.3% during the period from 2003/04 to 2011/12 among all adults aged 15-49, and from 6.3% to 3.9% among men in the same age group, there has not been a statistically significant decrease among women. For both men and women, HIV prevalence increases with age generally and women invariably have higher prevalence rates in all age groups compared to men. However, prevalence among young women aged 25 – 29 is 3 times higher compared to young men in the same age group. The incidence of HIV infection in the age group 15-49 years peaked at 1.34% in 1992, declined rapidly down to 0.64% in 2000, and steadily declined further to 0.32% in 2012. Similarly, HIV prevalence increased to a peak of 8.4% in 1996, declined to 5.7% in 2008, and declined further to 5.3% by 2012. However, a wide variation exists between regions and within regions across social and age groups (THIS 2004, THMIS 2012).

2.2.2 HIV Prevalence by Regions in Tanzania

Regional variation throughout Mainland Tanzania ranges from 1.5% in Manyara to 14.8% in Njombe. While there was an overall decline in HIV prevalence in Tanzania in the period 2008 and 2012, there are some regions in which the prevalence rates rose up. The regions that witnessed an increase in prevalence levels are 8 and these include; Ruvuma, Rukwa, Kagera, Mtwara, Kilimanjaro, Kigoma, Singida and Arusha. The increase in HIV prevalence in these regions could be a factor of successful care and treatment programmes or an actual rise in HIV infection within the regions or both. Other possible factors, such as HIV test refusal rates, should also be explored to explain the change in prevalence over this short time period. (THMIS 2012)

 

Table 1, HIV Prevalence in Tanzania Regions

S/No	REGION	PREVALENCE RATE (%)		S/No	PREVALENCE RATE (%)	REGION
1.	Arusha	3.2		13	Iringa	9.1
2.	Kilimanjaro	3.8		14	Mbeya	9.0
3.	Manyara	1.5		15	Rukwa	6.2
4.	Mara	4.5		16	Kagera	4.8
5.	Dodoma	2.9		17	Mwanza	4.2
6.	Singida	3.3		18	Geita	4.7
7.	Pwani	5.9		19	Tabora	5.1
8.	Dar es salaam	6.9		20	Shinyanga	7.4
9.	Lindi	2.9		21	Katavi	5.9
10.	Mtwara	4.1		22	Kigoma	3.4
11.	Ruvuma	7.0		23	Morogoro	2.9
12.	Njombe	14.8		24	Tanga	2.4
				25	Simiyu	3.6

 

 

 

 

 

Source: THMIS, 2011/12

 

 

HIV Prevalence rate for Tanzania Regions (THMIS, 2011/12)

 

 

2.2.3 Orphans and Most Vulnerable Children

According to a 2007 study, approximately one million children in Tanzania had been orphaned,

12% of the vulnerable children had been separated from their siblings, and up to 240,000 children below the age of 15 were living with HIV and AIDS (Social Protection in Tanzania, 2007). More recently, orphaned children were estimated at 11.2% in urban areas and 9.2% in rural areas in Mainland Tanzania. Regarding food scarcity, 9% of urban and 17% of rural households reported often having problems satisfying their food needs. Access to improved sources of drinking water is also unavailable for more than 11.4% of urban dwellers and 53.2% of rural dwellers. While almost all youths aged 15-24 years have heard about HIV and AIDS, less than half have enough knowledge to protect themselves against infection.

 

2.2.4 Early Sexual Practices

Early sexual debut and adolescent sexual networking without protection exposes young people, especially girls, to HIV and STI infection. In Mainland Tanzania, 9.7% of young women and 10.2% of young men aged 15-24 had sexual intercourse before age 15, while 51.6% of young women and 43.9% of young men aged 18-24 had sexual intercourse before 18 (THMIS 2011-2012). Out of those who have never married (15-24), only 57.9% of women and 59% of men used condom during their last sexual intercourse (THMIS2011/12). According to the Violence Against Children survey (VAC) results, 4% of Tanzanian girls received money or goods in exchange for sex at least once in their lifetime. Of the girls, 82% who reported receiving money or goods for sex also reported childhood sexual violence; 90% who received money or goods for sex reported childhood physical violence by a relative, and 50% who received money or goods for sex reported childhood emotional violence (Violence Against Children Report, 2011). A study conducted in Mwanza region on cross-generational and transactional sexual relations revealed that the main reason for having sexual relationship was to receive presents or money. The study involved male and female respondents aged 12 years and above from primary 52% and secondary schools 10% (Luke & Kurtz, 2002).

 

2.2.4 Gender Based Violence (GBV)

Gender inequality and gender based violence have been cited in various reports to contribute to HIV infection. Unequal power relations between men and women limits decision making for women and girls in negotiating for safe sex and condom use, and increases the extent of violation of women’s and girls’ rights. The most common forms of GBV are physical, sexual, psychological, and economic, including financial deprivation and exploitation. The Tanzania Demographic and Health Survey (2010) reveals that 39% of women in the age 15-49 years have experienced physical violence at least once in their lives, with 33% of such violence occurring within the 12 months preceding the survey. There are notable zonal variations in GBV ranging from 61% of women in the Central zone to 22% in the Northern zone having experienced GBV, irrespective of woman’s education or economic status (DHS, 2010). Overall 10% of women in the age 15-49 years had a forced first sexual intercourse (DHS, 2010). Results from the National Survey on “Violence against Children” in 2012 by UNICEF in Tanzania show that girls are particularly vulnerable to sexual violence. Nearly one out of three females and one out of seven males have experienced some form of sexual violence prior to the age of eighteen. Few children disclose, fewer children seek services, and even fewer receive them when they are brave enough to report. Overall, the National Survey showed that about 48% of girls and 68% of boys had never disclosed the sexual violence that they had experienced in childhood prior to the survey. Only about 20% of girls and 10% of boys who had experienced sexual violence sought services after the experience, but not all respondents who sought services received them. Approximately 13.0% of females and 3.7% of males who experienced sexual violence reported that they actually received services after seeking them. Girls who received services said they received counseling, clinic, or hospital services, or help from an elder or community leader. Tanzanian children experiencing sexual abuse and violence are more likely to be exposed to sexual exploitation, including transactional sex, less likely to have a HIV test or use condoms, and more likely to have multiple sexual partners as they grow older (Violence Against Children Report, 2011). The result from “Child Sex Abuse “in 2012 revealed that young children are not safe. The problem of child and sexual abuse in the society is growing. The need for concerted public education on the nature of this violence and its consequences is imperative.

Women and girls are more vulnerable to HIV infection than their male counterparts in Tanzania due to biological, socio-cultural and economic factors. According to UNAIDS, up to 80% of HIV sero-positive women in long term relationship acquired the virus from their partners. This might resulted from inequalities manifested by gender based violence, such as rape, sexual assault and battery. Other factors such as multiple sexual partnership, polygamy, violence, alcohol, and substance abuse also play an exacerbating role in reinforcing gender inequalities.

 

 

2.2.5 Risky Traditional Practices

Although Tanzania has positive traditional practices which help to mitigate the impact of HIV and AIDS, such as strong extended family support structures and social sanctions, there are also some risky traditional practices that hinder the effectiveness of the national response. These include wife inheritance by a male relative of the deceased husband, female genital mutilation, early or child marriages, and limited property rights for widows. HIV Prevalence among widows aged 15 and 49 years is estimated at 24.7%. A comparison of TDHS 2004 data and that of the TDHS 2010 shows that the proportion of married young women aged 15-19 years fell by 20% while, pregnancy and childbirth among young women of this age dropped by more than 12%. Nevertheless, despite the gains, one in six young women aged 15-19 is married. In addition, young women and girls face a significantly higher risk of death from pregnancy and delivery-related complications, which is further compounded by the high frequency of births which occur at home without skilled attendants. Such situations are risky for new HIV infections.

 

 

2.2.6 HIV Prevalence among Key Populations

Key Populations, in this context refer to populations at high risk for exposure to HIV or for transmitting HIV. For our case these key populations include all PLHA, as well as discordant couples, sex workers and their clients, men who have sex with men, women who have anal sex, and people who inject drugs. Other vulnerable groups who may also be among those at higher risk for HIV exposure or transmission include women and girls, youth, people in conflict and post-conflict situations, refugees and internally displaced persons, migrant laborers, and people working in mining and fishing industry and their surrounding communities. Recent studies conducted in various regions in Tanzania showed varying degrees of HIV prevalence among key population groups, with the prevalence of MSM, FSW, and PWID all are significantly above the national average (Country Progress Reporting, Part A: Tanzania Mainland, 2012). This variation is alarming and therefore calls for effective strategic HIV prevention interventions. In the Tanzanian context, other population groups that deserve special consideration in HIV programming include prisoners, long-distance track drivers, disabled (in all forms), fishing communities, and people in mining, women and children.

 

2.2.6.1 Sex Workers

A sex worker includes anyone who exchanges sexual services for money or goods, whether regularly as a full-time activity, or temporarily as a short-term measure. Sex workers include both men and women, young and old. Prevention, care, treatment, and support programmes for sex workers and their clients are being implemented in Tanzania, but need significant expansion and support. In a study conducted with 537 female sex workers in Dar es Salaam, one-third of respondents were reported to be divorced or separated, while over half were never married. In the study, 69.7% reported that sex work constituted their main source of income; 31.4% tested HIV positive; 69.3% reported always using a condom with regular clients though only 31.6% reported always using a condom with their steady partner in the previous 30 days. A high prevalence of 51.7% sexual and physical abuse were reported as among the issues associated with sex work. Stigma and discrimination against sex workers remains high, posing a significant challenge to outreach and delivery of friendly health services.

 

2.2.6.2 Men Who Have Sex with Men (MSM)

In a research study of 271 MSM with a mean age of 26 years, 41% were reported to have tested

HIV positive; 63.1% had also been married or cohabited with a woman at least once in their life. Those reporting no condom use with their last casual sex partner was 43.2%, while 49.1% used condoms with their last regular sex partner. About 30% of all respondents were reported to be engaged in commercial sex work (Condom Use in MSM, 2013). Stigma and discrimination against MSM remains high, also posing a significant challenge to outreach and delivery of friendly health services. Given the criminalization of consensual adult homosexual intercourse, any response requires significant cooperation from all key stakeholders to ensure that MSM are reached with HIV and AIDS services.

2.2.6.3 People Who Inject Drugs (PWID)

A small sample survey of 430 respondents undertaken in Temeke Municipality, Dar es Salaam region revealed an HIV prevalence of 26% (34.8 % among Injecting Drug Users and 11.7 % Non Injecting Drug Users). Among the newly diagnosed Injecting Drug Users, women had higher HIV prevalence and there was also a high proportion of Hepatitis C co-infection. Gender also played a significant role in the risk profile of injecting and non-injecting drug using participants. Males and females did not report significantly different injecting risk behaviours, but females were more likely to have sold sex and have a higher number of sex partners thus increasing their vulnerability to HIV infection.  Among People Who Inject Drugs (PWID) with non-injecting partners, 89% of males and 75% of females reported inconsistent condom use with their regular partner (Risk Practices among PWID in Temeke, 2011). Stigma and discrimination against PWID remains high, posing a signify cant challenge to outreach and delivery of friendly health services. This highlights the need to prioritize the recommended package of comprehensive intervention for HIV prevention and care among PWID. Furthermore, the importance of PWID not sharing needles should remain a key component of the comprehensive harm reduction package in Tanzania, together with education about the risks of sexual transmission and the need for protection through consistent and correct use of condoms.

 

2.2.7 Mobility and Migration

Migration is common in Tanzania. In particular, the expansion of the mining sector has led to greater urbanization and mobility between rural and urban areas. This means that young and sexually active men come into close contact with ‘high risk sexual networks’ made up of sex workers, women at truck stops and miners: all of whom have high levels of HIV prevalence. Long-distance truck drivers, agricultural plantation workers and fisherman working along coastal trading towns are also at an increased risk of HIV. It is not only mobile men who are at increased risk of HIV infection. Women who travel away from home five or more times in a year have been found to be twice more likely to be infected with HIV than women who do not travel (Avert  report, 2016).

Mobile population groups such as seasonal labourers in plantations, road construction sites, mobile markets, truck drivers, fishermen and miners are vulnerable to HIV infection because they often practice higher risk sex with non-marital or co-habitating partners. Studies have found samples of long-distance truck drivers with high HIV prevalence. These results are consistent with the findings in the THMIS 2007/08 and 2011/12, which found that individuals who travel away from home frequently are more likely to be HIV positive than those who do not. Among women in the THMIS 2011/12, those who had slept away from home five or more times in the past 12 months were twice as likely to be HIV positive (11%) as those who did not travel away from home (5%).

2.2.8 Stigma and Discrimination against PLHA

Stigma is highly prevalent in Tanzania at various levels and settings, as data from the 2012 Stigma Index indicates that here is breaching of confidentiality through health delivery systems. While 15% of the PLHA felt that health care providers did not keep their information confidential, another 5.4% had their HIV status disclosed without their consent. Further, the study revealed discrimination by health care providers. For example, 13% of PLHA were told not have children, 44% were denied access to reproductive health information, 14% were coerced in accepting particular infant feeding options, and about 9% were coerced in their use of family planning methods. Few (19%) eligible pregnant women living with HIV received ART for PMTCT. Others were coerced into sterilization and pregnancy termination by health service providers due to their HIV positive status (People Living with HIV Stigma Index, 2012). The study also reveals high levels of self-stigma. Most PLHA reported a sense of shame (44%), self-blame (63.4%), feelings of worthlessness (85%), feelings that PLHA deserves to be punished (10%), and self-isolation because of their HIV positive status. Self-Stigma drives many PLHA who are sexually active not to bear children (38%) or get married (16%) because of their HIV positive status. PLHA also remove themselves from places where they would be potentially stigmatized, including work places, for fear of gossip (45%), being verbally insulted, harassed, and threatened (30%). Furthermore, the study showed that fewer PLHA know where to seek assistance once their human rights are violated. A majority of PLHA are not aware of their rights, the national HIV and AIDS Policy, legal information, and global commitments on HIV and AIDS (AIDS-NMSF, 2013). In addition, community acceptance towards PLHA is very low. As the stigma index reports, 25% of women and 40% of men in Tanzania do accept interacting with PLHA. The situation is critical in rural areas where only 21% of women and 35% of men have positive attitudes toward PLHA, as compared to 36% of women and 54% of men in the urban areas.

 

2.2.9 Enrolment in Care and Treatment Centers

By June 2012, one-third (34%) of PLHA had not been enrolled for care: only 54% of all children and adults enrolled in care and treatment were ever enrolled on ARVs as of March 2012 and these constituted 41% of the estimated total of PLHA. Thus, both the overall target of enrolling 90% of PLHA on ART and 18% of all enrolled PLHA on ART as children has not been met. There is significantly low (35%) enrolment of males in care and treatment and have shown to report late for treatment (MoHSW, 2011). Nevertheless, the number of people estimated to be infected with HIV has held steady because of ongoing new infections, population growth, and the availability of life-sustaining treatment for those infected. The cumulative number of clients on antiretroviral treatment (ART) as of June 2012 was 626,444, surpassing the “3 by 5” target of 440,000 by 2011.

 

2.2.10 HIV Policy and Legal Environment

Tanzania developed its first National Policy for HIV and AIDS in 2001, subsequently implemented through two strategic frameworks which were completed in 2012. In 2008, Tanzania enacted the HIV Prevention and Control Act (HAPCA). Part VIII of the Act provides for PLHA rights and obligations. Section 33(1) (a) and (b) provide for rights to access quality medical services and treatment for opportunistic diseases. Section 33(2) (a) and (b) provide for obligation of protection to others from re-introducing infections into the population. According to Section 28-32 of this law, discrimination is a punishable offence. In 2010, regulations for HIV Counseling and Testing, use of ARVs, and disclosure were developed and published. The regulations provide for protection against forced testing and mandatory disclosure. The National HIV and AIDS Policy (2012) further emphasize the importance of respect for the human rights of PLHA, as stipulated in the Constitution of the United Republic of Tanzania. Specifically the policy commits to enhancing measures that ensure all civil, legal and human rights for men, women, boys and girls living with HIV and AIDS, in accordance with the URT Constitution and other International Conventions. Against a backdrop of protective policies and laws, the Law of Marriage Act (1971), which provides for early marriage (15 years for females by statute, or 14 years with consideration of “special circumstances”) thus increasing the risk of HIV infection to young women and girls, and other similar laws need to be urgently revised and enforced.

 

3.0 STRATEGIC PRIORITIES

This strategic plan 2017-2021 has been developed through a consensus which involved extensive consultation with various stakeholders using meetings and individual consultations. Consultations involved some board members, organization leadership, staff, PLHA, district coordinators and some regional health officers including Regional AIDS Control Coordinator (RACC). Being a participatory process we believe that this plan is people-driven and is going to be implemented using a people-centered approach.

 

                              Stakeholders during priority setting session

 

Needs Assessment consultations came up with the several strategic issues that KIWAKKUKI should focus on for the next five years period. These issues were clearly scrutinized and prioritized accordingly. They include;

1. Voluntary Counseling and Testing
2. Promoting agriculture and livestock initiatives using up to date technologies
3. Continue searching for internal and external sources of funds
4. Encourage KIWAKKUKI grass root working groups to incorporate income generating activities in their programs
5. Enhance publicity of KIWAKKUKI organization through organized events, KIWAKKUKI website and other media.
6. Networking with likeminded organizations
7. Encouraging the communities to take the responsibility of supporting the vulnerable groups
8. Sensitize the community on child rights, proper parenting and development
9. Impart health education to the community on Sexual and Reproductive Rights, and gender.
10. Design different ways/approaches for fundraising
11. Continual support the community on memory work activities
12. Encourage KIWAKKUKI members to keep up the voluntarism spirit
13. Encourage youth to organize themselves into KIWAKKUKI youth groups
14. Enhance “school without walls” HIV and AIDS education approach
15. Coordinate Home Based Care (HBC) community activities
16. Develop and conduct youth programs for HIV prevention outcomes.

The above strategic issues led to the formulation of four program components whereby respective activities for the coming five years were clustered accordingly.

The four program components are;

5. Community Economic Empowerment
5. Awareness rising about HIV, AIDS and STIs prevention
5. Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination
5. Most Vulnerable Children (MVC) support

 

4.0 PROGRAMME DESCRIPTION

4.1 COMMUNITY ECONOMIC EMPOWERMENT

SDG goal 1.1 target is by 2030, to eradicate poverty for all people everywhere, currently measured as people living on less than $1.25 a day. On the other hand, goal 1.5 target is, by 2030 to build the resilience of the poor and those in vulnerable situations, and reduce their exposure to vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters. In line with these targets, KIWAKKUKI objective 1 intends to build the capacity of the communities particularly HIV and AIDS affected households in sustainable agriculture and animal keeping activities using up to date technologies which are very considerate on climate changes and environment protection. On the other hand the food crops and animal varieties which are sought for such projects those with high nutritional values to keep healthy the PHLA, orphans and their respective families. This is also supported by SDG goal 2 which aims to end hunger, achieve food security, improving nutrition and promoting sustainable agriculture.

Despite the international SDGs targets, the Tanzania Vision 2025 aims at transforming the national economy from low agricultural productivity to a semi industrialized one led by modernized and highly productive agricultural activities. Furthermore, national FYDP II goal is to nurture industrialization for Economic Transformation and Human Development. Thus, KIWAKKUKI has aligned objective 1 with these broader national goals. We expect that, the communities will produce surplus crops and animals which will have read-markets the nation is struggling to put in place industries which will require internal raw materials.

 

Objective 1

Activities

Encourage communities to engage in sustainable income generating activities including microcredit facilities

Resource Mobilization Improve and advertise organization hired assets and services (eg, KIWAKKUKI meeting halls, tailor-made trainings, and VCT services. Promote voluntarism among members Community sensitization about secured projects Establishing community groups Establishment of demonstration plots (for agricultural projects) Conduct trainings for capacity building on projects concerned Projects Monitoring & Evaluation Identify and expand the capacity of super farmers Conducting entrepreneurship trainings to KIWAKKUKI grass root working groups Incorporate  VICOBA/VSLA in community groups Encourage the KIWAKKUKI groups to undertake formal registration Monitoring  the groups’  activities Encouraging youth to join the IGA groups Conducting localized Social Accountability Monitoring (SAM)

 

 

4.2 Awareness rising about HIV, AIDS and STIs prevention

According to HIV and AIDS Policy 2001, the community is the key in curbing the HIV and AIDS epidemic. Thus it calls for the communities to be fully informed about HIV and AIDS and the real life challenges in its prevention and care. In the coming five years KIWAKKUKI will continue to provide HIV and AIDS knowledge and information to the community, support the development of appropriate approaches to reduce HIV infections and care for PLHA, and orphans in their localities. Thus in Objective 2 the following activities will be implemented;

 

Objective 2

Activities

Promote  HIV and AIDS prevention through community awareness raising for behavior change

Daily education on HIV and AIDS to the drop-in people Education session on HIV and AIDS to youth in schools and out-of-schools External HIV and AIDS sessions to other institutions Life skills training to youth Sexual and Reproductive health, and STIs education to youth Networking with like-minded organizations Provide health and gender education to the wider community Encouraging youth to join KIWAKKUKI grass root working groups Provide AIDS education in both formal and non formal gatherings Conducting Social Accountability Monitoring (SAM)

 

 

 Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination

While maintaining confidentiality as required by the policy, KIWAKKUKI will promote early diagnosis of HIV infection through voluntary testing with pre-and-post test counseling. Also the organization will coordinate Home Based Care that will be offered to PHLA within the respective households, by the community grassroots groups.

 

Objective 3

Activities

Provide support to the infected and affected people through VCT and coordinate the associated home based care.

Free same day results for Mobile/ Outreach VCT using the Tanzanian National HIV and AIDS policy guidelines Free same day results at the Office stand alone VCT using the Tanzanian National HIV and AIDS policy guidelines Algorithms for testing. Referrals complementing other available services e.g. CTC services, Orphans support, and PLHA clubs  Coordinate home based care activities External referrals to other specialized centers for further Diagnosis, Investigations. Facilitate and encourage KIWAKKUKI groups to visits and support AIDS patients in their homes Follow up to ensure the groups provide quarterly reports.

 

4.4 Most Vulnerable Children (MVC) support

Poverty and lack of well-developed national and community supporting systems have impeded MVC access to quality care and support services. Studies indicate that community based care programs increase access to important interventions for people living with HIV and those affected by HIV and AIDS. Upon availability of resources, KIWAKKUKI will continue to support MVC and also empower the communities to take care of this group.

 

Objective 4

Activities

Promote community empowerment on child development programs and support to most vulnerable children

School sponsorship include: Primary, Secondary. (Ordinary level and /Advanced levels) and Vocational Skills is done. Students of Institutions of Higher learning not beneficiaries of the program.    Shelter support to the needy  orphaned  child headed families Income Generating Activities (IGA’s) to orphans families caring children less than 8 years through their caregivers. Psychosocial support to parents/caregivers and children as the case may be.   Memory work to facilitate communication between PLHA parents and children on their status, how to write memory book and to have legal arrangements for the future of their children when the need arises. Facilitate and encourage KIWAKKUKI grass root working groups to prepare an action plan for vulnerable groups support Popularizing ICDP knowledge to parents/guardians and the wider community Education to the community about child rights Enhancing community actions on Violence Against Children (VAC) Carrying out Social Accountability Monitoring (SAM)

 

4.5 Organization Capacity Building

The organization prosperity highly depends on availability of committed and competent staff, availability of financial and other resources, friendly working environment as well as enabling policies, rules and regulations. In order to achieve this objective, we have planned to do the following throughout the next five years;

• Continuous fundraising efforts and community contribution
• Staff development through short courses, trainings etc.
• Proper resources management
• Networking

 

5.0 BUDGET PROJECTION (US$)

Expected budget allocation to support program activities for the five years is summarized below:

 

PROGRAM ITEM	2017 Est	2018 Est	2019 Est	2020 Est	2021 Est
Community Economic Empowerment	81,000	112500	174000	156000	171000
Awareness rising about HIV, AIDS and STIs prevention	21600	37500	46400	41600	45600
Voluntary Counseling and Testing (VCT) and (HBC) Coordination	40,500	56250	87000	78000	85500
Most Vulnerable Children (MVC) support	32400	37500	69600	62400	68400
Organization Capacity Building	27000	37500	58000	52000	57000
Organizational Administration	54000	75000	116000	104000	114000
Balance to carry forward	13,500	18750	29000	26000	28500
TOTALS US$	270000	375000	580000	520000	570000
GRAND TOTAL USD	2,315,000

 

6.0 SWOT ANALYSIS

Successful implementation of this five years plan depends on various factors. This necessitates us to evaluate ourselves and position ourselves in a way that we understand and maximize the utilization of our strengths and opportunities, foresee challenges and minimize them accordingly. 

6.1 Organization strength

• Board of trustees who play an oversight and advisory role for the organization.
• Committed and cooperative  organization members
• Committed grass root working groups who understand their roles and responsibilities
• Voluntarism spirit among staff and members of grassroots groups
• Participatory planning which lead to people’s ownership of the interventions
• Committed human resource, financial and accounting policies and regulations
• Well established reporting structure
• Effective collaboration and networking
• Presence of international and national frameworks, Acts, policies and guidelines which guide KIWAKKUKI’s activities
• Good reputation and relationship with government at all levels
• Highly trusted VCT centre

 

 

6.2 Weaknesses

• Dependency on donor funds to support the programs
• Limited funds
• Lack of M&E personnel in the organization
• Inadequate resource mobilization strategies
• Limited  number of program staff
• Communities dependency on KIWAKKUKI for material support especially the HIV and AIDS affected households

 

6.3 Opportunities

• Committed members are ready and willing to volunteer for ongoing support of PLHA
• Government support to our office stand alone VCT center
• Current Government campaigns for people to work hard “Hapa kazi tu”
• Organization has its own premise
• Most of the PLHA who use ART are in good health and energetic.
• Many PLHA are involved in empowerment efforts in the community, for self support
• Volunteers from abroad who come with different skills

 

6.4 Threats

• Diminishing financial resources
• Inability to hire new, competent staff
• Poor facility to reach PLHA directly in their households for HBC monitoring
• Minimal provision for adequate support to community vulnerable groups particularly the MVC.

 

7.0 RESOURCE MAPPING

CATEGORY	AVAILABLE	REQUIREMENT
Human Resources	Currently KIWAKKUKI has 12 staff and 5 volunteers at our main office.	Upon availability of funds KIWAKKUKI will hire 10 more staff for the main office and 5 staff for each district in 7 districts that KIWAKKUKI works with. Main Office requires: -2 VCT new staff, -1 staff HIV education program -2 staff for MVC program -2 staff for CEE program -2 staff for M&E and fundraising -1 program Coordinator   District Offices require: -1 counselor for VCT services -1 District Coordinator -1 Office attendant -1 Security guard
Materials -Vehicles -computers -cameras -projectors -buildings	We have; - 2 motor vehicles -1 video camera and -2 LCD machines   We have a well established office building, the main office.  We also have 1 office in Same district, and 1 building in Korongoni Ward.	We need; -1 motorbike for each of the 7 districts.   -1 Computer and 1 camera for each of the 7 districts   -Each district need to have office premise owned by KIWAKKUKI

 

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE

KIWAKKUKI is a nongovernmental organization which was found in 1990 and formally got registration in 1995 with a registration number SO 8488.  Later in 2011 KIWAKKUKI complied with NGO Act 24/2002 and received a Certificate of Compliance No.00001413. KIWAKKUKI is governed by supreme Board of Trustees and the Members’ Council who are democratically elected by members as stipulated in the organization constitution.

Currently, KIWAKKUKI Management is comprised of the Executive Coordinator, Head of Programmes, Head of Finance and an Administrator. The team oversees day to day implementation of organization activities.

 

MEMBERS

AGM (REPRESENTATIVES FROM EACH DISTRICT)

REGIONAL COUNCIL

BOARD OF TRUSTEES

EXECUTIVE COORDINATOR

HEAD OF FINANCE

HEAD OF PROGRAMMES

ADMINISTRATOR

CASHIER

RESOURCE MOBILIZATION OFFICER

PROGRAMME OFFICERS OFFICERS

M & E OFFICER

SUPPORT STAFF STAFF

DISTRICT COORDINATORS

DISTRICT ANNUAL GENERAL MEETING

DISTRICT COUNCIL

GRASSROOT WORKING GROUPS

KIWAKKUKI ORGANOGRAM

 

 

FIVE YEARS STRATEGIC PLAN

2017-2021

Contents

LIST OF ABBREVIATIONS. iii

EXECUTIVE SUMMARY. v

1.0 INTRODUCTION.. 1

1.1 VISION, MISSION, CORE PURPOSE AND GOAL. 1

1.2 KIWAKKUKI’s CORE VALUES. 1

1.3 PROGRAMME STRATEGY. 2

1.4 PROGRAM APPROACH.. 3

1.5 GEOGRAPHICAL AREA OF FOCUS. 3

2.0 SITUATION ANALYSIS. 4

2.1 SOCIO-ECONOMIC ANALYSIS. 4

2.1.1 GLOBAL CONTEXT. 4

2.1.2 ECONOMIC SITUATION IN TANZANIA.. 5

2.2 HIV AND AIDS SITUATION IN TANZANIA.. 7

2.2.1 HIV Prevalence in the Country. 8

2.2.2 HIV Prevalence by Regions in Tanzania. 8

2.2.3 Orphans and Most Vulnerable Children. 9

2.2.4 Early Sexual Practices. 10

2.2.4 Gender Based Violence (GBV). 10

2.2.5 Risky Traditional Practices. 11

2.2.6 HIV Prevalence among Key Populations. 11

2.2.6.1 Sex Workers. 12

2.2.7 Mobility and Migration. 13

2.2.8 Stigma and Discrimination against PLHA.. 14

2.2.9 Enrolment in Care and Treatment Centers. 14

2.2.10 HIV Policy and Legal Environment. 15

3.0 STRATEGIC PRIORITIES. 15

4.0 PROGRAMME DESCRIPTION.. 17

   4.1 COMMUNITY ECONOMIC EMPOWERMENT. 17

   4.2 Awareness rising about HIV, AIDS and STIs prevention. 18

   4.3Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination. 19

   4.4 Most Vulnerable Children (MVC) support. 20

5.0 BUDGET PROJECTION (US$). 21

6.0 SWOT ANALYSIS. 22

   6.1 Organization strength. 22

   6.2 Weaknesses. 23

   6.3 Opportunities. 23

    6.4 Threats. 23

7.0 RESOURCE MAPPING.. 23

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE. 24

9.0 PROGRAMME MONITORING.. 26

 

LIST OF ABBREVIATIONS

AIDS                             Acquired Immune Deficiency Syndrome

ART                              Antiretroviral Therapy

ARV                             Antiretroviral drugs

CTC                              Care and Treatment Centre

DHS                             Demographic Health Survey

FDI                               Foreign Direct Investment

FYDP                            Five Years Development Plan

GDP                             Gross Domestic Productivity

GBV                             Gender Based Violence

HAPCA                         HIV Prevention and Control Act

HBC                             Home-Based Care

HDI                              Human Development Index

HIV                              Human Immunodeficiency Virus

HMIS                           Health Management Information System

IGA                              Income Generating Activity

ICDP                            International Child Development Programme

KIWAKKUKI                  Kikundi cha Wanawake Kilimanjaro Kupambana Na Ukimwi

MDGs                          Millennium Development Goals

MVC                            Most Vulnerable Children

MW                             Megawatts

MKUKUTA                   Mkakati wa Kukuza Uchumi na Kupambana na Umasikini Tanzania

M & E                          Monitoring and Evaluation

MSM                           Men who have Sex with Men

MoHSW                       Ministry of Health and Social Welfare

MTCT                          Mother to Child Transmission

NGO                            Non- Governmental Organization

PHLA                            People Living with HIV and AIDS

PMTCT                                    Prevention of Mother to Child Transmission

PWID                           People Who Inject Drugs

SAM                             Social Accountability Monitoring

RACC                           Regional AIDS Control Coordinator

STI                               Sexually Transmitted Infection

SDGs                            Sustainable Development Goals

TACAIDS                      Tanzania Commission for AIDS

TDV                             Tanzania Development Vision 2025

THIS                             Tanzania HIV Indicator Survey

THMIS                         Tanzania HIV and Malaria Indicator Survey

VCT                              Voluntary Counseling and Testing

VAC                             Violence Against Children

VICOBA                       Village Community Bank

VSLA                            Village Saving and Credit Association

UNICEF                        United Nations Children Education Fund

UNAIDS                        Joint United Nations Programme on AIDS

UNDP                           United Nations Development Programme

 

EXECUTIVE SUMMARY

KIWAKKUKI is a nongovernmental organization founded in 1990 by women group to fight against HIV and AIDS in Kilimanjaro. The organization is based in Moshi Municipality and operates in all seven districts of Kilimanjaro region.

 

The current strategic plan will expire on December 2016. This has prompted us to design a new plan for the next five years. The new Five Years Strategic Plan has taken into consideration the achievements and challenges that we went through while implementing the previous 2012-2016 strategic plan. Thorough analysis of the success and challenges enabled the stakeholders to come up with priorities for the coming five years 2017-2021. The strategy is also aligned with the broader international and national development plans and policies which include; Sustainable Development Goals, Tanzania Vision 2025, National Five Years Development Plan II, and HIV and AIDS Policy of 2012.

 

Despite the fact HIV prevalence has fallen in Tanzania over the past decade, tens of thousands of people become infected with HIV every year. Stigma against HIV positive people and human resource shortages are among the obstacles to ensuring a sustained reduction of new HIV infections and to providing care and treatment to those already infected. However, Kilimanjaro region where KIWAKKUKI runs her programs is among the regions where HIV prevalence has increased from the average of 1.9% of 2008 to 3.8% in 2012. It is the responsibility of every one of us, individually and collectively, to prevent new HIV infections. We therefore appeal to the country as whole to ensure that the next generation is free from HIV, through prevention measures, regular testing and treatment in the case of infection to eliminate mother to child transmission. Sustaining this effort will also require investing in the skills, systems, and infrastructure until Tanzania is able to realize an AIDS free generation.

Although Tanzania has long been a popular country with foreign donors, in a strained financial climate, the current levels of funding are by no means guaranteed. Increased funding for HIV and AIDS from the Tanzanian government and commitment to prevention efforts will be necessary if Tanzania is to overcome the debilitating effects of HIV epidemic on its economy and the society.

Due to reduced donor funding on various developmental plans including KIWAKKUKI’s HIV and AIDS interventions, our stakeholders have taken this into consideration and proposed to focus more on economic empowerment to the communities for sustainable HIV and AIDS services. Thus, in the coming five years KIWAKKUKI will target the projects that will enhance economic capacity of the beneficiaries. However, whenever service delivery projects are secured will also be accepted but the mode of service delivery to beneficiaries will be modified for sustainability interests and approaches.

 

For the coming five years KIWAKKUKI will run a programme with four components namely: Community Economic Empowerment; Awareness rising about HIV and AIDS, and STIs prevention; Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination; and support for Most Vulnerable Children (MVC). The main approach that is going to be used is to empower the beneficiaries with knowledge, skills, and information so that actively they take roles and responsibilities towards securing economic power for improved livelihoods. The budget estimated for the organization to be able to carry out the planned activities for five years is $2,315,000 which is equivalent to TZS …………………..

KIWAKKUKI is currently facing some challenges including shortage of financial and human resources. However, as we begin implementing this plan we are going to work hard to ensure the challenges are minimized and our passion to fight HIV and AIDS is realized. Individual and collective efforts are required to fulfill our goal.

 

……………………………

Dr. Adela Materu

Executive Coordinator

 

KIWAKKUKI

1.0 INTRODUCTION

KIWAKKUKI is a Kiswahili acronym (Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI which means Women Group Against AIDS in Kilimanjaro region. It was founded in 1990 and in 1995 was registered as an NGO with the goal of enhancing women’s access to information on HIV and AIDS and empowering them with skills essential for fighting HIV and AIDS in their communities. In those years the pandemic was a scaring threat for people, with high prevalence rate accompanied by high levels of stigma, various misconceptions and beliefs about the disease. On the other hand the communities had limited access to information, and some cultural norms posed challenges to fight AIDS. Thus, the organized group of women (KIWAKKUKI) was formed to help the communities deal with such challenges.

 

 

1.1 VISION, MISSION, CORE PURPOSE AND GOAL

KIWAKKUKI’s vision is having a responsible community taking appropriate measures to fight against HIV and AIDS, poverty and contributing efforts to mitigate AIDS impact.

 

KIWAKKUKI’s mission is to integrate holistic programs that focus on HIV and AIDS prevention and increased community empowerment to support those infected and affected by HIV and AIDS with conscious gender mainstreaming

 

KIWAKKUKI’s Core Purpose is to mobilize women and the wider community by empowering them with knowledge and skills towards sustainable livelihoods particularly HIV and AIDS affected households

 

KIWAKKUKI’s Goal is to contribute towards sustainable community empowerment to respond and fight against the causes and effects of HIV and AIDS in Kilimanjaro region.

 

1.2 KIWAKKUKI’s CORE VALUES

KIWAKKUKI members and staff are linked, to live and cherish the following values;

5. God fearing
5. Voluntarism
5. Integrity and Honest
5. Love and Care
5. Unity
5. Respect
5. Sharing and Cooperation
5. Teamwork
5. Transparency
5. Accountability
5. Recognition of talents

 

1.3 PROGRAMME STRATEGY

KIWAKKUKI is always up-to-date with relevant knowledge regarding HIV and AIDS information locally, nationally and internationally. Furthermore, we are constantly in a search for current knowledge and information regarding international, regional and national plans, policies, Acts, regulations and laws that have a bearing on HIV and AIDS so as to align our programs and activities.  Then through program activities we ensure that the communities that we serve receive correct information and use it accordingly, the main aim being reducing HIV infections, improved home based care, improved support to most vulnerable children (MVC) and improved community livelihoods both socially and economically.

 

This strategic plan is expected to guide the organization operations for the next five years. The decision to develop this plan was prompted by several reasons, one of which is the Tanzania government has formulated a new National Five Years Development Plan 2016/17 – 2020/21; the second reason is the reviewed MDGs performance which led to the formulation of Sustainable Development Goals; the third is the reviewed national HIV and AIDS policy.  The fourth are the reports that are regularly and annually produced by different national and international organizations whose recommendations are very useful for us to adjust our work towards achieving KIWAKKUKI’s goal.

 

THEORY OF CHANGE

 

KIWAKKUKI  Empowerment base with Knowledge, skills and information

Target beneficiaries PHLA KIWAKKUKI groups Youth VSLA/VICOBA groups MVC Wider Community

Expected Change Improved Socio-economic wellbeing Enhanced food security Enhanced MVC social services Improved HBC to PHLA Reduced risky behaviors, traditions and practices Reduced stigma to PHLA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.4 PROGRAM APPROACH

The broader aim of our mission, vision and the overall goal is to build knowledge competent communities concerning HIV and AIDS prevention and the appropriate measures to mitigate the impact of AIDS. In the coming five years KIWAKKUKI intends to build economic power of communities by encouraging KIWAKKUKI grass root working groups to incorporate income generating activities (IGAs) in their current and future plans. As they gain economic power they will also be encouraged to establish formal Village Saving and Loan Associations (VSLA) which will enable them to have better access to credit facilities.  In the past two years KIWAKKUKI has started an agricultural project in Moshi rural which involves new technologies in food crops farming and livestock keeping. The groups which are involved in the project get nutritious foods for their families especially AIDS affected households. The surplus farm production is sold for income for carrying out home based care to AIDS patients, and support MVC with basic needs particularly education.

 

Thus the major approaches that are going to be used by KIWAKKUKI are the following;

 

1. Building the capacity of the communities with correct information on HIV and AIDS and   the current disease trends locally and globally. 
2. Facilitating and securing good empowerment interventions for improved livelihoods in the face of the socio-economic challenges facing the communities.
3. Building the capacity of the communities to develop approaches that will mitigate the impact of the disease. 
4. Empowerment of women and youth on awareness of human rights so that they can realize and claim their rights, as well as be part of decision making

 

1.5 GEOGRAPHICAL AREA OF FOCUS

Program interventions and VCT, will continue in Kilimanjaro region covering all the seven districts. According to this strategic plan about 70% of time and interventions will focus on   promoting community economic empowerment. The rest of the time will be spent on other programs particularly MVC support and home based care coordination.  However, education and advocacy materials like posters, brochures, CDs and some publications are made available to interested partners and people beyond the focused geographical area.

 

 

 

 

2.0 SITUATION ANALYSIS

Our situation analysis begins with the key sectors that are closely related with HIV and AIDS.

 

2.1 SOCIO-ECONOMIC ANALYSIS

2.1.1 GLOBAL CONTEXT

 

MDGs progress report on poverty eradication indicates that the target of reducing extreme poverty rates was met five years ahead of the 2015 deadline. The global poverty rate at $1.25 a day fell in 2010to less than half the 1990 rate. 700 million fewer people lived in conditions of extreme poverty in 2010 than in 1990. However, at the global level 1.2 billion people are still living in extreme poverty (UNDP, 2014)   This imply that, majority of people living in extreme poverty are found in developing countries and the conditions are worse to the poor who are HIV infected in poverty stricken areas particularly rural localities in Tanzania. Poverty has also led to HIV infection particularly women and girls who exchange sex with money to support their lives, children or families.

Globally, there are plans that were put forth for poverty reduction and improving people’s socio-economic well being. Sustainable Development goals (SDGs) particularly goal 1 and 2 aim at ending poverty in all its forms everywhere and hunger while goal 3 aims at ensuring healthy lives and promote wellbeing for all at all levels. Extreme poverty has been cut by more than half since 1990. However, more than 1 in 5 people live on less than $1.25 a day. Poverty is more than lack of income or resources; it includes lack of basic services, such as education, health, hunger, social discrimination and exclusion, human rights lack of participation in decision making. Gender inequality plays a large role in the perpetuation of poverty and its risks; it leads to potentially life-threatening risks from early pregnancy, and often lost hopes for an education and a better income. Age groups are affected differently when struck with poverty; its most devastating effects are on children, to whom it poses a life threat. It affects their education, health, nutrition and security. It also negatively affects the spiritual, emotional, and social development of children.

 

The aim of SDG goal 2 is to End hunger, achieve food security and improved nutrition and promote sustainable agriculture. Globally, about 842 million people (1 in 9 people) are undernourished; more than 99 million children under five age group are undernourished and underweight. The vast majority of these people live in developing countries. Agriculture is the single largest employer in the world, providing livelihoods for 40 per cent of today’s global population. It is the largest source of income and jobs for poor rural households. Women comprise on average 43% of the agricultural labor force in developing countries, and over 50% in parts of Asia and Africa, yet they only own 20% of the land. Poor nutrition causes nearly half (45 per cent) of deaths in children under five – 3.1 million children each year.

 

Goal 3 aims at Good Health and Well-being - Ensure healthy lives and promote well-being for all at all ages. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality, and major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV and AIDS.

             MDGs progress report indicates that new HIV infections continue to decline in most regions. The number of new infections per 100 adults (aged 15-49) decline by 44% between 2001 and 2012. An estimated 2.3 million cases of people of all ages are newly infected and 1.6 million people died from AIDS-related causes. Comprehensive knowledge of HIV transmission remains low among young people, along with condom use. On the other hand, about 210,000 children died of AIDS –related causes in 2012 compared to 320,000 in 2005

 

 

 2.1.2 ECONOMIC SITUATION IN TANZANIA

Tanzania is among the poorest countries in the world with a per capita Gross National Income of US $ 550. Tanzania is ranked at position 152 out of 187 countries on the Human Development Index (UNDP 2011). The economy depends heavily on agriculture, which accounts for more than one-quarter of GDP, provides 85% of exports, and employs about 80% of the work force. Macro-economic performance in Tanzania has been resilient to shocks with an estimated real GDP growth of 6.4% in 2012. Furthermore, GDP is projected to remain buoyant, increasing to 6.9% in 2013 and projected to 7% in 2014, creating opportunities for financing key social sectors, such as health, including HIV, TB, and malaria programmes (Tanzania Country Notes, 2013).Despite the impressive GDP growth, poverty remains persistent and has been at the centre of the development debate. The gap between the rich and the poor has continuously widen to date. It was against this background that the new national development agenda, MKUKUTA II, was designed with a greater focus on making growth more broad based and pro-poor. Under the food and nutrition security anti-poverty strategy, the government rolled out the “Kilimo Kwanza” or “Agriculture First” initiative, designed to reduce poverty through increased productivity in agriculture, which has been an integral part of the overall development strategy. This strategy was targeted to reduce poverty from the 2012/2013 level of 34% to 24% by 2015 – still higher than the MDG target of 19.3%. Priorities include clean water provision and irrigation, financial and insurance services, value addition, trade and exports development. Unemployment also remains a concern with nearly 2.4 million people unemployed as of 2011. Most of the unemployed are young and urban-based, representing 10.7% of the population. A lack of sufficient employment opportunities for young women, in particular, exposes them to risky behavior with incumbent dangers of HIV infection. Recognizing the challenges posed by Tanzania’s economic climate, and the social and economic vulnerability of a significant part of the national population, the government of Tanzania has put in place Vision 2025 (TDV 2025) plan, the second National Five Years Development plan (FYDP II 2016/17-2020/21), and has ratified the Sustainable Development Goals (2015-2030). 

 

 

2.1.2.1 The Tanzania Vision 2025

The utmost goal of TDV 2025 is that, by 2025 Tanzanians will be living in improved conditions and by then will be a substantially developed one with a high quality livelihood. This plan also expects to eradicate abject poverty. In other words, it is envisioned that Tanzanians will have graduated from a least developed country to a middle income country by the year 2025 with a high level of human development. The economy will have been transformed from a low productivity agricultural economy to a semi-industrialized one led by modernized and highly productive agricultural activities which are effectively integrated and buttressed by supportive industrial and service activities in the rural and urban areas. A solid foundation for a competitive and dynamic economy with high productivity will have been laid. Consistent with this vision, Tanzania of 2025 should be a nation imbued with five main attributes; high quality livelihood; peace, stability and unity; good governance; a well educated and learning society; and a competitive economy capable of producing sustainable growth and shared benefits.

 

2.1.2.2 National Five Years Development Plan 2016/17-2020/21 (FYDP II)

In line with the TDV 2025, the Five Years Development Plan II theme is “Nurturing Industrialization for Economic Transformation and Human Development”. Plan is projected to raise annual real GDP growth to 10 percent by 2021 (from 7.0 percent in 2015), per capita income to US$ 1,500 (from US$ 1,043in 2014) and reduction of the poverty rate to 16.7 percent from 28.2 percent recorded in 2011/12. The Plan also envisages raising Foreign Direct Investment (FDI) flows from US$ 2.14 billion in 2014 to over US$ 9.0 billion by 2021; increase electricity generation from 1,501MW in 2015 to 4,915MW by 2020 and improving electricity connections to 60 percent of the population, up from 36 percent in 2015. On average, manufacturing sector will grow by over 10 percent per annum with its share in total exports increasing from 24 percent in 2014/15 to 30 percent in 2020. An under- five mortality rate reduction from 81 deaths per 1000 live births recorded in 2014/15 to around 45 deaths per 1000 live births; maternal mortality reduced from 432 per 100,000 in 2014/15 to below 250 deaths by 2020/21. Also, access to clean and safe water in rural areas improved from 72 percent recorded during 2014/15 to 85 percent by 2020/21 and in urban areas to more than 90 percent. As a result, there will be improvement in national Human Development Index (HDI) from the value of 0.52 (2014) to 0.57 by 2021. However, fiscal performance continued to exhibit “stresses” due to faster rates of expenditure compared to domestic resource mobilization, despite revenue collection generally improving. Revenue to GDP ratio increased modestly from 11.6 percent during 2010/11 to 12.4 percent during 2014/15. The ratio was, however, well below FYDP I target of 14.4 percent.

Just as it was for the Arusha Declaration, Good Governance is essential for successful realization of expected economy level. There must be integrity and strong accountability systems for fiscal control. “For Tanzania to achieve development we need Good Politics, Good Leadership, Land and People” J.K. Nyerere. Economic growth and stability will provide relief to PLHA and to AIDS affected households.

 

 

 HIV AND AIDS SITUATION IN TANZANIA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Since the first three AIDS cases were reported in Tanzania in 1983, infections have spread rapidly leading to a generalized epidemic, with some areas more concentrated with the epidemic, and a devastating impact on social and economic development. The predominant mode of HIV transmission is heterosexual contact between HIV-infected and uninfected individuals, with sexual transmission accounting for approximately 80% of infections. Mothers to newborns transmission account for about 18% of infections and medical transmission through unsafe blood for approximately 1.8%. TDHS (2010) reported that Mother to Child Transmission (MTCT) is the second most common cause of HIV transmission within the Country. There are two notable gaps; these include low levels of attendance of ante-natal clinics (out of the 4 recommended visits) and lack of full integration of Prevention of Mother to Child Transmission (PMTCT) services in Maternal and Child Health services. Approximately, 24% of HIV positive pregnant women that attended antenatal clinics were not reached by PMTCT services and 43% of HIV exposed infants who needed ARVs to prevent MTCT did not receive it due to limited access to treatment, stock outs of commodities, or attrition from the program (TDHS, 2011). By the end of 2012, Tanzania had an estimated 1.5 million people living with HIV and approximately 86,000 new HIV infections (Spectrum, 2013). This can be attributed in part to widespread risky behaviors, inconsistent and incorrect condom use, inadequate numbers of eligible individuals on antiretroviral therapy, increased gender-based vulnerability, and some risky, traditional cultural practices.

2.2.1 HIV Prevalence in the Country

Although HIV prevalence in Mainland Tanzania has declined from 7.0% to 5.3% during the period from 2003/04 to 2011/12 among all adults aged 15-49, and from 6.3% to 3.9% among men in the same age group, there has not been a statistically significant decrease among women. For both men and women, HIV prevalence increases with age generally and women invariably have higher prevalence rates in all age groups compared to men. However, prevalence among young women aged 25 – 29 is 3 times higher compared to young men in the same age group. The incidence of HIV infection in the age group 15-49 years peaked at 1.34% in 1992, declined rapidly down to 0.64% in 2000, and steadily declined further to 0.32% in 2012. Similarly, HIV prevalence increased to a peak of 8.4% in 1996, declined to 5.7% in 2008, and declined further to 5.3% by 2012. However, a wide variation exists between regions and within regions across social and age groups (THIS 2004, THMIS 2012).

 

2.2.2 HIV Prevalence by Regions in Tanzania

Regional variation throughout Mainland Tanzania ranges from 1.5% in Manyara to 14.8% in Njombe. While there was an overall decline in HIV prevalence in Tanzania in the period 2008 and 2012, there are some regions in which the prevalence rates rose up. The regions that witnessed an increase in prevalence levels are 8 and these include; Ruvuma, Rukwa, Kagera, Mtwara, Kilimanjaro, Kigoma, Singida and Arusha. The increase in HIV prevalence in these regions could be a factor of successful care and treatment programmes or an actual rise in HIV infection within the regions or both. Other possible factors, such as HIV test refusal rates, should also be explored to explain the change in prevalence over this short time period. (THMIS 2012)

 

Table 1, HIV Prevalence in Tanzania Regions

S/No	REGION	PREVALENCE RATE (%)		S/No	PREVALENCE RATE (%)	REGION
1.	Arusha	3.2		13	Iringa	9.1
2.	Kilimanjaro	3.8		14	Mbeya	9.0
3.	Manyara	1.5		15	Rukwa	6.2
4.	Mara	4.5		16	Kagera	4.8
5.	Dodoma	2.9		17	Mwanza	4.2
6.	Singida	3.3		18	Geita	4.7
7.	Pwani	5.9		19	Tabora	5.1
8.	Dar es salaam	6.9		20	Shinyanga	7.4
9.	Lindi	2.9		21	Katavi	5.9
10.	Mtwara	4.1		22	Kigoma	3.4
11.	Ruvuma	7.0		23	Morogoro	2.9
12.	Njombe	14.8		24	Tanga	2.4
				25	Simiyu	3.6

 

 

 

 

 

Source: THMIS, 2011/12

 

 

HIV Prevalence rate for Tanzania Regions (THMIS, 2011/12)

 

 

2.2.3 Orphans and Most Vulnerable Children

According to a 2007 study, approximately one million children in Tanzania had been orphaned,

12% of the vulnerable children had been separated from their siblings, and up to 240,000 children below the age of 15 were living with HIV and AIDS (Social Protection in Tanzania, 2007). More recently, orphaned children were estimated at 11.2% in urban areas and 9.2% in rural areas in Mainland Tanzania. Regarding food scarcity, 9% of urban and 17% of rural households reported often having problems satisfying their food needs. Access to improved sources of drinking water is also unavailable for more than 11.4% of urban dwellers and 53.2% of rural dwellers. While almost all youths aged 15-24 years have heard about HIV and AIDS, less than half have enough knowledge to protect themselves against infection.

 

2.2.4 Early Sexual Practices

Early sexual debut and adolescent sexual networking without protection exposes young people, especially girls, to HIV and STI infection. In Mainland Tanzania, 9.7% of young women and 10.2% of young men aged 15-24 had sexual intercourse before age 15, while 51.6% of young women and 43.9% of young men aged 18-24 had sexual intercourse before 18 (THMIS 2011-2012). Out of those who have never married (15-24), only 57.9% of women and 59% of men used condom during their last sexual intercourse (THMIS2011/12). According to the Violence Against Children survey (VAC) results, 4% of Tanzanian girls received money or goods in exchange for sex at least once in their lifetime. Of the girls, 82% who reported receiving money or goods for sex also reported childhood sexual violence; 90% who received money or goods for sex reported childhood physical violence by a relative, and 50% who received money or goods for sex reported childhood emotional violence (Violence Against Children Report, 2011). A study conducted in Mwanza region on cross-generational and transactional sexual relations revealed that the main reason for having sexual relationship was to receive presents or money. The study involved male and female respondents aged 12 years and above from primary 52% and secondary schools 10% (Luke & Kurtz, 2002).

 

2.2.4 Gender Based Violence (GBV)

Gender inequality and gender based violence have been cited in various reports to contribute to HIV infection. Unequal power relations between men and women limits decision making for women and girls in negotiating for safe sex and condom use, and increases the extent of violation of women’s and girls’ rights. The most common forms of GBV are physical, sexual, psychological, and economic, including financial deprivation and exploitation. The Tanzania Demographic and Health Survey (2010) reveals that 39% of women in the age 15-49 years have experienced physical violence at least once in their lives, with 33% of such violence occurring within the 12 months preceding the survey. There are notable zonal variations in GBV ranging from 61% of women in the Central zone to 22% in the Northern zone having experienced GBV, irrespective of woman’s education or economic status (DHS, 2010). Overall 10% of women in the age 15-49 years had a forced first sexual intercourse (DHS, 2010). Results from the National Survey on “Violence against Children” in 2012 by UNICEF in Tanzania show that girls are particularly vulnerable to sexual violence. Nearly one out of three females and one out of seven males have experienced some form of sexual violence prior to the age of eighteen. Few children disclose, fewer children seek services, and even fewer receive them when they are brave enough to report. Overall, the National Survey showed that about 48% of girls and 68% of boys had never disclosed the sexual violence that they had experienced in childhood prior to the survey. Only about 20% of girls and 10% of boys who had experienced sexual violence sought services after the experience, but not all respondents who sought services received them. Approximately 13.0% of females and 3.7% of males who experienced sexual violence reported that they actually received services after seeking them. Girls who received services said they received counseling, clinic, or hospital services, or help from an elder or community leader. Tanzanian children experiencing sexual abuse and violence are more likely to be exposed to sexual exploitation, including transactional sex, less likely to have a HIV test or use condoms, and more likely to have multiple sexual partners as they grow older (Violence Against Children Report, 2011). The result from “Child Sex Abuse “in 2012 revealed that young children are not safe. The problem of child and sexual abuse in the society is growing. The need for concerted public education on the nature of this violence and its consequences is imperative.

 

Women and girls are more vulnerable to HIV infection than their male counterparts in Tanzania due to biological, socio-cultural and economic factors. According to UNAIDS, up to 80% of HIV sero-positive women in long term relationship acquired the virus from their partners. This might resulted from inequalities manifested by gender based violence, such as rape, sexual assault and battery. Other factors such as multiple sexual partnership, polygamy, violence, alcohol, and substance abuse also play an exacerbating role in reinforcing gender inequalities.

 

 

2.2.5 Risky Traditional Practices

Although Tanzania has positive traditional practices which help to mitigate the impact of HIV and AIDS, such as strong extended family support structures and social sanctions, there are also some risky traditional practices that hinder the effectiveness of the national response. These include wife inheritance by a male relative of the deceased husband, female genital mutilation, early or child marriages, and limited property rights for widows. HIV Prevalence among widows aged 15 and 49 years is estimated at 24.7%. A comparison of TDHS 2004 data and that of the TDHS 2010 shows that the proportion of married young women aged 15-19 years fell by 20% while, pregnancy and childbirth among young women of this age dropped by more than 12%. Nevertheless, despite the gains, one in six young women aged 15-19 is married. In addition, young women and girls face a significantly higher risk of death from pregnancy and delivery-related complications, which is further compounded by the high frequency of births which occur at home without skilled attendants. Such situations are risky for new HIV infections.

 

 

2.2.6 HIV Prevalence among Key Populations

Key Populations, in this context refer to populations at high risk for exposure to HIV or for transmitting HIV. For our case these key populations include all PLHA, as well as discordant couples, sex workers and their clients, men who have sex with men, women who have anal sex, and people who inject drugs. Other vulnerable groups who may also be among those at higher risk for HIV exposure or transmission include women and girls, youth, people in conflict and post-conflict situations, refugees and internally displaced persons, migrant laborers, and people working in mining and fishing industry and their surrounding communities. Recent studies conducted in various regions in Tanzania showed varying degrees of HIV prevalence among key population groups, with the prevalence of MSM, FSW, and PWID all are significantly above the national average (Country Progress Reporting, Part A: Tanzania Mainland, 2012). This variation is alarming and therefore calls for effective strategic HIV prevention interventions. In the Tanzanian context, other population groups that deserve special consideration in HIV programming include prisoners, long-distance track drivers, disabled (in all forms), fishing communities, and people in mining, women and children.

 

2.2.6.1 Sex Workers

A sex worker includes anyone who exchanges sexual services for money or goods, whether regularly as a full-time activity, or temporarily as a short-term measure. Sex workers include both men and women, young and old. Prevention, care, treatment, and support programmes for sex workers and their clients are being implemented in Tanzania, but need significant expansion and support. In a study conducted with 537 female sex workers in Dar es Salaam, one-third of respondents were reported to be divorced or separated, while over half were never married. In the study, 69.7% reported that sex work constituted their main source of income; 31.4% tested HIV positive; 69.3% reported always using a condom with regular clients though only 31.6% reported always using a condom with their steady partner in the previous 30 days. A high prevalence of 51.7% sexual and physical abuse were reported as among the issues associated with sex work. Stigma and discrimination against sex workers remains high, posing a significant challenge to outreach and delivery of friendly health services.

 

 

2.2.6.2 Men Who Have Sex with Men (MSM)

In a research study of 271 MSM with a mean age of 26 years, 41% were reported to have tested

HIV positive; 63.1% had also been married or cohabited with a woman at least once in their life. Those reporting no condom use with their last casual sex partner was 43.2%, while 49.1% used condoms with their last regular sex partner. About 30% of all respondents were reported to be engaged in commercial sex work (Condom Use in MSM, 2013). Stigma and discrimination against MSM remains high, also posing a significant challenge to outreach and delivery of friendly health services. Given the criminalization of consensual adult homosexual intercourse, any response requires significant cooperation from all key stakeholders to ensure that MSM are reached with HIV and AIDS services.

 

2.2.6.3 People Who Inject Drugs (PWID)

A small sample survey of 430 respondents undertaken in Temeke Municipality, Dar es Salaam region revealed an HIV prevalence of 26% (34.8 % among Injecting Drug Users and 11.7 % Non Injecting Drug Users). Among the newly diagnosed Injecting Drug Users, women had higher HIV prevalence and there was also a high proportion of Hepatitis C co-infection. Gender also played a significant role in the risk profile of injecting and non-injecting drug using participants. Males and females did not report significantly different injecting risk behaviours, but females were more likely to have sold sex and have a higher number of sex partners thus increasing their vulnerability to HIV infection.  Among People Who Inject Drugs (PWID) with non-injecting partners, 89% of males and 75% of females reported inconsistent condom use with their regular partner (Risk Practices among PWID in Temeke, 2011). Stigma and discrimination against PWID remains high, posing a signify cant challenge to outreach and delivery of friendly health services. This highlights the need to prioritize the recommended package of comprehensive intervention for HIV prevention and care among PWID. Furthermore, the importance of PWID not sharing needles should remain a key component of the comprehensive harm reduction package in Tanzania, together with education about the risks of sexual transmission and the need for protection through consistent and correct use of condoms.

 

2.2.7 Mobility and Migration

Migration is common in Tanzania. In particular, the expansion of the mining sector has led to greater urbanization and mobility between rural and urban areas. This means that young and sexually active men come into close contact with ‘high risk sexual networks’ made up of sex workers, women at truck stops and miners: all of whom have high levels of HIV prevalence. Long-distance truck drivers, agricultural plantation workers and fisherman working along coastal trading towns are also at an increased risk of HIV. It is not only mobile men who are at increased risk of HIV infection. Women who travel away from home five or more times in a year have been found to be twice more likely to be infected with HIV than women who do not travel (Avert  report, 2016).

Mobile population groups such as seasonal labourers in plantations, road construction sites, mobile markets, truck drivers, fishermen and miners are vulnerable to HIV infection because they often practice higher risk sex with non-marital or co-habitating partners. Studies have found samples of long-distance truck drivers with high HIV prevalence. These results are consistent with the findings in the THMIS 2007/08 and 2011/12, which found that individuals who travel away from home frequently are more likely to be HIV positive than those who do not. Among women in the THMIS 2011/12, those who had slept away from home five or more times in the past 12 months were twice as likely to be HIV positive (11%) as those who did not travel away from home (5%).

2.2.8 Stigma and Discrimination against PLHA

Stigma is highly prevalent in Tanzania at various levels and settings, as data from the 2012 Stigma Index indicates that here is breaching of confidentiality through health delivery systems. While 15% of the PLHA felt that health care providers did not keep their information confidential, another 5.4% had their HIV status disclosed without their consent. Further, the study revealed discrimination by health care providers. For example, 13% of PLHA were told not have children, 44% were denied access to reproductive health information, 14% were coerced in accepting particular infant feeding options, and about 9% were coerced in their use of family planning methods. Few (19%) eligible pregnant women living with HIV received ART for PMTCT. Others were coerced into sterilization and pregnancy termination by health service providers due to their HIV positive status (People Living with HIV Stigma Index, 2012). The study also reveals high levels of self-stigma. Most PLHA reported a sense of shame (44%), self-blame (63.4%), feelings of worthlessness (85%), feelings that PLHA deserves to be punished (10%), and self-isolation because of their HIV positive status. Self-Stigma drives many PLHA who are sexually active not to bear children (38%) or get married (16%) because of their HIV positive status. PLHA also remove themselves from places where they would be potentially stigmatized, including work places, for fear of gossip (45%), being verbally insulted, harassed, and threatened (30%). Furthermore, the study showed that fewer PLHA know where to seek assistance once their human rights are violated. A majority of PLHA are not aware of their rights, the national HIV and AIDS Policy, legal information, and global commitments on HIV and AIDS (AIDS-NMSF, 2013). In addition, community acceptance towards PLHA is very low. As the stigma index reports, 25% of women and 40% of men in Tanzania do accept interacting with PLHA. The situation is critical in rural areas where only 21% of women and 35% of men have positive attitudes toward PLHA, as compared to 36% of women and 54% of men in the urban areas.

 

2.2.9 Enrolment in Care and Treatment Centers

By June 2012, one-third (34%) of PLHA had not been enrolled for care: only 54% of all children and adults enrolled in care and treatment were ever enrolled on ARVs as of March 2012 and these constituted 41% of the estimated total of PLHA. Thus, both the overall target of enrolling 90% of PLHA on ART and 18% of all enrolled PLHA on ART as children has not been met. There is significantly low (35%) enrolment of males in care and treatment and have shown to report late for treatment (MoHSW, 2011). Nevertheless, the number of people estimated to be infected with HIV has held steady because of ongoing new infections, population growth, and the availability of life-sustaining treatment for those infected. The cumulative number of clients on antiretroviral treatment (ART) as of June 2012 was 626,444, surpassing the “3 by 5” target of 440,000 by 2011.

 

2.2.10 HIV Policy and Legal Environment

Tanzania developed its first National Policy for HIV and AIDS in 2001, subsequently implemented through two strategic frameworks which were completed in 2012. In 2008, Tanzania enacted the HIV Prevention and Control Act (HAPCA). Part VIII of the Act provides for PLHA rights and obligations. Section 33(1) (a) and (b) provide for rights to access quality medical services and treatment for opportunistic diseases. Section 33(2) (a) and (b) provide for obligation of protection to others from re-introducing infections into the population. According to Section 28-32 of this law, discrimination is a punishable offence. In 2010, regulations for HIV Counseling and Testing, use of ARVs, and disclosure were developed and published. The regulations provide for protection against forced testing and mandatory disclosure. The National HIV and AIDS Policy (2012) further emphasize the importance of respect for the human rights of PLHA, as stipulated in the Constitution of the United Republic of Tanzania. Specifically the policy commits to enhancing measures that ensure all civil, legal and human rights for men, women, boys and girls living with HIV and AIDS, in accordance with the URT Constitution and other International Conventions. Against a backdrop of protective policies and laws, the Law of Marriage Act (1971), which provides for early marriage (15 years for females by statute, or 14 years with consideration of “special circumstances”) thus increasing the risk of HIV infection to young women and girls, and other similar laws need to be urgently revised and enforced.

 

3.0 STRATEGIC PRIORITIES

This strategic plan 2017-2021 has been developed through a consensus which involved extensive consultation with various stakeholders using meetings and individual consultations. Consultations involved some board members, organization leadership, staff, PLHA, district coordinators and some regional health officers including Regional AIDS Control Coordinator (RACC). Being a participatory process we believe that this plan is people-driven and is going to be implemented using a people-centered approach.

 

                              Stakeholders during priority setting session

 

Needs Assessment consultations came up with the several strategic issues that KIWAKKUKI should focus on for the next five years period. These issues were clearly scrutinized and prioritized accordingly. They include;

1. Voluntary Counseling and Testing
2. Promoting agriculture and livestock initiatives using up to date technologies
3. Continue searching for internal and external sources of funds
4. Encourage KIWAKKUKI grass root working groups to incorporate income generating activities in their programs
5. Enhance publicity of KIWAKKUKI organization through organized events, KIWAKKUKI website and other media.
6. Networking with likeminded organizations
7. Encouraging the communities to take the responsibility of supporting the vulnerable groups
8. Sensitize the community on child rights, proper parenting and development
9. Impart health education to the community on Sexual and Reproductive Rights, and gender.
10. Design different ways/approaches for fundraising
11. Continual support the community on memory work activities
12. Encourage KIWAKKUKI members to keep up the voluntarism spirit
13. Encourage youth to organize themselves into KIWAKKUKI youth groups
14. Enhance “school without walls” HIV and AIDS education approach
15. Coordinate Home Based Care (HBC) community activities
16. Develop and conduct youth programs for HIV prevention outcomes.

 

The above strategic issues led to the formulation of four program components whereby respective activities for the coming five years were clustered accordingly.

The four program components are;

5. Community Economic Empowerment
5. Awareness rising about HIV, AIDS and STIs prevention
5. Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination
5. Most Vulnerable Children (MVC) support

 

4.0 PROGRAMME DESCRIPTION

4.1 COMMUNITY ECONOMIC EMPOWERMENT

SDG goal 1.1 target is by 2030, to eradicate poverty for all people everywhere, currently measured as people living on less than $1.25 a day. On the other hand, goal 1.5 target is, by 2030 to build the resilience of the poor and those in vulnerable situations, and reduce their exposure to vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters. In line with these targets, KIWAKKUKI objective 1 intends to build the capacity of the communities particularly HIV and AIDS affected households in sustainable agriculture and animal keeping activities using up to date technologies which are very considerate on climate changes and environment protection. On the other hand the food crops and animal varieties which are sought for such projects those with high nutritional values to keep healthy the PHLA, orphans and their respective families. This is also supported by SDG goal 2 which aims to end hunger, achieve food security, improving nutrition and promoting sustainable agriculture.

Despite the international SDGs targets, the Tanzania Vision 2025 aims at transforming the national economy from low agricultural productivity to a semi industrialized one led by modernized and highly productive agricultural activities. Furthermore, national FYDP II goal is to nurture industrialization for Economic Transformation and Human Development. Thus, KIWAKKUKI has aligned objective 1 with these broader national goals. We expect that, the communities will produce surplus crops and animals which will have read-markets the nation is struggling to put in place industries which will require internal raw materials.

 

Objective 1

Activities

Encourage communities to engage in sustainable income generating activities including microcredit facilities

Resource Mobilization Improve and advertise organization hired assets and services (eg, KIWAKKUKI meeting halls, tailor-made trainings, and VCT services. Promote voluntarism among members Community sensitization about secured projects Establishing community groups Establishment of demonstration plots (for agricultural projects) Conduct trainings for capacity building on projects concerned Projects Monitoring & Evaluation Identify and expand the capacity of super farmers Conducting entrepreneurship trainings to KIWAKKUKI grass root working groups Incorporate  VICOBA/VSLA in community groups Encourage the KIWAKKUKI groups to undertake formal registration Monitoring  the groups’  activities Encouraging youth to join the IGA groups Conducting localized Social Accountability Monitoring (SAM)

 

 

4.2 Awareness rising about HIV, AIDS and STIs prevention

According to HIV and AIDS Policy 2001, the community is the key in curbing the HIV and AIDS epidemic. Thus it calls for the communities to be fully informed about HIV and AIDS and the real life challenges in its prevention and care. In the coming five years KIWAKKUKI will continue to provide HIV and AIDS knowledge and information to the community, support the development of appropriate approaches to reduce HIV infections and care for PLHA, and orphans in their localities. Thus in Objective 2 the following activities will be implemented;

 

 

Objective 2

Activities

Promote  HIV and AIDS prevention through community awareness raising for behavior change

Daily education on HIV and AIDS to the drop-in people Education session on HIV and AIDS to youth in schools and out-of-schools External HIV and AIDS sessions to other institutions Life skills training to youth Sexual and Reproductive health, and STIs education to youth Networking with like-minded organizations Provide health and gender education to the wider community Encouraging youth to join KIWAKKUKI grass root working groups Provide AIDS education in both formal and non formal gatherings Conducting Social Accountability Monitoring (SAM)

 

 

 Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination

While maintaining confidentiality as required by the policy, KIWAKKUKI will promote early diagnosis of HIV infection through voluntary testing with pre-and-post test counseling. Also the organization will coordinate Home Based Care that will be offered to PHLA within the respective households, by the community grassroots groups.

 

Objective 3

Activities

Provide support to the infected and affected people through VCT and coordinate the associated home based care.

Free same day results for Mobile/ Outreach VCT using the Tanzanian National HIV and AIDS policy guidelines Free same day results at the Office stand alone VCT using the Tanzanian National HIV and AIDS policy guidelines Algorithms for testing. Referrals complementing other available services e.g. CTC services, Orphans support, and PLHA clubs  Coordinate home based care activities External referrals to other specialized centers for further Diagnosis, Investigations. Facilitate and encourage KIWAKKUKI groups to visits and support AIDS patients in their homes Follow up to ensure the groups provide quarterly reports.

 

4.4 Most Vulnerable Children (MVC) support

Poverty and lack of well-developed national and community supporting systems have impeded MVC access to quality care and support services. Studies indicate that community based care programs increase access to important interventions for people living with HIV and those affected by HIV and AIDS. Upon availability of resources, KIWAKKUKI will continue to support MVC and also empower the communities to take care of this group.

 

Objective 4

Activities

Promote community empowerment on child development programs and support to most vulnerable children

School sponsorship include: Primary, Secondary. (Ordinary level and /Advanced levels) and Vocational Skills is done. Students of Institutions of Higher learning not beneficiaries of the program.    Shelter support to the needy  orphaned  child headed families Income Generating Activities (IGA’s) to orphans families caring children less than 8 years through their caregivers. Psychosocial support to parents/caregivers and children as the case may be.   Memory work to facilitate communication between PLHA parents and children on their status, how to write memory book and to have legal arrangements for the future of their children when the need arises. Facilitate and encourage KIWAKKUKI grass root working groups to prepare an action plan for vulnerable groups support Popularizing ICDP knowledge to parents/guardians and the wider community Education to the community about child rights Enhancing community actions on Violence Against Children (VAC) Carrying out Social Accountability Monitoring (SAM)

 

4.5 Organization Capacity Building

The organization prosperity highly depends on availability of committed and competent staff, availability of financial and other resources, friendly working environment as well as enabling policies, rules and regulations. In order to achieve this objective, we have planned to do the following throughout the next five years;

• Continuous fundraising efforts and community contribution
• Staff development through short courses, trainings etc.
• Proper resources management
• Networking

 

5.0 BUDGET PROJECTION (US$)

Expected budget allocation to support program activities for the five years is summarized below:

 

PROGRAM ITEM	2017 Est	2018 Est	2019 Est	2020 Est	2021 Est
Community Economic Empowerment	81,000	112500	174000	156000	171000
Awareness rising about HIV, AIDS and STIs prevention	21600	37500	46400	41600	45600
Voluntary Counseling and Testing (VCT) and (HBC) Coordination	40,500	56250	87000	78000	85500
Most Vulnerable Children (MVC) support	32400	37500	69600	62400	68400
Organization Capacity Building	27000	37500	58000	52000	57000
Organizational Administration	54000	75000	116000	104000	114000
Balance to carry forward	13,500	18750	29000	26000	28500
TOTALS US$	270000	375000	580000	520000	570000
GRAND TOTAL USD	2,315,000

 

6.0 SWOT ANALYSIS

Successful implementation of this five years plan depends on various factors. This necessitates us to evaluate ourselves and position ourselves in a way that we understand and maximize the utilization of our strengths and opportunities, foresee challenges and minimize them accordingly. 

6.1 Organization strength

• Board of trustees who play an oversight and advisory role for the organization.
• Committed and cooperative  organization members
• Committed grass root working groups who understand their roles and responsibilities
• Voluntarism spirit among staff and members of grassroots groups
• Participatory planning which lead to people’s ownership of the interventions
• Committed human resource, financial and accounting policies and regulations
• Well established reporting structure
• Effective collaboration and networking
• Presence of international and national frameworks, Acts, policies and guidelines which guide KIWAKKUKI’s activities
• Good reputation and relationship with government at all levels
• Highly trusted VCT centre

 

 

6.2 Weaknesses

• Dependency on donor funds to support the programs
• Limited funds
• Lack of M&E personnel in the organization
• Inadequate resource mobilization strategies
• Limited  number of program staff
• Communities dependency on KIWAKKUKI for material support especially the HIV and AIDS affected households

 

6.3 Opportunities

• Committed members are ready and willing to volunteer for ongoing support of PLHA
• Government support to our office stand alone VCT center
• Current Government campaigns for people to work hard “Hapa kazi tu”
• Organization has its own premise
• Most of the PLHA who use ART are in good health and energetic.
• Many PLHA are involved in empowerment efforts in the community, for self support
• Volunteers from abroad who come with different skills

 

6.4 Threats

• Diminishing financial resources
• Inability to hire new, competent staff
• Poor facility to reach PLHA directly in their households for HBC monitoring
• Minimal provision for adequate support to community vulnerable groups particularly the MVC.

 

7.0 RESOURCE MAPPING

CATEGORY	AVAILABLE	REQUIREMENT
Human Resources	Currently KIWAKKUKI has 12 staff and 5 volunteers at our main office.	Upon availability of funds KIWAKKUKI will hire 10 more staff for the main office and 5 staff for each district in 7 districts that KIWAKKUKI works with. Main Office requires: -2 VCT new staff, -1 staff HIV education program -2 staff for MVC program -2 staff for CEE program -2 staff for M&E and fundraising -1 program Coordinator   District Offices require: -1 counselor for VCT services -1 District Coordinator -1 Office attendant -1 Security guard
Materials -Vehicles -computers -cameras -projectors -buildings	We have; - 2 motor vehicles -1 video camera and -2 LCD machines   We have a well established office building, the main office.  We also have 1 office in Same district, and 1 building in Korongoni Ward.	We need; -1 motorbike for each of the 7 districts.   -1 Computer and 1 camera for each of the 7 districts   -Each district need to have office premise owned by KIWAKKUKI

 

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE

KIWAKKUKI is a nongovernmental organization which was found in 1990 and formally got registration in 1995 with a registration number SO 8488.  Later in 2011 KIWAKKUKI complied with NGO Act 24/2002 and received a Certificate of Compliance No.00001413. KIWAKKUKI is governed by supreme Board of Trustees and the Members’ Council who are democratically elected by members as stipulated in the organization constitution.

Currently, KIWAKKUKI Management is comprised of the Executive Coordinator, Head of Programmes, Head of Finance and an Administrator. The team oversees day to day implementation of organization activities.

 

 

 

 

MEMBERS

AGM (REPRESENTATIVES FROM EACH DISTRICT)

REGIONAL COUNCIL

BOARD OF TRUSTEES

EXECUTIVE COORDINATOR

HEAD OF FINANCE

HEAD OF PROGRAMMES

ADMINISTRATOR

CASHIER

RESOURCE MOBILIZATION OFFICER

PROGRAMME OFFICERS OFFICERS

M & E OFFICER

SUPPORT STAFF STAFF

DISTRICT COORDINATORS

DISTRICT ANNUAL GENERAL MEETING

DISTRICT COUNCIL

GRASSROOT WORKING GROUPS

KIWAKKUKI ORGANOGRAM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WOMEN GROUP AGAINST HIV AND AIDS IN KILIMANJARO REGION (KIWAKKUKI)

 

 

 

 

 

 

 

 

FIVE YEARS STRATEGIC PLAN

2017-2021

 

 

 

 

 

 

 

 

Contents

LIST OF ABBREVIATIONS. iii

EXECUTIVE SUMMARY. v

1.0 INTRODUCTION.. 1

1.1 VISION, MISSION, CORE PURPOSE AND GOAL. 1

1.2 KIWAKKUKI’s CORE VALUES. 1

1.3 PROGRAMME STRATEGY. 2

1.4 PROGRAM APPROACH.. 3

1.5 GEOGRAPHICAL AREA OF FOCUS. 3

2.0 SITUATION ANALYSIS. 4

2.1 SOCIO-ECONOMIC ANALYSIS. 4

2.1.1 GLOBAL CONTEXT. 4

2.1.2 ECONOMIC SITUATION IN TANZANIA.. 5

2.2 HIV AND AIDS SITUATION IN TANZANIA.. 7

2.2.1 HIV Prevalence in the Country. 8

2.2.2 HIV Prevalence by Regions in Tanzania. 8

2.2.3 Orphans and Most Vulnerable Children. 9

2.2.4 Early Sexual Practices. 10

2.2.4 Gender Based Violence (GBV). 10

2.2.5 Risky Traditional Practices. 11

2.2.6 HIV Prevalence among Key Populations. 11

2.2.6.1 Sex Workers. 12

2.2.7 Mobility and Migration. 13

2.2.8 Stigma and Discrimination against PLHA.. 14

2.2.9 Enrolment in Care and Treatment Centers. 14

2.2.10 HIV Policy and Legal Environment. 15

3.0 STRATEGIC PRIORITIES. 15

4.0 PROGRAMME DESCRIPTION.. 17

   4.1 COMMUNITY ECONOMIC EMPOWERMENT. 17

   4.2 Awareness rising about HIV, AIDS and STIs prevention. 18

   4.3Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination. 19

   4.4 Most Vulnerable Children (MVC) support. 20

5.0 BUDGET PROJECTION (US$). 21

6.0 SWOT ANALYSIS. 22

   6.1 Organization strength. 22

   6.2 Weaknesses. 23

   6.3 Opportunities. 23

    6.4 Threats. 23

7.0 RESOURCE MAPPING.. 23

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE. 24

9.0 PROGRAMME MONITORING.. 26

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF ABBREVIATIONS

AIDS                             Acquired Immune Deficiency Syndrome

ART                              Antiretroviral Therapy

ARV                             Antiretroviral drugs

CTC                              Care and Treatment Centre

DHS                             Demographic Health Survey

FDI                               Foreign Direct Investment

FYDP                            Five Years Development Plan

GDP                             Gross Domestic Productivity

GBV                             Gender Based Violence

HAPCA                         HIV Prevention and Control Act

HBC                             Home-Based Care

HDI                              Human Development Index

HIV                              Human Immunodeficiency Virus

HMIS                           Health Management Information System

IGA                              Income Generating Activity

ICDP                            International Child Development Programme

KIWAKKUKI                  Kikundi cha Wanawake Kilimanjaro Kupambana Na Ukimwi

MDGs                          Millennium Development Goals

MVC                            Most Vulnerable Children

MW                             Megawatts

MKUKUTA                   Mkakati wa Kukuza Uchumi na Kupambana na Umasikini Tanzania

M & E                          Monitoring and Evaluation

MSM                           Men who have Sex with Men

MoHSW                       Ministry of Health and Social Welfare

MTCT                          Mother to Child Transmission

NGO                            Non- Governmental Organization

PHLA                            People Living with HIV and AIDS

PMTCT                                    Prevention of Mother to Child Transmission

PWID                           People Who Inject Drugs

SAM                             Social Accountability Monitoring

RACC                           Regional AIDS Control Coordinator

STI                               Sexually Transmitted Infection

SDGs                            Sustainable Development Goals

TACAIDS                      Tanzania Commission for AIDS

TDV                             Tanzania Development Vision 2025

THIS                             Tanzania HIV Indicator Survey

THMIS                         Tanzania HIV and Malaria Indicator Survey

VCT                              Voluntary Counseling and Testing

VAC                             Violence Against Children

VICOBA                       Village Community Bank

VSLA                            Village Saving and Credit Association

UNICEF                        United Nations Children Education Fund

UNAIDS                        Joint United Nations Programme on AIDS

UNDP                           United Nations Development Programme

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXECUTIVE SUMMARY

KIWAKKUKI is a nongovernmental organization founded in 1990 by women group to fight against HIV and AIDS in Kilimanjaro. The organization is based in Moshi Municipality and operates in all seven districts of Kilimanjaro region.

 

The current strategic plan will expire on December 2016. This has prompted us to design a new plan for the next five years. The new Five Years Strategic Plan has taken into consideration the achievements and challenges that we went through while implementing the previous 2012-2016 strategic plan. Thorough analysis of the success and challenges enabled the stakeholders to come up with priorities for the coming five years 2017-2021. The strategy is also aligned with the broader international and national development plans and policies which include; Sustainable Development Goals, Tanzania Vision 2025, National Five Years Development Plan II, and HIV and AIDS Policy of 2012.

 

Despite the fact HIV prevalence has fallen in Tanzania over the past decade, tens of thousands of people become infected with HIV every year. Stigma against HIV positive people and human resource shortages are among the obstacles to ensuring a sustained reduction of new HIV infections and to providing care and treatment to those already infected. However, Kilimanjaro region where KIWAKKUKI runs her programs is among the regions where HIV prevalence has increased from the average of 1.9% of 2008 to 3.8% in 2012. It is the responsibility of every one of us, individually and collectively, to prevent new HIV infections. We therefore appeal to the country as whole to ensure that the next generation is free from HIV, through prevention measures, regular testing and treatment in the case of infection to eliminate mother to child transmission. Sustaining this effort will also require investing in the skills, systems, and infrastructure until Tanzania is able to realize an AIDS free generation.

Although Tanzania has long been a popular country with foreign donors, in a strained financial climate, the current levels of funding are by no means guaranteed. Increased funding for HIV and AIDS from the Tanzanian government and commitment to prevention efforts will be necessary if Tanzania is to overcome the debilitating effects of HIV epidemic on its economy and the society.

Due to reduced donor funding on various developmental plans including KIWAKKUKI’s HIV and AIDS interventions, our stakeholders have taken this into consideration and proposed to focus more on economic empowerment to the communities for sustainable HIV and AIDS services. Thus, in the coming five years KIWAKKUKI will target the projects that will enhance economic capacity of the beneficiaries. However, whenever service delivery projects are secured will also be accepted but the mode of service delivery to beneficiaries will be modified for sustainability interests and approaches.

 

For the coming five years KIWAKKUKI will run a programme with four components namely: Community Economic Empowerment; Awareness rising about HIV and AIDS, and STIs prevention; Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination; and support for Most Vulnerable Children (MVC). The main approach that is going to be used is to empower the beneficiaries with knowledge, skills, and information so that actively they take roles and responsibilities towards securing economic power for improved livelihoods. The budget estimated for the organization to be able to carry out the planned activities for five years is $2,315,000 which is equivalent to TZS …………………..

 

KIWAKKUKI is currently facing some challenges including shortage of financial and human resources. However, as we begin implementing this plan we are going to work hard to ensure the challenges are minimized and our passion to fight HIV and AIDS is realized. Individual and collective efforts are required to fulfill our goal.

 

……………………………

Dr. Adela Materu

Executive Coordinator

 

KIWAKKUKI

1.0 INTRODUCTION

KIWAKKUKI is a Kiswahili acronym (Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI which means Women Group Against AIDS in Kilimanjaro region. It was founded in 1990 and in 1995 was registered as an NGO with the goal of enhancing women’s access to information on HIV and AIDS and empowering them with skills essential for fighting HIV and AIDS in their communities. In those years the pandemic was a scaring threat for people, with high prevalence rate accompanied by high levels of stigma, various misconceptions and beliefs about the disease. On the other hand the communities had limited access to information, and some cultural norms posed challenges to fight AIDS. Thus, the organized group of women (KIWAKKUKI) was formed to help the communities deal with such challenges.

 

 

1.1 VISION, MISSION, CORE PURPOSE AND GOAL

KIWAKKUKI’s vision is having a responsible community taking appropriate measures to fight against HIV and AIDS, poverty and contributing efforts to mitigate AIDS impact.

 

KIWAKKUKI’s mission is to integrate holistic programs that focus on HIV and AIDS prevention and increased community empowerment to support those infected and affected by HIV and AIDS with conscious gender mainstreaming

 

KIWAKKUKI’s Core Purpose is to mobilize women and the wider community by empowering them with knowledge and skills towards sustainable livelihoods particularly HIV and AIDS affected households

 

KIWAKKUKI’s Goal is to contribute towards sustainable community empowerment to respond and fight against the causes and effects of HIV and AIDS in Kilimanjaro region.

 

1.2 KIWAKKUKI’s CORE VALUES

KIWAKKUKI members and staff are linked, to live and cherish the following values;

5. God fearing
5. Voluntarism
5. Integrity and Honest
5. Love and Care
5. Unity
5. Respect
5. Sharing and Cooperation
5. Teamwork
5. Transparency
5. Accountability
5. Recognition of talents

 

1.3 PROGRAMME STRATEGY

KIWAKKUKI is always up-to-date with relevant knowledge regarding HIV and AIDS information locally, nationally and internationally. Furthermore, we are constantly in a search for current knowledge and information regarding international, regional and national plans, policies, Acts, regulations and laws that have a bearing on HIV and AIDS so as to align our programs and activities.  Then through program activities we ensure that the communities that we serve receive correct information and use it accordingly, the main aim being reducing HIV infections, improved home based care, improved support to most vulnerable children (MVC) and improved community livelihoods both socially and economically.

 

This strategic plan is expected to guide the organization operations for the next five years. The decision to develop this plan was prompted by several reasons, one of which is the Tanzania government has formulated a new National Five Years Development Plan 2016/17 – 2020/21; the second reason is the reviewed MDGs performance which led to the formulation of Sustainable Development Goals; the third is the reviewed national HIV and AIDS policy.  The fourth are the reports that are regularly and annually produced by different national and international organizations whose recommendations are very useful for us to adjust our work towards achieving KIWAKKUKI’s goal.

 

THEORY OF CHANGE

 

KIWAKKUKI  Empowerment base with Knowledge, skills and information

Target beneficiaries PHLA KIWAKKUKI groups Youth VSLA/VICOBA groups MVC Wider Community

Expected Change Improved Socio-economic wellbeing Enhanced food security Enhanced MVC social services Improved HBC to PHLA Reduced risky behaviors, traditions and practices Reduced stigma to PHLA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.4 PROGRAM APPROACH

The broader aim of our mission, vision and the overall goal is to build knowledge competent communities concerning HIV and AIDS prevention and the appropriate measures to mitigate the impact of AIDS. In the coming five years KIWAKKUKI intends to build economic power of communities by encouraging KIWAKKUKI grass root working groups to incorporate income generating activities (IGAs) in their current and future plans. As they gain economic power they will also be encouraged to establish formal Village Saving and Loan Associations (VSLA) which will enable them to have better access to credit facilities.  In the past two years KIWAKKUKI has started an agricultural project in Moshi rural which involves new technologies in food crops farming and livestock keeping. The groups which are involved in the project get nutritious foods for their families especially AIDS affected households. The surplus farm production is sold for income for carrying out home based care to AIDS patients, and support MVC with basic needs particularly education.

 

Thus the major approaches that are going to be used by KIWAKKUKI are the following;

 

1. Building the capacity of the communities with correct information on HIV and AIDS and   the current disease trends locally and globally. 
2. Facilitating and securing good empowerment interventions for improved livelihoods in the face of the socio-economic challenges facing the communities.
3. Building the capacity of the communities to develop approaches that will mitigate the impact of the disease. 
4. Empowerment of women and youth on awareness of human rights so that they can realize and claim their rights, as well as be part of decision making

 

1.5 GEOGRAPHICAL AREA OF FOCUS

Program interventions and VCT, will continue in Kilimanjaro region covering all the seven districts. According to this strategic plan about 70% of time and interventions will focus on   promoting community economic empowerment. The rest of the time will be spent on other programs particularly MVC support and home based care coordination.  However, education and advocacy materials like posters, brochures, CDs and some publications are made available to interested partners and people beyond the focused geographical area.

 

 

 

 

2.0 SITUATION ANALYSIS

Our situation analysis begins with the key sectors that are closely related with HIV and AIDS.

 

2.1 SOCIO-ECONOMIC ANALYSIS

2.1.1 GLOBAL CONTEXT

 

MDGs progress report on poverty eradication indicates that the target of reducing extreme poverty rates was met five years ahead of the 2015 deadline. The global poverty rate at $1.25 a day fell in 2010to less than half the 1990 rate. 700 million fewer people lived in conditions of extreme poverty in 2010 than in 1990. However, at the global level 1.2 billion people are still living in extreme poverty (UNDP, 2014)   This imply that, majority of people living in extreme poverty are found in developing countries and the conditions are worse to the poor who are HIV infected in poverty stricken areas particularly rural localities in Tanzania. Poverty has also led to HIV infection particularly women and girls who exchange sex with money to support their lives, children or families.

Globally, there are plans that were put forth for poverty reduction and improving people’s socio-economic well being. Sustainable Development goals (SDGs) particularly goal 1 and 2 aim at ending poverty in all its forms everywhere and hunger while goal 3 aims at ensuring healthy lives and promote wellbeing for all at all levels. Extreme poverty has been cut by more than half since 1990. However, more than 1 in 5 people live on less than $1.25 a day. Poverty is more than lack of income or resources; it includes lack of basic services, such as education, health, hunger, social discrimination and exclusion, human rights lack of participation in decision making. Gender inequality plays a large role in the perpetuation of poverty and its risks; it leads to potentially life-threatening risks from early pregnancy, and often lost hopes for an education and a better income. Age groups are affected differently when struck with poverty; its most devastating effects are on children, to whom it poses a life threat. It affects their education, health, nutrition and security. It also negatively affects the spiritual, emotional, and social development of children.

 

The aim of SDG goal 2 is to End hunger, achieve food security and improved nutrition and promote sustainable agriculture. Globally, about 842 million people (1 in 9 people) are undernourished; more than 99 million children under five age group are undernourished and underweight. The vast majority of these people live in developing countries. Agriculture is the single largest employer in the world, providing livelihoods for 40 per cent of today’s global population. It is the largest source of income and jobs for poor rural households. Women comprise on average 43% of the agricultural labor force in developing countries, and over 50% in parts of Asia and Africa, yet they only own 20% of the land. Poor nutrition causes nearly half (45 per cent) of deaths in children under five – 3.1 million children each year.

 

Goal 3 aims at Good Health and Well-being - Ensure healthy lives and promote well-being for all at all ages. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality, and major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV and AIDS.

             MDGs progress report indicates that new HIV infections continue to decline in most regions. The number of new infections per 100 adults (aged 15-49) decline by 44% between 2001 and 2012. An estimated 2.3 million cases of people of all ages are newly infected and 1.6 million people died from AIDS-related causes. Comprehensive knowledge of HIV transmission remains low among young people, along with condom use. On the other hand, about 210,000 children died of AIDS –related causes in 2012 compared to 320,000 in 2005

 

 

 2.1.2 ECONOMIC SITUATION IN TANZANIA

Tanzania is among the poorest countries in the world with a per capita Gross National Income of US $ 550. Tanzania is ranked at position 152 out of 187 countries on the Human Development Index (UNDP 2011). The economy depends heavily on agriculture, which accounts for more than one-quarter of GDP, provides 85% of exports, and employs about 80% of the work force. Macro-economic performance in Tanzania has been resilient to shocks with an estimated real GDP growth of 6.4% in 2012. Furthermore, GDP is projected to remain buoyant, increasing to 6.9% in 2013 and projected to 7% in 2014, creating opportunities for financing key social sectors, such as health, including HIV, TB, and malaria programmes (Tanzania Country Notes, 2013).Despite the impressive GDP growth, poverty remains persistent and has been at the centre of the development debate. The gap between the rich and the poor has continuously widen to date. It was against this background that the new national development agenda, MKUKUTA II, was designed with a greater focus on making growth more broad based and pro-poor. Under the food and nutrition security anti-poverty strategy, the government rolled out the “Kilimo Kwanza” or “Agriculture First” initiative, designed to reduce poverty through increased productivity in agriculture, which has been an integral part of the overall development strategy. This strategy was targeted to reduce poverty from the 2012/2013 level of 34% to 24% by 2015 – still higher than the MDG target of 19.3%. Priorities include clean water provision and irrigation, financial and insurance services, value addition, trade and exports development. Unemployment also remains a concern with nearly 2.4 million people unemployed as of 2011. Most of the unemployed are young and urban-based, representing 10.7% of the population. A lack of sufficient employment opportunities for young women, in particular, exposes them to risky behavior with incumbent dangers of HIV infection. Recognizing the challenges posed by Tanzania’s economic climate, and the social and economic vulnerability of a significant part of the national population, the government of Tanzania has put in place Vision 2025 (TDV 2025) plan, the second National Five Years Development plan (FYDP II 2016/17-2020/21), and has ratified the Sustainable Development Goals (2015-2030). 

 

 

2.1.2.1 The Tanzania Vision 2025

The utmost goal of TDV 2025 is that, by 2025 Tanzanians will be living in improved conditions and by then will be a substantially developed one with a high quality livelihood. This plan also expects to eradicate abject poverty. In other words, it is envisioned that Tanzanians will have graduated from a least developed country to a middle income country by the year 2025 with a high level of human development. The economy will have been transformed from a low productivity agricultural economy to a semi-industrialized one led by modernized and highly productive agricultural activities which are effectively integrated and buttressed by supportive industrial and service activities in the rural and urban areas. A solid foundation for a competitive and dynamic economy with high productivity will have been laid. Consistent with this vision, Tanzania of 2025 should be a nation imbued with five main attributes; high quality livelihood; peace, stability and unity; good governance; a well educated and learning society; and a competitive economy capable of producing sustainable growth and shared benefits.

 

2.1.2.2 National Five Years Development Plan 2016/17-2020/21 (FYDP II)

In line with the TDV 2025, the Five Years Development Plan II theme is “Nurturing Industrialization for Economic Transformation and Human Development”. Plan is projected to raise annual real GDP growth to 10 percent by 2021 (from 7.0 percent in 2015), per capita income to US$ 1,500 (from US$ 1,043in 2014) and reduction of the poverty rate to 16.7 percent from 28.2 percent recorded in 2011/12. The Plan also envisages raising Foreign Direct Investment (FDI) flows from US$ 2.14 billion in 2014 to over US$ 9.0 billion by 2021; increase electricity generation from 1,501MW in 2015 to 4,915MW by 2020 and improving electricity connections to 60 percent of the population, up from 36 percent in 2015. On average, manufacturing sector will grow by over 10 percent per annum with its share in total exports increasing from 24 percent in 2014/15 to 30 percent in 2020. An under- five mortality rate reduction from 81 deaths per 1000 live births recorded in 2014/15 to around 45 deaths per 1000 live births; maternal mortality reduced from 432 per 100,000 in 2014/15 to below 250 deaths by 2020/21. Also, access to clean and safe water in rural areas improved from 72 percent recorded during 2014/15 to 85 percent by 2020/21 and in urban areas to more than 90 percent. As a result, there will be improvement in national Human Development Index (HDI) from the value of 0.52 (2014) to 0.57 by 2021. However, fiscal performance continued to exhibit “stresses” due to faster rates of expenditure compared to domestic resource mobilization, despite revenue collection generally improving. Revenue to GDP ratio increased modestly from 11.6 percent during 2010/11 to 12.4 percent during 2014/15. The ratio was, however, well below FYDP I target of 14.4 percent.

Just as it was for the Arusha Declaration, Good Governance is essential for successful realization of expected economy level. There must be integrity and strong accountability systems for fiscal control. “For Tanzania to achieve development we need Good Politics, Good Leadership, Land and People” J.K. Nyerere. Economic growth and stability will provide relief to PLHA and to AIDS affected households.

 

 

 HIV AND AIDS SITUATION IN TANZANIA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Since the first three AIDS cases were reported in Tanzania in 1983, infections have spread rapidly leading to a generalized epidemic, with some areas more concentrated with the epidemic, and a devastating impact on social and economic development. The predominant mode of HIV transmission is heterosexual contact between HIV-infected and uninfected individuals, with sexual transmission accounting for approximately 80% of infections. Mothers to newborns transmission account for about 18% of infections and medical transmission through unsafe blood for approximately 1.8%. TDHS (2010) reported that Mother to Child Transmission (MTCT) is the second most common cause of HIV transmission within the Country. There are two notable gaps; these include low levels of attendance of ante-natal clinics (out of the 4 recommended visits) and lack of full integration of Prevention of Mother to Child Transmission (PMTCT) services in Maternal and Child Health services. Approximately, 24% of HIV positive pregnant women that attended antenatal clinics were not reached by PMTCT services and 43% of HIV exposed infants who needed ARVs to prevent MTCT did not receive it due to limited access to treatment, stock outs of commodities, or attrition from the program (TDHS, 2011). By the end of 2012, Tanzania had an estimated 1.5 million people living with HIV and approximately 86,000 new HIV infections (Spectrum, 2013). This can be attributed in part to widespread risky behaviors, inconsistent and incorrect condom use, inadequate numbers of eligible individuals on antiretroviral therapy, increased gender-based vulnerability, and some risky, traditional cultural practices.

2.2.1 HIV Prevalence in the Country

Although HIV prevalence in Mainland Tanzania has declined from 7.0% to 5.3% during the period from 2003/04 to 2011/12 among all adults aged 15-49, and from 6.3% to 3.9% among men in the same age group, there has not been a statistically significant decrease among women. For both men and women, HIV prevalence increases with age generally and women invariably have higher prevalence rates in all age groups compared to men. However, prevalence among young women aged 25 – 29 is 3 times higher compared to young men in the same age group. The incidence of HIV infection in the age group 15-49 years peaked at 1.34% in 1992, declined rapidly down to 0.64% in 2000, and steadily declined further to 0.32% in 2012. Similarly, HIV prevalence increased to a peak of 8.4% in 1996, declined to 5.7% in 2008, and declined further to 5.3% by 2012. However, a wide variation exists between regions and within regions across social and age groups (THIS 2004, THMIS 2012).

 

2.2.2 HIV Prevalence by Regions in Tanzania

Regional variation throughout Mainland Tanzania ranges from 1.5% in Manyara to 14.8% in Njombe. While there was an overall decline in HIV prevalence in Tanzania in the period 2008 and 2012, there are some regions in which the prevalence rates rose up. The regions that witnessed an increase in prevalence levels are 8 and these include; Ruvuma, Rukwa, Kagera, Mtwara, Kilimanjaro, Kigoma, Singida and Arusha. The increase in HIV prevalence in these regions could be a factor of successful care and treatment programmes or an actual rise in HIV infection within the regions or both. Other possible factors, such as HIV test refusal rates, should also be explored to explain the change in prevalence over this short time period. (THMIS 2012)

 

Table 1, HIV Prevalence in Tanzania Regions

S/No	REGION	PREVALENCE RATE (%)		S/No	PREVALENCE RATE (%)	REGION
1.	Arusha	3.2		13	Iringa	9.1
2.	Kilimanjaro	3.8		14	Mbeya	9.0
3.	Manyara	1.5		15	Rukwa	6.2
4.	Mara	4.5		16	Kagera	4.8
5.	Dodoma	2.9		17	Mwanza	4.2
6.	Singida	3.3		18	Geita	4.7
7.	Pwani	5.9		19	Tabora	5.1
8.	Dar es salaam	6.9		20	Shinyanga	7.4
9.	Lindi	2.9		21	Katavi	5.9
10.	Mtwara	4.1		22	Kigoma	3.4
11.	Ruvuma	7.0		23	Morogoro	2.9
12.	Njombe	14.8		24	Tanga	2.4
				25	Simiyu	3.6

 

 

 

 

 

Source: THMIS, 2011/12

 

 

HIV Prevalence rate for Tanzania Regions (THMIS, 2011/12)

 

 

2.2.3 Orphans and Most Vulnerable Children

According to a 2007 study, approximately one million children in Tanzania had been orphaned,

12% of the vulnerable children had been separated from their siblings, and up to 240,000 children below the age of 15 were living with HIV and AIDS (Social Protection in Tanzania, 2007). More recently, orphaned children were estimated at 11.2% in urban areas and 9.2% in rural areas in Mainland Tanzania. Regarding food scarcity, 9% of urban and 17% of rural households reported often having problems satisfying their food needs. Access to improved sources of drinking water is also unavailable for more than 11.4% of urban dwellers and 53.2% of rural dwellers. While almost all youths aged 15-24 years have heard about HIV and AIDS, less than half have enough knowledge to protect themselves against infection.

 

2.2.4 Early Sexual Practices

Early sexual debut and adolescent sexual networking without protection exposes young people, especially girls, to HIV and STI infection. In Mainland Tanzania, 9.7% of young women and 10.2% of young men aged 15-24 had sexual intercourse before age 15, while 51.6% of young women and 43.9% of young men aged 18-24 had sexual intercourse before 18 (THMIS 2011-2012). Out of those who have never married (15-24), only 57.9% of women and 59% of men used condom during their last sexual intercourse (THMIS2011/12). According to the Violence Against Children survey (VAC) results, 4% of Tanzanian girls received money or goods in exchange for sex at least once in their lifetime. Of the girls, 82% who reported receiving money or goods for sex also reported childhood sexual violence; 90% who received money or goods for sex reported childhood physical violence by a relative, and 50% who received money or goods for sex reported childhood emotional violence (Violence Against Children Report, 2011). A study conducted in Mwanza region on cross-generational and transactional sexual relations revealed that the main reason for having sexual relationship was to receive presents or money. The study involved male and female respondents aged 12 years and above from primary 52% and secondary schools 10% (Luke & Kurtz, 2002).

 

2.2.4 Gender Based Violence (GBV)

Gender inequality and gender based violence have been cited in various reports to contribute to HIV infection. Unequal power relations between men and women limits decision making for women and girls in negotiating for safe sex and condom use, and increases the extent of violation of women’s and girls’ rights. The most common forms of GBV are physical, sexual, psychological, and economic, including financial deprivation and exploitation. The Tanzania Demographic and Health Survey (2010) reveals that 39% of women in the age 15-49 years have experienced physical violence at least once in their lives, with 33% of such violence occurring within the 12 months preceding the survey. There are notable zonal variations in GBV ranging from 61% of women in the Central zone to 22% in the Northern zone having experienced GBV, irrespective of woman’s education or economic status (DHS, 2010). Overall 10% of women in the age 15-49 years had a forced first sexual intercourse (DHS, 2010). Results from the National Survey on “Violence against Children” in 2012 by UNICEF in Tanzania show that girls are particularly vulnerable to sexual violence. Nearly one out of three females and one out of seven males have experienced some form of sexual violence prior to the age of eighteen. Few children disclose, fewer children seek services, and even fewer receive them when they are brave enough to report. Overall, the National Survey showed that about 48% of girls and 68% of boys had never disclosed the sexual violence that they had experienced in childhood prior to the survey. Only about 20% of girls and 10% of boys who had experienced sexual violence sought services after the experience, but not all respondents who sought services received them. Approximately 13.0% of females and 3.7% of males who experienced sexual violence reported that they actually received services after seeking them. Girls who received services said they received counseling, clinic, or hospital services, or help from an elder or community leader. Tanzanian children experiencing sexual abuse and violence are more likely to be exposed to sexual exploitation, including transactional sex, less likely to have a HIV test or use condoms, and more likely to have multiple sexual partners as they grow older (Violence Against Children Report, 2011). The result from “Child Sex Abuse “in 2012 revealed that young children are not safe. The problem of child and sexual abuse in the society is growing. The need for concerted public education on the nature of this violence and its consequences is imperative.

 

Women and girls are more vulnerable to HIV infection than their male counterparts in Tanzania due to biological, socio-cultural and economic factors. According to UNAIDS, up to 80% of HIV sero-positive women in long term relationship acquired the virus from their partners. This might resulted from inequalities manifested by gender based violence, such as rape, sexual assault and battery. Other factors such as multiple sexual partnership, polygamy, violence, alcohol, and substance abuse also play an exacerbating role in reinforcing gender inequalities.

 

 

2.2.5 Risky Traditional Practices

Although Tanzania has positive traditional practices which help to mitigate the impact of HIV and AIDS, such as strong extended family support structures and social sanctions, there are also some risky traditional practices that hinder the effectiveness of the national response. These include wife inheritance by a male relative of the deceased husband, female genital mutilation, early or child marriages, and limited property rights for widows. HIV Prevalence among widows aged 15 and 49 years is estimated at 24.7%. A comparison of TDHS 2004 data and that of the TDHS 2010 shows that the proportion of married young women aged 15-19 years fell by 20% while, pregnancy and childbirth among young women of this age dropped by more than 12%. Nevertheless, despite the gains, one in six young women aged 15-19 is married. In addition, young women and girls face a significantly higher risk of death from pregnancy and delivery-related complications, which is further compounded by the high frequency of births which occur at home without skilled attendants. Such situations are risky for new HIV infections.

 

 

2.2.6 HIV Prevalence among Key Populations

Key Populations, in this context refer to populations at high risk for exposure to HIV or for transmitting HIV. For our case these key populations include all PLHA, as well as discordant couples, sex workers and their clients, men who have sex with men, women who have anal sex, and people who inject drugs. Other vulnerable groups who may also be among those at higher risk for HIV exposure or transmission include women and girls, youth, people in conflict and post-conflict situations, refugees and internally displaced persons, migrant laborers, and people working in mining and fishing industry and their surrounding communities. Recent studies conducted in various regions in Tanzania showed varying degrees of HIV prevalence among key population groups, with the prevalence of MSM, FSW, and PWID all are significantly above the national average (Country Progress Reporting, Part A: Tanzania Mainland, 2012). This variation is alarming and therefore calls for effective strategic HIV prevention interventions. In the Tanzanian context, other population groups that deserve special consideration in HIV programming include prisoners, long-distance track drivers, disabled (in all forms), fishing communities, and people in mining, women and children.

 

2.2.6.1 Sex Workers

A sex worker includes anyone who exchanges sexual services for money or goods, whether regularly as a full-time activity, or temporarily as a short-term measure. Sex workers include both men and women, young and old. Prevention, care, treatment, and support programmes for sex workers and their clients are being implemented in Tanzania, but need significant expansion and support. In a study conducted with 537 female sex workers in Dar es Salaam, one-third of respondents were reported to be divorced or separated, while over half were never married. In the study, 69.7% reported that sex work constituted their main source of income; 31.4% tested HIV positive; 69.3% reported always using a condom with regular clients though only 31.6% reported always using a condom with their steady partner in the previous 30 days. A high prevalence of 51.7% sexual and physical abuse were reported as among the issues associated with sex work. Stigma and discrimination against sex workers remains high, posing a significant challenge to outreach and delivery of friendly health services.

 

 

2.2.6.2 Men Who Have Sex with Men (MSM)

In a research study of 271 MSM with a mean age of 26 years, 41% were reported to have tested

HIV positive; 63.1% had also been married or cohabited with a woman at least once in their life. Those reporting no condom use with their last casual sex partner was 43.2%, while 49.1% used condoms with their last regular sex partner. About 30% of all respondents were reported to be engaged in commercial sex work (Condom Use in MSM, 2013). Stigma and discrimination against MSM remains high, also posing a significant challenge to outreach and delivery of friendly health services. Given the criminalization of consensual adult homosexual intercourse, any response requires significant cooperation from all key stakeholders to ensure that MSM are reached with HIV and AIDS services.

 

2.2.6.3 People Who Inject Drugs (PWID)

A small sample survey of 430 respondents undertaken in Temeke Municipality, Dar es Salaam region revealed an HIV prevalence of 26% (34.8 % among Injecting Drug Users and 11.7 % Non Injecting Drug Users). Among the newly diagnosed Injecting Drug Users, women had higher HIV prevalence and there was also a high proportion of Hepatitis C co-infection. Gender also played a significant role in the risk profile of injecting and non-injecting drug using participants. Males and females did not report significantly different injecting risk behaviours, but females were more likely to have sold sex and have a higher number of sex partners thus increasing their vulnerability to HIV infection.  Among People Who Inject Drugs (PWID) with non-injecting partners, 89% of males and 75% of females reported inconsistent condom use with their regular partner (Risk Practices among PWID in Temeke, 2011). Stigma and discrimination against PWID remains high, posing a signify cant challenge to outreach and delivery of friendly health services. This highlights the need to prioritize the recommended package of comprehensive intervention for HIV prevention and care among PWID. Furthermore, the importance of PWID not sharing needles should remain a key component of the comprehensive harm reduction package in Tanzania, together with education about the risks of sexual transmission and the need for protection through consistent and correct use of condoms.

 

2.2.7 Mobility and Migration

Migration is common in Tanzania. In particular, the expansion of the mining sector has led to greater urbanization and mobility between rural and urban areas. This means that young and sexually active men come into close contact with ‘high risk sexual networks’ made up of sex workers, women at truck stops and miners: all of whom have high levels of HIV prevalence. Long-distance truck drivers, agricultural plantation workers and fisherman working along coastal trading towns are also at an increased risk of HIV. It is not only mobile men who are at increased risk of HIV infection. Women who travel away from home five or more times in a year have been found to be twice more likely to be infected with HIV than women who do not travel (Avert  report, 2016).

Mobile population groups such as seasonal labourers in plantations, road construction sites, mobile markets, truck drivers, fishermen and miners are vulnerable to HIV infection because they often practice higher risk sex with non-marital or co-habitating partners. Studies have found samples of long-distance truck drivers with high HIV prevalence. These results are consistent with the findings in the THMIS 2007/08 and 2011/12, which found that individuals who travel away from home frequently are more likely to be HIV positive than those who do not. Among women in the THMIS 2011/12, those who had slept away from home five or more times in the past 12 months were twice as likely to be HIV positive (11%) as those who did not travel away from home (5%).

2.2.8 Stigma and Discrimination against PLHA

Stigma is highly prevalent in Tanzania at various levels and settings, as data from the 2012 Stigma Index indicates that here is breaching of confidentiality through health delivery systems. While 15% of the PLHA felt that health care providers did not keep their information confidential, another 5.4% had their HIV status disclosed without their consent. Further, the study revealed discrimination by health care providers. For example, 13% of PLHA were told not have children, 44% were denied access to reproductive health information, 14% were coerced in accepting particular infant feeding options, and about 9% were coerced in their use of family planning methods. Few (19%) eligible pregnant women living with HIV received ART for PMTCT. Others were coerced into sterilization and pregnancy termination by health service providers due to their HIV positive status (People Living with HIV Stigma Index, 2012). The study also reveals high levels of self-stigma. Most PLHA reported a sense of shame (44%), self-blame (63.4%), feelings of worthlessness (85%), feelings that PLHA deserves to be punished (10%), and self-isolation because of their HIV positive status. Self-Stigma drives many PLHA who are sexually active not to bear children (38%) or get married (16%) because of their HIV positive status. PLHA also remove themselves from places where they would be potentially stigmatized, including work places, for fear of gossip (45%), being verbally insulted, harassed, and threatened (30%). Furthermore, the study showed that fewer PLHA know where to seek assistance once their human rights are violated. A majority of PLHA are not aware of their rights, the national HIV and AIDS Policy, legal information, and global commitments on HIV and AIDS (AIDS-NMSF, 2013). In addition, community acceptance towards PLHA is very low. As the stigma index reports, 25% of women and 40% of men in Tanzania do accept interacting with PLHA. The situation is critical in rural areas where only 21% of women and 35% of men have positive attitudes toward PLHA, as compared to 36% of women and 54% of men in the urban areas.

 

2.2.9 Enrolment in Care and Treatment Centers

By June 2012, one-third (34%) of PLHA had not been enrolled for care: only 54% of all children and adults enrolled in care and treatment were ever enrolled on ARVs as of March 2012 and these constituted 41% of the estimated total of PLHA. Thus, both the overall target of enrolling 90% of PLHA on ART and 18% of all enrolled PLHA on ART as children has not been met. There is significantly low (35%) enrolment of males in care and treatment and have shown to report late for treatment (MoHSW, 2011). Nevertheless, the number of people estimated to be infected with HIV has held steady because of ongoing new infections, population growth, and the availability of life-sustaining treatment for those infected. The cumulative number of clients on antiretroviral treatment (ART) as of June 2012 was 626,444, surpassing the “3 by 5” target of 440,000 by 2011.

 

2.2.10 HIV Policy and Legal Environment

Tanzania developed its first National Policy for HIV and AIDS in 2001, subsequently implemented through two strategic frameworks which were completed in 2012. In 2008, Tanzania enacted the HIV Prevention and Control Act (HAPCA). Part VIII of the Act provides for PLHA rights and obligations. Section 33(1) (a) and (b) provide for rights to access quality medical services and treatment for opportunistic diseases. Section 33(2) (a) and (b) provide for obligation of protection to others from re-introducing infections into the population. According to Section 28-32 of this law, discrimination is a punishable offence. In 2010, regulations for HIV Counseling and Testing, use of ARVs, and disclosure were developed and published. The regulations provide for protection against forced testing and mandatory disclosure. The National HIV and AIDS Policy (2012) further emphasize the importance of respect for the human rights of PLHA, as stipulated in the Constitution of the United Republic of Tanzania. Specifically the policy commits to enhancing measures that ensure all civil, legal and human rights for men, women, boys and girls living with HIV and AIDS, in accordance with the URT Constitution and other International Conventions. Against a backdrop of protective policies and laws, the Law of Marriage Act (1971), which provides for early marriage (15 years for females by statute, or 14 years with consideration of “special circumstances”) thus increasing the risk of HIV infection to young women and girls, and other similar laws need to be urgently revised and enforced.

 

3.0 STRATEGIC PRIORITIES

This strategic plan 2017-2021 has been developed through a consensus which involved extensive consultation with various stakeholders using meetings and individual consultations. Consultations involved some board members, organization leadership, staff, PLHA, district coordinators and some regional health officers including Regional AIDS Control Coordinator (RACC). Being a participatory process we believe that this plan is people-driven and is going to be implemented using a people-centered approach.

 

                              Stakeholders during priority setting session

 

Needs Assessment consultations came up with the several strategic issues that KIWAKKUKI should focus on for the next five years period. These issues were clearly scrutinized and prioritized accordingly. They include;

1. Voluntary Counseling and Testing
2. Promoting agriculture and livestock initiatives using up to date technologies
3. Continue searching for internal and external sources of funds
4. Encourage KIWAKKUKI grass root working groups to incorporate income generating activities in their programs
5. Enhance publicity of KIWAKKUKI organization through organized events, KIWAKKUKI website and other media.
6. Networking with likeminded organizations
7. Encouraging the communities to take the responsibility of supporting the vulnerable groups
8. Sensitize the community on child rights, proper parenting and development
9. Impart health education to the community on Sexual and Reproductive Rights, and gender.
10. Design different ways/approaches for fundraising
11. Continual support the community on memory work activities
12. Encourage KIWAKKUKI members to keep up the voluntarism spirit
13. Encourage youth to organize themselves into KIWAKKUKI youth groups
14. Enhance “school without walls” HIV and AIDS education approach
15. Coordinate Home Based Care (HBC) community activities
16. Develop and conduct youth programs for HIV prevention outcomes.

 

The above strategic issues led to the formulation of four program components whereby respective activities for the coming five years were clustered accordingly.

The four program components are;

5. Community Economic Empowerment
5. Awareness rising about HIV, AIDS and STIs prevention
5. Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination
5. Most Vulnerable Children (MVC) support

 

4.0 PROGRAMME DESCRIPTION

4.1 COMMUNITY ECONOMIC EMPOWERMENT

SDG goal 1.1 target is by 2030, to eradicate poverty for all people everywhere, currently measured as people living on less than $1.25 a day. On the other hand, goal 1.5 target is, by 2030 to build the resilience of the poor and those in vulnerable situations, and reduce their exposure to vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters. In line with these targets, KIWAKKUKI objective 1 intends to build the capacity of the communities particularly HIV and AIDS affected households in sustainable agriculture and animal keeping activities using up to date technologies which are very considerate on climate changes and environment protection. On the other hand the food crops and animal varieties which are sought for such projects those with high nutritional values to keep healthy the PHLA, orphans and their respective families. This is also supported by SDG goal 2 which aims to end hunger, achieve food security, improving nutrition and promoting sustainable agriculture.

Despite the international SDGs targets, the Tanzania Vision 2025 aims at transforming the national economy from low agricultural productivity to a semi industrialized one led by modernized and highly productive agricultural activities. Furthermore, national FYDP II goal is to nurture industrialization for Economic Transformation and Human Development. Thus, KIWAKKUKI has aligned objective 1 with these broader national goals. We expect that, the communities will produce surplus crops and animals which will have read-markets the nation is struggling to put in place industries which will require internal raw materials.

 

Objective 1

Activities

Encourage communities to engage in sustainable income generating activities including microcredit facilities

Resource Mobilization Improve and advertise organization hired assets and services (eg, KIWAKKUKI meeting halls, tailor-made trainings, and VCT services. Promote voluntarism among members Community sensitization about secured projects Establishing community groups Establishment of demonstration plots (for agricultural projects) Conduct trainings for capacity building on projects concerned Projects Monitoring & Evaluation Identify and expand the capacity of super farmers Conducting entrepreneurship trainings to KIWAKKUKI grass root working groups Incorporate  VICOBA/VSLA in community groups Encourage the KIWAKKUKI groups to undertake formal registration Monitoring  the groups’  activities Encouraging youth to join the IGA groups Conducting localized Social Accountability Monitoring (SAM)

 

 

4.2 Awareness rising about HIV, AIDS and STIs prevention

According to HIV and AIDS Policy 2001, the community is the key in curbing the HIV and AIDS epidemic. Thus it calls for the communities to be fully informed about HIV and AIDS and the real life challenges in its prevention and care. In the coming five years KIWAKKUKI will continue to provide HIV and AIDS knowledge and information to the community, support the development of appropriate approaches to reduce HIV infections and care for PLHA, and orphans in their localities. Thus in Objective 2 the following activities will be implemented;

 

 

Objective 2

Activities

Promote  HIV and AIDS prevention through community awareness raising for behavior change

Daily education on HIV and AIDS to the drop-in people Education session on HIV and AIDS to youth in schools and out-of-schools External HIV and AIDS sessions to other institutions Life skills training to youth Sexual and Reproductive health, and STIs education to youth Networking with like-minded organizations Provide health and gender education to the wider community Encouraging youth to join KIWAKKUKI grass root working groups Provide AIDS education in both formal and non formal gatherings Conducting Social Accountability Monitoring (SAM)

 

 

 Voluntary Counseling and Testing (VCT) and Home Based Care (HBC) Coordination

While maintaining confidentiality as required by the policy, KIWAKKUKI will promote early diagnosis of HIV infection through voluntary testing with pre-and-post test counseling. Also the organization will coordinate Home Based Care that will be offered to PHLA within the respective households, by the community grassroots groups.

 

Objective 3

Activities

Provide support to the infected and affected people through VCT and coordinate the associated home based care.

Free same day results for Mobile/ Outreach VCT using the Tanzanian National HIV and AIDS policy guidelines Free same day results at the Office stand alone VCT using the Tanzanian National HIV and AIDS policy guidelines Algorithms for testing. Referrals complementing other available services e.g. CTC services, Orphans support, and PLHA clubs  Coordinate home based care activities External referrals to other specialized centers for further Diagnosis, Investigations. Facilitate and encourage KIWAKKUKI groups to visits and support AIDS patients in their homes Follow up to ensure the groups provide quarterly reports.

 

4.4 Most Vulnerable Children (MVC) support

Poverty and lack of well-developed national and community supporting systems have impeded MVC access to quality care and support services. Studies indicate that community based care programs increase access to important interventions for people living with HIV and those affected by HIV and AIDS. Upon availability of resources, KIWAKKUKI will continue to support MVC and also empower the communities to take care of this group.

 

Objective 4

Activities

Promote community empowerment on child development programs and support to most vulnerable children

School sponsorship include: Primary, Secondary. (Ordinary level and /Advanced levels) and Vocational Skills is done. Students of Institutions of Higher learning not beneficiaries of the program.    Shelter support to the needy  orphaned  child headed families Income Generating Activities (IGA’s) to orphans families caring children less than 8 years through their caregivers. Psychosocial support to parents/caregivers and children as the case may be.   Memory work to facilitate communication between PLHA parents and children on their status, how to write memory book and to have legal arrangements for the future of their children when the need arises. Facilitate and encourage KIWAKKUKI grass root working groups to prepare an action plan for vulnerable groups support Popularizing ICDP knowledge to parents/guardians and the wider community Education to the community about child rights Enhancing community actions on Violence Against Children (VAC) Carrying out Social Accountability Monitoring (SAM)

 

4.5 Organization Capacity Building

The organization prosperity highly depends on availability of committed and competent staff, availability of financial and other resources, friendly working environment as well as enabling policies, rules and regulations. In order to achieve this objective, we have planned to do the following throughout the next five years;

• Continuous fundraising efforts and community contribution
• Staff development through short courses, trainings etc.
• Proper resources management
• Networking

 

5.0 BUDGET PROJECTION (US$)

Expected budget allocation to support program activities for the five years is summarized below:

 

PROGRAM ITEM	2017 Est	2018 Est	2019 Est	2020 Est	2021 Est
Community Economic Empowerment	81,000	112500	174000	156000	171000
Awareness rising about HIV, AIDS and STIs prevention	21600	37500	46400	41600	45600
Voluntary Counseling and Testing (VCT) and (HBC) Coordination	40,500	56250	87000	78000	85500
Most Vulnerable Children (MVC) support	32400	37500	69600	62400	68400
Organization Capacity Building	27000	37500	58000	52000	57000
Organizational Administration	54000	75000	116000	104000	114000
Balance to carry forward	13,500	18750	29000	26000	28500
TOTALS US$	270000	375000	580000	520000	570000
GRAND TOTAL USD	2,315,000

 

6.0 SWOT ANALYSIS

Successful implementation of this five years plan depends on various factors. This necessitates us to evaluate ourselves and position ourselves in a way that we understand and maximize the utilization of our strengths and opportunities, foresee challenges and minimize them accordingly. 

6.1 Organization strength

• Board of trustees who play an oversight and advisory role for the organization.
• Committed and cooperative  organization members
• Committed grass root working groups who understand their roles and responsibilities
• Voluntarism spirit among staff and members of grassroots groups
• Participatory planning which lead to people’s ownership of the interventions
• Committed human resource, financial and accounting policies and regulations
• Well established reporting structure
• Effective collaboration and networking
• Presence of international and national frameworks, Acts, policies and guidelines which guide KIWAKKUKI’s activities
• Good reputation and relationship with government at all levels
• Highly trusted VCT centre

 

 

6.2 Weaknesses

• Dependency on donor funds to support the programs
• Limited funds
• Lack of M&E personnel in the organization
• Inadequate resource mobilization strategies
• Limited  number of program staff
• Communities dependency on KIWAKKUKI for material support especially the HIV and AIDS affected households

 

6.3 Opportunities

• Committed members are ready and willing to volunteer for ongoing support of PLHA
• Government support to our office stand alone VCT center
• Current Government campaigns for people to work hard “Hapa kazi tu”
• Organization has its own premise
• Most of the PLHA who use ART are in good health and energetic.
• Many PLHA are involved in empowerment efforts in the community, for self support
• Volunteers from abroad who come with different skills

 

6.4 Threats

• Diminishing financial resources
• Inability to hire new, competent staff
• Poor facility to reach PLHA directly in their households for HBC monitoring
• Minimal provision for adequate support to community vulnerable groups particularly the MVC.

 

7.0 RESOURCE MAPPING

CATEGORY	AVAILABLE	REQUIREMENT
Human Resources	Currently KIWAKKUKI has 12 staff and 5 volunteers at our main office.	Upon availability of funds KIWAKKUKI will hire 10 more staff for the main office and 5 staff for each district in 7 districts that KIWAKKUKI works with. Main Office requires: -2 VCT new staff, -1 staff HIV education program -2 staff for MVC program -2 staff for CEE program -2 staff for M&E and fundraising -1 program Coordinator   District Offices require: -1 counselor for VCT services -1 District Coordinator -1 Office attendant -1 Security guard
Materials -Vehicles -computers -cameras -projectors -buildings	We have; - 2 motor vehicles -1 video camera and -2 LCD machines   We have a well established office building, the main office.  We also have 1 office in Same district, and 1 building in Korongoni Ward.	We need; -1 motorbike for each of the 7 districts.   -1 Computer and 1 camera for each of the 7 districts   -Each district need to have office premise owned by KIWAKKUKI

 

8.0 GOVERNANCE AND ACCOUNTABILITY STRUCTURE

KIWAKKUKI is a nongovernmental organization which was found in 1990 and formally got registration in 1995 with a registration number SO 8488.  Later in 2011 KIWAKKUKI complied with NGO Act 24/2002 and received a Certificate of Compliance No.00001413. KIWAKKUKI is governed by supreme Board of Trustees and the Members’ Council who are democratically elected by members as stipulated in the organization constitution.

Currently, KIWAKKUKI Management is comprised of the Executive Coordinator, Head of Programmes, Head of Finance and an Administrator. The team oversees day to day implementation of organization activities.

 

 

 

 

MEMBERS

AGM (REPRESENTATIVES FROM EACH DISTRICT)

REGIONAL COUNCIL

BOARD OF TRUSTEES

EXECUTIVE COORDINATOR

HEAD OF FINANCE

HEAD OF PROGRAMMES

ADMINISTRATOR

CASHIER

RESOURCE MOBILIZATION OFFICER

PROGRAMME OFFICERS OFFICERS

M & E OFFICER

SUPPORT STAFF STAFF

DISTRICT COORDINATORS

DISTRICT ANNUAL GENERAL MEETING

DISTRICT COUNCIL

GRASSROOT WORKING GROUPS

KIWAKKUKI ORGANOGRAM