Increasing male involvement in community Home based care by Oulu


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Presented by; Kennedy Oulu (Technical Adviser) P/Bag 26, Chitipa Tel: Land- +265 1382384 Cell: +265 9134588 Fax: +265 1382269 E-mail

Why male involvement!
 Culture is pregnant with gender constructs  Roles of men/boys and women/girls are well defined within the culture  Care of the sick in the community is thus a womanthing  Men/boys are brought up to breadwin  BUT:  Women/girls are overwhelmed, due to the debilitating impact of HIV/AIDS….and…Resources have become scarce even to men  And, women do not control productive resources  Hence- Men must care; men must be on the move to support; for men to be REAL MEN

What had Tutulane achieved by November 2007?
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Out of 64 care-givers, 20 were male and 44 female, representing a gender ratio of 31% being male. Out of 47 care-givers trained, 14 were men, representing 30% of male carers trained. Among 18 PLWHIV under Tutulane+ support group, 10 men have publicly declared their status, being 55%. Client visitation per month per care-giver stood at 7(Not differentiated by Gender) Number of PLWHIV under care at 93 37% of male clients were on ARV compared to 63% of female clients. PASAKA membership was at 65 in one TA-Mwaulambya 4/8 Group village heads were PASAKA members.

Where are we @ now?
 There are 75 care-givers, where 34 are males and 41 female. As a percentage, 45% are male and increase of 14%. In absolute terms, 11 new male-carers entered the program compared to 2 female carers. Additional 6 male-carers were trained under a refresher course on HBC service provision in January 2008, making the total male carers trained so far to be 20. The number of PLWHIV under care stands now at 101, being 47 male and 54 female clients, being an increase of 7 (From 93 in November) The frequency of visitation has gone down from 7 to an average of 4 per month. The frequency for male carers is 3 while for female-carers is 5. The number of clients on ARV stands at 53/101, which is 52.5%. Out of this, 25 males and 28 females are on ARV. This is a deviation from the previous scenario.

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Where we @.....contd.
 PASAKA (Men team advocating on PMTCT, ART literacy and review of risky cultures escalating HIV) have expanded to 2 TAs (Kameme and Mwaulambya)  The following table illustrates the new membership by TA and the increase thereof.
Traditional Authority No. New in Memb Nov. ers 2007 65 65 50 50 No. @ Feb. 2008 60 50 110

Mwaulamby a Kameme Totals

Where we @.....contd
 Tutulane GIPA program has expanded to support Kameme TA(Through TASO), Chinunkha-through Chinunkha CBO, Nthalire-through Acgoman CBO, Misukuthrough Timverane Tayali and Wenyathrough Rainbow CBO. There are thus 70 members of PLWHIV+ support groups in the District, with 26 males and 44 female. Acgoman of Nthalire has not been mobilised. Support group
Tutulane+ Titi+(TASO)

10 4

Fem ale
11 14

21 18










Tukumbuke+(Timv erane Tayali)




Justification of the trend;
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Tutulane has realized “significant” increase in male involvement in community and Home based care, and PASAKA. The following are justifications for the trend; Intensified PASAKA campaigns in the community. Expansion of PASAKA concept to other TAs, especially Kameme Greater involvement of Traditional authority leaders and cultural ombudsmen More interest by donors willing to support the concept Gender awareness and the increasing burden of care in the community Increased services to the PLWHIV, through access to OI drug supplies under the PACT-M project Improved volunteers capacity, especially HBC and PASAKA Greater involvement of PLWHIV through the affiliated Tutulane+ Support groups

Analysis of trend
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The increase in number of male care-givers is attributed to advocacy on male involvement, better volunteer management and increased access to OI palliative supplies The increased number of PLWHIV under care is hinged to improved quality of service, more openness around HIV/AIDS among PLWHIV enhancing disclosure. The frequency of visitation has gone down, due to previous lack of OI drug kits thus demotivating care-givers. Increase in number on ARV is due mostly to ART literacy, but can also be attributed to the availability of CD4 count machine at the District Hospital, though not yet well publicized. This is an opportunity for the district to expand the roll-out, but a challenge when access to ARVs is still a big issue. The increase in Support group membership is due to the coordinated partnership initiative with other CBOs and planned roll-out of GIPA campaign by Tutulane under the PACT-M project.

 Training volunteers on areas considered a preserve of the medical profession  Volunteers feeling that benefits of supplies and services should be controlled by them  Lack of exposure by volunteers and community on what others have done on male involvement  Transport and mobility constraints due to inadequate facilities  Cultural ombudsmen feeling that they are losing grip.  Decentralization of ARV roll-out not effective  Inadequate incentives to volunteers(Volunteers doing catholic work at the expense of their breadwinning roles)

Opportunities for scale up
 PACT-M/Tutulane integrated project  CD4 count machine and possibly a blood count machine at the District Hospital  Proposed exchange visit to Chipata-Zambia on male-involvement by RAISA  Support of the concept of male-involvement by the District  Formation of Chitipa CBO Network, which will take this as an advocacy issue  Scale up of GIPA principle in the district by TUTULANE and partner CBOs.

The motivation:
“If you feel that your contribution is like a drop in the ocean, be sure that your drop has started waves of change and hope.” Celina del Felice

Tutulane Motto;
With Tutulane, you will never walk alone. In times of goodness or sadness, we are with you. We hold your hand and walk together. TUTULANE means; Let’s help one another. END.

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