Sierra Leone – Local self-assessment, program planning and follow-up improves HIV outcomes in rural and urban communities of Port Loko and Moyamba

THE PROBLEM - Sierra Leone is a West African country with an adult HIV prevalence of 1.7%. While more than 55,000 Sierra Leoneans are infected with HIV, formal health services are limited in coverage to provide effective HIV services. THE PROGRAM - Plan International, a child-centered community development organization, has implemented since 2008 a five-year project in Moyamba and Port Loko Districts, aiming to increase HIV prevention and treatment among rural and urban populations through the “HIV competence” approach. This approach gives communities the required capacities to contribute better to a local HIV/AIDS response through employing tools such as the “HIV/AIDS Competence Self-assessment” framework. Using this framework and with external and internal facilitation, communities self-assess their HIV/AIDS competence. Thereafter, they set targets for improvement to be followed up using a planning and monitoring tool. Chiefdom/community facilitators monitor the communities' self-assessment, planning and follow-up and also encourage inter-community learning. They also work with neighboring health facilities to facilitate access to essential HIV services. RESULTS – Project staff works with 80 chiefdom/community facilitators in at least three communities (10,000-15,000 people) each year. In the first two years of the project, and after reaching nearly 25,000 people, HIV/AIDS awareness increased from 21% to 45%; PMTCT utilization increased by 44.6%; HIV prevalence among pregnant women reduced to 1.5% from 4.4%; VCCT increased by 54.5%; ARV is used by all who require the treatment. CONCLUSIONS - Communities are successful in their HIV/AIDS response if given the required confidence and support.