FHI - Ethiopia Program Reaches One Million with HIV Counseling and Testing

JULY 2008 — "It's important to know your HIV status because, first and foremost, knowledge is power," says Aida Girma, MD, MPH, FHI/Ethiopia Care and Support Senior Technical Officer. "[Knowing your HIV status] helps you maintain HIV negative status through behavior change. Early HIV diagnosis also facilitates early opportunistic infection care and access to antiretroviral therapy so that it improves the quality of individuals' lives."

In 2007, FHI's Ethiopia country office helped empower one million with knowledge of their HIV status by increasing the availability and demand for voluntary counseling and testing (CT) services. FHI equipped more than 500 service outlets to provide CT and worked with the government to create demand for services through a mass media promotional campaign called "Knowing is the Modern Way of Living." Besides underpinning peer education programs, this theme has been featured on posters and in radio and television ads.

The combination of opening new service sites and generating public demand for CT allowed FHI/Ethiopia to greatly exceed the goals it had set for the number of people it would reach with CT in 2007. And the number of people tested at FHI-supported sites in Ethiopia skyrocketed from just 5,565 in 2003 to a million last year.

Girma also attributes rising client demand for CT to the quality of the services being provided at FHI-supported sites.

"In Addis Ababa, the sites saw two or three clients per day during the initiation phase of the program. People had the perception that the health centers would not provide proper service simply because they were government, not private, sites," she says. "Today, the sites have developed an excellent reputation for providing high-quality services. Clients are satisfied, and people flood to the government sites."

For FHI/Ethiopia, building strong collaborative relationships with implementing organizations, partners, and other stakeholders, such as local governments, has been crucial to increasing the quality and availability of services. FHI/Ethiopia sought consensus from all stakeholders on program design — including selection of CT sites — and invested in strengthening existing structures and systems so that services can be sustained. Throughout, the project has emphasized helping local partners strengthen their clinical, supervisory, and program management skills.

"The effective transfer of knowledge and skills to our partners has been especially important in the CT program's success," Girma says. "In Addis Ababa, for instance, the health bureau now conducts the counseling and testing training with very little help from us. They have their own pool of trainers."

FHI has ensured that all sites receive supportive supervision that includes checking site-level activities, motivating staff, and addressing questions.

"This encourages the staff incredibly," Girma says. "It gives them the opportunity to learn from their mistakes, improve their performance, and inspires them to provide high-quality service. A highly motivated, well-trained staff results in high-quality programs. This has made us better able to serve more clients."

"We are so happy about our success—although I wouldn't even call it our success, but more like the success of our local partners, who are really doing wonderful work," adds Francesca Stuer, FHI/Ethiopia Country Director. "Still, it is great to feel that FHI's support is making a difference."

PHOTO: Early HIV diagnosis facilitates early opportunistic infection care and access to antiretroviral therapy, improving the quality of individuals' lives. (FHI/Ethiopia)

— Mary Dallao