Successes of the FHI GHARP Project

OCTOBER 2008 — Guyana has one of the highest HIV prevalence rates in the Pan Caribbean Region. Out of a population of about 750,000, approximately 18,000 people in Guyana live with HIV. Most are between the ages of 15 and 49. 

To address this problem, in 2003 FHI embarked on the Guyana HIV/AIDS Reduction and Prevention (GHARP) Project, a four-year collaboration between the governments of Guyana and the United States, with funding from the President's Emergency Plan for AIDS Relief through USAID. Under GHARP, FHI engaged all sectors of society to reduce the spread of HIV/AIDS and promoted a comprehensive prevention and care program. GHARP focused on improving health infrastructure and enhancing the skills of health workers. Key to the success of the project was collaboration with 25 Guyanese NGOs and faith-based organizations.

GHARP was a national leader in implementing voluntary counseling and testing (VCT), and worked with the MOH to integrate these services into the MOH system. To provide counseling and testing to people who lived in hard-to-reach areas, GHARP offered technical guidance and support in setting up and managing a mobile testing team, which was transitioned to a local NGO in 2006. More than 70,000 people in Guyana received HIV counseling and testing through GHARP. GHARP also worked with the Ministry of Health to develop the Guyana National Strategic Behavioral Communication (SBC) Strategy, which served as a framework for all local SBC initiatives.

GHARP's work emphasized building the organizational capacity of local NGOs in technical and programmatic areas, and developing monitoring and evaluation plans. The project undertook significant work through partner Management Sciences for Health, and focused on three principal technical areas: NGO capacity building, mainstreaming HIV/AIDS activities into line ministries, and leadership development. GHARP helped local NGOs learn about proposal development, governance, project management, and USAID contractual regulations, and also provided ongoing mentorship. Community Support Development Services (CSDS), a local organization, is now the primary mechanism for NGO institutional capacity building, and GHARP's focus has shifted from direct support to the NGOs to strengthening CSDS's capacity to provide that support.

Other areas addressed by GHARP have included the following:

Prevention of mother-to-child transmission (PMTCT): Preventing mother-to-child transmission of HIV is a major public health challenge in Guyana. The GHARP Project supported activities including counseling and testing for pregnant women, PMTCT training, and facilities upgrades. Read more »

Orphans and Other Vulnerable Children (OVC): By partnering with local organizations, GHARP provided support to orphans and other children vulnerable to HIV/AIDS. Programs and services addressed the numerous complex challenges these children face, including poverty, poor health and nutrition, and lack of education. Read more »

Workplace Initiatives: The GHARP Project and its partners recognized that the workplace is often an ideal place for HIV/AIDS education. Particularly within Guyana's mining and logging industry, opportunities exist to reach people with messages about prevention and other key issues. Read more » 

Most-at-risk populations (MARPs): Targeted interventions were a cornerstone of the GHARP Project. GHARP initiatives focused on reaching at-risk groups including sex workers, men who have sex with men, and youth. Read more »

Strategic Information (SI): GHARP's strategic information activities included monitoring and evaluation (M&E), targeted evaluation design, implementation, and surveillance. The project's SI activities were critical in defining the magnitude of the HIV epidemic in Guyana. Read more »

FHI also has worked to provide adherence support and promote the Abstinence, Be Faithful, Condom Use (ABC) approach. Read more »

PHOTO: Clinic clients attend a PMTCT training. (FHI/Guyana)