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Final Report for the AIDSCAP
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Table of Contents I. Country Program Description
III. Non-Subproject Highlights General Population Promotion of the National AIDS Law (FCO 55445-2)
Objectives The Executive Office of the Dominican Republic signed national HIV/AIDS legislation entitled "Ley 55-93 sobre el SIDA." With AIDSCAP's assistance, the Instituto Nacional de Salud (INSALUD), in coordination with the Program for the Control and Prevention of STI/AIDS (PROCETS) disseminated the new "AIDS Law." The main objectives of the project were to inform various sectors of the population about the implications of the law and to design a follow-up plan with each group for continued reform of HIV/AIDS policies. Outcomes Three meetings were held in 1994 to disseminate the AIDS Law among different segments of the population. The first was held for health personnel (physicians, nurses, laboratory technicians, and professors from medical universities). The next meeting addressed women's groups, and the third meeting targeted persons involved in the legislative process (lawyers, judges, legislators, and human rights organizations). During each meeting participants provided INSALUD with information in regards to their needs and recommendations for further disseminating the AIDS law. INSALUD oversaw the development and edition of an AIDS Law Regulations document used in dissemination activities. To contribute with the dissemination of the AIDS Law, INSALUD also participated in numerous radio and television programs throughout the life of the agreement. On December 13, 1994, INSALUD conducted a National Health Forum that included HIV/AIDS. Forum participants included representatives of the three aforementioned groups. During the Forum, participants outlined priorities for intersectorial coordination in the area of HIV/AIDS policy and prevention. Constraints INSALUD found that it was not able to develop a specific action plan with each of the three target populations during the course of the three meetings. The primary constraint was the low level of knowledge. This made it difficult to move beyond general suggestions for activities in the future. However, the discussions and questions asked at the meetings, as well as subsequent meetings among the organizers provided sufficient information for INSALUD to draft a general action plan which included all groups. The final document produced from the meetings was entitled "Law 55-93 on AIDS : Analysis, Commentary and Regulations for its Application." This document was presented to AIDSCAP/DR and to the Ministry of Health prior to widespread publication. Further funding was not available within the AIDSCAP Project to continue dissemination activities. It was expected that the NACP would take over the judicial socialization of the AIDS Law and regulations. Findings and Recommendations INSALUD found three broad areas where follow-up activities were needed which were common to all of the segments of the population: 1) additional education to increase knowledge levels and sensitize the population to the impact of HIV/AIDS; 2) continued dissemination of the AIDS Law as well as regulations for its application; and 3) use of mass media. INSALUD also drafted an outline of detailed recommended actions for each of the three target populations and identified coordinating agencies. Examples of these recommendations were to elaborate and disseminate a bioethics code and to train health personnel in biosafety measures; to develop counseling and support services for women in the neighborhood health centers; and designing a curriculum regarding AIDS legislation in the law universities which includes cooperation with social services to provide legal advice to HIV+ individuals. Community AIDS Education in Santo Domingo (FCO 23453)
Objectives The Instituto Dominicano de Desarrollo Integral (IDDI) has been dedicated to working with local organizations to improve communities' living conditions since its inception in 1984. The goal of this project was to reduce the spread of HIV/AIDS in the barrios of La Zurza and Herrera in Santo Domingo. In order to achieve this goal, IDDI strengthened the communities' educational programs and extended existing STI/HIV/AIDS information and condom distribution sites. Accomplishments IDDI brought together neighborhood associations and community based organizations to participate in HIV/AIDS prevention efforts. Monthly coordination meetings kept all of the groups involved and working on schedule. Forty volunteers were recruited as health educators and trained on relevant medical and social issues as well as popular education techniques during November 1992 and January 1993. In turn these educators recruited and trained adult and adolescent volunteers who were trained in March 1993. The health educators were supervised by a technical team from IDDI, and their work was evaluated in quarterly meetings. In all, 314 training contacts (206 women and 108 men) were made through this process. IDDI's community outreach program reached 25,553 individuals (12,593 women, 11,173 men and 1,787 gender unspecified), or 16 percent of the two communities' populations. It also distributed 35,380 free condoms donated by UNFPA and PROCETS at the project sites. The health educators conducted seminars, home visits and face to face education as well as distributed 8,716 educational materials. Permanent information and condom distribution sites were installed in the project areas. Constraints Condom social marketing proved to be the area where IDDI encountered the greatest difficulty. Other donating agencies in the two target areas were distributing free condoms, creating a lack of demand. Findings and Recommendations The KABP information conducted during the study demonstrated the continued need for prevention efforts in La Zurza and Herrera. The volunteer network established by IDDI proved to be extremely successful. Following this project, it was recommended that IDDI and the AIDSCAP implementing agency CASCO collaborate to receive the benefits of IDDI's community contacts and CASCO's experience with youth.
Community Education Affiliates for AIDS Education (FCO 23454)
Objectives The Patronato de Lucha Contra el Sida (PLUS) began its work in AIDS prevention and counseling for HIV+ individuals in 1988. The project began in 1992 with the purpose of reducing HIV transmission among the general population in eight health regions. The project hoped to increase the number of trained volunteers conducting outreach activities, increase the number of communities participating in the intervention and establish a condom distribution network. Accomplishments PLUS conducted trainings for 169 persons (103 women and 66 men) over the course of the project. They reported reaching 19,446 people (7,297 women, 6,978 men and 5,171 gender not specified) in all eight health areas through the network of community volunteers. This network of volunteers distributed 31,136 educational materials and 28,863 condoms, either sold (6,700) or distributed for free (22,163). In addition to the educational sessions and peer to peer education, PLUS successfully organized interactive theater presentations. These were played out by Fundación Cultural y Educativa para la Salud (FUCES), a collaborating theater NGO. By the project's end, 13 new communities were integrated into the project and 19 condom distribution sites were established. Due to program reorientation and budget limitations, funding to PLUS was limited to short term activities.
Educational Theater (FCO 23445)
Objectives The Fundación Cultural y Educativa para la Salud (FUCES) was founded by a group of actors in July 1990. This project sought to reduce HIV transmission by educating the general population during short theater presentations. Outcomes FUCES produced over seventy theater skits which promoted the importance of correct condom use and provided information on STIs/HIV/AIDS in an easy to understand format. The presentations were made in schools, clubs, churches and parks. Each presentation was followed by condom use demonstrations, distribution of educational materials, and a forum in which the audience's questions were answered by an educator. Through these activities FUCES was able to reach approximately 6,368 individuals. FUCES also conducted two theater training workshops for amateur theater groups to insure program continuation in the different areas throughout the country. Leaders from various community groups were selected to participate in these workshops. Constraints/Recommendations After a certain period of time FUCES presentations became stale and new storyboards were demanded by the public they served and collaborating NGOs. FUCES, however, was not able to produce them. Furthermore, because they were professionals, their presentations became too costly. Popular theater alternatives were explored where cost-effectiveness is higher. Also, this allows for more community involvement. Therefore, further funding of FUCES activities was discontinued.
Endnotes
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