USAID/Positive Living

The Positive Living Project (2006-2010)

With funding from the President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development, the Centre for Development and Population Activities (CEDPA) will implement the four-year, $12.8 million Positive Living project to improve the quality of life of people living with HIV/AIDS, their families and communities in Nigeria.

Nigeria has the third largest number of HIV infections in the world, with roughly four million men, women and children living with HIV and AIDS according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). Infection rates have spiraled over the past decade, particularly among young women; half of Nigeria's 36 states have an HIV prevalence rate of over 5 percent according to the 2003 national prevalence survey. Because of Nigeria's poor health infrastructure, there is an enormous unmet need for HIV/AIDS prevention, care and treatment services.

To address these needs, CEDPA will lead the USAID-funded Positive Living project in Nigeria from 2006-2010, working hand-in-hand with a consortium of local faith-based organizations, community groups and networks of people living with HIV/AIDS (PLWHA) to:

• Provide expanded gender-sensitive, community-based palliative and home-based care services to 36,000 people living with HIV/AIDS and their families;  

• Reach two million Nigerians with HIV prevention messages, including promotion of abstinence and be-faithful prevention messages, prevention of mother-to-child HIV transmission (PMTCT), and promotion of correct and consistent condom use particularly among HIV-positive individuals;

• Provide livelihood programs, including income-generation, micro-credit and business development opportunities for PLWHAs and their families through referrals and linkages to existing local activities;

• Strengthen institutional management and technical capacity of multiplier organizations, which include networks of individuals living with HIV/AIDS, national-level faith-based organizations, non-governmental organizations and others.

Because of the critical role that faith communities play in providing health services and influencing behavior change in Nigeria, key partners in the effort are leading faith-based organizations including the Anglican Communion, Church of Christ and the National Supreme Council for Islamic Affairs. The project will begin with a rapid roll-out to quickly support and build capacity of local groups that are already providing HIV/AIDS services in five states: Anambra, Bauchi, Cross River, Edo and Kano; and will expand into Benue, Borno, Nassarawa and Rivers in year two.

Expanded Quality Palliative Care

To address the enormous unmet need for quality, community-level palliative care of people living with HIV/AIDS and their families, sub-grants will be given to 18 grassroots organizations to expand delivery of their existing services. Key components will be strengthening community capacity to deliver services and fostering close linkages between these community health initiatives (by families, faith groups, women’s groups and PLWHA support groups) and government, private and workplace health facilities to ensure referrals for anti-retroviral therapy (ART), treatment of opportunistic infections and advanced complications, and other medical services.

The project also will train 1,000 professional health workers (e.g., physicians, physician technicians and community health extension officers) to build competencies in providing palliative care to people living with HIV/AIDS, including diagnosis and management of ART side effects and tuberculosis counseling. Training will include a special emphasis on the needs of HIV-positive women, including gynecological complications, nutritional status, their role as caregivers, and issues related to stigma and discrimination.

Finally, the Positive Living Project will train master trainers at the state, diocese and parish level who will in turn train a minimum of 12,000 community health volunteers to expand home-based care. These volunteers, under the supervision of nurses or medical doctors, will make regular home visits to provide routine nursing care, nutritional assessment and counseling, identify danger signs for opportunistic infections, and provide referrals to social services for education, food assistance, counseling and medical assistance.

Awareness and Prevention

The project will mobilize community-based organizations, parish-level AIDS programs of Nigerian faith-based organizations, and PLWHA support groups to lead HIV/AIDS awareness, stigma reduction and prevention campaigns. Through weekly church and mosque sermons, special events, rallies, media and advocacy campaigns, these groups will reach target audiences including out-of-school and in-school youth, pregnant and breastfeeding women, people living with HIV/AIDS and their families, and community leaders and influentials.  

Economic Empowerment

Support organizations for people living with HIV/AIDS indicate that most AIDS programs fail to comprehensively address the livelihood needs of PLWHAs and their caregivers. The Positive Living program will support local business development organizations—including entrepreneurship development, basic business management, micro-credit and income generation, skills development, apprenticeship and mentorship programs—to establish regional networks of Nigerian service providers that will design, manage and implement community-based micro-enterprise development and income generation services.  

Institutional Capacity Building  

In addition to human resource training, the Positive Living project includes activities to strengthen organizational management, financial systems, human resources, and patient monitoring and referral systems to build sustainable community-based and national institutions that can lead ’s response to the AIDS pandemic. CEDPA will work with implementing partner organizations to conduct an organizational assessment, design an intervention plan to build on existing strengths and address problem areas, and monitor and evaluate results.