Economic and Social Empowerment
of Rural Communities (ESERC)

GF HIV-NFM Project

Global Fund HIV/AIDS New Funding Model (GF HIV-NFM)
ESERC is the Sub-Recipient to Society for Family Health (SFH); one of the Principal Recipients of the Global Fund HIV project in Nigeria. SFH was responsible for the implementation of HIV Prevention programmes for the General Population, Key Population-Men who have Sex with Men (MSM), Female Sex Workers (FSW) and People who Inject Drugs (PWID) and an Action Research among Adolescent and Young Persons. The project was implemented in ten States of Akwa Ibom, Edo, Enugu, Kano, Kaduna, Gombe, Anambra, Imo, Lagos, Oyo and FCT Abuja.

ESERC was responsible for the implementation of HIV prevention for the Men who have Sex with Men (MSM) in Enugu State using Minimum Prevention Package Intervention (MPPI) strategy . The project started in October 2015 and ended in December, 2017.

The approach of the NFM was "Investing for Impact against Tuberculosis and HIV" so as to achieve the following outcomes by December 2017:

1. To reduce new HIV infections, and improve the quality of life for the infected and affected. 2. To provide Nigerians with universal access to high-quality, patient-centred prevention, diagnosis, and treatment services for TB, TB/HIV, and drug-resistant TB by 2020. 3. To contribute to the restoration of public confidence in primary health care services in Nigeria, and thereby reverse declines in the utilization of primary health care facilities.

The specific objectives of the NFM grant are to: 1. Attain universal coverage for bridge populations with mobile HIV Testing services as part of a package of prevention services. 2. Increase availability and access to condom and lubricants to about 1,137,877 general populations over the period of the grant. 3. Reach a total of 54,407 KPs with minimum prevention package of interventions (MPPI) 4. Unravel factors that increase vulnerability of girls (15-24 years) to HIV and AIDS through an action research. 5. Generate, implement and share evidence, innovations and lessons learnt through the action research.

Worked in 4 Local Government Areas of Enugu state; mainly the urban and semi-urban LGAs of Enugu State;

1. Enugu East LGA 2. Enugu North LGA 3. Enugu South LGA 4. Nsukka LGA

ESERC recruited and trained MSM Peer Educators in each of these LGAs who carried out HIV/AIDS peer sessions in different sites. ESERC also carried out HIV/STIs Testing Services (HTS) for the MSM in these LGAs. Those that tested positive to HIV or other STIs were referred to designated health facilities in Enugu State.

Output Indicator:

Despite the achievements and new leanings, there were challenges in the implementation of the project which included:

• Same Sex Marriage Prohibition ACT which hindered many MSM from identifying with the project.
• High level of stigma against the MSM community.
• Non-disclosure of HIV positive status to Counselor testers.
• Erroneous belief in cure due to long placement on anti-retroviral.

In the course of implementation of the project, there were new leanings of which some of them are:

• Accompanied referrals and engaging the Facility Health care workers in community outreaches improved linkages to care and increased uptake of integrated HIV services.
• Active participation of MSM also referred to as community members in programme implementation through their Community-Based Organizations (CBOs) increased service uptake especially among the MSM community.
• The use of Peer tracking card to a large extent minimized the issues with double counting and duplication of services among highly mobile MSM.
• Ensuring commodity availability at the onset of programme implementation is sine-qua-non to continuous service provision and overall grant performance.
• Meaningful engagement with State Actors during project implementation promotes ownership and sustainability at the state levels.