Executive Summary

Ashar Prodeep (AP) is a community based Non-Governmental Organization of People Living with HIV and AIDS (PLHIV) with around fourteen years’ experience of providing a range of services including counseling, training, Group Session, Home visit, Networking. Ashar Prodeep has been working in partnership with HIV Collaborative Fund in South Asia since August 2008. Initially the project started for one year and continued from June 2009. After the successful completion “Awareness building on treatment issue and empowerment of PLHIV women” –from June 2009 to May 2010, the second project was granted for another year which started from June 2011 to May 2013. Since 2013 AP has been working with Ashar Alo Society (AAS). To share different experiences and feelings with each other’s, PLHIVs Women gather in a Group Session. Beside that counselors and staffs of AP also shared different social and programmatic issues in that Session. Here people know how to lead a positive life. On the other side counseling helps lo lead a positive life. To raise awareness among general people about AIDS, to reduce stigma, discrimination and prejudices which are deeply embedded in the society AP has conducted Home Visit and Counseling. Networking with Govt. officials, Health service providers, NGO’s staff, Hospital providing support properly and make an enabling environment and for PLHIV Women through the “WFA – Strengthening Feminist Movements” project –from January 2022 to July 2022.   Currently Ashar Prodeep is working on “Reducing Sigma & Discrimination and Increasing Awareness on HIV among the Family Members of the Woman PLHIV” also funded by Women Fund Asia (WFA) with duration of 01 August 2022 to 31 July 2023.

Organizational Overview

Organizational Profile: Ashar Prodeep (AP), is the first HIV positive women organization in Bangladesh which started its journey from 2008 as a women network lead by a group of HIV positive women who came together to share information, experiences and ensure support. It has a general committee with 35 members and an executive committee of 7 members.  The organization has a constitution and registered in 10 January, 2010 under the Women and Children Affairs Bureau, Bangladesh. The vision: of Ashar Prodeep (AP) is to ensure stigma and violence free society, ensure treatment rights as well as establish basic rights for all PLHIV women and children in Bangladesh. Previously Ashar Prodeep worked with HIV Collaborative Fund in South Asia and implemented the project named “Increasing access to ART treatment for PLHIV women to reduce HIV morbidity & mortality and make the support more effective through treatment education and empowerment of PLHIV women”. Ashar Prodeep worked in partnership with HIV Collaborative Fund in South Asia since August 2006. Initially the project started for one year and continued from June 2009. After successful completion, second project was started namely “Awareness building on treatment issue and empowerment of PLHIV women” –for June 2009 to May 2013.

Since 2013, Ashar Prodeep has been working with Ashar Alo Society (AAS) on “Organizational capacity and service development of Ashar Prodeep (AP)” project. In 2022, Ashar Prodeep has been funded by “WFA – Strengthening Feminist Movements” for continuing the  “Organizational capacity and service development of Ashar Prodeep” project from January 2022 – June 2022. Currently Ashar Prodeep is working on “Reducing Sigma & Discrimination and Increasing Awareness on HIV among the Family Members of the Woman PLHIV” also funded by Women Fund Asia (WFA) with duration of 01 August 2022 to 31 July 2023.

Project Name: Reducing Sigma & Discrimination and Increasing Awareness on HIV among the Family Members of the Woman PLHIV

 Reference Number: 026-CG-K-SSGSPAY-COM-2022-ASS 2

Project Goal:

The goal of this project to sustain Ashar Prodeep and work for advancing rights of women PLHIV by providing direct services, engaging in advocacy, building networks and reducing stigma & discrimination against Women PLHIV.

Activities:

  1. Information Sharing sessions on HIV and AIDS
  2. Providing Counselling support to women PLHIV.
  3. Home-visits
  4. Including with Govt. ART centres for the new HIV positive person
  5. Meeting with Govt. ART centres
  6. Networking and meetings to facilitate job replacement
  7. Provision of food and cash for poor women
  8. Treatment Support for Women PLHIV
  9. Regular Executive Committee meeting

Expected Results:

  1. Increased capacity of Ashar Prodeep to undertake capacity building, advocacy and network building related activities.
  2. Increased networking with government, donors and ART centres.
  3. Increased access to services and knowledge of rights among Women PLHIV

 

Project Period: 01 August, 2022 – 31 July, 2023

Mid-grant Report Submission: 15 January, 2023

Final Narrative Report Submission: 15 August, 2023

Activities at a Glance 01 August, 2022 – 31 December, 2023

Activity 1.1: Information Sharing Session

An Information Sharing Session under the “Reducing Sigma & Discrimination and Increasing Awareness on HIV among the Family Members of the Woman PLHIV” Project supported by Women’s Fund Asia (WFA) was held on 23 August, 2023 at Training room of Ashar Alo Society (AAS), Dhaka and around 15 PLHIV women both from inside and outside Dhaka had participated in this Session. 

Objective:

  • Sharing information about the Ashar Prodeep’s services and activities.
  • Orientation on HIV and AIDS.
  • Awareness building of the participants through the orientation on Peer Education and Care Giver.
  • Orientation on safeguarding policies.

Output: Participants that attended the session was told about the activity plan of AP under the project supported by Women’s Fund Asia (WFA). After this session the participants were oriented on HIV/AIDS, Peer Education and Care Giver, and they were more aware of their role towards the PLHIV community, and that of their peers. The participants were encouraged to provide their support for the strengthening of AP – A women PLHIV organization. The participants were also encouraged to join as a member of the General Committee of AP constitution.

Activity 1.2: Counseling Support to Women PLHIV

Counseling is provision of advice or guidance in decision-making, in particularly, in emotionally significant situations. Counselors help their clients by counseling them. Counselors also help clients to explore and understand their worlds and so discover better ways of thinking and living.

Name of Service Venue Target Progress / Achievement
Counseling Ashar Prodeep Office, Dhaka N/A 18

 

Activities:

  • General Counselling
  • Positive Living Counselling
  • STI Counselling
  • Condom Promotion Counselling
  • Behaviour Change counselling 

Output: Ashar Prodeep (AP) provides peer support, including peer counseling to the women PLHIV. Counseling has shown to improve linkage, adherence, viral suppression, retention and psychosocial wellbeing of these women. AP also provides women PLHIV with opportunities for leadership development, capacity building training which helps them to combat the negative effects of self-stigma and discrimination.

Activity 1.3: Home Visit for Ensuring Treatment and Solving Problems

Ashar prodeep has been working with ART centers for conducting home visits of Loss to follow-up (LTFU) Women PLHIV. During August – December 2022, AP conducted 04 home visits to increase the level of ART adherence.

Objective: It’s important to visit ARV receiver at home and monitor their adherence level by counting pill and through discussion. As majority of the infected women live at rural area, they show less interest to receive service from a doctor. So to reduce this problem AP organizes need based home visit and follow-up visit to the ARV drug receiver to ensure adherence.

Output: When we visit we try to solve the problem after that we follow up and we communicate with this person if she needs any emergency help we take initiative to solve the problem. This activity has increased ART adherence and helped many PLHIV women with their problems.

Activity 1.4: Including with Govt. ART centers for the new HIV positive person

Objective: This activity is an integral part of the counseling support provided by Ashar Prodeep. Ashar Prodeep has linkage with Govt. ART centers where new identified women HIV positive are referred to Ashar Prodeep for various services and skills for the women PLHIV in the areas of counselling support for mental wellbeing and ART adherence, home-visit legal support, treatment and care support, IGA support, job opportunities, nutritional support etc. During August – December 2022 ART centers referred 07 women PLHIV to Ashar Prodeep and 06 new identified women PLHIV were also referred to ART centers.

Output: With this activity the referred women PHIV from ART centers are first provided with proper counselling as it improves linkage, ART adherence, viral suppression, retention and psychosocial wellbeing of these women. We also linkage new identified women PHIV to the Govt. ART centers.

Activity 1.5: Meeting with Govt. ART centers

A coordination meeting the Dhaka Infectious Disease Hospital’ (IDH) ART center was held on 23 November 2022. Dr. Mohammad Mizanur Rahman, Superintendent of IDH hospital chaired the meeting. The focal person, Medical Consultant, Medical Officer Nurses, ART Center Counselor, Medical Technologist, PLHIV members, President of PLHIV Network PN+, and other relevant person was present in the meeting. Program Organizer and Project Coordinator of Ashar Prodeep organized and moderated the meeting.

Objective: Dhaka Infectious Disease Hospital (IDH) is the only government hospital in Dhaka city where there is a HIV ward and treatment facility dedicated to HIV patients.  To ensure PLHIV women rights, treatment & Care service as well as introduce their organization, AP organized an Advocacy and Sharing Meeting with IDH. In this meeting AP introduced their activities and services to IDH through a presentation. In this meeting many important topics were discussed and ultimately a working policy was established between AP and IDH which will help AP on organizational development, strengthen ART service delivery, increase ART adherence among women PLHIV, decrease the lost to follow up patients from the women PLHIV and develop coordination among Ashar Proddep and the ART centers, Ashar Prodeep organizes coordination meeting with ART centers.

Output:

  • Strengthening ART service delivery for women PLHIV
  • Include newly identified women PLHIV to the ART center
  • Increase ART adherence among women PLHIV
  • Established a regular communication flow between ART center and Ashar Prodeep
  • Developed coordination mechanism between ART center and Ashar Prodeep and reduce lost to follow up patient through the combined effort.
  • Create an enabling environment for women ART receivers.

Activity 1.6: Networking and Meetings to Facilitate Job Replacement

Ashar Prodeep is working on to develop a network and referral system to monitor referred women to these organizations, local institutions to access different services and skills for the women PLHIV in the areas of skill building and job replacement.

Objective: To enable an environment for women empowerment Ashar Prodeep has been working towards developing the skill and capacity of women PLHIV through networking meetings with various stakeholders and organizations to ensure that women PLHIV and their caregiver get proper skill building trainings (Professional Computer Course, Spoken and Written English Course, Tailoring, Designing, Garments Operator and Food Preparing and Packaging Courses) for them to have better chance at job replacement with these organizations. With this goal Ashar Prodeep has already gave skill building training support to many women PLHIV and their caregiver. During the project period of August – December 2022, AP organized computer course training for 04 women PLHIV provided by Ministry of Women Affairs Bangladesh where the women got the training for free and after the completion of the training they will get Govt. certificates, 12,000TK and job placement facility upon their performance. AP also organized Spoken/Written English Course training for 1 women PLHIV and 2 caregivers, provided by PLHIV Network (PN+).

Output:

  • These trainings will give PLHIV women and their caregivers the chance to build their capacity and find better jobs to support themselves.
  • These trainings will inspire the other PLHIV women.
  • Ashar Prodeep will be benefited overall through the skill building of these women PLHIV.

Activity 1.7: Provision of Food and Cash for Poor Women/ Treatment Support for Women PLHIV

Ashar Prodeep also provides monetary support to the vulnerable women PLHIV in their times of need by providing cash, food/nutrition support and treatment support. During the project period of August – December 2022, AP has given cash/food support to 05 women and treatment support to 03 women.

Objective: The majority of women living with HIV in Bangladesh are in a vulnerable group due to their low socioeconomic background. Due to their HIV status, many women are widowed or abandoned by their spouses. Some of these women also have HIV-positive children to care for. Women PLHIV have always been targets of stigma and discrimination. These women frequently lack access to shelter due to family members’ negligence. Most of these mothers and children require assistance with finances, nutrition, and medical care. Ashar Proddep therefore makes an effort to locate these vulnerable women, who are frequently referred by ART centers, in order to give them the support they require.

Output:

  • With the monetary support provided by Ashar Prodeep pthese women will be able to get back on their feet by using the money to start a small household business.
  • Women PLHIV who can’t take ARV medication due to poor nutrition will be able to better their health with the nutrition support provided by Ashar Prodeep.
  • Women PLHIV who are unable bear pathological test and medicine cost will be able to benefit from the treatment support provided by Ashar Prodeep.

Activity 1.7: Executive Committee Meeting for Organizational Development

A Meeting was held with AP staff and Executive Committee member of Ashar Prodeep on 07 December, 2022 under the “Reducing Sigma & Discrimination and Increasing Awareness on HIV among the Family Members of the Woman PLHIV” Project supported by Women’s Fund Asia (WFA) at Meeting room of Ashar Alo Society (AAS), Adabor, Mohammadpur, Dhaka.

Objective: For working efficiently as an organization Ashar Prodeep need to work for organizational development, regular discussion and sharing among the Executive Committee members will help the organizational development.

Output: The meeting will be conducted every three months where all EC members and AP  Staff participated. Total 1 meeting was organized during the WFA project period at office. Though the discussion of those meeting some dicisions were found for WFA project completion and organizational development.

Activity 1.8: Day Observation and Activism

Along with the project activities Ashar Prodeep Also Participates in various activities, workshop, meetings and activisms. Some of the significant activities during August – December 2022, Ashar Prodeep participated the World AIDS Day, 2022 Standing Rally to raise awareness on HIV/AIDS. AP also took the initiative to decorate the HIV ward of Infectious Disease Hospital (IDH), Dhaka on 30 november of 2022 so that, the admitted patients can also celebrate the World AIDS Day and AP also arranged for some refreshments for the patients, ward nurses, ward doctors and ART center staffs. Ashar Prodeep also participated in the 16 days of activism against gender-based violence along with EC tthe members of AP.

Challenges:

  • Still Health Care providers & relevant stakeholders in different areas of Bangladesh are not sensitized on HIV and AIDS issue therefore they show denial attitudes towards the PLWHA.
  • Very limited scope of credit facilities for PLHIVs by GO, NGO improving their livelihood options.
  • Limited treatment & care for PLHIV women in Bangladesh, e.g. necessary combination of ARV Therapy, Pathological testing out of Dhaka, PMTCT, Inpatient Treatment and Home based care etc. is not available.
  • Difficult to manage Opportunistic Infections of PLHIV without nutrition and other medication support.
  • No income or Low economic status is root cause of PLHIV treatment & health care issue.
  • Women PLHIV participation is still poor due to fear of disclosing their HIV status.
  • It is difficult to manage the program in limited budget allocation.

Lessons learnt:

  • Coming under the umbrella of AP, PLHIV women able to increase their confidence. They believe that it is possible to live long with HIV+ status.
  • Need a professional counselor at AP office with peer counselor who will be helped the peer counselor and solve the critical issue.
  • Need training to the AP staff on Management, Monitoring & Evaluation, Counseling, and other relevant training.
  • AP staff need exposure visit in internal and external related organization which will helped them to increase knowledge and will be helped to develop their organization.
  • ART adherence training is important not only for ART receiver but also for them who are not on ART. So they realize the importance of ART and overcome the fear of ART.
  • Care giver training is essential to get maximum output of ART adherence.
  • Women who are receiving ART they need nutritional food but they cannot take it regularly because of financial problems.
  • Home visit counseling is very effective because the PLHIV women are always frustrated about their physical condition and also their family. So in spite of being counseled sometimes they ignore themselves. By home visit care giver counseling can provide. The PLHIV Women are scattered around the country so that it is difficult to address them in proper way.
  • Arranging more sensitization program for health care providers will also increase the access of PLHIV in public and private health care centers.
  • Continuous networking with other institutions and service providers can help for the treatment care and wellbeing support of PLHIV women in Bangladesh.
  • Due to poor nutritional status of PLHIV women it is necessary to provide nutrition support for pregnant PLHIV women and children.