Despite free antiretroviral (ARV) medication for people living with HIV (PLHIV) in Tanzania, poverty prevents many PLHIV from being able to pay for medication to treat opportunistic infections that frequently arise as a consequence of living with HIV. The introduction of social accountability and monitoring (SAM) to districts has helped to solve the problem by raising awareness of the issue, which led to access to Community Health Fund (CHF) insurance to PLHIV in Bahi district. The initiative spearheaded by the SAM team and the community development department of Bahi District aims to benefit all PLHIV, especially those in the Bahi district cluster.
National Council of People Living with HIV (NACOPHA), under the United States Agency for International Development (USAID) SAUTI YETU project, is strengthening Local Government Authority’s (LGA) SAM to enable the authorities to analyse data collected from the relevant departments of the District Councils. The purpose is to influence decisions and processes at various levels in the community, local government, or national authorities that impact the lives and rights of PLHIV in the nation at large.
NACOPHA facilitated a one week SAM training in October 2014 to representatives from PLHIV, Civil Society Organizations, Councillors, the Council HIV/AIDS Coordinator and the Chairman of the Council Multi-sectoral HIV Committee and religion leaders, which came together to make the SAM monitoring team for Bahi District Council PLHIV cluster. They were trained on methodologies of data collection and analysis based on five social accountability stages and management of documents produced from the process. Following the training, the SAM team called a two-day meeting with heads of departments from LGA that highlighted their responsibilities as officials.
Based on that training and meeting, participants better understood their rights and LGA personnel better understand their responsibility to involve society, especially SAM team who are representing the entire society, in planning and budgeting. This is why Council HIV AIDS Coordinator (CHAC) under the Community Development Department involved PLHIV in planning and budgeting in December 2015. SAM team leaders used that opportunity to raise the issue of PLHIV not being able to pay for medication for opportunistic infections and came up with a solution of helping them to have CHF insurance. In January 2016 CHF cards were given to all PLHIV cluster members.
According to CHAC, Mr. Joseph Kileo, the process was influenced by SAM training which raised the understanding of their responsibility of involving representatives for PLHIV in their plans and implementation of activities. Mr. Joseph Kileo said, “I share the idea of inducing CHF insurance to PLHIV with the chairman of NACOPHA’s District cluster who is also the chairman of SAM team. I wanted to identify the needs and see where we can support.”
He added that the program started by supporting 261 PLHIV from Bahi district cluster while the cards will be used regionally. The program is expected to support more PLHIV with CHF insurance since many are joining the district cluster in order to benefit from the program.
Mr Peter Msilili, chairman of NACOPHA’s District cluster and chairman of SAM team, says that before CHF card there are were complaints since a majority of PLHIV could not meet the expenses of drugs for opportunistic infections which were being sold to them in health centers. “We are grateful for SAM training;
We had a very bad situation especially in obtaining health services, and now through CHF we have no doubt” Mr. Msilili said.
Currently 261 PLHIV living in Bahi district have CHF cards and in the future the program may grow to reach out all PLHIV in Bahi district. The council is planning to make this program sustainable so that many people can benefit from the program, although this will depend on the council’s budget allocation.