Major Area: HIV and AIDS and Children
The ‘Woman to Woman Initiative on HIV’, launched by UNICEF and partners in 2007, provides women with a platform and a safe space to learn about HIV and the issues that make them vulnerable to infection, such as sexually transmitted infections (STIs), female genital mutilation (FGM), violence and abuse. UNICEF supports leading women’s NGOs to engage vulnerable women and assist them in accessing correct HIV information and services and to develop solutions that work for them. The initiative focuses on female headed households, internally displaced women, adolescent girls and marginalized women. It covers four regions in Somaliland, five in Puntland and six in Central and Southern Somalia.
The "Woman to Woman Initiative on HIV" is a programme that empowers women and provides them with tools to learn more about HIV/AIDS, and what makes them vulnerable to this and other infections.
The Woman to Woman Initiative is evidence-based and informed by participatory action research and Knowledge, Attitude, Practice (KAP) surveys. It uses complementing strategies to ensure quality through the peer education sessions and coverage through the special outreach activities. Monitoring strategies look at numbers and qualitative change. Ownership among national partners is high. While it can easily be replicated in other countries, including in emergency situations, diligent monitoring and partner support is required to produce results that can be taken to scale.
In the patriarchal Somali society, women have limited access to information and services to prevent HIV infection and to live positively if infected or affected. The UNICEF Multiple Indicator Cluster Survey (MICS) 2006 confirmed the low level of correct knowledge; only four percent of women aged 15-49 had comprehensive knowledge about HIV. At the same time, HIV prevalence is increasing. The data from the last sero-surveillance survey (2004) show a mean prevalence of 1.4% in Somaliland, 1.0% in Puntland and 0.6% in Central and Southern Somalia. Surveys among women attending antenatal clinics have found HIV prevalence in some parts of the country as high as 2.3% (WHO, 2005). Antenatal clinic data suggests that the Somali AIDS epidemic remains significant with wide variations in prevalence between Somaliland, Puntland and Central and Southern Somalia. It is heterosexually driven and a great cause for concern, especially amongst young women.
UNICEF launched the Woman to Woman Initiative in 2007 with partners to scale up activities that reduce the risks and vulnerability of women and girls to HIV. It complements efforts among adolescents and leaders at various levels to effect change at individual and societal levels.
A trained pool of 90 community based female facilitators conduct house visits, peer education classes and special outreach activities to reach vulnerable women and girls with information, provide an opportunity to dialogue and find solutions. The peer education sessions are linked to non formal education classes or income generating opportunities, since poverty and illiteracy are key underlying factors which increase women’s vulnerability to infection. The initiative is informed by qualitative research which guided the development of strategy and materials. UNICEF has introduced the Most Significant Change methodology to monitor qualitative changes in addition to quantitative results
In all programme regions (six regions of Central and Southern Somalia, five regions of Puntland and Somaliland) over 30,000 women and girls were engaged in HIV prevention campaigns. Results from the Most Significant Change monitoring methodology suggest that participants have gained new knowledge, mastered certain life skills (especially communication skills) and are now more likely to provide care and support for people living with HIV.
UNICEF plans to scale up the initiative in all three administrative zones. During 2007, referral pathways to medical and psychosocial services were introduced, and were strengthened in 2008, especially for survivors of sexual violence. The newly launched Prevention of Mother to Child Transmission of HIV services will be closely linked to the Woman to Woman Initiative to offer a comprehensive package of services, ranging from primary prevention and prevention of transmission, to care and support for women and their families. Partners require further support to strengthen the monitoring systems. Efforts will also be undertaken to feed the findings of the initiative and women’s views into national scale strategy development and advocacy efforts for greater protection and participation of women and girls.