Final evaluation report : HIV/AIDS prevention in Africa program [HAPA], Marondera District, Zimbabwe

The project was implemented by World Vision Zimbabwe (WVZ) and the Ministry of Health (MOH). The project achieved most of its goals. Educational seminars or training were provided to health workers, teachers, youths, community leaders, midwives, farmers, and church leaders. In addition, posters, stickers, t-shirts, pamphlets, and leaflets, as well as nearly 200,000 condoms, were distributed by project staff. Focus group surveys of targeted groups indicate that nearly one-third of respondents on commercial farms had heard about the project in Marondera, and nearly half of the same sample knew that HIV/AIDS is a disease, an improvement of 25% from the 1990 baseline Knowledge, Attitude, and Practice (KAP) survey. While this change cannot be attributed directly to the project, it can be assumed that the project played a significant part. The most troublesome finding to come from the focus group discussions is that although more people know the seriousness of AIDS today than was the case 2 years ago, there is the continual problem of multiple sexual partners and a sexually active segment of the population. Were this trend to be confirmed by a more detailed study, it would raise fundamental questions over the current strategy to promote AIDS awareness in the country. In addition, comments from respondents indicate that health workers are setting a bad example by their own promiscuous behavior, suggesting the need to develop a health education campaign specifically targeted at health workers. Further, health workers, especially in the hospitals, avoid dealing with HIV/AIDS patients, delegating their care to junior workers, who should be included in future HIV/AIDS outreach activities. The main lessons learned concern the difficulties of creating a host-country/PVO partnership for the implementation of a project. (1) The failure to link a project with the government management system (in terms of transportation, subsistence, travel, materials production, etc.) can delay implementation and frustrate PVO staff. Conversely, the use of government and community structures can be an effective way to extend scarce resources. (2) It would be helpful to formulate an official protocol between the PVO and government ministry, outlining the responsibility of each partner, financial disbursement procedures, use of equipment and staff, and monitoring and supervisory responsibilities. (3) Inadequate planning capacity in both the MOH and WVZ hindered the use of survey results in developing new HIV/AIDS awareness strategies. (4) The project was particularly difficult to execute because it tried to address the changing of attitudes. It is recommended that, due to its late start, the project be extended for 1-2 years, with the stipulation that a protocol be developed to outline responsibilities between the MOH and WVZ.