Report of evaluation on All India HIV/AIDS Facilitation program

Background:
The Salvation Army (TSA) Western Territory (Mumbai) started to respond to HIV/AIDS in 1989. This was the first HIV/AIDS response by TSA in India. Later on the project has been established in all 6 Indian Territories of TSA. 
At present there are 8 existing projects including National facilitation project (SASAHAC) under National secretariat. The entire program is coordinated and monitored by the National Coordinator.

Purpose/objective:
To study the ‘impact’ of project work, although it was recognized that long term impact would be available at end of the ten year project, but that preliminary results would be available.
a) To collect and analyze case studies and best practices that illustrates the empowerment of PLHIVs.
b) To suggest steps for effective and meaningful implementation of project and sustainability of the work.

Methodology:
The approach was participatory. The plan was shared with the TSA implementing territories. During the Focused Group Discussions (FGD) and interviews, all stakeholders – beneficiaries, coordinators, implementers and decision makers also reflected on what had been achieved, what worked and what did not, and where providing suggestions on the way forward. Perceptions of these stakeholders were shared in an informal debrief with each Territorial staff and Territorial leaders. 
The project staff helped the team to refine results, but most importantly building greater ownership for the findings and future actions. The evaluation included site visits, semi formal interviews with key staff and community members, focus group discussions, desk reviews of plans, reports, and budgets. 

Key findings:
Relevance of issues of HIV is evident in all 6  territories of TSA, hence the goal of the proposal continues to be relevant
The findings are divided in 7 different areas: Awareness, Prevention, Facilitation, Care and support, Networking, Capacity building and monitoring.
Awareness activities All Partner Territories have done considerable work on educating the people on what is HIV and AIDS, how it transmits and consequences if people infected are stigmatized and discriminated and role of community members in addressing the epidemic. Regarding prevention of HIV have been promoted through special events such as World AIDS Day and Week. A number of events are held. There was IEC material available from SACS offices and utilized as a part of awareness in the communities. India South Eastern Territory has published booklet and IEC materials, India South western and South Eastern Territory have published News letters quarterly. The level of knowledge was found to be limited at community level and with Project Staff, and it was also noticed that the Needs Assessment part before designing the proposal was not done.   
Prevention activities There were several myths and misconceptions and self interpretation relating to mind set, conceptual clarity and importance of Condom promotion amongst Salvation Army project staff. But in other Territories limited condom promotional activities were found. In Mizoram, under one of Chan's initiative, drop in center for IDU works where the needy people are supported with free disposable syringes and condoms.
The projects closely working with hospital system/setup like in India South Eastern Territory and India Western Territory ( Emery Hospital, Anand  and  Catherine Booth hospital, Nagercoil)  promoting as well as creating massive awareness on Prevention of Parent to Child transmission (PPTCT).  Appropriate strategies and linkages are established for administrating Navaripine in accordance with the guidelines of National AIDS Control Organization (NACO).
The facilitation process is effective and meaningful. A uniformed strategy has to be redefined for enhancing the conceptual clarity and appropriate strategies.
In Indian scenario of coping with HIV epidemic the spiritual facilitation is rarely found, but this project has a strong impact on religious aspects and has developed appropriate life skills for making people less vulnerable for getting sexually transmitted infections.
The social and religious barriers in discussing on HIV/AIDS are also effectively addressed by the church without embarrassment.
Care and support of identified PLHIV and CLHIV is evident. Basic capacities in addressing complexity of PLHIV and CLHIV needs and community responses are observed. Majority of the project workers were able to describe the special needs of children who are infected, affected and vulnerable to HIV The children who are in need are being identified and referred and linked with available services. One of the biggest hurdles regarding social inclusion of PLHIV and CLHIV remains challenging in communities since they prefer to be ‘invisible’ thus missing out on community support. A variety of services are available but the demand exceeds supply. The component of promoting home based care is visible in all Territories but the staff needs intensive trainings on promotion of Home based care and empowerment to caregivers.
The networking and linkages with the Government system is very good but still the project needs to work more closer in addressing issues identified by SACS and to avoid duplications.
Capacity building. There has been no Training Needs Assessment to guide the capacity building which was therefore intermittent, piecemeal and did not address the complexity of program issues. The coordinators and field staff are trained in short term based on the need and there is no specific long term trainings conducted.
Monitoring. Review meetings are conducted monitoring support from National Secretariat is done in an effective and efficient manner.

Recommendations:
TSA is a pioneer in the country in complex issues of HIV/AIDS and Facilitation. The concept in this project needs to capitalize on this momentum. Also neglected and downtrodden communities needs more emphasis being TSA’s area of special expertise
Selection of partners must be rigorous, assess needs and the capacity of the organization to manage complex technical issues like HIV in a compact geographical area.
The role of National Secretariat and National Coordinator need strengthening in planning, capacity building and monitoring, and will require continuity and expansion of national team with appropriate technical expertise
Appointment of project staff should be on the length of project period.
The possibility of converting part of existing TSA hospitals into Care & support centers/positive living centers should be looked at.
When developing the next proposal, NACP guidelines and priorities should be considered.
Capacity building should take a major share (up to 40%) in overall budget and be continuous

Comments from the organisation, if any:
The Evaluation was challenging being carried out in so many different locations and to be merged into one report for all implementing territories. The findings gives valuable input for future actions The recommendations will be taken into consideration in the process of writing a new proposal for continued work