Tonata Celebrates a Major Milestone in Ondjungulume Village

Yambidhidha CAG and Tonata celebrate their success together
Judith Uushona of Tonata dances with the procession of Yambidhidha CAG
to welcome the arrival of dignitaries at the milestone celebration

 

 

Tonata recently hosted a celebration for achieving a major milestone in it’s Community Adherence Group project, attended by a high level delegation including the Office of the Governor of Omusati, the Office of the Executive Director of the Ministry of Health and Social Services, the Director of Omusati Regional Health Directorate, the Honorable Councilor of Otamanzi Consitutency, and representatives from the Uukwambi Traditional Authority, the Ambassador of the United States for Namibia, and representatives from the United States Agency for International Development. The event was held in Ondjungulume village in Onkani, Omusati region, and was hosted by Yambidhidha Community Adherence Group.


The centerpiece of this gathering of eminent persons was the achievement of the Community Adherence Group project, a joint program between the Ministry of Health and Social Services, the United States, and Tonata PLHIV Network. To date, over 3000 community members have joined the program, an immense increase from 205 people in the program last year. The aim of this project is to promote adherence and retention of patients on HIV. It is one thing for a person to begin taking their medication, it is another for them to continue taking their medication correctly, every day, for the years to come, and that is exactly what will be required for Namibia to eliminate HIV as a public health threat. How it works is that HIV positive community members organize themselves into self-governing groups, and they elect two people, who will take turns going to the clinic and pick up their ART medication for the entire group when it is time for the members to refill their medication. Once that person returns to the community, the group assembles and each person’s medicine is distributed. This process saves the individuals time and money, and makes it so they can go about their necessary tasks without the interruption of hours and days spent transiting to clinics and waiting in queues. By decreasing the burden of clinic visits on patients, and increasing the support they receive from one another, CAG members are thus empowered to remain stable on their treatment, keeping themselves strong and healthy for the long term.
This Community Adherence Group project is at the heart of Namibia’s Differentiated Service Delivery model, which seeks to make high quality medical services available even to our most remote communities. This project is being undertaken by the Ministry of Health and Social Services, which has begun forming groups in various districts throughout the country. Because of Namibia’s strong partnership with the United States in addressing the HIV epidemic, the United States, through its funding organizations PEPFAR and USAID, has partnered with the Ministry in this project to fast track the expansion of the program. To that end, USAID is providing funding to Tonata to scale up the development of the CAG project, taking advantage of Tonata’s already well established network of HIV support groups.

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Watch NBC's Coverage of the Milestone Event

NBC provided excellent coverage of the event. Watch the full story here

https://www.nbc.na/news/us-ambassador-namibia-johnson-motivates-community-adherence-groups.22962

Tonata Celebrates a Major Milestone in Ondjungulume Village

Yambidhidha CAG and Tonata celebrate their success together
Judith Uushona of Tonata dances with the procession of Yambidhidha CAG
to welcome the arrival of dignitaries at the milestone celebration

 

 

Tonata recently hosted a celebration for achieving a major milestone in it’s Community Adherence Group project, attended by a high level delegation including the Office of the Governor of Omusati, the Office of the Executive Director of the Ministry of Health and Social Services, the Director of Omusati Regional Health Directorate, the Honorable Councilor of Otamanzi Consitutency, and representatives from the Uukwambi Traditional Authority, the Ambassador of the United States for Namibia, and representatives from the United States Agency for International Development. The event was held in Ondjungulume village in Onkani, Omusati region, and was hosted by Yambidhidha Community Adherence Group.

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Tonata in collaboration with Okalongo Health Clinic held a Consultative Meeting with Ombandja Traditional Authority regarding community based HIV medicine distribution

TONATA IN COLLABORATION WITH OKALONGO HEALTH CENTRE ENGAGED OMBANDJA TRADITIONAL AUTHROTIY TO MOBILISE THEIR COMMUNITIES TO MAKE USE OF COMMUNITY BASED HIV MEDICATION DISTRIBUTION SERVICES DELIVERY

Namibia is making great strides in making access to HIV medication a reality. Decentralisation of anti-retroviral (ARVs) drug distribution from health facilities to communities is one of the models of Antiretroviral Therapy (ART) service delivery outlined by the Ministry of Health and Social Services. There is a need to raise awareness and mobilise communities to ensure people have access to available ART services according to their needs. Traditional authorities plays an important role in community mobilisation effort. Tonata in collaboration with the MoHSS-Okalongo Health Centre engaged the traditional authority (TA) of Ombandja to discuss the available ARVs drug distribution approaches and how the TA could assist in ensuring that their communities receive the services they deserve.

Meeting with Ombandja Traditional Authority
Chief Walaula of Ombandja Traditional Authority (second from left) with Tonata and MoHSS staff 

 

Tonata PLHIV network is funded by PEPFAR through USAID to scale-up Community Adherence Group (CAG) refill groups approach to ART service delivery in eight health districts of Oshikuku, Engela, Onandjokwe, Omuthiya, Tsumeb, Grootfontein, Nyangana and Andara in collaboration with the Ministry of Health and Social Services (MoHSS). 

Tonata Oshikuku District in collaboration with Okalongo Health Centre organised a consultation meeting with Ombandja Traditional Authority (OTA) held on 19 July 2019. The purpose of the consultation meeting was to introduce ART Differentiated Services Delivery models stipulated in the National Guidelines on Antiretroviral Therapy (2016) issued by the MoHSS. Particularly, the aim was to sensitise OTA leadership on Community Adherence Group (CAG) model part of Community ART Service Delivery so that they could mobilise Ombandja traditional community to embrace opportunities and benefits of CAG.

The meeting was held with Chief Walaula and his Ombandja Traditional Authority council and all village headmen. The council comprised of Senior Traditional Councillors, Traditional Councillors, and Secretary of the Traditional Authority. In Namibia, especially in the North Central regions such as Omusati Region, traditional authorities, which are the custodians of traditional customs, norms, values, language, culture, and customary laws, remain the centrepiece of community life. The traditional authorities guide and teach on moral and ethical conduct of their subjects. They are responsible for decisions regarding the collective welfare of the traditional community and can have decisive impact on activities taking place in that community, especially if the programs are initiated from outside the local community. Members of OTA council derives their leadership and authorities from the Chief in line with customary laws and relevant national legislations. The Chief is a figure of great reverence and respect in the traditional community.

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Tonata's Groups Grow in Engela District

Meeting with Emilia Shimweefeleni CAG leadership under the tree
Tonata team meets with leaders of Emilia Shimweefeleni CAG Leaders to subdivide it into smaller groups.

 

Tonata is now one year into it's efforts to scale up the Community Adherence Group project, and the needs of the program are evolving. Recently, a Tonata team visited Omutaku Village in Ohangwena Region, where the established support group Emilia Shimweefeleni has been growing rapidly and needs to be subdivided.

Before meeting with the group leadership, the Tonata team also met Mrs. Haihwema, the nurse in charge of Hamukoto Wakapa clinic, who oversees the refills of the support group. During the informal meeting, Tonata staff were able to discuss success and challenges with Mrs. Haihwema, and address issues that she identified.

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CAG Success Story - Eben Esser

Eben Esser CAG Members sing and dance at meeting
Eben Esser CAG has plenty of reason to celebrate

 

Namibia has made immense strides in combating the HIV epidemic in the country. It has almost reached the international UNAIDS 95-95-95 goals for 2010, were 95% of its HIV-positive people are tested and know their status, 95% of those tested positive are on anti-retroviral treatment (ART), and of those on treatment, 95% are virally suppressed, which means it is practically impossible for them to transmit the virus. Latest figures show that Namibia has reached a commendable 94-96-95. However, in any race, the last mile is the longest and the hardest, and the United States Agency for International Development (USAID) is committed to supporting Namibia in its effort to find the remaining few percent to close the last gap. Despite the many people now on lifesaving ART treatment, taking the medication properly every day is still a challenge and burden for many people in rural communities, and USAID is funding efforts to make HIV medication easily accessible for those living in remote areas.


Visits to the nearest health facility, which may be several kilometers away, to refill medication are costly and time consuming, and appointments can disrupt the vital work schedules of the household, such as livestock herding, planting, harvesting and processing of crops. For many rural people in Namibia, livestock and subsistence cultivation of millet is the primary source of income and food, so interruption of these tasks places a heavy burden on families. The Community Adherence Group (CAG) program works to alleviate this burden by enabling two members of a community to visit the clinic and pick up refill medication for those patients registered in the program, and bring and distribute the medication in the village. This reduces the cost of transportation for the families on ART, congestion at clinics, and strengthens the community support for these families.

 

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