Focus on Men: Mphilonhle-Mpilonde
Project Name Focus on Men:
A Programme to Improve Male Involvement in Sexual & Reproductive Health (known locally as Mpilonhle-Mpilonde)
Project Focus HIV/AIDS;
HIV prevention; sexual & reproductive health; STIs; migration; gender-based violence; urban-based public health interventions.
6 hostels and 5 informal settlements adjacent to these hostels in Benrose, Johannesburg
Duration of Project :
December 2003 - December 2006
City of Johannesburg, Greenhouse Project; Market Photo Workshop; IDASA; Soul City; Freeplay Foundation.
Joanna Vearey; Dr Sinead Delany-Moretlwe; Mary Edwards
Project Aims /Objectives:
This three-year project aims to address risk factors for HIV transmission, including sexual violence, sexually transmitted infections and inconsistent condom use. Its focus is on increasing male involvement in sexual and reproductive health decisions as a strategy for empowering communities to respond to sexual and reproductive health priorities.
The specific objectives are:
- To determine risk factors associated with HIV/STI acquisition in this population
- To design an intervention to increase knowledge and awareness of the risk factors associated with STI/ HIV transmission in this population
- To increase awareness of the influence of gender on STI/HIV transmission amongst this population
- To increase the access of high-risk men to improved primary health care services for STI/HIV prevention and treatment (especially VCT, STI treatment services, and condom distribution);
To increase self-reported condom use in high-risk men in all sexual encounters
- To decrease the prevalence of self-reported STI symptoms.
The operational research programme included a formative research phase, a population-based baseline survey of behaviour and biological markers of HIV risk, the development of an intervention, and detailed process evaluation.
The baseline survey data was used to develop an intervention based on the Sustainable Livelihoods Approach for the target beneficiaries of the project. Results from the formative research led the research team to extend the project to include women who live in the informal settlements adjacent to the single sex male hostels.
Quality Life Clubs (QLC)were introduced at each of the project sites with the aim of building the capacity of individuals who attend the clubs to move from survival mode to one where they can cope and respond to daily stresses and shocks and move towards aspiring to a better life. Members met twice a week for 6 months to learn, reflect and change. While the intention of the programme was always to focus on HIV prevention, this approach recognized that HIV is frequently low on the list of priorities in poor communities. This approach encouraged community members to identify and prioritise their own health needs first, making it easier to address issues around HIV prevention when community members were more ready and able to cope with these messages.
Three rounds of the 6-month “Learn, reflect, change" programme have now been implemented and the QLCs has been handed over from RHRU to a community-based organization (CBO) which emerged from the QLCs. This CBO, Sipho Eshihle (Precious Gift) will attempt to ensure the sustainability of the QLC approach beyond the life of the donor funding cycle continue to lead the QLCs in this area, with the support of local organisations.
Results from the population-based baseline survey of 2,500 hostel and informal settlement residents, showed that 55.5% of women and 23% of men were infected with HIV.
Additional results - from research to analyse the impact of the intervention in this community are expected in 2007/8
Capacity building of community members:
- Formation of Community Based Organisation - Sipho Eshihle
- Community photography training and exhibition
- 52 Freeplay radios distributed to community
- Reproductive Health Priorities Conference 2004, poster: 'Quality of Life, Long Life: Questions raised while gaining access to inner city hostels and informal settlements for research and interventions
- Reproductive Health Priorities Conference 2004, plenary: Mobile Populations
- Reproductive Health Priorities Conference 2004, presentations: Real People Real experiences: simulated clients and urban clinics assessments
- Reproductive Health Priorities Conference 2005. HIV and public health interventions: testing a model that enhances quality of life in inner city Johannesburg
- Reproductive Health Priorities Conference 2005. Experiences from the implementation of Mpilonhle Mpilonde Quality Life Long Life public health intervention
- Reproductive Health Priorities Conference 2005. Traditional Healers as primary care providers in inner city hostels of Johannesburg, South Africa
- AIDS conference 2006, poster: 'HIV and Public Health Interventions: Testing a Model that Enhances Quality of Life in Inner City Johannesburg'
Research capacity building:
- 2004: London School of Hygiene & Tropical Medicine (LSHTM) MSc student thesis: Initiating an HIV/STI programme for migrant men in inner city hostels : the challenges of engaging government and community within the urban SA context
- 2006: London School of Hygiene & Tropical Medicine (LSHTM) MSc Student Thesis':
- Detection of Trichomanas Vaginalis by colorimetric PCR in urine samples
- 2006: Risk factors for HIV and the relationship between quality of life and HIV in women living in informal settlements in Johannesburg South Africa
- 2006: Risk factors for HIV and the relationship between quality of life and HIV in migrant men living in inner city hostels in Johannesburg, SA
- 2006: Evaluating the process : analysis of the Mpilonhle Mpilonde Quality Life Long life programme, Johannesburg, SA
- 2006 - 2009 University of the Witswatersrand PhD Student: How to respond to public health challenges within complex urban environments?
- 'Structural interventions-Mpilonhle-Mpilonde, Quality Life Long Life'; HIV/AIDS & STI News, DfID Knowledge Programme, no. 11, March 2006
- University of Witwatersrand Community Engagement Showcase exhibitors
- 'Interventions testing a model for internal migrants residing ininner city Johannesburg'; Forced Migration & Society Seminar Series, University of Witwatersrand
- 'Hidden Spaces: Lessons learnt from an innovative research informed public health intervention for a population of domestic migrants residing in inner city Johannesburg'; abstract accepted, Inclusive Cities, 2007
A follow up post-intervention survey is planned.
Projects in the STI's & HIV Research Cluster: