Nadoum – Stigma free services

“Many health practitioners don’t have awareness. They won’t even think to test you for HIV” - Dr. Mohammed Behery, providing services at Al Shehab’s drop-in centre, Cairo, Egypt.

Key information

  • Organisation: Caritas Egypt
  • Country: Egypt
  • Region: Middle East and North Africa
  • Stage of innovation: Stage 5: Market ready
  • Start date: 2019
  • Type of innovation: Policy innovation: change to policy thinking or behavioural intentions
  • Funder: Ford Foundation and Multi Country Grant Global Fund

Summary of intervention

People living with HIV (PLHIV) and other marginalised populations continue to experience institutionalised stigma and discrimination from health care providers and health facility staff, acting as a barrier to health services.

Caritas Egypt has an extensive programme to promote stigma-free services. Through its AIDS Intervention Unit – Caritas AIU – a partnership has been set up with Alexandria Directorate of Health. Regular quarterly workshops sensitise health care providers to improve attitudes towards PLHIV and other marginalised groups. Focal points from among health care providers in seven government hospitals in Alexandria have taken the lead as activists, monitoring and assuring stigma-free services. Key community focal points are placed at each facility to support beneficiaries throughout their health journey, including with referrals, where needed. Importantly, community members and clients have the opportunity to provide regular feedback on their experiences.

Through this programme, the Alexandria Directorate of Health has now issued a circular clearly stating that PLHIV and other marginalised groups have rights to high-quality medical care in any government hospital without discrimination — including antenatal care and access to free milk powder for babies. The circular was distributed to all government general hospitals in Alexandria. Caritas conducts an annual rapid participatory appraisal to evaluate satisfaction levels and remaining barriers, which in 2021 shows significant improvement in the services provided, as well as gaps that need further development and strengthening.

learnings

Deeply ingrained attitudes, stigma, fear of contracting HIV and other misconceptions around PLHIV and other marginalised populations remain an ongoing challenge.

next steps

Caritas will place focal points in all government hospitals in Alexandria so that efforts to enforce the messages from the Directorate are sustained and services are improved in a greater number of facilities. The model could be scaled and adopted in other governates.

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