NGO Project Summaries - Macedonia
 

Healthy Options Project Skopje (HOPS) Background: HOPS began its operations as a project supported by The Lindensmith Centre and The Open Society Institute Macedonia in 1997. It is a Skopje based not-for-profit organization with 18 part-time employees and 4 volunteers/trainees, mainly medical professionals and social workers. Since its creation, HOPS has successfully implemented programs to reduce drug related harm, prevent HIV and other sexually transmitted and blood-borne infections as well as social reintegration and re-socialization targeting young people and vulnerable groups (drug users, their families, sex workers and their families) in Skopje, Macedonia. In 2000, HOPS implemented the first project on HIV prevention and social assistance for women involved in sex work and their families. In 2003, HOPS continued with further development and upgrading of the existing programs by focusing on outreach to IDUs and CSWs and upgrading the reach and quality of medical and social services. In collaboration with IOM and NGO “Happy Childhood”  HOPS began implementing four preventive-education modules for trafficking victims living in the Transit Centre for Victims of Trafficking (VOT) in Skopje. Skopje has a population of 700,000 inhabitants and an estimated 7,000 drug users (multiplied by 5 the actual number of registered users) with somatic, psycho-social problems related to drug use.   Project title: Develop and implement “client” centred HIV, AIDS and STI preventive interventions among IDUs in Skopje   Project duration: August 2004 - February 2006 (1st round*) May 2006 – December 2006 (3rd round*)   Target groups: Injecting Drug Users in Skopje   Budget: 17,320 € from Partnerships in Health (1st round*) 5,000 € (3rd round*)   Baseline Information: There was only one drop-in centre located in the northern part of Skopje. As this centre was able to provide services to only 10% of the drug user population, there is a definite need to establish additional day centres for larger coverage and easier access to drug users from other parts of Skopje.   Project description Conduct outreach activities on HIV and STI prevention among IDUs in Skopje through outreach workers and gatekeepers and recruit, train and involve new gatekeepers in outreach.  Establish a day centre to provide medical and social assistance to IDUs with “user friendly” services based on “low threshold” principle. By promoting “shared care responsibility”, it is possible for every user to get services. Use multidisciplinary approach to solve specific problems that drug users face and facilitates collection of information regarding drug users and their problems as well as make efficient use of human and material resources. The services available at the day centre for IDUs are: VCCT on HIV and AIDS, hepatitis C, STI; counselling on the harmful consequences of drug use, promote treatment of drug-dependence and basic conservative treatment of the consequences of long-term and improper injection as well as social assistance.   Result to-date: Opened 3 new VCCT centres in Skopje and integrating harm reduction services to another VCCT centre: a total of 4 VCCTs. As of February 2006, 154 clients counseled and tested on HIV.   Non-anticipated benefits (co-financing, new partnerships etc.): The project was co-financed by PSI Romania. PSI Romania focused on social marketing and provided condoms for the clients, whereas FPH’s activities focused on delivering VCCT in the harm reduction centres to IDUs. The opening of new VCCT sites provides a unique form service to the marginalized populations in Macedonia and has produced better results than all the other institutions. This approach will be used to incorporate into other NGO centres serving Roma populations, MSM, CSW, and the general population in health education and HIV prevention.

Macedonian Interethnic Association (MIA)   http://www.miaaids.org.mk/ Background                          MIA is a non-governmental organization founded in 1996 and its primary objectives are health promotion and health education. MIA is the first organization working on HIV, AIDS and STI prevention in Macedonia. Today, MIA represents MIA and Youth of MIA with the mission to raise awareness of HIV, AIDS and STI infections, maintain positive behaviour and develop safe behaviour. It aims to promote information and communication campaigns among youth, adolescents, women, Roma community, and people with different sexual orientations, commercial sex workers and PWHA through AIDS Info Line, peer education, inter-generational open conversations, media campaigns, promotion materials, library services, raising awareness and prevention activities.   Baseline information                           Few Roma communities in Macedonia have been involved in educational programs in health care and family planning. Roma female in general have little opportunity to such education in the past. They lack awareness of HIV, AIDS and STI. MIA’s research and outreach and past project activities indicate that Roma families are mainly consisted of young couples on average each couple has more than 3 children. Roma community appeared to have an unusual increase in the number of IDUs and CSWs. There is high unemployment, low education level and cultural practices related to early marriage and no pre-marital sex.   Project title Roma action in HIV and STI prevention   Project duration October 2004 - January 2006   Target group Roma adolescents and the general Roma population in Macedonia.   Budget 42,870 € from Partnerships in Health   Project description                               Roma adolescents need specific health education and intervention for sustainable family and environmental support. The project will make efforts to provide information and services to Roma adolescents and the general Roma population with a special focus on developing a partnership with local Roma NGOs to tailor interventions to meet their unique needs and situation. The project aims to achieve this through nine activities: (1) conduct survey among Roma in reproductive age (14 - 45), about their needs on HIV and STI prevention and sexual experience, (2) build capacities of local Roma NGOs, (3) train Roma adolescent peer educators on HIV and STIs prevention, behaviour change strategies and open conversation with their parents, (4) expanded peer HIV and STIs prevention outreach activities, (5) Facilitate discussions between Roma NGO, social and health care professionals to improve communication with Roma people, (6) promote and distribute condom, (7) promote preventive information including to people with limited literacy, (8) provide media coverage of the project activities, and (9) organize HIV  and STI awareness campaigns with Roma NGOs in five selected municipalities ( Skopje, Bitola, Veles, Strumica and Delcevo) targeting 25,000 Roma people. The target group is Roma adolescents aged 14 – 24, who are recognized as at risk for HIV, AIDS and STIs. The project hopes to build a sustainable civic contribution to a coordinated local community and government response in order to prevent major HIV, AIDS and STI epidemics in Roma communities.   Results to-date     A baseline survey of 450 Roma was conducted, 45 local Roma NGO members trained on media communication, two “HIV and AIDS education” organized to train 60 Roma peers on HIV prevention. Outreach to over 3000 Roma through 186 presentations. In addition, 2 round table discussions were organized with 50 participants (doctors, social workers and NGO workers) to tailor services to the health needs of Romas in Macedonia. In addition, MIA has supported 5 Roma NGO awareness campaigns distributing educational material and organizing media shows for HIV/AIDS.   Unanticipated benefits (co-financing, new partnerships etc)       None

Macedonian Red Cross (MRC)   http://ckrm.org.mk/ Background MRC was founded in 1945, and has been working independently since 1992. Since 1994, MRC is recognized by the Macedonian Red Cross Law as the organization to assist the State institutions in humanitarian work in accordance with the Geneva Conventions. In 1995, MRC became a member of the ICRC and the Red Crescent Societies. MRC has a HQ of National Society and 35 branches throughout Macedonia. There are 115 employees, 200,000 members and 5,000 volunteers. In the past 10 years, MRC has been actively helping refugees and IDPs during the recent regional conflicts. Twenty percent of its core funding is allocated to health work such as TB prevention, HIV and AIDS peer education, health care in disasters, drug use prevention, and first aid or blood donation. MRC started HIV counselling in cooperation with the MoH in 2003.   Baseline information Target groups indicated that they had little knowledge about HIV and were not awareness of VCCT possibilities. CSW had low or no education, particularly among those working independently. Home villagers where migrants were from had low income and education resulting in limited information.   Project title Reducing HIV risk behaviours among vulnerable groups in Macedonia   Project duration September 2004 – January 2006   Target groups Migrant workers and truck drivers in Strumica, Bitola, Prilep, Ohrid, Veles and Kavadarci and CSWs in Strumica and other municipalities   Budget 32,441.95 € from Partnerships in Health   Project description This project aims to develop targeted HIV prevention activities among high-risk groups. MRC volunteers will provide counselling services and promote counselling through community activities. The community activities include discussion with CSWs in Strumica, pre and post discussion surveys so the education will suit their specific needs, preventive education discussions for the rural population and truck drivers of forwarding companies and migrants in Strumica, Bitola, Prilep, Ohrid, Veles and Kavadarci.   Results to-date The project reached 31 CSWs, (31 pre-tests and 21 post-tests), gave over 40 presentations to 232 truck drivers, over 60 presentations for 1387 migrants and their home community members, 68 counselling sessions and distributed around 10,000 condoms.   Unanticipated benefits (co-financing, new partnerships etc) Expanding outreach activities to CSW in other municipalities had excellent results.

HERA – Health Education and Research Association Background HERA’s goal is to promote and advance sexual and reproductive health in Macedonia with special focus on prevention of HIV and AIDS. HERA’s main activities are in the following areas: Prevention: From 2000 to 2005, HERA established a network of peer educators nationally for continuing education focused on the rural areas and marginalized populations. This programme has been implemented in partnerships with UNICEF and IPPF. HERA is a member of Young Peers network with UNDP. There are 3,000 youth peers from various social and cultural backgrounds. Publication & dissemination: From1999 to 2005, HERA published 15 different educative brochures in Albanian, Macedonian, Braille’s alphabet for the blind, audio cassettes and distributed over 200,000 condoms. Social campaigns: Since 1999, HERA organizes annual campaigns for the World AIDS Day in line with the campaign supported by United Nations Theme Group in Macedonia. Promoting friendly services: Info line: HERA’s first activity was the Info line on HIV, AIDS and STIs. By now, the info line has served over 8,000 citizens with the supported from UNICEF and Norwegian Church Aid. VCCT:  This free service started since HERA was established. The team has contacted 1,000 people. In 2005 with support from the Norwegian Church Aid, USAID, ISC, HOPS and the Clinic of Infectious Diseases in Skopje, HERA opened a counseling center and ambulatory services for HIV and AIDS. Youth Center: HERA opened its first Youth Center “I want to know” in 2005 in partnership with Primary Health Care. This Centre provides youth friendly services on sexual and reproductive health with support from IPPF. Care and support for PWHA: HERA reaches PWHA through VCCT to ensure easy access to ARVs and palliative care.   Baseline Information UNICEF, UNFPA, IPPF, World Bank, Family Health International, Futures Group has been promoting sexual and reproductive health services especially dedicated to young people (age 14-24). This global campaign aims to address the specific health issues of young people in the context of growing and devastating HIV and STI epidemics and design health services to fill the gas within the current system. Macedonia is one of the transitional countries in the Balkan region. The rapid changes are recognized as major facilitating factors for potential rapid HIV and STI transmission in the country, especially among youth. Recent KAP survey in Macedonia revealed great ignorance of contraceptive use among high schoolers as well as misconceptions about HIV and STI. The National Assessment on Youth Friendly Services in Macedonia, conducted in 2005 revealed fragmented, over-medicalised and specialised biomedical approaches in health service delivery for youth. The service for the most marginalized populations, such as Roma (approximately 20,000 people) was particularly lacking.   Project Title HIV/AIDS awareness, sexual and reproductive health and rights promotion among ROMA young people in Skopje draw on community needs in a youth friendly approach   Project Duration April – December 2006   Target Groups Roma population   Budget 15,483 € from Foundation Partnerships in Health   Project Description The project aims to fill the gap of current primary health care service in improving Roma youth’s sexual and reproductive health through encouraging responsible behavior with a youth friendly service. It is in the public health institution “Suto Orizari’. This is an extension of the “I want to know” model initiated by HERA and the Primary Health Care Center “Skopje” The activities include Quality of Care self-assessment, develop implementation plan, renovate and refurbish the clinic,  train service providers, distribute IEC materials, conduct youth events and seminars with community workers as well as parents in addition to provide SRH services including peer educations.   Results to-date The project started in April 2006 and is currently in progress.   Unanticipated benefits (co-financing, new partnerships etc) This project was initiated by HERA and the Public Health Institution Skopje as a joint effort to expand sexual and reproductive health youth friendly services to Roma populations. For this purpose they have mobilized multiple donors to contribute to sustain this centre as well as ensuring that by the end of the project the Ministry of Health of Macedonia will take over the responsibility of  maintaining the services provided at ths same site. The agencies supporting this initiatives are as follows: UNICEF – office equipment and refurbishment of premises GFATM fund at Ministry of Health – medical supplies Ministry of Health to take over the clinic after the current project funding period. IPPF/HERA – part of the activities and seminars FPH – clinical staff and activities Public Health Institution – staff and clinic premises