MILITARY ACTION PREVENTION PROGRAM (MAPP)

MILITARY ACTION PREVENTION PROGRAM (MAPP)

Within the framework of the implementation of the Military Action and Prevention Program (MAPP), the Society for Family Health is tasked with the responsibility of ensuring the capacity enhancement of key military personnel to ensure capacity for HIV prevention, care and support. This program has been receiving financial support from the US Department of Defense since 2003.

For over 17 years, SFH has been working in partnership with the U.S Department of Defense (DOD) and the Namibian Ministry of Defense to implement a Military Action and Prevention Program (MAPP) The organisation works closely with the Ministry of Defense (MoD) to reduce the military personnel’s and their families’ vulnerability to HIV, while creating a more positive environment for other at risk populations.

The Namibian Ministry of Defense recruits young men and women at a time of their greatest risk to HIV, in the 15 to 25 year age group where 21% of all new infections occurs. The military risk environment is further enhanced by the mobility and absences from home and community that military life demands. The dynamic of transmission could be viewed as similar to that seen in long-distance transport workers and migrants employed in the construction and mining sectors.
        
The primary objective of this program is to implement a standard package of HIV interventions that intensifies previously implemented activities aimed at providing HIV prevention services to military personnel and their families, especially new recruits, young men and women.

• The package of HIV prevention services included condom demonstration and distribution, HIV risk reduction education, as well as referrals and linkages to health services including HCT, Voluntary Medical Male Circumcision (VMMC), Tuberculosis (TB), STIs screening and treatment, and other sexual and reproductive health services. The programme is implemented in 13 military bases in country targeting all military personnel and civilians at each of the 13 bases.
• To enhance program efficiency and promote ownership, SFH trained peer educators at each of the military bases to support activity implementation and reach out to their peers.
• Training has also been provided to Commanders and HIV unit coordinators.
• The program equally addresses other cross-cutting issues such as gender, stigma and discrimination.

The goal of Military Action for Prevention Program (MAPP) is to support the Ministry of Defense/Namibian Defense Force (MOD/NDF) to implement the standard package of interventions and enabling the MOD to better manage the MAPP activities.  Project objectives included:

• Reducing new infections among military personnel and their families
• Strengthening linkages to HIV services for military personnel and their families
• Increasing military personnel and their families’ access to condoms
• Providing technical assistance and strengthening the capacity of the military to implement the MAPP program including on condom forecasting and distribution plan development and implementation

Highlights of achievements

• A total of 1,920,000 camouflage and flavored condoms were procured and handed over to the Ministry of Defense.
• Although funding from US DoD ceased in the first quarter of 2017, SFH continued to provide technical support to sustain the program. Resource mobilization plan and sustainability plan are being operationalized to ensure that the program continues.

Challenges addressed

• The creation of a follow up and support system for supervision at the regional and base level using newsletters, site visits and condom distribution.
• Increase effectiveness of the peer education approach by providing refresher courses for trainers and peer educators as a forum for sharing experiences and moral support. This approach will ensure that wherever peer educators are redeployed, they will continue to fulfill their roles.

Lessons learned:

• Cascade training has proved to be an efficient way of reaching military personnel as it does not involve additional resources after organizing the first ToT workshops. The rest of the cascade training is taken over by the respective military base commanders. The training can also be easily modified for the needs of the audience, taking into consideration culture, religion and language, among other factors.
• The program becomes successful when there is great support from the Battalion commanders and unit commanding officers
• Most military personnel have adequate knowledge when it comes to HIV related matters which they have gained by attending sessions over the years.
• Effective communication cannot be overemphasized as a cornerstone of success even in a program of this nature and it is because of good communication that the program achieved much progress.
• There is a great need for the program to continue more importantly for new intakes as most of them are in their early youth and are more vulnerable.
• Good collaboration with other stakeholders such as Ministry of Health and Social Services (MoHSS) during outreach events leads to a greater outcome such as provision of HTC services and VMMC
• Military personnel more likely to use camouflage military condoms than any other condoms procured by government
• The Ministry of Defense has a forecasting and distribution plan for condoms in place; this resulted in this activity not to be conducted as anticipated.