In most countries, Fast-Track City work is mutually reinforcing. It brings together projects directly benefiting people, support for city-wide processes, and strategy, including through direct programmatic support. In Windhoek, partnerships between the city, institutional supporters (such as the Fast-Track Cities project) and civil society are creating robust strategies that can be translated into real outcomes on the ground.
Support for process and programmes
The City of Windhoek receives support from the Fast-Track Cities project to plan the HIV response. This includes the Municipal Council of Windhoek 2017-2022 HIV Strategic Plan, which is closely guided by Namibia’s National Strategic Framework for HIV and AIDS 2017-2022 and incorporates Windhoek’s Fast-Track City commitments. A revised plan has been developed to take into account the recommendations of a recent mid-term review.
At the same time, UN Volunteers (UNV) provides programmatic support for projects. This includes a UNV volunteer for communications, who takes care of documentation and report writing. Another UNV programme officer supports city implementation, including by advocating for and supporting the city’s efforts to strengthen public health and HIV responses and to integrate public health into city operations.
Support for people
The city’s initiatives include an internal workplace programme that ensures the health and wellness of employees of the City of Windhoek. Public health and community aspects of the response are primarily delivered through partnerships with civil society organizations. A key element of this is population-based interventions targeting key and vulnerable populations.
For example, in 2021 the city worked with three civil society organizations (CSOs) on the “Support to HIV response in Windhoek through Key Populations” project. The CSOs targeted specific vulnerable groups with appropriate interventions to improve the uptake of HIV prevention, testing and treatment services and promote adherence.
King’s Daughters Organization (KDO), a local NGO, provides HIV prevention for and links female sex workers to care through the Etegameno Resource Centre. Over a six-month period, KDO increased access among sex workers to HIV prevention, testing, and/or retention services and documented their lived experiences of health care services through eight recorded interviews.
Interventions provided through the Resource Centre included interpersonal communication (IPC) sessions for individual clients, as well as 20 adherence support group sessions. Clients were referred to health centres for HIV counselling and testing, where they were also able to access same-day initiation of treatment or pre-exposure prophylaxis (PrEP) as necessary. KDO also provided prevention commodities, including 8,052 condoms and 2,300 lubricants, and co-facilitated IAPAC training-of-trainers for peer educators.
Weekly support group meetings for those who had enrolled in treatment provided education about antiretroviral medicines and the importance of adherence. Members were able to support each other, with the added assistance of student social workers.
A shortage of commodities was resolved through a partnership with Namibia Planned Parenthood Association (NAPPA). Skills training and job placement were provided where sex workers had inadequate incomes, while counselling on personal issues was provided by student social workers to those who needed it. The support group meetings also helped participants to identify goals and thus counter feelings of hopelessness. When KDO staff noticed that clients were not seeking care after referrals, they began to accompany them to health centres.
Out-Right Namibia (ORN) is Namibia’s leading LGBTI human rights organization, with gender-, sex- and sexually diverse members working towards legal and social justice, equality and equity. Like KDO, ORN has worked with the city to increase access to services through community outreach and the documentation of lived experiences, with a focus on men who have sex with men and transgender women. The key to the programme was the provision of a safe and supportive environment in which clients could seek support and services.
ORN provided dedicated IPC sessions to clients – which included both HIV-related information and support for the development of life skills – and ongoing psychosocial counselling and support where needed. It also provided commodities such as condoms and lubricants; HIV self-testing kits; and referrals to HIV confirmatory testing, counselling and testing. Over six months, ORN tested 27 people, of whom three were diagnosed HIV-positive, and distributed 2,000 condoms and 1,000 lubricants.
In addition, ORN linked clients to services offering HIV treatment and pre- and post-exposure prophylaxis (PReP and PEP), accompanying them to facilities if necessary. ORN widened the scope of this outreach, and increased demand for services, by disseminating messages through its website and social media platforms (including Facebook, Twitter and Instagram), on a range of issues, including stigma and discrimination; access to services; HIV prevention, and HIV (self) testing and counselling.
ORN also distributed questionnaires to beneficiaries, resulting in extremely valuable data and testimonials on the lived experiences of men who have sex with men and transgender women, including their challenges in accessing HIV services. This increased awareness and engagement on these issues within and beyond the organization, and informed future programming for these populations.
The Namibia National Association of the Deaf (NNAD) led a new training programme to improve knowledge and understanding among Windhoek’s deaf community of their human rights and the resources available to them. Three sessions were held during weekends to ensure greater participation. For many in the deaf community, discrimination, inequalities and injustice are daily occurrences. These are compounded by a lack of information about the legislation in place – and what is available is not deaf-friendly.
The training focused on understanding human rights; sexual orientation, gender identity and expression and sex characteristics; key populations; health rights and services; the links between human rights and health for the deaf community; specific health services (HIV, sexual and reproductive health, and services for key populations); and community mobilization. The sessions aimed to challenge discrimination, inequality and injustices towards members of the deaf community. Among the most successful elements was the sharing of lived experiences, which provided invaluable insights into the human rights violations and challenges faced by members of the deaf community.
As a result of discussions during the training sessions, NNAD members elaborated an advocacy and awareness campaign plan for implementation during National Disability Month in September. The plan covered human rights and improving civic education and policy engagement; improving health care services through training on HIV, sexual and reproductive health, and mental health and wellbeing; and access to information on health and rights for the deaf community. The plan was accompanied by a full week of commemorative events and activities.
These partnerships – and others – are helping the City of Windhoek to ensure that no one is left behind in its efforts to end AIDS.
