Challenges

There is high prevalence of HIV in Cameroon, where more than 4 per cent of the population live with HIV. About 620,000 people live with HIV (PLHIV), which includes 341,000 women, 240,000 men and 39,000 children. In addition, the annual new infections and deaths have continued to remain high in Cameroon, at 44,000 and 33,000, respectively.

The most HIV-affected regions in Cameroon are the eastern region with a 6.3 per cent prevalence and Adamaoua region with 5.3 per cent HIV prevalence. They have been burdened by high rates of chronic malnutrition and food insecurity with an influx of refugees from the Central African Republic (CAR). A vulnerability survey on PLHIV in 2011 revealed that 14.1 per cent suffer from malnutrition and 49.1 per cent of the households are food-insecure.

Toward a Solution

To address the above challenge, the World Food Programme (WFP) started a project in Cameroon that aimed to improve livelihoods and ensure food security in a sustainable manner among vulnerable households of PLHIV by improving their access to safe and nutritious foods. The Village Savings and Loans Associations (VSLA) model combined with theoretical and practical training on improved agricultural and livestock techniques have been used to build the livelihoods of vulnerable population living with HIV in Cameroon.

The Government of Ethiopia has been successful in implementing an Urban HIV Safety Net Programme together with the support of WFP. This Programme has had a considerable impact on the lives of PLHIV in Ethiopia. Based on this success story and with similar needs identified in Cameroon, a South-South exchange was organized to learn from Ethiopia’s wealth of experience in implementing their Programme to allow Cameroon to understand, modify and adopt a similar approach.

This South-South exchange involved capacity building of government staff in Cameroon to construct their own adopted approach of the VSLA model and build the livelihoods of PLHIV.

This project built on improving the livelihoods in Cameroon of PLHIV using the following methodological components:

• A learning exchange visit between Cameroon and Ethiopia to understand the successful practice of Ethiopia’s Urban HIV Safety Net Programme was followed by the adaptation for the resilience building programme in Cameroon.
• Vulnerability assessment of the PLHIV was conducted to understand the current situation of nutrition support and establishment of project eligibility criteria.
• Beneficiaries were divided into groups of 15-25 members to form a savings and loans association. They were expected to save a minimum amount every week and were also able to take loans with minimal interest rates.
• The beneficiaries were supported in identifying the activity they could engage in to strengthen their capacities in modern agricultural techniques, livelihood rearing, petty trade, food transformation and financial literacy skills.
• In addition to this training, beneficiaries were provided with start-up kits for agricultural, livestock rearing, petty trade activities, and with grinding mills to generate income to boost their group savings.
• Weekly meetings of these groups were encouraged, which helped to provide a forum for continuous follow-up of treatment adherence, referral to adequate treatment, especially for Prevention of Mother to Child Transmission (PMTCT) and training on essential actions in nutrition, water and sanitation (WASH) practices.
• These groups were also linked to local microfinance institutions, which increases their access to financial services.

The design and implementation process of the VSLA was based on a participatory approach. It included consultations from various stakeholders such as PLHIV, Cameroon Government HIV treatment and care staff, local authorities, as well as other humanitarian and development organizations working in the same project area.

The Programme has made considerable progress to date and has achieved the following key outcomes:

• 56 per cent of beneficiaries have been trained in petty trade and received start-up kits for petty business, and 75 per cent have started selling activities (e.g. fresh food, flour, staple foods).
• 25 per cent of beneficiaries have received agricultural kits and training in agricultural techniques and have developed vegetable gardens in the region.
• 19 per cent of the participants have received small stock animals and are rearing them for sales and producing additional incomes.
• US$200 were generated as income from grinding mills managed by the groups.
• No relapse into malnutrition has been recorded for the participants.
• One of the key achievements is that the bond of solidarity, peer support, mutual aid, social cohesion and economic empowerment among PLHIV has now been strengthened in the region.

VSLA groups have been trained to function independently; they have been legalized and registered at the authorized government office for a lifespan of 99 years and are equally eligible to benefit from government social safety net programmes. Practical skills acquired during training sessions and income- generating activities in place will continue to contribute to generating income, even when WFP’s Programme is over.

For a successful transfer of knowledge to take place, it is necessary to:

• Conduct a needs assessment exercise to identify specific vulnerabilities in the community
• Set clear vulnerability and project eligibility criteria for the Programme and the opinions of the PLHIV
• Bring the national government actors and key stakeholders on board for an integrated support package
• Continuously monitor and evaluate the Programme to track progress.