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ROADS to a Healthy Future: A regional response to HIV in Africa

April 23, 2014

The transport corridors of east, central and southern Africa are economic lifelines that link countries with their neighbors, serving as pathways for trade and engines for expanding local economies. They are also major transmission routes for HIV. High unemployment and underemployment, multiple concurrent sexual partnerships, substance abuse, widespread gender-based violence and poor access to quality health services — including HIV prevention, care and treatment services — all fuel HIV transmission. Selects ROADS transport corridors in east, central and southern Africa.

The Roads to a Healthy Future (ROADS II) project, funded by the U.S. President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development (USAID), links communities along these transport corridors with critical HIV and other health services.

Country-owned and community-led

Since 2005, ROADS programming has emphasized country ownership and leadership, gender equality and capacity building. Across east, central and southern Africa, ROADS has supported more than 1,300 local organizations in designing and implementing health programs that respond to specific needs.

Watch this brief video to learn more.

Integrating HIV with other critical health services

ROADS programming was initially designed to extend HIV services to target communities along regional transport corridors. To improve the overall health and well-being of these communities, ROADS now works with public- and private-sector partners to integrate family planning and reproductive health, maternal and newborn child health, and nutrition activities into HIV programming. ROADS also works with ministries of health to strengthen their ability to provide and deliver integrated services.

Read more about our work to integrate HIV and health services in Burundi and Mozambique.

Coordinating regional health programming and policies for greater impact

ROADS partners with regional policymakers and other stakeholders to standardize and extend HIV and broader health services to communities along major transport corridors, including cross-border areas. For example, ROADS is working with the East African Community — the intergovernmental organization representing Burundi, Kenya, Rwanda, Tanzania and Uganda — to develop a regional health strategy that ensures uninterrupted access to HIV services to resident and migrant populations along new and emerging transport routes.

Partnering with key populations to develop more effective messages on HIV

ROADS works closely with key populations affected by HIV and AIDS, including sex workers, men who have sex with men, truck drivers and others, to develop appropriate, relevant and effective HIV prevention, care and treatment messages. In multiple countries, ROADS has also facilitated collaboration between key populations and ministries of health and national AIDS commissions to design, pre-test and produce targeted communications materials. In Kenya, messages developed by sex workers and men who have sex with men are featured on the National AIDS and STI Programme website, helping to initiate discussions on sensitive HIV-related topics.

Read this story to learn more about our work with target populations in Burundi.

Women picking kale.Encouraging economic growth and increased food security

ROADS expands livelihood opportunities and boosts household economic resilience by providing training and technical assistance in locally relevant activities, such as group savings and loans, microenterprise development and modern agricultural skills (for instance, livestock management or urban and organic gardening). The goal of integrating economic development with health programming is to reduce reliance on survival strategies, such as sex work, that increase an individual’s vulnerability to HIV, increase access to health services and improve health outcomes for target populations.

Learn more about our economic strengthening work in Tanzania.

Advancing gender equality and women’s leadership

ROADS promotes equitable gender participation and decision-making, creates opportunities for women’s leadership and helps protect women and girls from violence and exploitation. ROADS uses an innovative, community-organizing approach called the cluster model. This model brings together local groups with similar interests to plan and conduct activities that meet community needs. ROADS-supported clusters are led by individuals on local steering committees, 51 percent of which are women. In addition, women have used skills learned in ROADS programming to attain leadership positions at the local and national levels.

Read how ROADS fostered the leadership development of a woman in Rwanda.

Working closely with the private sector

Across Africa, the private sector is becoming increasingly involved in implementing social programs that benefit and strengthen their beneficiaries. ROADS is partnering with private companies, such as DP World (Dubai) and General Motors East Africa, to achieve shared objectives within the communities in which the project works.

External evaluators praise ROADS

A team of independent consultants and USAID staff members conducted an external evaluation of ROADS II from late May through September 2012. The report spoke favorably about ROADS’ programmatic successes and its rapid adoption of USAID Forward principles, noting, “ROADS has shown substantial leadership on and even foreshadowed the principles of the U.S. Government’s GHI [Global Health Initiative] and USAID Forward. The project’s focus on country ownership and leadership, gender equity, and capacity building, including technical training and programmatic design and leadership, financial and grants management, and M&E [monitoring and evaluation] is a forerunner of such approaches, which over the last few years have become a priority for USAID.”