‘ROADS’ to health and development in East and Central Africa

The USAID Regional office for East Africa launched a transport corridor program in 2005 called the Regional Outreach Addressing AIDS through Development Strategies (ROADS) based on the premise that mobile populations such as long distance truck drivers may also be ‘drivers’ of the HIV epidemic along the routes they travel. One transport corridor starts in Mombasa, Kenya and moves west to and through Uganda on to Southern Sudan or Rwanda, Burundi and the Democratic Republic of Congo. Another corridor starts at the port of Dar es Salaam in Tanzania, as does one that starts in Djibouti and passes through Ethiopia.

Along the way the ROADS project is establishing Safe-T-Stops for truckers where they can find HIV education, recreation that keeps them away from bars, and services like counseling and testing (CT). The project also works in the towns surrounding truck stops and has formed clusters of women (including sex workers), youth, and people living with HIV/AIDS CBOs. These groups not only engage in peer education and community theater, but also promote CT, ARV adherence, home based care and nutrition activities that support AIDS patients and vulnerable groups like orphans.

Economic development is a growing component of the ROADS portfolio with businesses and farms being set up in and by local communities. Integration of family planning services is underway at some sites and throughout the 26 current ROADS communities there is capacity building for public, NGO and private health care providers.

women-cluster-in-kenya-sensitizing-community-on-malaria.jpgAn example of further integration was a pilot project for malaria control in ROADS communities of Malaba and Busia that span the Kenya-Uganda boarder. WHO reported that it “developed project activities with the District Health Management Teams of Tororo and Teso districts as well as with the Truck Drivers Associations on both the Kenya and Uganda… The project enhanced access to ITNs to the target populations in both the Kenya and Uganda by procuring a total of 6,145 ITNs and distributing them to the cluster members. 1,711 of the old crop of ITNs were re-treated. Of the new ITNs given to the clusters, 800 were set aside for income generating activities. The cluster members were trained on ITNs use and re-treatment.”

This project demonstrated the value of integration malaria control into a strong community participation and multi-sectoral health and development model. Based on this experience WHO has decided to use this approach as a ‘best practice.’

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