Gate - the The development Research and Projects Centre (dRPC)

Report of Rapid Community Assessment in the Federal Capital Territory (FCT) for the
Global HIV/AIDS Initiative in Nigeria (GHAIN).
24 November to 15 December, 2004
Assessment Team, Development Research and Projects Centre (dRPC)
Ms.Veronica Osaghae
Dr. Yahaya Hashim
Dr. Ani Etokidem
Dr. Sani B. Garko
Mr. Samuel Egwu
Mr. Joseph Okeibunor
Mr. Oke Olubisi
Henry Osadolo
Joyce Mangvwat
(Editors Dr. Pertti J. Pelto and Dr. Lorie Broomhall)
This Report presents the process and results of the Phase I community assessment in the FCT area,
carried out by the team from the Development Research and Project Centre (dRPC), headed by Dr.
Judith Walker. The training and data-gathering reported here are a pilot exploration of the methods
and strategy for community assessments to be carried out in the other targeted "saturation states" to
be covered in the GHAIN program. The community assessment training and data-gathering were
facilitated by Dr. Pertti J. Pelto (consultant) and Dr. Lori Broomhall (FHI, North Carolina). This
Phase One assessment is intended to produce and analyze the inventory of governmental and non-
governmental organizations involved in the HIV/AIDS intervention campaigns in each of the
targeted states. A separate assessment of the health facilities has already been carried out in the
Federal Capital Territory. The community assessments in the other selected states (parallel to the
materials reported here) are scheduled to begin early in January, 2005. The work will be carried out
by the dRPC team.
Introduction and Background
The Global HIV/AIDS Initiative Nigeria (GHAIN) is a five year, $200 million project, funded by
USAID, in which the objectives are 1) to decrease mother-to-child transmission, 2) increase access
to antiretroviral drugs for people living with HIV/AIDS; 3) provide care and support to PLWHAs
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as well as AIDS orphans and other vulnerable children; and 4) to prevent the further spread of the
virus especially among high risk populations such as commercial sex workers (CSW), low income
women, and members of the armed forces. GHAIN is a partnership of eight national and
international organizations and educational institutions referred to as the Project Management team
(PMT), by Family Health International (FHI). 1 Nigeria‟s population of 120 million represents one
fifth of all people living on the African continent. According to the recent Human Development
Report of the UNDP, it is estimated that nearly four million persons in Nigeria are infected with
HIV, constituting an overall rate of over five percent of the population. This means that the HIV
problem in Nigeria has reached the stage of a generalized epidemic, affecting all sectors of the
population. Combating this very serious threat to the nation's health now requires the mobilization of
all facets of the Nigerian social system, including public, private and non-governmental
organizations, as well as massive scaling up of existing HIV/AIDS services and the creation of new
ones.
Under the GHAIN plan, the first step in scaling up services calls for rapid community assessments in
the target states of Anambra, Edo, Lagos, Cross River, Bauchi and Kano, as well as the Federal
Capital Territory (FCT). One objective is to identify organizations providing services, determine
who is being served and what kinds of support are currently being offered, and learn how these
groups operate. The relevant organizations include governmental agencies and committees, civic
associations, support groups for people living with HIV/AIDS (PLWHA), public and private clinics,
women‟s groups, faith-based organizations (FBOs), and others, both formal and informal, involved
in AIDS related activities. Another objective is to understand the organizational networks, to find
out which groups are collaborating with each other, and how they are linked. In addition, it is
important to identify the locate “hot spots” or places where high risk activity is concentrated. Most
of those places of high risk sexual behaviors are residential areas, in which there are also
concentrations of PLWHAs and PABAs (people affected by AIDS), who are in need of care and
support. The organizations, health facilities, hotspots and other features are represented spatially on
a series of maps constructed with the help of key informants during the assessment process.
1 Other PMT members include the Institute of Human Virology/University of Maryland (IHV/UMD), The
Futures Group International (FUTURES), the Nigerian and American Red Cross (NRC/ARC), the Centre for
Development and Population Activities (CEDPA), Howard University, the German Leprosy Relief Agency
(GLRA) and the Axios Foundation.
2

Methods and Strategies of The Community Assessment
Training the Assessment Team
The training activities were conceptualized as "training of trainers," because the participants from
the dRPC will (in January, 2005) go out to the designated "saturation states" to recruit, train and
work with additional data-gatherers to carry out the community assessments. All the participants are
already experienced in rapid assessment techniques, although some of the methods introduced in our
sessions were new to them. During the first five days the training focused on demonstrations and
practice sessions of specific data-gathering techniques, designed to be used by the team when they
recruit, train and work with the local assessment team members in the selected states.
The main data-gathering techniques emphasized in the sessions were the following:
Social mapping
Mapping in general is a primary emphasis in the strategy of community assessment, as the focus of
attention is on identifying geographic locations of sex worker concentrations (and other high risk
groups), and concentrations of PLWHAs and others in need of care and support, as well as mapping
their relationships to the facilities and organizations involved in HIV/AIDS related programs. In
"social mapping" informants are asked to indicate relevant information on hand-drawn maps,
particularly the locations of "hotspots," health facilities, and other data. The mapping procedures
facilitate the free flow of additional descriptive information, as the informants explain the details in
their maps. We provided the team members with large sheets of paper and colored markers when
they went out to meet with informants in various organizations. Quite early in the interaction the
interviewers asked informants to locate some key points on the map.
The mapping processes in the FCT led to a thorough inventory of the main "hotspots," (see Map 2),
as well as health facilities, NGOs and other features. Such maps are always "works in process," and
it is advised that in the next round of community assessment the data-gatherers revise and update the
current maps with new information. That is, we emphasize that the process of social mapping, and
3

the use of maps in community assessment and program planning should be a dynamic process, with
continuing revision of the map data.
The photograph on the following page is an illustration a social mapping demonstration, in which
the key informant is drawing features on his sketch map of Kano city, while at the same time
narrating about HIV/AIDS related information, in answer to the interviewer's questions.
4

Plate 1. Key informant giving information while mapping features of Kano City.
(Demonstration of social mapping during training session).
5

Key informant interviewing
Interviewing of persons in NGOs, government agencies and other organizations is the second
keystone of the community assessment strategy. Our training emphasized techniques of open-ended
interviewing, to get concrete descriptive materials about the activities of each organization, their
collaboration with other NGOs and government agencies, problems encountered by HIV/AIDS
programs, and other information. In order to be sure that certain main points were covered in each
interview, the team developed checklists of key information, which were consulted during the
interviews, although they did not use the checklists directly as "interview protocols." Very often the
interviews uncovered new, unexpected information about the organizations, their attitudes about the
HIV/AIDS issues, and their contacts with the populations and places with concentrations of high
risk behaviors.
Careful documentation through note-taking was particularly stressed. The team participants were
urged to expand their notes as soon as possible after each contact in the field. They quickly found
that writing out extensive notes on the computers is a very time-consuming process. At the same
time, the extensive note-taking provides our main source of necessary descriptive data for
understanding the activities and structures of organizations involved in the HIV/AIDS campaign.
Free listing and rating techniques
One of our first activities in the community assessment process was to collect lists from our team of
all the organizations they could think of that are involved in HIV/AIDS programs in this part of
Nigeria. Collection of such lists produces a quick preliminary inventory of the relevant
organizations, and also results in a rough measure of "salience," in the form of the frequency of
mention of individual organizations. Thus, those NGOs and governmental units that are mentioned
by a large percentage of the informants can be regarded as more salient, or "better known," in the
HIV campaign. Such lists should be collected in each of the selected states (and sub-areas of states),
from local key informants.
Near the end of our assessment activities we collected ratings from the team members, in which
they were asked to indicate which organizations they believed to be the "most effective" in the
HIV/AIDS campaign. Ideally such ratings would be collected from key informants out in the
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communities, but in this case we chose (because of lack of time) to carry out ratings among the team
members themselves. Their ratings (see Appendix F) are very useful, as they had a good
opportunity to review and compare the activities of a wide range of organizations during the field
work.
These structured qualitative interviewing techniques (free listing and rating), which are relatively
less well known to most research groups, were introduced as rapid and effective ways of gathering
inventories of organizations, health facilities, and other information. These techniques are often
integrated with key informant interviewing. Various rating data, (for example, rating of
organizations doing AIDS related work), are generally collected using index cards, which can be
sorted by informants into categories, or "ratings" of "more effective," "less effective" or other
types of assessments. All of the usual structured qualitative data-gathering methods--free listing,
pile sorting, and ratings--are processed and analyzed using the ANTHROPAC computer software.
Direct Observation
Our team members are already familiar with the usefulness of direct observation of marketplaces,
beer parlours and other entertainment spots, neighborhoods, health facilities, and other places. Such
direct observation adds important information to verify the statements of key informants. The
observations carried out by our team were mainly in the hotspots, where they could see first hand the
crowded conditions in slum areas, and the situations of the small hotels and beer parlours that are
important in the commercial sex work activities. The direct observations in the hotspots were
frequently re-enforced with mapping, in order to give clearer visual information about the fields of
activity in those locations.
Map 1, below, shows an example of the situations around military barracks, which are locations of
considerable commercial sex work activity, and also residential areas with increasing numbers of
PLWHAs. In the map the important feature is the "Mami Market," which we found to be typical of
all or most barracks areas. The "Mami Market" is controlled and operated by the women who
reside in the barracks, and provides them with additional income sources. At the same time, the
Mami Markets have beer parlours, food service, and other entertainment features, and at night they
become active places of commercial sex work. The mapping at the cantonment area also revealed
7

the information that ex-soldiers often settle in groups in areas near their old military contacts. That
feature is show as the "Ex-Soldier's Village."
The very short time period alloted for community assessments means that extensive field
observations are not possible. However, it is extremely important that the assessment teams visit
some selected areas, including important health facilities, in order to see first hand the conditions
and situations affecting HIV/AIDS program activities. More examples of data from direct
observation are given below, in the section on "Hotspots."
8

Gate
Health
Clinic
Ex-Soldiers' Village
Map 1. Mogadishu Cantonment Area
(Example of Mapping data)
Mami Market
Residence
Residence
9
Residence
Residence
DAM
Angwan
Isa

Computer Training
The management of data in community assessments generally requires the recording and sorting of
extensive text data to facilitate rapid and thorough retrieval and analysis. For this reason, team
members were trained to use the computer software, ATLAS/ti, for coding and text data retrieval.
The essential coding and retrieval aspects of the program are very easy to learn, and the process of
coding is an important early step in data categorizing and analysis. More complicated maneuvers
with the software are unnecessary in this kind of data-gathering. Later in the training, the team
learned to use ANTHROPAC, a software program designed to process free listing, pile sorting and
rating data.
Most of the dRPC team have laptops, and are developing good practical computer skills, particularly
writing text into the WORD processor. It is not expected that the additional data-gatherers in the
other states will be able to work with computers, so the dRPC primary team will bear the burden of
writing up interviews and observation notes, and coding the data in ATLAS/ti.
The Community Assessment Data-Gathering
Beginning Friday, November 26 th , the assessment teams went out for field work in three separate
groups. Contacts with governmental HIV/AIDS program units began with interviewing at the
Ministry of the FCT, with the Secretary of Health and Human Services and the Program officer for
HIV/AIDS.. The interview covered a wide range of activities concerning HIV/AIDS programs and
planning activities, including the structural system reaching from NACA to FACA (Federal Action
Committee on AIDS) and out to the grassroots structures, which are the Local Action Committees
for AIDS (LACAs). There are six LACAS in the FCT (see description below).
Networking Organizations
During the first discussions within our data-gathering team we had gathered lists of organizations
involved in HIV/AIDS (free listing, as described above). In the lists we found that there are
specialized (NGOs) whose main functions are to develop communications and networking among
the many different types of organizations. Our teams interviewed two of these organizations very
early in our data-gathering process: CiSNHAN (Civil Society Network on HIV/AIDS in Nigeria
has offices throughout the nation, and in the FCT it has a directory of 56 organizations who are
10

members the network. Their office is in the same building with the Network of PLWHA in Nigeria
(NEPWHAN), which maintains ties with the growing numbers of individual PLWHA groups
throughout the FCT. Interviews with these two organizations provided us with frameworks for
conceptualizing the very large number of different kinds of organizations, and they were also able to
give contact information about persons and telephone numbers, for arranging visits and interviews.
It is clear that in each of the selected states, the community assessment teams should make contact
with those two networking organizations soon after the contacts with the governmental people in the
State Action Committee for AIDS (SACA) and the state health offices. It is also useful for the
teams to check back with those networking organizations from time to time, to probe further
concerning types of organizations, and their linkages.
Types of HIV/AIDS NGOs
Based on the first rounds of contacts with governmental and non-governmental organizations, we
developed a rough categorizing of the types of NGOs (see below, Section ____ ). It was
immediately clear that we would need to gather data from those main types: 1) women's
organizations, 2) youth organizations, 3) faith-based organizations, and 4) PLWHA support
groups. We decided that we would spend less time in meeting with the international NGOs, as they
generally carry out their programs through the activities of the more localized governmental and
non-governmental entities.
During the interviews and mapping sessions, the interviewers mapped out the main concentrations
of commercial sex activities (hotspots) in the FCT (see Map _____). Direct observation and
interviewing were carried out in Nyanya, the Mogadishu Barracks area, Mabushi, and the rural
town of Mpape, but the teams were also able to get good descriptions of some of the other main
concentrations of commercial sex work. They were also able to observe the situations in some
private and governmental health facilities. The health facilities generally received less attention, as
the other assessment activity had been focused exclusively on the health facilities that would be
relevant for the different care and support facets of the GHAIN program.
The sequence of data-gathering operations is shown in Figure 2, on the next page.
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Figure 1. Steps in the Community Assessment Process
Phase I Phase II Phase III
Contact with the FCT
Ministry:
Interviews with Exec.
Secretary for Health
and Human Services,
and Program Officer ,
HIV/AIDS.
Contact with the
FACA.
Phase IV Phase V
Visits to "Hotspots" for
interviews, mapping, and
direct observation.
Interviews and social
mapping, with
informants in the
networking
organizations (esp.
CISNHAN,
NEPWHAN).
Free-listing of
relevant
organizations by
key informants
Phase VI
Phase VII
Further interviews with
selected NGOs,
including faith-based
(FBOs).
Computerized data entry and analysis of free-lists, some
ratings, and the text data from in-depth interviews.
Follow-up data collection with some special NGOs.
Data compilation and analysis. Writing the Report.
12
Interviews and
mapping at each of the
six LACAs of the FCT.

The Federal Capital Territory (FCT): General Features
For purposes of the GHAIN program the FCT is considered as a "state," though it is smaller in area
than most of the other 36 states of Nigeria. Abuja became the official capital of Nigeria in 1991,
and since that time there has been a very rapid increase in population in the federal territory.
Official figures put the population at around 2.5 million, but unofficial estimates run closer to four
million inhabitants. The fact that Abuja and the FCT are largely made up of "new communities" is a
major factor in affecting the spread of HIV and also the situations of PLWHA. People from nearby
states are pouring into the FCT to work in construction, selling of goods to the more affluent part of
the population, and for other economic opportunities. Housing is at a premium, which has led to the
growth of slum pockets, and to overly rapid expansion of some communities on the outskirts of the
main metropolitan area. Services are largely concentrated in the urban area, and costs of goods and
services are higher than in many other parts of Nigeria.
The differences between living conditions in the urban area versus the rural parts of the FCT are
another set of factors affecting the HIV/AIDS picture. Most of the organizations involved in
HIV/AIDS are in the central urban area. Other services, too, are concentrated in metropolitan
Abuja. Investment in infrastructure, including the provision of equipment and supplies for health
facilities tend to favor the urban area, particularly the more affluent parts of Abuja. Private health
facilities are found in the rural areas, but they are fewer in relative numbers, and less well equipped
to deal with aspects of the HIV/AIDS epidemic. The partial exception is Gwagwalada, which has
somewhat more medical facilities, and other services, as it is a university center, with somewhat
greater influx of new, better educated population.
In religious affiliations, the FCT appears to be nearly equally divided between Islamic and Christian
inhabitants, according to informants. Among the Christian part of the population there is a very
great variety of large and small denominations among the Protestants. In addition to the Catholic
church (approximately 15 percent of the population), the Evangelical Church of West Africa and the
Anglican church have significant numbers of members, and one sees the roadside signs and
announcements of dozens of other denominations.
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Because of the nature of economic migration to the new opportunities the nation's capital, family
networks in the FCT are generally very small, as in-migrating people are largely cut off from their
larger kin networks in home areas. The lack of larger family structures often poses serious problems
for persons who need care and support, as there are fewer grandparents or other kin to help with
home-based care. Some of the same family and population dynamics affect risk-taking behaviors, as
young people have fewer social constraints on sexual activities and other behaviors that make them
vulnerable to HIV infection. Thus there are a variety of factors that put the FCT among the most at-
risk states with regard to HIV infections. The recently published UNDP Human Resources Report
gives an estimate of 8.4 percent HIV+ for the FCT population, considerably higher than the national
average, which is around five percent. Only three states are thought to have higher rates of HIV
than the FCT. Of those, Cross River, with an estimated 12 percent, is the most seriously affected.
The Nigerian Governmental Structures for Combating the HIV/AIDS Epidemic
Action Committees have been created on the national (NACA), state (SACA) and local (LACA)
levels. The purpose of the three-tiered structure is to make programs more sensitive to local needs,
and therefore, more effective. NACA, a multisectoral, multidisciplinary group consisting of the top
government ministers, and leaders from the private sector, is charged with making policies that
guide the development and implementation of programs at the state and local levels. SACA and
LACA coordinate all HIV/AIDS activities on their respective levels. Each state and the FCT have
one SACA, whereas LACA organizations are formed in the various local government areas.
NACA financial resources, fortified with addition funds obtained by the SACAs and LACAs, are
channeled to the various action committees, which in turn, support local governments, civic and
private organizations to actualize the programs.
Parallel to the action committees are the Planning Teams that manage the NACA and SACAs and
provider technical assistance. LACAs also can form LPTs, although the majority has not yet done
so. The National Planning Team (NPT) and the State Planning Teams (SPT) provide the technical
expertise that most committee members do not have. In addition, the planning teams perform all the
management and administrative duties for the action committees.
14

Figure 2: Nigerian governmental HIV/AIDS program structure
Federal Action Committee on AIDS
The Federal Capital Territory, which comprises Nigeria‟s capital city, Abuja and surrounding areas,
is the starting point of the community assessment process. The FCT is one of the 6 „saturation
states,‟ although, technically, it is not a state. With the third highest HIV infection rate in Nigeria,
the overall prevalence rate, as of 2003, is reported to be 8.4%. HIV levels vary across the territory
from a high of 10.2% in Asokoro and 9.3% in Nyanya to a low of 5.8% in Gwagwalada 2 . The
Asokoro and Nyanya figures show a slight decline in HIV prevalence since 2001; however the drop
may be due to underreporting, or, as one HIV/AIDS program officer suggested, the positive impact
of HIV awareness campaigns.
LACAs
SACA
NACA
FACA SACA SACA
LACA LACA LACA LACA LACA LACA
CBOs FBOs PLHAs PHCs
2 These statistics were present it to the field team by Dr. Tali Gbutkap, HIV/AIDS Program Officer at the
Ministry of the Federal Capital Territory (MFCT) in Abuja.
15
Private
Clinics
NPT
Women’s
Groups
STP
LPT
Trade
Unions

LACAs, the action committees in local communities, have been established in five of the six area
councils (local governments), that make up the FCT. They are the Abuja Municipal Area Council
(AMAC), and Bwari, Kwali , Abaji and Kuje Area Councils. The one remaining area council in
Gwagwalada has yet to establish a LACA. Each LACA is made up of community members living
within the boundaries of the area council. There is no set number of members; however, in general,
the more populous areas have more committee members. For example Abaji, a mostly rural district
of 450,000 residents, has six LACA members including the Chief Imam and the chairman of the
Okada Riders (motorcycle taxi drivers) Association. In comparison, AMAC, which encompasses the
Abuja metropolitan area with a population of 1.5 million, has 15 members including two PLWHAs,
AMAC‟s Public Health coordinator and the head of social welfare. Local organizations carrying out
AIDS related activities are required to register with LACA before they can be represented on, or
receive assistance from, the action committee. In principle, LACAs are supposed to receive support
from FACA, and are encouraged to seek additional funding from private sources such as religious
groups, and individual donors , their respective local governments, and NGOs. Currently, however,
none of the LACAs in the FCT has received monetary support from FACA.
The LACA entities in the rural part of the FCT have only been activated fairly recently, and they
generally have little or no funding or other resources. For example, the LACA coordinator in Bwari
was appointed about a month before our community assessment, and he has now begun a few
activities of awareness raising, and plans to initiate awareness workshops in schools and with
NGOs. The LACA coordinator in another area complained of lack of financial or other support
from the FCT (FACA):
Q: What about FACA, does it support your activities?
A: We wrote them about the World’s AIDS Day to ask for financial support to
mark it here in [Local Community], but we have had no response up until now, one week
after the day. We get tired as our efforts are not encouraged. National
Youth Service Peer Educators on AIDS come to help and the Red Cross,
but no encouragement on the part of the government.
The general situation in the peripheral localities appears to be a lack of funds, as well as lack of
clear operational guidelines from the central government.
16

Planning for the Next Stage of Activities
On December 15 th , 2004 the Ministry of the FCT and the FACA organization held a Stakeholders
Meeting in Abuja, to present and review a comprehensive "Response Strategy for Care, Support and
Prevention in the Federal Capital Territory." The meeting was attended by about 75 persons from a
broad range of international and local organizations, in addition to the FACA committee members.
Some criticisms were presented concerning the draft document, but on the whole the draft, and
accompanying Work Plan was thought to be quite comprehensive and nearing readiness for
implementation. The plan includes the commitment of governmental funds the program, but it
appears that much of the ambitious scope will require external funding from international sources.
Several speakers in the meeting commented that there has been enough talk and planning, and its
now time for action.
Governmental and Non-governmental Health facilities in the FCT
Our community assessment did not make a systematic, thorough review of the hospitals and other
health facilities, as the "health facilities" team had carried out an assessment of some of the
hospitals earlier (November 2004). The following materials are intended to provide an introductory
overview concerning some of the facilities in the different rural and urban communities, as well as
medical establishments mentioned in the networking reported by various governmental and NGO
informants.
General Hospitals
Administrators in the Ministry of FCT reported that there are altogether 14 hospitals in the FCT,
six of which are currently being used for HIV services. These are in the following locations:
Nyanya, Asokoro, Wuse, Gwarinpa, Maitama and Gwagawalada. Based on their list, we can see
that some of the outlying rural Local Area Councils do not have HIV services in their hospitals.
Each local government area has at least a small General Hospital, but several of them do not have
HIV/AIDS programs. That is, Bwari, Abaji, Kuje and Kwali are not included in the FCT list, and
most of the HIV services are concentrated in the urban area. The informant in the FCT Ministry of
Health and Human Services told our interviewers that they have a total staff of around 300 persons,
17

"including highly motivated doctors, pharmacists and nurses." On the other hand, it was admitted
that the system has weakness in the area of laboratory staff.
The general hospitals in the outlying Local Area Councils are small, some of them being upgraded
from primary health centers. For example, the Abaji general hospital people reported that their
facility of approximately 40-50 beds was recently upgraded from a Comprehensive Health Center,
and the construction was not yet complete in December 2004. They still have no laboratory space,
and the facilities do not yet have the capability of providing an HIV/AIDS program.
Some general hospitals in the urban area are also recently upgraded and expanded. For example, in
the Nyanya general hospital, the informant reported that "until five years ago it was a
Primary Health Care Center, and facilities are currently being upgraded to the status of a
General Hospital." The interview team estimated that the women and children's ward has about 30
to 40 beds, and there is a smaller male ward as well as Outpatient Department. Services are mainly
focused on pregnancy and childbirth, but they do treat opportunistic infections of HIV persons, STI
cases, as well as offering VCCT.
In the rural areas the local governmental health services are distributed in "health districts." For
example, the Gwagwalada Area Council has four health districts: Gwagwalada (the municipal
area), and three others, and each district has two primary health clinics, headed by Community
Health Extension Workers or Community Health Officers. These health centers are quite small, and
can only handle very minor complaints, so they refer the more serious problems to the general
hospitals in their areas.
In addition to the General Hospitals of the FCT system, informants frequently mentioned the
governmental Specialist Hospital in Gwagwalada as a facility for HIV/AIDS services.
Private Hospitals and other Facilities
The Catholic church organization operates eight hospitals in the FCT. The most frequently
mentioned by key informants is St. Mary's Hospital in Gwagwalada. Several organizations,
including the local governmental people spoke of referring people to St. Mary's Hospital for HIV
18

testing and for PMTCT. Three other Catholic hospitals offer PMTCT services, of which the
Daughters of Charity Catholic Hospital in Kubwa plays a particularly important role.
The Gede Foundation has a very specialized role in relation to HIV/AIDS programs. It is basically a
research laboratory organization, with quite advanced, modern facilities for specialized testing, such
as their late model, German-made Cyflow machine for CD4 counts. The Gede Foundation informant
said that the Gede Foundation was one of two places in Nigeria with this high level equipment. She
added that the CD4 testing equipment at the NIPR is not as up to date as their Cyflow machine.
Their laboratory also has Polymerase Chain Reaction (PCR) equipment, for testing viral load, as
well as other technical measurements. The informant said that the PCR equipment can detect the
presence of HIV infection within the first 24 to 28 hours.
Several organizations, including both governmental facilities and NGOs reported that they refer HIV
persons to the Gede Foundation for testing and other services. Key informants from the Umma
Support Group (Islamic) said that "referrals are usually to the National Hospital and Gede
Foundation; the latter… has been the main source for USG members requiring ARV." (excerpt from
interview notes). The informants at the small hospital in Abaji said they had recently referred four
HIV patients to the Gede Foundation.
The FCT area, both urban and rural, has many small private clinics and laboratories, with both
qualified and unqualified practitioners. Many small private "hospitals" and clinics are found in or
near the "hotspot" areas. For example, in the Nyanya area our field workers found the Panraf
Hospital located about 80 meters from the Mobile Police Quarters, across a small street from the
southwest end of Obalende (hotspot area). The hospital has only a few beds, perhaps enough for
about 10 patients. They have a medical laboratory for cardiac testing, HIV testing, and some other
laboratory procedures. The building is a substantial residential apartment building, converted into a
small private hospital. The facility has been there for the past five years. There is a sign outside
indicating the Panraf Hospital. The Chief Matron of the hospital described that they do HIV testing;
they have a PMTCT program, and they even provide some ARV treatment, to a small number of
local patients. There appear to be dozens of such small private "hospitals" scattered about the FCT,
including in the "hotspot" areas. Similarily, our field researchers found that there were many small
19

medical laboratories. For example, we found two laboratories on the main road in the community of
Mpape (one of the "hotspots") that offered testing for HIV. Those laboratories reported that they
have a thriving business of testing among the local population.
Discussion
A recurring theme among the governmental hospitals and health centers is the lack of funding for
personnel, equipment, and other needs. All of the facilities visited had first-hand contact with
HIV/AIDS cases, and they all reported referring cases to the larger, better supported facilities, both
governmental and private. Although the informants in government hospitals and other health
facilities reported that they had had training concerning HIV/AIDS, it was evident that there is need
for further, up-dated training among the health care personnel. There were also some reports of
continuing stigmatization in the health care settings.
Non-Governmental Organizations involved in HIV/AIDS
There are a very large number of NGOs, CBOs and faith-based organizations (FBOs) involved in
HIV/AIDS activities in the Abuja area. Lists of those organizations were obtained from the FACA
(Federal Action Committee for AIDS) and from some of the networking organizations, such as
CISNHAN and NEPWHAN. During interviews with individual organizations, a number of other
CBOs, NGOs and others were mentioned. The majority of the larger organizations are located in the
Garki area of Abuja, but there are branches and local units in some of the outlying areas. Local
groups of people living with HIV/AIDS may be active without getting officially registered, and
without identifying themselves to governmental and non-governmental organizations. Thus, there
are likely to be many very small, localized organizations that are potentially important in the area.
Large International NGOs and other Organizations
Abuja has offices of a large number of International organizations with various kinds of HIV/AIDS
projects, such as Action AIDS, Family Health International (FHI), CEDPA, DfiD, and others.
These organizations have not been a primary focus of our situation assessment, because their
activities tend to be mediated or "operationalized" through the various other government and NGO
groups at more local levels. On the other hand, the "networking NGOs" are important, as they are
20

intended to maintain communications with a wide range of different organizations who are
"members" of the network.
CiSNHAN (Civil Society Network on HIV/AIDS in Nigeria) is an organization whose
mission is to develop greater interactions (networking) among the various different NGOs, and to
circulate information and materials, as well as training among the member organizations. As of
November 2004 the CISNHAN directory listed 56 members, including a considerable number of
organizations that are PLWHA support groups. The offices of CISNHAN are located at the
intersection of Lafia Close and Ilorin Street in Area 8 of Garki in Abuja. The organization was
established in the year 2000 as a coalition of civil society organizations working in the area of
HIV/AIDS. In November 2004 the office had four female staff members, five male staff, and one
male support person. They do not have volunteers or part-time staff.
The office in Garki (Abuja) is the National Secretariat, which means that they are active in
communications to the various branch offices in other states, in addition to the activities in the FCT.
In addition to the training, networking, and capacity building, the organization has recently added
another function, that of "leveraging funding" for member organizations. Recently the National
Action Committee for AIDS (NACA) sent out a request for program proposals, and CISNHAN was
asked to contact their membership to solicit proposals, and to select the more fundable proposals
from among those submitted. As part of its activities, CISNHAN produces or accesses IEC materials
from other organizations in order to distribute the materials to its members. IEC materials, training
materials, and other information from the governmental sources (NACA) are handed over to this
networking agency for distribution to their memberships. The information distributed by them
include bulletins of information from other countries, so that the CISNHAN members can be better
informed about activities happening in other parts of the world.
The National Secretariat has a 12-member Facilitating Committee (equivalent of a board)
from among which a National Moderator is elected for a two-year term.
The regular meeting of the national body is held every other month. The diagram on the next page
shows the relationship of this National office to the network of their offices in other states.
21

Programmatic Significance of CISNHAN
The organization is not directly involved in programmatic interventions with target
populations, since it's mission is directed to coordinating and facilitating the work of its member
organizations.
Their structural position, linking large numbers of non-governmental organizations, makes
them an ideal site for certain types of communications, including dissemination of IEC materials.
They would also be an important resource if one were organizing meetings of various types of
NGOs for discussing programmatic strategies.
Their organization already has a "directory" of over 50 organizations, and they are
accumulating the addresses and telephone numbers. They could be contracted to develop a more
comprehensive "Directory" of HIV/AIDS NGOs; or they could be part of a "Working
Group" to develop such a directory.
NATIONAL | NATIONAL COORDINATOR
FACILITATING COMMITTEE
ZONAL COORDINATORS
� 6 IN TOTAL
� ELECTION EVERY 2 YEARS
� Each zone has 6 or 7 states
STATE LEVEL:
STATE FOCAL PERSONS
NEPWHAN (Network of PLWHA in Nigeria) is located in the same building as CISNHAN,
although it does not seem that the two organizations have particularly close working relationships.
22

NEPWHAN was established in the year 2000. However prior to this date, there existed 5
organisations of PLWHA in the country, prominent among them was the UNIQUE AIDS
CONTROL ORGANISATION in Nyanya, (Abuja) and the Council of Positive People (COPOP),
Kano. These groups, along with some faith-based organizations were under the leadership of John
Ibekwe who served as their president. They had a series of meetings in Lagos and Ibadan in
1998/1999.
In the year 2000, Nigerians who attended the Durban HIV/AIDS conference were impressed by the
way PLWHAs from other countries had organized themselves into formidable networks. The
participants therefore saw the need for a National network of PLWHAs in Nigeria. Thus in the same
year, PLWHAs from all over the country came together under one umbrella called NEPWHAN and
Dr Pat Matemilola was elected as the president.
The key informant at NEPWHAN described that in the first year or two of their activities
they had difficulties in getting up any momentum for action because of delays and bureaucratic
confusions in relation to their mentors, FMOH and NACA. Evidently they had no office facilities,
and lacked a coherent structure as well. In the midst of these confusions, Dr Pat Matemilola laid
before the Policy Projects the difficulties experienced by the group, and how this impacted
negatively on the mobilization of members. At some point in these organizational "growing pains,"
Dr. Matemilola had discussions with FHI‟s Dr Oke. FHI intervened by assuming the responsibility
of supporting NEPWHAN‟s meetings. Subsequently the organization has been able to better
communicate within its members, and to achieve some stability of funding and operations. Their
funding sources in more recent times have been from UNAIDS, UNDP, NACA, Ford Foundation, ,
Christian AID, and the African AIDS Prevention Initiative (APIN).
Women's Organizations
23

There are many women's organizations in Nigeria that are involved in HIV/AIDS activities,
and many are in Abuja. Some of the women's groups are connected with faith-based organizations,
while others are more or less secular. The following illustrate a bit of the wide variety of
orientations and potentials in these groups.
Women's Health, Education and Development (WHED)
Established in Abuja: 2000 (formerly in Kano)
Executive Director, Irene Ogbogu
Address: Plot 288 Lagos Crescent. Off Samuel Ladoke Akintola Boulevard. Garki II.
Abuja.
Phone: 09 2342184, 08037864826
E-mail info@whedmogeroa.org
Publication: CHANGE April-June 2004 first issue of this multicolored newsletter.
This organization has a number of projects, and a very successful and important
activity is their training and development of sex workers as peer educators. The women (sex
workers) are trained in condom promotion, counseling for HIV testing, and other one-on-one
counseling with their peers. WHED informants told us that they had earlier trained approximately
500 sex workers in Kano, and now, more recently some 300 to 400 in Abuja. In Abuja they have
outreach activities in six locations (Idu, Apo, Mabushi, Gwagwa, Mogadishu Barracks, and Dantata
Village). Provision of condoms, and teaching the importance of condom use is a primary focus of
the peer educator system of WHED, in their various outreach locations. The organization provides
condoms to their peer educators, who then sell them and make a bit of income. WHED has a simple
form with pictures on it, onto which their peer educators (including illiterate persons) can tally their
contacts for each day of the week.
WHED originated in Kano in 1994, but moved to Abuja in the year 2000 because of the
imposition of Sharia law in Kano state. In 2002 the WHED organization was visited by President
Jimmy Carter, former president of the United States, and Bill Gates Sr. They went with the WHED
workers to meet with sex workers in a dirt-floor location in Mabushi (which is a beer parlour at
night). According to the note (in CHANGE, PAGE 4) Mabushi is home to an estimated 4000
female sex workers.
24

Recently the WHED activities have increased concentration on VCT counseling and related
activities. The strategy of WHED , focused on working with sex workers, is to combine Education
and Enabling.
"Enabling strategy aims to make it easier for people toprotect their health by increasing
their control over their lives. This is often referred to as "empowerment." Enabling activities
include improving health care, supplying condoms, making agreement with police, which prevent
[meaning protect] sex workers from harassment and violence, as well as supporting sex workers'
rights organisations." (from CHANGE page 3).
Significance of WHED for the FHI Program
The WHED program appears to be one of the programs that has active peer educators out in
the "hot spots," and is aggressively promoting condoms, including supplying condoms. This means
that they are very likely to be in much closer touch with the "target populations" than are most of the
other organizations.
Women Against AIDS and Infectious Diseases (WAAIDS)
Mrs. Laraba Joshua, Coordinator
Blessing Ezemadu , Financial Secretary
Ph. 08035868387
Started 2003
No regular staff; only volunteers.
The 50 members are women living with HIV/AIDS, including widows, nursing mothers, and others.
Volunteers, including persons from some churches, give some material support to the members
(including financial support). Also provide nutrition education and information concerning feeding
options for their babies.
Women's Right to Education Programme
Ms. Mimidoo Achakpa (Executive Director)
Suite 16 Road 9 Garki Cornershop
Samuel Ldoke Akintola Boulevard, Garki 11
Cell phone: 08027786161
25

The organization is newly established, and they have been focused on "a quest for quality education
for all…" They recently submitted an application to the dRPC to initiate a program of "road
shows in the form of traditional dances and dramas...We believe in the power of picture and music
having a strong impression on the minds of people. Through this, drama will be used to highlight
the trauma that surrounds HIV/AIDS and at the same time casual sex will be discouraged and people
will see the reason why they need to be faithful to their partners. People will be enlightened on the
use of condom, however abstinence will be emphasized particular for the youths."
Religious Organizations
There are many religious organizations that are active to one degree or other in relation to
HIV/AIDS. Many such organizations are focused on PLWHAs and some degree of care and
support, particularly for their "own people." Some religious organizations are active in awareness
raising and education. There seems to be a good deal of variation in the orientations and styles of
the different religious organizations. The fact that some Islamic groups are now involved in
HIV/AIDS is a good development, and should be followed up with strong support for their
programs, as there is an impression among NGO people that the Muslim populations have been
somewhat less well-informed, or less aware, of the threats of the HIV epidemic.
Some NGO people commented that the various larger donor organizations, INGOs, and
others have tended to neglect the widely varied faith-based organizations, partly because there are
so many, and the majority are relatively small and localized groups. In addition, it has been
commented that "outsiders" are unaware of the wide differences in orientation among the different
FBOs among the various Protestant groups.
A very provisional categorization of Christian and Muslim FBOs emerged from the first
wave of situation assessment:
I. Islamic organizations
II. Catholic (Especially the Catholic Action Committee for AIDS).
26

III Anglican
IV. Other Protestant established churches:
Methodist, Baptist, Evangelical Church of West Africa, Assembly of God, Church
of Christ in Nigeria (COCIN).
V. Syncretic Church groups
Brotherhood of the Cross
Celestial Church of Christ
Aladura
White Garment churches
VI. Pentecostal groups.
Deeper Life, Mountain of Fire, Redeem, Winner's Chapel, House of the Rock,
Redeemed Christian Church of God (and a very large number of others).
Many of those FBOs are opposed to condom promotion and condom distribution as an HIV
preventive strategy. On the other hand, many of them are involved in promoting VCCT, prevention
of mother-to-child transmission, home-based care (HBC), and other care and support activities.
AIDS Program for Muslim Umma (APMU)
Umma Support Group (USG)
NSCIA Offices, National Mosque, Abuja.
Tel 09 – 5230796, Fax 09 – 5230794
Contact Person: Mohammed Ikorie (080 35 86 18 50; 08043463631)
Project Manager.
okorie76ng@yahoo.com nsciaapmu@yahoo.com
Ustaz Musa Ihejieto Member Program Implementation Committee
It appears that the APMU is intended to be a capacity-building program of the NSCIA,
while the USG is the active, intervention program. It is the Umma Support Group that is a member
of the CISNHAN Network.
According to the key informants in the organization, The USG (and the general program,
APMU) was formed in November 2001 in an attempt to counter the misconceptions and negative
attitudes that many Muslims have about HIV/AIDS. Most believed that HIV/AIDS was God‟s
punishment for sinners and other wayward persons. As a result of this misconception, many Muslim
individuals and groups were turning away from any interaction or assisistance to HIV+ people.
27

The Nigerian Supreme Council for Islamic Affairs (NSCIA), the parent-body of USG, set up
a committee in 2001 to develop a response to HIV/AIDS from an Islamic perspective. This resulted
in a meeting of the “AIDS Programme for Muslim Umma” (APMU) in November 2001 with the
support of DFID. They got resource persons from an Uganda-based Islamic group working on
HIV/AIDS. The three participants from NSCIA formed the nucleus of USG.
Main activities of USG include:
Education and counseling for HIV+ persons;
Awareness and sensitization for Muslims, on individual and group levels, such as in
mosques;
Education on prevention of mother-to-child-transmissions (PMTCT);
Counseling and referrals to testing centres for pregnant women. Referrals are usually to the
National Hospital and Gede Foundation; the latter provided OVC services and has been the
main source of ARVs for USG members.
USG has a membership of about 200 persons, of which about 100 are active, according to the key
informants. About 75 of this number are females. USG has carried out sensitization sessions in
Gwagwalada, Jikwoyi, Karshi, Ruga, and Nyanya areas of FCT. USG has received some funding
from NACA and FACA. All the resources and facilities that USG people have access to are owned
and provided by NSCIA. USG has collaborated with Interfaith Coalition (a body which brings
Muslim and Christian development workers together) to find a common ground to fight a common
enemy: AIDS. USG is a member of NEPWHAN, CisNHAN and the Interfaith Coalition. The
Interfaith Coalition is a meeting of Muslim and Christian representatives. We need more
information on that.
Catholic Action Committee on AIDS (CACA)
Mr. Emmanuel Udoh 08033495134
Federal Ministry of Urban & Housing Development Units
Gaduwa Estate River Court
Road One, Flat One, Durumi III. Abuja
08036297019, 08055082752
E-mail: caca_abuja@yahoo.com
28

The CACA organization has very substantial activities in a number of areas of Abuja.
Within the FCT the Catholic program against HIV/AIDS is coordinated by CACA, but implemented
at local levels by Parish Action Committees for AIDS (PACAs). The Parish groups have Volunteers
(PAVs) who work in various aspects of the program. At the level of the CACA the organization has
an HIV/AIDS coordinator, under whom there are the OVC coordinator, PMTCT coordinator, VCCT
coordinator, HBC coordinator, and Support Group coordinator. They have 13 paid staff, all paid by
the church organization.
HIV/AIDS Activities
The above-mentioned coordinators indicate the broad scope of the CACA program. In
addition, there is a school program, in which CACA facilitates the formation of school AIDS Clubs
. It also trains Peer Health Educators . Three to four years ago, Catholic Relief Services (CRS)
sponsored the training of peer health educators The program also builds the capacity of priests .
"There is an annual award for the best priest .This is usually the priest who incorporates HIV/AIDS
education into his sermons the most." They have a system of interviewing parishioners to ask "how
many times did your priest mention HIV/AIDS in his sermon last month?”
The CACA HIV/AIDS work includes collaboration with the Islamic Education Trust (IET),
Umma Support Group, Anglican church and CISNHAN.
Church of Nigeria Anglican Communion (Abuja)
Location: Espicopicals House, No. 23 Dualla Street Wuse Zone 5
P .O. Box 212ADCP
Contact Person: Emmanuel Olatunji (Program Manager)
Phone: 0803-604-8620
The church has an estimated congregation of 18 million nation-wide and currently has 82 diocese
nation-wide, with established Diocesan AIDS Action Committees (DACAs) in 62 of the 82 diocese.
The HIV/AIDS program of the church was started in 2002. In the FCT the church has one diocese
(DACA?) and its catchment areas are Kubwa, Nyanya, Gwarinpa, Lugbe and Wuse. There are three
staff working in the project, Emmanuel Olatunji the project coordinator who has a nursing back
ground and is a public health officer, Phoebe Peter a nurse, a priest who helps in counseling sessions
29

plus an office assistant. The group receives support from Action Aid, UNAIDS and Interfaith
(council?) for the HIV/AIDS activities. Clinical services are provided in the church branches in Jos,
Zaria, Abuja, Akwa and Lagos. Positive people are referred to facilities in these cities.
The church has a clinic within its premises in Abuja, and provides integrated services to clients.
Services at the Center are provided to clients irrespective of their faith. Both Christians and Muslims
are provided with free treatment and counseling. Majority of those that come for counseling are
young couples that plan to get married and want know their status. They also have had men having
sex with men (MSM) come for counseling. They promote the use condoms among married and
discordant couples but promote abstinence among youths.
They provide/carry out
Awareness creation on VCCT services available every Sunday during church services.
VCT services.
Referrals of PLWHA to other facilities (National Hospital, CACA, Labor House where there
are support groups.
Monthly forum for people living with HIV/AIDS.
Provide capacity building for clergy wives concerning home-based care (HBC).
Training priests in counseling.
Summary Comments
As mentioned above, the very large numbers of FBOs constitute a rich inventory of potential
participants in the comprehensive GHAIN program. Any plans to involve some of these FBOs
should pay close attention to the variations in their religious orientations, their different
philosophical-moral attitudes, and styles of operation. They would appear to be particularly
important in relation to care and support, including home-based care.
30

"Hot Spots" or Areas of Concentration of High Risk Behaviors.
During the social mapping and key informant interviewing, the main "hot spots" of sexual activity
were identified by the various key informants, and were plotted onto our master map. The areas of
greater commercial sex work activity are quite many in the FCT, but the primary patterns are as
follows:
A. Military barracks are major points of sexual activity, particularly as each barracks has associated
with it a "Mami Market," in which there are beer parlors, and other services, with considerable
night-time commercial sex activity. Most of the military barracks are along the Outer Northern
Express Road that skirts the northern edge of the Abuja metropolitan area.
B. Major market areas are also areas of commercial sexual activity, particularly if the trucks that
supply them have parking areas nearby, so that the truckers stay some time in the area.
C. Some low income residential areas, or "slums," have become areas of commercial sex work, as
the populations of poor families are crowded together, with many women finding a need to
engage in sex work to maintain their family incomes. As certain such areas become known as
"places with many sex workers," and increased numbers of beer parlors and small hotels spring
up, they attract clients from other areas.
D. The University campus at Gwagwalada was mentioned by a number of informants as an area of
major sex work activity, as increased numbers of female students have turned to sex work in
order to have sufficient money for tuition and other expenses. In addition, as the area has
attracted increased numbers of male clients, (according to key informants) many non-student
young women have moved into the area, in part posing as students, in order to take advantage of
the supposedly higher rates they could charge for sexual services in that area.
E. Major highway junction points, or truck/bus terminal points are usually favored places for sex
workers. The FCT area does not have many such terminal or junction points, except for two or
three, of which Zuba is the largest and best known. Zuba is at the junction where the Outer
Northern Expressway from the east meets the major North-South highway that bisects the FCT.
Gwagwalada is also a major junction point, where the Southern Express Road joins the North-
South highway. That highway traffic, especially the long distance drivers, add to the intensity of
commercial sex activity of the Gwagwalada area.
31

F. The Garki area of Abuja is referred to by many key informants as a major "hot spot," having a
large number of sex workers and general night life activity. The area has two mid-sized hotels,
the Broadway and the Rita Lori Hotel, which are centers of night time entertainment activities
with bars and dancing. Nearby are a number of smaller establishments that are also "hot spots"
of night life. The sex workers and their clients who come to the area are not necessarily from the
immediate neighborhood, as they may come from more distant locations to take part in the night-
time activities, including sex work of the Garki area.
Large, Medium and Small Hotspots
Our field workers and key informants have made very provisional estimates of the sizes of the
various hotspots, grouping them in to three categories based on estimated size.
Large Hotspots
The best-known, frequently mentioned concentrations of sex work activity are thought to be the
largest in numbers of active sex workers. They are: Garki area, Nyanya, Mabushi, Wuse zone 4,
the Gwagwalada University and transport terminal areas, Gwagwa, Mararaba, and Apo.
Mabushi (see Map ????)
Mabushi is a "village" on the outskirts of Abuja metropolitan area, near the Nigerian federal housing
ministry buildings. The village is reached by the paved roadway, but the roads inside the village are
unpaved. The area has both a small mosque (several small mosques??) and there are one or more
small Christian churches. The police post is near the entrance to the village area. Field workers
identified several small medical facilities in the area. The community is divided into ethnic
communities--Tiv, Hausa, and Gwari. There is a main "ring road" in the village, called
Namdiazikwe road (named after Nigeria‟s first president). A government PHC (funded by AMAC)
is located on the ring road. Inside the PHC there were a number of health posters taped on the wall:
Malaria, TB, nutrition to prevent Vitamin A deficiency,diabetes and leprosy. But no posters on
HIV/AIDS. The PHC staff includes two senior community health extension workers, and 3
community health officers including herself. The PHC can manage only very small ailments, and all
other health problems are referred to the general hospital.
32

Sex worker clusters were identified particularly in the Tiv and Gwari areas of the village. The sex
workers occupy very small hutments or housing that is extremely crude,
with dirt floor and dirt walls. Some are slightly more substantial, with cement walls. The hutments
are very close together, and the "alleys" for passersby are only a few feet wide, so it is a very
congested area. There are various vendors, medicine shops, and some other health providers.
Mabushi was visited by Ex-President Jimmy Carter and Bill Gates Sr., in connection with their
HIV/AIDS touring in west Africa in 2002. They were visiting with the WHED organization (see
Directory), which organization has an outreach program with peer educators in the Mabushi area.
The WHED newsletter estimates that there are 4000 sex workers in Mabushi.
Nyanya
A number of key informants identified Nyanya as a major "hot spot" in the Abuja municipal area.
The area seems to be undergoing considerable transformation, as some middle class housing is
being contructed right in the area that had formerly been the Mami Market and adjoining area of sex
work activities.
Nyanya is a residential area at the eastern edge of metropolitan Abuja, at what is known as the
Karu Junction Roundabout. The road beyond the Karu Junction Roundabout is the direction to
Mararaba/ Jos. The Nyanya General Hospital is across the road from the main areas of sex work.
Key informants identified the main sex work area as "Obalende," which is evidently named after a
similar "hot spot" area in Lagos. In the Obalende area there is a Mobile Police Barracks, and there
had been an active "Mami Market" near the Mobile Police quarters. Informants estimated that there
may be 50 police families living in that "barracks area." However, that Mami Market area has now
been subdivided and sold as house plots, and a number of houses are being built there. The vendors
in the Mami Market, and the sex workers, have scattered somewhat into the various areas of
"Obalende." The area has a number of small hotels and other small dwellings, where both "country-
brewed" (pito or burukutu) and commercial beer are available. In the evenings the area has much
more activity, and the small shops bring out additional chairs for people to sit and drink, and the sex
workers ply their trade. The hotels, such as the NO.1 Hotel, Kasham Hotel, and De-Gorges Hotel
are small places with perhaps 10 to 15 rooms, with a bar on the ground floor (inside, in contrast to
33

the open beer bars that are prominent in the night life of the area.) Sex workers hutments are
generally one-room, made of mud, but plastered on the outside with cement, according to
informants. The floor is dirt; and the roof is generally of corrugated metal. Such hutments are easily
erected, and even more easily torn down, as many have been torn down to make room for the larger
houses being built in the area.
As seen on the map of the Nyanya area, there are a number of small clinics of medical practitioners,
as well as the Panraf "hospital" at one end of the Obalende area. (Also see notes on Nyanya). The
"hotels" in terms of the HIV/AIDS phenomenon include NO.1 Hotel, Kasham Hotel, and De-
Gorges Hotel and Night Club. Although there are no open bars in the day time, the activity opens up
in the night when tables and chairs are brought out by the shop people who sell assorted drinks.
Map 2. Mapping by Key Informant in the Nyanya Hotspot area.
34

In the rough draft map, above, "H" refers to hotels, the + marks are clinics, and we note the
Panraf Hospital on the right hand side, across the street from the Obalende "hotspot" area of
activities.
Medium sized Hotspots
Each of the military barracks (mainly located along the Outer Northern Express Highway) has an
associated Mami market, and related commercial sex activities (see Map 1, page 7) Our informants
considered those to be "medium sized," as compared to the larger concentrations in the first group.
Also, two or three residential areas in Bwari were considered to be "medium," including Bwari
town and Mpape (close to metropolitan Abuja).
The Mami Market is a large square with a circular road that rings the inside of the market. Along
the road are many shops including beer parlors and restaurants, but mostly dry goods (housewares,
shoes, clothes). Inside the circle behind the stores are beer parlors and pepper soup joints and suya
(barbeque) spots making an inner circle. There were no other types of stores in this area. Other
beer parlors could be found in the four corners of the market . In every beer parlor is a TV set
where people come to watch movies and other shows throughout the evening, so that women and
children will go to the parlors as well as men who come to drink. In fact, the TVs are one of the
biggest attractions of the mami market after dark. We entered one beer parlor and ordered grilled
fish and watched soldiers come to the various drinking spots to relax with their friends after work.
We did not observe any sex work activity, but it was early (6 pm) and sex workers usually begin to
appear after dark. [Informant] told us that many of these men are not necessarily looking for sex,
but rather just socializing with friends. (Excerpt from field notes).
PROFILE OF MPAPE TOWN (Medium-sized hotspot)
Just off the main highway, on the southern edge of Bwari administrative area.
(Information assembled by Samuel Egwu. Some of the history here is from his personal knowledge,
as he lived in Abuja for a year in 2003).
Mpape was identified by the key informant in Bwari as a "hot spot" with a large number of sex
workers, and a lot of bars, small hotels, and other features related to night life and risky sexual
activities.
After a visit to Bwari town, the administrative headquarter of Bwari Area Council on Tuesday,
November 31, 2004, the team decided to pay a familiarization visit to Mpape, a location that was
mentioned as important in the context of HIV/AIDS programming in the Area Council in the course
35

of the key informant interview and the social mapping that followed. Mpape, like other locations
such as Kubwa, Dutse and Deidei is important for the following reasons:
� High density population dominated by low income groups and the unemployed.
� Existence of hotels, beer palors and other activities which expose people to high risk sexual
behavior
� Strong presence of construction companies and workers indicating the potentials of the town
in terms of expansion.
The team arrived Mpape around 2pm. But what was expected to be a snappy visit turned out to be
rather prolonged because of a traffic hold up in the center of the town. The fact that Mpape has only
one major road leading into the town without clearly marked adjoining streets creates additional
problem in attempting to avoid such a situation.
Mpape is located on a hill on the right side of the express road running from Asokoro to Zuba,
opposite the Maitama district, AMAC. Although the team did not seek information on the origin of
the town, Mpape is one of the surviving Gbagyi villages. In the past ten years or so, the town has
witnessed phenomenal growth and expansion as a result of the influx of other Nigerians who have
outgrown the population of the natives. Mpape offers attraction to workers and new arrivals to Abuja
because it offers relatively cheap accommodation. For many middle rank civil servants and those
engaged in self-employment, the relatively cheap cost of plots has made Mpape attractive for
building own houses. The photograph (below) is taken at the start of the main street that bisects the
community.
36

Map 3. The Mabushi Hotspot Area.
37

Plate 2. Scene in Mpape, a crowded residential area.
38

Map 4. Main "Hotspots" in the Federal Capital Territory. Red "spots" are the hotspots.
The size of the "spots" indicate "large," "medium" and "small" concentrations. Note concentrations
of hotspots in the urban area of Abuja.
39

Small Hotspots
The smaller hotspots are mainly located in the more rural, peripheral areas of the FCT,
particularly at the towns that are LGA centers. For example, here is an excerpt from interviews that
illustrates sexual activity in the town of Kwali:
Question: Let us talk about risk settings in your community. Are there markets
where truck drivers come to for or bring commodities?
Answer Yes there are three big markets – Kwoita, Kwali, and Gada-biyu – which
are active in the interval of 4 days each. Large trucks come to buy
vegetables and food items such as yams, plantains and grains. The truck
drivers don’t stay long. The longest they stay is overnight and most do
same day return.
Q: What about other places where sexual activities can be expected to be
taking place?
A: There are three small hotels which have STSRs (short time service rooms)
for sex available. There are sex workers around these hotels. There are
many drinking joints selling beer, palm wine and other local brews. These
are also meeting joints and can be found along the road you drove into
town on and at the settlement located immediately [nearby].
HIV/AIDS and Military Personnel
Military installations and personnel (including the police) are recognized as an "at risk population"
by HIV/AIDS workers and policy makers. At the Stakeholders' Meeting in Abuja on 15 December,
2004, a representative from the military spoke, urging the FACA policy-makers and active
organizations to participate with the military HIV/AIDS programs.
Information about military organizations and agencies in the FCT were gleaned from interviews
conducted with personnel at the Mogadishu Barracks. Team members talked with Major Irigo
(coordinator) and Captain Ojie (Assistant Coordinator) of the Defense Health Club (DHC), a group
for HIV positive people living at the Barracks. They also talked with a DHC member, Audu 3 , who is
a self described AIDS activist and active duty soldier assigned to the Mogadishu Barracks. He is
HIV positive and is open about his serostatus 4
3 Audu is a pseudonym.
4 At the the time of the Interview, Audu was wearing a bright yellow T-shirt with HIV Positive printed on the
front in big black letters and I am a stigma fighter written on the back.
40

The AIDS Club
According to Captain Ojie, each base has its own DHC. At Mogadishu, the DHC is called “The
AIDS Club.” Founded in 2002, the club has a membership of 86: 54 women and 32 men. In
addition, 22 AIDS orphans, three of whom are HIV+, live in the barracks. Membership includes
active duty servicemen, their spouses and children; and ex-soldiers (retired and discharged) and their
dependents. The club has a staff of 10, all of whom are volunteers. With respect to HIV prevention,
the DHC targets youth dependents attending the base secondary schools, young soldiers, wives and
soldiers preparing to be deployed on peacekeeping missions outside Nigeria. The group organizes
awareness workshops, and provides some support services to club members. For example, two
women in the AIDS Club who received home-based care (HBC) training through the Catholic
Church and Red Cross, volunteer to give HBC to club members who need it. In addition, the club
holds biweekly meetings and invites newly tested HIV positive people to join.
For AIDS awareness and prevention activities, the AIDS Club targets youth dependents attending
the base secondary schools, young soldiers, wives and soldiers preparing to be deployed on
peacekeeping missions outside Nigeria. The group also organizes awareness workshops. When
asked about their most successful program, Ojie and Irigo pointed to the “campaign to fight stigma,”
which took place in December 2003. The campaign included an HIV/AIDS sensitization rally at the
local market that included dramas and condom distribution. The condoms were given by Pathfinder
through the Center for Rights to Health.
AIDS Club Support
Military support for PLWHAs comes in the form of basic medical services. Active duty servicemen
and their dependents who are HIV positive can receive free medical treatment at the barracks
hospital. These services also extend to ex-service personnel and their dependents and even non-
military people living in nearby neighborhoods. Although the Barracks hospital does not have ARV
medication, the clinical staff treats opportunistic infections and supplies vitamins. Medications are
subsidized and clients pay a small fee for them. Irigo mentioned that they want to be connected with
a large NGOs like FHI and drug companies that will provide more subsidized drugs. They also want
to be included in programs to deliver ART. With respect to PMTCT, the base hospital does pre and
41

post-test counseling. At one time they gave pregnant women who were positive vitamins and, at the
time of birth, neviripine tablets. They also gave neviripine “syrup” to infants immediately after
birth. Pathfinder provided the drugs. But now these mothers are referred to General hospital to
deliver their babies.
In addition to basic medical services, the military also provides office space for the AIDS club. For
additional support, the group seeks help from a number of private and non-governmental sources.
For example, the week before this visit, club members collected food and other supplements from
FACA. Occasionally, local churches donate money, food and gifts. For example, Redeem Christian
Church of God recently donated a bag of rice as did NEPHWAN, and the House of the Rock, a
Pentecostal Church in Abjua, gave 50,000 naira to assist PLWHAs. Other contributions include
services. Through Audu, 12 local NEPHWAN groups offer HIV counseling to PLWHAs, the Center
for Rights to Health provides home-based care, and Pathfinder gave 200 testing kits for pregnancy
and HIV to the barracks hospital.
Stigma and the Military
The Military has a non-discrimination policy with regard to HIV positive service men and women;
however policy may not always translate into practice. According to key informant Audu, the non-
discriminition policy is frequently violated. As a counselor to many service people with HIV, Audu
said that he has heard stories of blatant discrimination directed towards PLWAs, so much so that
most HIV positive soldiers refuse to “come out” for fear of the negative consequences. For example
, Captain Ojie said that HIV positive soldiers are assigned light duty like patrolling. “They are given
regular jobs. This is the law,” she said. However, to reap this benefit, a soldier must tell the
commanding officer his serostatus, thus risking exposure. According to Audu, soldiers are afraid to
come out because “they will be pushed aside.” He then recounted an incident in which a
commanding officer told an HIV positive serviceman in his unit to “just go” because the rest of the
unit did not want him around.
In addition, They cannot travel, they are disqualified from getting a travel allowance, which is small
but critical to the families‟ income. Audu, himself, has suffered from blatant discrimination by
members of his unit after revealing his serostatus:
42

“I had to give back my office key because I am positive, and when I rise from a
chair, someone will wipe it clean before anyone else will sit down.”
Women soldiers with HIV are especially stigmatized. According to key informants, some female
soldiers were infected by their husbands who are now dead. They told us that most military women
with HIV will not come out; instead they will ask him for HIV/AIDS counseling. They said that 20
HIV positive female soldiers currently live in the barracks, and they spoke of six positive women
who travel to Lagos every month for ARV because they don‟t want to be identified. One informant
estimated the HIV prevalence rate among women soldiers to be around 40%.
VCCT, PMTCT, Care and Support
From our contacts with a wide array of organizations in the FCT it is apparent that testing for HIV
infection is very widespread. There are large numbers of private practitioners who do testing for
HIV, many of them without proper pre-test counseling. Many of the FBOs and other organizations
urge their members to be tested for HIV, and many NGOs and government services have VCCT
services; meaning that they have trained personnel providing counseling. The following "clippings"
from various interviews illustrate some of the widespread VCCT activity:
NEPWHAN:
Virtually all member support groups offer VCCT. Many other NGO’s also offer the services. The
nearest to the NEPWHAN office is the Center for Right to Health at Minna street ,
Abaji General Hospital
He informed us that most of the staff in the hospital have benefited from UNICEF
training in VCCT and are trained as counsellors.
43

Catholic Action Committee for AIDS (CACA)
CACA carries out both pre and posttest counseling. Rapid test is done in the office
using equipment supplied to CACA by Catholic Relief Services (CRS). Positive cases are referred to
either GEDE FOUNDATION or the National institute for Pharmaceutical Research and
Development for confirmatory testing. All the 8 Catholic hospitals also do testing.
During the World AIDS Day 2004 celebration, GEDE foundation conducted free
testing in collaboration with CACA. Two hundred and fifteen people benefited. Out of
100 results so far assessed, 30 to 40 % are positive.
Gede Foundation
The health care providers in Maitama Hospital were trained on VCCT and PMTCT. The hospital
was given some nevirapine, TV sets and AV materials on HIV/AIDS for their ANC. The mothers
watch the films and see how the test is done. The nevirapine was given free to the hospital by Gede
Foundation but they will charge a token from the beneficiaries.
Umma Support Group (Islamic)
Question: You mentioned during the discussion that you established a
VCCT Center. Can you tell us more about it and where it is located?
Answer: Yes. It is right here in the security of the National Mosque where we
thought we could protect people from stigma. But it is more of a VCC
without the T, as we do not have the equipment for testing. There is a
medical doctor volunteer amongst us who does the counseling and we
refer people to the general hospital for testing.
WHED
They recently hired a microbiologist and one sociologist for the VCTC (proposed) programme. "We
have the money to buy the necessary equipment for the testing and we are now looking for
organizations to provide us with subsidies to provide free testing and offer a reduced rate for the
CD4 count testing. All of those things can be done here at the organization.
Anglican Church
They provide/carry out awareness creation on VCT services every Sunday during church
Services.
Panraf Hospital: (example of a small private hospital in "hotspot" area.
The Clinic does VCT for all antenatal women and such women are informed that they are
being screened for HIV/AIDS.
There is evidence that more and more organizations, including churches, are requiring couples to
be counseled and tested for HIV before they are allowed to marry. A social welfare administrator
in the AMAC told our interviewers that they are now enforcing the rule that all couples coming for
civil marriage must be tested for HIV. The informant described the counseling procedure. The
44

equirement is not a legal enactment for the entire FCT, but is a procedural rule in the Abuja
municipal area council.
Prevention of Mother to Child Transmission (PMTCT)
The provision for PMTCT is similarly widespread throughout the health facilities of the FCT.
Many of the facilities that mentioned providing VCCT also have PMTCT programs. In some
cases, as in the Panraf Hospital, it appeared that the "VCT" was actually intended primarily as
PMTCT.
ARV Treatment
ARV treatment is available at several medical facilities in the FCT, although the availability is
severely hampered by lack of funds. ARV is available for government employees at the Statehouse
Clinic, but for the general public there are limited supplies of ARV treatment at the National
Hospital in Abuja, the Specialist Hospital in Gwagwalada, the National Institute for Research and
Development, and the Gede Foundation, which provides subsidized ARVs at 6,000 naira per
month and does tests such as CD4+ count at 1,000 naira. There is also an understanding, according
to a CACA informant, that if there are ten referrals at a time, Gede Foundation would provide
ARVs at 5,000 naira instead of 6,000.
This is, of course, an incomplete inventory of ARV availability, as there are undoubtedly many
private small and large clinics and hospitals that also provide ARV treatment for those who can
afford to pay the costs.
Concerning the lack of funds for ARV, one informant reported that the Specialist Hospital in
Gwagwalada has a waiting list of 15,000 HIV+ cases, as they can only afford to give treatment to a
limited number of patients.
45

Home-Based Care (HBC)
Our data suggest that the faith-based organizations are particularly concerned to assist, where they
can, with home-based care, although of course it is the families of afflicted individuals who bear the
brunt of HBC obligations. Care is often directed to practical matters of food, and immediate basic
necessities, and several organizations mentioned gifts of rice and other foods, often from the
religious organizations. Support groups of PLWHA, whether attached to FBOs or not, are another
main source of HBC for individuals and families.
As one example of various sources of care and support for PLWHA, the informants at the Defense
Health Club (their local AIDS organization) in the Mogadishu Barracks, reported that:
The DHC also raises funds from churches that donate money, food and gifts for PLWHA in the
hospital. The informant serves as the contact person. Redeemed Christian Church of God recently
donated a bag of rice, and House of the Rock, a Pentecostal Church in Abuja, gave 50,000 naira.
He also mentioned that the Center for Rights to Health provides family support in the
form of home based care, and Pathfinders gave 200 HIV testing kits for pregnancy [PMTCT] and
HIV. (Excerpt from interview notes).
The informant at NEPWHAN told our interviewers that "Most support groups have home based
care services, some are formal while others are informal. CACA provides HBC in collaboration
with the Catholic Relief Services.(CRS)."
Although there appear to be a large number of PLWHA groups and FBOs and others who provide
some home-based care, it appears that there are many individuals and families who are not reached
by such services. In the first place there are many HIV+ persons who do not wish to join the
support groups. Also, the HBC services appear to be sporadic, and often lacking in sufficient
funding to maintain adequate levels of care. Training for HBC is often lacking among the small
local groups.
46

Prevention of HIV: Condom Awareness, Attitudes and Promotion
Many of the religious groups and others involved in prevention efforts put emphasis on "abstention"
and "avoidance of casual sex" as mainstays of their awareness messages. This appears to be
especially true among the groups who do awareness raising among school students and other
unmarried young people. However, it appears likely that the "abstention" messages are not very
effective in most cases, and there is need for stronger, more intensive and systematic promotion of
condom use, including the distribution of condoms, particularly in areas of commercial sex work
concentrations.
There is very wide variation in the attitudes of different groups and individuals with regard to
condoms. Some NGOs reported that they are very active in promoting condom use. On the other
hand, some of the informants reported that they avoid promoting condoms, for religious and moral
reasons. An informant in a Primary Health Center is an example of an individual who is quite
ambivalent regarding condom promotion:
She said that she never gave condoms to anyone who came to the PHC, and that there are no
condoms there. She said she would not give condoms to anyone but married people. We asked why
only married people, she replied that they can use condoms for family planning. But “for all these
young boys and girls, I know what they are using for.” However, a bit later she appeared to change
her attitude, saying: “No matter the level of awareness the young ones will still engage in the sexual
act. Therefore you have to give them condom as well for protection.” But she still emphasizes
abstinence. During awareness campaigns she took her bible with her to talk to the sex workers
about HIV/AIDS. But she did not distribute condoms.
(excerpt from interview notes).
Another person in a rural LACA post said:
Informant: "I don't emphasize condoms." He referred to the bible, and noted the association of
condoms with fornication. Then he added, "As a true believer I can't [advocate condom use]." And
then he added: "but people can't hold themselves…" [ In which he seemed to be saying that some
people should be using condoms. [He belongs to an evangelical Christian church.]
Interviewer: "What about people who are HIV positive?"
Informant: “I advise those who are positive to use condoms and seek prayer.” (Excerpts from
Interview notes).
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Some of the people who are uninterested, or negative, toward condom distribution express views
that are not directly based on religious concerns. A person in a government office told the
interviewers that:
However, on the question of condom use,[ the administrator's] attitude seems to be that awareness
campaigns has to be considerably stepped down because enough
campaigns had been mounted in the past. As the [administrator] summarized the
feeling: “Enough has been said about condom. I personally believe that sufficient
awareness has been created. Those who will use it will use it. Those who will not use will
never use it”.
In some locations where condom promotion was supposed to be active, the supplies of condoms
were temporarily unavailable:
Informant at a rural government hospital: "No social marketing of condoms for now." She showed
us the empty cartons of condoms, that had been used in the past.
She informed us that condom promotion is central to their HIV/AIDS activities.
The attitude of the Catholic Church toward contraception and condoms is, of course, well known.
So it is expectable that the very active HIV/AIDS programs at CACA would not include condom
promotion. When our interviewers visited the CACA people, they found that there is considerable
ambiguity and soul-searching among their workers:
The informant reported that “CACA is aware of condom use and the high degree of safety. It is also
aware of the failure rate.” Then he continued “CACA gives adequate information about condom
“and I mean adequate in terms of adequate”. CACA tells people the good and the bad side of
condom but it does not distribute or promote condoms. He then described a seminar that was
organized for the youths. The participants were asked to write down their questions. About 80% of
them asked question pertaining to condoms. Four weeks ago [November], there was another
seminar in which
the right way to use condom was practically demonstrated, using a dummy penis. He further added
that “though we promote fidelity for married couples and abstinence
for unmarried ones, we have departed from those days when people were shy about talking about
the condom”. Then he continued that for moral and ethical considerations, “there is need for us to
handle the issue with great care”
We do not have a full inventory of organizations that are actively promoting condom use, including
condom distribution. However, two organizations are interesting examples of that orientation:
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The Nigerian Union of Road Transport Workers (NURTW) is very much focused on condom
distribution as a central feature of their behavioral change campaigns among their membership. The
following is an excerpt from an interview with one of their spokespersons:
My informant told me that promotion of condoms is a key activity of the Union, among others. He
assured me that if I checked the pigeon hole of most taxi and mini-bus drivers I would find at least
two condoms. He said even though he does not carry passengers like other drivers he has more than
five condoms in his bag. I then sought to know how the Union has access to condoms and whether
it engages in social marketing of condoms. The Union does not engage in social marketing of
condoms and leadership does not think along that line for now.
The main source of condom supply is the national body or national headquarters, which periodically
makes condoms available for distribution to members. The Road Safety Commission, the Police and
the Vehicle Inspection Office (VIO) have in the past given or delivered condoms to members.
The Women's Health, Education and Development (WHEN) organization (described above) has an
active outreach program in six different areas of Abuja. They told us that the areas were selected for
them by their sex worker peer educators.
This organization has a number of projects, but a very successful and important activity is their
training and development of sex workers as peer educators. The women
(sex workers) are trained in condom promotion, counseling for HIV testing, and other one-on-one
counseling with their peers. So far they have trained 300-400 peer educators (sex workers). They
have had a social marketing program, with condoms obtained from FHI.
There are undoubtedly many other organizations and programs in the FCT that promote condom
awareness, and some that participate in condom distribution. In addition, there is extensive sale of
condoms by vendors in the "hotspots," in addition to the regular sales of condoms by the medicine
shops, pharmacies, and some other small shops. It is noteworthy that there are billboards in Abuja
advertising "Gold Circle" condoms, a social marketing by the Society for Family Health.
Undoubtedly there are many organizations in the Society for Family Health network.
Summary
The condom promotion performance within governmental facilities, such as the PHCs and in LACA
activities, has some major weaknesses. On the one hand the lack of funding appears to be an
important factor affecting local levels. In addition, based on the examples above, it appears that
49

there are administrators who are quite indifferent about condom promotion/distribution, and some
are opposed on religious and moral grounds. Strongest programs of condom promotion and
distribution are likely to be found in NGOs and other organizations that are not affiliated with
religious organizations.
Networking Among the Governmental and Non-governmental Organizations
Our field workers found that there are complex patterns of interaction among the various
organizations involved in HIV/AIDS activities. Of course the networking organizations such as
CiSNHAM and NEPWHAN make it their business to be in contact with many different
organizations. A second point of organizational networking is in the FACA organization
(involving governmental entities and NGO representation), and the various LACA structures in
local areas, where they, too, have governmental and non-governmental participation in the planning
and development of HIV/AIDS activities. As noted above, the networking at the LACA levels is
more of a promise for the future than an on-going reality, as most of those structures are recently
activated.
Referrals of cases to health facilities constitute another type of networking activity, involving the
interactions of non-medical, or low-level medical facilities with the higher levels, in which more
complex services are provided for testing and treatment. Many groups, both governmental and non-
governmental, mentioned referrals to the Specialist Hospital (governmental), St. Mary's Hospital
(Catholic) and the Gede Foundation. The following excerpt from an interview with the Kwali
LACA coordinator illustrates some complex networking:
In September 14 we tested four people who were positive. We sent them to St. Mary’s Catholic
Hospital Gwagwalada for confirmatory test and they were confirmed. Our tests are free under a
program we run with the Islamic Education Trust (IET). IET ,working with a USAID sponsored
Pathfinder International project, gave us 100 test kits to use.
Several organizations reported that they are in contact with CACA. The informant in that Catholic
Action organization said that they particularly collaborate "with the Islamic Education Trust (IET),
Umma Support Group, Anglican church and CISCGHAN [CiSNHAN].
The Womens Health, Education and Development (WHED) informants said that they send women
to COPOP (Community of Positive Women). Referrals are made to the NIPR ( Nigerian Institute of
Pharmaceutical Research) for testing. Other collaboration: We belong to CiSNHAN; APIN (Aids
Prevention Initiative in Nigeria) is funding us; also NACA, MFCT, DFID, MacArthur Foundation,
SFH (Society for Family Health), FHI, Action AID, and also some charities….
50

The Umma Support Group at the Central Mosque makes referrals to the National Hospital and to the
Gede Foundation. They receive funding from NACA and FACA, and their facilities are provided by
the NSCIA (Islamic leadership). They also collaborate with the Interfaith Coalition. The USG is a
member of NEPWHAN and CiSNHAN.
These excerpts from a few of the interviews point to the existence of considerable networking
among the organizations, with the NEPWHAN and CiSNHAN playing important roles in
maintaining communications among the groups. The need to refer persons for various kinds of
testing and services put the smaller organizations into contact with the major hospitals, as well as
with special entities such as the Gede Foundation and the Nigerian Institute of Pharmaceutical
Research (NIPR). The evidence of collaboration between Islamic and Christian groups is
especially important, and any future upscaling of programs should seek to strengthen those efforts.
Conclusions: The Uses of these Community Assessment Data
The primary objective in carrying out community assessments is to provide information that can be
used in program planning and development. In this case the data are intended for the use of
Program Officers who will develop the GHAIN programmatic system in the FCT. Therefore the
information given here is intended to be as concrete as possible. The information gained from three
weeks of field research gives a framework for understanding the overall picture of HIV/AIDS in the
FCT. The persons developing the GHAIN activities in Abuja can follow these pathways to get
more detailed information from the specific organizations with which they enter into agreements and
working relations.
The data contained in this report are a rough draft of a sort of "yellow pages" directory, with
information about how the various organizations can be sorted into different categories in terms of
their orientations and origins, and how they inter-relate in the complex system of actions for
developing a more effective HIV/AIDS campaign in the FCT.
The Maps
The products of the community assessment include a number of rough maps, as well as more
carefully drawn maps showing major features derived from the data-gathering. Those maps should
51

e used by program people in the next phases of community assessment, as well as in developing
action programs. We recommend that the Program Officers for the FCT GHAIN project should
have these maps available, and programmatic strategies should be developed at least in part on with
reference to the geographic/locational information. Further contacts with people in the "hotspots,"
the various barracks areas, and the LACAs (for example), should make use of the various maps to
orient and organize frameworks of intervention actions. The relationships between the urban center
and the peripheral areas should especially be kept in view, and also the strategic position of
Gwagwalada as having important HIV/AIDS facilities, and playing a kind of "bridging role"
between the urban and rural sectors of the FCT.
In our Preliminary Report to the USAID people we presented the following tentative "themes"
from the data gathering:
1. There is a general consensus among the people we interviewed, that HIV/AIDS is a very serious
problem in the FCT.
2. We consider a very hopeful sign that a large number of organizations, both governmental and
non-governmental, are involved in very wide range of HIV/AIDS activities in the FCT.
3. Some networking organizations, such as CiSNHAN (Civil Society Network on HIV/AIDS in
Nigeria) and NEPWHAN (Network of People with HIV/AIDS in Nigeria) play very important
roles in maintaining contacts and sharing information with a wide range of relevant
organizations.
4. The "hotspots" of the Abuja area are several, well-known, and experiencing considerable
development and change over time.
5. Faith-based organizations (FBOs), such as CACA, the Umma Support Group, the Agnlicans, and
others, play critical roles in dealing with HIV/AIDS issues, particularly in terms of VCCT
(Voluntary Counseling and Confidental Testing) and home-based care (HBC). There appears to
be increasing "inter-denominational" collaboration, including cooperation between Islamic and
Christian groups.
6. The LACAs in the more rural areas have not yet been very active, as they only recently were
activated, and lack funding and facilities. However, HIV/AIDS activities in the Abuja
Municipal Area Council (AMAC) are more developed.
7. Abuja being the Federal capital, there is a continuing influx of migrants from other states, thus
creating a unique social mixture of peoples, which in turn affects the ways in which the
HIV/AIDS epidemic is developing.
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These generalizations are intended as quite preliminary, and in any case the more useful data for
developing programmatic strategies will be found in the details about the various organizations, and
how they relate to the governmental structures. The governmental structures, from the NACA down
to the community level of LACA organizations, is interwoven with the health facilities in the
various rural and urban areas. The memberships in the LACA and state level (FACA) planning
entities are intended to relate the non-governmental organizations to the basic governmental
framework. However, the major challenge in developing effective programs will be in creating
effective networks and clear understandings of cooperation between the governmental and the
multiplicity of non-governmental components.
.
53

APPENDIX A. FREELISTING AND RATINGS
Instructions for Free Lists
During the community assessment there will be many situations where it is useful to collect
free lists. Three very important "lists" that we are interested in at the very beginning of the
situation assessment: 1) organizations working in the area of HIV/AIDS; 2) "Hot spots" of high
risk behaviors; and 3) care and support facilities. You will think of many others during the datagathering.
Here are two lists that should be collected in each area (several locations in each state):
1. "Which are the most effective organizations working in connection with HIV/AIDS in
your area?"
Collect this list from 15 or 20 different individuals, in different organizations, in
order to get a view of which organizations (govt. or NGO) are most salient in the
area. This free listing should be done at the earliest, during the first few days of the
situation assessment. The free list "question" can be posed with the people in the
SACA, but the best place to get this list will probably be in a Stake-holders' Meeting,
at the beginning of your work in the area.
Of course it is very important to ask the informants "why do you consider this
______ organization effective?"
2. "Which are the organizations you have the most contact with?"
This second item can also be presented as a "rating," a bit later in your situation
assessment. (See next set of instructions).
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Instructions Concerning Ratings of Organizations
Objective: To get concrete (semi-quantitative) data on the networking among organizations.
Procedure:
1. Within each subarea within each state, collect (from SACA and key informants) lists of all the
govt. and NGO and CBO, etc. organizations active in HIV/AIDS in the area. (In Abuja we
collected these lists from some of the networking organizations, such as CISNHAM.)
Collect the free lists: a) from the FHI state people when you meet with them; b) at any stakeholders'
meeting. C) During meetings with individual organizations.
2. With the help of key informants, pick out about 24-28 organizations that
a) represent the range of different types of groups, and different sizes, etc..
b) International NGOs can be included if they are directly carrying out programs in the state.
c) A few hospitals or other health facilities should be included in the selection of organizations.
3. Write the names of the organizations on cards. One per each card. Number the cards, at the
back of the card.
4. Ask individual key informants at the organizations that you visit, including the LACAs:
(NOTE: Normally it is best to do this with individuals instead of groups, but sometimes you will
find it interesting to have a pair of informants.)
"Which of the following organizations do you have the most contact with, or work with most?"
Place all of those that are "most contact/work with" into a group.
"Which of these organizations you have no contact, or very little contact with?"
(Place all those cards into the "least or no contact" group.)
5. All the remaining cards (organizations) are "intermediate," so they get a score of "2". This is
the same rating procedure we followed in our training workshop. On the table, your results look
like this:
"Hi contact"
"3"
"intermediate"=2
6. USING ANTHROPAC: compile the ratings data (COMPILE THE DATA AS A DL FILE
(see the example in your handouts). The "average ratings" give us the profile of the "degree of
centrality" of the various organizations, in terms of the number of different organizations that rated
them as "high contact."
55
"Low contact"
"1"

7. Following the flow charts in the handouts, do the following:
A. Got to Tools--- Univariate, to get the "average ratings."
B. Take the resulting file from Univariate, to do "Extract" and "Transpose."
Note: The organizations that receive the most "high contact" ratings are the ones that are
more "connected" to other groups.
RATING OF THE "EFFECTIVENESS" OF ORGANIZATIONS."
Using the same collection of organizations (on cards), ask people (GET ABOUT 20 TO 25
INFORMANTS) to rate them as follows:
"Please pick out two or three organizations that you feel are particularly effective in their
HIV/AIDS work. Please note that some organizations may be quite small (have a small area they
are covering), yet they are very effective within their limited area. LETS PLACE THOSE TWO OR
THREE OVER HERE, ON THE RIGHT SIDE."
"Now, please pick out two or three organizations that you feel are not effective; not doing
much, concerning their HIV/AIDS activities. LETS PUT THOSE CARDS OVER HERE ON
THE OTHER SIDE."
"Now please add other organizations to those "high effective" and the "low effective"
groups. You don't have to put all the cards (organizations) into one or the other. The rest will be
considered "intermediate."
PROCESS THESE DATA, USING THE "DL FILE PROCEDURE."
AN EXAMPLE OF THE PRODUCT OF SUCH RATINGS IS GIVEN BELOW.
56

RATINGS OF ORGANIZATIONS INVOLVED IN HIV/AIDS PROGRAMS (FCT)
The ratings were collected from eight of the members of our Development Research and Projects
Centre assessment team, after they had had three weeks of research with many of these
organizations.
The ratings are intended here as an illustrative example of the usefulness of the rating procedures, to
gather information about the apparent strengths and weaknesses of organizations. The rating
procedures can be used for a very wide variety of different topical areas, qualities, and assessments.
Mean (based on a 1 to 5 rating scale. 5 is "very high."
----
1 NEPWHAN 4.43
2 CACA 4.43
3 AAID 4.43
4 CEDPA 4.43
5 NACA 4.43
6 ECWA 4.00
7 WHED 4.00
8 CISNHAN 4.00
9 WAAIDS 3.71
10 PLP 3.71
11 GEDE FDN 3.71
12 FACA 3.57
13 NURTW 3.43
14 COPOP 3.43
15 COCIN 3.43
16 USG 3.14
17 SWAAN 3.14
18 GHFCT 3.14
19 ARH 3.14
20 STATEH 3.00
21 CYD 2.86
22 UACO 2.86
23 ANGLICAN 2.71
24 NUT 2.71
25 YOUTHA 2.71
26 LACA 2.57
27 NCWS 2.43
DATA WERE PROCESSED USING:
ANTHROPAC 4.983/X Copyright 1985-2002 by Analytic Technologies.
57

FREE LISTING OF ORGANIZATIONS IN NIGERIA INVOLVED IN HIV/AIDS
ACTIVITIES.
The list was collected from the participants in the Community Assessment training activity, in
November, 2004. Participants were simply asked to write out (list) as many organizations as they
could think of. We see at the bottom of the list that the respondents, on average, listed 14
organizations each. This activity required only a few minutes, and produced a tremendous number
of items (124 organizations). This kind of listing is very useful at the beginning of a community
assessment, and can be carried out with people in a stakeholder's meeting, for example.
SORTED BY FREQ
ITEM FREQUENCY RESP PCT AVG RANK Smith's S
----------------------------------------------------- --------- --------- --------- ---------
1 NACA 9 75 6.778 0.462
2 DRPC 6 50 2.500 0.402
3 FHI 6 50 4.000 0.396
4 SWAAN 6 50 4.667 0.353
5 CEDPA 4 33 9.500 0.143
6 USAID 4 33 8.500 0.153
7 CHISGHAN 4 33 12.000 0.149
8 NATIONAL UNION OF ROAD TRANSPORT WORKERS 3 25 8.667 0.130
9 ACTION AIDS 3 25 8.333 0.129
10 GIRLS POWER INITIATIVE 3 25 5.667 0.181
11 FORD FOUNDATION 2 17 9.000 0.082
12 PATHFINDER 2 17 9.000 0.081
13 SACA 2 17 10.000 0.110
14 FOMWAN 2 17 8.000 0.044
15 WORLD BANK 2 17 14.000 0.046
16 MACARTHUR FOUNDATION 2 17 9.500 0.077
17 UNAIDS 2 17 16.500 0.051
18 WOMEN IN NIGERIA 2 17 3.500 0.147
19 DFID 2 17 11.000 0.068
20 SOCIETY FOR FAMILY HEALTH 2 17 11.500 0.057
21 YAKURR WOMEN'S LEAGUE 1 8 14.000 0.016
22 NIGERIAN YOUTH AIDS NETWORK 1 8 6.000 0.057
23 ACTION HEALTH INC 1 8 2.000 0.078
24 YOUTH COMMUNICATION ORGANIZATION 1 8 9.000 0.042
25 DEVELOPMENT COMMUNICATIONS INITIATIVES 1 8 7.000 0.052
26 SOC. AGAINST THE SPREAD OF AIDS 1 8 5.000 0.063
27 SALVATION ARMY 1 8 12.000 0.026
28 POLICE OFFICERS WIVES ASSOCIATION 1 8 13.000 0.021
29 CHRISTIAN HEALTH ORGANIZATION 1 8 13.000 0.028
30 LIVING EARCH 1 8 15.000 0.010
31 MEDIA RESEARCH AND DEVELOPMENT CENTER 1 8 16.000 0.005
32 YOUTH EMPOWERMENT FOUNDATION 1 8 1.000 0.083
33 AIDS INITIATIVE NIGERIA 1 8 17.000 0.009
34 CATHOLIC RELIEF ORGANIZATION 1 8 3.000 0.074
35 COCIN 1 8 2.000 0.078
36 FAITH AND LIFE FOUNDATION 1 8 3.000 0.072
37 TOMWAON 1 8 4.000 0.067
38 BEACON OF HOPE 1 8 6.000 0.056
39 NKA IBAN UKO 1 8 8.000 0.047
40 NEPHEW 1 8 8.000 0.044
41 ANGLICAN CHURCH 1 8 9.000 0.039
42 CDC/USAID 1 8 11.000 0.037
43 NETWORK OF PEOPLE LIVING WITH HIV/AIDS 1 8 12.000 0.032
44 CATHOLIC CHURCH 1 8 3.000 0.071
45 MARKET WOMEN'S ASSOCIATION 1 8 4.000 0.064
46 NIGERIA UNION OF TEACHERS 1 8 15.000 0.019
47 NIGERIAN MEDICAL ASSOCIATION 1 8 6.000 0.051
48 JNI 1 8 8.000 0.038
49 NYAP 1 8 9.000 0.032
50 YOUTH CONGRESS ASSOCIATION 1 8 10.000 0.026
51 STOP AIDS LAGOS 1 8 11.000 0.019
52 NIGERIAN NETWORK OF POSITIVE PEOPLE 1 8 12.000 0.013
58

53 ECWA 1 8 13.000 0.006
54 GEDE FOUNDATION 1 8 7.000 0.056
55 AFRICARE INTERNATIONAL 1 8 3.000 0.063
56 ASSOCIATION FOR REPRODUCTIVE HEALTH 1 8 4.000 0.052
57 WOMEN LAW AND DEVELOPMENT CENTER 1 8 11.000 0.031
58 JOURNALISTS AGAINST AIDS 1 8 15.000 0.006
59 NUSAD 1 8 1.000 0.083
60 AFRICARE 1 8 2.000 0.067
61 ASSOCIATION OF NURSES AND MIDWIVES 1 8 5.000 0.058
62 CARE 1 8 3.000 0.072
63 ABANTU FOR DEVELOPMENT 1 8 5.000 0.061
64 FIDA 1 8 6.000 0.056
65 NIGERIA RED CROSS 1 8 18.000 0.005
66 FAMILY RESEARCH CENTER 1 8 9.000 0.039
67 FEDERATION OF CATHOLIC STUDENTS 1 8 10.000 0.033
68 LIVING WITH HOPE 1 8 12.000 0.022
69 PEOPLE LIVING POSITIVELY 1 8 13.000 0.017
70 PARTNERSHIP FOR LIFE 1 8 14.000 0.011
71 COMMUNITY YOUTH DEVELOPMENT 1 8 15.000 0.006
72 ENVIRONMENTAL RIGHTS AGENDA 1 8 10.000 0.036
73 CENTER FOR COMMUNITY DEVELOPMENT 1 8 8.000 0.010
74 AIDSCAP 1 8 4.000 0.065
75 COPOP 1 8 7.000 0.048
76 YEDA 1 8 8.000 0.042
77 YOSPIS 1 8 9.000 0.036
78 NLC 1 8 11.000 0.024
79 NCWS 1 8 12.000 0.018
80 WHED 1 8 13.000 0.012
81 WOFAN 1 8 14.000 0.006
82 GHARF 1 8 2.000 0.078
83 WACOL 1 8 3.000 0.072
84 WARO 1 8 4.000 0.067
85 SAVE OUR CHILDREN 1 8 5.000 0.061
86 PHACG 1 8 10.000 0.033
87 UNIZIK JAYCEES 1 8 11.000 0.028
88 LACA 1 8 3.000 0.071
89 CIRDOJC 1 8 15.000 0.006
90 EPWHAN 1 8 4.000 0.069
91 STOP AIDS 1 8 5.000 0.065
92 MOCA 1 8 7.000 0.056
93 PERHAF 1 8 8.000 0.051
94 YOUTH DEVELOPMJENT 1 8 9.000 0.046
95 ASHOKA 1 8 10.000 0.042
96 POSITIVE LIFE ASSOCIATION 1 8 16.000 0.014
97 NETHERLANDS EMBASSY 1 8 18.000 0.005
98 UNIVERSITY COLLEGE HOSPITAL 1 8 1.000 0.083
99 UBTH 1 8 2.000 0.071
100 QUEENS HOSPITAL 1 8 3.000 0.060
101 MEDOX CONSULTANT CLINIC 1 8 4.000 0.048
102 DEBORAH MISSION 1 8 7.000 0.012
103 HEALTH SUSTENANCE ACTION 1 8 1.000 0.083
104 CARE INITIATIVE 1 8 2.000 0.080
105 PRIDE OF WOMANHOOD 1 8 3.000 0.077
106 CENTRE FOR HEALTH WORKS RESEARCH AND DEVELOPMENT 1 8 5.000 0.071
107 RUENPROT 1 8 7.000 0.065
108 ACADA FOUNDATION 1 8 8.000 0.063
109 KET ALICE FOUNDATION 1 8 9.000 0.060
110 WIDRI 1 8 10.000 0.057
111 INTERNATIONAL DEVELOPMENT ALLIANCE 1 8 11.000 0.054
112 PWPWR PROJECT 1 8 12.000 0.051
113 WOMENS HEALTH AND RURAL DEVELOPMENT INITIATIVE 1 8 13.000 0.048
114 NOSAD 1 8 14.000 0.045
115 NIU 1 8 15.000 0.042
116 ACTG 1 8 16.000 0.039
117 NANTAP 1 8 17.000 0.036
118 NINPREH 1 8 21.000 0.024
119 JAAIDS 1 8 22.000 0.021
120 NECSHA 1 8 24.000 0.015
121 CACO 1 8 25.000 0.012
122 CONCERN UNIVERSAL 1 8 26.000 0.009
123 CONCERN WORLDWIDE 1 8 27.000 0.006
59

124 JDPC 1 8 28.000 0.003
----------------------------------------------------- --------- ---------
Total/Average: 172 14.333
APPENDIX B : THE ASSESSMENT TEAM
Development Research and Projects Centre (dRPC)
Ms.Veronica Osaghae
Dr. Yahaya Hashim
Dr. Ani Etokidem
Dr. Sani B. Garko
Mr. Samuel Egwu
Mr. Joseph Okeibunor
Mr. Oke Olubisi
Henry Osadolo
Joyce Mangvwat
Malvin Wright
Facilitators/Trainers
Dr. Pertti J. Pelto , consultant
Dr. Lorie Broomhall, FHI, North Carolina
Mr. Solomon Pai (FHI State (FCT) Program Manager)
60