Galvanizing Religious Leaders for Accelerated Identification & Linkage to Pediatric ART (GRAIL) Project is a Congregational-based approach to promoting Early Diagnosis and Treatment for Children Living with HIV/AIDS through the training of Religious Leaders in Nigeria.
Historical Background
After the diagnosis of the first two cases of HIV in Nigeria in 1986 Nigeria maintained a consistent position as the second biggest contributor to the global HIV burden, attracting massive investments into the delivery of HIV/AIDS prevention, care, and treatment services. However, these strategies primarily focused on adults, and where children were recognized to be under-diagnosed and under-treated, the frequent response was to scale up PMTCT services.
The Vatican and Caritas Nigeria have been promoting a global response to address Pediatric HIV with a special focus on Nigeria which contributes over 12% of the global pediatric HIV burden with only 21% of the estimated population of children living with HIV (CLHIV) actually receiving life-preserving HIV anti-retroviral therapy (ART).
The Nigeria Working Group at the Regional Consultation on Early Diagnosis and Treatment for Children Living with HIV or CLHIV (which took place in Nigeria from the 14th to 16th of June, 2017) adopted several country-level strategies on engaging Faith-based Organizations (FBOs) to address pediatric HIV/AIDS. One of the key resolutions was to strengthen the capacity of religious leaders to use their moral and social influence on their congregations to counter the myths related to HIV and HIV-related stigma and discrimination and, where possible, deploy them as instruments in closing the gaps in community-based testing and treatment of children who are HIV positive but yet to commence treatment.
Congregational Approach
The GRAIL project was a conceptual progression of the successful implementation of the Congregational Approach to Baby Shower framework where Caritas Nigeria (the developmental agency of the Catholic Bishops’ Conference of Nigeria) successfully used religious leaders to increase coverage of antenatal care (ANC) for pregnant women and their partners, including the delivery of prevention of mother to child transmission (PMTCT) of HIV services in faith congregations to women who would otherwise have not gone clinics and hospitals for orthodox obstetric care
With support from the Joint United Nations program on AIDS (UNAIDS) and the Presidential Emergency Plan for AIDS Relief (PEPFAR) Caritas Nigeria (the developmental agency of the Catholic Bishops’ Conference of Nigeria) and Caritas Internationalis designed and successfully used religious leaders to increase knowledge about HIV transmission and correct myths that propagated HIV stigma. Trained clergy could also identify recurrently sick children and ensure that they completed a referral for medical review (including an HIV test) to increase access to early diagnosis and treatment of Children Living with HIV (CLHIV).
GRAIL was implemented in phases since 2018. The first phase (GRAIL I) was implemented in April 2018 for 12 months with an additional no-cost extension in 2019.
