We successfully implemented an Adolescent Girls and Young Women intervention project between 2018-2019 in Akwa Ibom state, with funding from the Society for Family Health (SFH) and the United Nations Population Fund (UNFPA). Leveraging our expertise and experience in community engagement, team building, advocacies, and training in sexual and reproductive health, we implemented the project in sixteen (16) LGAs, including Okobo, Oron, Eket, Ibeno, Esit Eket, Urue-Offong Oruko, Mbo, Uyo, Uruan, Eastern Obolo, Mkpat enin, Ikot Abasi, Udonguko, Nsit Ibom, Onna, and Nsit Ibom LGAs. The Adolescent Girls and Young Women intervention project was impactful and rewarding, contributing significantly to the National Response in reversing the trend of HIV, particularly among young people. The project's success and achievements include:
1. Capacity building of 865 Adolescent Girls and young Women (AGYW) aged 15-24 to carry out HIV services in communities.
2. Training of 155 mothers of adolescent girls and young women on parent-child behavioral change communication skills and sexuality education.
3. Reaching 58,021 AGYW with HIV Testing services, as well as STI management and treatment.
4. Placing 598 positive clients on drugs and suppressing their viral load.
5. Treating 219 STI cases, including Gonorrhea, and training the individuals on condom use.
6. Establishing 25 non-traditional condom outlets in communities as a condom programming approach for AGYW to have easy access to condom use, using business entrepreneurs and artisans to provide condoms at street kiosks, hairdressing salons, and hot spots.
7. Building the skills of 57 Adolescent-friendly health providers in PHC to carry out counseling and HIV services for referred AGYW to the facilities.

The MACC4 Project, a PEPFAR-funded award for sustainable HIV/AIDS prevention, care and support, was implemented from 2007 to 2014 in Akwa Ibom and Cross River states, targeting individuals in key populations such as TB clients, orphans, and vulnerable children, PLHIV, and their households. Over 200,000 individuals received HIV services through the MACC4 Project. The project maximized the Minimum Package Prevention Intervention (MPPI) to provide effective HIV prevention services to the MARPA community.
It engaged with communities through advocacies and sensitization, participatory appraisal, and strengthened community structures for health, protection, social inclusion, and grievance redress. This included support for Community Development Committees, establishing Village Saving and Loan Associations, setting up community food banks for orphans and vulnerable children, providing institutional development assistance to CBOs and support groups for people living with and affected by HIV, and facilitating registration and government recognition. Regular stakeholders' meetings were held to provide feedback to various stakeholders on progress and accomplishments made through the project. During the project's implementation, 142,690 persons, including 58,289 key populations and other vulnerable populations, were linked to HIV testing and counseling. Out of this number, 11,387 clients, including key populations and other vulnerable populations, tested HIV positive and were linked to care and treatment. In addition, 4,481 PABAs provided palliative care services, and 3,211 OVCs received OVC services. ECEWS continues to implement sustainable interventions that will effectively address the challenges posed by HIV/AIDS in Nigeria.

We partnered with the Akwa Ibom State Action Committee on AIDS and The World Bank to provide capacity building for 15 CBOs and 2 NGOs with low capacity in program planning and implementation from 2005 to 2007. The project aimed to improve the effectiveness and efficiency of the community-based organizations in delivering HIV/AIDS services to communities So, we supported the CBOs and NGOs by providing training in financial management, monitoring and evaluation, program planning, and implementation. As a result of this partnership, several communities in Mbo, Oron, Ibiono-Ibom, Uyo, and other LGAs were reached with HIV/AIDS community outreach activities. This capacity-building initiative contributed to the strengthening of the HIV/AIDS response in Akwa Ibom State and helped to ensure that more people in the affected communities were aware of HIV/AIDS prevention and treatment measures. The successful implementation of this project highlights the importance of capacity building in improving the quality of services provided by CBOs and NGOs in the fight against HIV/AIDS.

In 2005, the "Saving the Unborn Child" project was initiated to improve HIV/AIDS education among Traditional Birth Attendants (TBAs) in rural communities. TBAs were the primary birth attendants, and the project aimed to equip them with basic tools for PMTCT and protection against potential infection. A total of 22 TBAs in Uyo and 7 in Ibesikpo Asutan LGAs were sensitized on PMTCT and universal precautions. We at ECEWS provided Voluntary Confidential Counseling and Testing of HIV as part of ProHealth International's Free Health Care programs. This included awareness campaigns in antenatal care clinics and capacity building of health workers. In September 2013 - 2014, we received funding support from Nka Uforo Iban Akwa Ibom State USA Inc. to implement an empowerment project for ultra-poor market women in the Akpan Andem entrepreneurial market, Uyo, and Abak main market. The project's active implementation began with advocacy to relevant stakeholders, community mobilization and sensitization, identification and selection of beneficiaries, capacity building in Basic Business Practices, seed grants disbursement, supporting the market association to achieve minimum operating standards, monitoring, and reporting on the project.
At the end of the project, 51 women received funding. Beneficiaries such as Eno Tom and Madam Eno Efanga, who previously depended on others for credit to buy and sell periwinkle, could now purchase periwinkle in bags from the source. They cleared their debts and expanded their product offerings. The Market Women Association now has a well-documented list of members by group, holds regular executive and general meetings with minutes, and can monitor projects executed to benefit their members.

From 2013-2017, we led a comprehensive HIV prevention, care, and treatment project that reached 618,450 individuals with HIV testing services, including key populations through community-based organizations. The project expanded across condom distribution, antiretroviral therapy, prevention of mother-to-child transmission, and tuberculosis services. We at ECEWS also built capacity among local healthcare workers, social workers, and volunteers to ensure a sustainable HIV response. As a result of the project, 3,890 clients were newly initiated on antiretroviral therapy and 4,462 people living with HIV were placed on treatment. Additionally, 6,904 key population members were reached with combination prevention interventions, including sexual transmitted infection and tuberculosis services. A total of 5,227 key population members were tested for HIV, with 530 identified as HIV positive and successfully linked into care at KP-friendly hospitals in Enugu and Imo states with a positivity rate of 11.8%.

From 2016 to 2017, ECEWS and the Society for Family Health Nigeria formed a partnership with support from the Global Fund. Their goal was to strengthen the capacity of 15 emerging community-based organizations (CBOs) led by key populations (KPs), which included five CBOs led by people who inject drugs (PWID), five led by men who have sex with men (MSM), and five led by female sex workers (FSW). These organizations received training and support for leadership and management, paralegal services, finance and human resource management, safety and security, advocacy and human rights, monitoring and evaluation, resource mobilization and proposal writing, organizational growth and institutional development, strategic collaboration and partnership, governance, as well as finance, procurement, and logistics management. The project also focused on implementing HIV interventions within KP-led CBOs and linking them to HIV services, such as prevention, care, and treatment. SFH established one-stop-shop centers for HIV care and treatment for those testing positive. Moreover, the project supported the establishment of five KP technical working groups and networks in Anambra, Enugu and Imo, Lagos, and Oyo states. These KPs were able to provide support for HIV prevention and treatment services to community members. As a result, 2,415 KPs were linked to HIV testing services with a 12.3% positivity rate, which is similar to recent high rates published in the NAISS 2019 report.

Between 2017 and 2019, ECEWS partnered with KNCV Tuberculosis Foundation on a project funded by the United States Agency for International Development (USAID) in nine Nigerian states: Akwa Ibom, Cross River, Rivers, Enugu, Benue, Ogun, Lagos, Osun, and Ondo. The project aimed to sensitize and screen individuals for tuberculosis (TB), with a total of 36,018 people being reached and screened. As a result of this effort, 9,510 presumptive TB cases were identified, and their sputum samples were tested using GeneXpert. Of these cases, 797 individuals tested positive for MTB and were linked to appropriate treatment. This project was a significant effort to combat the spread of TB in Nigeria, and the partnership between ECEWS and KNCV Tuberculosis Foundation was instrumental in achieving the project's goals. Through their collaborative efforts, they were able to reach a substantial number of individuals in multiple states and ensure that those who tested positive received the necessary treatment.

The UNFPA funded this project from 2017-2020, which included capacity building interventions for SPHR, VAWG, SGBV HIV Prevention, and linkages to care and treatment, PMTCT, and FP. Through the project, 2810 individuals, including sex workers, men who have sex with men, and people who inject drugs, received HTS and TB services. Of those tested, 75KPs were diagnosed with HIV and successfully linked to KP Friendly HIV/TB care and treatment centers. The ECEWS confidence center, located in Uyo, is linked to the UNODC-supported addiction drop-in Centre (ADC) for treatment of PWID based on consent. Additionally, ECEWS partnered with the UNFPA to build the capacity of healthcare workers in Benue, Kaduna, Akwa-Ibom, and Cross River States to integrate Sexual and Reproductive Health and HIV services. Under the project, the capacity of 149 health workers was built to provide integrated/HTC services in Benue and Cross River States. Thirteen private health facilities in Benue State were supported for FP/HTC integration, including linkages with the Ministry of Health for family planning service commodities. A family planning project to scale up Sayana press contraceptives, a new contraceptive injectable, was implemented over a six-month period in Akwa Ibom State, reaching over 1000 young girls with services.

The key intervention on this Project was HIV, TB, SRHR & KP. 883,307 individuals were provided with HIV Testing services from which 13,358 HIV positive individuals were identified. 14,079 Clients were newly enrolled into Care and 13,981 individuals (99%) were newly initiated on ART within the year. 50,783 Clients accessed Viral load service, 32,733 viral load test result were received and 26,506 (81%) had viral suppression. 81,134 pregnant women were offered HIV Testing Services for PMTCT, 902 identified as HIV positive and 864 (96%) positive pregnant women were Newly provided with antiretroviral drugs to prevent HIV transmission to unborn babies. 1,637 <2months and 1,261, 2-12months Children had their early Infant diagnosis: 756 <2months and 582, 2-12months results were received.

In 2018, ECEWS implemented several interventions to identify active TB cases, including targeted community outreach, community screening by PMVs, and house-to-house/tent-to-tent case search. As of March 2021, 442,287 individuals in 15 LGAs across Akwa Ibom, Delta, Imo, Bayelsa, and Cross River States were screened for TB, and 28,635 presumptive cases were identified. Of these, 25,150 individuals had their sputum samples analyzed using gene Xpert/AFB, resulting in 1,277 laboratory-confirmed TB cases. 1,247 of these confirmed cases were placed on treatment. In addition, targeted community outreaches, house-to-house case search, and household contact investigation strategies resulted in the diagnosis and treatment initiation of 1,674 cases of all forms of TB. Overall, 1,646 individuals (129% of diagnosed cases) started treatment during the reporting period.

In 2021-2022, ECEWS collaborated with the Catholic Caritas Foundation of Nigeria - Catholic Bishops Conference of Nigeria (CCFN) to provide a comprehensive HIV prevention, care, and treatment program for Key Populations (KPs). ECEWS trained 21 OSS staff and government officials on Integrated HIV Care and Treatment and PrEP service provision, with a focus on gender, sexual diversity, and violence prevention for KPs in Delta. Additionally, ECEWS facilitated the inauguration of the Delta State Violence Response Team for KPs.