Community-based Approaches
Integration initiatives and Community responses in HIV/AIDS interventions
community self-management Aims at MEALS approach:
Motivating Equipping Accompanying Linking Sustaining
Community-based Approaches works in the following sectors: Agriculture Enterprise and marketing Micro finance Shelter technology Child care and education Community health HIV/AIDS
Problems faced by children affected by HIV/AIDS
Expelled from school due to stigma.
Forced to leave school due to financial difficulties.
Forced to discontinue because parents migrate. Stigmatized discriminated- abused at all levels. Branded as cursed especially the orphans. Faced with starvation.
Lack emotional support. Working children and child-headed families.
Children as care givers.
Street children/sexually abused and forced into commercial sex. Denial of property rights and property grabbing.
Unfulfilled emotional, health, educational, nutritional, and social needs leading to insecurity and increased vulnerability.
Community mobilization process
Self-help groups CBOs, Youth Clubs Community-based NGO facilitation Integrated approach with CD programs Linkage with mainstream health care providers Networks and collective functioning Volunteers, religious leaders
Identification strategies
Sensitization through direct participation.
Diverse identification strategies based on the context and ongoing development initiatives. Identification/access as part of the community development process. Mutual learning by sharing field experiences.
Stigma and Discrimination Stigma and discrimination does exist at all levels, sectors, and services.
Negative attitudes and responses are common experiences in the initial stages. But there are also encouraging positive experiences as a result of the mobilization and sensitization process.
Community responses
Home-based care Donation for food, education, clothes Educational support Adoption/sponsorship by relatives SHG sponsorship - integration Housing support Access to care institutions/meal centers Medicines and health care Volunteers
Community support available for: educational, nutritional, shelter, health, and emotional needs of the children.
Encouraging response from: Primary health centers, government hospitals, and private medical practitioners as a result of linkages. Volunteers: from among the affected people and others.
A fistful of rice:
Community responds by contributing rice.
The story of a seven-year-old child
A specific struggle for readmission in school which generated sustained impact. Education for this child was the starting point that led to many other initiatives for children affected by HIV/AIDS.
There is no fear of HIV/AIDS; when I see her children I only feel for them.
- SHG member
I have two children. If she dies, I will take care of her three children and bring up all of them as my own
-a relative of the infected woman in the SHG.
Community-based interventions
Building on what exists Need-based interventions Participatory tools and methods Collective functioning Integrated approach Process planning Rapid appraisals Strengthening existing capacities Linkages and Mainstreaming
Community-based interventions
Establishing working models for replication and mainstreaming Sustainability through community participation, viable operation and mainstream linkages Space in the project framework for initiating a sustainability process
Constraints Challenges
Rural poverty, illiteracy, cultural issues Fatalistic attitude Lack of resources, capacity, services NGO capacity and reach Policy limitations Project framework limitations Stigma HIV, orphans, poverty
Constraints Challenges
Community: Service providers or clients Alternative services or mainstreaming Networks/SHGs - potentials and limitations Sector specialization and isolated interventions (ASOs, Development NGOs, and CBOs) Issues in prioritizing HIV children/families in the context of marginalized children/poverty
Lessons and a way forward
Importance of poverty related issues in planning community-based HIV/AIDS interventions. Poverty, girl child, rural context, and HIV/AIDS is a complex combination that demands interventions with a broader development perspective.
Instead of focusing on negative experiences building on the positive responses of the community is the way forward.
Empowering community to face the challenge, along with centralised delivery of services, is important for effective results.
Participatory process is the key in community-based approach.
Reliable and competent partnership is essential for effective community-based interventions.
Confidence in partners reliability, implementing ability, and process managing capacity are more important than monitoring of strict adherence to the planned project frame and activities.
