HIV/AIDS and community conflict in Nigeria: implications and challenges

Gruber, Janet; Caffrey, Margaret M.

doi:10.1016/j.socscimed.2004.06.053

Cited by 30 publications

(18 citation statements)

References 5 publications

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“…As a result, they fail to resonate with the worldviews and perceived needs and interests of their target groupings, or to take adequate account of the complex social relations into which programmes are inserted (Gruber & Caffrey, 2005;Pfeiffer, 2003). Too often target communities are seen as passive recipients of prevention, care and treatment services (the ''objects'' of interventions) rather than active participants working in partnership with health professionals to improve their health (the ''subjects'' of interventions) (Campbell, 2003).…”

Section: Introductionmentioning

confidence: 99%

Towards a “fourth generation” of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

2010

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Many biomedical and behavioural HIV/AIDS programmes aimed at prevention, care and treatment have disappointing outcomes because of a lack of effective community mobilisation. But community mobilisation is notoriously difficult to bring about. We present a conceptual framework that maps out those dimensions of social context that are likely to support or undermine community mobilisation efforts, proposing that attention should be given to three dimensions of social context: the material, symbolic and relational. This paper has four parts. We begin by outlining why community mobilisation is regarded as a core dimension of effective HIV/AIDS management: it increases the "reach" and sustainability of programmes; it is a vital component of the wider "task shifting" agenda given the scarcity of health professionals in many HIV/AIDS-vulnerable contexts. Most importantly it facilitates those social psychological processes that we argue are vital preconditions for effective prevention, care and treatment. Secondly we map out three generations of approaches to behaviour change within the HIV/AIDS field: HIV-awareness, peer education and community mobilisation. We critically evaluate each approach's underlying assumptions about the drivers of behaviour change, to frame our understandings of the pathways between mobilisation and health, drawing on the concepts of social capital, dialogue and empowerment. Thirdly we refer to two well-documented case studies of community mobilisation in India and South Africa to illustrate our claim that community mobilisation is unlikely to succeed in the absence of supportive material, symbolic and relational contexts. Fourthly we provide a brief overview of how the papers in this special issue help us flesh out our conceptualisation of the "health enabling social environment". We conclude by arguing for the urgent need for a 'fourth generation' of approaches in the theory and practice of HIV/AIDS management, one which pays far greater attention to the wider contextual influences on programme success.

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Section: Introductionmentioning

confidence: 99%

Towards a “fourth generation” of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

2010

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“…Gruber and Caffrey (2005) discuss an AIDS project in Nigeria which failed to consider the local context. The project, which sought to build youth and women's leadership skills, was perceived as a threat by powerful male community elders, who undermined its efforts.…”

Section: Introductionmentioning

confidence: 99%

Hearing community voices: grassroots perceptions of an intervention to support health volunteers in South Africa

Campbell

Gibbs

Maimane

et al. 2008

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS -as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. Given the growing emphasis on involving community voices in project research, we conducted 17 discussions with 34 community members, including those involved and uninvolved in project activities -at the end of this 3-year period. These discussions aimed to elicit local people's perceptions of the project, its strengths and its weaknesses. Community members perceived the project to have made various forms of positive progress in empowering volunteers to run a more effective home nursing service. However, discussions suggested that it was unlikely that these efforts would be sustainable in the long term, due to lack of support for volunteers both within and outside of the community. We conclude that those seeking to increase the role and capacity of community volunteers in AIDS care need to make substantial efforts to ensure that appropriate support structures are in place. Chief among these are: sustainable stipends for volunteers; commitment from community leaders and volunteer team leaders to democratic ideals of project management; and substantial support from external agencies in the health, welfare and NGO sectors. Keywords: Evaluation, home-based care, volunteers, task shifting, participation, stipends, leadership. RésuméEtant donnée la rareté des professionnels africains de la santé, les volontaires sont destinés à des rôles de plus en plus importants dans la gestion du VIH/SIDA, avec un nombre croissant de projets reposant sur les membres des communautés de base pour qu'ils fournissent des soins à domicile à ceux vivant avec le SIDA -dans le cadre d'un agenda plus large de transfert des taches. Pourtant, on sait très peu comment faciliter au mieux cette implication. Cet article rend compte des perceptions de la communauté d'un projet de 3 ans qui visait à former et à appuyer les travailleurs volontaires de la santé dans une communauté rurale en Afrique du Sud. Etant donnée l'attention croissante accordée à l'implication de la parole des communautés dans l' étude du projet, nous avons organisé 17 discussions avec 34 membres de la communauté, y compris ceux qui sont impliqués dans des activités du projet et ceux qui ne le sont pas -à la fin de la période de 3 ans. Ces discussions visaient à obtenir les perceptions des personnes locales sur le projet, ses forces et ses faiblesses. Les membres de la communauté ont perçu le projet comme un projet ayant permis diverses formes de progrès positifs dans l'habilitation des volontaires à gérer un service de soin à domicile plus efficace. Cependant, les...

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“…The project specifically sought to facilitate effective local community responses rather than 'intervening from the outside,' as is often the case with youth programmes. Its commitment to facilitating youth participation in shaping and implementing HIV/AIDS programmes, rather than imposing externally designed programmes on young people, was based on the assumption that these projects have a greater chance of success if they build on existing resources and work to ensure that project goals and activities resonate with local youths' own perceptions of their needs and interests (Campbell, 2003;Gruber & Caffrey, 2005;Campbell, Nair & Maimane, 2007). The needs and interests of youths vary and manifest differently from one local community to another.…”

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confidence: 99%

Mismatches between youth aspirations and participatory HIV/AIDSprogrammes in South Africa

Gibbs

Campbell

Maimane

et al. 2010

African Journal of AIDS Research

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HIV/AIDS and community conflict in Nigeria: implications and challenges

Cited by 30 publications

References 5 publications

Towards a “fourth generation” of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

Towards a “fourth generation” of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

Hearing community voices: grassroots perceptions of an intervention to support health volunteers in South Africa

Mismatches between youth aspirations and participatory HIV/AIDSprogrammes in South Africa

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