Special Edition, Spring 2002

Community-based Initiatives
Tools and Training Strengthen African AIDS Groups

In sub-Saharan Africa, AIDS has stricken some 21 million adults and children, according to recent estimates. In the early 1990s, many grassroots organizations sprang up in response to the devastation. Population Council researchers Ann Leonard and Esther Muia undertook four collaborative interventions to further strengthen such groups. The efforts demonstrated that providing simple, carefully selected forms of technical assistance can greatly improve the ability of grassroots organizations to achieve their goals.

“These results give valuable insight into how the international community can support grassroots groups—beyond direct financial aid. Modest investments of time and expertise, made in collaboration with the groups, can yield generous returns,” says Leonard.

The effort began in 1993 when the Population Council and Glaxo Wellcome established a project on Community-based AIDS Prevention and Care in Africa: Building on Local Initiatives. The first phase entailed a survey of 65 community-based organizations in Kenya, Tanzania, Uganda, Zambia, and Zimbabwe and documentation of eight particularly successful groups as case studies.

“We highlighted the elements essential to good programs for other people who are interested in making these types of efforts, so that they do not have to reinvent the wheel,” Leonard says.

“When we began the intervention phase, we wanted to do research that would also immediately benefit the groups themselves,” she continues. In collaboration with four of the eight groups and with the help of local colleagues, the researchers tailored projects that would also address problems typical of many growing and successful volunteer groups.

A notebook, a plan
In Uganda, the National AIDS Control Program’s Community Counseling Aides (CCA) Project deploys trained volunteers to conduct AIDS education and provide basic nursing care. When the Council intervention began, the goal of having local communities administer and support this program was hampered by a lack of information about the program’s performance.

Researchers developed simple yet effective monitoring tools in a report format in which CCAs record their activities and complete monthly worksheets; their supervisors then summarize the results for review by local supporting agencies. After the intervention, the local government in one district began to include the CCAs in discussions on planning the allocation of funds, and the health establishment gained greater respect for the work of the volunteers.

KIWAKKUKI, a women’s group in Moshi, Tanzania, provides AIDS education and care for people affected by AIDS. At the time the intervention began, the group had grown so rapidly that its ad hoc structure could no longer cope with the range and scale of activities. Here, creating an organizational structure and management system to improve services was the intervention goal.

Group members and others concerned in the group’s mission analyzed the organization’s problems and developed solutions. A new organizational structure was put into place and evaluated after one year. Creation of committees reduced overlapping efforts and evened out the burden of responsibility, a branch system increased the group’s membership and outreach, and a fundraising committee broadened the base of support.

Giving new skills
In Ndola, Zambia, the INDENI Petroleum Refinery’s HIV/AIDS Committee conducts educational activities, provides condoms and medical care, and addresses the needs of employees’ families. But because committee staff nevertheless felt they were not sufficiently changing people’s attitudes and behavior, the intervention concentrated on developing and testing culturally appropriate counseling methods.

Participation in a series of workshops, exercises, and field work experiences resulted in participants feeling more skillful and more committed. The effectiveness of the approach, as reflected within the community, will be assessed through such measures as focus group discussions, clinic and field work notes, and other indices.

In Lusaka, Zambia, the women of the KWASHA MUKWENU care for children orphaned by AIDS. When they joined the Council intervention, the women were interested in expanding the income-generating skills of older orphans.

The skills orphans most wanted to learn were carpentry and tailoring, so intervention staff organized classes. Participants in the tailoring workshop completed the curriculum ahead of schedule and, with their first earnings, repaired the KWASHA MUKWENU sewing machines and purchased fabric. They now hope to set up a sewing cooperative. The carpentry workshop, which is still underway, entails lessons, an apprenticeship, and an opportunity to be tested for a professional certificate.

In their report on the intervention, Leonard and Muia note that the sewing workshop imparted more than tailoring skills: "Initially quiet, shy, and soft-spoken girls have now become budding entrepreneurs, full of determination to succeed."

And in reflecting on the project overall, Leonard says, "As terrible as AIDS is, the response of these people is truly inspiring." Muia echoes the thought: "We are building on the inherent courage and creativity of the African people. Community-based responses inspire hope, rather than helplessness, as a response to the AIDS crisis. Originally published in Population Briefs 4(3), September 1998.

Source
Leonard, Ann and Esther Muia. 1998. Community-Based AIDS Prevention and Care in Africa, Building on Local Initiatives: Results of Four Action-Research Interventions in East and Southern Africa. New York: Population Council.

Outside funding
Glaxo Wellcome, Swedish International Development Cooperation Agency

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