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African Journal of AIDS Research

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Building partnerships to support community-led HIV/AIDS management: a case study from rural South Africa

Yugi Nair, Catherine Campbell

Abstract


The importance of partnerships between marginalised communities and support agencies (from the public sector, private sector and civil society) is a pillar of HIV/AIDS management policy. Such alliances are notoriously difficult to promote and sustain. We present a case study focusing on the first stage of a project seeking to build partnerships to facilitate local responses to HIV/AIDS in a remote rural community in South Africa. To date the Entabeni project has been successful in its goal of training volunteer health workers in home-based care, peer education, project management and procedures for accessing grants and services. The paper focuses on the project's other goal — to create external support structures for these volunteers (drawing on government departments, local NGOs and private-sector philanthropists). The partnership aims to empower volunteers to lead HIV-prevention and AIDS-care efforts, and to make public services more responsive to local needs. We illustrate how features of the local public-sector environment have actively worked against effective community empowerment. These include a rigid hierarchy, poor communication between senior and junior health professionals, lack of social development skills and the demoralisation and/or exhaustion of public servants dealing with multiple social problems in underresourced settings. We outline the obstacles that have prevented private-sector involvement, suggesting a degree of scepticism about the potential for private-sector contributions to development in remote areas. We discuss how the project's most effective partners have been two small under-funded NGOs — run by highly committed individuals with a keen understanding of social-development principles, flexible working styles and a willingness to work hard for small gains. Despite many challenges, the partnership formation process has seen some positive achievements; we outline these and discuss the essential role played by an external change agent, and conclude with a discussion of the possibility of building long-term structures to sustain the project.

Keywords: community development, community response, empowerment, external change agent, networks, public sector, resource-poor settings, volunteers

African Journal of AIDS Research 2008, 7(1): 45–53



http://dx.doi.org/10.2989/AJAR.2008.7.1.6.434
AJOL African Journals Online