Community Based Organizations in HIV/AIDS Prevention, Patient. Care and Control in Ethiopia
AbstractThe main objective of this review is to provide a preliminary evaluation of the suitability of community-based organizations (CBOs) to contribute to HIV/AIDS prevention, care/support and control programs in Ethiopia. In order to put CBOs and programs in the context of HIV transmission and spread, the role of the Multisectoral HIV/AIDS Strategy (2000-2004) and other government policies and programs in promoting an environment conducive for these organizations and initiatives are highlighted. The Ethiopian literature and recent news releases on CBOs were reviewed and findings examined in the context of recent government policies, community initiatives and prevailing infrastructure in health programs, socioeconomic and cultural constraints.
Findings show that the Multisectoral HIV/AIDS Strategy, the current Health Policy, and plans to strengthen the weredas and kebeles facilitate the development of CBOs and programs and infrastructure through the HIV/AIDS Council, the Ministry of Health and various other governmental organizations. CBOs studied are at different stages of planning and implementing preventive and care/support programs but little is known about their progress, operations and effectiveness due to the recency of most programs and lack of monitoring and evaluation mechanisms. Although most CBOs are either still in the formative stage or in process of carrying out HIV/AIDS prevention programs on a limited scale, their self initiative, their knowledge of and acceptance by the community and their relative cost-effectiveness render them suitable as owners, advocates and participants in programs. Several organizations and health agents are operating in integrated primary health and HIV/AIDS prevention programs that have a multi-disease, multi-organizational and poverty-reduction focus and use appropriate and promising behavioral change communication methods that may contribute significantly to overcoming social stigma and reduce HIV exposure risk.
The various CBOs can be partners in HIV/AIDS prevention, patient care/support and control programs. They may facilitate efforts to curb the spread of HIV through the expansion of awareness creation and prevention initiatives and also provide patient care and support. The kebele may act as forum for community initiatives and as a link between the community and outside institutions if they can overcome bureaucratic intransigence and create an enabling environment. Towards that objective, CBOs need both internal strengthening of programs and outside support for their sustainability, and persisting stigma and discrimination against living with HIV/AIDS persons need to be reduced. Among new strategies, integrated home-based care programs involving people living with HIV/AIDS (PLWHA), families and neighbors, and poverty alleviation with an integrated HIV/AIDS component promise to create an enabling environment and promote project ownership by communities, which facilitate program design, management and effectiveness.
Recommendations are made for further research towards identifying, promoting, strengthening and upscaling CBOs and programs to the regional and national levels.
[Ethiopian J. Health Dev. Vol.17 Special Issue 2003: 3-31]