This report is the result of research into the current impact of HIV/AIDS on NGOs and CBOs in KwaZulu-Natal, the worst-affected province of South Africa. A survey of organisations found that most were aware that they eventually would have to grapple with HIV/AIDS among their own staff and volunteers, and they knew this could have serious consequences for their organisations' effectiveness and sustainability. This report aims to provide not just information on the status of the surveyed organisations, but also tools to help organisations in South Africa and elsewhere plan for and manage the epidemic among their own staff and volunteers.
Human Resources
THE IMPACT OF HIV/AIDS ON CIVIL SOCIETY: ASSESSING AND MITIGATING IMPACTS
Human resources impact assessment
Many decision-makers readily point to human resource problems as the chief bottleneck they face in attempting to scale up health systems. Yet time and again the reform agenda neatly skirts around the sensitive and difficult issues involved—not least because there are major gaps in the knowledge base required for a realistic workforce strategy. This editorial of the World Health Organisation Bulletin provides an overview of the role of human resources within the health sector, regardless of whether it is public or private. The editorial discusses the importance of human resources management within the health sector, and suggests that policy-makers and donors concerned with human resources problems may want to request those proposing a major new project or policy to make a systematic and formal ‘human resource impact assessment’ during its preparation. Such assessments would examine the likely effects of the proposed project or policy on the health workforce.
Stigma in the Workplace
South African law protects the rights of employees living with HIV/AIDS on paper, but the reality is that discrimination and denial still prevails in the workplace in a country which has one of the highest HIV/AIDS rates in the world. "We have the best legal frameworks around but this hasn't changed mindsets. People still get dismissed because of their HIV status. I handle HIV/AIDS discrimination cases almost every day," Jennifer Joni, an attorney for the AIDS Law Project told IRIN.
Catastrophe or controllable crisis? The impact of the AIDS epidemic on schooling in Africa
It is widely believed that children who are directly affected by AIDS are greatly disadvantaged at school and that teachers are a high risk group for HIV infection. Research in Botswana, Malawi and Uganda suggests that the situation is much more complex. An international team of researchers surveyed 41 primary and secondary schools across the three countries and interviewed education managers, teachers and other stakeholders. They investigated the effectiveness of HIV prevention programmes and the impact of the AIDS epidemic on pupils and teachers. They found little evidence that education on HIV/AIDS, sexual and reproductive health (SRH) and life skills has a major impact on behaviour. Economic and social pressures that fuel unsafe sexual practices among adolescents remain high. Teachers lack the training and commitment to integrate HIV/AIDS education into carrier subjects. The study identified an urgent need for full-time SRH/life skills teachers in both primary and secondary schools giving regular timetabled lessons.
Down and out in Zomba: the situation and education of orphans in Malawi
What does it mean to be a young orphan? Why and how are numbers burgeoning? Why are orphans socially excluded and how might education support their inclusion? This study investigates the lives of orphans in an area of Malawi, suggests why the numbers of orphans are exploding and indicates how the social unrest that may follow could be avoided. This small project conceives of education in the broadest possible sense to include what the orphans need to know to survive in the short term, to fruitfully participate in their surroundings in the medium term, and to prosper in the long term. It attempts to build a picture of their lives and aspirations, the particular perceptions of female orphans and also of their carers, organised in state registered, community level Orphan Care Groups (OCGs).
HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission
An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behaviour. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%-40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.
Further details: /newsletter/id/29425
Occupational hazard – protecting healthworkers from TB in Malawi
High rates of TB and HIV infection in sub-Saharan Africa increase the risk of healthworkers of catching TB from their patients. In mid-1998, Malawi’s National Tuberculosis Control Programme produced guidelines for hospitals on TB control. Are hospitals sticking to the guidelines? Are they having any effect?
Clearing up confusion: peer-led AIDS education in Zambia
Do African adolescents know enough about AIDS to protect themselves against infection? What is the best way to educate them about the risks of HIV? A report from Population Services International evaluates a peer-led HIV prevention programme in a secondary school in Zambia.
HIV Risk a Question of Place as Well as People
A group of American researchers now suggest that the community in which one lives is as important as an individual's behavior in determining the risk of HIV infection. "The risk of individual behavior is enhanced or lessened by the type of place in which it takes place," said study lead author Dr. Shelah S. Bloom of the University of North Carolina at Chapel Hill. Bloom and her colleagues reported their findings in Sexually Transmitted Infections (2002;78:261-266). The researchers analyzed data from surveys conducted in a rural northern Tanzanian region with about 20,000 inhabitants between 1994 and 1997.
Further details: /newsletter/id/29350
Zimbabwe: 30 Percent of Teachers HIV-Positive
AT least 30 percent of all school teachers countrywide are HIV-positive, according to Mr Saul Murimba of the Southern Africa Consortium for Monitoring Educational Quality. He told participants at a two-day workshop on management of HIV/Aids at the education district level that the teachers would eventually succumb to the pandemic.