This Agency for Co-operation and Research in Development (Acord) report features two country case studies (Uganda and Burundi) which explored the role of community-based research in responding to HIV stigma and discrimination. The research found that issues of stigma and discrimination reached all spheres of life, including the home, family, the workplace, school, health settings and the larger community. It also identified a number of key factors that contribute to stigma and discrimination. These include ignorance and fear, cultural norms and values, some religious teachings, the lack of legal sanctions, lack of rights awareness, the design of government and other programmes, and inaccurate or irresponsible media coverage.
Governance and participation in health
The role of community based research in unravelling HIV stigma
Cost and cost-effectiveness of community based DOTS in Tanzania
Cost Effectiveness and Resource Allocation 2005
Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre health resources is important. One such approach is community based direct observed treatment (DOT). The purpose of the study was to determine the cost and cost effectiveness of health facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania. The conclusion is that community based DOT presents an economically attractive option to complement health facility based DOT. This is particularly important in settings where TB clinics are working beyond capacity under limited resources.
The case of Kenya Partnership for Health program
International Journal for Equity in Health 2005
The Kenya Partnership for Health (KPH) program began in 1999, and is currently one of the 12 field projects participating in the WHO's 'Towards Unity for Health initiative' implemented to develop partnership synergies in support of the Primary Health Care (PHC) approach. This paper illustrates how Program-linked Information Management by Integrative-participatory Research Approach (PIMIRA) as practised under KPH has been implemented within Trans-Nzoia District, Kenya to enhance community-based health initiatives. It shows how this model is strategically being scaled-up from one community to another in the management of political, social, cultural and economic determinants (barriers and enhancers) of health.
Involving young people in the care and support of people living with HIV/AIDS in Zambia
This study, from the Horizons programme, examines the potential of trained members of anti-AIDS clubs to contribute to care, support and stigma-reduction activities and attempts to determine the impact of their involvement in these activities on HIV-related beliefs and behaviours. The findings suggest that youth can be empowered to confront the realities of HIV in their own lives and communities and to confront the barriers of stigma, denial and ignorance, while serving as a resource to people in their communities. The study also demonstrates that organisations and youth clubs working in isolated rural and semi-urban areas can achieve high levels of participation.
Developing locally relevant health information
It is an ongoing challenge to share health information with resource-poor communities that is locally relevant and owned by the communities themselves. When health information from outside the community goes against deeply held beliefs and attitudes about personal and sexual matters, this challenge becomes still greater. As positive a step as open discussion is, unless poor people can access and accept the information they need, they will not be able to make informed decisions regarding their lives and future, according to this article on the website of the Public Library of Science.
Health activists set up 'Unicef Watch'
The newly appointed chief of UNICEF has come under heavy criticism from health activists worldwide. People's Health Movement, a global coalition of grass roots activists and academics, is launching a "UNICEF WATCH" to monitor the new director's 'anti-children' activities and thus defend UNICEF and the rights of children. Ms. Ann Veneman, former US Secretary of Agriculture, is set to begin a 5-year term as the Executive Director of UNICEF on May 2, 2005. "We will be monitoring her every move" said Todd Jailer, a spokesperson for the UNICEF WATCH.
Further details: /newsletter/id/30929
Towards a unified agenda and action for people’s health, equity and justice
Report of a Regional Meeting: Health civil society in east and southern Africa
This report, of a Regional Meeting of Health civil society in east and southern Africa: 'Towards a unified agenda and action for people's health, equity and justice' held in Lusaka 17-19 February 2005 outlines the proceedings of the meeting and the resolutions and plans for future work made by the health civil society groups at the meeting. The meeting was hosted by CHESSORE, the theme co-ordinator in EQUINET on participation in health, with support from TARSC.
Assessing the impact of health centre committees on health system performance and health resource allocation
This study sought to analyse and better understand the relationship between health centre committees in Zimbabwe as a mechanism of participation and specific health system outcomes, including: Improved representation of community interests in health planning and management at health centre level; Improved allocation of resources to health centre level, to community health activities and to preventive health services; Improved community access to and coverage by selected priority promotive and preventive health interventions; Enhanced community capabilities for health (through improved health knowledge and health seeking behaviour, appropriate early use of services); Improved quality of health care as perceived both by providers and users of services.
Local response to HIV in Zambia
The Synergy Project documents a successful model for facilitating a strong community response to HIV and AIDS. The model was used in the Salvation Army Change programme in the Ndola and Choma districts of Zambia. It aims to build on local strengths and resources which enable ordinary people to address barriers to using HIV and AIDS information and services. The basis of this approach is that the demand for and use of voluntary counselling and testing (VCT), prevention of mother-to-child transmission and antiretroviral therapy services will only increase by addressing risk, stigma and the potential for personal change.
Moving from information transfer to information exchange in health and health care
This article is an examination and sustained critique of current approaches to communication and information provision within health settings. The authors argue that current practices are based in a one-way model of information transfer that is characterised by a focus on individual behaviour and responsibility, and which is rooted in power relations that are derived from an expert-oriented, unidirectional pattern of speech. They support their criticisms with evidence from a series of qualitative interviews with different populations being addressed, focusing on different subject areas.