Building contexts that support effective community responses to HIV/AIDS: a South African case study
Building contexts that support effective community responses to HIV/AIDS: a South African case study
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DOI：
10.1007/s10464-007-9116-1
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发表时间：
2007-06-01
影响因子：
3.1
通讯作者：
Maimane, Sbongile
中科院分区：
文献类型：
--
作者：
Campbell, Catherine;Nair, Yugi;Maimane, Sbongile
在本文中，我们讨论了我们的概念化的“健康有利的社会环境”，和一些我们目前正在使用的战略，以建立社会背景最有可能支持有效的艾滋病毒/艾滋病管理在南部非洲。在发展这些想法的过程中，我们利用了与南非偏远农村社区Entabeni居民的持续合作，该社区43%的孕妇艾滋病毒呈阳性。这种合作的目的是促进环境的变化，使人们很少或根本没有机会获得正式的保健或福利支助，艾滋病毒/艾滋病受到严重歧视的偏远地区能够更有效地进行社区主导的艾滋病毒/艾滋病管理。我们给出了迄今为止的三个阶段的合作帐户。其中包括研究;传播调查结果并就今后的方向进行社区协商;初步项目活动（志愿卫生工作者的技能培训;建立伙伴关系和青年集会），以此说明我们认为促进“艾滋病防治能力”社区发展的六项关键战略：积累知识和基本技能;创造对话和批判性思维的社会空间;促进地方对问题的主人翁意识和采取行动的激励措施;强调社区的力量和资源;调动现有的正式和非正式地方网络;在边缘化社区与地方、国家和国际上更强大的外部行为者和机构之间建立伙伴关系。我们讨论了这项工作的一些胜利和考验，最后讨论了在高度保守的父权制社区的社区层面上工作时，需要设定现实的目标，以解决当地人几乎无法控制的经济和政治进程可能形成的问题。
In this paper we discuss our conceptualisation of a 'health-enabling social environment', and some of the strategies we are currently using to build social contexts most likely to support effective HIV/AIDS management in southern Africa. In developing these ideas, we draw on our on-going collaboration with residents of Entabeni, a remote rural community in South Africa where 43% of pregnant women are HIV positive. The aim of this collaboration is to facilitate contextual changes that will enable more effective community-led HIV/AIDS management in an isolated area where people have little or no access to formal health or welfare support, and where HIV/AIDS is heavily stigmatised. We give an account of the three phases of collaboration to date. These include research; the dissemination of findings and community consultation about the way forward; preliminary project activities (skills training for volunteer health workers; partnership building and a youth rally) as a way of illustrating what we believe are six key strategies for facilitating the development of 'AIDS-competent' communities: building knowledge and basic skills; creating social spaces for dialogue and critical thinking; promoting a sense of local ownership of the problem and incentives for action; emphasising community strengths and resources; mobilising existing formal and informal local networks; and building partnerships between marginalized communities and more powerful outside actors and agencies, locally, nationally and internationally. We discuss some of the triumphs and trials of this work, concluding with a discussion of the need to set realistic goals when working at the community level in highly conservative patriarchal communities to tackle problems which may be shaped by economic and political processes over which local people have little control.