HIV/AIDS prevention: building on community strengths in Ajegunle, Lagos

Abstract

This paper builds upon field research in Ajegunle, Nigeria, which suggests that effective HIV/AIDS prevention requires a much higher degree of independent community participation. In exploring ways to achieve this, we suggest that assessing community strengths provides positive scope for understanding and utilising a much wider variety of HIV/AIDS responses which have not been previously used in the context of community development. Community-based approaches also encourage a deeper understanding of locally-specific vulnerability issues that surround HIV and AIDS. Such initiatives can be linked to trends that value the knowledge and capacities of neglected local people and build on their resources, including their networks, relationships and trust. However, the connection to, and use of, the resources of international NGOs (INGOs) remain central to success. If an interactive community-based agenda of working with local level resources receives enough acceptance at the higher levels of the INGOs, the results could be very significant. Such international/local agreements, where INGOs seek to work more closely with local community groups and their people on shared agendas, could begin to tackle some of the key structural issues, especially conflict and poverty, that exacerbate HIV/AIDS at the grassroots and are not responsive to purely medical solutions.

Prévention du VIH/sida: développer les points forts des communautés à Ajegunle, Lagos

Ce document se base sur des recherches menées sur le terrain à Ajegunle, au Nigeria, qui suggèrent que, pour être efficace, la prévention du VIH et du sida requiert un degré beaucoup plus élevé de participation communautaire indépendante. Dans le cadre d'une étude des manières d'arriver à ce résultat, nous suggérons qu'une évaluation des points forts de la communauté donne des perspectives positives pour la compréhension et l'utilisation d'une variété beaucoup plus importante d'interventions en matière de VIH/sida qui n'ont pas été précédemment lancées dans le contexte du développement communautaire. Les approches fondées sur les communautés encouragent par ailleurs une compréhension plus profonde des questions de vulnérabilité propres au niveau local autour du VIH et du sida. Les initiatives de ce type peuvent être reliées à des tendances qui accordent une importance aux connaissances et aux capacités des populations locales délaissées et qui se basent sur leurs ressources, y compris leurs réseaux, leurs relations et leur confiance. Cependant, la connexion avec les ressources des ONG internationales (ONGI) et leur utilisation restent essentielles pour le succès. Si un ordre du jour interactif fondé sur les communautés du travail avec les ressources locales reçoit une acceptation suffisante aux échelons plus élevés des ONGI, les résultats pourraient être très considérables. Les accords internationaux/locaux de ce type, dans le cadre desquels les ONGI cherchent à travailler en plus étroite collaboration avec les groupes communautaires locaux et leurs membres sur des ordres du jour partagés, pourraient commencer à remédier à des problèmes structurels clés, en particulier les conflits et la pauvreté, qui ont pour effet d'exacerber le VIH/le sida au niveau de la base populaire et ne peuvent pas être résolus par des moyens purement médicaux.

Prevenção do HIV/AIDS: aproveitando os pontos fortes da comunidade em Ajegunie, Lagos

Este artigo baseia-se em uma pesquisa de campo em Ajegunle, Nigéria, que sugere que a prevenção efetiva do HIV/AIDS exige um grau muito maior de participação da comunidade independente. Ao explorar maneiras para se alcançar isto, sugerimos que avaliar os pontos fortes da comunidade oferece um escopo positivo para se compreender e utilizar uma variedade muito mais ampla de respostas ao HIV/AIDS que não foram utilizadas anteriormente no contexto de desenvolvimento da comunidade. Abordagens baseadas na comunidade também incentivam uma compreensão mais profunda de questões de vulnerabilidade localmente específica que cercam o HIV e AIDS. Tais iniciativas podem ser conectadas a tendências que valorizam o conhecimento e a capacidade de pessoas locais negligenciadas e aproveitar seus recursos, inclusive suas redes de trabalho, relacionamentos e confiança. Porém, a conexão com recursos de ONGs Internacionais (ONGIs) e o uso deles permanecem centrais para o sucesso. Se uma agenda de trabalho interativa baseada na comunidade com recursos no âmbito local obtém aceitação suficiente nos níveis mais altos das ONGIs, os resultados podem ser muito significativos. Tais acordos internacionais/locais, em que ONGIs buscam trabalhar de maneira mais próxima com grupos da comunidade local e suas pessoas em agendas compartilhadas, poderiam começar a lidar com algumas das questões estruturais centrais, especialmente conflito e pobreza, que agravam o HIV/AIDS na base e não são suscetíveis a soluções puramente médicas.

La prevención del VIH/SIDA: confiando en las fortalezas de la comunidad. Una experiencia en Ajegunie, Lagos

Este ensayo se centra en una investigación de campo realizada en Ajegunle, Nigeria, la cual demostró que para conseguir una prevención efectiva del VIH/SIDA se requiere de una profunda e independiente participación comunitaria. En su investigación sobre cómo lograr este objetivo, los autores sugieren que valorar las fortalezas comunitarias puede ser una base sólida para concebir y utilizar una gama de respuestas ante el VIH/SIDA más amplia de la que hasta ahora se aplica en el contexto del desarrollo comunitario. Los métodos basados en la comunidad también contribuyen a que se entiendan mejor las vulnerabilidades específicas y locales ante el VIH/SIDA. Estas iniciativas pueden contribuir a valorar más los hasta ahora ignorados conocimientos y capacidades de las personas locales, los cuales se basan en sus recursos propios como sus redes, sus relaciones sociales y su confianza. Sin embargo, el acceso a, y el uso de, los recursos de las ONG internacionales (ONGI) siguen siendo factores importantes para lograr el éxito. Si las directivas de las ONGI consideraran una agenda de trabajo interactiva con las comunidades utilizando los recursos locales, los resultados podrían ser muy significativos. Con este tipo de acuerdos internacionales/locales en los que las ONGI intentan trabajar más estrechamente con los grupos comunitarios y las personas a nivel local compartiendo estrategias, podrían comenzar a atajarse algunos de los principales problemas estructurales, en especial en situaciones de conflicto y pobreza, que agravan el VIH/SIDA entre personas de la base y que no pueden resolverse únicamente con soluciones médicas.

Keywords:

• Civil society
• Social sector
• Sub-Saharan Africa

Notes

The INGOs most active in Ajegunle were those closely linked to donors (Global Fund, USAID, Pathfinder, Family Health International [FHI], WHO, World Bank). So for the purposes of this paper, donors/INGOs are largely synonymous – it does not cover those INGOs who, as noted in the conclusion, seek to be independent of donors and relate more to needs on the ground.

The definition of social and cultural capital here follows that of Bourdieu (1990), and has been usefully operationalised in terms of knowledge, networks and mobilisation capacity. Here we have found the work of Healey, de Magalhaes et al. (2003) useful. They have extended the definition into a formulation of three major forms of resources – knowledge, relational and mobilisation (political) capacity – as three forms of ‘social capital’.

They define these resources in detail as follows:

a.	Knowledge resources are the range of knowledge-based resources to which participants have access; the frames of reference that shape conceptions of issues, problems, opportunities and interventions. The extent to which range and frames are shared among stakeholders, integrating different spheres of policy development around place qualities; the capacity to absorb new ideas and learn from them (openness and learning).
b.	Relational resources are the range of stakeholders involved in the issue or in what goes on in an area; the morphology of their social networks, in terms of the density (or thickness) of network interconnections; the extent of integration of the various networks; the location of the power to act, the power relations between actors and the interaction with wider authoritative, allocative and ideological forces.
c.	Mobilisation capacity is the opportunity structure; the institutional arenas used and developed by stakeholders: the repertoire of mobilisations techniques that are used to develop and sustain momentum; the presence, or absence, of critical change agents at different stages (Healey et al. 2003: 65).

The two dyads were formed from the two existing hospitals in Ajegunle – Rikki and Beebat hospitals. The term ‘dyad’ refers to the two-way INGO/NGO relationships on which they were based.

In the interests of confidentiality, all the names used in this article are pseudonyms.