Promoting health, preserving culture: adapting RARE in the Maasai context of Northern Tanzania

Abstract

HIV/AIDS prevention strategies often neglect traditions and cultural practices relevant to the spread of HIV. The role of women in the HIV/AIDS context has typically been relegated to high-risk female groups such as sex workers, or those engaged in transactional sex for survival. Consequently, these perceptions are born out in the escalation of HIV/AIDS among communities, and female populations in particular where prevention frameworks remain culturally intolerant. We have attempted to address these issues by using an adapted Rapid Assessment Response and Evaluation (RARE) model to examine the impact of HIV/AIDS in the Maasai community of Ngorongoro. Our adapted RARE model used community engagement venues such as stockholder workshops, key informant interviews, and focus groups. Direct observations and geomapping were also done. Throughout our analysis, a gender and a pastoralist-centered approach provided methodological guidance, and served as value added contributions to out adaptation. Based in the unique context of a rural pastoralist community, we made recommendations appropriate to the cultural setting and the RARE considerations.

Keywords:

• HIV/AIDS
• RARE model
• prevention strategies

Acknowledgements

The authors would like to thank the Public Health Officer, Saning'o Godwin Ole Mshumba, Staff and Institution, Endulen Hospital, Tanzania; and Archdiocese of Arusha, Tanzania for their support.

Notes

1. According to Bates et al. (2007, p. 24), direct observations are defined as “the selection of target locations, systematic visual assessment of the physical and behavioural features of a location, identification of risk behaviours at the location, and the detailed recording of observed patterns.”

2. Comparative action sequences of high-risk behaviors describe actions associated with risk behaviors, occurring more often when certain factors are at play. Such factors may include habit, education, etc.

3. These recommendations inform the action plan, which aims to “bring together all of the key information from the rapid assessment, focus, and facilitate discussion to reach consensus on what can be achieved locally in light of economic, social, political and other constraints, and plan and develop intervention strategies based on the site recommendations and the contingency review” (Bates et al., 2007, p. 26).