AVERT is an international HIV and AIDS charity based in the UK. We work with independent partner organisations in sub-Saharan Africa to implement specific projects that are developed and run by local people, and respond to the needs of communities in the area. The work that we support have a particular emphasis on sustainable, cost-effective community responses to HIV and AIDS. Click on the icons below to read about projects being implemented by AVERT's partners in Southern Africa.
back to top Sisonke Project (South Africa)
Introducing Sisonke
AVERT has supported Sisonke since 2004. Sisonke is a Zulu word meaning 'we are all together'.
The aim of the Sisonke project is to empower communities to develop community-initiated, sustainable, and innovative responses to the HIV and AIDS epidemic. They achieve this by providing training and mentoring to groups within the community.
Sisonke is implemented by the Diocese of Grahamstown’s Department of Social Responsibility (DSR) and we work closely together to develop and expand the project and ensure that it is meeting the needs of local communities. The DSR is a community-based organisation working in Eastern Cape, one of the regions most affected by the HIV and AIDS epidemic in South Africa. They work with around 20 rural communities, reaching an estimated 1,800 people directly and 84,000 indirectly.
What is the context of the project?
HIV and AIDS have had a devastating effect on families in this region, leaving many children without one or both parents, and grandparents to play the role of caregiver. Communities require support to understand and deal with this loss and to provide the necessary care for people living with HIV (PLHIV) and orphans and vulnerable children (OVC).
The elderly, who once had a respected and established role in the community, had become disempowered and were lacking a sense of purpose. Sisonke provides elderly, mainly female, carers with the knowledge and power to take control of their situation, to have the confidence to reinstate themselves as the head of the community and to spread knowledge about HIV and AIDS.
You can also visit our dedicated webpage for more information about the response to the HIV and AIDS epidemic in South Africa.
What are the project activities?
Sisonke mobilises and empowers these elderly women who have formed a network known as the Gogogetters (gogo is the Xhosa word for ‘grandmother’), by providing mentoring and training. The support they receive has helped them build knowledge around HIV and AIDS, develop counselling skills, acquire home-based care qualifications, and get involved in national discussions affecting the elderly.
The Gogos have also built strong support networks and meet regularly to plan their work, or eat and sew together.
Sisonke also provides small-scale farming training to communities. Currently communities are receiving training in goat rearing, permaculture and container gardening techniques (to grow herbs and vegetables). This ensures communities have a sustainable supply of nutritious milk and food, which is particularly important for OVC and PLHIV. Communities are able to pass on this learning to others, making it more sustainable.
The project also provides paralegal support at the DSR office for communities. The majority of people are seeking advice about accessing social security benefits, while others need to talk through things that have happened to them and how to access legal services.
Finally, a small grant fund is available to enable communities to overcome barriers to sustainable food and livelihoods.
What is Sisonke's vision and impact?
The Sisonke project is developed and led by the community themselves, therefore it is truly owned at a community level and the activities undertaken are what the community really needs.
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An interview with the director of Sisonke
The DSR’s role is to provide the mentoring, training and guidance to local people to build their capacity to deal with the impact of the AIDS epidemic and empower them to overcome challenges and build a sustainable response. The change envisaged by the project is to avert the spread of HIV and AIDS by building stronger community networks and changing behaviour.
The elderly women reached by the Sisonke project feel empowered by the training and mentoring they have received from the DSR and it has greatly improved their confidence levels and their ability to take care of children and young people. In turn this has improved both their health and that of those in their care.
"It is with great joy that we have been privileged to see in
the last 7 years how the potential has been realised. These
achievements would not have been possible without the supportive
partnership with AVERT. The journey is ongoing and we continue to move
forward as a partnership, making a difference in thousands of
lives" (Desire Nokele, Sisonke Group
Developer).
Tony Schnell, Director of the DSR, contributed an article for AVERT's World AIDS Day 2012 guest writer feature 'Reflections on the Epidemic'. Follow this link to read Tony's article entitled 'Gogo-getters become elders'.
back to top back to top Umunthu Foundation (Malawi)
Introducing Umunthu
AVERT has been working with Umunthu Foundation (meaning ‘humanity to others’ in Chichewa) in Malawi since 2010. Umunthu is a community-based organisation working in the townships of Bangwe and Limbe, in Malawi’s second city, Blantyre.
We work closely with Umunthu to ensure that the project is having maximum impact on communities. In 2011 the project directly reached more than 10,000 people from surrounding areas.
Umunthu’s aim is to promote democracy, human rights and good governance; to mitigate the causes and impact of HIV and AIDS; to promote food security among rural households; and to economically empower vulnerable groups and young people.
What is the context of the project?
HIV and AIDS pose an urgent public health issue in this region of Malawi. Young people are particularly at risk of HIV infection and women are vulnerable due to gender inequalities, high levels of gender-based violence and their ability to negotiate condom use.
Coverage of voluntary counselling and testing (VCT) services is limited, meaning people often access antiretroviral treatment (ART) late or not at all, and do not receive the necessary psychosocial support. Community services for people living with HIV (PLHIV) are also lacking. Levels of poverty and education exacerbate the epidemic as a lack of sustainable livelihoods and poor HIV and AIDS knowledge can result in risky behaviour.
Umunthu aims to fill these gaps by providing services that enable
people to know their HIV status and receive the necessary referrals and
support; improve the quality of life of PLHIV and the wider community;
and improve knowledge of HIV and AIDS and gender issues.
You can also visit our dedicated webpage for more information about the response to the HIV and AIDS epidemic in Malawi.
What are the project activities?
Umunthu provides comprehensive VCT services across three centres in Bangwe and Limbe, including the Umunthu office. These services are fully integrated into the community. Between February 2010 and January 2013 a total of 21,026 people have been tested for HIV by Umunthu's VCT centres. They refer people who test HIV positive for CD4 count testing to determine if they need to start treatment, and pregnant women are referred to prevention of mother-to-child transmission (PMTCT) services. VCT services also provide psychosocial support, and basic treatment for opportunistic infections. Umunthu are now the sole providers of VCT in this area as other services have closed due to lack of funding.
Through innovative community-based HIV prevention and awareness-raising activities, such as radio debates, drama and song, Umunthu promotes behaviour change and works to break down stigma and myths around the virus. At Umunthu’s offices support groups for PLHIV and home-based carers meet regularly to share experiences and knowledge, and receive training. The organisation has also initiated community dialogue with both men and women to reduce incidents of gender-based violence (GBV) and makes the links between violence and HIV clearer. Umunthu also provides psychosocial support and referrals to legal services for victims of GBV.
The project has a specific focus on young people in the community and runs various anti-AIDS youth groups both in and out of schools to provide young people with a platform to talk about HIV and sexual health. Umunthu’s offices also house an open-access information library on HIV and AIDS, nutrition, ART and adherence, sexually transmitted diseases (STDs) and rights of PLHIV, for young people, PLHIV and the wider community.
In 2013, a new activity is starting up at Umunthu Foundation to improve the livelihoods of people living with HIV in the local community. Umunthu have set up a revolving loan fund, which provides soft loans at zero percent interest. The loans will enable people to set up small income generation activities, such as selling fruit and vegetables, to strengthen their income and boost self-esteem. It will also help people living with HIV to have greater access to food security, improving their general health, and to provide greater support to their families. Loans are repayable within 12 months, so that the fund can continue to help others in need of a helping hand. All loan recipients will receive training on setting up small businesses and will be provided with a simple cashbook and support from Umunthu to complete it. The loan fund is being launched at the Blantyre District Health Office on 1 July 2013.
What is Umunthu's vision and impact?
Umunthu’s vision is of an HIV and AIDS and poverty free society where every person is valued and treated equally before the law. The project is based on the philosophy that community-led initiatives are an effective way of addressing the social challenges of HIV, AIDS and GBV in a sustainble way at community level. Umunthu are an integral part of the community they serve and the organisation is run by local staff and volunteers who consult regularly with communities to ensure they are responding to their needs.
The project has had a far-reaching impact on local communities through increased access to VCT services, enabling more people to access life-saving treatment and reducing the risk of the virus being transmitted from mother to child. Umunthu have successfully increased awareness of the risks of HIV transmission and influenced behaviour change among local communities, particularly among young people. The project has also strengthened community support structures and systems for PLHIV, leading to improved treatment adherence, nutrition levels and greater psychosocial support.
On International Women's Day, 8 March 2013, Joyce* from the Umunthu Foundation was interviewed by AVERT. You can read what it means to be a part of the Umunthu Foundation's 'Home-based Carers’ support group in her IWD message.
David Odali, Director of Umunthu Foundation, contributed an article for AVERT's World AIDS Day 2012 guest writer feature 'Reflections on the Epidemic'. Follow this link to read David's article entitled 'Resources for a rights based approach to address the HIV/AIDS pandemic'. A short article was also written by Mercy Banda, a young person involved in the Umunthu project, entitled 'Narrow escape'.
back to top Research Project (South Africa)
Introducing the project
AVERT co-funds a three-year research project on quality of care in the home in rural South Africa. AVERT was keen to support this project as it has a strong potential for advocacy to strengthen home-based care (HBC), and ultimately health systems, in South Africa, and potentially more widely in Southern Africa. The project is implemented by the Rural AIDS & Development Action Research Programme (RADAR), affiliated to the University of Witwatersrand, South Africa.
What is the project context?
HIV and AIDS have had a profound effect on health services in South Africa, exacerbating a problem of weak and vulnerable health systems, particularly in rural areas. HBC was presented as a potential solution, but practice-based evidence of quality in the care provided is limited and no suitable instruments to measure quality are available.
South Africa’s National Strategic Plan for HIV and AIDS (2007-2011) recognised health systems strengthening as key to expanding access to services and placed specific emphasis on the role of community care workers. It was in this context that RADAR carried out a situational analysis to provide a contextual overview of the strengths, weaknesses, opportunities, and threats of HBC at all levels (NGOs, government, policy), to form the basis of their study.
You can read more about the response to the HIV and AIDS epidemic in South Africa on our dedicated webpage.
What is the objective of the research?
The main objective of the RADAR research project is to examine the relationship between the community care worker, primary care giver and the client, while also investigating the quality of care provided to clients. Bushbuckridge sub-district (Mpumalanga province) has been used as the study sample. The framework used measures the quality of care taking into account how important services are to beneficiaries (acceptability) and the frequency (availability) of services.
Project staff hold regular meetings with local organisations and provide updates on their research at meetings with high-level stakeholders to report on key learning and gaps identified. They are regularly invited to participate in regional and national health policy debates. The project has also been approached for its research to inform current healthcare reforms, particularly around access to healthcare.
Project progress?
The qualitative and quantitative data is being captured and analysed by the team and they are on track to finalise the research outputs by mid-2013. A total number of 1790 participants were interviewed as part of the research; this is made up of community health workers, primary caregivers and recipients of HBC.
Results of this study will be used to inform opportunities for capacity-building and health systems strengthening so as to better position HBC to relieve the burden on the formal health system. Tentative conclusions highlight that in order to measure the quality of HBC and to strengthen health systems, the importance of the services beyond medical care need to be acknowledged and included.
In June 2013, the RADAR team held a conference to present research outputs to key local and national stakeholders from government, NGOs, academia and home-based care organisations and discuss how to translate learning into action. You can read more about the conference and access a policy discussion document in an article on AVERT.org and access the conference presentations via this link. You can also read more about the research in an overview document.
Mosa Moshabela, the research coordinator, contributed an article for AVERT's World AIDS Day 2012 guest writer feature 'Reflections on the Epidemic'. Follow this link to read Mosa's article entitled 'HIV/AIDS care begins at home'.
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Notes
*not her real name