In Namibia, the President's Emergency Plan for AIDS Relief supports an innovative community mobilization intervention implemented through the Johns Hopkins University Health Communication Partnership (HCP).
For the first time, different groups of people in Rehoboth, a small town in Namibia, were able to talk frankly about the impact of AIDS in their community. "People never ask us what we feel, what we believe," said one young woman. "For the first time people are listening to us." Another added, "We are usually invisible here. But we all are being hurt by this disease. Now our ideas are being heard."
The U.S. supported the launch of the community mobilization program in 2003 to create social change at the grassroots level by addressing the major behavioral and social factors that are driving the epidemic. The program focuses on treatment and prevention of mother to child transmission sites designated by the Namibian Ministry of Health and Social Services. HCP has helped six communities mobilize and expects to move into 15 additional communities by the end of 2005.
The mobilization process helps participants identify the behavioral causes of HIV in their communities and then develop strategies to eliminate the negative social norms that fuel the epidemic. Communities explore ways to reinforce positive norms to reduce stigma and discrimination.
Community mobilization is a long-term process, beginning with meetings with community and opinion leaders to introduce the method, followed by a baseline household knowledge attitudes and practice survey. Survey results are used at community consultative sessions, which are facilitated by trained community members. Afterwards, discussions within peer groups delineated by age and gender culminate in a plenary meeting where all community members and peer groups come together. Depending on the community structure, either a "Community Action Forum," or similar structure is used to promote the implementation of long-term solutions and programs to address the root causes of HIV/AIDS.
While HCP trains and supports community groups throughout the program, the resulting processes and strategies are created by and unique to each individual community. Networking via the Regional AIDS Coordination Committees, the Regional HIV/AIDS Committee for Education and other community-based organizations allows communities to share their strategies and solutions.
Mobilization activities have yielded positive results. A nurse who attended a meeting was shocked to hear how negatively participants viewed the hospital, and promised to relay this feedback to the nurses and doctors. Older women described the situation as the first time they had been included in HIV/AIDS programs. Although they were often surprised by discussions, one said, "Now we know how to be better parents and community advocates."
Overall, community mobilization programs seek to create AIDS-competent communities where people grasp the extent of the HIV/AIDS problem. The power to create necessary change is found within the communities themselves, which have the ability to take action and make a difference in combating HIV/AIDS.
Community participants enthusiastically agree. "We've always been told about HIV and AIDS and how we should think or feel about it, but we've never been asked our side of it," said one participant. "We want to be involved and never knew how before. This project finally lets us do something ourselves. I'm going to do whatever I can to help."
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