You are here: |
| |
What is in this guide?
Good coordination is the key to dealing with HIV/AIDS. In this guide we look at ways of organising Local AIDS Councils, referral systems and contacting resource organisations. This guide contains the following sections:
- Introduction
- Local AIDS Councils
- Coordination and Task teams
- Strategy and action plan- Provincial AIDS Councils
- District AIDS Councils
- What is a referral system?
- How to set up a referral system
- Useful resources
This web site contains the following guides on HIV/AIDS
Important things to know about HIV/AIDS
Introduction to community projects on HIV/AIDS
How to run HIV/AIDS prevention and education projects and campaigns
How to care for people living with HIV/AIDS and their families
How to care for children affected by HIV/AIDS
No organisation or project can tackle HIV/AIDS alone. At national, provincial and district level the government has set up AIDS councils to bring together government services, NGOs and community organisations. At a local level, we need good coordination so that we can work together and properly use scarce resources. Local projects on HIV/AIDS can be divided into the three main areas of work we have dealt with in this manual:
Education and prevention
Care, support and treatment for people with HIV/AIDS
Care for children affected by HIV/AIDS
Many organisations, services and projects can play a role to do work in each of these areas. It is very important that they should all work together to make sure we prevent the further spreading of the disease and that people and families affected by HIV/AIDS get the support they need.
There are different ways of coordinating local efforts. You can set up an AIDS Forum or coordinating committee and involve all the different stakeholders. If the local municipality is committed to dealing with HIV/AIDS, a Local AIDS Council is a good way of coordinating work between government and civil society.
If the municipality is not able or not willing to commit people and resources to coordination of HIV/AIDS structures, try to get one of the stronger stakeholders to play that role.
In many parts of South Africa, municipalities are trying to set up Local AIDS Councils. The aim of the LAC is to develop a coherent strategy and action plan to deal with HIV/AIDS in the area. It should coordinate local efforts to ensure that services are properly delivered and to monitor effectiveness.
The LAC should have a clear link to government so that all government services and departments can be easily accessed. As the form of government closest to people, municipalities are well placed to initiate setting up of a LAC. All relevant government departments should also be drawn in – for example Welfare (Social Development) Health, Education and Home Affairs. Any welfare organisations and community projects that work on prevention, education or care projects should be involved. A Local AIDS Council should link with all local organisations, religious organisations, schools and businesses.
Coordination and task teams
We suggest that the LAC works as a coordinating structure and that the work happens in task teams around specific areas of work. The LAC can include everyone and be a broad forum that does not need to meet often. A smaller coordinating committee should be set up to do day to day coordination. This committee should consist of the task team heads, key government or welfare workers and one or two senior staff and politicians from the municipality.
It is important to first bring together those organisations and services that are already doing something and involve them in task teams that focus on the three areas of work. Municipalities should try to bring together every organisation and service that can help in any way. The municipality should play a facilitating role and not try to take over the good work that others are already doing.
Structures should not be too bureaucratic and should be designed to coordinate specific areas of work, bring resources together, promote communication and information sharing and mobilise broader involvement.
It should not be seen as a structure that will "control" AIDS work in the area. It should aim to make sure that the most affected areas and individuals in the municipality are effectively serviced. The LAC must ensure that available resources are used as efficiently as possible. Ongoing monitoring and assessment should be part of its work.
The municipality should play a leading role in coordination and using its resources to facilitate meetings and administration of the structure. It may be good to put the coordinating structure under the authority of the mayor to give it political influence and status. It is vital that any coordinating structure does not become a gatekeeping structure that stops organisations from getting involved. AIDS affects everyone. It should not be dealt with in a way that excludes anyone.
It is important to set up task teams that work together on specific projects – for example care for people with HIV/AIDS or public education. People who are directly involved in these areas should play a leading role in these teams.
You should have at least the following three task teams with these members:
Prevention and education
All education projects, health workers, school life skills project, councillors, community organisations, youth leaders and trade unions.
Care, support and treatment for people with HIV/AIDS
Health workers, social workers, people living with HIV/AIDS, religious organisations, welfare organisations, and community projects working on care.
Care for children affected by HIV/AIDS
Social workers, Child Welfare Society, school principals, religious organisations, community projects providing care for children.
The municipality should play these roles:
Coordination: Bring together stakeholders to develop strategy and coordinate implementation of projects.
Facilitation: Assist projects from civil society to get access to resources and other government services and funding. Make council facilities available and use municipal communications facilities like newsletters and notice boards. Use clinics and public toilets for condom distribution.
Planning: Ensure that the impact and consequences of AIDS are taken into account in the long term planning around the municipal IDP (Integrated Development Plan). Develop clear poverty alleviation and indigent policies and target child-headed families and families that have lost breadwinners.
Leadership: Mayors and ward councillors should be role models for the community and provide moral leadership in dealing with AIDS and people who are affected by AIDS.
Strategy and action plan
Before the LAC can start working, it should develop a clear strategy for dealing with AIDS. The process used to develop a strategy should have the following components:
Understanding the terrain
Drawing in stakeholders
Analysing incidence, impact, available resources and key interventions needed
Deciding priorities and activities
Each task teams should then work out action plans with clear budgets and timeframes so that they can implement the strategy.
Understanding the terrain
Successful strategies are built on understanding a problem properly and finding the best way of addressing it. As a first step, the people involved in developing the strategy should be educated on AIDS. The last two chapters of this manual can be used to assist with an education workshop. Good research should be done in each municipal area to find out how serious the problems associated with HIV/AIDS are, who are the most affected and what interventions are effective and realistic.
Here are some examples of the information needed:
Statistics:
What is the incidence of infection and wards are most affected?
Estimates for number of orphans.
Number of families that have lost a breadwinner.
Number of people receiving care from hospitals and clinics.
Number of people receiving support form welfare services and organisations
Availability of services and resources:
Educational and preventative services and projects available
Counselling, testing and support services available in area.
Health care services and facilities available
Home-based or other care services and projects
Orphan care projects and services available in area.
Municipal resources and services currently used
Organisations for people living with AIDS
Initiatives taken by schools and employers
Projected impact of HIV/AIDS on the following
Local health and welfare services
The local economy and availability of labour
Education
Social problems and crime
Housing and service delivery
Identify the projects and services and key gaps that exist in terms of the following areas:
Prevention and education
Provision of care for people living with AIDS or ill from AIDS
Provision of care and support for orphans
Drawing in stakeholders
Municipalities cannot deal with AIDS without the cooperation and support of other government services, religious, community, welfare organisations and volunteers.
In every municipality, there are a number of key actors that should be involved in developing a strategy to tackle AIDS. It is important to recognise the different roles that different people can play. Municipal officials will play a different role from municipal councillors who will play a different role from government services or civil society organisations.
It is important to make a difference between the stakeholders and key people who can contribute to developing a strategy and the stakeholders that you would want to involve in the long term. For example an effective AIDS strategy will try to involve all school principals to make sure that orphans are identified and supported. But an AIDS strategy workshop will only involve perhaps one school principal who has already done something that will help you to develop a better strategy.
The following are examples of who should be asked to help develop a strategy:
Municipalities should play a coordinating role and bring stakeholders together to jointly develop a strategy and action plan. Within the municipality, key officials and politicians should be drawn in. The mayor, speaker and municipal manager are three key individuals who should be involved.
Key local individuals from government departments like the Health, Social Development and Home Affairs departments.
Welfare organisations like Child Welfare Society, orphanages and church welfare organisations.
Organisations from the community that already offer a service or have some expertise about AIDS.
Major employers, church leaders and community leaders.
Members of district or Provincial AIDS Councils can act as resource people.
Analysing incidence, impact, available resources and key interventions
A strategy workshop of all stakeholders should be held where the research and information gathered should be presented for discussion. Stakeholders should analyse the information, develop problem statement and discuss the key interventions that are needed in the area to lower the infection rate and to care for people affected by AIDS. They should set broad goals for what they want to achieve in the long term.
Deciding priorities and activities
The strategy workshop should decide on short-term objectives and priorities and discuss the kind of approaches that are needed. They should identify possible partnerships and existing and potential resources that can be used to implement the strategy.
A strategy is only a plan and implementation depends on having the best organisational structures to ensure effective coordination and mobilisation of resources.
All provinces have set up Provincial AIDS Councils to coordinate the fight against AIDS. The Provincial AIDS Councils are meant to coordinate the work of different government departments as well as the work of civil society organisations.
The Provincial AIDS Councils should develop a coherent strategy for the province and make sure all stakeholders are working together to implement it. The Provincial AIDS Councils should link with government departments like Health and Social Development, as well as with District and Local AIDS Councils. It should also work closely with welfare, faith-based and community-based organisations.
The Provincial AIDS Council should also help to mobilise resources that can be used in the fight against AIDS. It can play an important role to make sure that government and donor funding gets to the places where they are most needed.
It is important to find out what the Provincial AIDS Council in your province is doing and how to get support and advice from it.
All provinces are setting up District AIDS Councils to help coordinate work on AIDS in each municipal district. Most of these DACs have not been set up for long and many of them are still finding their feet. In different provinces, they sometimes work in different ways. The Department of Health is a key player in setting up the DACs. Health is organised according to districts and the district health officials coordinate all the government programmes like testing, treatment, clinics, support for home-care and treatment for sexually transmitted infections and TB.
The most important roles of DACs are to:
Bring together the most important organisations and government departments that are involved in the fight against AIDS in the district
Make sure that there is a strategy for tackling AIDS in the district
Monitor implementation of the strategy and initiate work where there are no local projects
Help to mobilise resources and build capacity for AIDS projects and for Local AIDS Councils
Most of the work on AIDS has to happen at a local level to have any effect. It is very important that DACs work closely with LACs and support their work on the ground. It is not practical to bring everyone to district meetings all the time and to try and coordinate work over a huge area. The LACs are in a better position to work with projects and organisations on the ground.
Once LACS are set up in all municipalities in a district, they should send representatives to the DAC so that there can be better coordination. DACs should help LACs to develop strategies, set up projects and access funding and resources.
When someone with HIV/AIDS or a member of their family comes to one project or service for help, they should also be given access to all other services that can benefit them. A referral system is one way to make sure this happens.
Your area may have projects like support groups, food parcels and home care for people with HIV/AIDS. When a teacher finds out that a child is looking after ill parents, there must be a system in place to make sure that family gets support from all the other projects.
Set up a data base
All projects and services should work together in the relevant task teams. Part of the work of each task team should be to build up a list of people who need support in each part of the community. The names will come from different services and projects.
The different task teams must share names since a family may be getting home-based care, but children may not be getting grants. It is important for people from different task teams to come together every few months and to compare their lists.
List all services
A second important task for the LAC is to build up a list of all services and projects that can help families in need. This list with contact details should be published and given to people when they come to any of the projects for help. Keep the information very simple and clear and always say what a project or service can offer. All projects and services should use the list so that they can send people elsewhere for further help.
Each project or service should make a card for each person or family receiving support. On this card, there should be space to show whether the person or family has been referred to other projects for help.
Here is an example of a referral list
Places you can go for help:
Medical treatment:
The Clinic Mandela Hospital
6th Avenue Main Road
Thembalethu Contact: Sister Lekau
Open 7am – 7pm 23 4532Contact: Sister Makwetla
23 6548
People who are ill at home and need care:
Home-based care project The Hospice
Catholic Church Beaufort Street
Main Road Contact Mrs Malan
Contact: Father Peters Phone: 23 4563
23 6453
The Clinic
6th Avenue
Thembalethu
Open 7am – 7pmContact: Sister Makwetla
23 6548
Government grants: Children in need of care
Department Social Development Child Welfare Society
Community Centre Church street
Thembalethu Contact: Mrs Naidoo
Contact: Mrs Ndebele 23 4532
23 8976
Food parcels: Vegetable growing:
Batho Pele Project Food club
Community centre Agricultural centre
Thembalethu Sakkiesdorp
Contact: Mr Ndude Contact: Mr Twale
23 9877 no phone
Emotional support: Legal advice
People living with HIV/AIDS Advice office
Contact through clinic, social worker Thembalethu shop 17
Or advice office Contact Thabo
23 8956
Here is an example of a card that can be used to set up your list of people in need.
ORGANISATION/SERVICE _____________________
Staff name _______________________Case number _________ Date __________
Client Name _____________________Address _____________________________
(be sensitive that some people may want to be anonymous at first)
Describe problem
List needs
___________________________________________________________________
Family details – children, parents, income, health
___________________________________________________________________
Action list:
List support given?
Describe the advice and referral given?
What follow up is needed?
This is a very brief guide to where to get more information and resources. Please try to contact you Provincial or District AIDS Council to get better access to resources, training, funding and materials in your area.
The Department of Health has published a directory of AIDS projects that is very useful. In most provinces and districts, the Health and Social Development Departments have people working specifically on HIV/AIDS and they can advise you. Look under provincial government in the back of the phone book and get hold of the department in your province.
AIDS Training and Information Centres
ATICs were set up at provincial and sometimes at district level to help organisations on the ground with resource materials and training. Here are some contact details:
Cape Town: Nelspruit:
Phone 021 797 3327 Phone 013 759 2167
Fax 021 797 3356 Fax 013 759 3770
Durban: Pietermaritzburg:
Phone 031 300 3104 Phone 033 395 1612
Fax 031 306 9294 Fax 033 342 3245
East London: Port Elizabeth:
Phone 043 705 2620 Phone 041 506 1415
Fax 043 705 2620 Fax 041 506 1486
The Department of Health in your province should be able to supply numbers for all ATICs.
AIDS Helpline
The Department of Health together with Life Line operates a free helpline where you can get advice, counselling and information. The number is 0800 012 322. You can also directly phone any Life Line service in your province.
AIDS Law Project
The AIDS Law Project publishes a book called "HIV/AIDS and the Law" and offers information about human rights and HIV/AIDS. Contact them at:
Phone 011 717 8600
Fax 011 403 23 41
e-mail alpadm@wits.ac.za
The AIDS Consortium
The AIDS Consortium brings together organisations that work on HIV/AIDS. Contact them at:
Phone 011 403 0265
Fax 011 403 2016
National Association of People Living with HIV/AIDS (NAPWA)
NAPWA organises people living with HIV/AIDS. Get the details of local branches from their national office at:
Phone 011 872 0975
Fax 011 872 1343
Treatment Action Campaign
TAC campaigns for accessible medical treatment for all. They can be contacted at:
Phone 011 403 7021
Fax 011 403 2106
Education and Training Unit
ETU runs strategic planning workshops for municipalities and other stakeholders that work with HIV/AIDS. ETU will also assist community based organisations and projects with training to manage and implement their work.
Websites
There are many websites with good information – for example UNAIDS as well as the Department of Health have good sites on AIDS. Try the Department website on www.health.gov.za or www. Aidsinfo.co.za. UNAIDS has a series of booklets on Best Practices and HIV/AIDS which can be read on www.unaids.org. The Department of Social Development has a website on www.socdev.gov.za and an email service to send up to date information from all over the world to people with email. The contact is Carol Lombard and you can get hold of her through emailing carol.lombard@socdev.gov.za
The Treatment Action Campaign has a website at www.tac.org.za. The AIDS with AIDS as well as other organising and human rights issues at www.etu.org.za Consortium can be found at www.aidsconsortium.org.za
ETU (the publishers of this manual) has a website that deals
HIV/AIDS Prevention | Care for Children | Care for People with HIV | HIV/AIDS and Municipalities | Community Action | How to coordinate work around HIV/AIDS | How to set up Support Groups |
This material may not be used for profit without permission from ETU